How we can prepare for future public health emergencies
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The U.S. is experiencing an increasing number of disease outbreaks and extreme weather events. While state and national preparedness for public health emergencies has improved in some areas, dangerous gaps remain, says a recent report from Trust for America’s Health.
Titled, “Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism,” the report identifies gaps in national and state preparedness for public health emergencies and provides recommendations for improvement.
Using nine key indicators, the report categorizes all U.S. states and the District of Columbia into three readiness levels: high, medium, and low. The writers hope the report will help policymakers in under-performing states improve public health infrastructure.
Read on to learn more about what the research found and how we can individually prepare for future public health emergencies.
There’s work to be done
The report highlights areas with strong performance as well as those that need improvement.
Some areas with strong performance:
- State public health funding: Most states and the District of Columbia either maintained or increased their public health funding during the 2023 fiscal year.
- Health care labor force preparedness: Most states have started expanding the health care labor force for improved emergency response. As of 2023, 39 states participated in the Nurse Licensure Compact, which allows nurses to work in multiple member states without the need for additional state licenses.
Some areas that need improvement:
- Hospital safety scores: Only 25 percent of acute care hospitals earned the highest patient safety grade in fall 2023. These scores measure health care-associated infection rates, intensive care unit capacity, and other metrics. More high-scoring hospitals would improve preparedness for future public health emergencies.
- Access to paid time off: From March 2018 to March 2023, only 55 percent of U.S. workers used paid time off. Access to paid time off is important for reducing the spread of infectious diseases.
We can all do our part by staying up to date on vaccines
While the report focuses on policy changes that would improve emergency preparedness, Trust for America’s Health’s research identifies one way that we can individually prepare for future public health emergencies: staying up to date on vaccines.
The report found that during the 2022-2023 flu season, only 49 percent of those eligible for the flu vaccine received it. Public health experts are concerned that false claims about COVID-19 vaccines have resulted in overall vaccine hesitancy.
A decline in vaccination rates has led to an uptick in life-threatening, vaccine-preventable diseases, such as measles. Increasing vaccine uptake would prevent the spread of vaccine-preventable diseases and reduce strain on hospital systems during public health crises.
Make sure that you and your children have received all recommended vaccines to prevent severe illness, hospitalization, and death. Learn more about recommended vaccines for adults and children from the CDC.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Dry Needling for Meralgia Paresthetica?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Could you address dry needling, who should administer it, and could it be a remedy for meralgia paresthetica? If not, could you speak to home-based remedies for meralgia paresthetica? Thank you?❞
We’ll need to take a main feature some time to answer this one fully, but we will say some quick things here:
- Dry needling, much like acupuncture, has been found to help with pain relief.
- Meralgia paresthetica, being a neuropathy, may benefit from some things that benefit people with peripheral neuropathy, such as lion’s mane mushroom. There is definitely not research to support this hypothesis yet though (so far as we could find anyway; there is plenty to support lion’s mane helping with nerve regeneration in general, but nothing specific for meralgia paresthetica).
Some previous articles you might enjoy meanwhile:
- Pinpointing The Usefulness Of Acupuncture
- Science-Based Alternative Pain Relief
- Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
- What Does Lion’s Mane Actually Do, Anyway?
Take care!
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The Painkilling Power Of Opioids, Without The Harm?
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When it comes to painkilling medications, they can generally be categorized into two kinds:
- non-opioids (e.g. ibuprofen, paracetamol/acetaminophen, aspirin)
- ones that actually work for something more serious than a headache
That’s an oversimplification, but broadly speaking, when there is serious painkilling to be done, that’s when doctors consider it’s time to break out the opioids.
Nor are all opioids created equal—there’s a noteworthy difference between codeine and morphine, for instance—but the problems of opioids are typically the same (tolerance, addiction, and eventual likelihood of overdose when one tries to take enough to make it work after developing a tolerance), and it becomes simply a matter of degree.
See also: I’ve been given opioids after surgery to take at home. What do I need to know?
So, what’s the new development?
A team of researchers have found that the body can effectively produce its own targetted painkilling peptides, similar in function to benzodiazepines (an opioid drug), but—and which is a big difference—confined to the peripheral nervous system (PNS), meaning that it doesn’t enter the brain.
- The peptides killing the pain before it can reach the brain is obviously good because that means the pain is simply not experienced
- The peptides not having any effect on the brain, however, means that the mechanism of addiction of opioids simply does not apply here
- The peptides not having any effect on the brain also means that the CNS can’t be “put to sleep” by these peptides in the same way it can if a high dose of opioids is taken (this is what typically causes death in opioid overdoses; the heart simply beats too slowly to maintain life)
The hope, therefore, is to now create medications that target the spinal ganglia that produce these peptides, to “switch them on” at will.
Obviously, this won’t happen overnight; there will need to be first a lot of research to find a drug that does that (likely this will involve a lot of trial and error and so many mice/rats), and then multiple rounds of testing to ascertain that the drug is safe and effective for humans, before it can then be rolled out commercially.
But, this is still a big breakthrough; there arguably hasn’t been a breakthrough this big in pain research since various opioid-related breakthroughs in the 70s and 80s.
You can see a pop-science article about it here:
And you can see the previous research (from earlier this year) that this is now building from, about the glial cells in the spinal ganglia, here:
Peripheral gating of mechanosensation by glial diazepam binding inhibitor
But wait, there’s more!
Remember what we said about affecting the PNS without affecting the CNS, to kill the pain without killing the brain?
More researchers are already approaching the same idea to deal with the same problem, but from the angle of gene therapy, and have already had some very promising results with mice:
Structure-guided design of a peripherally restricted chemogenetic system
…which you can read about in pop-science terms (with diagrams!) here:
New gene therapy could alleviate chronic pain, researchers find
While you’re waiting…
In the meantime, approaches that are already available include:
- The 7 Approaches To Pain Management
- Managing Chronic Pain (Realistically!)
- Science-Based Alternative Pain Relief ← when painkillers aren’t helping, these things might!
Take care!
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Bold Beans – by Amelia Christie-Miller
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We all know beans are one of the most healthful foods around, but how to include more of them, without getting boring?
This book has the answer, giving 80 exciting recipes, divided into the following sections:
- Speedy beans
- Bean snacks & sharing plates
- Brothy beans
- Bean bowls
- Hearty salads
- Bean feasts
The recipes are obviously all bean-centric, though if you have a particular dietary restriction, watch out for the warning labels on some (e.g. meat, fish, dairy, gluten, etc), and make a substitution if appropriate.
The recipes themselves have a happily short introductory paragraph, followed by all you’d expect from a recipe book (ingredients, measurements, method, picture)
There’s also a reference section, to learn about different kinds of beans and bean-related culinary methods that can be applied per your preferences.
Bottom line: if you’d like to include more beans in your daily diet but are stuck for making them varied and interesting, this is the book for you!
Click here to check out Bold Beans, and get your pulse racing (in a good way!)
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How To Avoid UTIs
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Psst… A Word To The Wise
Urinary Tract Infections (UTIs) can strike at any age, but they get a lot more common as we get older:
- About 10% of women over 65 have had one
- About 30% of women over 85 have had one
Source: Urinary tract infection in older adults
Note: those figures are almost certainly very underreported, so the real figures are doubtlessly higher. However, we print them here as they’re still indicative of a disproportionate increase in risk over time.
What about men?
Men do get UTIs too, but at a much lower rate. The difference in average urethra length means that women are typically 30x more likely to get a UTI.
However! If a man does get one, then assuming the average longer urethra, it will likely take much more treatment to fix:
Case study: 26-Year-Old Man With Recurrent Urinary Tract Infections
Risk factors you might want to know about
While you may not be able to do much about your age or the length of your urethra, there are some risk factors that can be more useful to know:
Catheterization
You might logically think that having a catheter would be the equivalent of having a really long urethra, thus keeping you safe, but unfortunately, the opposite is true:
Read more: Review of Catheter-Associated Urinary Tract Infections
Untreated menopause
Low estrogen levels can cause vaginal tissue to dry, making it easier for pathogens to grow.
For more information on menopausal HRT, see:
What You Should Have Been Told About Menopause Beforehand
Sexual activity
Most kinds of sexual activity carry a risk of bringing germs very close to the urethra. Without wishing to be too indelicate: anything that’s going there should be clean, so it’s a case for washing your hands/partner(s)/toys etc.
For the latter, beyond soap and water, you might also consider investing in a UV sanitizer box ← This example has a 9” capacity; if you shop around though, be sure to check the size is sufficient!
Kidney stones and other kidney diseases
Anything that impedes the flow of urine can raise the risk of a UTI.
See also: Keeping Your Kidneys Healthy (Especially After 60)
Diabetes
How much you can control this one will obviously depend on which type of diabetes you have, but diabetes of any type is an immunocompromizing condition. If you can, managing it as well as possible will help many aspects of your health, including this one.
More on that:
How To Prevent And Reverse Type 2 Diabetes
Note: In the case of Type 1 Diabetes, the above advice will (alas) not help you to prevent or reverse it. However, reducing/avoiding insulin resistance is even more important in cases of T1D (because if your exogenous insulin stops working, you die), so the advice is good all the same.
How do I know if I have a UTI?
Routine screening isn’t really a thing, since the symptoms are usually quite self-evident. If it hurts/burns when you pee, the most likely reason is a UTI.
Get it checked out; the test is a (non-invasive) urinalysis test. In other words, you’ll give a urine sample and they’ll test that.
Anything else I can do to avoid it?
Yes! We wrote previously about the benefits of cranberry supplementation, which was found even to rival antibiotics:
❝…recommend cranberry ingestion to decrease the incidence of urinary tract infections, particularly in individuals with recurrent urinary tract infections. This would also reduce the [need for] administration of antibiotics❞
Read more: Health Benefits Of Cranberries
Take care!
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Banana Bread vs Bagel – Which is Healthier?
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Our Verdict
When comparing banana bread to bagel, we picked the bagel.
Why?
Unlike most of the items we compare in this section, which are often “single ingredient” or at least highly standardized, today’s choices are rather dependent on recipe. Certainly, your banana bread and your bagels may not be the same as your neighbor’s. Nevertheless, to compare averages, we’ve gone with the FDA’s Food Central Database for reference values, using the most default average recipes available. Likely you could make either or both of them a little healthier, but as it is, this is how we’ve gone about making it a fair comparison. With that in mind…
In terms of macros, bagels have more than 2x the protein and about 4x the fiber, while banana bread has slightly higher carbs and about 7x more fat. You may be wondering: are the fats healthy? And the answer is, it could be better, could be worse. The FDA recipe went with margarine rather than butter, which lowered the saturated fat to being only ¼ of the total fat (it would have been higher, had they used butter) whereas bagels have no saturated fat at all—which characteristic is quite integral to bagels, unless you make egg bagels, which is rather a different beast. All in all, the macros category is a clear win for bagels, especially when we consider the carb to fiber ratio.
In the category of vitamins, bagels have on average more vitamin B1, B3, B5, and B9, while banana bread has on average more of vitamins A and C. A modest win for bagels.
When it comes to minerals, bagels are the more nutrient dense with more copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while banana bread is not higher in any minerals. An obvious and easy win for bagels.
Closing thoughts: while the micronutrient profile quite possibly differs wildly from one baker to another, something that will probably stay more or less the same regardless is the carb to fiber ratio, and protein to fat. As a result, we’d weight the macros category as the more universally relevant. Bagels won in all categories today, as it happened, but it’s fairly safe to say that, on average, a baker who makes bagels and banana bread with the same levels of conscientiousness for health (or lack thereof) will tend to make bagels that are healthier than banana bread, based on the carb to fiber ratio, and the protein to fat ratio.
Enjoy!
Want to learn more?
You might like to read:
- Should You Go Light Or Heavy On Carbs?
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Wholewheat Bread vs Seeded White – Which is Healthier?
Take care!
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What is Ryeqo, the recently approved medicine for endometriosis?
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For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.
A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.
Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.
What does Ryeqo do?
Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.
Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.
Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.
All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.
Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).
Is it really new?
The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.
But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.
Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.
In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.
The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.
You can’t take the contraceptive pill with Ryeqo but the endometriosis drug could replace it.
ShutterstockHow to take it and what not to do
Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.
It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.
Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.
Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.
The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.
It’s costly for now
Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.
While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.
Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.
Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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