Category Archives: Preventative Medicine

New York City, via Newswire.com -- The Vilcek Foundation and The Arnold P. Gold Foundation announced in early June that the 2022 Vilcek-Gold Award for Humanism in Healthcare would be presented toDr. Mona Fouad, MD, MPH.

The Vilcek-Gold Awardis a shared initiative of the Vilcek Foundation and the Gold Foundation that embodies the missions of both organizations. The award is given annually to outstanding immigrant healthcare professionals in the United States and honors the positive impact that accessible, humanistic, and compassionate care has on public health.

Dr. Fouad has been selected for the 2022 Vilcek-Gold Award for her leadership in health disparities research and for her career-long commitment to equity in healthcare. Dr. Fouad is the founding director of the University of Alabama, Birmingham (UAB) Minority Health and Health Disparity Research Center; senior associate dean for diversity and inclusion in the UAB Marnix E. Heersink School of Medicine; and professor and director of the UAB Division of Preventive Medicine. Her work has been foundational to the development of rigorous research and interventions to make healthcare more accessible and equitable to historically underserved populations in the United States.

Dr. Fouad was born in Cairo, Egypt. She studied medicine at Alexandria University Medical School and subsequently completed an internship with the university hospital before practicing medicine in rural communities in Egypt for a year. Her experiences at the university hospital and in caring for underserved communities brought new insight into how socioeconomic factors influence access to healthcare and health outcomes.

In 1980, Dr. Fouad and her husband moved to the United States, first settling in College Station, Texas. In 1984, the couple moved to Birmingham, Alabama, where Dr. Fouad completed her Master of Public Health degree at the UAB. She then took a research assistant position in the Division of Preventive Medicine at UAB, assessing heart disease risk factors among city employees.

Similar to her experiences in rural Egypt, Dr. Fouad saw in Birmingham how deeply socioeconomic status, race, and ethnicity were tied to healthcare access and outcomes.

Dr. Fouad recognized that concrete scientific evidence of social determinants of health would be an essential foundation for the future development of interventions to support equitable health outcomes. With this goal in mind, she founded the Minority Health and Health Disparity Research Center at the UAB in 2002. Since its establishment, the center has grown from a few researchers to more than 200 members across a range of disciplines and specialties.

"Throughout her career, Dr. Mona Fouad has been so attuned to the importance of accessible health education and preventative care, and she has built groundbreaking systems to expand such care and galvanize more partners in her work," said Dr.Jan Vilcek, chairman and CEO of the Vilcek Foundation. "As a public health advocate in the southern United States, she has mobilized both her medical training and understanding of the human condition to improve the lives of the patients and communities she serves."

Said Dr.Richard I. Levin, president and CEO of the Gold Foundation, "For humanism in healthcare to thrive, it must be nurtured on both the individual level of compassionate connection and the far-reaching, system level. Dr. Mona Fouad has made exceptional contributions to both. Her creation of the UAB Minority Health and Health Disparity Research Center is just one example of how her vision, steeped in experiences from both Egypt and America, is transforming U.S. healthcare. We congratulate Dr. Fouad on her 2022 Vilcek-Gold Award, and we thank her for her great leadership in humanism in healthcare."

Dr.Selwyn Vickers, senior vice president and dean of the UAB Marnix E. Heersink School of Medicine commented, "From her first work as an MD in Egypt to her latest work, she has modeled the attributes of compassion, collaboration, and scientific excellence and created lasting change in the lived experiences of countless residents of Alabama and beyond. Her respect and empathy toward people living in underserved communities, and her dedication to creating lasting change to benefit is a defining feature of her professional career."

In addition to her work with UAB, Dr. Fouad served as a member of the National Institutes of Minority Health and Health Disparities Advisory Council and as principal investigator for several NIH and CDC health disparities projects such as the CDC-funded Racial and Ethnic Approaches across the U.S. (REACH US) Center and the Mid-South Center of Excellence in the Elimination of Disparities (CEED), which implemented, evaluated, and disseminated evidence-based interventions to reduce breast and cervical cancer disparities between African American and white patients. In recognition of her outstanding work in medicine and public health, Dr. Fouad was elected to the National Academy of Medicine in 2017.

The original press release concerning this award can be read here:

The Vilcek-Gold Award for Humanism in Healthcare includes an unrestricted cash prize of $10,000 and a commemorative heart-shaped trophy. The 2022 award will be presented to Dr. Fouad at theAssociation of American Medical Colleges (AAMC)annual meeting in November 2022.

The Arnold P. Gold Foundationwas founded in 1988 with the vision that healthcare will be dramatically improved by placing the interests, values, and dignity of all people at the core of teaching and practice. The Gold Foundation champions humanism in healthcare, which the foundation defines as compassionate, collaborative, and scientifically excellent care; the foundation embraces all, and targets any barriers that prevent individuals or groups from accessing this standard of care. The Gold Foundation empowers experts, learners, and leaders to create systems and cultures that support humanistic care for all. The Arnold P. Gold Foundation is a public not-for-profit organization, a federally tax-exempt organization under IRS Section 501(c)(3).

Read more here:
Vilcek-Gold Award for Humanism in Healthcare will be presented this fall to Health Equity Leader Dr. Mona Fouad - City-sentinel

Dr. David Margolius will become the city of Clevelands new director of public health, Mayor Justin M. Bibb announced June 8. He will start his new position Aug. 1.

We are pleased to welcome such an accomplished clinician and researcher to lead our public health work at this critical time when Cuyahoga County is once again seeing high transmission of COVID-19, Bibb said in a news release. In addition to his medical expertise, Dr. Margolius also has a strong record of leadership and community service, and he cares deeply about addressing health disparities in our communities.

Margolius is the division director of internal medicine at MetroHealth in Cleveland, an associate professor in the School of Medicine at Case Western Reserve University in Cleveland and faculty co-lead for the medical director leadership Institute at Harvard Medical Schools Center for Primary Care, according to the release.

He has been published in peer-reviewed journals on many public health topics from COVID-19 response in underserved communities and the opioid crisis, to hypertension in low-income populations and best practices in primary care, preventative medicine and family medicine, the release stated.

Margolius holds an M.D. from Alpert Medical School at Brown University in Providence, R.I., and a B.A. in biology from Brown. He completed his residency in internal medicine at University of California, San Francisco, where he spent his last year as chief resident of quality improvement and patient safety before returning to Cleveland and joining the MetroHealth system.

He lives with his wife and two children in the Old Brooklyn neighborhood of Cleveland.

Originally posted here:
Margolius named Cleveland director of public health - Cleveland Jewish News

Guest columnist Dr. Robert A. Salata is a professor of medicine, international health and epidemiology/biostatistics at University Hospitals Cleveland Medical Center and Case Western Reserve University. As the STERIS Chair of Excellence in Medicine and the John H. Hord Professor and Chairman of the Department of Medicine Chief of the Division of Infectious Diseases, he studies the epidemiology of infectious diseases, clinical trials of new therapeutic agents and vaccines for emerging infections such as COVID-19.

As much as we all want the pandemic to end, COVID-19 unfortunately has not gone away -- and wont for some time.

As an infectious disease specialist and chairman of the Department of Medicine at University Hospitals Cleveland Medical Center, I have seen surges in COVID cases firsthand and know how important it is to stay vigilant.

A two-month plateau in numbers this spring caused some to tuck away their masks, but we are now seeing another spike, propelled by an Omicron BA.2 subvariant that is more transmissible than the last.

Cases were up 0.7 percent in the first week of June, to 283,000 overall in Cuyahoga County.

As we head into the summer months, here are three things to keep in mind about COVID-19:

An Omicron sub variant -- known as BA.2.12.1 -- is now the dominant strain among new United States virus cases.

Viruses are constantly changing, and sometimes these mutations result in a new variant. Omicron BA.2.12.1 is more contagious than any other variant and often presents with upper respiratory symptoms that appear like a bad cold.

Symptoms of the BA.2 subvariant may include sore throat, stuffy nose, coughing, sneezing and headache. The good news, though, is that this variant has a reduced ability to infect the lungs, making it less likely for sufferers to experience shortness of breath, chest pain or pneumonia.

Because the symptoms of Omicron BA.2 resemble a summer cold or allergy, its important, if you are feeling any symptoms or have been exposed to COVID, to get tested.

Vaccinations continue to be an important tool in fighting the severity of COVID-19.

If you havent been vaccinated or boosted, consider scheduling it now. Multiple studies have indicated that if you receive the primary series of COVID-19 vaccines and get a booster dose, the rates of serious complications and death related to COVID infection are less.

For those who have been waiting for the roll-out of vaccines for children ages 6 months to 5 years, we have good news: June 21 is the anticipated FDA approval date. Studies have shown that the vaccine is safe and has been well tolerated in children.

Getting the vaccine protects kids from severe sickness and hospitalization and helps protect vulnerable adults they might interact with, like grandparents or people who are immunocompromised.

As the virus has evolved, so have the treatment options.

While the best option for COVID treatment is still to avoid getting it, we are seeing more options for treatment.

There are now two approved oral antiviral medications -- Paxlovid and Molnupiravir -- for early treatment of COVID infection in individuals at risk for complications, hospitalizations and death.

And Remdesivir, which was the first drug approved by the FDA for treatment of hospitalized COVID patients, can now be given as a three-day outpatient course. (Originally, it had to be given intravenously for five days).

We also have a preventative option showing promising results. Evusheld -- an antibody drug from AstraZeneca -- is the first antibody therapy authorized in the U.S. to prevent COVID-19 in immunocompromised persons.

In summary, the COVID-19 pandemic is still going on, but we are hopeful that with control measures, newer vaccines and early treatments that we can make this infection endemic -- meaning the virus may be more seasonal and manageable.

We continue to move at the speed of science in our approach to this significant worldwide problem.

To learn more, sign up for NCJWS webinar: COVID 19: WILL THIS EVER END? - Cleveland (ncjwcleveland.org) at 7 p.m. Tuesday, June 21.

Readers are invited to submit Opinion page essays on topics of regional or general interest. Send your 500-word essay for consideration to Ann Norman at anorman@cleveland.com. Essays must include a brief bio and headshot of the writer. Essays rebutting todays topics are also welcome.

Go here to see the original:
Three things to know about COVID-19 at this time: Dr. Robert A. Salata - cleveland.com

A new drug called dostarlimab saw astonishing results in a 12-person rectal cancer trial: Every one of the dozen patients went into remission.

All the patients were still in remission in a six-month follow-up of the trial as well. Additionally, none of the patients had received chemoradiotherapy or undergone any preventative surgery, and no cases of progression or recurrence were reported during the volunteers follow-up appointments, according to the study.

The drug, sold under GlaxoSmithKlines brand name of Jemperli, has already been approved by the Food and Drug Administration in the treatment of certain endometrial cancers.

The study was published to The New England Journal of Medicine, and even though it featured so few patients, such a success rate is unheard of, according to Alan Venook, a colorectal cancer specialist at the University of California, San Francisco who spoke to The New York Times.

The authors of the trial caution that while their study is promising, it was quite small, and further research featuring more diverse ethnic backgrounds will need to be conducted to see the true efficacy of dostarlimab.

By the end of the trial, it is expected that there will be 30 total participants, which could give a better idea of how safe and effective the cancer-fighting drug truly is, according to CBS.

But most experts and rectal cancer specialists are celebrating the news as great cause of optimism.

Dostarlimab costs about $11,000 per dose for a standard course of treatment, according to the Times, and is administered every three weeks for six months time.

The drug also had what experts are calling a surprisingly low rate of side effects, which were generally well-tolerated, especially when compared to conventional cancer treatments.

Typically, treatments can leave patients with a lower quality of life due to permanent effects on fertility, sexual health, bowel and bladder function, Andrea Cercek, a medical oncologist and principal investigator in the study stated in a news release.

This drug is one of a class of drugs called immune checkpoint inhibitors. These are immunotherapy medicines that work not by directly attacking the cancer itself, but actually getting a persons immune system to essentially do the work, Hanna Sanoff of the University of North Carolinas Lineberger Comprehensive Cancer Center told NPR.

These are drugs that have been around in melanoma and other cancers for quite a while, but really have not been part of the routine care of colorectal cancers until fairly recently, Sanoff added.

The first participant in the trial told the Times that she recalled crying happy tears at the news her cancer had gone into remission. Sascha Roth said that when she told her family, they didnt believe [her], but that two years later, she is still cancer free.

See the rest here:
Remission seen in every rectal cancer patient in small study of drug - The Hill

Throughout the pandemic, the SARS-CoV-2 virus has laid bare weak points in the worlds health care systems. This has been true in arguably every country and every community, but the fractures have been especially apparent in rural areas, where poor access to health care long predated the pandemic.

In this three-part story, Undark explores the gaps in rural health care systems around the world, following the daily work of a village health worker in a small township in central Zimbabwe; a newly graduated rural doctor on a required year-long stint at a remote clinic in northern Ecuador; and a family doctor at a private practice in upstate New York.

Rural life in each of these countries is vastly different, and the challenges that the health care workers face, in some cases, also vary. In Hoja Blanca, Ecuador, for instance, its a three-day round trip just to send a Covid-19 test for analysis, requiring travel by motorcycle, bus, and ferry, and in Makusha Township, Zimbabwe, the health care worker gets around on a bike. Meanwhile, doctors in New York State have access to couriers and can hop in a car for house calls. There are also inequalities when it comes to vaccine availability, funding, and even access to basic medicines like ibuprofen.

But Covid-19 has also revealed common problems. There are far fewer doctors and nurses in these remote areas compared to their urban counterparts. Each rural community feels the pinch of badly broken health care systems on the national level. Covid misinformation and disinformation, as well as pandemic fatigue, reaches even the most remote areas. And as the pandemic lingers, all of the health care workers, no matter their country of origin, continue to toil to keep their villages safe.

This reporting project was created in partnership with Undark and produced with the support of the International Center for Journalists and the Hearst Foundations as part of the ICFJ-Hearst Foundations Global Health Crisis Reporting Grant.

On a recent Sunday, Lucia Chinenyanga, 42, navigates her bicycle through the bumpy terrain of Makusha Township in Shurugwi District in rural Zimbabwe, 200 miles outside the countrys capital city of Harare.

Chinenyanga, a village health worker, is headed to a nearby home to educate a family on vaccines and other Covid-19 protection measures. On her way, she meets Robert Nyoka, a local. As they talk, he expresses concern about his pregnant wife receiving her second dose of the Covid-19 vaccination.

Chinenyanga assures him its safe. Your wife can receive her second jab, she says. But should she feel any slightest side effect afterwards, she must report to the nurses to check her.

As a village health worker, Chinenyanga oversees and responds to the health needs of people in Makusha Townships Ward 9. She works at the local clinic. Her tasks include education around tuberculosis, home-based care for the elderly, monitoring pregnant women, and health awareness programsespecially on Covid-19 vaccines. The position required three weeks of training conducted by the Ministry of Health and Child Care, which coordinates health workers. She has worked in the village since 2019, the year before the pandemic hit Zimbabwe.

While nearly two-thirds of Zimbabwes 15.3million people lived in rural areas like Makusha Township as of 2020, rural health facilities in the country are often under-resourced, with fewer nurses and doctors compared to urban hospitals. Village health workers such as Chinenyanga fill the gap. And although the village health workers play an essential role in the primary health care system, providing care for the marginalized or remote communities in rural areas, they receive little paythe equivalent of $42 every month from nongovernmental organizations that work with the government.

The health sector in Zimbabwe is a mix of public and private facilities; the latter are costly, charging more and offering better services compared to government-run institutions. In Shurugwi, there are three private facilities, but most local residents cannot afford those services due to poverty and opt for the public clinics. Others rely entirely on the services of health workers who do community rounds. Shurugwi consists of 13 wards, with a population of 23,350 according to a 2014 census.

The pandemic has stretched the system even more. Over the past months, Covid-19 has increasingly become a dominant problem, killing high numbers of community members, Chinenyanga says in January following a spike in Covid-19 cases in the country. The deaths came with shortages of pretty much every necessity: quarantine facilities, personal protective equipment, medicines, and doctors. Like many places around the world, the country has also struggled with people sharing fake news about the dangers of vaccination.

Enforcing Covid-19 protocols can be draining for Chinenyanga. Every day she has to convince the rural villagers, mostly small-scale gold miners in the area, many of whom are skeptical of vaccines, to mask up, practice physical distancing, sanitize, and avoid gatherings at places like pubs, where people tend to forgo prevention measures.

Despite some pockets of vaccine hesitancy, as ofJune 7,2022, a total of4.3million Zimbabweans have been fully vaccinated for Covid-19, amounting to about28percent of the population.More than a millionhave received a booster shot.

In Shurugwi, people grew scared when family members started dying of Covid-19, Chinenyanga says. One family would lose both the wife and the husband at the same time. This is when locals started understanding that Covid-19 wasnt just a flu, but a deadly disease which had come to our community.

***

When Zimbabwe gained independence from the United Kingdom in 1980, the new countrys health sector adopted a strong focused health care system, moving from only providing more advanced health care services for the urban population to involving more vulnerable sections of the society in rural areas. Health workers like Chinenyanga now play a pivotal role in the countrys health systems, says Samukele Hadebe, a senior researcher at the Chris Hani Institute, a South African think tank.

In rural areas, the health workers must be empowered with both finances and resources to do their job effectively, he adds, as a majority of people rely on them.

If you come from a health background you will realize those who have succeeded in building universal health care or a viable health care system, it is not the specialist doctors, he says. Wherever there is a successful health care system, it is actually the basic community health care, the one that in some countries where they dont even earn salaries. Those are the people fighting to just get recognized. Those are the people who manage the fundamental work.

But over the years, Hadebe says, Zimbabwes government neglected the rural health sector by not taking care of its health care professionals and paying them inadequate salaries, which pushed many qualified workers to leave the country for better opportunities overseas. In Zimbabwe, the infrastructure is gone, he adds, and health workers from the basic to the specialist are leaving the country. Why? Not just because of the salaries, but because someone will leave the country because they are worried about social security.

Zimbabwes 2010 Health System Assessment from USAID, a U.S. federal agency focused on foreign development, shows that there was a dramatic deterioration in Zimbabwes key health indicators beginning in the early 1990s. The current life expectancy for Zimbabwe in 2022 is just under 62 years, a 0.43 percent increase from 2021, according to projections from the United Nations.

With little hospital funding from the government, village health workers have to do their work with limited resources. Clinics likeChinenyangasin Makusha are poorly resourced and cannot accommodate patients with severe Covid-19 or other critical ailments, as there are no relevant medicines or oxygen tanks.

Even larger hospitals in Zimbabwe dont always provide oxygen to every patient, especially if the patient cant pay. You must have money upfront, Hadebe says. And how many people can access that? So, its a dire situation.

Itai Rusike, who heads the Community Working Group on Health in Zimbabwe, agrees that most rural health care facilities in the country were not equipped to deal with severe cases of Covid-19. In addition to the lack of oxygen tanks, he says, we also do not have intensive care units in our rural health facilities. Most of the rural facilities have no doctors, he adds, and the nurses who do work in rural areas may also not be well-equipped and skilled enough to deal with severe cases of Covid-19.

In November 2021, the Minister of Finance and Economic Development, Mthuli Ncube, announced that the country had acquired 20 million doses of vaccines. China reportedly committed in mid-January to donating 10 million doses over the course of 2022, which can be used for both initial and booster shots.

Rusike says that to ramp up the vaccination drive program, community outreach is needed, especially in rural areas. We need to take vaccination to the people, he says, rather than just wait for the people to come to the health facility and get vaccinated.

I think it is important, especially in remote locations, we come up with innovative strategies to take vaccination to the people, he adds. We know there are certain hard-to-reach areas where we can even use motorbikes to make sure that people can be vaccinated where they are, in their communities.

***

In addition to resource shortages, Chinenyanga has experienced another serious challenge most days in her work: vaccine misinformation and disinformation.

The problem is common across rural Zimbabwe, according to Rutendo Kambarami, a communication officer at UNICEF, who says that the most common reason communities are not taking the vaccine is fear.

Even though much of Zimbabwes population lives in rural areas, they still are connected on social media through mobile devicesand the mobile devices and social media platforms allow for plenty of access to inaccurate information and outright conspiracies about vaccines. So we realized that we needed to give more information in order to dispel misinformation, she said at a December workshop on Covid and mental health for journalists in Zimbabwe.

Village health workers, as front line workers, and even the teachers were saying: We needed to do more interpersonal communication within those areas. So, front line workers play an incredibly huge role in terms of even misinformation and disinformation.

As Chinenyanga wraps up her day, after visiting several homes, she agrees that social media has contributed to misinformation. The people she serves in the Makusha community often share with her unproven remedies to treat Covid-19. She lists some of the misinformation that shes seen so far. People believe in steaming, that it helps. They also believe that eating Zumbani, a woody shrub that grows in the country, also prevents Covid-19, she says.

Still, she manages to smile as she leans against her bicycle. She says she loves her job and its usefulness to the community. As village health workers, our role is to share information we are taught by the Ministry of Health, she says. We prioritize prevention as the most effective tool against Covid-19.

Karen Topa Pilalooks around the windowless reception area in the small health care station of Hoja Blanca, Ecuador, its pale yellow walls stained with patches of mold. When did the electricity go out last night? Topa Pila, a doctor in this remote corner of the country, asks. Her co-workers shrug, throwing worried glances at a small container filled with ice packs. Its only 8:30 a.m. one morning in December 2021, but outside its already over 70 degrees.

Topa Pila closes a cooler containing 52 Covid-19 nasal swabs. Those tests need to be refrigerated and we only have one fridge, which is exclusively for vaccines, she says. Her team has nowhere to store the tests, she adds, and so to avoid getting them spoiled in the jungle heat, the clinic wants to use up all of them on the same day. The very next morning, a health care worker is going to take them to the laboratory in the district hospital.

Topa Pila, 25, and her team arrived in Hoja Blanca, a village of 600 located in the heart of Ecuadors Esmeraldas province, in September 2021. As freshly graduated health care professionals, they all are required to serve an ao rural, working one year in a rural community in order to get their professional license or advance into postgraduate courses in medicine. (The Ministry of Public Health implemented the ao rural in 1970, and the practice is also common across Latin America.) Topa Pilas team is the third deployed in Hoja Blanca since the start of the pandemic. The Hoja Blanca station is also responsible for six other communities, made up of mestizos, Indigenous Chachis, and Afro-Ecuadoriansabout 3,000 people in total. Some of the communities are so remote that to reach them, the health care workers traverse thick rainforest and then travel by canoe for a whole day.

Ecuador has suffered big losses from the pandemic. In the early months,corpseslittered the streets of the countrys biggest city, Guayaquil. By June 2020, the mortality rate from the virus reached8.5 percent, one of the highest in the world at the time. As of June 5, 2022, the countryrecorded35,649 official Covid deaths, although the real count is likely far higher.

Many public health experts agree that Covid-19 has also surfaced deep-rooted systemic problems in Ecuadors rural health care system. In 2022, Ecuador, the smallest of the Andean nations, reached more than 18 million inhabitants; an estimated 36 percent live in rural communities. As with private health care providers, the countrys public health care system is fragmented, divided among various social security programs and the Ministry of Public Health. There are about 23 physicians and 15 nurses per 10,000 people on average. But only a small portion of the countrys health care professionalsroughly 9,800, by the estimate of Dr. John Farfn of the National Association of Rural Doctors serve the more than 6.3 million rural Ecuadorians.

Although Ecuador is relatively financially stable, many Ecuadorians lack access to adequate medical care and the country has some of the highest out-of-pocket health spending in South America. In rural areas, access to hospitalas well as clinics like Hoja Blancasis hampered by bad infrastructure and long distances to facilities. Before the pandemic, Ecuador was undergoing budget cuts to counter an economic crisis; public investment in health care fell from $306 million in 2017 to $110 million in 2019. As a result, in 2019, around 3,680 workers from the Ministry of Public Health were laid off. Ecuador has also experienced long-standing inconsistencies in health leadership. Over the last 43 years, the country has had 37 health ministersincluding six since the start of the pandemic.

Before the Ministry of Public Healths selection system placed Topa Pila for her service, she had never been to Hoja Blanca, and it took her more than eight hours to get there. She says that when she first arrived at the modest health care station, she thought, This is going to collapse.

Early in the pandemic, Ecuador weathered shortages in everything: face masks, personal protective equipment, medications, and even health care workers. By April 2020, the government had relocated dozens of doctors and nurses from rural areas to urban hospitals and health centers, leaving many communities without medical attention.

At one point, says Gabriela Johanna Garca Chasipanta, a doctor who spent her ao rural in Hoja Blanca between August 2020 and August 2021, her team didnt even have basic painkillers like acetaminophen or ibuprofen. It was an infuriating experience, she says. I even had to buy medication out of my own pocket to give to some patients, the ones who really needed it and didnt have the economic means to get it. Some rural outposts had to resort to desperate DIY solutions during the worst months of the pandemic, says Esteban Ortiz-Prado, a global health expert at the University of Las Americas in Ecuadorjury-rigging an oxygen tank to split it between four patients, for instance, and using plastic sheets to create isolation tents in a one-room health center.

The pandemic has strained rural doctors in other ways, too. In 2020 and 2021, Ecuadors National Association of Rural Doctors received many complaints of delayed salaries, some more than three months late. There were rural health care workers who were even threatened by their landlords that they were going to be evicted, saysFarfn, a doctor and former association president.

Even under better conditions, remote health care outposts are only equipped to provide primary care. Anything more serious requires referral to the district hospital, which in Hoja Blancas case means a 300-mile round trip to the parish of Borbn.

The health administration used to take into account Ecuadors geographical and cultural diversity and the poor infrastructure in rural areas. But in 2012, the government restructured the system into nine coordination zones that public health experts say no longer follow a geographical logic. You cannot make heads or tails of it, saysFernando Sacoto, president of the Ecuadorian Society of Public Health. This is not just a question of bureaucracy, but also something that has surely impacted many peoples health.

Although there have also been significant developments in the health care sector in the past 15 yearsincluding universal health coverage and a $16 billion investment in public health from 2007 to 2016it mostly focused on the construction of hospitals, says Ortiz-Prado. But the countrys leadership didn't pay too much attention to prevention and primary health care, he adds. The system was not built to prevent diseases, but was built to treat patients.

In 2012, the government also dismantled Ecuadors Dr. Leopoldo Izquieta Prez National Institute of Hygiene and Tropical Medicinewhich was responsible for emerging diseases research, epidemiological surveillance, and vaccine production, among other things. (It was replaced by several smaller regulatory bodies, one of which failed completely, according to Sacoto.) The majority of a nationwide network of laboratories shut down as well. Sacoto and other experts believe that if the government had continued investing in the Institute rather than dismantling it, it would have lessened the severity of the pandemics impacts in Ecuador.

Initial plans to track and trace Covid-19 cases faltered; the country had barely any machines to process PCR tests, the gold-standard Covid-19 tests. During the first days of the pandemic, samples collected in Guayaquil were taken to Quito by taxi, Sacoto says, because that was the only place PCR tests were being analyzed. But public transportation to rural communities is limited, so even the few rural residents who had access to tests sometimes waited two weeks for test results.

***

Topa Pilas team tries to convince everyone they cross paths withthe butchers wife, people waiting for the bus, men at the cockfighting arenato take a Covid-19 test. While the PCR results are faster than they used to be, they still take a week, as one of the health care workers has to personally shuttle the samples to Borbna 3-day roundtrip that involves a motorcycle, two different buses, and crossing a river with a shabby ferry. Up until yesterday, we had Covid-19 rapid tests. Today, the [district] leader took all the tests we had, says Topa Pila. The district hospital had requested the rapid tests, she adds, because theyve run out of tests and they need them.

Since Hoja Blanca is fairly isolated, the community has had very few Covid-19 cases, and all were mild. Topa Pila fears having any patients in a critical condition, Covid-19 or otherwise, because all she can do is ask the villagers and ferry operator for help with transport. There are no ambulances. We dont have oxygen because the tank we have over there is expired and you cant use it anymore, she says. Weve asked for replacement but nothing has happened.

The way Topa Pila sees it, its a lot to ask of the inexperienced health care workers on their ao rural. We start from zero without knowing anything every year, she says, recalling that the previous team had already left by the time she arrived in Hoja Blanca. And all of those patients whose treatments have been supervised by a doctor for a year lose their treatments, because they knew the doctor would come to their house, she says. We arrive and dont know where they live, since as you can see there are no addresses here. The Covid-19 pandemic has further distanced the rural doctors from their patients, she adds. Between the lockdowns and the coronavirus, other health matters like childhood vaccinations have been put off.

As in other parts of Latin America, the Covid-19 crisis in Ecuador also allowed corruption to fester. Sacoto says he believes the health care sector has become a bargaining chip among politicians. There really are mafias embedded in, for example, public procurement, he says, because the public procurement system is so convoluted that only the person who knows how the fine print works benefits. Between March and November 2020, the countrys Attorney Generals office reported196corruption cases related to the Covid-19 pandemic, including allegations of embezzlement and inflated pricing of medical supplies.

Lately, there have been signs of improvement. After taking office in May 2021, the government of Guillermo Lasso has accelerated vaccination efforts against Covid-19, approved a new program to tackle childrens malnutrition, and announced a Ten-Year Health Plan to improve health equity.

Sacoto says he remains skeptical whether these plans will translate to concrete and lasting actions. A good start would be decentralizing the health care system by building more rural clinics, he says, which could build up a network for preventative care for everything from childhood malnutrition to future pandemics. Ortiz-Prado says the country should better integrate its fragmented health care systems to make it easier for patientsand their recordsto move between them when needed. And it needs to improve the working conditions and salaries of rural health care workers to make the work more appealing, Farfn says, while also creating more permanent positions focused on rural communities. There is a lack of concern, lack of budget, he says, adding, Its a vicious circle, and sadly, governments are trying to apply Band-Aid solutions for the health issues here.

But all of that is in the future. Now, back at the Hoja Blanca health care station, the lights flicker back on in less than a day. The vaccines in the fridge are safe. But the 52 Covid-19 tests are still at risk: A health care worker must take the cooler to the lab in Borbn. There were heavy rains the night before, though, and water levels havent dropped enough for the river ferry to restart operations. Its just the first leg of what will ultimately be a 13-hour journey, and the icepacks are quickly melting amid the balmy equatorial heat.

Before Covid-19, there were no doctors in the village of Otego in central New York. Now there is one. During the pandemic, Mark Barreto quit his job at the Veterans Affairs hospital 89 miles away in Albany and opened a family medicine practice in his basement.

Just 910 people live in Otego, which sits along the Susquehanna River in Otsego County, a pastoral landscape of rolling hills and narrow creek valleys. Barreto lives on a dead-end road, a single street with pastureland on both sides. The downstairs waiting room looks like it could be anywhere in rural Americaa row of identical burgundy chairs against a pale beige wall, kids art hanging above.

In early December 2021, two of Barretos neighbors make an appointment. April Gates and her spouse Judy Tator are both in their 70s. They live around the corner. A friend joined them for Thanksgiving dinner and subsequently came down with Covid. Two weeks later, neither woman has symptoms and both got negative results with at-home tests. But theyre worried. Theyve come to take PCR tests, plus get a blood pressure check for Tator.

You dont have to be symptomatic. Its never bad to get tested if youve had a positive exposure, says Barreto. Are we being overly precautious? Maybe. But particularly with your cardiac history, youre at higher risk.

I worry most about giving it to someone else, Gates says. Thats the biggest thing.

New York State has an estimated 20.2 million residents. Two years into the pandemic, over one quarter of the population has had Covidmore than 5 million cases and more than 71,000 deaths, according to the state department of health. In the first six months of the pandemic, New York hospitals were overwhelmed with more Covid patients than beds. While they've continued to be overstretched, thelimiting factoris staffing. A similar situation has played out across the country: Medical personnel have quit in record numbers, according to the U.S. Bureau of Labor Statistics. Turnover rates were four times higher for lower-paid health aides and nursing assistants than physicians, peaking in late 2020, JAMA reported in April.

The problems are most acute in rural areas that were already chronically understaffed. We have a health care shortage in the county, in the region, says Amanda Walsh, director of public health for Delaware County, just across the river from Otego. Walsh and her nursing staff averaged 12 hour days, seven days a week, for all of 2020. It was an insane amount of time, she says. The hours only eased after the state established phone banks with remote contract tracers, and Walsh started sending her team home by six, even though the work wasnt done.

In Barretos office, after 40 minutes chatting with Gates and Tator about their health concerns, Barreto swabs both patients, walks them out, and then calls a courier to pick up the tests. While he waits, he pulls up the Otsego County webpage. The Covid dashboard shows 7,235 total cases, and the county recently broke its record for most active cases, at 386. Before December, that number had never climbed above 300.

Barreto swivels away from his desk. In the first months of Covid, he says, medical systems that were already dysfunctional simply fell apart. Commuting to Albany on empty highways, hed pass a digital DOT sign reprogrammed to read: Stay home, save lives. He took the message to heart, wondering, he recalls: What is my role as a health care provider? Because we're expected to put ourselves in harm's way to help people. The problem is we didn't know what to do to help them.

For 15 years working in hospitals, Barreto had been dissatisfied with how he saw patients treated. He notes two problems. One is getting access in a reasonable amount of time. And two is continuity of care, he says. The ongoing relationship is key, someone who knows your full story, he says, because thats what your medical history is, its a story.

When Covid hit, he adds, things only got worse.

***

With each successive wave of Covid, the disease spikes in cities and then rolls out to rural areas. Towards the second half of 2020, both case rates and mortality rates were highest in rural counties, according to USDA researchespecially those only with communities of 2,500 people and under. The study pinpointed four contributing factors: older populations, more underlying health conditions, less health insurance, and long distances from the nearest ICU.

In December, omicron followed the same pattern, peaking in New York City two weeks before it really hit Otsego County, says Heidi Bond, who directs the countys department of public health. By early January, active cases in Otsego County shot up to 1,120 before the county abruptly stopped reporting the data. The health department was swamped, Bond says, and it was not possible to get an accurate number with the limited contact tracing and case investigation that is being done.

Sparsely populated regions like central New York, which have smaller health departments and hospitals, are easily overwhelmed during surges, says Alex Thomas, a sociologist at SUNY Oneonta who studies rural health care. Otsego County has fewer than 10 public health staff working on Covid, and 14 ICU hospital beds. Neighboring Delaware County has no ICUs.

In a 2021 study of New York public health staff, Thomas and his team found that 90 percent felt overwhelmed by work, and nearly half considered quitting their jobs. A survey from the Centers for Disease Control and Prevention of about 26,200 public health employees found similar results, with anxiety, depression, PTSD, and suicidal ideation among the fallouts. Thomas predicts dire consequences: We have a serious public health emergency, and there's nobody to take care of it.

Covid revealed long-term flaws in the system, and Barreto predicts the U.S. health care system will eventually collapse on itself. Bond has a more positive perspective: Health care is stronger now after the trial by fire, largely because we know a tremendous amount more than we did two years agoabout Covid, but also about how to help institutions adapt to evolving medical needs.

Before Covid, Bond adds, public health was certainly not a priority at the state or local level. Few elected officials wanted to invest enough or plan for providing robust care for a future crisis. Establishing better partnerships with community organizations let her team overcome these funding deficiencies. Having those in place moving forward, you know, things will happen much more quickly, she says, because we know who to reach out to, to just lend us a hand.

In Otsego County, dealing with the fallout of Covid became a community effort. Volunteers sent up a local Facebook group to share information and services; it quickly had more than 1,000 members. The local hospital organized an ad hoc County Health and Wellness Committee that met biweekly on Zoom. And between 50 and 100 locals representing medicine, public health, and social service agencies, non-profits, and churches exchanged information and ideas and then stepped up to help, says Cynthia Walton-Leavitt, a pastor at a church in Oneonta.

Still, Bond says she worries that public opinion will hamper her departments ability to prepare for the future. What I worry about is the fatigue, the kind of mental fatigue of Covid, she adds. We can't let our guard down.

***

Before Christmas, Barreto drives about 15 minutes to Oneonta to see his own doctor. Oneonta is the biggest city in six counties with 13,000 residents and has the closest hospital to Barretos home practice.

Barreto brings a list of questions, knowing how hard it can be to squeeze out answers from his doctor in the allotted 15 minutes. There are always two agendas. There's your agenda as a doctor, why you wanted to see the patient, he says. And then there's a patient's.

After his appointment, Barreto grabs breakfast and then heads to his first house call of the day. He says he enjoys making home visits like an old-time country doctor. He crisscrosses three counties to see patients, 50 miles in any direction, and gives them his cell number, encouraging them to call whenever they need him. He sees two or three people per daycompared to eight to 15 in former hospital jobs.

Barreto guides his minivan to the interstate and then climbs out of the valley to visit Al Raczkowski, age 88. A former combat medic, Raczkowski still struggles with PTSD, has partial heart failure and some dementia, and requires weekly visits from nurses and therapists through a palliative care agency.

The family has no yardthe hemlocks grow right to the door. Barreto knocks then peeks in. Raczkowski stands in his semi-finished basement wearing a winter coat. Hes not wearing his hearing aid so Barreto shouts: Al, is Maureen here? Do you know why I came?

Raczkowski sits down on a futon. You're here to check on me, he says. With that, Barreto gets to work. The room is crowdedfirewood and tools jumbled by a woodstove, cardboard boxes, cases of soda and seltzer. A miniature Christmas tree stands on one table, an unfinished instant soup cup on another. Barreto unearths a stool and sets up his laptop beside the soup.

Do you remember why were wearing these masks? Barreto asks. Raczkowski isn't sure. Remember about Covid? Were wearing these masks to prevent spreading disease. Raczkowski nods.

Maureen, Al's wife, appears and shuffles to a seat. For the next hour, the three converse as Barreto performs his examination, mostly asking Raczkowski questions that Maureen answers. How are things with the care agency? Without their help I dont even think we would be here, Maureen tells him. Living on this mountain for 76 years. The nurses give Raczkowski showers, check his blood pressure and vitals, and keep him company.

Barreto asks how the medication is going. Its OK, Raczkowski says, but youd do better with a bottle of brandy.

Maureen complains about her husbands other health care. She drove him 80 miles to the Albany VA to try his new hearing aid, only to learn it had been mailed. As for the new psychiatrist? She closed our case, Maureen says. An appointment scheduled for September never happened, she adds, and no one ever answered her phone calls.

After Raczkowskis appointment, back in his car, Barreto vents frustration: If you look at a hospital system, and you count the number of medical personnel, versus the number of administration, there's a skew that shouldn't be there. All that oversight, he adds, doesn't help your relationship with your patient. It doesn't help them get the medicine.

Then he winds back down the mountain road to his next appointment.

See more here:
On Three Different Continents, Rural Health Strains under the Weight of the Coronavirus - Scientific American

Within the serene greenery of Burlingtons landscape lies an intimate yet vibrant campus that is the fifth-oldest university in New England, after Harvard, Yale, Dartmouth, and Brown. This is the University of Vermont (UVM), a top research university championing multidisciplinary learning at all levels of study. Here, ideas and opportunities flow dynamically between student and faculty, enhanced by its stunning natural landscapes that foster some of the countrys brightest minds.

The Graduate College is where excellence is taken up a notch to reshape how ideas are expressed. Thanks to its world-class faculty and outstanding research, this small but mighty knowledge powerhouse offers a world of opportunities for students to instigate meaningful changes. Take its College of Nursing and Health Sciences (CNHS), for instance, which promotes the highest standard of patient-centric care committed to improve their quality of life. Through hands-on experience and rigorous professional preparation, graduates emerge career-ready to deliver compassionate and informed healthcare to others.

Far from merely preparing graduates for their profession, CNHS relies on evidence-based practice to stay on top of current developments in healthcare and wellness. In addition to professional doctorate programmes in Nursing, Occupational Therapy and Physical Therapy, incoming students can choose from any of the five masters degree programmes and an Interprofessional Health Sciences Ph.D. programme. For aspiring nurses, there are two options to enrol into the programme either through the Nursing: Master of Science Clinical Nurse Leader route for those with prior nursing degrees, or the Direct Entry route if you have a bachelors degree or higher qualification in non-nursing fields.

Outside of nursing, CNHS offers specialisations in speech-language pathology, physical activity and wellness science, and medical laboratory science for students who want to branch out to other health disciplines. Dive into practical work under licensed speech-language pathologists to prepare for clinical fellowship, engage in preventative health through expert understanding of the mind-body connection, or develop new technologies to stop communicable diseases the potential to go further is endless at the college.

With UVMs reputation as a top 100 public research university in the US, its unsurprising that CNHS is engaged in research to advance multimodal treatment emphasising prevention and wellness-promotion strategies. Researchers at the college have made headway on multiple fronts in the health field, anywhere from employing precision medicine to improve cancer therapies to long-term effects of concussion in academic performance. The Interprofessional Health Sciences (IHS) programme provides an opportunity to engage in interprofessional research across fields and in the biomedical and psychosocial domains relevant to the health sciences.The UVM Dissertation of the Year award in Social Sciences, Humanities and the Creative Arts for 2021-22 was earned by an IHS student, Dr. Mariana Wingood.

Taking the reins in innovation, UVMs Larner College of Medicine has been at the forefront of reimagining a holistic approach to healthcare for generations. Since its founding in 1822, this seventh-oldest medical school in the US is ranked first nationally in active patient care and primary care physicians per capita, and is home to over 300 graduate students across multiple branches of medical studies.

With the University of Vermont Medical Centre on campus, students benefit from a vast network of clinical programmes and services firsthand, which they will repeatedly interact with throughout their studies. The direct student-faculty engagement is key to foster an immersive and experiential environment for cultivating advanced clinical and research skills.

For instance, the Master of Science in Pharmacology offers a thesis-based degree option where experimentation in areas such as cardiovascular regulation and medicinal chemistry can be conducted in any pharmacology-focused lab within the university. The faculty also train doctoral students in cross-disciplinary programmes such as neuroscience or cellular, molecular and biomedical sciences.

The college-town environment of Burlington and close-knit research community at the university encourage greater interactivity among students for dynamic idea exchange. Source: Graduate College, the University of Vermont

The result of this collaborative nature in disseminating knowledge speaks for itself: students go on to write award-winning original theses, while faculty members are inducted into prestigious scientific academies such as the National Academy of Sciences and the American Association for the Advancement of Science (AAAS).

Aside from the Doctor of Medicine (MD) qualification, the college is home to other cutting-edge graduate programmes in health sciences. If youre keen on pursuing your passion to the fullest, the doctorate programmes at the college can prepare you for promising futures in academia, industry, or governmental work.

The 100% online Master of Public Health takes population health beyond pathology to explore larger issues shaping policies and crisis interventions to tackle current and emerging challenges in healthcare disparities. Theres also the option to pursue graduate certificate courses if you cant commit to long-term study. Earn a more thorough understanding in fields such as epidemiology and professional end-of-life care to progress to the next rung of your career ladder within the sector while surrounded by a close-knit scientific community.

Actionable science starts here

Part of the solution in improving patient care access starts with training adept and compassionate health practitioners. UVM has all the tools and expertise in its arsenal to consistently push the boundaries of medicine for the betterment of collective wellbeing through evidence-based studies.

The Graduate Colleges health-based programmes not only conform to the most current development in scientific research; theyre also humane in practice, putting patients needs as a top priority in delivering efficient and quality care. It may be science that drives UVMs trailblazing achievements in healthcare, but its empathy that makes all the difference in a patients healing journey.

To join a team of outstanding healthcare practitioners at the Graduate College, click here.

Follow the University of Vermonts Graduate College on Facebook and Twitter

See the original post here:
University of Vermont: Advancing healthcare through impactful medicine - Study International News

HealthDay News

If you find a lump in your breast, don't delay -- see your doctor as soon as possible. Anything you notice that's different from your normal breast tissue should be investigated. The good news is that more than 80 percent of breast lumps turn out to be benign tumors or cysts.

How can my doctor tell whether a lump is cancerous?

If a breast exam, mammogram, or follow-up ultrasound turns up a suspicious mass in your breast, you may want to have a biopsy -- a procedure in which a doctor takes a small tissue sample from the lump and a pathologist looks at it under a microscope. That's the only way to be sure whether a lump is cancerous. There are a number of different biopsies you can get, and each procedure has its pros and cons. An excisional biopsy (removing the whole lump) should be definitive, but it is also a more invasive procedure. A needle or core biopsy (in which fluid or tissue are extracted) may be quick and only needs local anesthesia, but also may require a follow-up biopsy since it more easily misses cancer cells. Afterwards, even if the biopsy is negative, the lump should be followed -- and removed if it grows or changes.

People are also reading

If it's not cancer, what could it be?

In addition to the many kinds of completely harmless breast lumps, there are some that may slightly increase your risk of getting breast cancer in the future and a few that may not be cancer but should be removed anyway. Here's a guide to some of the most common types of breast lumps and what you should do about them.

Most breast lumps are caused by fibrocystic breast changes, also known as benign breast disease or mammary dysplasia. In spite of the intimidating names, this condition is harmless. At least half of all women have it at some point, usually during their childbearing years.

Some of the lumps are solid, and some are fluid-filled cysts. (A cyst may form when one of your milk ducts becomes blocked.) No one knows what causes these changes in the breasts, but estrogen and progesterone, the hormones that control the menstrual cycle, can make lumps or cysts more prominent or painful during the week before your period begins. You may feel one lump or many. Some women say their breasts feel like bags of peas; others don't feel the lumps at all.

These masses usually show up on both mammograms and ultrasound scans. To determine whether a suspicious lump is fibrocystic rather than cancerous, your doctor may need to do a biopsy. If the lump is a cyst, the fluid can be drained with a needle and syringe in the doctor's office. Having fibrocystic changes may slightly increase your risk for getting breast cancer. In rare cases, the cells from a fibrocystic lump show some precancerous changes called atypical hyperplasia, a condition that may increase your chance of developing breast cancer. How big a risk atypical hyperplasia presents depends on a woman's other risk factors -- family history and age of first pregnancy among them. If you have this condition, you may want to talk to your doctor to see if a preventative course of tamoxifen would be appropriate for you. Also discuss with your doctor how often you should have breast exams and mammograms.

Not all women have pain or other symptoms as a result of fibrocystic changes. Some women do find that their symptoms improve when they cut back on caffeine and salt or take diuretics, although studies have found no benefit from this. Some physicians recommend vitamin E or capsules of evening primrose oil. If your symptoms are severe, ask your doctor about the prescription drugs danazol (Danocrine) and bromocriptine (Parlodel), but be aware that they're expensive and can have serious side effects. Particularly bothersome lumps that don't respond to any of these treatments can be surgically removed.

A movable lump that feels like a marble in your breast may be a fibroadenoma. This is a benign mass made up of both connective and glandular tissue (tissue from the milk ducts and glands). Fibroadenomas are most common in women who are in their 20s and 30s. Some are too small to feel; others may be several inches across. Doctors sometimes recommend that you have this kind of lump surgically removed to make sure that it's not cancerous, even if the biopsy was negative. Some studies show that women with fibroadenomas have a slightly increased risk of getting breast cancer later on.

Rarely, a lump may turn out to be a phyllodes tumor. Most often benign, this kind of lump also consists of both connective and glandular tissue, but the connective-tissue cells may have started to grow too fast. Most of the time you'll have the lump removed, along with a roughly one-inch margin of healthy breast tissue. It's important to have a clear margin of normal tissue because, even when they're benign, these tumors have a high rate of local recurrence. In very rare cases, the lump will be malignant, and you may need to have your breast removed.

If you notice a bloody discharge from your nipple, you may have an intraductal papilloma -- usually a small growth in a milk duct behind the nipple. If the lump isn't large enough to be felt, a ductogram may be needed. This is a mammogram that's taken after liquid is injected through the nipple into the milk duct. On the x-ray, the location of the liquid shows whether the duct contains a mass. A papilloma is usually removed, along with a segment of the milk duct. Ductoscopy, a technique for directly visualizing the inside of the duct using tiny scopes, is now used to aid in the diagnosis and treatment of bloody nipple discharge. The technique allows the doctor to see the growth before it's removed so that less of the duct needs to come out with it.

A firm, movable lump measuring half an inch to an inch across may be a granular cell tumor. These masses are very rare and almost always benign, but they should be removed anyway. Having one doesn't make you more likely to get breast cancer.

A lump that develops after you've had surgery, a breast injury, or radiation treatment may be caused by fat necrosis, or scar tissue overlying an area of fatty tissue that has been damaged. Its firmness makes it difficult to distinguish from cancerous lumps by feel. Sometimes, instead of forming scar tissue, the damaged fat cells die and release the fat inside, which collects to form an oil cyst. This can be drained with a needle and syringe.

If a lump is soft and diffuse, it's likely to be a lipoma, a pocket of fat that's become encased in scar tissue. Lipomas are soft and mobile nodules that are usually surrounded by a thin connective tissue capsule. They feel like fatty pillows in the breast. They can be mistaken for cancer if they're particularly firm, but a biopsy will sort things out. Lipomas are quite common and aren't dangerous at all. They don't increase your chances of getting cancer or need to be removed.

American Cancer Society. Benign Breast Conditions: Not All Lumps Are Cancer.

American Cancer Society. What Are Risk Factors for Breast Cancer? American Cancer Society. For Women Facing a Breast Biopsy.

Johnson C. Benign breast disease. Nurse Pract Forum. Vol. 10(3):137-44.

Ziegfeld CR. Differential diagnosis of a breast mass. Lippincotts Prim Care Pract. Mar-Apr;2(2):121-8.

Sign up here to get the latest health & fitness updates in your inbox every week!

See more here:
Benign Breast Lumps | Health, Medicine and Fitness | siouxcityjournal.com - Sioux City Journal

Retiree Active lifestyle walking outdoors

kate_sept2004 / Getty

Experiencing arthritis and inflamed joints with age is common among adults, but according to a new study, one routine part of your day could help battle these conditions. Recent research published in Wiley Online Library noted that walking could keep knee pain at bay for those with osteoarthritis. Dr. Grace Hsiao-Wei Lo, an assistant professor at Baylor College of Medicine in Houston and the lead author on the study, says this finding symbolizes "a paradigm shift," as "this highlights the importance and likelihood that interventions for osteoarthritis might be something different, including good old exercise."

The team of researchers came to this conclusion after surveying over 1,000 people over the age 50 who had knee osteoarthritis, starting in 2004. The scientists found that the participants had varying experiences with pain; some had discomfort from the start and others did not. Over the course of four years, the people who had constant knee pain and walked as a form of exercise cut their risks of experiencing new structural damage or stiffness around these joints.

Related: Taking 7,000 Steps Each DayInstead of the Previously Recommended 10,000Can Help Reduce Heart Disease Risks

The participants' physical progress was studied by X-ray, which showed the state of the joint. From there, the researchers told the participants to document their exercise routines and checked in on their pain-related symptoms during visits. After the study period, 37 percent of the volunteers who didn't walk for exercise (this didn't include baseline trips, like running errands) experienced new knee pain. Only 26 percent of those who did walk ended up developing consistent knee pain.

Research from this study also proves how walking can be a preventative tactic for inflammatory conditions. Ultimately, Dr. Lo recommends that those who are at risk for developing knee osteoarthritis take a daily walk to ward off symptoms. Plus, this simple tactic has benefits for other areas of the body. The new study notes that walking can help ease pain in other joints, as well, specifically the hips, hands, and feet.

Go here to see the original:
Do You Suffer from Knee Pain Due to Inflammation or Arthritis? Taking More Walks Will Help, a New Study Shows - Yahoo Life

Supplied

Murine typhus is spread by fleas living on vermin such as rats and mice.

Flea-borne typhus has been found in northwest Auckland after three locals were hospitalised with the rare disease.

This type of typhus also known as murine typhus is usually carried by vermin, such as rats and mice, and spreads to humans and other animals via infected fleas living in the animals fur.

Dairy Flat Veterinary Clinic was notified of the outbreak on June 3, after a family in the Kaukapakapa area told clinic staff the stray kittens they had treated were carrying the disease.

Dr Angela Matthews, a vet at the clinic, said the cases were connected to two adults in the family and their employee who had handled the kittens while trying to rehome them.

READ MORE:* Auckland rabbit owners ordered to get rid of 300 pets after neighbours complain* Plea for Australian government to declare mouse plague a natural disaster* Overgrown, rat infested vacant site a fire hazard, neighbours warn

The family told the clinic because they were very worried about the disease being in the area and wanted locals to be aware of it, Matthews said.

The three have been released from hospital and are recovering at home.

Animals do not become sick if they have murine typhus, but humans do.

When the family first brought the stray litter into the vet clinic, they were told to check the kittens did not have toxoplasmosis, Matthews said.

Toxoplasmosis is an unrelated infection caused by parasites found in cat faeces and, in humans, has similar symptoms to murine typhus.

Supplied

The best way to prevent murine typhus is to keep your pets flea and worm treatments up to date.

The best way to avoid being infected by murine typhus or other diseases carried by fleas, is to make sure all of your animals are up to date with their flea and worm treatments.

Preventative medicine should be the first step, not just for your cats but rabbits and dogs too, Matthews said.

This treatment is not only for keeping your pets well, but their owners and the community who might come into contact with them.

Matthews said it was important to set up vermin controls, especially if you have old sheds or barns, where rats or mice are likely to live.

This is not the first time an outbreak of murine typhus has occurred in the Kaukapakapa and Helensville area, with a few cases popping up in 2010.

SPCA/Supplied

Helensville locals were infected by murine typhus due to handling stray kittens that had not been treated for fleas.

There can be years between the cases, so people sometimes forget that infection is a possibility, Matthews said.

An Auckland Regional Public Health Service (ARPHS) spokesperson confirmed it was notified of a probable case of murine typhus in early June, and that others from the same household were "suspected of having the illness.

The symptoms of murine typhus can include fever, headache, malaise, swollen lymph nodes, sore muscles and a rash, the spokesperson said.

ARPHS advised locals to keep tight lids on rubbish and compost bins, wear gloves if handling sick animals, and use insect repellant if you are spending time outside.

Department of Conservation/Supplied

Dr Angela Matthews said it is important for locals to have vermin controls in place.

Matthews said anyone who started to develop symptoms should let their doctor know if they had recently handled a stray animal, or been in contact with vermin.

People are infected with the disease can be very sick for a number of weeks, she said. The best course of action is swift diagnosis followed by prompt treatment.

Matthews said the threat of murine typhus did not mean locals could not handle strays or help rehome them, but they should be aware of the disease.

STUFF

In 2019, one pest bugged New Zealanders more than most. Here's how to stop it in its tracks.

The first thing to do is to flea [the animals], but do not bring them into your home, Matthews said.

Be cautious if you find them in a shed or a barn where there is likely to be vermin living in. Get them into an area that is easy to clean.

ARPHS said cases in murine typhus in Auckland are rare, with the most recent case before this outbreak recorded in 2017.

Original post:
Flea-borne typhus outbreak puts three Aucklanders in hospital - Stuff

At-home COVID-19 tests results have no reporting system, creating a challenge for experts to track accurate COVID-19 case counts.

SEATTLE The Washington State Department of Health (DOH) said only a fraction of COVID-19 cases are being reported to the state.

This is making it difficult for health experts to predict when a new surge of infections is coming.

At-home COVID-19 tests are easy, accessible and free through the federal government.

But the experts who study COVID-19 trends said at-home tests create inaccuracy with data.

We are definitely missing cases, said Dr. Helen Chu, Associate Professor at UW Medicine Department of Epidemiology

A vast majority of positive COVID-19 cases are not reported to the state, Chu said.

We are probably only capturing 10% of positive cases through the reporting," Chu said.

In a statement to KING 5, the DOH said due to at-home testing and other factors (such as people not testing at all) cases reported likely only represent approximately 15% of infections in Washington.

According to Chu, this makes it hard to predict when a new wave of cases is headed our way.

So people still look at the dashboards and they say, you know, the numbers don't look that high," Chu said. "They look like they may be going down. But that's because we don't have the data."

Now, instead of case numbers, the department of health is using hospitalization data to understand COVIDs prevalence.

At this stage in the pandemic, our focus has though shifted away from case counts and towards hospital capacity as a key indicator of the health of the state," DOH said in a statement.

Chu said UW Medicine is using the same metrics but argues the system has its flaws as well.

Hospitalizations only go up one to two weeks after the numbers of cases in the community go," Chu said. "So, we can track it, but we are probably a couple of weeks delayed in identifying an oncoming surge. I think that we missed the boat here with not developing a system to mandate capture of home antigen test data.

To report a positive COVID case from an at-home test to the state, call the COVID-19 hotline at 1-800-525-0127.

Even with the difficulty in reporting cases, the state still recommends at-home COVID testing, along with other preventative measures, the agebct said in a statement:

Along with vaccination, wearing a mask, hand washing, and physical distancing, frequent at-home testing can help you protect your families and friends, and is a great way to help in the fight against COVID-19. We recommend testing if you are feeling sick, think you may have been in contact with someone with COVID-19, are planning to attend a gathering or large event, or are traveling. Households across the state are eligible to receive free COVID-19 tests from the Department of Health through our Say Yes! COVID Test initiative. This is in addition to the Federal initiative. Households can place two orders each month, which includes up to 10 free tests per month. Orders can be submitted online via sayyescovidhometest.org or the DOH COVID Hotline."

If someone does test positive for COVID it is important to stay home and continue to take all precautions necessary to keep you and those around you safe.

People can also report their test results from an at-home test via the DOH hotline.

See the rest here:
'We are definitely missing cases:' Just a fraction of COVID-19 cases reported in Washington - KING5.com