iab-education – Zittrex Store

No antibiotics worked, so this woman turned to a natural enemy of bacteria to save her husband’s life | CNN

Post By Health antibiotics, Armed forces, bacteria, bacterial infections, bombings, brand safety-nsf health issues, brand safety-nsf sensitive, brand safety-nsf violence, brand safety-nsf war and military, business, business and industry sectors, conflicts and war, continents and regions, demographic groups, diseases and disorders, domestic alerts, domestic-health and science, domestic-us news, domestic-us politics, economy and trade, females (demographic group), health and medical, iab-business and finance, iab-college education, iab-diseases and conditions, iab-education, iab-industries, iab-infectious diseases, iab-medical health, iab-mental health, iab-pharmaceutical drugs, iab-pharmaceutical industry, iab-science, iab-undergraduate education, Infectious Diseases, international alerts, international-health and science, international-us news, international-us politics, labor and employment, life forms, medical fields and specialties, medical research, microscopic life, military, North America, pharmaceutical industry, pharmaceuticals, pharmaceuticals and prescription drugs, population and demographics, psychology, science, society, texas a&m university, texas a&m university system, the americas, United States, Universities and Colleges, university of california system, university of california-san diego, unrest, viruses, women workers and professionals, workers and professionals

CNN
—

In February 2016, infectious disease epidemiologist Steffanie Strathdee was holding her dying husband’s hand, watching him lose an exhausting fight against a deadly superbug infection.

After months of ups and downs, doctors had just told her that her husband, Tom Patterson, was too racked with bacteria to live.

“I told him, ‘Honey, we’re running out of time. I need to know if you want to live. I don’t even know if you can hear me, but if you can hear me and you want to live, please squeeze my hand.’

“All of a sudden, he squeezed really hard. And I thought, ‘Oh, great!’ And then I’m thinking, ‘Oh, crap! What am I going to do?’”

What she accomplished next could easily be called miraculous. First, Strathdee found an obscure treatment that offered a glimmer of hope — fighting superbugs with phages, viruses created by nature to eat bacteria.

Then she convinced phage scientists around the country to hunt and peck through molecular haystacks of sewage, bogs, ponds, the bilge of boats and other prime breeding grounds for bacteria and their viral opponents. The impossible goal: quickly find the few, exquisitely unique phages capable of fighting a specific strain of antibiotic-resistant bacteria literally eating her husband alive.

Next, the US Food and Drug Administration had to greenlight this unproven cocktail of hope, and scientists had to purify the mixture so that it wouldn’t be deadly.

Yet just three weeks later, Strathdee watched doctors intravenously inject the mixture into her husband’s body — and save his life.

Their story is one of unrelenting perseverance and unbelievable good fortune. It’s a glowing tribute to the immense kindness of strangers. And it’s a story that just might save countless lives from the growing threat of antibiotic-resistant superbugs — maybe even your own.

“It’s estimated that by 2050, 10 million people per year — that’s one person every three seconds — is going to be dying from a superbug infection,” Strathdee told an audience at Life Itself, a 2022 health and wellness event presented in partnership with CNN.

“I’m here to tell you that the enemy of my enemy can be my friend. Viruses can be medicine.”

How this ‘perfect predator’ saved his life after nine months in the hospital

During a Thanksgiving cruise on the Nile in 2015, Patterson was suddenly felled by severe stomach cramps. When a clinic in Egypt failed to help his worsening symptoms, Patterson was flown to Germany, where doctors discovered a grapefruit-size abdominal abscess filled with Acinetobacter baumannii, a virulent bacterium resistant to nearly all antibiotics.

Found in the sands of the Middle East, the bacteria were blown into the wounds of American troops hit by roadside bombs during the Iraq War, earning the pathogen the nickname “Iraqibacter.”

“Veterans would get shrapnel in their legs and bodies from IED explosions and were medevaced home to convalesce,” Strathdee told CNN, referring to improvised explosive devices. “Unfortunately, they brought their superbug with them. Sadly, many of them survived the bomb blasts but died from this deadly bacterium.”

Today, Acinetobacter baumannii tops the World Health Organization’s list of dangerous pathogens for which new antibiotics are critically needed.

“It’s something of a bacterial kleptomaniac. It’s really good at stealing antimicrobial resistance genes from other bacteria,” Strathdee said. “I started to realize that my husband was a lot sicker than I thought and that modern medicine had run out of antibiotics to treat him.”

With the bacteria growing unchecked inside him, Patterson was soon medevaced to the couple’s hometown of San Diego, where he was a professor of psychiatry and Strathdee was the associate dean of global health sciences at the University of California, San Diego.

“Tom was on a roller coaster — he’d get better for a few days, and then there would be a deterioration, and he would be very ill,” said Dr. Robert “Chip” Schooley, a leading infectious disease specialist at UC San Diego who was a longtime friend and colleague. As weeks turned into months, “Tom began developing multi-organ failure. He was sick enough that we could lose him any day.”

Patterson's body was systemically infected with a virulent drug-resistant bacteria that also infected troops in the Iraq War, earning the pathogen the nickname

After that reassuring hand squeeze from her husband, Strathdee sprang into action. Scouring the internet, she had already stumbled across a study by a Tbilisi, Georgia, researcher on the use of phages for treatment of drug-resistant bacteria.

A phone call later, Strathdee discovered phage treatment was well established in former Soviet bloc countries but had been discounted long ago as “fringe science” in the West.

“Phages are everywhere. There’s 10 million trillion trillion — that’s 10 to the power of 31 — phages that are thought to be on the planet,” Strathdee said. “They’re in soil, they’re in water, in our oceans and in our bodies, where they are the gatekeepers that keep our bacterial numbers in check. But you have to find the right phage to kill the bacterium that is causing the trouble.”

Buoyed by her newfound knowledge, Strathdee began reaching out to scientists who worked with phages: “I wrote cold emails to total strangers, begging them for help,” she said at Life Itself.

One stranger who quickly answered was Texas A&M University biochemist Ryland Young. He’d been working with phages for over 45 years.

“You know the word persuasive? There’s nobody as persuasive as Steffanie,” said Young, a professor of biochemistry and biophysics who runs the lab at the university’s Center for Phage Technology. “We just dropped everything. No exaggeration, people were literally working 24/7, screening 100 different environmental samples to find just a couple of new phages.”

While the Texas lab burned the midnight oil, Schooley tried to obtain FDA approval for the injection of the phage cocktail into Patterson. Because phage therapy has not undergone clinical trials in the United States, each case of “compassionate use” required a good deal of documentation. It’s a process that can consume precious time.

But the woman who answered the phone at the FDA said, “‘No problem. This is what you need, and we can arrange that,’” Schooley recalled. “And then she tells me she has friends in the Navy that might be able to find some phages for us as well.”

In fact, the US Naval Medical Research Center had banks of phages gathered from seaports around the world. Scientists there began to hunt for a match, “and it wasn’t long before they found a few phages that appeared to be active against the bacterium,” Strathdee said.

Back in Texas, Young and his team had also gotten lucky. They found four promising phages that ravaged Patterson’s antibiotic-resistant bacteria in a test tube. Now the hard part began — figuring out how to separate the victorious phages from the soup of bacterial toxins left behind.

“You put one virus particle into a culture, you go home for lunch, and if you’re lucky, you come back to a big shaking, liquid mess of dead bacteria parts among billions and billions of the virus,” Young said. “You want to inject those virus particles into the human bloodstream, but you’re starting with bacterial goo that’s just horrible. You would not want that injected into your body.”

Purifying phage to be given intravenously was a process that no one had yet perfected in the US, Schooley said, “but both the Navy and Texas A&M got busy, and using different approaches figured out how to clean the phages to the point they could be given safely.”

More hurdles: Legal staff at Texas A&M expressed concern about future lawsuits. “I remember the lawyer saying to me, ‘Let me see if I get this straight. You want to send unapproved viruses from this lab to be injected into a person who will probably die.’ And I said, “Yeah, that’s about it,’” Young said.

“But Stephanie literally had speed dial numbers for the chancellor and all the people involved in human experimentation at UC San Diego. After she calls them, they basically called their counterparts at A&M, and suddenly they all began to work together,” Young added.

“It was like the parting of the Red Sea — all the paperwork and hesitation disappeared.”

The purified cocktail from Young’s lab was the first to arrive in San Diego. Strathdee watched as doctors injected the Texas phages into the pus-filled abscesses in Patterson’s abdomen before settling down for the agonizing wait.

“We started with the abscesses because we didn’t know what would happen, and we didn’t want to kill him,” Schooley said. “We didn’t see any negative side effects; in fact, Tom seemed to be stabilizing a bit, so we continued the therapy every two hours.”

Two days later, the Navy cocktail arrived. Those phages were injected into Patterson’s bloodstream to tackle the bacteria that had spread to the rest of his body.

“We believe Tom was the first person to receive intravenous phage therapy to treat a systemic superbug infection in the US,” Strathdee told CNN.

“And three days later, Tom lifted his head off the pillow out of a deep coma and kissed his daughter’s hand. It was just miraculous.”

Patterson awoke from a coma after receiving an intravenous dose of phages tailored to his bacteria.

Today, nearly eight years later, Patterson is happily retired, walking 3 miles a day and gardening. But the long illness took its toll: He was diagnosed with diabetes and is now insulin dependent, with mild heart damage and gastrointestinal issues that affect his diet.

“He isn’t back surfing again, because he can’t feel the bottoms of his feet, and he did get Covid-19 in April that landed him in the hospital because the bottoms of his lungs are essentially dead,” Strathdee said.

“As soon as the infection hit his lungs he couldn’t breathe and I had to rush him to the hospital, so that was scary,” she said. “He remains high risk for Covid but we’re not letting that hold us hostage at home. He says, ‘I want to go back to having as normal life as fast as possible.’”

To prove it, the couple are again traveling the world — they recently returned from a 12-day trip to Argentina.

“We traveled with a friend who is an infectious disease doctor, which gave me peace of mind to know that if anything went sideways, we’d have an expert at hand,” Strathdee said.

“I guess I’m a bit of a helicopter wife in that sense. Still, we’ve traveled to Costa Rica a couple of times, we’ve been to Africa, and we’re planning to go to Chile in January.”

Patterson’s case was published in the journal Antimicrobial Agents and Chemotherapy in 2017, jump-starting new scientific interest in phage therapy.

“There’s been an explosion of clinical trials that are going on now in phage (science) around the world and there’s phage programs in Canada, the UK, Australia, Belgium, Sweden, Switzerland, India and China has a new one, so it’s really catching on,” Strathdee told CNN.

Some of the work is focused on the interplay between phages and antibiotics — as bacteria battle phages they often shed their outer shell to keep the enemy from docking and gaining access for the kill. When that happens, the bacteria may be suddenly vulnerable to antibiotics again.

“We don’t think phages are ever going to entirely replace antibiotics, but they will be a good adjunct to antibiotics. And in fact, they can even make antibiotics work better,” Strathdee said.

In San Diego, Strathdee and Schooley opened the Center for Innovative Phage Applications and Therapeutics, or IPATH, in 2018, where they treat or counsel patients suffering from multidrug-resistant infections. The center’s success rate is high, with 82% of patients undergoing phage therapy experiencing a clinically successful outcome, according to its website.

Schooley is running a clinical trial using phages to treat patients with cystic fibrosis who constantly battle Pseudomonas aeruginosa, a drug-resistant bacteria that was also responsible for the recent illness and deaths connected to contaminated eye drops manufactured in India.

And a memoir the couple published in 2019 — “The Perfect Predator: A Scientist’s Race to Save Her Husband From a Deadly Superbug” — is also spreading the word about these “perfect predators” to what may soon be the next generation of phage hunters.

How naturally occurring viruses could help treat superbug infections

“I am getting increasingly contacted by students, some as young as 12,” Strathdee said. “There’s a girl in San Francisco who begged her mother to read this book and now she’s doing a science project on phage-antibiotic synergy, and she’s in eighth grade. That thrills me.”

Strathdee is quick to acknowledge the many people who helped save her husband’s life. But those who were along for the ride told CNN that she and Patterson made the difference.

“I think it was a historical accident that could have only happened to Steffanie and Tom,” Young said. “They were at UC San Diego, which is one of the premier universities in the country. They worked with a brilliant infectious disease doctor who said, ‘Yes,’ to phage therapy when most physicians would’ve said, ‘Hell, no, I won’t do that.’

“And then there is Steffanie’s passion and energy — it’s hard to explain until she’s focused it on you. It was like a spiderweb; she was in the middle and pulled on strings,” Young added. “It was just meant to be because of her, I think.”

Source link

#antibiotics #worked #woman #turned #natural #enemy #bacteria #save #husbands #life #CNN

Concern grows around US health-care workforce shortage: ‘We don’t have enough doctors’ | CNN

Post By Health Bernie Sanders, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, continents and regions, curricula, doctor shortage, domestic alerts, domestic-business, domestic-health and science, domestic-us news, domestic-us politics, economic conditions, economy and economic indicators, economy and trade, education, education systems and institutions, epidemics and outbreaks, graduate and professional schools, health and medical, Health Care, health care professionals, higher education, iab-business and finance, iab-college education, iab-economy, iab-education, iab-education industry, iab-healthcare industry, iab-industries, iab-medical health, iab-politics, iab-postgraduate education, iab-professional school, international alerts, international-business, international-health and science, international-us news, international-us politics, labor and employment, medical education, medical staff, North America, physicians and surgeons, political figures - us, Public health, the americas, United States, workers and professionals

CNN
—

There is mounting concern among some US lawmakers about the nation’s ongoing shortage of health-care workers, and the leaders of historically Black medical schools are calling for more funding to train a more diverse workforce.

As of Monday, in areas where a health workforce shortage has been identified, the United States needs more than 17,000 additional primary care practitioners, 12,000 dental health practitioners and 8,200 mental health practitioners, according to data from the Health Resources & Services Administration. Those numbers are based on data that HRSA receives from state offices and health departments.

“We have nowhere near the kind of workforce, health-care workforce, that we need,” Vermont Sen. Bernie Sanders told CNN on Friday. “We don’t have enough doctors. We don’t have enough nurses. We don’t have enough psychologists or counselors for addiction. We don’t have enough pharmacists.”

The heads of historically Black medical schools met with Sanders in a roundtable at the Morehouse School of Medicine in Atlanta on Friday to discuss the nation’s health-care workforce shortage.

The health-care workforce shortage is “more acute” in Black and brown communities; the Black community constitutes 13% of the US population, but only 5.7% of US physicians are Black, said Sanders, chairman of the Senate Committee on Health, Education, Labor, and Pensions.

“What we’re trying to do in this committee – in our Health, Education, Labor Committee – is grow the health-care workforce and put a special emphasis on the needs to grow more Black doctors, nurses, psychologists, et cetera,” Sanders said.

At Friday’s roundtable, the leaders of the Morehouse School of Medicine, Meharry Medical College, Howard University and Charles R. Drew University called for more resources and opportunities to be allocated to their institutions to help grow the nation’s incoming health-care workforce.

“Allocating resources and opportunities matter for us to increase capacity and scholarships and programming to help support these students as they matriculate through,” Dr. Valerie Montgomery Rice, president of the Morehouse School of Medicine, told CNN.

“But also, the other 150-plus medical schools, beyond our four historically Black medical schools, owe it to the country to increase the diversity of the students that they train,” Rice said, adding that having a health-care workforce that reflects the communities served helps reduce the health inequities seen in the United States.

Historically Black medical schools are “the backbone for training Black doctors in this country,” Dr. Hugh Mighty, senior vice president for health affairs at Howard University, said at Friday’s event. “As the problem of Black physician shortages rise, within the general context of the physician workforce shortage, many communities of need will continue to be underserved.”

A new study commissioned by the National Institute on Minority Health and Health Disparities estimates that the economic burden of health inequities in the United States has cost the nation billions of dollars. Such inequities are illustrated in how Black and brown communities tend to have higher rates of serious health outcomes such as maternal deaths, certain chronic diseases and infectious diseases.

The researchers, from Johns Hopkins University and other institutions, analyzed excess medical care expenditures, death records and other US data from 2016 through 2019. They took a close look at health inequities in the cost of medical care, differences in premature deaths and the amount of labor market productivity that has been lost due to health reasons.

The researchers found that, in 2018, the economic burden of health inequities for racial and ethnic minority communities in the United States was up to $451 billion, and the economic burden of health inequities for adults without a four-year college degree was up to $978 billion.

“These findings provide a clear and important message to health care leaders, public health officials, and state and federal policy makers – the economic magnitude of health inequities in the US is startlingly high,” Drs. Rishi Wadhera and Issa Dahabreh, both of Harvard University, wrote in an editorial that accompanied the new study in the journal JAMA.

The Covid-19 pandemic “pulled the curtain back” on health inequities, such as premature death and others, Rice said, and “we saw a disproportionate burden” on some communities.

“We saw a higher death rate in Black and brown communities because of access and fear and a whole bunch of other factors, including what we recognize as racism and unconscious bias,” Rice said.

“We needed more physicians, more health-care providers. So, we already know when we project out to 2050, we have a significant physician shortage based on the fact that we cannot educate and train enough health care professionals fast enough,” she said. “We can’t just rely on physicians. We have to rely on a team approach.”

She added that the nation’s shortage of health-care workers leaves the country ill-prepared to respond to future pandemics.

The United States is projected to face a shortage of up to 124,000 physicians by 2034 as the demand outpaces supply, according to the Association of American Medical Colleges.

The workforce shortage means “we’re really not prepared” for another pandemic, Sanders said.

“We don’t have the public health infrastructure that we need state by state. We surely don’t have the doctors and the nurses that we need,” Sanders said. “So what we are trying to do now is to bring forth legislation, which will create more doctors and more nurses, more dentists, because dental care is a major crisis in America.”

In March, Bill McBride, executive director of the National Governors Association, wrote a letter to Sanders and Louisiana Sen. Bill Cassidy detailing the “root causes” of the health-care workforce shortage and potential ways some states are hoping to tackle the crisis.

“Governors have taken innovative steps to address the healthcare workforce shortage facing their states and territories by boosting recruitment efforts, loosening licensing requirements, expanding training programs and raising providers’ pay,” McBride wrote.

“Shortages in healthcare workers is not a new challenge but has only worsened in the past three years due to the COVID-19 pandemic. Burnout and stress have only exacerbated this issue,” he wrote. “The retirement and aging of an entire generation is front and center of the healthcare workforce shortage, particularly impacting rural communities.”

Source link

#Concern #grows #healthcare #workforce #shortage #dont #doctors #CNN

Let us now praise single moms | CNN

Post By Health arts and entertainment, children, demographic groups, domestic alerts, domestic-entertainment, education, families and children, family life, family members and relatives, iab-education, iab-entertainment, iab-family and relationships, iab-movies, iab-parenting, iab-single life, international alerts, international-entertainment, movies, parents and parenting, population and demographics, single parents, society

CNN
—

Roughly 24 million, or one-third of all American children under age 18, are living with an unmarried parent, according to a 2018 Pew Research Center analysis of US Census Bureau data. And 81% of those single parent homes are headed by a mom.

This has been a growing trend since the late 1960s. The number of kids being raised by mostly single moms has more than doubled between 1968 and 2017.

Yet despite growing up in the middle of this trend, in the 1970s and ’80s, when divorce was increasingly common and “Kramer vs. Kramer” felt like the documentary of our childhood, and despite being part of a generation of latchkey kids who came home from school while parents were still at work, I was, I confess, embarrassed to be raised by a single mom when I was growing up.

For the majority of my 12 years of Catholic school, I was the only student who lived with one parent. And for that reason, I was also, demonstratively, the poorest kid in my school. We lived off one paycheck, or paychecks when my mom held multiple jobs at once. The modest child support went to school tuition.

Like most kids, I didn’t want to be different. I wanted to be “normal.” “Why can’t we just be normal?” I’d often lament to my mom.

I was embarrassed by our car, which broke down; embarrassed that we didn’t seem to go anywhere for vacation; that I didn’t have brand-name clothes (thank God for school uniforms that greatly leveled the playing field); or video games; or cable TV; or anything else that my classmates had. I was embarrassed that my dad, who lived in a neighboring state, never came to any school events.

And I was teased for it. “Why don’t you get a new car?” “Your gym shoes are fake Nikes.” “Do you even have a dad?” I was often angry. I got into a lot of fights. When the principal’s office called home because I got into it with another kid, it was always my mom who had to come in.

Of course, my mother, like all parents, only added to that embarrassment. She was, and still is, artistically inclined and health-conscious. We went to museums and art stores instead of amusement parks and toy stores. I went to a summer camp run by cloistered monks … in heavy brown robes. My mom performed in community theater and sometimes roped me into bit parts. We went to clown school … together. At Christmas, I often got books and clothes. And my mom shopped for groceries at health food stores, which was much more unusual back then and involved a lot of bulk foods, homegrown sprouts and warm, freshly ground peanut butter. I had an all-carob Easter one year. I was embarrassed by my un-tradable school lunches and embarrassed at meals when friends spent the night.

Sitting under a framed movie poster of Richard Attenborough’s “Gandhi,” my friend would stare at an unappetizing breakfast bowl of “natural” cereal I poured for him out of a bulk food bag. His breath would blow a few rice puffs out of the bowl and across the table. “We can drizzle honey on it!” I’d say, as if that would solve everything. And then he’d go home to eat his Honeycomb or Count Chocula or whatever.

“Why can’t we just be normal?”

There has been a lot of research over the decades that has shown children of single parents report more family distress and conflict and live at a lower socioeconomic status compared to those growing up in two-parent households. Two-parent families usually have more income and are generally able to provide more emotional resources to children, and that’s also a reflection of how little the United States in general does to support working mothers with parental paid leave and access to more health services and quality education.

And of course, it’s difficult to compare single parenting outcomes to hypothetical alternatives. For many, a single mom can create a much safer or more stable environment than living with an abusive parent and spouse. Just growing up in an unhappy marriage has an effect on children.

A 2017 study, however, looked at the long-term effects of single parenthood on kids and found that it had nearly no impact on their general life satisfaction. The authors also found no evidence “supporting the widely held notion from popular science that boys are more affected than girls by the absence of their fathers.” What mattered most in terms of thriving, they concluded, was the quality and strength of the relationship between children and parents.

A separate 10-year study on single parenting that collected data from 40,000 households in the UK came to a similar conclusion last year. “There is no evidence of a negative impact of living in a single parent household on children’s wellbeing, with regard to self-reported life satisfaction, quality of peer relationships, or positivity about family life,” the report states. “Children who are living or have lived in single parent families score as highly, or higher, against each measure of wellbeing than those who have always lived in two parent families”

Speaking for myself, I’d go further and say there were benefits to being raised by a single mother, that it was foundational to becoming the adult I am now.

Being raised by a single parent required an Emersonian amount of self-reliance. I got myself to school in the morning, figured out how to apply to college, paid my way through that education and embarked on a career with no shortcuts or introductions. Our poverty made me class-conscious even as I earned my way into the middle class myself. My role model for what women are and should be was smart, strong, independent and deserving of all respect.

Even my childhood embarrassment was character-building, giving me a deeper sense of self-worth that is dependent neither on material things nor the opinion of those I don’t admire.

I’m not embarrassed now. Being raised by a single mother means the opposite to me today: I have a pride in her for enduring so much (including the indignity of a son perpetually embarrassed by our situation).

But even as a kid, I thought of her as a role model of resilience and resourcefulness. She imparted integrity, a love of the arts and a sense of occasion for the things I loved, like “Star Wars” and Orioles baseball. Before the age of 10, I was exposed to classical music, classic film, anti-nuclear activism, boxing (as participant) and yoga (long before it was a thing people did at gyms). And her exuberant creativity meant she was also a lot of fun growing up. We once invented a board game about the holidays of the world’s religions. On weekend mornings, we went to a park near a music conservancy to hear musicians practice while we ate our granola breakfast.

Join the conversation on CNN Parenting’s Facebook page

See the latest news and share your comments with CNN Parenting on Facebook.

Nothing about the financial and logistical stress of our years together kept her from raising a responsible, decent, curious, creative and accomplished son with very high life satisfaction. She gets more credit for that than any other individual, except maybe me. I’m not embarrassed, I’m grateful.

Let us now praise single mothers. All of them. The “weird” ones. The struggling ones. The driven ones who choose to parent alone. The widowed, who didn’t. The brave ones who divorced for the well-being of their kids and/or themselves. They are all raising about 19 million children right now, and they need all the support they can get.

This story was original published in October 2019. It has been updated.

Source link

#praise #single #moms #CNN

Covid-sniffing dogs can help detect infections in K-12 schools, new study suggests | CNN

Post By Health Air Pollution, Animals, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, california, children, commercial and residential property, continents and regions, coronavirus, demographic groups, diseases and disorders, dogs, domestic alerts, domestic-coronavirus, domestic-health and science, domestic-us news, economy and trade, education, education systems and institutions, environment and natural resources, experimentation and research, families and children, family members and relatives, health and medical, Health Care, health care facilities, housing communities, iab-business and finance, iab-diseases and conditions, iab-dogs, iab-education, iab-education industry, iab-environment, iab-family and relationships, iab-healthcare industry, iab-houses, iab-industries, iab-infectious diseases, iab-lung and respiratory health, iab-medical health, iab-pets, iab-real estate, iab-real estate industry, iab-science, Infectious Diseases, international alerts, international-coronavirus, international-health and science, international-us news, life forms, long term health care, mammals, microscopic life, North America, nursing and residential care facilities, nursing homes, Pollution, population and demographics, Primary and secondary education, real estate, residential property, respiratory diseases, science, senior housing, society, southwestern united states, the americas, United States, viruses, volatile organic compounds

CNN
—

Elementary students lined up behind a white curtain in the middle of a grand gymnasium at their school in northern California. They stood still as a dog handler walked a yellow Labrador along the other side of the curtain.

Hidden from the children’s view, the 2-year-old female pup sniffed each child’s shoes from beneath that curtain barrier. After each sniff, the dog looked back up at the handler. Then the handler brought the dog to the next tiny pair of feet beneath the curtain, and the dog curiously brought her snout close to those toes, then a young girl’s lavender tennis shoes and then another child’s white high-tops.

The dog was smelling for what are called volatile organic compounds that are known to be associated with Covid-19 infections.

While watching the Covid-sniffing dog in action, Dr. Carol Glaser saw her vision come to life.

Months prior, Glaser and her team were implementing the school’s Covid-19 testing program, using antigen nasal swab tests. Around that same time, Glaser heard about reports of dogs being used to screen for Covid-19 infections in sports venues, airports and other public settings.

That’s when Glaser had her “aha” moment – incorporating canines into Covid-19 testing programs at schools, nursing homes or other public facilities could help save time, personnel, possibly even costs, and “would be a lot more fun,” she said.

“I thought if we had dogs in schools to screen the students it would be so much faster and less burdensome for schools,” said Glaser, assistant deputy director in Central Laboratory Services and medical officer for infectious disease laboratories at the California Department of Public Health.

“Remember when an antigen test is done at school, as opposed to home, there’s a whole bunch of rules and regulations that run under that. It’s not as simple as just handing those things out at school and having the kids do them,” said Glaser, who oversaw antigen testing programs at some California public schools.

For now, Glaser and her colleagues described in a new study the lessons they learned from the Covid-19 dog screening pilot program that they launched in some California K-12 public schools.

In their research, published Monday in the journal JAMA Pediatrics, they wrote that the goal was to use dogs for screening and only use antigen tests on people whom the dogs screened as positive – ultimately reducing the volume of antigen tests performed by about 85%.

They wrote that their study supports the “use of dogs for efficient and noninvasive” Covid-19 screening and “could be used for other pathogens.”

The dogs used in the pilot program – two yellow Labradors named Rizzo and Scarlett – trained for a couple of months in a laboratory, sniffing donated socks that were worn by people who either had Covid-19 or didn’t. The dogs alerted their handlers when they detected socks that had traces of the disease – and received a reward of either Cheerios or liver treats.

“The one thing we do know for sure is when you’re collecting a sample off of a human being, you want to go where the most scent is produced. That is the head, the pits, the groin and the feet. Given those options, I went with feet,” said Carol Edwards, an author of the study and executive director of the nonprofit Early Alert Canines, which trains medical alert service dogs, including Rizzo and Scarlett.

“We collected some socks from people willing to donate socks, and we taught the dogs, by smelling the socks, which ones were the Covid socks and they picked it up very quickly,” Edwards said. “Then we moved into the schools and started sniffing the kids at the ankles.”

Last year, from April to May, the dogs visited 27 schools across California to screen for Covid-19 in the real world. They completed more than 3,500 screenings.

Rizzo acted as an energized worker, performing tasks with eagerness, Edwards said, while Scarlett tended to have more of a mellow and easygoing personality.

The screening process involves people – who voluntarily opted in to participate – standing 6 feet apart while the dogs, led by handlers, sniff each person’s ankles and feet. The dogs are trained to sit as a way of alerting their handlers that they detect a potential Covid-19 infection.

To protect each person’s privacy, sometimes the people face away from the dogs and toward a wall or behind a curtain, so that they can’t see the dogs or when a dog sits. If the dog sits in between two people, the handler will verbally ask the dog, “Show me?” And the dog will move its snout to point toward the correct person.

“Our dogs can come in, they can screen 100 kids in a half hour, and then only the ones the dog alerts on have to actually do a test,” Edwards said. “There’s no invasive nasal swab unless the dog happens to indicate on you.”

The researchers found that the dogs accurately alerted their handlers to 85 infections and ruled out 3,411 infections, resulting in an overall accuracy of 90%.

However, the dogs inaccurately alerted their handlers to infections in 383 instances and missed 18 infections, which means the dogs demonstrated 83% sensitivity and 90% specificity when it came to detecting Covid-19 infections in the study.

“Once we stepped into the schools, we saw a drop in their specificity and sensitivity due to the change,” Edwards said, referring to the distractions that children in a school setting can bring. However, Edward said, accuracy improved as the dogs spent more times in schools.

In comparison, Covid-19 BinaxNOW antigen tests have been shown in one real-world study to demonstrate 93.3% sensitivity and 99.9% specificity. That study was conducted in San Francisco and published in 2021 in The Journal of Infectious Diseases.

“We never said the dogs will replace the antigen. This was a time for us to learn how they compared,” Glaser said. “We will always plan on doing some amount of backup testing, but the idea would be that the actual antigen testing would be a fraction of what it would currently be because of the dogs.”

“To run these antigen testing programs at school, it’s taking a lot of school personnel resources, test cards as well as biohazard waste. So, I have no doubt in the long-run once it can be perfected, dogs will be cheaper, but I don’t have a great cost comparison,” she said.

This isn’t the first time that dogs’ abilities to detect traces of Covid-19 infections in real-time have been studied in the scientific literature.

“What we have learned in this work is that the dogs in general are capable of discriminating samples from individuals testing,” said Dr. Cindy Otto, professor and director of the Penn Vet Working Dog Center at the University of Pennsylvania, who was not involved in the new study.

Regarding the new research, Otto said, “On the surface their results are encouraging and with the appropriate selection of dogs, rigorous training and impeccable quality control, there is the potential for dogs to be incorporated in threat monitoring.”

Now that Glaser and her colleagues have published research about their Covid-19 dog screening pilot program, she is eager to implement the approach in nursing home settings.

“Honestly, schools aren’t that interested in testing anymore. The outbreaks just aren’t what they used to be, but what we have done is we’ve transitioned to nursing homes, because there is a tremendous need in nursing homes,” Glaser said, adding that many residents may prefer to undergo screening with a dog than with uncomfortable nasal swabs. “What would you rather have: A swab in your nose or something that just maybe tickles your ankle at most for testing?”

Covid-sniffing dogs Scarlett and Rizzo at a skilled nursing home in California.

In skilled nursing homes, the dogs visit each resident’s room to sniff their feet, calmly smelling for Covid-19 volatile organic compounds as the resident lies in bed or sits in a chair.

“Thinking about where dogs would be deployed, I do really think nursing homes and residential care facilities and even schools – if they were ever to have a big outbreak – would be the natural next fit for this,” Glaser said.

“We think we’ll probably end up primarily using them in nursing homes,” she said. “But we’re still doing a little bit of both – there was a school that asked us to come back last week.”

The pilot program within California public schools also has left Edwards with hope for future opportunities in which canines can help detect disease in humans.

“I really do think it’s the tip of the iceberg. This is the door swinging wide open, and now we need to collaborate with those in the science world and figure out where we can take this,” Edwards said.

“There’s been a lot of chatter, even in the very beginning of this project, talking about what other diseases they could do. We’ve talked about TB, we’ve talked about flu A and B, possibly for this next flu season, seeing if we can get the dogs to alert on that,” she said, as volatile organic compounds are also produced by people with influenza. “It’s just a matter of being able to figure out how to collect samples, how to train the dogs, and then to be safe and effective around those diseases too.”

Source link

#Covidsniffing #dogs #detect #infections #K12 #schools #study #suggests #CNN

ADHD medication abuse in schools is a ‘wake-up call’ | CNN

Post By Health adhd, behavior disorders, brand safety-nsf drugs negative, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, controlled substances, demographic groups, diseases and disorders, domestic alerts, domestic-health and science, drugs and society, economy and trade, education, families and children, family members and relatives, health and medical, iab-business and finance, iab-diseases and conditions, iab-education, iab-family and relationships, iab-industries, iab-medical health, iab-parenting, iab-parenting teens, iab-pharmaceutical drugs, iab-pharmaceutical industry, iab-substance abuse, international alerts, international-health and science, pharmaceutical industry, pharmaceuticals, pharmaceuticals and prescription drugs, population and demographics, prescription drug abuse, society, students and student life, substance abuse, teenagers

CNN
—

At some middle and high schools in the United States, 1 in 4 teens report they’ve abused prescription stimulants for attention deficit hyperactivity disorder during the year prior, a new study found.

“This is the first national study to look at the nonmedical use of prescription stimulants by students in middle and high school, and we found a tremendous, wide range of misuse,” said lead author Sean Esteban McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan in Ann Arbor.

“In some schools there was little to no misuse of stimulants, while in other schools more than 25% of students had used stimulants in nonmedical ways,” said McCabe, who is also a professor of nursing at the University of Michigan School of Nursing. “This study is a major wake-up call.”

Nonmedical uses of stimulants can include taking more than a normal dose to get high, or taking the medication with alcohol or other drugs to boost a high, prior studies have found.

Students also overuse medications or “use a pill that someone gave them due to a sense of stress around academics — they are trying to stay up late and study or finish papers,” said pediatrician Dr. Deepa Camenga, associate director of pediatric programs at the Yale Program in Addiction Medicine in New Haven, Connecticut.

“We know this is happening in colleges. A major takeaway of the new study is that misuse and sharing of stimulant prescription medications is happening in middle and high schools, not just college,” said Camenga, who was not involved with the study.

Published Tuesday in the journal JAMA Network Open, the study analyzed data collected between 2005 and 2020 by Monitoring the Future, a federal survey that has measured drug and alcohol use among secondary school students nationwide each year since 1975.

In the data set used for this study, questionnaires were given to more than 230,000 teens in eighth, 10th and 12th grades in a nationally representative sample of 3,284 secondary schools.

Schools with the highest rates of teens using prescribed ADHD medications were about 36% more likely to have students misusing prescription stimulants during the past year, the study found. Schools with few to no students currently using such treatments had much less of an issue, but it didn’t disappear, McCabe said.

“We know that the two biggest sources are leftover medications, perhaps from family members such as siblings, and asking peers, who may attend other schools,” he said.

Schools in the suburbs in all regions of the United States except the Northeast had higher rates of teen misuse of ADHD medications, as did schools where typically one or more parent had a college degree, according to the study.

Schools with more White students and those who had medium levels of student binge drinking were also more likely to see teen abuse of stimulants.

On an individual level, students who said they had used marijuana in the past 30 days were four times as likely to abuse ADHD medications than teens who did not use weed, according to the analysis.

In addition, adolescents who said they used ADHD medications currently or in the past were about 2.5% more likely to have misused the stimulants when compared with peers who had never used stimulants, the study found.

“But these findings were not being driven solely by teens with ADHD misusing their medications,” McCabe said. “We still found a significant association, even when we excluded students who were never prescribed ADHD therapy.”

Data collection for the study was through 2020. Since then, new statistics show prescriptions for stimulants surged 10% during 2021 across most age groups. At the same time, there has been a nationwide shortage of Adderall, one of the most popular ADHD drugs, leaving many patients unable to fill or refill their prescriptions.

The stakes are high: Taking stimulant medications improperly over time can result in stimulant use disorder, which can lead to anxiety, depression, psychosis and seizures, experts say.

If overused or combined with alcohol or other drugs, there can be sudden health consequences. Side effects can include “paranoia, dangerously high body temperatures, and an irregular heartbeat, especially if stimulants are taken in large doses or in ways other than swallowing a pill,” according to the Substance Abuse and Mental Health Services Administration.

Research has also shown people who misuse ADHD medications are highly likely to have multiple substance use disorders.

Abuse of stimulant drugs has grown over the past two decades, experts say, as more adolescents are diagnosed and prescribed those medications — studies have shown 1 in every 9 high school seniors report taking stimulant therapy for ADHD, McCabe said.

For children with ADHD who use their medications appropriately, stimulants can be effective treatment. They are “protective for the health of a child,” Camenga said. “Those adolescents diagnosed and treated correctly and monitored do very well — they have a lower risk of new mental health problems or new substance use disorders.”

The solution to the problem of stimulant misuse among middle and high school teens isn’t to limit use of the medications for the children who really need them, McCabe stressed.

“Instead, we need to look very long and hard at school strategies that are more or less effective in curbing stimulant medication misuse,” he said. “Parents can make sure the schools their kids attend have safe storage for medication and strict dispensing policies. And ask about prevalence of misuse — that data is available for every school.”

Families can also help by talking to their children about how to handle peers who approach them wanting a pill or two to party or pull an all-night study session, he added.

“You’d be surprised how many kids do not know what to say,” McCabe said. “Parents can role-play with their kids to give them options on what to say so they are ready when it happens.”

Parents and guardians should always store controlled medications in a lockbox, and should not be afraid to count pills and stay on top of early refills, he added.

“Finally, if parents suspect any type of misuse, they should contact their child’s prescriber right away,” McCabe said. “That child should be screened and assessed immediately.”

Source link

#ADHD #medication #abuse #schools #wakeup #call #CNN

Mental health struggles are driving more college students to consider dropping out, survey finds | CNN

Post By Health brand safety-nsf health issues, brand safety-nsf sensitive, college students, demographic groups, diseases and disorders, domestic alerts, domestic-health and science, driver education, education, education systems and institutions, health and medical, higher education, iab-business and finance, iab-college education, iab-diseases and conditions, iab-education, iab-education industry, iab-industries, iab-medical health, iab-mental health, international alerts, international-health and science, mental health, mental illnesses, population and demographics, school attendance, society, students and student life

CNN
—

Isabel, a 20-year-old undergraduate student, is no stranger to hard work. She graduated high school a year early and spent most of 2021 keeping up with three jobs. But when she started college that fall, she felt like she was “sinking.”

She knew that she wasn’t feeling like herself that first semester: Her bubbly personality had dimmed, and she was crying lots more than she was used to.

It all came to a head during a Spanish exam. Isabel, who identifies as both Latina and Black, overheard a video that other students were watching about racism in her communities. Negative emotions swelled, and she had to walk out without finishing the test. She rushed back to her room, angry and upset, and broke her student card when hitting it on the door to get in.

“And I just started having a full-blown panic attack,” she said. “My mind was racing everywhere.”

Isabel says she begged her parents to let her stay on campus, but they insisted that she make the three-hour drive home, and she soon took a medical withdrawal.

A new survey shows that a significant number of college students struggle with their mental health, and a growing share have considered dropping out themselves.

Two out of 5 undergraduate students – including nearly half of female students – say they frequently experience emotional stress while attending college, according to a survey published Thursday by Gallup and the Lumina Foundation, a private independent organization focused on creating accessible opportunities for post-secondary learning. The survey was conducted in fall 2022, with responses from 12,000 adults who had a high school degree but had not yet completed an associate’s or bachelor’s degree.

More than 40% of students currently enrolled in an undergraduate degree program had considered dropping out in the past six months, up from 34% in the first year of the Covid-19 pandemic, the survey found. Most cited emotional stress and personal mental health as the reason, far more often than others like financial considerations and difficulty of coursework.

Young adult years are a vulnerable time for mental health in general, and the significant changes that often come with attending college can be added stressors, experts say.

“About 75% of lifetime mental health problems will onset by the mid-20s, so that means that the college years are a very epidemiologically vulnerable time,” said Sarah K. Lipson, an assistant professor at Boston University and principal investigator with the Healthy Minds Network, a research organization focused on the mental health of adolescents and young adults.

“And then for many adolescents and young adults, the transition to college comes with newfound autonomy. They may be experiencing the first signs and symptoms of mental health problems while now in this new level of independence that also includes new independence over their decision-making as it relates to mental health.”

An estimated 1 in 5 adults in the United States lives with a mental illness, and young adults between the ages of 18 and 25 are disproportionately affected. The share of college students reporting anxiety and depression has been growing for years, and it has only gotten worse during the Covid-19 pandemic.

An analysis of federal data by the Kaiser Family Foundation shows that half of young adults ages 18 to 24 have reported anxiety and depression symptoms in 2023, compared with about a third of adults overall.

Mental health in college is critically important, experts say.

It’s “predictive of pretty much every long-term outcome that we care about, including their future economic earnings, workplace productivity, their future mental health and their future physical health, as well,” Lipson said.

And the need for support is urgent. About 1 in 7 college students said that they had suicidal ideation – even more than the year prior, according to a fall 2021 survey by the Healthy Minds Network.

Isabel knew that she was struggling, but it took a while to realize the extent of her mental health challenges.

“The number one thing I struggled with was feeling overwhelmed and like I had space to even remember to eat,” she said. “People were like, ‘You don’t know how to take care of yourself.’ But no – I had five papers due, and assignments, and I also had to work and go to [class] on top of that. And then I also had to find time to sleep. Most of the time, I was chugging an energy drink. And God forbid if you have a social life.”

For Isabel, as with many college students, thinking about or deciding to leave a degree program because of mental health challenges can often bring its own set of negative emotions, such as anxiety, fear and grief.

“For a lot of students, this isn’t what they saw their life looking like. This isn’t the timeline that they had for themselves,” said Julie Wolfson, director of outreach and research for the College ReEntry program at Fountain House, a nonprofit organization that works to support people with mental illness.

“They see their friends continuing on and becoming juniors and seniors, graduating and getting their first job. But they feel stuck and like they’re watching their life plan slipping away.”

It can create a sort of “shame spiral,” Lipson said.

But mental health professionals stress the importance of prioritizing personal needs over the status quo.

“There’s no shame in taking some time off,” said Marcus Hotaling, a psychologist at Union College and president of the Association of University and College Counseling Center Directors.

“Take a semester. Take a year. Get yourself better – whether it be through therapy or medication – and come back stronger, a better student, more focused and, more importantly, healthier.”

They also encourage higher education institutions to help ease this pressure by creating policies that simplify the process to return.

“When a student is trying to do the best thing for themselves, that should be celebrated and promoted. For a school to then put up a ton of barriers for them to come back, it makes students not want to seek help,” Wolfson said.

“I would hope that in the future, there could be policies and systems that are more welcoming to students who are trying to take care of themselves.”

Appropriately managing mental health is different for each person, and experts say a break from school isn’t the best solution for everyone.

Tracking progress through self-assessments of symptoms and gauges of functioning, like class attendance and keeping up with assignments, can help make that call, said Ryan Patel, chair of the American College Health Association’s mental health section and senior staff psychiatrist at The Ohio State University.

“If we’re making progress and you’re getting better, then it could make sense to think about continuing school,” he said. “But if you’re doing everything you can in your day-to-day life to improve your mental health and we’re not making progress, or things are getting worse despite best efforts, that’s where the differentiating point occurs, in my mind.”

Understanding the support system a student would have if they return home, including access to resources and treatment providers, is also a factor, he said.

For a while, experts say, it was a challenge to articulate the problem and build the case for broader attention to the mental health of college students. Now, the mental health of students is consistently cited as the most pressing issue among college presidents, according to a survey by the American Council on Education.

As the need for services increases, however, college counseling centers are struggling to meet demand – and the shortage of mental health professionals doesn’t stop at the edge of campus.

But colleges are uniquely positioned to surround students with a close network of support, experts say. Taking advantage of that structure needs buy-in to create a broader “community of care.”

“Colleges have an educational mission, and I would make the argument that spreads to education about health and safety,” Hotaling said.

College faculty should be trained in recognizing immediate concerns or threats to a student’s safety, he said. But they should also understand that students can face a range of mental health challenges and know the appropriate resource to direct them to.

Isabel recently graduated from Fountain House’s College ReEntry program and is back at school – this time at university that’s a little closer to home, one that a close friend from high school also attends. It helps her to know that she has a strong friend group to support her and an academic program that supports her professional goals – to become an art curator.

Things are still challenging this time around, but she says she feels like she now has the right tools to cope.

“This foundation I am building is constantly in need of maintenance. There’s like a crack every day,” she said. “Back when I was trying to figure everything out, I feel like I was looking for a screwdriver when I needed a hammer. Now, it’s not that I know I can handle it – but I know that I have the healthy coping mechanisms and strategies and people to help. That gave me confidence and stamina to do it again.”

Source link

#Mental #health #struggles #driving #college #students #dropping #survey #finds #CNN

How human gene editing is moving on after the CRISPR baby scandal | CNN

Post By Health anemia, biochemistry, biology, Biotechnology, blood disorders, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, Cancer, congenital diseases, diseases and disorders, domestic alerts, domestic-business, domestic-health and science, economy and trade, genes and chromosomes, genetic diseases, genetic engineering, genetics, health and medical, iab-biological sciences, iab-biotech and biomedical industry, iab-blood disorders, iab-business and finance, iab-cancer, iab-college education, iab-diseases and conditions, iab-education, iab-genetics, iab-healthcare industry, iab-industries, iab-medical health, iab-pharmaceutical drugs, iab-science, iab-technology & computing, international alerts, international-business, international-health and science, medical biotechnology, medical fields and specialties, pharmaceuticals, scandals, science, sickle cell disease, Technology

Sign up for CNN’s Wonder Theory science newsletter. Explore the universe with news on fascinating discoveries, scientific advancements and more.

London
CNN
—

For most of her life, Victoria Gray, a 37-year-old mother of four from Mississippi, had experienced excruciating bouts of pain.

Born with the blood disorder sickle cell disease, lengthy hospital stays and debilitating fatigue disrupted her childhood, forcing her to quit pursuing a college nursing degree and take potent and addictive painkillers.

“The pain I would feel in my body was like being struck by lightning and hit by a freight train all at once,” she said this week at the Third International Summit on Human Genome Editing in London.

In 2019, she received an experimental treatment for the inherited disease that used the gene-editing technique CRISPR-Cas9, which allowed doctors to make very precise changes to her DNA. While the procedure itself was grueling and took seven to eight months to fully recover from, she said it has transformed her life.

“The feeling is amazing. I really feel that I’m cured now,” Gray said. “Because I no longer have to face the battles that I faced on a day-to-day (basis). I came from having to have an in-home caregiver to help me take baths, clean my house and care for my children. Now I do all those things on my own.”

She’s now able to enjoy a life she once felt was passing her by. She holds down a full-time job as a Walmart cashier, and she’s able to attend her children’s football games and cheerleading events and enjoy family outings. “The life I felt I was just existing in I’m now thriving in,” she said.

Gray shared her experience with doctors, scientists, patient advocates and bioethicists who gathered in London for the human genome editing summit, at which participants reported on advances made in the field and debated the thorny ethical issues posed by the cutting-edge technology.

“I’m here really to be a light because there’s mixed feelings about gene editing. And I think people can see the positive result of it. You know that a person who was once suffering in life, was miserable, now is able to be a part of life and enjoy it,” Gray told CNN.

Gray’s uplifting story, which received a standing ovation from the audience, stood in contrast to a presentation made the last time the conference was held, in Hong Kong in 2018, when Chinese doctor He Jiankui stunned his peers and the world with the revelation that he had created the world’s first gene-edited babies.

The two girls grew from embryos He had modified using CRISPR-Cas9, which he said would make them resistant to HIV. His work was widely condemned by the scientific community, which decried the experiment as medically unnecessary and ethically irresponsible. He received a three-year jail sentence in 2019.

Questions about the baby scandal still linger more than four years later, and after being recently released from prison, He is reportedly seeking to continue his work. China has tightened its regulation of experimental biomedical research since 2018, but it hasn’t gone far enough, said Joy Zhang, a medical sociologist at the University of Kent in the United Kingdom.

“Ethical governance in practice is still confined to traditional medical, scientific, as well as educational, establishments. The new measures fail to directly address how privately funded research and other … ventures will be monitored,” Zhang said at the conference.

Ethically questionable experimental research isn’t an issue confined to China, said Robin Lovell-Badge, head of the Laboratory of Stem Cell Biology and Developmental Genetics at the Francis Crick Institute in London, who chaired the 2018 Hong Kong conference session in which He attempted to defend his work.

“(He Jiankui) is not the only concern in this area. One of our big concerns I always have is the possibility that there will be rogue companies, rogue scientists setting up to do genome editing in an inappropriate way,” Lovell-Badge said on Monday at the conference.

Gray shared her story at Monday's conference.

While the CRISPR baby scandal tarnished the technology’s reputation, CRISPR-Cas9 and related techniques have made a major impact on biomedical research, and two scientists behind the tool — Emmanuelle Charpentier and Jennifer A. Doudna — won a Nobel prize for their work in 2020.

“Clinical trial results demonstrate that CRISPR is safe, and it’s effective for treating and curing human disease — an extraordinary advance given the technology is only 10 years old,” Doudna said at the conference in a video address. “It’s important with a powerful technology like this to grapple with the challenges of responsible use.”

In addition to the sickle cell trial that includes Gray, clinical trials are also underway to test the safety of gene editing in treating several other conditions, including a related blood disorder called beta thalassemia; leber congenital amaurosis, which is a form of inherited childhood blindness; blood cancers such as leukemia and lymphoma; type 1 diabetes; and HIV/AIDS.

DNA acts as a instruction manual for life on our planet, and CRISPR-Cas9 can target sites in plant and animal cells using guide RNA to get the Cas-9 enzyme to a more precise spot on a strand of DNA. This allows scientists to change DNA by knocking out a particular gene or inserting new genetic material at a predetermined site in the strand.

People with sickle cell disease have abnormal hemoglobin in red blood cells that can cause them to get hard and sticky, clogging blood flow in small vessels.

In the trial that Gray was part of, doctors increased the production of a different kind of hemoglobin, known as fetal hemoglobin, which makes it harder for cells to sickle and stick together. The process is invasive and involves removing premature cells from the bone marrow and modifying them — by using CRISPR-Cas9 in the lab — to eventually produce fetal hemoglobin. The patient has to undergo a round of chemotherapy before receiving the gene-edited cells to ensure the body doesn’t reject them.

The conference also shed light on new, more sophisticated gene-editing techniques, such as prime editing and base editing, which recently was used to modify immune cells and successfully treat a teen with treatment-resistant leukemia.

These next generation techniques will allow humans “to have some say in the sequence of our genomes so we are no longer so beholden to the misspellings in our DNA,” said David Liu, the Richard Merkin professor and director of the Merkin Institute of Transformative Technologies in Healthcare at the Broad Institute of MIT and Harvard University.

The gene therapy trials currently underway involve treating people who were born with a certain disease or condition by altering non-reproductive cells in what’s known as somatic gene editing.

The next frontier — many would say red line — is heritable gene editing: altering the genetic material in human sperm, eggs or embryos so that it can be safely passed onto the next generation. The goal would be to prevent babies from inheriting genetic diseases.

A researcher handles a petri dish while observing a CRISPR/Cas9 process through a stereomicroscope at the Max-Delbrueck-Centre for Molecular Medicine in 2018.

“It’s a very different set of ethical trade-offs when you’re not a treating disease in an existing individual but you’re in fact preventing an individual yet to be born from suffering from a disease. That’s a very different set of considerations,” said George Daley, Caroline Shields Walker Professor of Medicine and dean of the faculty of medicine at Harvard Medical School.

In a statement released at the end of the conference, the organizers said “heritable human genome editing remains unacceptable at this time.”

They added that public discussion and policy debates should continue and were important for resolving whether this technology should be used.

The hope offered by gene therapy is creating fresh ethical storms — primarily over who gets access to such treatments. The therapy Gray received, which is expected to soon receive regulatory approval, is likely to cost more than $2 million per person, putting it out of reach for many who need it in the United States and in low-income countries.

“If we want to be serious about equitable access to these kinds of therapies, we have to start talking early on about ways to develop them and make them available and make them cost effective and sustainable,” said Alta Charo, the Warren P. Knowles Professor Emerita of Law and Bioethics at the University of Wisconsin at Madison.

Researchers want to develop CRISPR therapies that can be delivered though an injection rather than the chemotherapy and invasive bone marrow transplant Gray went through.

Worldwide, more than 300,000 children are born with sickle cell disease every year, over 75% of whom live in sub-Saharan Africa, where screening programs and treatment options are limited.

Even relatively affordable drugs to treat sickle cell disease, such as hydroxyurea, don’t reach everyone who needs them in India, said Gautam Dongre, the secretary of the National Alliance of Sickle Cell Organizations in India and father of two children with sickle cell disease.

“After 40 years if these drugs aren’t reachable for the common people, then what about gene therapy?” Dongre asked at the conference.

Julie Makani, an associate professor in the department of haematology and blood transfusion at Muhimbili University of Health and Allied Sciences in Tanzania, said more genomic research should take place in Africa.

“The ultimate thing for me, particularly as a physician scientist, is not just discovery, but also seeing the application of knowledge…into (an) improvement in health,” Makani said.

Source link

#human #gene #editing #moving #CRISPR #baby #scandal #CNN

High levels of chemicals could pose long-term risks at Ohio train derailment site, researchers say | CNN

Post By Health 2023 ohio train disaster, Accidents, Air Pollution, brand safety-nsf accidents and disasters, brand safety-nsf oil negative, brand safety-nsf sensitive, business, business and industry sectors, chemical industry and chemicals, disasters and safety, domestic alerts, domestic-health and science, economy and trade, environment and natural resources, environmental protection agency, environmental regulation and policy, government organizations - us, iab-college education, iab-disasters, iab-education, iab-environment, iab-science, iab-undergraduate education, international alerts, international-health and science, plastics, Pollution, rail transportation, science, texas a&m university, texas a&m university system, train accidents, transportation and warehousing, Universities and Colleges, us federal departments and agencies, us government independent agencies

CNN
—

An analysis of data from the US Environmental Protection Agency’s measurements of pollutants released from the Norfolk Southern train derailment in East Palestine, Ohio, suggests that nine of the dozens of chemicals that the EPA has been monitoring are higher than would normally be found in the area, according to a group of scientists from Texas A&M and Carnegie Mellon University.

If the levels of some of these chemicals remain high, it could be a problem for residents’ health in the long term, the scientists say. Temperature changes or high winds might stir up the chemicals and release them into the atmosphere.

The highest levels found in East Palestine were of a chemical called acrolein, the analysis says.

Acrolein is used to control plants, algae, rodents and microorganisms. It is a clear liquid at room temperature, and it is toxic. It can cause inflammation and irritation of the skin, respiratory tract and mucous membranes, according to the US Centers for Disease Control and Prevention.

“It’s not elevated to the point where it’s necessarily like an immediate ‘evacuate the building’ health concern,” said Dr. Albert Presto, an associate research professor of mechanical engineering at Carnegie Mellon’s Wilton E. Scott Institute for Energy Innovation, who is working on the university’s chemical monitoring effort in East Palestine. “But, you know, we don’t know necessarily what the long-term risk is or how long that concentration that causes that risk will persist.”

Much of what scientists know about chemical exposure comes from people’s contact with chemicals at work, Preston said, which generally means exposure for about eight hours a day. People now living in East Palestine are in constant contact with the chemicals, he said, and the impact of that kind of exposure on the human body is not fully understood.

The EPA and local government officials have repeatedly said that their tests show the air quality in the area is safe and that the chemicals should dissipate. As of Sunday, officials have tested air in 578 homes, and they say chemical pollution levels have not exceeded residential air quality standards.

EPA’s air monitoring data shows that levels of monitored chemicals “are below levels of concern for adverse health impacts from short-term exposures,” an agency spokesperson told CNN on Monday. “The long-term risks referenced by this analysis assume a lifetime of exposure, which is constant exposure over approximately 70 years. EPA does not anticipate levels of these chemicals will stay high for anywhere near that. We are committed to staying in East Palestine and will continue to monitor the air inside and outside of homes to ensure that these levels remain safe over time.”

However, residents have reported rashes and trouble breathing, sometimes even in their own homes, Presto said.

“When someone says to them then, ‘everything is fine everywhere,’ if I were that person, I wouldn’t believe that statement,” he said.

So who’s right? The scientists say it’s not a black-and-white issue.

“I think it’s important for the public to understand that all sides are right. No one’s lying to them,” said Dr. Ivan Rusyn, director of the Texas A&M University Superfund Research Center and part of the team that did the analysis. “It’s just that every time you’re sharing information, whether it’s Administrator of EPA Michael Regan or Governor [Mike] DeWine or someone from Ohio EPA, when they say certain things are ‘safe,’ they really need to explain what they mean.”

Rusyn says the EPA and local officials need to do a better job of communicating with the public about the risk to residents when they are exposed to chemicals released in the crash.

Communication struggles have been a consistent pattern over the years and over numerous environmental disasters, he said. Officials will often do a good job of collecting and releasing data but then fail to give the proper context that the public will understand.

“That’s what I would like to encourage all parties to do rather than to point fingers,” Rusyn said. “The general public has to trust authorities. Cleanup is continuing. They are doing monitoring. We just need to do a better job communicating the results.”

Government communication about residents’ real level of risk has been a significant source of frustration in East Palestine, Presto said.

“People are furious. They feel like they’re getting this black-and-white answer – things are safe or not safe – when it’s not a black-and-white sort of situation,” Presto said.

The EPA says it will continue to monitor the air quality in the area and in residents’ homes. It is also setting up a community center so residents and business owners can ask questions about agency activity there.

The agency said it is collecting outdoor air samples for contaminants of concern, including vinyl chloride, a hard plastic resin used to make plastic products like pipes or packaging material that can be a cancer concern; n-butyl acrylate a clear liquid used to make resins and paint products that can cause eye, throat, nose and lung irritation or damage as well as a skin allergy; and ethylhexyl acrylate, another colorless liquid used to make paints, plastics and adhesives that can cause skin and eye irritation.

The EPA also collected field measurements for hydrogen sulfide, benzene, hydrogen cyanide, hydrogen chloride, phosgene and particulate matter.

Scientists from Texas A&M and Carnegie Mellon are monitoring the chemicals in the area using a mobile lab that they’ve used for the past decade to measure air pollution in real time in cities across the country. They expect to release data from their own tests in East Palestine on Tuesday.

The mobile lab has extremely sensitive equipment that can measure pollution in the parts per trillion. Scientists would then be able to plot them on a graph to show, in real time, where the concentrations of chemicals may be and at what level, Presto said.

Mobile lab workers will try to determine whether there are chemicals in the air that the EPA isn’t monitoring. They are also looking at pollution levels in places where the agency did not set up monitoring stations.

“The situation has to be monitored, and the EPA should continue measurements, and they should also communicate to the general public as to what they’re seeing and put this into context of risk, rather than use the numbers and expect people to figure it out for themselves,” Rusyn said.

Source link

#High #levels #chemicals #pose #longterm #risks #Ohio #train #derailment #site #researchers #CNN

Only 5.7% of US doctors are Black, and experts warn the shortage harms public health | CNN

Post By Health african americans, brand safety-nsf discrimination, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, continents and regions, curricula, demographic groups, discrimination, diversity, domestic alerts, domestic-business, domestic-health and science, domestic-us news, economy and trade, education, education systems and institutions, graduate and professional schools, health and health care (by demographic group), health and medical, Health Care, health care professionals, higher education, human resources and personnel management, iab-business, iab-business and finance, iab-college education, iab-education, iab-education industry, iab-healthcare industry, iab-healthy living, iab-human resources, iab-industries, iab-medical health, iab-pharmaceutical drugs, iab-pharmaceutical industry, iab-postgraduate education, iab-professional school, iab-women's health, internal medicine, international alerts, international-business, international-health and science, international-us news, labor and employment, medical education, medical fields and specialties, minority and ethnic groups, North America, obstetrics and gynecology, pharmaceutical industry, pharmaceuticals, pharmaceuticals and prescription drugs, physicians and surgeons, population and demographics, Public health, racism and racial discrimination, societal issues, society, students and student life, the americas, United States, womens health, workers and professionals, workplace diversity

CNN
—

When being truly honest with herself, Seun Adebagbo says, she can describe what drove her to go to medical school in a single word: self-preservation.

Adebagbo, who was born in Nigeria and grew up in Boston, said that as a child, she often saw tensions between certain aspects of Western medicine and beliefs within Nigerian culture. She yearned to have the expertise to bridge those worlds and help translate medical information while combating misinformation – for her loved ones and for herself.

“I wanted to go into medicine because I felt like, ‘Who better to mediate that tension than someone like me, who knows what it’s like to exist in both?’ ” said Adebagbo, 26, who graduated from Stanford University and is now a third-year medical school student in Massachusetts.

“The deeper I got into my medical education, the more I realized, if I’m in the system, I know how it works. I not only know the science, but I also know how the system works,” she said of how in many Black and brown communities, there can be limited access to care and resources within the medical system.

This has enabled Adebagbo to connect with patients of color in her rotations. She recognizes that their encounters with her are brief, she said, and so she tries to empower them to advocate for themselves in the health system.

“I know what to ask for on the patient side if I’m worried about something for myself. But then also, for my parents and my family,” Adebagbo said. “Because the way you have to move in the system as a Black person is very different, especially if you’re coming from a background where you don’t have family members that are doctors, you don’t know anyone in your periphery that went into medicine.”

Seun Adebagbo presenting her poster presentation as a first author at an international symposium and annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery.

Only about 5.7% of physicians in the United States identify as Black or African American, according to the the latest data from the Association of American Medical Colleges. This statistic does not reflect the communities they serve, as an estimated 12% of the US population is Black or African American.

And while the proportion of Black physicians in the US has risen over the past 120 years, some research shows, it’s still extremely low.

One reason why the percentage of US doctors who are Black remains far below that of the US population that is Black can be traced to how Black people have been “historically excluded from medicine” and the “institutional and systemic racism in our society,” said Michael Dill, the Association of American Medical Colleges’ director of workforce studies.

“And it occurs over the course of what I think of as the trajectory to becoming a physician,” Dill said. At young ages, exposure to the sciences, science education resources, mentors and role models all make it more likely that a child could become a doctor – but such exposures and resources sometimes are disproportionately not as accessible in the Black community.

“We can improve our admissions to medical school, make them more holistic, try to remove bias from that, but that’s still not going to solve the problem,” Dill said.

“We need to look at which schools produce the most medical students and figure out how we improve the representation of Black students in those schools,” he said. “That requires going back to pre-college – high school, middle school, elementary school, kindergarten, pre-K – we need to do better in all of those places in order to elevate the overall trajectory to becoming a physician and make it more likely that we will get more Black doctors in the long run.”

Many US medical schools have a history of not admitting non-Whites. The first Black American to hold a medical degree, Dr. James McCune Smith, had to enroll at the University of Glasgow Medical School in Scotland.

Smith received his MD in 1837, returned to New York City and went on to become the first Black person to own and operate a pharmacy in the United States, and to be published in US medical journals.

A few decades later, in 1900, 1.3% of physicians were Black, compared with 11.6% of the US population, according to a study published in the Journal of General Internal Medicine in 2021.

Around that time, seven medical schools were established specifically for Black students between 1868 and 1904, according to Duke University’s Medical Center Library & Archives. But by 1923, only two of those schools remained: Howard University Medical School in Washington and Meharry Medical School in Nashville.

In 1940, only 2.8% of physicians were Black, but 9.7% of the US population was Black; by 2018, 5.4% of physicians were Black, but 12.8% of the population was Black.

“The more surprising thing to me was for Black men,” said Dr. Dan Ly, an author of the study in the Journal of General Internal Medicine and assistant professor of medicine at the University of California, Los Angeles.

Data on only Black men who were physicians over the years showed that they represented 1.3% of the physician workforce in 1900, “because all physicians were pretty much men in the past,” Ly said. Black men represented 2.7% of the physician workforce in 1940 and 2.6% in 2018.

“That’s 80 years of no improvement,” Ly said. “So the increase in the percent of physicians who were Black over the past 80 years has been the entrance of Black women in the physician workforce.”

Over more than four decades between 1978 and 2019, the proportion of medical school enrollees who identify as Black, Hispanic or members of other underrepresented groups has stayed “well below” the proportions that each group represented in the general US population, according to a 2021 report in The New England Journal of Medicine.

Diversity in some medical schools also was affected in states with bans on affirmative action programs, according to a study published last year in the Annals of Internal Medicine. That study included data on 21 public medical schools across eight states with affirmative action bans from 1985 to 2019: Arizona, California, Florida, Michigan, Nebraska, Oklahoma, Texas and Washington.

The study found that the percentage of enrolled students from underrepresented racial and ethnic groups was on average about 15% in the year before the bans were implemented but fell more than a third by five years after the bans.

Now, the United States is reckoning with medicine’s history of racism.

In 2008, the American Medical Association, the nation’s largest organization of physicians, issued an apology for its history of discriminatory policies toward Black doctors, including those that effectively restricted the association’s membership to Whites. In 2021, the US Centers for Disease Control and Prevention declared racism a “serious public health threat.”

One encouraging datapoint says that the number of Black or African American first-year medical school students increased 21% between the academic years of 2020 and 2021, according to the Association of American Medical Colleges, which Dill said shows promise for the future.

“Does the fact that it’s higher in medical school mean that eventually we will have a higher percentage of physicians who are Black? The answer is yes,” he said.

“We will see the change occur slowly over time,” he said. “So, that means the percentage of the youngest physicians that are Black will grow appreciably, but the percentage of all physicians who are Black will rise much more slowly, since new physicians are only a small percentage of the entire workforce.”

But some medical school students could leave their career track along the way. A paper published last year in JAMA Internal Medicine found that among a cohort of more than 33,000 students, those who identified as an underrepresented race or ethnicity in medicine – such as Black or Hispanic – were more likely to withdraw from or be forced out of school.

Among White students, 2.3% left medical school in the academic years of 2014-15 and 2015-16, compared with 5.2% of Hispanic students, 5.7% of Black students and 11% of American Indian, Alaska Native, Native Hawaiian and Pacific Islander students, the study found.

The researchers wrote in the study that “the findings highlight a need to retain students from marginalized groups in medical school.”

During her surgical rotation in medical school, Adebagbo said, she saw no Black surgeons at the hospital. While having more physicians and faculty of color in mentorship roles can help retain young Black medical school students like herself, she calls on non-Black doctors and faculty to create a positive, clinical learning environment, giving the same support and feedback to Black students as they may provide to non-Black students – which she argues will make a difference.

“Despite the discomfort that may arise on the giver of feedback’s side, it’s necessary for the growth and development of students. You’re hurting that student from becoming a better student on that rotation, not giving them that situational awareness that they need,” she said. “That’s what ends up happening with students of color. No one tells them, and it seems as if it’s a pattern, then by the end of the rotation, it becomes, ‘Well, you’ve made so many mistakes, so we should just dismiss you [for resident trainees] or we can’t give you honors or high pass [for medical students].’ “

Seun Adebagbo, right, with the site director (second from left) and two peers on her last day of her surgery rotation.

Adebagbo says she had one site director, a White male physician, during her surgery rotation who genuinely cared, listened and wanted to see her grow as a person and physician.

“He has been the first site director who has legit listened to me, my experiences navigating third year as a Black woman and tried to understand and put it in perspective – a privilege I’m not afforded often,” Adebagbo said. “He made making mistakes, growing and learning from them a safe and non-traumatizing experience. Not everyone may understand the depths of what I’m saying, but those who do will understand why I was so grateful for that experience.”

But not all attending physicians are like her “mentor,” as she calls him.

For Dr. David Howard, one question haunted his thoughts in medical school.

During those strenuous days at Johns Hopkins University, when all-night study sessions and grueling examinations were the norm, his mind whispered: Where do I fit?

Howard, now a 43-year-old ob/gyn in New Jersey, reflects with pride – and candor – on the day in 2009 when he completed his doctoral degrees, becoming both an MD and a PhD.

At the time, “I felt like I didn’t fit,” Howard said. “I’m sure I’m not the only person who has thought those thoughts.”

Howard was one of very few men in the obstetrics and gynecology specialty, where most providers were women – and he is Black. He saw very few peers who looked like him and extremely few faculty in leadership positions who looked like him.

“When you’re going through a really difficult training program, it makes a big difference if there are people like you in the leadership positions,” he said, adding that this contributes to the disproportionate number of Black medical school students and residents who decide to leave the profession or are “not treated equally” when they may make a mistake.

Early on in his career, Howard shifted his thinking from “Where do I fit?” to “How do I fit?”

He even authored a paper in 2017, published in the American Journal of Obstetrics and Gynecology, about this self-reflection.

“Only slightly different semantically, the second question shifts focus away from the ‘where’ that implies an existing location. Instead, ‘how’ requires me to illustrate my relationship with existing labels and systems, rather than within them, allowing a multitude of answers to my question of ‘how do I fit?’ ” Howard wrote.

“Despite the challenges and realities of the medical field today, I fit wherever and however I can, actively shaping my space and resisting the assumptions that first prompted me to ask where I fit,” he said. “To finally answer my question: I don’t fit, but I am here anyway.”

The United States has made “some progress” with diversity in both clinical medicine and research – but diversity in medicine is still not at the point where it needs to be, said Dr. Dan Barouch, a professor at Harvard Medical School and director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, who has been an advocate for diversity and inclusion.

That point, essentially, would be where diversity in the physician workforce reflects the diversity in their patient population.

“It’s particularly important to have a diverse physician workforce to aptly serve the patients,” Barouch said. “We want to increase diversity in academia as well, but it’s particularly important for doctors, because having a diverse workforce is critical for the best patient encounters, and to build trust.”

Service to patients and patient trust are both among the cornerstones critical to the status of public health, according to researchers.

One example of broken trust between physicians and Black patients happened in the 1930s, when the US Public Health Service and the Tuskegee Institute launched an unethical study in which researchers let syphilis progress in Black men without treating them for the disease. The study ended in 1972.

Among Black men, “there were declines in health utilization, increases in medical mistrust and subsequent increases in mortality for about the 10- to 15-year period following the disclosure event,” when the true nature of the study was exposed in 1972, said Dr. Marcella Alsan, an infectious disease physician and professor of public policy at Harvard Kennedy School.

Yet research suggests that when Black physicians are treating Black patients, that trust can be rebuilt.

For instance, the impact is so significant that having Black physicians care for Black patients could shrink the difference in cardiovascular deaths among White versus Black patients by 19%, according to a paper written by Alsan while she was attending Stanford University, along with colleagues Dr. Owen Garrick and Grant Graziani. It was published in 2019 in the American Economic Review.

That research was conducted in the fall and winter of 2017 and 2018 in Oakland, California, where 637 Black men were randomly assigned to visit either a Black or a non-Black male doctor. The visits included discussions and evaluations of blood pressure, body mass index, cholesterol levels and diabetes, as well as flu vaccinations.

The researchers found that, when the patients and doctors had the opportunity to meet in person, the patients assigned to a Black doctor were more likely to demand preventive health care services, especially services that were invasive, such as flu shots or diabetes screenings that involve drawing blood.

“We saw a dramatic increase in their likelihood of getting preventive care when they engage with Black physicians,” said Garrick, who now serves as chief medical officer of CVS Health’s clinical trial services, working to raise awareness of how more diverse groups of patients are needed to participate in clinical research.

Initially, “it didn’t look like there was a strong preference for Black doctors versus non-Black doctors. It was only when people actually had a chance to communicate with their physicians, talk about ‘Why should I be getting these preventative care services?’ ” Alsan said.

The researchers analyzed their findings to estimate that if Black men were more likely to undergo preventive health measures when they see a Black doctor, having more Black doctors could significantly improve the health and life expectancy of Black Americans.

The nation’s shortage of Black physicians is concerning, experts warn, as it contributes to some of the disproportionate effects that infectious diseases, chronic diseases and other medical ailments have on communities of color. This in itself poses public health risks.

For example, in the United States, Black newborns die at three times the rate of White newborns, but a study published in 2020 in the Proceedings of the National Academy of Sciences found that Black infants are more likely to survive if they are being treated by a Black physician.

Black men and Black women are also about six to 14.5 times as likely to die of HIV than White men and White women, partly due to having less access to effective antiretroviral therapies. But Black people with HIV got such therapies significantly later when they saw White providers, compared with Black patients who saw Black providers and White patients who saw White providers in a study published in 2004 in the Journal of General Internal Medicine.

And when Black patients receive care from Black doctors, those visits tend to be longer and have higher ratings of patients feeling satisfied, according to a separate study of more than 200 adults seeing 31 physicians, published in 2003 in the journal Annals of Internal Medicine.

“There’s plenty of evidence, and other research has shown that the more the workforce in a health care setting really reflects the community it serves, the more open the patient population is to recommendations and instructions from their doctor,” said Dr. Mahshid Abir, an emergency physician and a senior physician policy researcher at the RAND Corp., a nonpartisan research institution.

But it can be rare to find health systems in which the diversity of the workforce reflects the diversity of the patients.

During her 15-year career as an emergency physician, Abir said, she has worked in many emergency departments across the United States – in the Northeast, South and Midwest – and in each place, the diversity of the health care workforce did not mirror the patient populations.

This lack of diversity in medicine is “not talked about enough,” Abir said.

“The research that’s been conducted has shown that it makes a difference in how well patients do, how healthy they are, how long they live,” she said. “Especially at this juncture in history in the United States, where social justice is in the forefront, this is one of the most actionable places where we can make a difference.”

Source link

#doctors #Black #experts #warn #shortage #harms #public #health #CNN

Almost half of children who go to ER with mental health crisis don’t get the follow-up care they need, study finds | CNN

Post By Health brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, children, children's health, children's hospitals, continents and regions, demographic groups, domestic alerts, domestic-business, domestic-health and science, domestic-us news, economy and trade, education, emergency rooms, families and children, family members and relatives, government health insurance, health and health care (by demographic group), health and medical, Health Care, health care facilities, health insurance, hospitals, iab-business and finance, iab-children's health, iab-diseases and conditions, iab-education, iab-family and relationships, iab-financial assistance, iab-government support and welfare, iab-health insurance, iab-healthcare industry, iab-healthy living, iab-industries, iab-insurance, iab-medical health, iab-mental health, iab-personal finance, Insurance, international alerts, international-business, international-health and science, international-us news, maternal and child health, medicaid, medical fields and specialties, mental health, mental health practice, North America, Pediatrics, population and demographics, psychology, social assistance and welfare, society, the americas, United States

Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide and Crisis Lifeline, or visit the hotline’s website.

CNN
—

Every night that Dr. Jennifer Hoffmann works as an attending physician in the pediatric ER, she says, at least one child comes in with a mental or behavioral health emergency. Over the span of her career, she’s seen the number of young people needing help grow enormously.

“The most common problems that I see are children with suicidal thoughts or children with severe behavior problems, where they may be a risk of harm to themselves or others,” said Hoffmann, who works at Ann & Robert H. Lurie Children’s Hospital of Chicago. “We’re also seeing younger children, especially since the pandemic started. Children as young as 8, 9 or 10 years old are coming to the emergency department with mental health concerns.

“It’s just mind-blowing.”

The surge of children turning up in emergency departments with mental health issues was a challenge even before 2020, but rates soared during the Covid-19 pandemic, studies show.

ER staffers may be able to stabilize a child in a mental health care crisis, but research has shown that timely follow-up with a provider is key to their success long-term. Unfortunately, there just doesn’t seem to be enough of it, according to a new study co-authored by Hoffmann. Without the proper follow-up, these children too often wound up back in the ER.

For their study, published Monday in the journal Pediatrics, Hoffmann and her co-authors looked at records for more than 28,000 children ages 6 to 17 who were enrolled in Medicaid and had at least one trip to the emergency department between January 2018 and June 2019. They found that less than a third of the children had the benefit of an outpatient mental health visit within seven days of being discharged from the ER. A little more than 55% had a follow-up within 30 days.

Research has shown that follow-up with a mental health care provider lowers a person’s suicide risk, raises the chances that they will take their prescription medicine and decreases the chances that they will make repeated trips to the ER.

The new study found that without a follow-up, more than a quarter of the children had to go back to the ER for additional mental health care within six months of their initial visit.

“The emergency department is a safety net. It’s always open, but there’s limited extent to the types of mental health services we can provide in that setting,” Hoffmann said. “This really speaks to inadequate access to services that these kids need.”

This dynamic can be “devastating” for parents and emergency department staff alike, she said.

“We know what a child needs, but we’re just not able to schedule follow-up due to shortages among the mental health profession. They’re widespread across the US,” she said.

A lack of professional help is a problem for many children. Before the Covid-19 pandemic, the US Centers for Disease Control and Prevention found that 1 in 5 children had a mental health disorder, but only about 20% got care from a mental health provider.

Children’s mental health has become such a concern in the US that the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association declared a national emergency in 2021.

Hoffmann’s study found that Black children fared worse than their peers. They were 10% less likely to have timely follow-up than White children – “which is very concerning, given that there are many disparities in access to care in our mental health system,” Hoffmann said.

The study can’t pinpoint why there is this racial disparity, but Hoffmann thinks there may be a few factors at play.

Black children are more likely to live in neighborhoods that have shortages of mental health professionals. There is also limited diversity among the mental health work force. Studies show that nearly 84% of psychologists are White, as are nearly 65% of counselors and more than 60% of social workers. And Black children more often rely on school-based mental health services, studies show.

Although the number of school counselors has been increasing over the years, few schools meet the National Association of School Psychologists’ recommended ratio of one school psychologist to 500 students. The national ratio for the 2021-22 school year was 1,127 to 1, the association found.

The new study found that the children who did not have mental health help before their ER visits had the most difficulty finding timely care afterward.

Dr. Toni Gross, chief of the Emergency Department at Children’s Hospital New Orleans, said she wasn’t entirely surprised by the study findings. Her hospital’s beds for with mental health concerns are “always busy,” she said.

“I’m well aware of the fact that we need more providers for these services. We deal with it every day,” said Gross, who was not involved in the new research.

The lack of providers who can do follow-up is a real source of concern. It’s not ideal to hand a phone number to a parent and hope they can arrange care, she said. It often takes weeks or even months to get a first appointment with a child and adolescent psychiatrist.

“It leaves a lot of us feeling like we wish we could do more,” Gross said. “When you always leave asking yourself at the end of the day, ‘did I really do what I set out to do, and that is to help people,’ it’s one of our biggest frustrations, and it may be one of the biggest reasons people in my group of physicians feel burnout.”

Like many children’s hospitals, hers has an active partnership with local school health programs that can provide some mental health care.

Hoffmann said that the amount of support varies by emergency department. Lurie has 24/7 coverage by mental health workers who can do an evaluation and provide recommendations for appropriate care, but not all areas do. For example, many rural emergency rooms don’t have pediatric mental health providers and may have few resources in the community, if any.

Several US counties have no practicing child and adolescent psychiatrists. Primary care physicians can help, but some patients would benefit from more specialized care, Hoffmann said.

President Joe Biden’s administration announced in August that plans to make it easier for millions of children to get access to mental health services by allowing schools to use Medicaid dollars to hire additional school counselors and social workers. He even mentioned the issue in his State of the Union address Tuesday.

But even more will need to be done. Hoffmann hopes her study will prompt policy-makers to invest more so children can access care no matter where they live. Investing in telehealth could also bridge the gap, she said, as would increasing Medicaid reimbursement rates for mental health services and more funding to pay for people to train to work with children as a mental health professional.

In a commentary published alongside the new study, the authors say their research shows that the US “is not meeting the behavioral health needs of our young people.”

“EDs are the last stop when all else has failed, and they, too, lack the resources to support, or even discharge, these patients,” the commentary says.

It points out that research has found this lack of access as far back as 2005.

“This new analysis adds to the overwhelming evidence that there is an urgent need for a dramatic change in our pediatric mental health care system,” the commentary says. “We believe it is time for a ‘child mental health moonshot,’ and call on the field and its funders to come together to launch the next wave of bold mental health research, for the benefit of these children and their families who so desperately need our support.”

Source link

#children #mental #health #crisis #dont #followup #care #study #finds #CNN

Zittrex Store

Cart

Cart

Tag: iab-education

No antibiotics worked, so this woman turned to a natural enemy of bacteria to save her husband’s life | CNN

Concern grows around US health-care workforce shortage: ‘We don’t have enough doctors’ | CNN

Let us now praise single moms | CNN

Join the conversation on CNN Parenting’s Facebook page

Covid-sniffing dogs can help detect infections in K-12 schools, new study suggests | CNN

ADHD medication abuse in schools is a ‘wake-up call’ | CNN

Mental health struggles are driving more college students to consider dropping out, survey finds | CNN

How human gene editing is moving on after the CRISPR baby scandal | CNN

High levels of chemicals could pose long-term risks at Ohio train derailment site, researchers say | CNN

Only 5.7% of US doctors are Black, and experts warn the shortage harms public health | CNN