New meta-analysis included 15 randomised controlled trials involving 598 patients with Alzheimer’s disease and found improvements in sleep and psycho-behavioural symptoms.
Light therapy leads to significant improvements in sleep and psycho-behavioural symptoms for patients with Alzheimer’s disease, according to a new study published this week in the open-access journal PLOS ONE by Qinghui Meng of Weifang Medical University, China, and colleagues.
The cognitive decline associated with Alzheimer’s disease is often accompanied by sleep disturbances and psycho-behavioural symptoms including apathetic and depressive behaviour, agitation and aggression. Photobiomodulation is a non-pharmacological therapy that uses light energy to stimulate the suprachiasmic nucleus (SCN), a sleep modulator in the brain. Despite light therapy receiving increased attention as a potential intervention for Alzheimer’s, a systematic evaluation of its efficacy and safety has been unavailable.
In the new study, researchers searched multiple research databases to identify all randomised controlled trials related to light therapy intervention for Alzheimer’s disease or dementia. Fifteen high-quality trials with available methods and relevant outcomes were selected for further analysis. The included trials were written in English, published between 2005 and 2022, and performed in seven countries. They included a combined 598 patients.
The meta-analysis of all fifteen trials found that light therapy significantly improved sleep efficiency, increased interdaily stability (a measure of the strength of circadian rhythms), and reduced intradaily variability (a measure of how frequently someone transitions between rest and activity during the day). In patients with Alzheimer’s disease, light therapy also alleviated depression and reduced patient agitation and caregiver burden.
Given the limited sample sizes in studies included in this meta-analysis, the authors advocate for larger future studies, which could also explore if bright light exposure could cause any adverse behaviour in patients. They conclude that light therapy is a promising treatment option for some symptoms of Alzheimer’s disease.
The authors add: “Light therapy improves sleep and psycho-behavioral symptoms in patients with Alzheimer’s disease and has relatively few side effects, suggesting that it may be a promising treatment option for patients with Alzheimer’s disease.”
The BASHIR™ Endovascular Catheter (THROMBOLEX, Inc.), recently approved by the US Food and Drug Administration (FDA), is paving the way to more effective and safe treatment for acute pulmonary embolism. Already demonstrated to be effective for reducing blockages in lung arteries, a new study in JACC: Advances shows that the BASHIR™ catheter also reduces blockages in the smaller segmental pulmonary artery branches. These branches are ultimately responsible for oxygenating the blood in the lungs.
The new study from Temple University which was part of the National Institutes of Health-sponsored multicentre RESCUE clinical trial, further showed a correlation between decreased numbers of blockages in the small lung arteries and functional recovery of the right ventricle of the heart, which pumps blood into the main pulmonary artery of the lungs.
Compared to other devices, the BASHIR™ catheter also had significantly lower bleeding rates, a key advance in acute pulmonary embolism treatment.
“Blockages in these smaller, distal pulmonary arteries have never previously been explored in patients treated for acute pulmonary embolism,” explained Riyaz Bashir, MD, FACC, Professor of Medicine, Director of Vascular and Endovascular Medicine in the Section of Cardiology, Department of Medicine at the Lewis Katz School of Medicine and Temple University Hospital, co-inventor of the BASHIR™ Endovascular Catheter, and first author on the new report.
The BASHIR™ catheter is a small tube-like device that consists of a helical basket with six mini-infusion catheters at its farthest end.
When the infusion basket is expanded within a clot in a large blood vessel, new channels open, enabling blood to flow through the clot. The blood carries the body’s clot-dissolving chemicals into the channels, accelerating clot breakdown.
Researchers at THROMBOLEX™ Inc. were involved in developing and commercialising this platform technology.
The occlusion of small lung arteries is the major reason for the reduction in blood flow in patients with acute pulmonary embolism.
“The more occlusions a patient has, the lower their survival,” Dr Bashir said.
“Among the treatment goals is relieving obstructions in both large and small arteries.”
Patients who survive may, over more extended periods, be at high risk of developing chronic thromboembolic pulmonary hypertension (CTEPH), which is a life-threatening condition caused by increased blood pressure in the lungs.
In the new study, Dr Bashir and colleagues observed reductions in occlusions in segmental and proximal branches of the pulmonary artery 48 hours following treatment with the BASHIR™ catheter.
The blockages decreased even in those arteries that were distant from where the infusion basket was located, enabling improved blood flow and healing of the right ventricle.
“We suspect that the improvements in blood flow are due to both the expansion of the basket and the flow of the body’s clot dissolving molecules into the clot, which cause the blockage to shrink,” Dr. Bashir said.
“As the volume of blood flow improved, right ventricular function also improved, which could translate to better survival.”
In future work, Dr Bashir and colleagues plan to investigate mechanisms behind the observed reductions in arterial blockage.
Further trials are also needed to understand better the impact of treatment with the BASHIR™ catheter on patient survival and incidence of CTEPH.
On 29 October, during its annual scientific meeting at the Sandton Convention Centre in Johannesburg, the South African Heart Association (SA Heart®) met with members of the National Department of Health (NDoH), Council for Medical Schemes (CMS), South African Medical Association, medical aid industry, pharmaceutical and medical device industry, as well as the Global Heart Hub – which supports patient advocacy for cardiovascular disease – with the intention to develop an advocacy forum to create a more empowered and engaged community of patients living with cardiovascular disease.
During the symposium, SA Heart® emphasised the cardiac profession’s difficulty in obtaining approval and full reimbursement for the evidence-based treatments, shown to improve patient outcomes. The rules and regulations surrounding the availability of treatments, variously determined by the NDoH, the CMS and funders, currently inhibit access to effective cardiovascular disease management. SA Heart®, an affiliate member of the European Society of Cardiology (ESC), adopts the ESC’s guidelines as its own, supplemented by consensus statements that take prevailing local circumstances into account. Instead of following the up-to-date recommendations of the ESC, both the NDoH and various private sector funders rather give preference to the CMS algorithms that are years out of date. These anachronisms determine standards of care, despite ongoing advances in evidence-based medicine.
Prescribed Minimum Benefits (PMB’s) are a set of defined benefits to ensure that all medical scheme members have continuous access to defined minimum health services, regardless of the benefit option they select. PMB’s are limited in their reach. Private sector funders often retreat behind rules and regulations within the state sector, as to the type and level of treatment that they approve. Each funder independently determines what will be funded and at what level. Based upon their unique Health Technology Assessments, each funder then decides what treatment is approved or declined. It is unfair to restrict treatment to what is available only in the state sector. Novel therapies could be more widely available if there were more constructive agreements between state and industry. The CMS is currently reviewing the PMB package and defining patient entitlement.
SA Heart® pointed out that physicians are at the interface between the patient and the funder. Frequently, the patient misunderstands their own relationship with their medical aid and may deem the practitioner responsible for limitations imposed on his/her treatment. The administrative burden on clinicians is often intolerable, requiring repeat motivations, chronic medication forms, PMB applications and telephone calls to funders.
During the symposium pertinent questions were raised around funder and regulator reimbursement decisions, as well as the obscure mechanisms governing the pricing of medicines and devices. SA Heart® also raised concerns about the future of both the public and private healthcare system. A balance between the two sectors is a delicate one, requiring careful policy decisions to ensure that both systems will contribute effectively to the overall health of our country. Debates often focus around issues of equity and quality of service. The idea of centralizing decisions and distribution in the pharmaceutical and medical device sectors can be seen as an effort to ensure equitable access to essential medicines and equipment. However, this approach could negatively impact the ability to cater for South Africa’s diverse and specific needs – with more bureaucracy and inefficiency.
The meeting was called to determine interest amongst the various parties in establishing a forum to find solutions to these problems, and to harmonise the regulations around access to both medications and devices. The panellists were unanimous in their agreement that the current rules, regulations and disparities between the public and private sectors need to be reworked and there was consensus that a forum should be created to continue these discussions and arrive at effective, durable solutions. SA Heart® committed to driving this process, and will regularly engage all stakeholders in future meetings, with the ultimate goal of improving patient access to innovative cardiovascular treatments.
After the stupendous effort for COVID vaccines and treatments, it may seem like other diseases were being neglected. Nevertheless, the US Food and Drug Administration suddenly had a fire lit underneath it, and got cracking with accelerated drug approvals. Now, 2023 seems to have brought plenty of new drugs to bolster the physician’s armamentarium – some are the first-ever treatment for their indications. Hopefully, with FDA and European Medicines Agency (EMA) approvals, South African approvals should not be too far behind.
Since the pandemic, hotly anticipated drugs have made a big splash or sunk without a trace. In 2021, semaglutide was approved for weight management, unleashing a wave of people using (and some abusing) the GLP-1 agonist for weight loss. Adagrasib, which targets KRAS, previously thought undruggable, was a major advance for the treatment of non-small-cell lung cancer and was one of a few notable new non-COVID pharmaceuticals.
Last year, Aduhelm seemed like yet another false start in the long battle against Alzheimer’s disease. This year though, it looks like help finally arrived for fight against the dreaded neurodegenerative disease with not one but two breakthrough drugs, both antiamyloid antibodies.
Up first is lecanemab/Leqembi from Eisai/Biogen. It targets the buildup of amyloid proteins in the brain, which otherwise lead to the formation of amyloid plaques and neurofibrillary tangles of tau protein, the hallmarks of the disease.
The other candidate is donanemab, which did not secure FDA approval last year, after pharma company Eli Lilly witnessed the disaster that was Aduhelm. It did show a reduction in decline in one measure of Alzheimer’s disease but not another, so its effects are a mixed bag.
Like Aduhelm, donanemab and lecanemab both have a serious downside: brain swelling, which claimed the lives of at three donanemab trial participants.
Previously minimised by the pandemic’s social distancing and routine masking, respiratory syncytial virus (RSV) experienced a resurgence in the wake of lifting these restrictions. RSV afflicts primarily those over 60 and young children. Among those 65 and older with RSV in the US, the Centers for Disease Control estimated 120 000 annual hospitalisations, with up to 10 000 of whom dying. Among children under 5, the figures are 58 000 annual hospitalisations and 100 to 300 deaths. Historically, RSV vaccine developments wound up being ineffective. Fortunately, this year saw the first approval for an RSV vaccine. A 120µg dose of their Arexvy vaccine produced statistically significant and clinically meaningful reductions in cases of lower respiratory tract disease caused by RSV in adults aged 60 years and older. Pfizer and Moderna are hot on HSK’s heels with their own vaccine applications.
Age-related macular degeneration
Apellis got an approval for pegcetacoplan this year, for geographic atrophy (GA) secondary to age-related macular degeneration, in its intravitreal injection. This is the first and so far only treatment for this indication. “The approval of SYFOVRE is the most important event in retinal ophthalmology in more than a decade,” said Eleonora Lad, MD, PhD, lead investigator for the phase 3 study. “Until now, there have been no approved therapies to offer people living with GA as their vision relentlessly declined. With SYFOVRE, we finally have a safe and effective GA treatment for this devastating disease, with increasing effects over time.”
Interestingly, Apellis also got an approval for paroxysmal nocturnal haemoglobinuria (PNH) with a patient-injectable version of pegcetacoplan. The disease results from the destruction of red blood cells by the immune system.
Abbvie and Genmab’s epcoritamab, for certain cases of large B-cell lymphoma (LBCL), got accelerated FDA and EMA approval earlier this year. The FDA has also granted accelerated approval to Roche’s glofitamab. The drugs bind to binding to CD20 on malignant B cells and CD3 on T cells to kill cancer cells, creating an effect like CAR-T cell therapy but without the complexity (and presumably, cheaper too).
Major depressive disorder, postpartum depression
Mental health is full of gaps needing to be filled by effective treatments. Not much has made been added for depression since selective serotonin reuptake inhibitors (SSRIs) came onto the market in the 1990s. Zuranolone, from Biogen and Sage Therapeutics, is the first oral treatment for postpartum depression, which previously was treated only by IV injection in a healthcare facility. Unlike slow-acting SSRIs, this treatment, which targets the GABA-A receptor, is a short course.
Inflammatory bowel disease
There has been a steady drip of new biologic drugs for inflammatory diseases, such as bimekizumab (psoriasis and deucravacitinib which recently received FDA approval. Eli Lilly entered this crowded marketplace with ixekizumab. Now, after trouncing Novartis’ Cosentyx for psoriasis with its own mirikizumab, it pulled its application for that indication and switched it to ulcerative colitis – beating about a dozen competitors to be the first IL-23 inhibitor. It aims to get an approval for Crohn’s disease in 2025. Pfizer’s etrasimod for ulcerative colitis got approval in October 2023, and should receive EMA approval in 2024. Its phase 3 trial achieved 27% remission versus 7.4% for placebo.
Pulmonary arterial hypertension
Last is sotatercept, a new drug for pulmonary arterial hypertension (PAH), which previously had no real treatment. Unlike the current therapy aimed at simply dilating blood vessels, sotaracept targets BMPR-II signalling, addressing the cause of PAH. It earned a priority preview by the FDA based on its phase 3 trial data, with possible approval by March 2024.
Moderate to severe traumatic brain injury carries lasting effects: trouble with focussing, recall and decision-making. Though many recover enough to live independently, their impairments prevent them from returning to school or work and from resuming their social lives. Current treatments offer little improvement, but results of a clinical trial of a new brain stimulation device, published in Nature Medicine, have shown great promise in at least partially restoring cognitive function.
“In general, there’s very little in the way of treatment for these patients,” said Jaimie Henderson, MD, professor of neurosurgery and co-senior author of the study.
But the fact that these patients had emerged from comas and recovered a fair amount of cognitive function suggested that the brain systems that support attention and arousal – the ability to stay awake, pay attention to a conversation, focus on a task – were relatively preserved.
These systems connect the thalamus, a relay station deep inside the brain, to points throughout the cortex, the brain’s outer layer, which control higher cognitive functions.
“In these patients, those pathways are largely intact, but everything has been down-regulated,” said Henderson, the John and Jene Blume-Robert and Ruth Halperin Professor. “It’s as if the lights had been dimmed and there just wasn’t enough electricity to turn them back up.”
In particular, an area of the thalamus called the central lateral nucleus functions as a hub that regulates many aspects of consciousness.
“The central lateral nucleus is optimised to drive things broadly, but its vulnerability is that if you have a multifocal injury, it tends to take a greater hit because a hit can come from almost anywhere in the brain,” said Nicholas Schiff, MD, a professor at Weill Cornell Medicine and co-senior author of the study.
The researchers hoped that precise electrical stimulation of the central lateral nucleus and its connections could reactivate these pathways, turning the lights back up.
In the trial, the researchers recruited five participants who had lasting cognitive impairments more than two years after moderate to severe traumatic brain injury. They were aged 22 to 60, with injuries sustained three to 18 years earlier.
The challenge was placing the stimulation device in a small target in the right area, which varied across individuals. Each brain is shaped differently to begin with, and the injuries had led to further modifications.
“That’s why we developed a number of tools to better define what that area was,” Henderson said. The researchers created a virtual model of each brain that allowed them to pinpoint the location and level of stimulation that would activate the central lateral nucleus.
Guided by these models, Henderson surgically implanted the devices in the five participants.
“It’s important to target the area precisely,” he said. “If you’re even a few millimetres off target, you’re outside the effective zone.”
A pioneering moment
After a two-week titration phase to optimise the stimulation, the participants spent 90 days with the device turned on for 12 hours a day.
Their progress was measured by a standard test of mental processing speed, called the trail-making test, which involves drawing lines connecting a jumble of letters and numbers.
“It’s a very sensitive test of exactly the things that we’re looking at: the ability to focus, concentrate and plan, and to do this in a way that is sensitive to time,” Henderson said.
At the end of the 90-day treatment period, the participants had improved their speeds on the test, on average, by 32%, far exceeding the 10% the researchers had aimed for.
“The only surprising thing is it worked the way we predicted it would, which is not always a given,” Henderson said.
For the participants and their families, the improvements were apparent in their daily lives. They resumed activities that had seemed impossible – reading books, watching TV shows, playing video games or finishing a homework assignment. They felt less fatigued and could get through the day without napping.
The therapy was so effective the researchers had trouble completing the last part of their study. They had planned a blinded withdrawal phase, in which half the participants would be randomly selected to have their devices turned off. Two of the patients declined, unwilling to take that chance. Of the three who participated in the withdrawal phase, one was randomized to have their device turned off. After three weeks without stimulation, that participant performed 34% slower on the trail-making test.
The clinical trial is the first to target this region of the brain in patients with moderate to severe traumatic brain injury, and it offers hope for many who have plateaued in their recovery.
“This is a pioneering moment,” Schiff said. “Our goal now is to try to take the systematic steps to make this a therapy. This is enough of a signal for us to make every effort.”
An estimated quarter of adults and two-thirds of children have strong fears around needles, according to the US Centers for Disease Control and Prevention. Yet, public health depends on the willingness of people receive vaccines, typically administered by a subcutaneous injection.
Darcy Dunn-Lawless, a doctoral student at the University of Oxford’s Institute of Biomedical Engineering, is investigating the potential of a painless, needle-free vaccine delivery by ultrasound.
He will share the recent advancements in this promising technique as part of Acoustics 2023 Sydney, running Dec. 4-8 at the International Convention Centre Sydney.
“Our method relies on an acoustic effect called ‘cavitation,’ which is the formation and popping of bubbles in response to a sound wave,” said Dunn-Lawless.
“We aim to harness the concentrated bursts of mechanical energy produced by these bubble collapses in three main ways. First, to clear passages through the outer layer of dead skin cells and allow vaccine molecules to pass through. Second, to act as a pump that drives the drug molecules into these passages. Lastly, to open up the membranes surrounding the cells themselves, since some types of vaccine must get inside a cell to function.”
Though initial in vivo tests reported 700 times fewer vaccine molecules were delivered by the cavitation approach compared to conventional injection, the cavitation approach produced a higher immune response.
The researchers theorize this could be due to the immune-rich skin the ultrasonic delivery targets in contrast to the muscles that receive the jab.
The result is a more efficient vaccine that could help reduce costs and increase efficacy with little risk of side effects.
“In my opinion, the main potential side effect is universal to all physical techniques in medicine: If you apply too much energy to the body, you can damage tissue,” Dunn-Lawless said.
“Exposure to excessive cavitation can cause mechanical damage to cells and structures. However, there is good evidence that such damage can be avoided by limiting exposure, so a key part of my research is to try and fully identify where this safety threshold lies for vaccine delivery.”
Dunn-Lawless works as part of a larger team under the supervision of Dr Mike Gray, Professor Bob Carlisle, and Professor Constantin Coussios within Oxford’s Biomedical Ultrasonics, Biotherapy and Biopharmaceuticals Laboratory (BUBBL). Their cavitation approach may be particularly conducing to DNA vaccines that are currently difficult to deliver. With cavitation able to help crack open the membranes blocking therapeutic access to the cell nucleus, the other advantages of DNA vaccines, like a focused immune response, low infection risk, and shelf stability, can be better utilised.
Renowned clinician, researcher and educator Professor Harry Seftel has passed away at the age of 94. For many, he was well-known for his radio appearances concerning health and medicine. Hailed as a “national treasure” by President Cyril Ramaphoa, Prof Seftel contributed greatly to the study of non-communicable diseases in South African populations and was a strident critic of apartheid.
The Wits Faculty of Health Science posted on Twitter/X: “The Faculty mourns the passing of Professor Harry Seftel, distinguished professor of medicine at @WitsUniversity. Renowned for making complex medical issues accessible to all, Prof. Seftel was a passionate advocate for health promotion.”
Born on 28 December 1928, Harold Cecil Seftel became an intern at Baragwanath Hospital in 1953 shortly after receiving his medical degree, and by 1982 was Professor of Medicine and Chief Physician at Hillbrow Hospital.
An outstanding clinician, he contributed greatly to the categorisation of infectious and non-infectious diseases among Black South Africans. He held numerous positions and received an honourary law degree from Wits.
His research interests focussed on diseases with a high prevalence in various South African populations: oral iron overload, cryptogenic cardiomyopathy and arterial hypertension among Black Africans; coronary artery disease and diabetes mellitus among Asians and familial hypercholesterolaemia among Afrikaaners.
He encouraged research at many levels, authoring more than 200 publications in fields ranging from endocrinology to infective diseases. In doing so, he collaborated with many of the finest minds in their fields, locally and internationally.
Not content with confining his teaching to academia, he also educated the general public with presentations in the media, becoming a familiar face over the years. He became known for many catchphrases, with “trust no one, least of all yourself” being one of his most revealing.
Prof Seftel was also friends with Nelson Mandela, having met him at Wits University. While Nelson Mandela was in prison, he heard one of Prof Seftel’s broadcasts and reduced his salt intake to help with the health problems he suffered throughout his incarceration. Not surprisingly, Prof Seftel was a strident critic of apartheid and the gross inequalities it produced.
In his 1973 inaugural lecture at Wits, he said of the distribution of medical service South Africa: “The present situation is deplorable and shameful. The man from Mars who is due here shortly would find it quite incomprehensible. In particular he would find our system of priorities wholly illogical and immoral.”
The state of South Africa’s mental well-being is a cause for concern
In Aon’s 2024 Global Medical Trend Rates Report, mental health is listed as a major contributor to morbidity, disability, injury and premature mortality; also increasing the risk of other health conditions. The state of South Africa’s mental wellbeing is cause for concern. The world has witnessed several major events that have also had widespread impacts on people’s mental health. Events such as the COVID-19 pandemic, natural disasters, economic uncertainties, social unrest and warfare have heightened stress levels and contributed to an increased focus on mental well-being.
South Africans are distressed and struggling with their mental health:
In Sapien Labs’ Mental State of the World 2022 report, South Africa was ranked as the country with the highest percentage (35.8%) of its population that are distressed and struggling with mental health.
Another prominent trend highlighted in the Sapien Labs report is the declining mental well-being of each successively younger generation. This is reflected in the Western Cape Government’s report on anxiety, depression and adolescent suicide which found that 9% of all teenage deaths are due to suicide.
According to the World Health Organisation (WHO) more than 700 000 people die by suicide every year, with South Africa rated as the country with the ninth highest suicide rate in the world at 23.5 per 100k, with suicide alarmingly being the fourth leading cause of death among 15 – 19-year-olds.
A WITS University study found that a quarter (25.7%) of South Africans are depressed with only a quarter of these affected individuals seeking assistance.
According to Jacqui Nel, business unit head of healthcare at Aon South Africa, depression is likely to be the world’s leading burden of disease by the year 2030, if not sooner. “It is easy to measure an individual’s weight, Body Mass Index (BMI), glucose and cholesterol levels, but it is much harder to measure what is going on in a person’s mind. The top challenge that human resource professionals are concerned with is keeping the workforce engaged and productive in the face of ongoing retrenchments, the spiralling cost of living, load shedding and the fact that 44% of South Africans have impaired credit records. All these factors are converging to create enormous contributory pressures when it comes to anxiety levels experienced by employees,” says Jacqui.
One of the leading trends in the mental well-being of employees is burnout, which places employees at risk of developing depression. It was classified as an occupational phenomenon in 2019 by the World Health Organisation (WHO) with its occurrence rate increasing on an annual basis, and it has only escalated since the onset of the pandemic and the radical changes to work models since then. “Employees that are burnt out feel exhausted, distance themselves from their colleagues and their job and show a reduction in professional efficacy,” Jacqui explains.
Finding a sustainable work-life balance model
These factors are clear indicators that there is something radically amiss in our work-life balance, and we need to do better as a society and employers in embracing a more sustainable work-life model that is cognisant of the forces that are at play in the workforce environment. “It starts by building resilience, agility and a sense of belonging at an individual and organisational level, and most of all, better support structures,” Jacqui explains.
Workforce resilience describes a person’s fundamental sense of security at work, a strong sense of belonging with the employer and the adaptability and motivation they need to reach their full potential. “Workforce resilience matters because businesses that put their people first are more likely to thrive. By creating a workplace environment that provides security, motivation and belonging, employees and colleagues are better able to weather and process the fiercest of storms and pressures,” Jacqui explains.
Workforce agility describes a workforce that thrives on and embraces change rather than being threatened by it, a workforce that can develop future skills at speed and naturally pivots to stand out from the competition – all the while balancing investment and people risk with agility, creating value for the employer and the customer, alike.
“By investing in impactful Employee Assistance Programmes (EAP), employers empower their employees to better measure their progress and manage risk, enabling a diverse, inclusive and agile workforce. Workforce agility is the difference between merely surviving and thriving,” says Jacqui.
“It may even extend beyond an EAP, with organisations implementing programmes that are specific to the organisation’s challenges. Insights that are underscored by data and analytics, will be able to identify employee trends and concerns, enabling employers to wisely spend money where it is most required within the wellness of employees,” she adds.
Belonging describes a connection to a community of peers and the support that each individual feels in relation to their working environment. “It is important because it enables a positive working life experience and underpins personal and professional growth, providing a voice and an opportunity to use it and be heard, regardless of role or rank. All the while, supporting wellbeing whilst driving diversity and innovation,” Jacqui explains.
“Fostering a sense of belonging in an employee starts by assessing how well the personality traits of a possible candidate align with the cultural fit of the organisation during the recruitment phase. It also extends to how well employees are supported during their time in the organisation, allowing them to naturally become agents of change and role models for the organisation’s culture by living the company ethos and way of operating to inspire adoption throughout,” Jacqui explains.
At the heart of this entire process, is the implementation of a well-rounded Employee Assistance Programmes (EAP) that is designed to support employees in dealing with personal and work-related stressors that may affect their well-being, mental health and productivity. This could include:
Confidential counselling sessions.
Assessments of an employee’s situation and referral to the correct counselling and support.
Crisis intervention for employees who are dealing with trauma such as bereavement, have been victims of violent crime or gender-based violence.
Offering work-life services that could range from finding childcare to legal assistance or financial planning.
Offering educational workshops and seminars on aspects such as personal finance through to health and wellbeing.
Wellness programmes that promote healthy habits and stress reduction and management techniques.
Consultation for managers and supervisors.
“There has been a significant increase in awareness and understanding of mental health issues as efforts by mental health advocates, employer groups and individuals have contributed to destigmatising mental health. This increased awareness has led to more open conversations about mental health in various sectors of society and it is here where Employee Assistance Programmes (EAP) play a crucial role in supporting employers and opening the doors for candid conversations and getting the needed help and support. The services of a trusted and skilled advisor are key in helping organisations develop and operate an EAP that is fit for your business and your people and their unique circumstances. “
“While there is a cost involved that is carried by the business, the results far outweigh the investment. It’s about providing employees and management with the means to weather the storms of an increasingly complex world of work, find a balance in their personal lives and come out on the other side with resilient and agile people who have a strong sense of belonging and purpose. This is about supporting employees to manage stress, improve productivity, and enhance their overall quality of life and wellbeing, which in turn improves workplace dynamics, contributing to a positive and productive work environment where skilled and valued employees want to be,” Jacqui concludes.
Scientists have long known that pancreatic β cells increase during pregnancy and promptly return to their original number following birth. But the underlying mechanisms that cause the cells to go back to their original number are still not well understood.
In a significant breakthrough, a research group using mouse models, has discovered that macrophages ‘eat’ (phagocytose) the pancreatic β cells, thereby revealing the process behind their return to previous levels after pregnancy.
The research group, which was led by Associate Professor Junta Imai, Assistant Professor Akira Endo, and Professor Hideki Katagiri from Tohoku University’s Graduate School of Medicine, published the results in the journal Development Cell.
Initially, the group examined the number of pancreatic β cells in the islets of Langerhans in a mouse model of pregnancy.
They confirmed the cell number was double at the end of the pregnancy when compared to non-pregnant mice, but that it then gradually decreased, returning to the original amount after delivery.
“After we observed the islets of Langerhans before and after delivery, we noticed an increase in macrophages, which protect the body from infections by engulfing bacteria, foreign substances and dead cells, after delivery,” says Imai.
“When we applied treatment to inhibit this process, the blood glucose levels became too low (hypoglycaemia).”
Additional microscopic observation of the islets of Langerhans after birth revealed β cells to be phagocytosed by macrophages.
This mechanism appeared to keep the mother’s blood glucose levels from decreasing excessively after delivery by rapidly reducing pancreatic β cells to their normal pre-pregnancy number.
Next, the group identified the protein responsible for attracting the macrophages into the islets of Langerhans: cytokine CXCL10.
Accordingly, the inhibition of CXCL10 function suppressed the decrease in pancreatic β cells after birth.
“We hope our results will contribute to clarifying the means by which normal blood glucose levels are maintained as well as the development of methods to prevent and treat diabetes,” adds Imai.
Blending 4IR technology and holistic approaches to health, the future of personalised and predictive ‘Wellcare’ comes to Cape Town and Johannesburg
InUversal Group, a health and biotech market disruptor in Africa and the Middle East that is transforming the way we think about healthcare, medicine and hospitals, is set to open next-gen medical and wellness hubs in Cape Town this December 2023 and a monumental R1 Billion Development in Sandton, Johannesburg, to follow in 2024. These visionary, state-of-the-art health and wellness facilities are designed to embrace the holistic nature of individuals’ wellbeing, emphasising the intricate interplay of biological, social and psychological facets.
Comprising a team of esteemed medical experts working collaboratively to transform disease treatment through innovative and holistic strategies, the InUversal Group is committed to alleviating South Africa and Africa’s healthcare challenges through the application of 4IR technology that is set to improve healthcare accessibility and standards for individuals across the continent. As an increasing number of international visitors travel the globe in search of medical treatments, the InUversal Group is committed to making South Africa’s major metropolises, including Johannesburg, Cape Town, and Durban, the go-to destinations for personalised Wellcare – a term coined by the group that is anticipatory in nature and requires a holistic approach to health.
Wellcare harnesses proven strategies to attain an optimal and healthy balance between individuals’ health, time, and finances, ensuring that they can lead healthier, happier and more fulfilling lives. This ambitious endeavour aligns with South Africa’s reputation as a hub for medical tourism, offering world-class medical services, competitive pricing, and a rich cultural and immersive experience.
The Institute of Universal Wellcare (InUWell) will be based in the heart of Cape Town at the prestigious V&A Waterfront Mall and is the first of its kind – a digitally-immersed, multidisciplinary institute of holistic health and wellbeing in a warm and welcoming retail environment. InUWell’s versatile multifunctional design, and forward-thinking commitment to radical sustainability, offers an unparalleled experience that is a seamless blend of physical and digital realms. The Institute is set over 2000 square metres and is considered to be the heart of “Wellcare.”
This festive season, InUWell is opening its doors to immersive health and wellness experiences where individuals are invited to learn more about health and well-being, while exploring and having fun in an engaging, euphoric, multi-sensory environment as they connect and share memorable moments with friends and family.
InUWell provides a diverse range of services including DNA genetic testing, comprehensive health screenings and diagnostics, specialised treatments and therapies, Wellcare lifestyle products and services, active health studios, multisensory immersive experiences and a digital health bank with evidence-based healthcare insights.
“The InUversal Group is an ecosystem shifting and stretching boundaries, creating connections, taking complex intricate life decisions and making them SIMPLE,” says Dr Kamlen Pillay, Founder and CEO of the InUversal Group and Plastic Surgeon. “InUWell, under the InUversal Group, is a single destination for all your health and wellness needs. It is the perfect place to learn about your body and how to take care of it, to access the latest technology and treatments and therapies, and to connect with other people who are on the same journey,” says Dr Pillay.
“The InUversal Group’s WellCare Programmes empower individuals of all generations to take precise, proactive, and preventative measures, not only to extend the quantity of years in our lives but also to infuse more vitality and quality into those years,” says Dr Pillay.
The Group is launching several innovative health technology products which will enter the market early next year, including the Johannesburg facility called SIM Sandton, that is unique in Africa and will host a 5* hotel, InUWell Precinct, Step-Down Facility as well as a multi-disciplinary Surgical Theatre Complex with more than 20 of Johannesburg’s top specialists.
Working with esteemed medical specialists, leading MedTech equipment and companies, and lifestyle and wellness retail brand partners, the InUversal Group invites potential collaborators to join the vanguard of companies and brands helping to shape the future of health and Wellcare practices in Africa and globally, with the shared mission of enhancing the well-being of countless individuals.
“Imagine a world where every man, woman and child has the agency over three valuable assets – their health, time and money. A world where every person has the dignity of choice where they live, work and play. A world where hospitals are not places we go to when we are sick but rather to stay healthy. Imagine a world where hospitals are for profits but not for profiteering. A world where each day, each and every one of us, uses our energy collectively to leave the world in a slightly better place than we found it, the day before,” concludes Dr Pillay.
To get involved or find out more information, visit: inuwell.global or contact email@example.com to book an appointment. InUWell Cape Town will officially be opening its doors on 19 December 2023.