SARS-like virus in bats shows potential to infect humans, study finds

first_img About the Author Reprints By Helen Branswell Nov. 9, 2015 Reprints @HelenBranswell Tags infectious diseasepublic healthSARS The new study was published in the journal Nature Medicine.The UNC scientists wanted to see if cousin viruses — coronaviruses that are carried by Chinese horseshoe bats — also posed a threat to people. They used one, SHC014, as a representative of the group.advertisement They inserted a key part of the virus, its spike protein, into a SARS virus and then ran experiments to see if the hybrid virus could infect human respiratory tract cells (in a dish) and mice that were vulnerable to the SARS virus.It did.“I think the existence of viruses that can jump directly is the important part, that was unanticipated,” lead author Vineet Menachery, who researches viral immunology, told STAT in an interview.“Based on what was known in the literature, we would have expected that viruses coming out of bats would have needed that one-in-million mutation.”Another coronavirus expert, Dr. Stanley Perlman at the University of Iowa, suggested the paper was a useful investigation. But he noted the hybrid virus was attenuated — weakened — and said the virus would probably need to adapt more in people before it could spread widely.SARS wasn’t a highly transmissible virus. Many patients didn’t infect anyone else during the 2003 outbreak. Once hospitals learned how to recognize the disease and put stringent infection control measures in place — isolating patients and requiring staff treating them to wear the right protective equipment — the outbreak was contained.The SHC014 virus is part of a cluster of related coronaviruses, explained senior author Ralph Baric, a professor of epidemiology at UNC. Some are quite similar to the SARS virus while others are more distant relatives, varying in terms of their genetic structures by between 5 percent and 60 percent. SHC014 was about 12 percent different from SARS.A coronavirus expert, Baric said if the viruses were too distantly related to SARS — more than 25 percent different — they would not be able to make a hybrid that would infect human cells. “Not all SARS-like coronaviruses have the inherent potential to replicate in mammalian cells and replicate in human cells.”And being able to do something in the artificial confines of a laboratory does not guarantee it will happen in nature. For a bat virus to start infecting people, the bat would have to come into contact with people in a way that would allow transmission. Even if a single person became infected, the virus would have to work efficiently in human cells, producing lots of copies of itself that could be coughed or sneezed out toward the airways of other people.“There are a lot of steps down this road,” Menachery said. “SHC014 has taken a step ahead. But there’s still a lot of other factors that are involved.”He and his co-authors noted they had to stop some of their work because of US government policies. The US has a moratorium on so-called gain-of-function research, which includes some research that enhances the ability of a pathogen such as a virus to infect people or spread among them.The authors expressed concern their findings might prompt further constraints on their work — something Dutch virologist Ron Fouchier hoped the team could avoid. Fouchier’s publication of a paper exploring what it would take to make H5N1 bird flu viruses more transmissible was one of the triggers for the gain-of-function research review.Figuring out the potential these viruses have to infect people is important, said Fouchier, who works at Erasmus Medical Center in Rotterdam, especially in light of ongoing outbreaks involving the coronavirus known as MERS, or Middle East respiratory syndrome. Scientific shorthand for coronavirus is CoV.“The MERS-CoV continues to cause problems, and we need to deal with that virus with whatever technology and lab work we have available, including gain-of-function research if needed,” Fouchier said in an email. Viruses that are related to SARS and that are found in some species of bats could become a source of future human outbreaks, according to a new study released Monday. And it appears that there are fewer barriers to that spillover than scientists initially thought.Researchers at the University of North Carolina at Chapel Hill said a virus in the same family as SARS — severe acute respiratory syndrome — appears to be able to infect human respiratory tract cells. The finding came as a surprise because the team thought the virus would have had to go through a process known as adaptation — meaning it would have had to acquire the ability to infect human cells by first learning how to infect the cells of another mammal.It’s believed that is how SARS went from being a bat virus to a major international outbreak that infected 8,400 people in 2003, killing at least 916 of them. In the case of SARS, the virus was probably passed from bats to palm civets and from palm civets to people.advertisement Helen Branswell Senior Writer, Infectious Disease Helen covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development. A SARS-like virus found in bats could become a source of future human outbreaks, scientists say. Eric Gay/AP In the LabSARS-like virus in bats shows potential to infect humans, study finds last_img read more

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Report: 10 ways to protect against a global health catastrophe

first_img The Independent Panel on the Global Response to Ebola has made 10 recommendations for changes, based on lessons learned from the West African Ebola outbreak and aimed at protecting against future devastating health emergencies.Read more: International panel calls for an overhaul of WHOThe panel, convened by the Harvard Global Health Institute and the London School of Hygiene and Tropical Medicine, said the changes it is proposing fall into four themes: preventing major disease outbreaks; responding to major disease outbreaks; producing and sharing of data, knowledge and technology through research; and governing the global system for preventing and responding to outbreaks.These are paraphrased versions of their recommendations:advertisement Senior Writer, Infectious Disease Helen covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development. A health worker with Doctors Without Borders carries a child suspected of having Ebola in October 2014 in Paynesville, Liberia. John Moore/Getty Images By Helen Branswell Nov. 22, 2015 Reprints The global community should come up with a strategy for strengthening health systems, including funding to help developing countries do so.The WHO should publicly commend countries that report disease outbreaks promptly and name and shame those that delay reporting. Financial incentives to compensate countries for losses linked to transparent disease reporting should be created.The WHO should set up a permanent outbreak response center with a guaranteed budget. It should report directly to the director general.The WHO should name a permanent emergency committee of experts to advise it on the threat posed by outbreaks. The committee should be able to convene itself and should consider adopting a graded system of warnings. Currently, emergency committees can only declare that something is or isn’t a global emergency.The UN should create an independent accountability commission that assesses response to major disease outbreaks.Governments, NGOs, the scientific community, and industry should develop rules for conducting research during an outbreak and a program for accelerating research between crises.Research funders should set up a facility to finance development of vaccines, drugs, disease tests, and other necessary medical equipment for diseases which the pharmaceutical industry won’t develop on its own.A global health committee should be set up as part of the UN Security Council to bring high-level attention to health issues and crises.The WHO should return its focus to its core functions, concentrating on efforts that only the WHO can undertake.The WHO’s executive board should establish a freedom of information policy; countries should stop earmarking the funding they provide the WHO; and countries should demand a WHO director general strong enough to stand up to the most powerful governments.Ebola’s deadly tallyVolume 90%Press shift question mark to access a list of keyboard shortcutsKeyboard ShortcutsEnabledDisabledPlay/PauseSPACEIncrease Volume↑Decrease Volume↓Seek Forward→Seek Backward←Captions On/OffcFullscreen/Exit FullscreenfMute/UnmutemSeek %0-9 facebook twitter Email Linkhttps://www.statnews.com/2015/11/22/ebola-panel-health-recommendations/?jwsource=clCopied EmbedCopiedLive00:0000:3700:37  HealthReport: 10 ways to protect against a global health catastrophe center_img @HelenBranswell Tags Ebolaglobal healthWorld Health Organization About the Author Reprints Helen Branswelllast_img read more

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The newest cancer therapies don’t work on everyone. Now, doctors have a clue why

first_img About the Author Reprints The reason that doesn’t happen in some 80 percent of cancer patients is that their tumors don’t have enough neoantigens to attract T cells. The total number of neoantigens roughly predicts whether cancer patients respond to immune-blockade drugs like Keytruda and Opdivo, a similar agent from Bristol-Myers Squibb, but the connection isn’t perfect.“You see cases with a lot of neoantigens who don’t respond, and some with few neoantigens who do respond,” said Dr. Eliezer Van Allen, a clinician-scientist at the Dana-Farber Cancer Institute in Boston and an author of the new study, which was published in Science.The number of neoantigens is only part of the story. This study goes beyond previous ones in showing that when neoantigens are found throughout a tumor rather than in some cells only, patients have the best shot at benefitting from immunotherapy. And that’s true even if there are relatively few neoantigens.For instance, 12 out of 13 study participants whose lung cancers responded to Keytruda not only had a lot of neoantigens (more than 70), most of those neoantigens were present throughout the tumor. They attracted tumor-attacking T cells, which Keytruda let in, destroying enough of the cancer to send the patients into remission.In contrast, 16 of 18 lung cancer patients who did not benefit from Keytruda either did not have many neoantigens or had neoantigens that were present in only some tumor cells. Even a patient with a huge number of neoantigens relapsed after only two months; more than 80 percent of his mutations were found in only some tumor cells.“The tumors that we think will respond the best [to Keytruda and similar drugs] have a certain neoantigen burden, but those neoantigens have to be in almost every tumor cell,” said Dr. Charles Swanton, a cancer geneticist at the Francis Crick Institute in London, who, with immunologist Sergio Quezada of University College London, led the study. Swanton, Quezada, and three other coauthors also filed several patents that cover methods for identifying neoantigens and predicting the prognosis of cancer patients accordingly. Sharon Begley The scientists got similar results in melanoma: The fewer total neoantigens, and the more scattered around a tumor they were, the less patients responded to Yervoy, an immunotherapy drug from Bristol-Myers Squibb.Notably, melanoma patients who had already received chemotherapy drugs or radiation had large numbers of neoantigens, apparently induced by those treatments, but each one was found in only a few tumor cells. Standard cancer therapies “may be causing changes in tumors that might not be helpful” in terms of making patients respond to subsequent immunotherapy, Swanton said.The evidence is too preliminary for doctors to act upon, but the findings suggest that some patients might be better off skipping slash-and-burn chemo and going right to immune-modulating agents. Plus, physicians may be able to tell, by analyzing neoantigens in cells taken via standard biopsy, whether a patient has a good chance of being helped by those drugs.The study results can also “be used to inform the development of personalized cancer vaccines,” said Van Allen. These experimental treatments, which are tailor-made to a patient’s neoantigen profile, are being tested in clinical trials now. They are designed to stimulate the immune system to attack neoantigens on tumors, but scientists hadn’t been sure which neoantigens would make the best vaccines.“This is a very important paper,” said Dr. Elizabeth Jaffee, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, who was not involved in the study. “It addresses a critical question in this field: Are all [neoantigens] equally important to the immune system or is there a way to sort this out?”The suggestion that the best neoantigens are found throughout the tumor “makes the case that we need to sample more of the tumor before predicting which expressed mutations are most relevant for immune targeting,” Jaffee said. ‘I want what Jimmy Carter had’: Patients clamor for the president’s cancer drug When neoantigens are found throughout a tumor, patients have the best shot at benefitting from immunotherapy drugs like Keytruda and Yervoy. Cancer Research UK/Phospho Biomedical Animation Related: The key to both — identifying patients likely to respond to the new immunotherapy drugs and producing tumor-attacking, individualized vaccines — lies in deciphering the crazy quilt of mutations a particular patient has.Only about one-fifth of cancer patients respond to immunotherapies like Keytruda, which is credited with helping Carter survive an advanced form of skin cancer. What makes “responders” different, previous studies in melanoma and lung cancer have suggested, is that they have a huge number of mutated genes producing molecules that find their way to the surface of the tumor cell. There, the aberrant molecules, known as neoantigens, stick out like pushpins in a corkboard.advertisement By Sharon Begley March 3, 2016 Reprints Turning your cancer against itselfVolume 90%Press shift question mark to access a list of keyboard shortcutsKeyboard ShortcutsEnabledDisabledPlay/PauseSPACEIncrease Volume↑Decrease Volume↓Seek Forward→Seek Backward←Captions On/OffcFullscreen/Exit FullscreenfMute/UnmutemSeek %0-9 facebook twitter Email Linkhttps://www.statnews.com/2016/03/03/cancer-immunotherapy-neoantigens/?jwsource=clCopied EmbedCopiedLive00:0002:0202:02  Personalized cancer vaccines rally the immune system to identify and kill cancerous cells based on genetic information from the patient’s own tumors. Alex Hogan and Hyacinth Empinado/STAT Because those neoantigens are newcomers, the immune system should recognize them as foreign and attack, destroying the cancer cell — which is where drugs like Merck’s Keytruda come in. They lift molecular blockades that tumors use to keep the immune system’s T cells out. As a result, T cells charge in and destroy the tumor.center_img Senior Writer, Science and Discovery (1956-2021) Sharon covered science and discovery. [email protected] Related: Watch: Turning your cancer against itself For cancer patients, the promise of new immune-modulating drugs like the one that apparently helped former President Jimmy Carter comes with a sobering downside: very few get any benefit from them.But if a new study published on Thursday is right, physicians might be able to figure out which patients those are, sparing others an expensive but useless treatment.The research also offers clues for how to make a promising but unproven treatment, personalized cancer vaccines, more likely to succeed.advertisement In the LabThe newest cancer therapies don’t work on everyone. Now, doctors have a clue why @sxbegle Tags cancercancer vaccinesKeytrudalast_img read more

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Squishy embryos, penis transplants, and 5 more advances in fertility treatment

first_img Privacy Policy Tags fertilityreproductive medicinewomen’s health Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. Frozen human semen in a tank of liquid nitrogen. Georges Gobet/AFP/Getty Images 3. Helping immature eggs get up to speedA new technique known as in vitro maturation, or IVM, takes immature eggs from a woman and grows them in a lab. When mature, they’re fertilized and implanted. The procedure has the potential to help women with certain ovarian disorders have children, but it is still experimental.4. Building sperm in a labResearchers in China have created sperm-like mouse cells in a Petri dish, which may prove useful for the millions of couples struggling with male infertility. Since these cells lack tails, they can’t swim into an egg, and must be injected. But they’re otherwise viable: They were able to fertilize eggs and generate offspring in mice. Scientists are excited about the prospects but caution that clinical applications are a long way off.advertisement In the LabSquishy embryos, penis transplants, and 5 more advances in fertility treatment 5. Squishing embryos to test their strengthStanford researchers announced last month that they’d developed a technique to determine whether an embryo should be implanted in an in vitro fertilization procedure. The trick: Check how squishy it is. The squishiness predicts how well the embryos will undergo cell division — and, in theory, how likely they are to thrive. A human trial is underway.6. Transplanting a womb to make pregnancy possibleAs the failure in Cleveland this week demonstrated, uterus transplants are tricky. But they can work: Swedish doctors have done several successful uterus transplants, and at least four of their patients have been able to carry pregnancies to term in the donated womb. It may even one day be possible to implant a uterus in a transgender woman, who could then become pregnant despite having been born a biological male.7. Expanding the freezing of eggs and spermBack in 2014, tech companies like Facebook and Google made headlines when they decided to cover the cost of female employees freezing their eggs for later use. Now the American military is following suit. It announced this year that it will cover freezing of both eggs and sperm. The procedure could let service members have children even after an injury to their reproductive organs. Please enter a valid email address. Leave this field empty if you’re human: By Ike Swetlitz March 10, 2016 Reprints The first uterus transplant in the US failed this week, but doctors at the Cleveland Clinic plan to keep trying, hoping to replicate the success of surgeons in Sweden. It’s an exciting time for reproductive medicine around the world. Here’s a rundown of the latest advances in the lab, the operating room, and the fertility clinic.1. Creating three-parent embryosWomen with certain genetic diseases are one step closer to being able to have healthy children, through a controversial procedure that involves creating an embryo using genetic material from three parents. The technique involves combining parts of the eggs from two women and fertilizing them with a man’s sperm. An expert panel recommended last month that research proceed in the US.2. Experimenting with penile transplantsThe first US patient to have a penis transplant has been selected: He’s a soldier reportedly injured in Afghanistan. Johns Hopkins doctors will carry out this procedure, which has been in the works for over a year — and they have permission to do dozens more. Only the penis will be transplanted — not the testes, which house the sperm — so the individual may or may not be able to have children after the procedure, depending on his prior injuries. Doctors are still looking for a donor.advertisementlast_img read more

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Doctors often unaware they are treating human trafficking victims

first_img Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Privacy Policy Please enter a valid email address. A member of the industry group Club Owners Against Sex Trafficking reads a guide card that explains human trafficking. Damian Dovarganes/AP Tags addictionhospitalsphysicianspublic health ‘I was just flabbergasted’: This doctor fights human trafficking Related: At its core, trafficking is treating a human being as a commodity, exploiting him or her for profit. Victims become trapped through combinations of extreme psychological manipulation and shaming, financial bondage, rape, and physical abuse. Today, a growing number are bound to their traffickers by the perfect leash of a heroin or opioid addiction, with the trafficker maintaining control by manipulating their highs and lows. When victims are no longer profitable to a trafficker, they are discarded; some are left to die.I didn’t have a single “aha” moment about the connection between human trafficking and health care. I heard about it in medical school, but it blended in with all the other things I was learning. When I heard about it again during my residency in emergency medicine, something clicked and I realized I had probably missed those telltale trafficking signs in many patients I had treated: the malnourished construction worker, the pregnant woman with unexplained bruises who could speak only Cantonese, the suicidal drug user, and more.I still wonder how things would have been different for them had I known about trafficking and somehow tried to stop their exploitation. I dream that I could have been part of their journeys to freedom. Instead, unaware of the true diagnosis — trafficking — I just treated their medical problems and released them from the emergency department.Once I began to look in earnest for signs of trafficking, I began to see them. The first patient I recall identifying as likely being trafficked was a 20-something woman hooked on heroin who came into the emergency department suicidal and asking for detox from her addiction.The more I realized that human trafficking wasn’t a rarity, I wanted to awaken my colleagues to the plight of this vulnerable population that many of them are not truly seeing. So I cofounded HEAL Trafficking in the fall of 2013. Today, HEAL Trafficking unites more than 800 health professionals around the globe to combat trafficking from a public health perspective. My colleague, Dr. Makini Chisolm-Straker, and I recently published a book, “Human Trafficking Is a Public Health Issue,” to draw attention to the problem.Why do we need an effort like HEAL Trafficking? Two-thirds or more of individuals who are being trafficked in the US seek health care during their exploitation. Yet most US doctors assume that trafficking is something that happens in European countries, as in the movie “Taken.”Just as trafficking can take many different forms, so can its signs. Sometimes they are similar to the signs of domestic violence: bruises at multiple stages of healing, stories that don’t match up with illnesses or injuries, and possibly a controlling individual — female or male — who demands to be part of the health visit. Victims of trafficking may not know where they are or how they got to the clinic or emergency department. Many don’t have access to their identification documents. They may be malnourished, have late-stage cancer, or bear unusual tattoos or scars from being branded. Hanni Stoklosacenter_img About the Author Reprints Jasmine was sold for sex in the Boston area for years. The primary care doctor she saw during that time had no clue that she was a virtual prisoner, a victim of human trafficking.Every clinician fears the missed diagnosis. For this doctor, it was hiding in plain sight. Jasmine frequently came into the clinic to be checked for a sexually transmitted disease, worried that she had been infected even though she regularly used condoms and a bleach douche if the condom broke. More often than not she showed up with bruises and bumps. She struggled with addiction. And as a result of a head injury, she experienced chronic headaches.To a clinician on the lookout for human trafficking, these were telltale signals that Jasmine was a victim of it. But trafficking wasn’t on Jasmine’s doctor’s radar, who missed critical opportunities to disrupt her cycle of violence.advertisement Human trafficking means using women and men, girls and boys against their will in underpaid and under-regulated industries that include domestic work, restaurants, commercial sex, agriculture, construction, nail salons, and more. It happens to Americans and immigrants alike. In fact, Jasmine was born in the US in an Italian-American family.Given its clandestine nature, no one knows the true scope of human trafficking. By one estimate, 21 million individuals are victims of this modern-day slavery.advertisement @hstoklosa Leave this field empty if you’re human: The health problems of trafficking victims tend to match what they have been exposed to as a result of their abuse. For a sex-trafficked American with a heroin addiction, it may be HIV and a heart infection; for a construction worker from Honduras, tuberculosis and a broken arm; for the Cantonese-speaking nail salon worker, it may be lung disease or other problems from long hours spent inhaling chemicals.The mental health repercussions of trafficking are especially pernicious. Many survivors suffer from complex forms of post-traumatic stress disorder, struggle from addiction, or experience unexplained chronic pain. Some become suicidal. Many believe there is no way out. After an unsuccessful suicide attempt, a trafficked patient recently told me, “I wish it had worked. I wish I were dead.”Doctors can play a special role in breaking the cycle of human trafficking. We meet people in moments of vulnerability. If we approach all of our patients with humanity and humility, they may entrust their deepest, darkest secrets, including being trafficked. It requires us to interrupt our rhythm of work, to look beyond the medical issues at hand and treat the whole person.Responding to a patient’s disclosure of being trafficked must be victim-centered, multidisciplinary, trauma-informed, and culturally and gender sensitive. In other words, it isn’t something a clinician should make up on the spot when a patient discloses that she or he is being trafficked. That’s why HEAL Trafficking has designed a protocol toolkit to help health systems design their responses. The National Human Trafficking Hotline at 888-373-7888 is another source of information. My colleague, Dr. Makini Chisolm-Straker, and I recently published a book, “Human Trafficking Is a Public Health Issue,” to draw attention to the problem.Jasmine was finally able to break free from her trafficker and is now running a ministry for trafficked women. But for every success story like hers, thousands of children and adults remain in captivity. Doctors can help some of them break free.Hanni Stoklosa, MD, is an emergency department physician at Brigham and Women’s Hospital, an instructor in emergency medicine at Harvard Medical School, executive director of HEAL Trafficking, and co-editor of “Human Trafficking Is a Public Health Issue” (Springer, February 2017).Revised to include updates from the author. First OpinionDoctors often unaware they are treating human trafficking victims By Hanni Stoklosa March 16, 2017 Reprintslast_img read more

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To end AIDS, we must tackle gender inequality

first_imgTake, for example, the situation of child brides. Gender inequality is at the heart of what drives child marriage. In low- and middle-income countries, one-third of all girls are married before age 18; 1 in 9 are married before the age of 15. That’s 15 million child brides every year. @LindaGailBekker Mabel van Oranje Privacy Policy First OpinionTo end AIDS, we must tackle gender inequality [email protected] Child marriage and other factors are increasing the spread of HIV to girls and young women in Kenya and other countries around the world. Brent Stirton/Getty Images for the GBC Child marriage has profound consequences for the health and well-being of adolescent girls and young women. Child brides are at greater risk of spousal or partner violence, and sexual or interpersonal violence is closely linked with an increased chance of acquiring HIV. Their husbands are also often older and have already been sexually active, which also increases the risk. In addition, it is quite difficult for child brides to negotiate safe sex and condom use. The tragic consequence is that HIV infection rates in married adolescents are 50 percent higher than in their unmarried, sexually active peers.We can change this seemingly hopeless situation by tackling the gender inequality that makes girls and young women particularly vulnerable to HIV infection. But it will mean that the HIV community must look beyond tests and pills, confront structural barriers, and work across different issue areas.We already know what works. Now we just need to scale up these programs and actions. @MabelvanOranje About the Authors Reprints Related: For nearly 30 years, the first day of December has offered an opportunity to unite in the fight against HIV/AIDS and highlight how far we have come. Despite all the advances, girls and young women are still being left behind. That is unacceptable and must change.Girls and young women are at particular risk for HIV infection. Around the world, nearly 2 million individuals over the age of 14 are infected with HIV every year. One in four of them are girls and young women between the ages of 15 and 24. In sub-Saharan Africa, nearly 60 percent of new HIV infections among young people are in girls and women in that age range.Why are young women at greater risk? Biology plays a part: They are physiologically more vulnerable to the sexual transmission of HIV than men their own age. But structural barriers such as gender inequality are also a major risk factor.advertisement Leave this field empty if you’re human: A perfect example is education. The longer a girl stays in secondary education, the less likely she is to marry as a child, the better her chances of employment, and the less likely she is to become infected with HIV.We need more HIV prevention initiatives and sexual and reproductive health services that support both married and unmarried adolescent girls. And things won’t improve unless we also engage boys, men, families, and communities to help promote gender equality and change long-standing norms about the role of girls and women in society.If we are serious about ending AIDS, we need a more holistic approach that includes tackling the gender inequality that puts girls and young women at increased risk of HIV infection.The HIV community can’t do this alone. Key actors in health, gender, education, justice, finance, and development must also play roles. At the 22nd International AIDS Conference (AIDS 2018) in Amsterdam next July, we will work together so the program offers practical ways to ensure advances across all sectors for adolescent girls and young women.If we can keep girls like Jackline in school, out of child marriage, and free of HIV, we will reap a triple dividend: healthier young people today, healthier adults in the future, and healthier parents for the next generation. And we will be creating societies that work for everyone.Linda-Gail Bekker is president of the International AIDS Society. Mabel van Oranje is chair of Girls Not Brides: The Global Partnership to End Child Marriage. Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Please enter a valid email address. Linda-Gail Bekker [email protected] Tags global healthinfectious diseasepublic healthwomen’s health These are girls like 14-year-old Jackline from Kenya, who lost both parents to AIDS. She had to leave school and marry a man 20 years her senior so she wouldn’t be a “burden” on her stepmother or neighbors. These girls often grow up without a decent shot at a happy, healthy, and productive future.advertisement By Linda-Gail Bekker and Mabel van Oranje Dec. 1, 2017 Reprints Victorious declarations that the ‘scales have tipped’ against HIV/AIDS don’t hold true for children last_img read more

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Democratic senator opens probe into Novartis over its dealings with Trump’s attorney

first_img Ed Silverman Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Pharmalot By Ed Silverman May 11, 2018 Reprints What’s included? Tags pharmaceuticalsSTAT+Trump [email protected] Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. About the Author Reprints Sen. Ron Wyden, D-Ore. Susan Walsh/APcenter_img Democratic senator opens probe into Novartis over its dealings with Trump’s attorney A lawmaker is opening an investigation into Novartis for paying $1.2 million to President Trump’s personal attorney, Michael Cohen, in an attempt to gain access to the White House, a disclosure that has prompted widespread criticism of the drug maker.The company has said it agreed to a one-year contract, beginning in February 2017, with Cohen’s firm, Essential Consultants, in order to create a direct channel to the Trump administration about “health care policy matters.” The arrangement, however, has been widely derided because Cohen is not a lobbyist or an expert in health care matters. And Novartis said it let the contract lapse when it expired. GET STARTED STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED Log In | Learn More @Pharmalot What is it?last_img read more

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Nail salon workers helped us turn the idea of community-centered health into reality

first_imgFirst OpinionNail salon workers helped us turn the idea of community-centered health into reality Please enter a valid email address. AP Photo/Jeff Chiu Related: facebook.com/hopeclinichouston/ One by one, the young nail salon workers came to the HOPE Clinic in Houston battling serious coughs, neck and arm pain, and fungal infections in their fingernails. Clinicians would help them with these ailments — but they kept coming back.Health care practitioners routinely see how social, economic, and environmental factors affect their patients’ health. Poverty, substandard housing, poor working conditions, lack of affordable healthy food, and limited places to exercise safely are just a few of the community conditions that contribute to chronic health issues like diabetes, heart disease, and asthma. What’s not always clear, though, is what role health care practitioners can play in improving these conditions beyond the confines of an exam room.After seeing firsthand the repeated health problems faced by nail salon workers, our organizations tried to find out.advertisement Tags hospitalspublic health About the Authors Reprints @Health4Texas Privacy Policy Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Neighborhoods influence health, for better and for worse @HOPECHC Andrea Caracostis By Andrea Caracostis and Jo Carcedo Aug. 2, 2018 Reprints Leave this field empty if you’re human: Although the community action our group took was focused on education, solutions to improve community conditions can take many forms.Episcopal Health Foundation recently launched the $10 million Texas Community-Centered Health Homes Initiative to help clinics address similar health issues in their communities. First developed by the Prevention Institute, the community health home clinic concept acknowledges that community conditions outside the clinic walls affect patient outcomes and that the clinic can actively participate in improving them. This initiative is a large-scale, long-term investment in getting community-based clinics to improve health — not just health care — in the areas they serve.Thirteen clinics, including HOPE, are currently participating in the community-centered health homes project. They’re focused a range of issues, such as reducing obesity through increased access to safe physical activity, improving access to healthy foods like fresh fruit and vegetables, reducing diabetes among families in poverty, and taking action to ensure that families don’t suffer from hunger and poor nutrition.Implementing a community-centered health home model represents more than a one-time effort to improve community health. Instead, it’s a cultural shift of how clinics think about their role in improving their surrounding communities.When we put ourselves in our patients’ shoes, the call to action becomes crystal clear: In addition to creating a health system that ensures that all patients receive quality medical care, we need to ensure that the places in which they live and work also keep them healthy.Andrea Caracostis, M.D., is CEO of HOPE Clinic, a federally qualified health center in Houston. Jo Carcedo is vice president for grants at Episcopal Health Foundation. While doctors and nurses at HOPE Clinic had seen the health issues firsthand, they wanted to ground their understanding of the problem by doing community research. With funding from Episcopal Health Foundation, they hired nail salon workers to be community researchers. These researchers visited nail salons across the Houston area and interviewed almost 400 workers about their physical and mental health, exposure to chemicals, access to health care, workplace safety, and more.The survey showed that a large number of salons use potentially hazardous chemicals, that nail salon workers who reported wearing masks were less likely to report waking up have shortness of breath or coughing, and that between 5 and 10 percent of workers reported physical pain “very often.”Based on the results, HOPE staff members were able to set priorities for action. But they didn’t want to decide on their own what steps were needed to address the working conditions in nail salons. Instead, they collaborated with community organizations and nail salon workers to listen to their ideas about what should be done. The key was to develop solutions with the community members, not for them.The Houston nail salon workers decided that the best solution would be to integrate specific health education into nail salon schools. So, with input from workers and the schools, HOPE Clinic created a curriculum to teach future workers about the importance of using gloves and protective masks when they polish nails; about choosing less-hazardous chemicals for polish, polish removal, and applying artificial nails; and the health benefits of using a lower chair and adopting good posture. Medical care can help treat these symptoms, but medical care alone wasn’t the key to improving the nail workers’ health. Instead, the solution required addressing the root causes of their problems. That’s why we embarked on an effort to use our experience and influence to improve the working conditions that were having a direct impact on the health of these women.advertisement facebook.com/Health4Texas/ Jo Carcedo In Houston, as in some other cities, nail salon workers tend to be young Asian women. They are routinely exposed to toxic chemicals that can irritate the skin and eyes, trigger allergies, and cause neurological issues. They’re also exposed to their clients’ blood and infected skin and nails. And they frequently experience neck, shoulder, wrist, and back problems because of poor ergonomics and repetitive movements.last_img read more

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For one cancer patient, biotech’s genetic test turns out to be a ‘lifesaver’

first_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. By Jonathan Saltzman — Boston Globe Dec. 4, 2018 Reprints Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED What is it? CAMBRIDGE — John White, a retired North Attleborough bioengineer, was diagnosed in early 2015 with aggressive prostate cancer. It had spread to his bladder and pelvic lymph nodes. It didn’t respond to hormone therapy and chemotherapy. His oncologist feared White might have only a year to live.Then scientists at Foundation Medicine, a Cambridge, Mass., biotech, ran a new diagnostic test to sequence the DNA of cancer cells in his prostate gland, which had been surgically removed. The bad news was that he had a rare form of the disease, marked by an extraordinary number of genetic changes in the cancerous cells. The good news: The new test showed that he might respond to any of three new immunotherapy drugs. What’s included? STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Jonathan Saltzman — Boston Globe Log In | Learn More Tags biotechnologyBostoncancerdiagnosticsgeneticsprecision medicineSTAT+ About the Author Reprints GET STARTED “I was only given months to live four years ago . . . I am still thriving,” said John White. Aram Boghosian for the Boston Globe Biotech For one cancer patient, biotech’s genetic test turns out to be a ‘lifesaver’ last_img read more

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Pregnant women with substance use disorders need treatment, not prison

first_img Nearly all doctors can freely prescribe opioids. Now a new movement aims to vastly deregulate an addiction treatment [email protected] Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. First OpinionPregnant women with substance use disorders need treatment, not prison Ongoing threats of criminal and punitive civil child welfare actions against this group of women with substance use disorders are feeding the most enduring and deadly barrier they face: fear. The policy of punishment has suppressed women’s disclosure of their substance use problems and kept them out of prenatal care and social services when early therapeutic approaches can help them recover and provide support to their families. The chronic-pain quandary: Amid a reckoning over opioids, a doctor crusades for caution in cutting back Incarceration rates in the U.S. are growing faster among women than among men, and black women are imprisoned at twice the rate of white women. With the country in the grip of a deadly opioid epidemic, segments of America continue to pursue prosecution and incarceration when treatment and support are needed.Why do legislators, law enforcement, and misdirected policymakers persist in this cruel and traumatic crusade against women and their children?One answer is the racism inherent in the justice system, in drug testing, and the demographics of punishment — an enduring and gendered plague. When entering prenatal care, every woman should receive a comprehensive physical and mental health evaluation, and every setting should use the national recommended standards for drug testing. But not all health care settings use these standards. Some rely instead on a single urine drug screen as their basis for diagnosis. The problem with this approach is that staff members are left to decide who to test based on what may be biased notions about which women look like they have a drug problem.Women of color and those living in poverty are more likely to be drug tested, and a single drug test has been used as grounds for prosecution of pregnant and parenting women. Rates of women’s drug use and drug sales are the same regardless of their race or ethnicity, but women of color are far more likely to face criminal charges for it. About the Author Reprints More than 210,000 women spent Mother’s Day 2019 in America’s prisons and jails.Two-thirds of them are mothers of young children; an unknown number are pregnant. Many of them have substance use disorders with a significant history of trauma and mental health problems. Some have been incarcerated solely for the alleged crime of substance use during pregnancy, and many have lost custody of their children because there aren’t enough treatment centers for women and their kids.Pregnant women with substance use disorders inside and outside of prisons and jails are struggling, and many are dying. The 2017 National Survey on Drug Use and Health found that 1 in 12 pregnant women had used an illicit drug in the past month. Recent reviews of maternal causes of death in three U.S. states identified opioid overdose as a significant contributor to maternal deaths, between 11% and 20% of all deaths during pregnancy. The number of newborns with neonatal abstinence syndrome has increased 300% in 28 states in the last 20 years.advertisement Please enter a valid email address. Related:center_img Masquerading as health policymakers purporting to protect the fetus, prosecutors, legislatures, and judges have incarcerated more than 1,000 pregnant women in the United States solely for substance use during pregnancy since the 1970s, and the practice continues today. Most of these punitive actions have occurred since 2005 due to increasingly heavy legal penalties for drug-related crimes and mass incarceration policies.advertisement Related: By Marty Jessup June 4, 2019 Reprints Leave this field empty if you’re human: Mythologies about remedies for women with substance use problems still rely on punishment-as-deterrence and prison-as-cure. A recent Associated Press poll revealed that a little more than half of Americans believe that addiction is a disease, yet most say they want no relationship with a substance user. In the same poll, respondents said they saw substance use problems as a matter of morality worthy of harsher legal consequences.These forms of disregard for so-called misbehaving mothers who need help are familiar and enduring American tropes. But the stigma of addiction grounded in sexism and its antique notions of “correct” womanhood and motherhood have gotten in the way of accepting the new truth for a complex problem: that treatment and recovery supports work.As several colleagues and I wrote recently in the journal Nursing Outlook, the American Academy of Nursing supports a public health response that incorporates multidisciplinary models of health care, child welfare, treatment and recovery supports, and clinician practices that are culturally and trauma responsive and in line with the accumulated scientific evidence.Today there is real reason for hope: After 50 years of research and listening to women’s stories, we now have tools for treating substance use during pregnancy and parenting, and there is clear evidence of their effectiveness. Science-based treatment, proven to help women recover from substance use problems, is not only within our reach, it’s here.Health care and substance use treatment professionals know how to set up and manage residential and outpatient programs for pregnant women and their infants and children. They can deliver medication-assisted treatment, motivational interventions, trauma treatment for those who need it, parenting education, kids’ health care, and comprehensive integrated gender- and culturally-responsive health and social services. States including Texas and Ohio have set up successful treatment program models for women and their children. Judges across the U.S. are active in a national therapeutic jurisprudence movement to establish family drug courts that protect children while providing recovery services and maintaining family cohesion without incarceration. These approaches not only work, but it is also cheaper to provide treatment to women with alcohol and drug problems than it is to incarcerate and ignore them. With these effective resources in our tool bag, why would we as a nation continue to deter women from treatment with a clearly failed punitive policy of prosecution and incarceration?We have a moral and humanitarian obligation to stop incarcerating women with substance use disorders. We must fully fund and expand treatment programs that house and serve them and their children and re-route efforts in every state away from punishment and toward providing programs of safe, therapeutic health care and social services.It’s time to end criminal prosecution and punitive civil actions and guarantee unobstructed access to treatment for women with substance use disorders so they no longer have to fear the worst for themselves and their children.Marty Jessup, Ph.D., R.N., is professor emerita at the University of California San Francisco School of Nursing and a fellow of the American Academy of Nursing. Eric Gay/AP Marty Jessup Privacy Policy Tags addictionopioidslast_img read more

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