Tag: public health

Categories : Ethics and Law General InterestTags :

Op-ed: Facebook Medical ‘Fact Checking’ Has No Room for Debate

On By ModernMedia

Fact-checking is increasingly important in an era of disinformation on social media, especially with the current COVID pandemic, but an article for MedPage Today calls into question the process for Facebook’s medical fact-checking.

After an op-ed in the Wall Street Journal by Marty Makary, MD, MPH, Johns Hopkins professor and editor-in-chief at MedPage Today, was labelled “misleading” by Facebook fact checkers, another op-ed in MedPage Today asks how the social media giant is choosing its medical fact-checkers. 

Mystified by why this would be labelled “misleading” by Facebook, and setting aside the ‘veracity’ of the article, Vinay Prasad, MD, MPH, a haematologist-oncologist and associate professor of medicine at the University of California San Francisco, investigated the website HealthFeedback.org that Facebook uses to fact-check some of its medical articles. 

The process involves two to four reviewers chosen to examine an article. Prior to the COVID pandemic, medical fact checking appears to have been done by academics, but the flood of disinformation has resulted in the change of this process, Dr Prasad noted.  

In one instance, a reviewer for the article was selected because he had already written an article critical of Dr Markary’s op-ed: in other words, he was selected because he had already announced his bias.

The website’s picking and choosing of reviewers “felt like a high school clique”, Dr Prasad wrote. One that allowed them to confirm their previously held ideas about COVID and extinguish differing viewpoints. Labelling the alternative views as misleading “instantly usurps the reader of their ability to make up their own mind. It is antithetical to the spirit of the academy.”

He found that the fact-checkers typically had large Twitter followings, while the typical medical professor seems to have them in the hundreds. This makes sense, Dr Prasad wrote, as leading academics and authorities are likely too busy to be courting large numbers of followers on Twitter.
Other than a “vague explanation” of the feedback process, Dr Prasad could not find any information on how Facebook chooses its reviewers, which of the billions of posts and articles on Facebook to fact-check, whether anyone is paid and how appeals are made.

Source: MedPage Today

Categories : Cancer General InterestTags :

Impact of French Nuclear Testing Underestimated

On By ModernMedia

A new report has found that the extent of radiation exposure to people involved in nuclear testing in French Polynesia has been significantly underestimated.

Over 1966 to 1996 at Moruroa and Fangataufa atolls in French Polynesia, France conducted An unofficial report has gone through thousands of recently declassified documents, focusing on the impact of three key nuclear tests: Aldébaran, Encelade and Centaure in 1966, 1971 and 1974.
The report suggests that the French government has underestimated fallout by as much as 40%, opening the door for tens of thousands more to claim compensation.

One millisievert (mSv) per annum is the maximum allowable public exposure. There is clear evidence for radiation effects at doses over 100mSv, while doses less than 10mSv are undetectable even in very large epidemiological studies and such low dose effects on human health are controversial. According to the linear-no dose-threshold (LNT) theory, all radiation exposure carries some level of harm.

Last February, a report was sent from Paris to French Polynesia on a cluster of cancers uncovered there, believed to be linked to radiation exposure . Email evidence suggests that at least 2000 of the 6000 military personnel involved in the tests had contracted at least one form of cancer.
It was only in 2010 that France established a compensation claims board for people with one of 23 cancers associated with radiation and who lived in French Polynesia at the time of the tests. However, many claimants do not have the means to access these claims, such as those who live on remote islands.

Faulty and imprecise monitoring equipment impacted the results, which were used to calculate the original dose calculations. The researchers recalculated the estimated doses absorbed by the population based on samples taken by the military at the time, and also using new methods involving meteorological data to plot the spread of radioactive fallout. Some recalculations did not show much change, but a 1966 test produced a level three times higher than the official estimate. Some 11 000 people exposed to the nuclear testing received a dose higher than 5mSv, the researchers found.

Source: The Guardian

Categories : COVIDTags :

Restaurants and Not Wearing Masks Increases COVID Transmission, CDC Warns

On By ModernMedia

Fully opening restaurants and not having mask rules in place and the Centers for Disease Control (CDC) warned.

“This report is a critical reminder that with the current levels of COVID-19 in communities and the continued spread of more transmissible virus variants, which have now been detected in 48 states, strictly following prevention measures remains essential for putting an end to this pandemic,” said CDC director Rochelle Walensky, MD, at a White House COVID briefing on Friday. “It also serves as a warning about prematurely lifting these prevention measures.”

Dr Walensky’s comments may have been made with states such as Texas and Mississippi in mind, with their governors announcing that they were dropping mask mandates and allowing full reopening, including businesses such as restaurants at full capacity. Some restaurants that are still enforcing 

Research has already shown that in-person dining and lack of mask regulations contribute to the spread of COVID cases. Taking data from state and local health department websites, COVID cases and deaths were analysed at county level The team compared data from post-implementation time points, ranging from 1-20 days to 81-100 days, to pre-implementation periods.

The researchers also attempted to control for other factors, such as restaurant closures during the mask mandates, mask mandates in the restaurant reopening models, stay-at-home orders, and bans on gatherings of more than 10 people.

Of the three-quarters of surveyed counties with mask mandates, the researchers found that within 1-20 days of mask mandates, there was a 0.5 percentage point drop in COVID case growth rates. Case and death growth rates saw almost a 2.0 percentage point decline 81-100 days after mask mandates came into effect.

Conversely, states allowed restaurants to re-open for in-person dining. While the impact was not immediate, COVID case growth rates increased 1.1 percentage points 81-100 days later. However, counties allowing in-person dining were associated with 2.2 percentage point increases at days 61-80 and a 3.0 percentage point increase at days 81-100 after restrictions were lifted.

The researchers speculated about the cause, such as restaurants potentially delaying reopening even after they were allowed to do so, and that patrons might have been more cautious during initial reopenings but more likely to dine at restaurants as time passed.

Source: MedPage Today

Categories : Gender HospitalsTags :

UK Says ‘Strong Evidence’ of Gender Health Gap Exists

On By ModernMedia
Woman in a hospital bed. Photo by Andrea Piacquadio from Pexels.

As an inquiry into the disparity of health service provision to women begins this week, Ministers in the UK say there is “strong evidence” of a gender gap.

The Women’s Health Strategy will speak to women and girls over the next 12 weeks on a variety of issues, ranging from maternity care to mental health.

Nadine Dorries, minister for women’s health, said: “Women’s experiences of healthcare can vary and we want to ensure women are able to access the treatment and services they need.

“It’s crucial women’s voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes.”

Patients have told the BBC they have felt overlooked in conditions like endometriosis, or procedures such a pelvic floor mesh.

There is less knowledge on female conditions and their treatment among clinicians. Despite the fact that they make up half of the population, female conditions are often considered a ‘niche’ area. Research shows that a large part of the problem is due to the fact that clinical trials have  failed to take into account gender. Eight out of ten drugs that were withdrawn in the US between 1997 and 2000 were as a result of side effects in women.
While campaigners have welcomed the view, they say that it is still vital to listen to women’s views and act on them.

Gill Walton, chief executive of the Royal College of Midwives, said: “We know that placing women at the centre of their own care not only improves outcomes in pregnancy, but also improves a woman’s experience of birth and maternity care.”

Mika Simmons, co-chair of the Ginsburg Women’s Health Board, filmmaker, and host of The Happy Vagina podcast, said: “Every single woman I speak to, myself included, has experienced either misunderstanding or loss as a direct result of slow or inaccurate diagnosis of their health concerns.

“I am delighted that this – the gender health gap – which grew out of a severe lack of historical research into women’s health issues, is not only finally being acknowledged but that steps are being taken to right size it.”

Source: BBC News

Categories : COVID General Interest VaccinesTags :

After Receiving Vaccine, Queen Elizabeth Encourages Others

On By ModernMedia

After receiving her COVID vaccine, Queen Elizabeth encouraged those who were wary to think of others and do the same.

She and Prince Philip received their vaccine in the initial wave of vaccinations for the elderly in the UK. Prince Philip, 99,  is currently in hospital for a non-COVID related illness. There are concerns about the health of her husband Prince Philip, but the palace says that he is responding to treatment, but likely to remain in hospital for a few more days.

“Once you’ve had a vaccine you have a feeling of you know, you’re protected which I think is very important and as far as I could make out it was quite harmless,” the 94-year old monarch queen said in a video call with health officials supervising inoculations across the UK.

“It was very quick, and I’ve had lots of letters from people who have been very surprised by how easy it was to get the vaccine. And the jab – it didn’t hurt at all,” she added, likening the virus to a plague.

Earlier this week, the UK’s vaccine minister said that 11% to 15% of people were hesitant about receiving a vaccine, especially among minority groups.

“It is obviously difficult for people if they’ve never had a vaccine because they ought to think about other people other than themselves,” said the queen.

She praised the “remarkable” Britain’s rollout of the vaccination, one of the world’s fastest. Other members of the royal family including Prince Charles and his son Prince William, have been visiting vaccination centres over the last two weeks to convey their thanks to staff and volunteers for their work.

Data from Public Health England suggest that the vaccines are 80% effective in preventing serious COVID in the elderly.

Source: Reuters

Categories : COVID Medical IndustryTags :

SA Medical Aid Schemes May Not Have to Pay for Public’s Vaccines

On By ModernMedia

Medical aid scheme executives have pointed out that the latest budget means that medical aid schemes may no longer need to contribute for the vaccination of the South African population without medical insurance. 

South Africa’s medical insurance schemes had been in discussions on funding at least part of the government’s vaccine rollout for uninsured members of the public.

The R9 billion allocated in the budget may be enough to cover the vaccine costs of the entire country, said executives from the two leading medical aid schemes.

About 7 million people are covered by medical aid schemes, about a quarter of the country’s population. Discovery Health, Medscheme and Momentum together administer some 80% of private sector medical aid plans.

“I think the government is looking at this and saying this is our role,” said Damian McHugh, executive head of sales and marketing at Momentum Health Solutions. He agreed with the idea that the budget figure implied that schemes may not have to help cover vaccinations for non-members, although it did not remove the discussion of subsidies.

McHugh went on to explain that the costs would depend on which vaccines were procured, and schemes would still have to contribute in case booster shots or new vaccination rounds became necessary.

However, given record additions to their reserves last year due to medical services not being taken or postponed, along with not having to contribute to the vaccination of non-members, medical aid schemes stand to reap even greater benefits.

Source: Reuters

Categories : COVID Medical IndustryTags :

Global COVID Recovery Needs to Address Oxygen Shortages

On By ModernMedia

At the virtual launch of Global Citizen’s Recover Better Together Campaign, access to vaccines and medical resources was highlighted as a key area to address.

“Covid-19 has threatened the lives and livelihoods of everyone on the planet. To respond, we must take several urgent actions. The only way that we will be able to recover better, together is by defeating the virus everywhere through universal access of vaccines, diagnostics, and therapeutics,” said World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus.

To this end, the Recover Better Together Campaign, an initiative organised by the Global Citizen, the European Commission and the WHO, aims to create momentum for global COVID pandemic recovery, with a return to the implementation of global goals.

“To fight the pandemic, we need to pool resources, capabilities, knowledge and intellectual property. That is why we continue to call on world leaders to support the COVAX facility to ensure rapid and equitable access to Covid-19 vaccines for all countries. Another important step is to enable the transfer of medical technology for the duration of the pandemic,” said President Cyril Ramaphosa.

One of key medical resource is oxygen, which is in short supply in many low- and middle-income countries, which have to provide enough for up to half a million COVID patients. WHO data shows that 1.1 million cylinders are needed daily in developing countries, with Africa seeing the biggest surge in demand. Hospitals in Nigeria have reported running out of oxygen, leading to preventable deaths.

According to the WHO, public hospitals across 41 African countries have fewer than 2000 working ventilators. In comparison, the United States has more than 170 000 ventilators. The South African private sector has about 4000 ventilators, and around 2000 in the public sector. The WHO said the launch of the Covid Tools Accelerator Therapeutics pillar, co-led by Unitaid and Wellcome, has improved access to oxygen. On 25 February the Covid-19 Oxygen Emergency Taskforce was also launched by the WHO.

Unitaid Executive Director Dr Philippe Duneton said the Taskforce now needs an additional $90 million US for delivery of oxygen in up to 20 countries including Malawi, Nigeria and Afghanistan.

“This is a global emergency that needs a truly global response, both from international organisations and donors. Many of the countries seeing this demand struggled before the pandemic to meet their daily oxygen needs,” said Duneton. “Now it’s more vital than ever that we come together to build on the work that has already been done, with a firm commitment to helping the worst-affected countries as quickly as possible.”

Source: Health-e News

Categories : Hospitals Medical Research & TechnologyTags :

Battery Backups Can Protect People Dependent on Medical Equipment

On By ModernMedia
A battery. Photo by Danilo Alvesd on Unsplash.

In countries prone to blackouts from extreme weather events (and in some cases solar flares) battery backups could provide a viable alternative to keep the medical support systems for vulnerable family members functioning. As climate change is set to increase the frequency and severity of weather-related blackouts, a study from the Columbia University Mailman School of Public Health examined the value of battery backups.

Millions of people are reliant on home medical equipment – the elderly, ill people, many of whom are poor or otherwise vulnerable. Medical equipment such as oxygen concentrators, nebulisers, ventilators, and dialysis and sleep apnoea machines often have no backup power in case of an outage.

In a 2019 wildfire which caused power outages, many vulnerable residents reported complications, such as one man who awoke, unable to breathe when his sleep apnoea breathing machine stopped functioning.
Community centres such as schools are often turned to for services when power fails, such as using their refrigerators to store food, but many do not have backup power.

“Climate change coupled with aging energy infrastructure is driving extreme weather-related power outages, as we’ve seen recently in Texas,” said study co-author Diana Hernández, PhD, Associate Professor of Sociomedical Sciences, Columbia University, “The technology to improve resiliency and energy independence exists, and it needs to be made more accessible to those who could most benefit. Battery storage units, particularly those powered by the sun, are a critical tool to help vulnerable individuals and communities survive the climate crisis.”

In the US territory of Puerto Rico, following the widespread destruction of the electrical grid by Hurricane Maria, many residents used solar panels instead of diesel generators due to ease of use, low cost, and not emitting fumes that exacerbate asthma and other lung conditions

A review of literature showed that blackouts can result in negative health consequences ranging from carbon monoxide poisoning, temperature-related illness, gastrointestinal illness, and mortality to cardiovascular, respiratory, and hospitalisations for kidney disease, especially for individuals dependent on electrically powered medical equipment.

Beyond electrical backup, in the US, older adults, poorer families, and individuals of non-Hispanic Black and Hispanic race/ethnicity are also less likely to have emergency supplies of food, water and medicine in the event of disaster.

Overall, the researchers found that more work is needed to better define and capture the relevant exposures and outcomes. “There is urgent need for data to inform disaster mitigation, preparedness, and response policies (and budgets) in an increasingly energy-reliant world,” said first author Joan Casey, PhD, assistant professor of environmental health sciences at Columbia Mailman School.

Eskom in South Africa is already facing a shortfall due to users abandoning its services for solar power generation, forcing tariff changes and increases. An uptake of battery backups to complement the solar panels may greatly alleviate vulnerabilities of people dependent on medical equipment in an uncertain power supply environment, as well as improving resilience to natural disasters, without the health hazards of generators.

Source: News-Medical.Net

Journal information: Mango, M., et al. (2021) Resilient Power: Battery storage as a home-based solution to address climate-related power outages for medically vulnerable populations. Futures. doi.org/10.1016/j.futures.2021.102707.

Categories : Cardiovascular Disease Diet and NutritionTags :

High GI Carbohydrates Raise CVD Risk Across Countries

On By ModernMedia

A multinational study has shown that high consumption of high glycaemic index foods increases the risk of cardiovascular disease (CVD) events such as stroke or heart disease, regardless of pre-existing CVD.

The study examined low-, middle- and high-income countries, beginning in 2006, with a median follow-up of 9.5 years. Data was used from nearly 120 000 participants.

The glycaemic index was first introduced in the 1970s to compare the rise of blood glucose from a given carbohydrate food in a patient in comparison to their blood glucose curve from the same patient ingesting glucose. This ranges from 20 for fructose to 100 for barley. In comparison to individuals eating low glycaemic index foods, those eating high glycaemic index foods had a greater risk of CVD events (51%) if there was pre-existing CVD, and even without CVD (21%). 

The highest glycaemic index foods were eaten in China, followed by Africa and Southeast Asia. The highest glycaemic loads were seen in Southeast Asia, followed by Africa and China. Glycaemic load is a better measure of a food’s effect on blood sugar taking into account how quickly it enters the bloodstream and how much glucose can be delivered.

There was less of an effect seen with glycaemic load only those with preexisting CVD showed an association between high glycaemic load diets and patient outcomes.

The participants were given a questionnaire, breaking foods down into seven categories based on glycaemic load and frequency, with a number of options each.

The broad geographic and economic scope of this study enabled the investigation of glycaemic index and load across a wide range of diets that would not be possible if it were restricted to sampling only Western-style diets.

“As expected, a higher glycaemic index was associated with an increased risk of adverse effects among the participants with a higher BMI, as reported previously,” the researchers wrote. “Although the glycaemic index of foods is independent of glucose-tolerance status, the overall postprandial glycaemic response to diet increases as the BMI increases.”

The authors acknowledge that economic development may have altered the mix of diets sampled over time, leading to an overestimation of glycaemic foods in China, for example. The findings nonetheless have important implications for primary and secondary prevention of CVD.

Source: MedPage Today

Journal information: Jenkins DJA, et al “Glycemic index, glycemic load, and cardiovascular disease and mortality” N Engl J Med 2021; DOI: 10.1056/NEJMoa2007123.

Categories : COVID General InterestTags :

Confusion Results in Vaccine Priority for ‘6.2cm’ Tall UK Man

On By ModernMedia

As a result of an error at his GP surgery, a healthy man aged 32 was offered an early COVID vaccination because his height was recorded as 6.2cm – giving him a calculated Body Mass Index (BMI) of 28 000.

Liam Thorp, political editor at The Liverpool Echo’s, said he was left “really confused” after he was offered the vaccine ahead of the government’s rollout, sharing the “frankly surreal” experience in a Twitter thread.  Vaccinations are not expected to begin until later in the year for the UK’s under-50s without underlying health conditions, perhaps as soon as March.

Manchester Evening News politics and investigations editor, Jennifer Williams, replied: “Should they not have been in touch before to see how the man the size of a thumb was getting on?” And palliative care doctor Rachel Clarke said: “This, for me, is the single best tweet of the entire pandemic, Liam. And may I please commend your decency in not exploiting your remarkable BMI to jump the queue?”

Despite being “on the chunky side”, Thorp didn’t think of his himself as obese. He said he was “uneasy”, thinking that he still ought to accept the invitation for vaccination, he contacted his GP about the situation whereupon he learned of the error which resulted in his height being recorded as 6.2cm – a mixup of his height as 6ft 2in (188cm). This resulted in his bizarre BMI of 28 000.

“If I had been less stunned, I would have asked why no one was more concerned that a man of these remarkable dimensions was slithering around south Liverpool. But he was very apologetic and really nice and I think he was just relieved that I found it so funny,” recalled Thorp.

Dr Fiona Lemmens, chair of NHS Liverpool clinical commissioning group, said: “I can see the funny side of this story but also recognise there is an important issue for us to address.”

Source: The Guardian