Dominican Government allocates more than 2 billion to purchase medicines
Santo Domingo.- This Wednesday, the Essential Medicines and Central Logistics Support Program (PROMESE/CAL) conducted a reading of the economic proposals for the National Public Tender reference PROMESE/CAL-CCC-LPN-2023 0011. This process will allocate 2.338 billion pesos for the purchase of medicines.
Santo Domingo.- This Wednesday, the Essential Medicines and Central Logistics Support Program (PROMESE/CAL) conducted a reading of the economic proposals for the National Public Tender reference PROMESE/CAL-CCC-LPN-2023 0011. This process will allocate 2.338 billion pesos for the purchase of medicines.
Adolfo Pérez, the director of PROMESE/CAL, stated that this procurement is a part of the institution’s annual planning. It will include not only medicines but also health supplies to ensure the National Public Health System and People’s Pharmacies’ needs are met.
Pérez emphasized the administration’s commitment to transparency in its processes. He expressed confidence that these efforts would lead to the restoration of trust in the state, its institutions, and public servants.
Over the past three years, under the government led by President Luis Abinader, more than 40 billion pesos have been allocated for purchasing medicines and health supplies, including high-cost medications. Pérez also highlighted the effectiveness of adhering to Law 340-06 on Purchasing and Contracting, leading to significant savings for the state while enhancing health coverage.
The event, held at a hotel in the capital, was conducted publicly in the presence of notaries public, bidders, a compliance officer from the Public Procurement Directorate, the PROMESE/CAL purchasing committee, media representatives, and opinion leaders. This public approach underscores the commitment to transparency and integrity in the procurement process.
1 year 6 months ago
Health
Belize News and Opinion on www.breakingbelizenews.com
Ministry of Health and Wellness to host World Aids Day Health Fair in Belmopan
Posted: Wednesday, November 29, 2023. 9:27 am CST.
By Zoila Palma Gonzalez: World Aids Day is recognized on December 1.
The day is set aside to bring together people from around the world to raise awareness about HIV/AIDS and demonstrate international solidarity.
The day will be observed under the theme, “Let communities lead”.
Posted: Wednesday, November 29, 2023. 9:27 am CST.
By Zoila Palma Gonzalez: World Aids Day is recognized on December 1.
The day is set aside to bring together people from around the world to raise awareness about HIV/AIDS and demonstrate international solidarity.
The day will be observed under the theme, “Let communities lead”.
World Aids Day is an opportunity to reflect on the progress made to date, to raise awareness about the challenges that remain to achieve the goals of ending AIDS by 2030 and to mobilize all stakeholders to jointly redouble efforts to ensure the success of the HIV response.
The Ministry of Health and Wellness (MOHW) is hosting a World Aids Day Health far this Friday in Belmopan.
The fair will be held at the steps of the National Assembly.
The Ministry will be offering free HIV and Syphilis testing, Hepatitis B testing and glucose and blood pressure checks.
The fair commences at 9am and ends at 3pm.
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1 year 6 months ago
Health, last news
The Dominican Republic will adapt Health Law to take advantage of Artificial Intelligence
Santo Domingo.- The first National Health and Artificial Intelligence Forum, an initiative by Listín Diario, has successfully convened various local and international health sector stakeholders. The event, aimed at exploring the integration of human talent and artificial intelligence (AI) in medicine, fostered a rich debate about the future of this convergence.
Santo Domingo.- The first National Health and Artificial Intelligence Forum, an initiative by Listín Diario, has successfully convened various local and international health sector stakeholders. The event, aimed at exploring the integration of human talent and artificial intelligence (AI) in medicine, fostered a rich debate about the future of this convergence.
Artificial intelligence has progressively infiltrated broader and more complex fields, revolutionizing traditional methods and enhancing efficiency in various sectors, including health. This evolution in medicine, especially in the Dominican Republic, has been marked by the integration of advanced machines and analysis systems. This progress aligns with the goals set in the National Health Strategic Plan (Plandes 2030), as stated by the Minister of Public Health, Daniel Rivera.
At the forum, Rivera highlighted that AI is rapidly transforming medical practices worldwide. He outlined seven key areas for AI implementation in the Dominican health system, starting with an evaluation of the technological needs of both public and private health systems. He emphasized that AI could significantly enhance medical research, information accessibility, service automation and personalization, and predictive analysis.
Rivera also announced a comprehensive digital health transformation program starting next year, backed by a budget of 900 million pesos. This includes the introduction of a digital health plan, Salud 2030, featuring an electronic medical record system to consolidate patient information. Additionally, the Law 42-01 on Health will be updated to include ethical regulatory frameworks for AI in healthcare.
The minister stressed the importance of transforming health sciences investment programs to incorporate AI training for health professionals. Both the Ministry of Public Health and the National Health Service are expected to undergo digital transformations. Educational programs in medical AI are also planned, alongside the procurement of new equipment and the promotion of public-private sector collaboration.
Addressing concerns about AI replacing doctors, Javier González, Associate President of Education and Director of the Pediatric Education Center in Cincinnati, assured that AI would not replace physicians but rather serve as a supportive tool, especially in medical education. He warned against over-reliance on AI, emphasizing the importance of maintaining human elements in medical training.
Julio Peguero, a cardiology and ultrasound specialist at the Memorial Healthcare System Broward County in Florida and a designer of AI systems for service management, explained that AI intersects with health science in diagnosis, medical analysis, and strategy development. Besides healthcare, AI has applications in robotics, scientific research, transportation, finance, and education.
The forum showcased the transformative potential of AI in healthcare, emphasizing its role as a complementary tool rather than a replacement for human medical professionals.
1 year 6 months ago
Health
STAT+: Colon cancer prevention paradox: Higher-risk patients pay more for colonoscopy
Ashley Conway-Anderson was prepared for a lot of things when it came to her first colonoscopy. She sought out tips to make the daylong prep more bearable. She braced herself mentally for what the doctors would find; her mother, after all, was just a couple years out of recovery from colorectal cancer. When she awoke from the procedure, she said, things seemed relatively fine.
“Surprisingly fine,” said Conway-Anderson, a 36-year-old agroforestry professor at the University of Missouri. There was an 11-millimeter precancerous polyp that the doctors had discovered, but they’d snipped it out of her colon and recommended surveillance every three years. “Obviously, it’s big news to hear, but grateful this seems to be manageable. I’ll do it,” she said. “Then the bill came.”
She was being charged nearly $12,000 for the procedure after insurance. Conway-Anderson’s head spun. She couldn’t understand how it could cost so much, especially when she thought the colonoscopy was preventative for cancer and thus covered. “I was floored,” she said. “I was like I can’t pay this. I don’t know what you want me to do.”
1 year 6 months ago
Health, Special Report, Cancer, Insurance, policy, Public Health, STAT+
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Medical Bulletin 29/November/2023
Here are the top medical news of the day:
Allergic responses to common foods could increase risk of heart disease, cardiovascular death
Here are the top medical news of the day:
Allergic responses to common foods could increase risk of heart disease, cardiovascular death
Allergic responses to common foods such as dairy and peanuts can increase the risk for heart disease and cardiovascular death as much or more than smoking, new research suggests in the Journal of Allergy and Clinical Immunology. These dangerous allergic responses can strike both people with food allergies and those with no obvious allergy symptoms.
Approximately 15% of adults produce IgE antibodies in response to cow's milk, peanuts and other foods. While these antibodies cause some people to have severe food allergies, many adults who make these antibodies have no obvious food allergy.
Reference: Corinne Keet, Emily C. McGowan, David Jacobs, Wendy S. Post, Nathan E. Richards, Lisa J. Workman, Thomas A.E. Platts-Mills, Ani Manichaikul, Jeffrey M. Wilson. IgE to common food allergens is associated with cardiovascular mortality in the National Health and Examination Survey and the Multi-Ethnic Study of Atherosclerosis. Journal of Allergy and Clinical Immunology, 2023; DOI: 10.1016/j.jaci.2023.09.038
Childhood trauma linked to headaches in adulthood
People who have experienced traumatic events in childhood such as abuse, neglect or household dysfunction may be more likely to experience headache disorders as adults, according to a meta-analysis published in the October 25, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.
The meta-analysis involved 28 studies, including 154,739 participants across 19 countries. Of the total participants, 48,625 people, or 31%, reported at least one traumatic childhood event, and 24,956 people, or 16%, were diagnosed with primary headaches
Among participants with at least one traumatic childhood event, 26% were diagnosed with a primary headache disorder, compared to 12% of participants that had no traumatic childhood events
Reference: Claudia Sikorski, Anna C Mavromanoli, Karishma Manji, Danial Behzad, Catherine Kreatsoulas. Adverse Childhood Experiences and Primary Headache Disorders: A Systematic Review, Meta-analysis, and Application of a Biological Theory. Neurology, 2023; 10.1212/WNL.0000000000207910 DOI: 10.1212/WNL.0000000000207910
Study indicates possible link between chronic stress and Alzheimer's disease
Some 160,000 people have some form of dementia in Sweden, Alzheimer's disease being the most common, a figure that is rising with our life expectancy.
Researchers from Karolinska Institutet have published a study in Alzheimer's Research & Therapy that addresses possible associations between chronic stress, mild cognitive impairment and Alzheimer's disease. The study shows how people aged between 18 and 65 with a previous diagnosis of chronic stress and depression were more likely than other people to be diagnosed with mild cognitive impairment or Alzheimer's disease.
The study shows that the risk of Alzheimer's disease was more than twice as high in patients with chronic stress and in patients with depression as it was in patients without either condition; in patients with both chronic stress and depression it was up to four times as high
Reference: Johanna Wallensten, Gunnar Ljunggren, Anna Nager, Caroline Wachtler, Nenad Bogdanovic, Predrag Petrovic, Axel C. Carlsson. Stress, depression, and risk of dementia – a cohort study in the total population between 18 and 65 years old in Region Stockholm. Alzheimer's Research & Therapy, 2023; 15 (1) DOI: 10.1186/s13195-023-01308-4
1 year 6 months ago
MDTV,Channels - Medical Dialogues,Medical News Today MDTV,Medical News Today
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Allergic responses to common foods could increase risk of heart disease, cardiovascular death
Allergic responses to common foods such as dairy and peanuts can increase the risk for heart disease and cardiovascular death as much or more than smoking, new research suggests in the Journal of Allergy and Clinical Immunology. These dangerous allergic responses can strike both people with food allergies and those with no obvious allergy symptoms.
Approximately 15% of adults produce IgE antibodies in response to cow's milk, peanuts and other foods. While these antibodies cause some people to have severe food allergies, many adults who make these antibodies have no obvious food allergy.
UVA Health scientists and their collaborators looked at thousands of adults over time and found that
GFX- People who produced antibodies in response to dairy and other foods were at elevated risk of cardiovascular-related death
This was true even when traditional risk factors for heart disease, such as smoking, high blood pressure and diabetes, were taken into account. The strongest link was for cow's milk, but other allergens such as peanut and shrimp were also significant.
GFx- "What we looked at here was the presence of IgE antibodies to food that were detected in blood samples," said researcher Jeffrey Wilson, M.D., Ph.D., an allergy and immunology expert at the University of Virginia School of Medicine.
Reference: Corinne Keet, Emily C. McGowan, David Jacobs, Wendy S. Post, Nathan E. Richards, Lisa J. Workman, Thomas A.E. Platts-Mills, Ani Manichaikul, Jeffrey M. Wilson. IgE to common food allergens is associated with cardiovascular mortality in the National Health and Examination Survey and the Multi-Ethnic Study of Atherosclerosis. Journal of Allergy and Clinical Immunology, 2023; DOI: 10.1016/j.jaci.2023.09.038
1 year 6 months ago
Cardiology-CTVS,Diet and Nutrition,Cardiology & CTVS News,Diet and Nutrition News,Top Medical News,Cardiology-CTVS Videos,Diet Nutrition Videos,MDTV,Cardiology MDTV,MD shorts MDTV,Cardiology Shorts,Channels - Medical Dialogues,Diet and nutrition MDTV,Diet
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Intermediate- to long-term amiodarone use safe and may not increase mortality risk in AF patients
Israel: Low-dose amiodarone in the contemporary atrial fibrillation (AF) population was associated with a lower risk of all-cause mortality in the absence of a substantial increase of interstitial lung disease (ILD) and primary lung cancer (PLC) risk, a nationwide Israeli study has shown.
"Constant exposure to low-dose amiodarone was associated with a trend towards increased ILD risk (15%-45%) but a clinically negligible change in absolute risk (maximum of 1.8%), no increased PLC risk, and a lower risk of all-cause mortality," reported Gal Tsaban, University of the Negev Beersheva, Israel, and colleagues.
The findings published in European Heart Journal highlight the safety of intermediate- to long-term amiodarone use, without evidence of increased mortality risks.
Amiodarone-related interstitial lung disease is the most severe adverse effect of treatment with amiodarone. Most studies on amiodarone-related ILD are derived from periods when amiodarone was given at higher doses than currently used. Therefore, the research team aimed to determine the association between constant exposure to low-dose amiodarone and the risk of ILD, PLC, or all-cause mortality among contemporary AF patients. For this purpose, they conducted a nationwide population-based study among patients with incident atrial fibrillation between 1999 and 2021.
The researchers matched amiodarone-exposed patients 1:1 with controls unexposed to amiodarone based on sex, age, ethnicity, and AF diagnosis duration. The final cohort comprised only matched pairs where amiodarone therapy was consistent throughout follow-up. Inverse probability treatment weighting (IPTW) modelling and directed acyclic graphs were used. Patients with either prior primary lung cancer or ILD were excluded. The primary outcome of the study was determined as the ILD incidence. The secondary endpoints were PLC and death.
The final cohort included 6039 patients exposed to amiodarone who were matched with unexposed controls. The median age was 73.3 years, and 51.6% were women.
The study led to the following findings:
- After a mean follow-up of 4.2 years, ILD occurred in 2.0% of the patients.
- After IPTW, amiodarone exposure was not significantly associated with ILD [hazard ratio (HR): 1.45].
- There was a trivial higher relative risk of ILD among amiodarone-exposed patients between Years 2 and 8 of follow-up [maximal risk ratio (RR): 1.019].
- Primary lung cancer occurred in 97 patients.
- After IPTW, amiodarone was not associated with PLC (HR: 1.18).
- All-cause death occurred in 18.1% of patients.
- After IPTW, amiodarone was associated with reduced mortality risk (HR: 0.65). The results were consistent across a variety of sensitivity analyses.
"Our findings showed that constant exposure to low-dose amiodarone was associated with clinically negligible, raised risk of ILD, no increased PLC risk, and lower risk of all-cause mortality," the researchers wrote.
"The results were consistent across several sensitivity analyses," they concluded.
Reference:
Tsaban, G., Ostrovsky, D., Alnsasra, H., Burrack, N., Gordon, M., Babayev, A. S., Omari, Y., Kezerle, L., Shamia, D., Bereza, S., Konstantino, Y., & Haim, M. Amiodarone and pulmonary toxicity in atrial fibrillation: A nationwide Israeli study. European Heart Journal. https://doi.org/10.1093/eurheartj/ehad726
1 year 6 months ago
Cardiology-CTVS,Medicine,Pulmonology,Cardiology & CTVS News,Medicine News,Pulmonology News,Top Medical News,Latest Medical News
China: Surge in respiratory illnesses caused by flu, not a novel virus
BEIJING (AP): A surge in respiratory illnesses across China that has drawn the attention of the World Health Organization (WHO) is caused by the flu and other known pathogens and not by a novel virus, the country’s health ministry said Sunday....
BEIJING (AP): A surge in respiratory illnesses across China that has drawn the attention of the World Health Organization (WHO) is caused by the flu and other known pathogens and not by a novel virus, the country’s health ministry said Sunday....
1 year 6 months ago
France to ban smoking on beaches
PARIS (AP): France will ban smoking on all beaches, in public parks, forests and some other public areas as part of a national anti-tobacco plan presented by the health minister on Tuesday. Tobacco products cause 75,000 avoidable deaths a year in...
PARIS (AP): France will ban smoking on all beaches, in public parks, forests and some other public areas as part of a national anti-tobacco plan presented by the health minister on Tuesday. Tobacco products cause 75,000 avoidable deaths a year in...
1 year 6 months ago
State will require patient consent for pelvic exams by medical students
HARRISBURG, Pennsylvania (AP): A new Pennsylvania law will require doctors to get a patient’s verbal and written consent before medical students can perform pelvic or rectal exams on someone who receives anaesthesia. At a press conference Monday,...
HARRISBURG, Pennsylvania (AP): A new Pennsylvania law will require doctors to get a patient’s verbal and written consent before medical students can perform pelvic or rectal exams on someone who receives anaesthesia. At a press conference Monday,...
1 year 6 months ago
Health risks of unhealthy eating habits
CHILDREN WITH poor eating habits do not get the right amounts of nutrients they need for healthy growth and development. Children’s food preferences and eating habits are formed early in life, and the time that they spend in their early years...
CHILDREN WITH poor eating habits do not get the right amounts of nutrients they need for healthy growth and development. Children’s food preferences and eating habits are formed early in life, and the time that they spend in their early years...
1 year 6 months ago
The importance of healthy eating during childhood
WHAT WE eat can play a critical role in determining our health, whatever our age. The eating patterns established in the first few years of life influence our health during childhood and adulthood. Encouraging good nutrition during the early years...
WHAT WE eat can play a critical role in determining our health, whatever our age. The eating patterns established in the first few years of life influence our health during childhood and adulthood. Encouraging good nutrition during the early years...
1 year 6 months ago
Managing your cholesterol can save your life
“A large percentage of deaths recorded in Grenada is as a result of complications related to heart disease and heart failure”
View the full post Managing your cholesterol can save your life on NOW Grenada.
“A large percentage of deaths recorded in Grenada is as a result of complications related to heart disease and heart failure”
View the full post Managing your cholesterol can save your life on NOW Grenada.
1 year 6 months ago
Health, PRESS RELEASE, blood and lung institute, cholesterol, gfnc, grenada food and nutrition council, national heart
Belize News and Opinion on www.breakingbelizenews.com
Ministry of Health and Wellness data shows more than 40 cases of HIV among pregnant women
Posted: Tuesday, November 28, 2023. 2:37 pm CST.
By Zoila Palma Gonzalez: World Aids Day is recognized on December 1.
The day is set aside to bring together people from around the world to raise awareness about HIV/AIDS and demonstrate international solidarity.
The day will be observed under the theme, “Let communities lead”.
Posted: Tuesday, November 28, 2023. 2:37 pm CST.
By Zoila Palma Gonzalez: World Aids Day is recognized on December 1.
The day is set aside to bring together people from around the world to raise awareness about HIV/AIDS and demonstrate international solidarity.
The day will be observed under the theme, “Let communities lead”.
World Aids Day is an opportunity to reflect on the progress made to date, to raise awareness about the challenges that remain to achieve the goals of ending AIDS by 2030 and to mobilize all stakeholders to jointly redouble efforts to ensure the success of the HIV response.
Data from the Ministry of Health and Wellness shows that in Belize, an estimated 3,682 people were living with HIV at the end of 2022.
Last year, 43 cases of HIV were reported among pregnant women and 17 of those were newly detected cases.
In addition, 35 babies were born to HIV positive women and 1 baby was infected with HIV.
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© 2023, BreakingBelizeNews.com. Content is copyrighted and requires written permission for reprinting in online or print media. Theft of content without permission/payment is punishable by law.
Comments
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1 year 6 months ago
Health, last news
Back Pain? Bum Knee? Be Prepared to Wait for a Physical Therapist
At no point along his three-year path to earning a degree in physical therapy has Matthew Lee worried about getting a job.
Being able to make a living off that degree? That’s a different question — and the answer is affecting the supply of physical therapists across the nation: The cost of getting trained is out of proportion to the pay.
At no point along his three-year path to earning a degree in physical therapy has Matthew Lee worried about getting a job.
Being able to make a living off that degree? That’s a different question — and the answer is affecting the supply of physical therapists across the nation: The cost of getting trained is out of proportion to the pay.
“There’s definitely a shortage of PTs. The jobs are there,” said Lee, a student at California State University-Sacramento who is on track to receive his degree in May. “But you may be starting out at $80,000 while carrying up to $200,000 in student debt. It’s a lot to consider.”
As many patients seeking an appointment can attest, the nationwide shortage of PTs is real. According to survey data collected by the American Physical Therapy Association, the job vacancy rate for therapists in outpatient settings last year was 17%.
Wait times are generally long across the nation, as patients tell of waiting weeks or even months for appointments while dealing with ongoing pain or post-surgical rehab. But the crunch is particularly acute in rural areas and places with a high cost of living, like California, which has a lower ratio of therapists to residents — just 57 per 100,000, compared with the national ratio of 72 per 100,000, according to the association.
The reasons are multifold. The industry hasn’t recovered from the mass defection of physical therapists who fled as practices closed during the pandemic. In 2021 alone, more than 22,000 PTs — almost a tenth of the workforce — left their jobs, according to a report by the health data analytics firm Definitive Healthcare.
And just as baby boomers age into a period of heavy use of physical therapy, and covid-delayed procedures like knee and hip replacements are finally scheduled, the economics of physical therapy are shifting. Medicare, whose members make up a significant percentage of many PT practices’ clients, has cut reimbursement rates for four years straight, and the encroachment of private equity firms — with their bottom-line orientation — means many practices aren’t staffing adequately.
According to APTA, 10 companies, including publicly held and private equity-backed firms, now control 20% of the physical therapy market. “What used to be small practices are often being bought up by larger corporate entities, and those corporate entities push productivity and become less satisfying places to work,” said James Gordon, chair of the Division of Biokinesiology and Physical Therapy at the University of Southern California.
There’s a shortage of physical therapists in all settings, including hospitals, clinics, and nursing homes, and it’s likely to continue for the foreseeable future, said Justin Moore, chief executive of the physical therapy association. “Not only do we have to catch up on those shortages, but there are great indicators of increasing demand for physical therapy,” he said.
The association is trying to reduce turnover among therapists, and is lobbying Congress to stop cutting Medicare reimbursement rates. The Centers for Medicare & Medicaid Services plans a 3.4% reduction for 2024 to a key metric that governs pay for physical therapy and other health care services. According to the association, that would bring the cuts to a total of 9% over four years.
Several universities, meanwhile, have ramped up their programs — some by offering virtual classes, a new approach for such a hands-on field — to boost the number of graduates in the coming years.
“But programs can’t just grow overnight,” said Sharon Gorman, interim chair of the physical therapy program at Oakland-based Samuel Merritt University, which focuses on training health care professionals. “Our doctoral accreditation process is very thorough. I have to prove I have the space, the equipment, the clinical sites, the faculty to show that I’m not just trying to take in more tuition dollars.”
All of this also comes at a time when the cost of obtaining a physical therapy doctorate, which typically takes three years of graduate work and is required to practice, is skyrocketing. Student debt has become a major issue, and salaries often aren’t enough to keep therapists in the field.
According to the APTA’s most recent published data, median annual wages range from $88,000 to $101,500. The association said wages either met or fell behind the rate of inflation between 2016 and 2021 in most regions.
A project underway at the University of Iowa aims to give PT students more transparency about tuition and other costs across programs. According to an association report from 2020, at least 80% of recent physical therapy graduates carried educational debt averaging roughly $142,000.
Gordon said USC, in Los Angeles’ urban core, has three PT clinics and 66 therapists on campus, several of whom graduated from the school’s program. “But even with that, it’s a challenge,” he said. “It’s not just hard to find people, but people don’t stay, and the most obvious reason is that they don’t get paid enough relative to the cost of living in this area.”
Fewer therapists plus growing demand equals long waits. When Susan Jones, a Davis, California, resident, experienced pain in her back and neck after slipping on a wet floor in early 2020, she went to her doctor and was referred for physical therapy. About two months later, she said, she finally got an appointment at an outpatient clinic.
“It was almost like the referral got lost. I was going back and forth, asking, ‘What’s going on?’” said Jones, 57. Once scheduled, her first appointment felt rushed, she said, with the therapist saying he could not identify an issue despite her ongoing pain. After one more session, Jones paid out-of-pocket to see a chiropractor. She said she’d be hesitant to try for a physical therapy referral in the future, in part because of the wait.
Universities and PT programs graduate about 12,000 therapists a year, Moore said, and representatives of several schools told KFF Health News they’re studying whether and how to expand. In 2018, USC added a hybrid model in which students learn mostly online, then travel to campus twice a semester for about a week at a time for hands-on instruction and practice.
That bumped USC’s capacity from 100 students a year to 150, and Gordon said many of the hybrid students’ professional skills are indistinguishable from those of students on campus full time.
Natalia Barajas received her PT doctorate from USC last year and was recently hired at a clinic in nearby Norwalk, with a salary of $95,000, a signing bonus, and the opportunity to earn more in incentives.
She’s also managing a lot of debt. Three years of tuition for the USC physical therapy program comes to more than $211,000, and Barajas said she owes $170,000 in student loans.
“If it were about money alone, I probably would have shifted to something else a while ago,” Barajas said. “I’m OK with my salary. I chose to do this. But it might not be the perfect situation for everybody.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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1 year 6 months ago
Aging, california, Health Industry, States, Medical Education
‘Everybody in This Community Has a Gun’: How Oakland Lost Its Grip on Gun Violence
OAKLAND, Calif. — The red-tipped bullet pierces skin and melts into it, Javier Velasquez Lopez explains. The green-tipped bullet penetrates armored vests. And the hollow-tipped bullet expands as it tears through bodies.
At 19, Velasquez Lopez knows a lot about ammunition because many of his friends own guns, he said. They carry to defend themselves in East Oakland, where metal bars protect shop windows and churches stand behind tall, chain-link fences.
Some people even hide AR-15-style assault weapons down their pants legs, he said.
“It doesn’t feel safe. Wherever you’re at, you’re always anxious,” said Velasquez Lopez, who dreams of leaving the city where he was born. “You’re always wondering what’s going to happen.”
Last year, two gunmen in ski masks stormed his high school, killing a school district carpenter and injuring five other adults, including two students.
Oakland won acclaim just a few years ago as a national model for gun violence prevention, in part by bringing police and community groups together to target the small number of people suspected of driving the gun violence.
Then, in 2020, the covid-19 pandemic shut down schools, businesses, and critical social services nationwide, leaving many low-income people isolated and desperate — facing the loss of their jobs, homes, or both. The same year, police murdered George Floyd, a Black man in Minneapolis, which released pent-up fury over racial discrimination by law enforcement, education, and other institutions — sparking nationwide protests and calls to cut police funding.
In the midst of this racial reckoning and facing the threats of an unknown and deadly virus, Americans bought even more guns, forcing some cities, such as Raleigh, North Carolina; Chicago; New York City; and Oakland, to confront a new wave of violent crime.
“There was emotional damage. There was physical damage,” said James Jackson, CEO of Alameda Health System, whose Wilma Chan Highland Hospital Campus, a regional trauma center in Oakland, treated 502 gunshot victims last year, compared with 283 in 2019. “And I think some of this violence that we’re seeing is a manifestation of the damage that people experienced.”
Jackson is among a growing chorus of health experts who describe gun violence as a public health crisis that disproportionately affects Black and Hispanic residents in poor neighborhoods, the very people who disproportionately struggle with Type 2 diabetes and other preventable health conditions. Covid further eviscerated these communities, Jackson added.
While the pandemic has retreated, gun violence has not. Oaklanders, many of whom take pride in the ethnic diversity of their city, are overwhelmingly upset about the rise in violent crime — the shootings, thefts, and other street crimes. At town halls, City Council meetings, and protests, a broad cross-section of residents say they no longer feel safe.
Programs that worked a few years ago don’t seem to be making a dent now. City leaders are spending millions to hire more police officers and fund dozens of community initiatives, such as placing violence prevention teams at high schools to steer kids away from guns and crime.
Yet gun ownership in America is at a historic high, even in California, which gun control advocates say has the strictest gun laws in the country. More than 1 million Californians bought a gun during the first year of the pandemic, according to the latest data from the state attorney general.
As Alameda County District Attorney Pamela Price told an audience at a September town hall in East Oakland: “We are in a unique, crazy time where everybody in this community has a gun.”
The Streets of Oakland
Oakland’s flatlands southeast of downtown are the backdrop of most of the city’s shootings and murders.
The area stands in stark contrast to the extreme wealth of the millionaire homes that dot the Oakland Hills and the immaculate, flower-lined streets of downtown. The city’s revived waterfront, named after famed author and local hero Jack London, draws tourists to trendy restaurants.
On a Saturday night in August, Shawn Upshaw drove through the flatlands along International Boulevard, past the prostitutes who gather on nearly every corner for at least a mile, and into “hot spots,” where someone is shot nearly every weekend, he said.
“When I grew up, women and kids would get a pass. They wouldn’t get caught in the crossfire,” said Upshaw, 52, who was born and raised in Oakland. “But now women and kids get it, too.”
Upshaw works as a violence interrupter for the city’s Department of Violence Prevention, which coordinates with the police department and community organizations in a program called Ceasefire.
When there’s a shooting, the police department alerts Upshaw on his phone and he heads to the scene. He doesn’t wear a police uniform. He’s a civilian in street clothes: jeans and a black zip-up jacket. It makes him more approachable, he said, and he’s not there to place blame, but rather to offer help and services to survivors and bystanders.
The goal, he said, is to stop a retaliatory shooting by a rival gang or grieving family member.
Police also use crime data to approach people with gang affiliations or long criminal records who are likely to use a gun in a crime — or be shot. Community groups follow up with offers of job training, education, meals, and more.
“We tell them they’re on our radar and try to get them to recognize there are alternatives to street violence,” said Oakland Police Department Capt. Trevelyon Jones, head of Ceasefire. “We give them a safe way of backing out of a conflict while maintaining their street honor.”
Every Thursday at police headquarters, officers convene a “shooting review.” They team up with representatives from community groups to make house calls to victims and their relatives.
After the program launched in 2012, Oakland’s homicides plummeted and were down 39% in 2019, according to a report commissioned by the Oakland Police Department.
Then covid hit.
“You had primary care that became an issue. You had housing that became an issue. You had employment that became an issue,” said Maury Nation, an associate professor at Vanderbilt University. “It created a surplus of the people who fit that highest risk group, and that overwhelms something like Ceasefire.”
With ever-rising housing prices in Oakland and across California, homeless encampments have multiplied on sidewalks and under freeway bypasses. The city is also bracing for the loss of jobs and civic pride if the Oakland Athletics baseball team relocates after April 2024, following departures by the NBA’s Golden State Warriors in 2019 and the NFL’s Raiders in 2020.
“Housing, food insecurity, not having jobs that pay wages for folks, all can lead to violence and mental health issues,” said Sabrina Valadez-Rios, who works at the Freedom Community Clinic in Oakland and teaches a high school class for students who have experienced gun violence. Her father was fatally shot outside their Oakland home when she was a child. “We need to teach kids how to deal with trauma. Violence is not going to stop in Oakland.”
Shared with permission from The Trace.
Homicides in Oakland climbed to 123 people in 2021, police reports show, dipping slightly to 120 last year. Police have tallied 108 homicides as of Nov. 12 this year. Neither the police department nor the city provided statistics on how many of those killings involved firearms, despite repeated requests from KFF Health News.
Experts also blame the rise in killings in Oakland and other American cities on the prevalence of gun ownership in the U.S., which has more guns than people. For all the pandemic disruption worldwide, homicide rates didn’t go up in countries with strict gun laws, said Thomas Abt, director of the Center for the Study and Practice of Violence Reduction at the University of Maryland.
“We saw gun violence, homicides, shootings spike up all around the country. And interestingly, it did not happen internationally,” Abt said. “The pandemic did not lead to more violence in other nations.”
Unrest in Oakland
Oakland residents are angry. One by one, business owners, community organizers, church leaders, and teenagers have stood at town halls and City Council meetings this year with an alarming message: They no longer feel safe anywhere in their city — at any time.
“It’s not just a small number of people in the evening or nighttime. This is all hours, day and night,” said Noha Aboelata, founder of the Roots Community Health Center in Oakland. “Someone’s over here pushing a stroller and someone’s getting shot right next to them.”
One morning in early April, automatic gunfire erupted outside a Roots clinic. Patients and staff members dropped to the ground and took cover. After the shooting stopped, medical assistants and a doctor gave first aid to a man in his 20s who had been shot six times.
Everyone is blaming someone or something else for the bloodshed.
Business owners have had enough. In September, Target announced it would close nine stores in four states, including in Oakland because of organized retail theft; the famed Vietnamese restaurant Le Cheval shut its doors after 38 years, partly blaming car break-ins and other criminal activity for depressing its business; and more than 200 business owners staged an hours-long strike to protest the rise in crime.
The leadership of the local NAACP, the nation’s oldest civil rights organization, made headlines this summer when it said Oakland was seeing a “heyday” for criminals, and pointed to the area’s “failed leadership” and “movement to defund the police.”
“It feels like there’s a dark cloud over Oakland,” said Cynthia Adams, head of the local chapter, which has called on the city to hire 250 more police officers.
Price, a progressive elected last year, already faces a recall effort, in part because she rejects blanket enhanced sentences for gangs and weapons charges, and has declined to charge youths as adults.
The new mayor, Sheng Thao, was criticized for firing the police chief for misconduct and breaking a campaign promise to double funding at the city’s Department of Violence Prevention. In her first State of the City address last month, Thao described the surge in crime as “totally and completely unacceptable,” and acknowledged that Oaklanders are hurting and scared. She said the city has expanded police foot patrols and funded six new police academies, as well as boosted funding for violence prevention and affordable housing.
“Not a day goes by where I don’t wish I could just wave a magic wand and silence the gunfire,” Thao said.
Many in the community, including Valadez-Rios, advocate for broader investment in Oakland’s poorest neighborhoods over more law enforcement.
City councils, states, and the federal government are putting their faith in violence prevention programs, in some cases bankrolling them from nontraditional sources, such as the state-federal Medicaid health insurance program for low-income people.
Last month, California’s Democratic Gov. Gavin Newsom approved an 11% state tax on guns and ammunition, and $75 million of the revenue annually is expected to go to violence prevention programs.
Although these programs are growing in popularity, it is unclear how successful they are. In some cases, proven programs that involve law enforcement, such as Ceasefire, were cut back or shelved after George Floyd was murdered, said Abt, the Maryland researcher.
“The intense opposition to law enforcement means that the city was unwilling to use a portion of the tools that have been proven,” Abt said. “It’s good to work on preventing youth violence, but the vast majority of serious violence is perpetrated by adults.”
Not a day goes by where I don’t wish I could just wave a magic wand and silence the gunfire.
Oakland Mayor Sheng Thao
A Focus on Schools
Kentrell Killens, interim chief at the Oakland Department of Violence Prevention, acknowledges that young adults drive Oakland’s gun violence, not high school kids. But, he said, shootings on the streets affect children. Of the 171 homicides in 2019 and 2020, 4% of victims were 17 or under, while 59% were ages 18 to 34, according to the Oakland Police Department.
The number of children injured in nonfatal shootings is also worrisome, he said. Roughly 6% of victims and 14% of suspects in nonfatal shootings were 17 or younger in 2019 and 2020.
“We’ve seen the impact of violence on young people and how they have to make decisions around what roles they want to play,” said Killens, who spent a decade as a case manager working with schoolkids.
By being in the schools, “we can deal with the conflicts” that could spill into the community, he added.
At Fremont High School, Principal Nidya Baez has welcomed a three-person team to her campus to confront gun violence. One caseworker focuses on gun violence and another on sexual assaults and healthy relationships. The third is a social worker who connects students and their families to services.
They are part of a $2 million city pilot program created after the Oakland School Board eliminated school-based police in 2020 — about one month after George Floyd was killed and after a nine-year push by community activists to kick police out of schools.
“We’ve been at a lot of funerals, unfortunately, for gang-related stuff or targeting of kids, wrong-place-wrong-time kind of thing,” said Baez, whose father was shot and injured on his ice cream truck when she was a child.
When Francisco “Cisco” Cisneros, a violence interrupter from the nonprofit group Communities United for Restorative Youth Justice, arrived at Fremont in January, students were wary, he said. Many still are. Students are hard-wired not to share information — not to be a “snitch” — or open up about themselves or their home life, especially to an adult, Cisneros said. And they don’t want to talk to fellow students from another network, group, or gang.
“If we catch them at an early age, right now, we can change that mindset,” said Cisneros, who was born and raised in Oakland.
Cisneros pulls from his past to build a rapport with students. This summer, for example, when he overheard a student chatting on the phone to an uncle in jail, Cisneros asked about him. It turns out Cisneros and the boy’s uncle had grown up in the same neighborhood.
That was enough to begin a relationship between Cisneros and the student, “J,” who declined to be identified by his full name for fear of retribution. The 16-year-old credits Cisneros, whom he describes as “like a dad,” with keeping him engaged in school and employed with summer jobs — away from trouble. Still, he regularly worries about making a wrong move.
“You could do one thing and you could end up in a situation where your life is at risk,” J said in Cisneros’ office. “You go from being in school one day to being in a very bad, sticky situation.”
The program is underway in seven high schools, and Cisneros believes he has helped prevent a handful of conflicts from escalating into gun violence.
A Better Life
After his school counselor was shot at Rudsdale High School in September 2022, Velasquez Lopez heard that the man and other victims were treated at nearby Highland Hospital.
“Seeing him get hurt, he obviously needed medical attention,” Velasquez Lopez said. “That made it obvious I could help my community if I were to be a nurse to help people that live around my area.”
When a recruiter from the Alameda Health System came to campus to promote a six-week internship at Highland Hospital, Velasquez Lopez applied. It was, he said, a dramatic step for a student who had never cared about school or sought vocational training.
Over the summer, he volunteered in the emergency room, learned how to take a patient’s vitals, watched blood transfusions, and translated for Spanish-speaking patients.
Velasquez Lopez, who graduated this year, is now looking for ways to get a nursing degree. The cost of college is out of reach at the moment, but he knows he doesn’t want to stay in a city where you can easily buy a gun for $1,000 — or half that, if it’s been used in a crime.
Velasquez Lopez said he has bigger goals for himself.
Young people in East Oakland “always feel like we’re trapped in that community, and we can’t get out,” he said. “But I feel like we still have a chance to change our lives.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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1 year 6 months ago
california, Multimedia, Public Health, States, Disparities, Guns
Endocrinologist leads precision medicine to better diabetes care
Dr Dwight Matthias has led no-cost pharmacological interventions of diabetes in Grenada, returning twice a year as part of the St George’s University Physician Humanitarian Network programme
View the full post Endocrinologist leads precision medicine to better diabetes care on NOW Grenada.
1 year 6 months ago
Health, curlan campbell, diabetes, dwight matthias, grenada diabetes association, st george’s university, world diabetes day
Posterior auricular complex graft can be used as spacer in upper eyelid repair
Use of the posterior auricular muscle complex graft as a spacer in upper eyelid retraction was first presented at the 20th annual scientific symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery in 1989.The results were promising, with an obvious decrease in lid adjustment operations.
In developing this technique, it was broached that utilization of an auricular cartilage graft, which was being widely used by ophthalmic plastic surgeons in lower eyelid retraction repair, had inherent problems in upper eyelid retraction repair. Often, the cartilage graft was
1 year 6 months ago
Many Autoimmune Disease Patients Struggle With Diagnosis, Costs, Inattentive Care
After years of debilitating bouts of fatigue, Beth VanOrden finally thought she had an answer to her problems in 2016 when she was diagnosed with Hashimoto’s disease, an autoimmune disorder.
For her and millions of other Americans, that’s the most common cause of hypothyroidism, a condition in which the thyroid, a butterfly-shaped gland in the neck, doesn’t produce enough of the hormones needed for the body to regulate metabolism.
There’s no cure for Hashimoto’s or hypothyroidism. But VanOrden, who lives in Athens, Texas, started taking levothyroxine, a much-prescribed synthetic thyroid hormone used to treat common symptoms, like fatigue, weight gain, hair loss, and sensitivity to cold.
Most patients do well on levothyroxine and their symptoms resolve. Yet for others, like VanOrden, the drug is not as effective.
For her, that meant floating from doctor to doctor, test to test, and treatment to treatment, spending about $5,000 a year.
“I look and act like a pretty energetic person,” said VanOrden, 38, explaining that her symptoms are not visible. “But there is a hole in my gas tank,” she said. And “stress makes the hole bigger.”
Autoimmune diseases occur when the immune system mistakenly attacks and damages healthy cells and tissues. Other common examples include rheumatoid arthritis, lupus, celiac disease, and inflammatory bowel disease. There are more than 80 such diseases, affecting up to an estimated 50 million Americans, disproportionately women. Overall, the cost of treating autoimmune diseases is estimated at more than $100 billion annually in the U.S.
Despite their frequency, finding help for many autoimmune diseases can prove frustrating and expensive. Getting diagnosed can be a major hurdle because the range of symptoms looks a lot like those of other medical conditions, and there are often no definitive identifying tests, said Sam Lim, clinical director of the Division of Rheumatology at Emory University School of Medicine in Atlanta. In addition, some patients feel they have to fight to be believed, even by a clinician. And after a diagnosis, many autoimmune patients rack up big bills as they explore treatment options.
“They’re often upset. Patients feel dismissed,” Elizabeth McAninch, an endocrinologist and thyroid expert at Stanford University, said of some patients who come to her for help.
Insufficient medical education and lack of investment in new research are two factors that hinder overall understanding of hypothyroidism, according to Antonio Bianco, a University of Chicago endocrinologist and leading expert on the condition.
Some patients become angry when their symptoms don’t respond to standard treatments, either levothyroxine or that drug in combination with another hormone, said Douglas Ross, an endocrinologist at Massachusetts General Hospital in Boston. “We will have to remain open to the possibility that we’re missing something here,” he said.
Jennifer Ryan, 42, said she has spent “thousands of dollars out-of-pocket” looking for answers. Doctors did not recommend thyroid hormone medication for the Huntsville, Alabama, resident — diagnosed with Hashimoto’s after years of fatigue and weight gain — because her levels appeared normal. She recently switched doctors and hopes for the best.
“You don’t walk around hurting all day long and have nothing wrong,” Ryan said.
And health insurers typically deny coverage of novel hypothyroidism treatments, said Brittany Henderson, an endocrinologist and founder of the Charleston Thyroid Center in South Carolina, which sees patients from all 50 states. “Insurance companies want you to use the generics even though many patients don’t do well with these treatments,” she said.
Meanwhile, the extent of Americans’ thyroid problems can be seen in drug sales. Levothyroxine is among the five most prescribed medications in the U.S. every year. Yet research points to some overprescribing of the drug for those with mild hypothyroidism.
A recent study, paid for by AbbVie — maker of Synthroid, a brand-name version of levothyroxine — said a medical and pharmacy claims database showed that the prevalence of hypothyroidism, including milder forms, rose from 9.5% of Americans in 2012 to 11.7% in 2019.
The number of people diagnosed will rise as the population ages, said McAninch. Endocrine disruptors — natural or synthetic chemicals that can affect hormones — could account for some of that increase, she said.
In their search for answers, patients sometimes connect on social media, where they ask questions and describe their thyroid hormone levels, drug regimens, and symptoms. Some online platforms offer information that’s dubious at best, but overall, social media outlets have increased patients’ understanding of hard-to-resolve symptoms, Bianco said.
They also offer one another encouragement.
VanOrden, who has been active on Reddit, has this advice for other patients: “Don’t give up. Continue to advocate for yourself. Somewhere out there is a doctor who will listen to you.” She has started an alternative treatment — desiccated thyroid medication, an option not approved by the FDA — plus a low dose of the addiction drug naltrexone, though the data is limited. She’s feeling better now.
Research of autoimmune thyroid disease gets little funding, so the underlying causes of immune dysfunction are not well studied, Henderson said. The medical establishment hasn’t fully recognized hard-to-treat hypothyroid patients, but increased acknowledgment of them and their symptoms would help fund research, Bianco said.
“I would like a very clear, solid acknowledgment that these patients exist,” he said. “These people are real.”
For an illustrated version of this article, click here.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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This story can be republished for free (details).
1 year 6 months ago
Health Care Costs, Health Industry, Insurance, Pharmaceuticals, Alabama, Autoimmune Diseases, Chronic Disease Care, Doctors, Patient Advocacy, texas, Women's Health
Surgery for epilepsy - Trinidad & Tobago Express Newspapers
Trinidad & Tobago Express Newspapers
1 year 6 months ago