Breadfruit ( Artocarpus altilis) is the fruit of the breadfruit tree, though it is often referred to as a vegetable when consumed before it is fully ripe. It comes from the same family as jackfruit and mulberry. Similar to bananas and plantains,...

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The number of new prescriptions written for biosimilar versions of the Humira rheumatoid arthritis treatment, one of the best-selling medicines in the U.S., surged to 36% from just 5% during the first week of April, thanks to the expanding reach that CVS Health has over the prescription drug market, STAT writes. The big jump was attributed to one particular biosimilar called Hyrimoz, which is manufactured by Sandoz, a former unit of Novartis that is a leading supplier of generic and biosimilar medicines. However, Hyrimoz is jointly marketed with Cordavis, a new subsidiary that CVS created last August specifically to sell biosimilar medicines in the U.S.

Shah Capital is seeking a change in leadership at Novavax and wants to appoint two handpicked directors, Pharmaphorum notes. In an open letter, the hedge fund accuses Novavax’s leadership of squandering its “many significant competitive advantages and sizeable market opportunity” due to “self-inflicted problems” under the current team led by chief executive John Jacobs. The bid by Shah Capital – which owns 6.7% of Novavax and is one of its top five shareholders – comes as the company has seen its share price come under massive pressure since the midst of the Covid-19 pandemic, when its shares were trading above $290 and it had a valuation of more than $40 billion.

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— Nearly a half-million health workers who stand to benefit from California’s nation-leading $25 minimum wage law could be in for a rude awakening if hospitals and other health care providers follow through on potential cuts to hours and benefits.

A medical industry challenge to a new minimum wage ordinance in one Southern California city suggests layoffs and reductions in hours and benefits, including cuts to premium pay and vacation time, could be one result of a state law set to begin phasing in in June. However, some experts are skeptical of that possibility.

The California Hospital Association brought a partly successful legal challenge to Inglewood’s $25 minimum wage ordinance, which barred employers from taking those sorts of steps to offset their higher costs.

“Layoffs, reductions in premium pay rates, reductions in non-wage benefits, reductions in hours, and increased charges are consequences of an employer having less money to spend—which will necessarily be the case given the significant increase in spending on wages due to the minimum wage,” the association said in its lawsuit. Additional examples include reducing health coverage and charging for parking or work-related equipment.

Inglewood voters approved the ordinance in November 2022, nearly a year before California legislators enacted a $25 minimum wage for health workers. Those statewide higher wages are to be phased in starting in June under California’s first-in-the-nation law, but Gov. Gavin Newsom has since said they are too expensive as the state faces a deficit estimated between $38 billion and $73 billion. It’s unclear if lawmakers will agree to a delay or take other steps to reduce the cost.

U.S. District Judge Dale S. Fischer agreed with the hospital industry in a March 11 tentative ruling when he shot down the portion of Inglewood’s ordinance banning layoffs and clawbacks by employers, while allowing the rest of the ordinance to remain in effect. He gave the sides time to object to his preliminary decision, though none did.

The California Hospital Association represents more than 400 hospitals and was a key backer of the state’s carefully crafted compromise law, which notably contains none of the employee safeguards included in the Inglewood ordinance.

Spokesperson Jan Emerson-Shea said the association doesn’t know how providers will react once the state law takes effect. “We don’t have any insights,” she said.

“The challenge for any health care organization is figuring out how to pay for the higher wages,” said Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at the University of California-San Francisco. “Since labor costs are the largest part of any health care organization’s costs, it’s hard to figure out how to reduce spending without looking at labor costs.”

Providers can try to increase revenues by bargaining for higher reimbursements from commercial insurers, she said. Public hospitals, nursing homes, and community clinics get most of their money through Medi-Cal, the state’s Medicaid program.

Providers could reduce the services they offer, pare back charity care, and cut or delay capital investments, Spetz said. In the long term, she expects some combination of spending cuts and revenue increases.

Both the state law and local ordinance cover far more than doctors and nurses, with a definition of health worker that includes janitors, housekeepers, groundskeepers, security guards, food service workers, laundry workers, and clerical staff.

The most recent estimate by the Health Care Program at the University of California-Berkeley Labor Center is that as many as 426,000 health workers would make an average of $6,400 extra in the law’s first year, a 19% average pay bump mainly benefiting lower-income workers of color and women. State finance officials project that well over 500,000 workers will benefit.

Researchers didn’t include layoffs and other potential staffing and benefit reductions when they projected the state law’s costs and benefits, said Laurel Lucia, the program’s director. But she pointed to initial projections by hospitals, doctors, and business and taxpayer groups that the wage hike would cost $8 billion annually, thereby imperiling services and resulting in higher premiums and higher costs for state and local governments.

“It seems like a contradiction to say this law’s going to cost billions of dollars while at the same time saying it’s going to reduce workers’ total compensation,” said Lucia, who projects a far lower price tag.

She added that state finance officials had anticipated that Medi-Cal reimbursements would reflect the increased labor costs, while Medicare would eventually at least partially compensate for the higher labor costs.

Michael Reich, chair of the Center on Wage and Employment Dynamics at UC Berkeley’s Institute for Research on Labor and Employment, and affiliated economist Justin Wiltshire recently argued that California’s new $20 minimum wage law for fast-food workers won’t result in mass layoffs and price increases, as some have predicted.

Health care is much different than fast food, Reich acknowledged, but he argued for much the same positive result.

“A higher minimum wage will make it easier and cheaper for hospitals to recruit and retain these workers. The cost savings, and the productivity benefits of more experienced workers, could offset much of the labor cost increase,” Reich said.

The hospital association filed its lawsuit against Inglewood’s ordinance in July, while it was still opposing early versions of the statewide minimum wage legislation. Among many other provisions, the statewide law put on hold an initiative to cap hospital executives’ salaries in Los Angeles.

The hospital association’s legal challenge referenced in part layoffs and reduced working hours imposed by Centinela Hospital Medical Center after Inglewood’s ordinance took effect.

But Centinela said the reduction was entirely unrelated to the ordinance and that all staff were offered alternate positions, which many accepted.

“Centinela Hospital also has since added many more jobs in new clinical positions above minimum wage scale,” the hospital said in a statement.

Service Employees International Union-United Healthcare Workers West, the prime backer of both the local ordinance and the statewide law, sued the hospital in April 2023 alleging that it cut workers’ hours to offset the higher minimum wage. The case is still pending.

The union did not respond to repeated requests for comment.

In a court filing, however, the union and city of Inglewood said similar employer restrictions in previous minimum wage laws have survived.

The ordinance “merely sets the backdrop for collective bargaining negotiations,” and does not bar employers from locking out employees or hiring replacement workers during a strike. Employers can still lay off workers or reduce their hours, they said, so long as they don’t do so to fund the higher minimum wage.

But Fischer agreed with the hospital association that layoffs and reductions in employees’ total compensation packages are “obvious responses by an employer to rising compensation costs.”

Restricting employers’ options would violate federal labor relations rules, he said.

“The minimum wage an employer has to pay its employees will invariably affect the total amount of compensation it is able or willing to pay,” he wrote “This will then invariably affect the number of employees it can retain and the number of hours those employees will be scheduled to work.”

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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The big jump was attributed to one particular biosimilar called Hyrimoz, which is manufactured by Sandoz, a former unit of Novartis that is a leading supplier of generic and biosimilar medicines. However, Hyrimoz is jointly marketed with Cordavis, a new subsidiary that CVS created last August specifically to sell any number of biosimilar medicines in the U.S.

This connection is crucial to the sudden jump in Hyrimoz prescriptions. How so? On April 1, CVS Caremark, which is one of the largest pharmacy benefit managers in the U.S., removed Humira from its major national formularies for health plans that cover about 30 million lives. Then, Hyrimoz was added to the formularies, which are the lists of medicines that are covered by health insurance.

Continue to STAT+ to read the full story…

Natural honey, molasses, unrefined maple syrup, fruit purees, dates prunes and Stevia are examples of healthier alternatives which can be used in moderation in place of refined sugars

View the full post Sources and benefits of natural sugars  on NOW Grenada.

prevention,” Daniel Zakowski, CEO and cofounder of Ready. Set. Food!, told Healio.Ready. Set. Food! is partnering with ObvioHealth to conduct the study with the goal of showing insurance

But in the U.S., the ethos of grinding and pulling yourself up by your own bootstraps is ubiquitous, both in the country's beginnings and our current environment of always-on technology and work hours. And getting enough sleep can seem like a dream.

The Gallup poll, released Monday, found 57% of Americans say they would feel better if they could get more sleep, while only 42% say they are getting as much sleep as they need. That’s a first in Gallup polling since 2001; in 2013, when Americans were last asked, it was just about the reverse — 56% saying they got the needed sleep and 43% saying they didn’t.

IMPROVE YOUR SLEEP BY OPTIMIZING 6 BIOMARKERS: ‘INTEGRAL TO HEALTH’

Younger women, under the age of 50, were especially likely to report they aren't getting enough rest.

The poll also asked respondents to report how many hours of sleep they usually get per night: Only 26% said they got eight or more hours, which is around the amount that sleep experts say is recommended for health and mental well-being. Just over half, 53%, reported getting six to seven hours. And 20% said they got five hours or less, a jump from the 14% who reported getting the least amount of sleep in 2013.

(And just to make you feel even more tired, in 1942, the vast majority of Americans were sleeping more. Some 59% said they slept eight or more hours, while 33% said they slept six to seven hours. What even IS that?)

The poll doesn't get into reasons WHY Americans aren't getting the sleep they need, and since Gallup last asked the question in 2013, there's no data breaking down the particular impact of the last four years and the pandemic era.

But what's notable, says Sarah Fioroni, senior researcher at Gallup, is the shift in the last decade toward more Americans thinking they would benefit from more sleep and particularly the jump in the number of those saying they get five or less hours.

"That five hours or less category ... was almost not really heard of in 1942," Fioroni said. "There’s almost nobody that said they slept five hours or less."

In modern American life, there also has been "this pervasive belief about how sleep was unnecessary — that it was this period of inactivity where little to nothing was actually happening and that took up time that could have been better used," said Joseph Dzierzewski, vice president for research and scientific affairs at the National Sleep Foundation.

It’s only relatively recently that the importance of sleep to physical, mental and emotional health has started to percolate more in the general population, he said.

And there’s still a long way to go. For some Americans, like Justine Broughal, 31, a self-employed event planner with two small children, there simply aren't enough hours in the day. So even though she recognizes the importance of sleep, it often comes in below other priorities like her 4-month-old son, who still wakes up throughout the night, or her 3-year-old daughter.

"I really treasure being able to spend time with (my children)," Broughal says. "Part of the benefit of being self-employed is that I get a more flexible schedule, but it’s definitely often at the expense of my own care."

So why are we awake all the time? One likely reason for Americans' sleeplessness is cultural — a longstanding emphasis on industriousness and productivity.

Some of the context is much older than the shift documented in the poll. It includes the Protestants from European countries who colonized the country, said Claude Fischer, a professor of sociology at the graduate school of the University of California Berkeley. Their belief system included the idea that working hard and being rewarded with success was evidence of divine favor.

"It has been a core part of American culture for centuries," he said. "You could make the argument that it ... in the secularized form over the centuries becomes just a general principle that the morally correct person is somebody who doesn’t waste their time."

Jennifer Sherman has seen that in action. In her research in rural American communities over the years, the sociology professor at Washington State University says a common theme among people she interviewed was the importance of having a solid work ethic. That applied not only to paid labor but unpaid labor as well, like making sure the house was clean.

A through line of American cultural mythology is the idea of being "individually responsible for creating our own destinies," she said. "And that does suggest that if you’re wasting too much of your time ... that you are responsible for your own failure."

"The other side of the coin is a massive amount of disdain for people considered lazy," she added.

Broughal says she thinks that as parents, her generation is able to let go of some of those expectations. "I prioritize ... spending time with my kids, over keeping my house pristine," she said.

But with two little ones to care for, she said, making peace with a messier house doesn't mean more time to rest: "We’re spending family time until, you know, (my 3-year-old) goes to bed at eight and then we’re resetting the house, right?"

While the poll only shows a broad shift over the past decade, living through the COVID-19 pandemic may have affected people's sleep patterns. Also discussed in post-COVID life is "revenge bedtime procrastination," in which people put off sleeping and instead scroll on social media or binge a show as a way of trying to handle stress.

Liz Meshel is familiar with that. The 30-year-old American is temporarily living in Bulgaria on a research grant, but also works a part-time job on U.S. hours to make ends meet.

On the nights when her work schedule stretches to 10 p.m., Meshel finds herself in a "revenge procrastination" cycle. She wants some time to herself to decompress before going to sleep and ends up sacrificing sleeping hours to make it happen.

"That’s applies to bedtime as well, where I’m like, ’Well, I didn’t have any me time during the day, and it is now 10 p.m., so I am going to feel totally fine and justified watching X number of episodes of TV, spending this much time on Instagram, as my way to decompress," she said. "Which obviously will always make the problem worse."

A number of communities in St Michael and Christ Church will be fogged by the Ministry of Health and Wellness’ Vector Control Unit this week.

The Unit will begin its fogging exercise on Monday, April 15, in the following St Michael districts: Brittons New Road, Rolling Road, Taitts Road, Eastmond Road, Gunsite Road, Bonnetts Housing Area, and surrounding districts.

It will then visit Thomas Road, Club Morgan Road with avenues, Plantain Walk, Clapham Drive, Simmons Road, and Rendezvous High Ridge with avenues, on Tuesday, April 16.

On Wednesday, April 17, the team will spray Fordes Road with avenues, Clapham Heights, Clapham Road, Clapham Park, Adam’s Road, Observatory Road, Clapham Ridge, Laynes Road, Clapham Close, and neighbouring districts.

The next day, Thursday, April 18, the Unit will go into Christ Church to fog Rendezvous Road, Rendezvous Ridge, Rendezvous Garden, Amity Lodge, Worthing Main Road, Bamboo Road, Craigg Road, Beckles Road, and Harmony Hall with avenues.

The fogging exercise for the week will conclude on Friday, April 19, in St Michael in Bridge Gap, Upper Goodland, Gills Gap and avenues, Browns Gap, Alkins Road, Wilkinson Road, Richmond Gap, Thomas Gap, and Lower Richmond Gap.

Fogging takes place from 4:30 to 8:30 p.m. daily. Householders are reminded to open their windows and doors to allow the spray to enter. Children should not be allowed to play in the fog.

Members of the public are advised that the completion of scheduled fogging activities may be affected by events beyond the Unit’s control. In such circumstances, the Unit will return to communities affected in the soonest possible time.

The post Fogging schedule for April 15 – 19 appeared first on Barbados Today.

In its most recent update, the Ministry of Health and Wellness stated that since the outbreak began in October 2023, four deaths have been recorded. It added that a number of people were referred to hospital with warning signs and some were hospitalised with severe dengue.

The predominant serotype identified has been type 2, followed by type 3. 

Up to the week ending April 6, 2024, there were 2 915 clinically suspected, and 1 059 laboratory confirmed cases of dengue fever in Barbados. This compares to the same period in 2023, when there were only 158 suspected cases, and 105 confirmed cases. 

The ministry reported that the current outbreak peaked in January, this year, and continued to decline in March. Although lower than February, numbers are still above the outbreak threshold for March. 

Health authorities have advised members of the public to implement measures to avoid contracting the illness, such as using repellent and wearing protective clothing; eliminating breeding sites by keeping their surroundings clean; and using protective window and door screens as well as mosquito nets, at home.

Furthermore, the Ministry of Health and Wellness disclosed that there has been an increase in gastroenteritis cases in the past two weeks, in persons five years and older. It stated that this may be due to more people eating food which is prepared outside of the home. However, cases in children under five years old have not surpassed the threshold of the expected number during this time period. 

“Persons choosing to purchase ready-prepared food are encouraged to check for cleanliness and tidiness of the establishment, including the presence of handwashing facilities if the vendor is itinerant or at a wayside stall.  Patrons are reminded to wash or sanitise their hands prior to eating, after coughing or sneezing into tissues, and after using the toilet facilities,” the health ministry stated.

The public is reminded that hot foods are to be served hot, at 140 degrees Fahrenheit or higher, and cold foods should be at 40 degrees Fahrenheit and below. Additionally, cooked and uncooked foods should always be separated.

As for respiratory cases, reports indicate that there was an increase in cases in persons five years and older up to April 6, this year, but levels in children under five years old continue to be low from the beginning of the year.

Influenza and other cough and cold viruses not confirmed may be contributing to the increase, the ministry said. COVID-19 infections remain very low, with no deaths recorded within the last month.

Health authorities encouraged Barbadians to practise stringent respiratory hygiene with use of hand washing, hand sanitising and mask wearing by those with symptoms or those vulnerable to severe disease. (BGIS)

The post Dengue outbreak continues despite fall in cases appeared first on Barbados Today.