Securely Attached –
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A lot of books on attachment theory are quite difficult to read. They’re often either too clinical with too much jargon that can feel like incomprehensible psychobabble, or else too wishy-washy and it starts to sound like a horoscope for psychology enthusiasts.
This one does it better.
The author gives us a clear overview and outline of attachment theory, with minimal jargon and/but clearly defined terms, and—which is a boon for anyone struggling to remember which general attachment pattern is which—color-codes everything consistently along the way. This is one reason that we recommend getting a print copy of the book, not the e-book.
The other reason to invest in the print copy rather than the e-book is the option to use parts of it as a workbook directly—though if preferred, one can simply take the prompts and use them, without writing in the book, of course.
It’s hard to say what the greatest value of this book is because there are two very strong candidates:
- Super-clear and easy explanation of Attachment Theory, in a way that actually makes sense and will stick
- Excellent actually helpful advice on improving how we use the knowledge that we now have of our own attachment patterns and those of others
Bottom line: if you’d like to better understand Attachment Theory and apply it to your life, but have been put off by other presentations of it, this is the most user-friendly, no-BS version that this reviewer has seen.
Click here to check out Securely Attached, and upgrade your relationship(s)!
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Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
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Protecting yourself and family from mosquito bites can be challenging, especially in this hot and humid weather. Protests from young children and fears about topical insect repellents drive some to try alternatives such as wristbands, patches and stickers.
These products are sold online as well as in supermarkets, pharmacies and camping stores. They’re often marketed as providing “natural” protection from mosquitoes.
But unfortunately, they aren’t a reliable way to prevent mosquito bites. Here’s why – and what you can try instead.
Why is preventing mosquito bites important?
Mosquitoes can spread pathogens that make us sick. Japanese encephalitis and Murray Valley encephalitis viruses can have potentially fatal outcomes. While Ross River virus won’t kill you, it can cause potentially debilitating illnesses.
Health authorities recommend preventing mosquito bites by: avoiding areas and times of the day when mosquitoes are most active; covering up with long sleeved shirts, long pants, and covered shoes; and applying a topical insect repellent (a cream, lotion, or spray).
I don’t want to put sticky and smelly repellents on my skin!
While for many people, the “sting” of a biting mosquitoes is enough to prompt a dose of repellent, others are reluctant. Some are deterred by the unpleasant feel or smell of insect repellents. Others believe topical repellents contain chemicals that are dangerous to our health.
However, many studies have shown that, when used as recommended, these products are safe to use. All products marketed as mosquito repellents in Australia must be registered by the Australian Pesticides and Veterinary Medicines Authority; a process that provides recommendations for safe use.
How do topical repellents work?
While there remains some uncertainty about how the chemicals in topical insect repellents actually work, they appear to either block the sensory organs of mosquitoes that drive them to bite, or overpower the smells of our skin that helps mosquitoes find us.
Diethytolumide (DEET) is a widely recommended ingredient in topical repellents. Picaridin and oil of lemon eucalyptus are also used and have been shown to be effective and safe.
How do other products work?
“Physical” insect-repelling products, such as wristbands, coils and candles, often contain a botanically derived chemical and are often marketed as being an alternative to DEET.
However, studies have shown that devices such as candles containing citronella oil provide lower mosquito-bite prevention than topical repellents.
A laboratory study in 2011 found wristbands infused with peppermint oil failed to provide full protection from mosquito bites.
Even as topical repellent formulations applied to the skin, these botanically derived products have lower mosquito bite protection than recommended products such as those containing DEET, picaridin and oil of lemon eucalyptus.
Wristbands infused with DEET have shown mixed results but may provide some bite protection or bite reduction. DEET-based wristbands or patches are not currently available in Australia.
There is also a range of mosquito repellent coils, sticks, and other devices that release insecticides (for example, pyrethroids). These chemicals are primarily designed to kill or “knock down” mosquitoes rather than to simply keep them from biting us.
What about stickers and patches?
Although insect repellent patches and stickers have been available for many years, there has been a sudden surge in their marketing through social media. But there are very few scientific studies testing their efficacy.
Our current understanding of the way insect repellents work would suggest these small stickers and patches offer little protection from mosquito bites.
At best, they may reduce some bites in the way mosquito coils containing botanical products work. However, the passive release of chemicals from the patches and stickers is likely to be substantially lower than those from mosquito coils and other devices actively releasing chemicals.
One study in 2013 found a sticker infused with oil of lemon eucalyptus “did not provide significant protection to volunteers”.
Clothing impregnated with insecticides, such as permethrin, will assist in reducing mosquito bites but topical insect repellents are still recommended for exposed areas of skin.
Take care when using these products
The idea you can apply a sticker or patch to your clothing to protect you from mosquito bites may sound appealing, but these devices provide a false sense of security. There is no evidence they are an equally effective alternative to the topical repellents recommended by health authorities around the world. It only takes one bite from a mosquito to transmit the pathogens that result in serious disease.
It is also worth noting that there are some health warnings and recommendations for their use required by Australian Pesticides and Veterinary Medicines Authority. Some of these products warn against application to the skin (recommending application to clothing only) and to keep products “out of reach of children”. This is a challenge if attached to young children’s clothing.
Similar warnings are associated with most other topical and non-topical mosquito repellents. Always check the labels of these products for safe use recommendations.
Are there any other practical alternatives?
Topical insect repellents are safe and effective. Most can be used on children from 12 months of age and pose no health risks. Make sure you apply the repellent as a thin even coat on all exposed areas of skin.
But you don’t need “tropical strength” repellents for short periods of time outdoors; a range of formulations with lower concentrations of repellent will work well for shorter trips outdoors. There are some repellents that don’t smell as strong (for example, children’s formulations, odourless formulations) or formulations that may be more pleasant to use (for example, pump pack sprays).
Finally, you can always cover up. Loose-fitting long-sleeved shirts, long pants, and covered shoes will provide a physical barrier between you and mosquitoes on the hunt for your or your family’s blood this summer.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How they did it: STAT reporters expose how ailing seniors suffer when Medicare Advantage plans use algorithms to deny care
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In a call with a long-time source, what stood out most to STAT reporters Bob Herman and Casey Ross was just how viscerally frustrated and angry the source was about an algorithm used by insurance companies to decide how long patients should stay in a nursing home or rehab facility before being sent home.
The STAT stories had a far-reaching impact:
- The U.S. Senate Committee on Homeland Security and Government Affairs took a rare step of launching a formal investigation into the use of algorithms by the country’s three largest Medicare Advantage insurers.
- Thirty-two House members urged the Centers for Medicare and Medicaid Services to increase the oversight of algorithms that health insurers use to make coverage decisions.
- In a rare step, CMS launched its own investigation into UnitedHealth. It also stiffened its regulations on the use of proprietary algorithms and introduced plans to audit denials across Medicare Advantage plans in 2024.
- Based on STAT’s reporting, Medicare Advantage beneficiaries filed two class-action lawsuits against UnitedHealth and its NaviHealth subsidiary, the maker of the algorithm, and against Humana, another major health insurance company that was also using the algorithm.
- Amid scrutiny, UnitedHealth renamed NaviHealth.
The companies never allowed an on-the-record interview with their executives, but they acknowledged that STAT’s reporting was true, according to the news organization.
Ross and Herman spoke with The Journalist’s Resource about their project and shared the following eight tips.
1. Search public comments on proposed federal rules to find sources.
Herman and Ross knew that the Centers for Medicare and Medicaid Services had put out a request for public comments, asking stakeholders within the Medicare Advantage industry how the system could improve.
There are two main ways to get Medicare coverage: original Medicare, which is a fee-for-service health plan, and Medicare Advantage, which is a type of Medicare health plan offered by private insurance companies that contract with Medicare. Medicare Advantage plans have increasingly become popular in recent years.
Under the Social Security Act, the public has the opportunity to submit comments on Medicare’s proposed national coverage determinations. CMS uses public comments to inform its proposed and final decisions. It responds in detail to all public comments when issuing a final decision.
The reporters began combing through hundreds of public comments attached to a proposed Medicare Advantage rule that was undergoing federal review. NaviHealth, the UnitedHealth subsidiary and the maker of the algorithm, came up in many of the comments, which include the submitters’ information.
“These are screaming all-caps comments to federal regulators about YOU NEED TO SOMETHING ABOUT THIS BECAUSE IT’S DISGUSTING,” Ross says.
“The federal government is proposing rules and regulations all the time,” adds Herman, STAT’s business of health care reporter. “If someone’s going to take the time and effort to comment on them, they must have at least some knowledge of what’s going on. It’s just a great tool for any journalist to use to figure out more and who to contact.”
The reporters also found several attorneys who had complained in the comments. They began reaching out to them, eventually gaining access to confidential documents and intermediaries who put them in touch with patients to show the human impact of the algorithm.
2. Harness the power of the reader submission box.
At the suggestion of an editor, the reporters added a reader submission box at the bottom of their first story, asking them to share their own experiences with Medicare Advantage denials.
The floodgates opened. Hundreds of submissions arrived.
By the end of their first story, Herman and Ross had confidential records and some patients, but they had no internal sources in the companies they were investigating, including Navihealth. The submission box led them to their first internal source.
(Screenshot of STAT’s submission box.) The journalists also combed through LinkedIn and reached out to former and current employees, but the response rate was much lower than what they received via the submission box.
The submission box “is just right there,” Herman says. “People who would want to reach out to us can do it right then and there after they read the story and it’s fresh in their minds.”
3. Mine podcasts relevant to your story.
The reporters weren’t sure if they could get interviews with some of the key figures in the story, including Tom Scully, the former head of the Centers for Medicare and Medicaid Services who drew up the initial plans for NaviHealth years before UnitedHealth acquired it.
But Herman and another colleague had written previously about Scully’s private equity firm and they had found a podcast where he talked about his work. So Herman went back to the podcast — where he discovered Scully had also discussed NaviHealth.
The reporters also used the podcast to get Scully on the phone for an interview.
“So we knew we had a good jumping off point there to be like, ‘OK, you’ve talked about NaviHealth on a podcast, let’s talk about this,’” Herman says. “I think that helped make him more willing to speak with us.”
4. When covering AI initiatives, proceed with caution.
“A source of mine once said to me, ‘AI is not magic,’” Ross says. “People need to just ask questions about it because AI has this aura about it that it’s objective, that it’s accurate, that it’s unquestionable, that it never fails. And that is not true.”
AI is not a neutral, objective machine, Ross says. “It’s based on data that’s fed into it and people need to ask questions about that data.”
He suggests several questions to ask about the data behind AI tools:
- Where does the data come from?
- Who does it represent?
- How is this tool being applied?
- Do the people to whom the tool is being applied match the data on which it was trained? “If racial groups or genders or age of economic situations are not adequately represented in the training set, then there can be an awful lot of bias in the output of the tool and how it’s applied,” Ross says.
- How is the tool applied within the institution? Are people being forced to forsake their judgment and their own ability to do their jobs to follow the algorithm?
5. Localize the story.
More than half of all Medicare beneficiaries have Medicare Advantage and there’s a high likelihood that there are multiple Medicare Advantage plans in every county across the nation.
“So it’s worth looking to see how Medicare Advantage plans are growing in your area,” Herman says.
Finding out about AI use will most likely rely on shoe-leather reporting of speaking with providers, nursing homes and rehab facilities, attorneys and patients in your community, he says. Another source is home health agencies, which may be caring for patients who were kicked out of nursing homes and rehab facilities too soon because of a decision by an algorithm.
The anecdote that opens their first story involves a small regional health insurer in Wisconsin, which was using NaviHealth and a contractor to manage post-acute care services, Ross says.
“It’s happening to people in small communities who have no idea that this insurer they’ve signed up with is using this tool made by this other company that operates nationally,” Ross says.
There are also plenty of other companies like NaviHealth that are being used by Medicare Advantage plans, Herman says. “So it’s understanding which Medicare Advantage plans are being sold in your area and then which post-acute management companies they’re using,” he adds.
Some regional insurers have online documents that show which contractors they use to evaluate post-acute care services.
6. Get familiar with Medicare’s appeals databases
Medicare beneficiaries can contest Medicare Advantage denials through a five-stage process, which can last months to years. The appeals can be filed via the Office of Medicare Hearings and Appeals.
“Between 2020 and 2022, the number of appeals filed to contest Medicare Advantage denials shot up 58%, with nearly 150,000 requests to review a denial filed in 2022, according to a federal database,” Ross and Herman write in their first story. “Federal records show most denials for skilled nursing care are eventually overturned, either by the plan itself or an independent body that adjudicates Medicare appeals.”
There are several sources to find appeals data. Be mindful that the cases themselves are not public to protect patient privacy, but you can find the number of appeals filed and the rationale for decisions.
CMS has two quality improvement organizations, or QIOs, Livanta and Kepro, which are required to file free, publicly-available annual reports, about the cases they handle, Ross says.
Another company, Maximus, a Quality Improvement Contractor, also files reports on prior authorization cases it adjudicates for Medicare. The free annual reports include data on raw numbers of cases and basic information about the percentage denials either overturned or upheld on appeal, Ross explains.
CMS also maintains its own database on appeals for Medicare Part C (Medicare Advantage plans) and Part D, which covers prescription drugs, although the data is not complete, Ross explains.
7. Give your editor regular updates.
“Sprinkle the breadcrumbs in front of your editors,” Ross says.
“If you wrap your editors in the process, you’re more likely to be able to get to the end of [the story] before they say, ‘That’s it! Give me your copy,’” Ross says.
8. Get that first story out.
“You don’t have to know everything before you write that first story,” Ross says. “Because with that first story, if it has credibility and it resonates with people, sources will come forward and sources will continue to come forward.”
Read the stories
Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need
UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care
UnitedHealth used secret rules to restrict rehab care for seriously ill Medicare Advantage patients
This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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For women with antenatal depression, micronutrients might help them and their babies – new study
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Getty Images Julia J Rucklidge, University of Canterbury; Elena Moltchanova, University of Canterbury; Roger Mulder, University of Otago, and Siobhan A Campbell, University of Canterbury
Antenatal depression affects 15% to 21% of pregnant women worldwide. It can influence birth outcomes and children’s development, as well as increase the risk of post-natal depression.
Current treatments like therapy can be inaccessible and antidepressants can carry risks for developing infants.
Over the past two decades, research has highlighted that poor nutrition is a contributing risk factor to mental health challenges. Most pregnant women in New Zealand aren’t adhering to nutritional guidelines, according to a longitudinal study. Only 3% met the recommendations for all food groups.
Another cohort study carried out in Brazil shows that ultra-processed foods (UPF) accounted for at least 30% of daily dietary energy during pregnancy, displacing healthier options.
UPFs are chemically manufactured and contain additives to improve shelf life, as well as added sugar and salt. Importantly, they are low in essential micronutrients (vitamins and minerals).
The consumption of these foods is concerning because a nutrient-poor diet during pregnancy has been linked to poorer mental health outcomes in children. This includes depression, anxiety, hyperactivity, and inattention.
Increasing nutrients in maternal diets and reducing consumption of UPFs could improve the mental health of the mother and the next generation. Good nutrition can have lifelong benefits for the offspring.
However, there are multiple factors that mean diet change alone may not in itself be sufficient to address mental health challenges. Supplementing with additional nutrients may also be important to address nutritional needs during pregnancy.
Micronutrients as treatment for depression
Our earlier research suggests micronutrient supplements for depression have benefits outside pregnancy.
But until now there have been no published randomised controlled trials specifically designed to assess the efficacy and safety of broad-spectrum micronutrients on antenatal depression and overall functioning.
The NUTRIMUM trial, which ran between 2017 and 2022, recruited 88 women in their second trimester of pregnancy who reported moderate depressive symptoms. They were randomly allocated to receive either 12 capsules (four pills, three times a day) of a broad-spectrum micronutrient supplement or an active placebo containing iodine and riboflavin for a 12-week period.
Micronutrient doses were generally between the recommended dietary allowance and the tolerable upper level.
Based on clinician ratings, micronutrients significantly improved overall psychological functioning compared to the placebo. The findings took into account all noted changes based on self-assessment and clinician observations. This includes sleep, mood regulation, coping, anxiety and side effects.
Adding micronutrients to the diet of pregnant women with antenatal depression significantly improved their overall psychological functioning. Getty Images Both groups reported similar reductions in symptoms of depression. More than three quarters of participants were in remission at the end of the trial. But 69% of participants in the micronutrient group rated themselves as “much” or “very much” improved, compared to 39% in the placebo group.
Participants taking the micronutrients also experienced significantly greater improvements in sleep and overall day-to-day functioning, compared to participants taking the placebo. There were no group differences on measures of stress, anxiety and quality of life.
Importantly, there were no group differences in reported side effects, and reports of suicidal thoughts dropped over the course of the study for both groups. Blood tests confirmed increased vitamin levels (vitamin C, D, B12) and fewer deficiencies in the micronutrient group.
Micronutrients were particularly helpful for women with chronic mental health challenges and those who had taken psychiatric medications in the past. Those with milder symptoms improved with or without the micronutrients, suggesting general care and monitoring might suffice for some women.
The benefits of micronutrients were comparable to psychotherapy but with less contact. There are no randomised controlled trials of antidepressant medication to compare these results.
Retention in the study was good (81%) and compliance excellent (90%).
Beyond maternal mental health
We followed the infants of mothers enrolled in the NUTRIMUM trial (who were therefore exposed to micronutrients during pregnancy) for 12 months, alongside infants from the general population of Aotearoa New Zealand.
This second group of infants from the general population contained a smaller sub-group who were exposed to antidepressant medication for the treatment of antenatal depression.
We assessed the neuro-behavioural development of each infant within the first four weeks of life, and temperament up to one year after birth.
These observational follow-ups showed positive effects of micronutrients on the infants’ ability to regulate their behaviour. These results were on par with or better than typical pregnancies, and better than treatments with antidepressants.
Micronutrients during pregnancy improved the neurological and behavioural development of infants. Getty Images Infants exposed to micronutrients during pregnancy were significantly better at attending to external stimuli. They were also better able to block out external stimuli during sleep. They showed fewer signs of stress and had better muscle tone compared to infants not exposed to micronutrients.
They also displayed greater ability to interact with their environment. They were better at regulating their emotional state and had fewer abnormal muscle reflexes than infants exposed to antidepressant medication in pregnancy.
Reassuringly, micronutrients had no negative impact on infant temperament.
These findings highlight the potential of micronutrients as a safe and effective alternative to traditional medication treatments for antenatal depression.
The prenatal environment sets the foundation for a child’s future. Further investigation into the benefits of micronutrient supplementation would gives us more confidence in their use for other perinatal (from the start of pregnancy to a year after birth) mental health issues. This could provide future generations with a better start to life.
We would like to acknowledge the contribution of Dr Hayley Bradley to this research project.
Julia J Rucklidge, Professor of Psychology, University of Canterbury; Elena Moltchanova, Professor of Statistics, University of Canterbury; Roger Mulder, Professor of Psychiatry, University of Otago, and Siobhan A Campbell, Intern Psychologist, Researcher – Te Puna Toiora (Mental Health and Nutrition Research Lab), University of Canterbury
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When Carbs, Proteins, & Fats Switch Metabolic Roles
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Strange Things Happening In The Islets Of Langerhans
It is generally known and widely accepted that carbs have the biggest effect on blood sugar levels (and thus insulin response), fats less so, and protein least of all.
And yet, there was a groundbreaking study published yesterday which found:
❝Glucose is the well-known driver of insulin, but we were surprised to see such high variability, with some individuals showing a strong response to proteins, and others to fats, which had never been characterized before.
Insulin plays a major role in human health, in everything from diabetes, where it is too low*, to obesity, weight gain and even some forms of cancer, where it is too high.
These findings lay the groundwork for personalized nutrition that could transform how we treat and manage a range of conditions.❞
*saying ”too low” here is potentially misleading without clarification; yes, Type 1 Diabetics will have too little [endogenous] insulin (because the pancreas is at war with itself and thus isn’t producing useful quantities of insulin, if any). Type 2, however, is more a case of acquired insulin insensitivity, because of having too much at once too often, thus the body stops listening to it, “boy who cried wolf”-style, and the pancreas also starts to get fatigued from producing so much insulin that’s often getting ignored, and does eventually produce less and less while needing more and more insulin to get the same response, so it can be legitimately said “there’s not enough”, but that’s more of a subjective outcome than an objective cause.
Back to the study itself, though…
What they found, and how they found it
Researchers took pancreatic islets from 140 heterogenous donors (varied in age and sex; ostensibly mostly non-diabetic donors, but they acknowledge type 2 diabetes could potentially have gone undiagnosed in some donors*) and tested cell cultures from each with various carbs, proteins, and fats.
They found the expected results in most of the cases, but around 9% responded more strongly to the fats than the carbs (even more strongly than to glucose specifically), and even more surprisingly 8% responded more strongly to the proteins.
*there were also some known type 2 diabetics amongst the donors; as expected, those had a poor insulin response to glucose, but their insulin response to proteins and fats were largely unaffected.
What this means
While this is, in essence, a pilot study (the researchers called for larger and more varied studies, as well as in vivo human studies), the implications so far are important:
It appears that, for a minority of people, a lot of (generally considered very good) antidiabetic advice may not be working in the way previously understood. They’re going to (for example) put fat on their carbs to reduce the blood sugar spike, which will technically still work, but the insulin response is going to be briefly spiked anyway, because of the fats, which very insulin response is what will lower the blood sugars.
In practical terms, there’s not a lot we can do about this at home just yet—even continuous glucose monitors won’t tell us precisely, because they’re monitoring glucose, not the insulin response. We could probably measure everything and do some math and work out what our insulin response has been like based on the pace of change in blood sugar levels (which won’t decrease without insulin to allow such), but even that is at best grounds for a hypothesis for now.
Hopefully, more publicly-available tests will be developed soon, enabling us all to know our “insulin response type” per the proteome predictors discovered in this study, rather than having to just blindly bet on it being “normal”.
Ironically, this very response may have hidden itself for a while—if taking fats raised insulin response without raising blood sugar levels, then if blood sugar levels are the only thing being measured, all we’ll see is “took fats at dinner; blood sugars returned to normal more quickly than when taking carbs without fats”.
You can read the study in full here:
Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease
Want to know more about blood sugar management?
You might like to catch up on:
- 10 Ways To Balance Your Blood Sugars
- Track Your Blood Sugars For Better Personalized Health
- How To Turn Back The Clock On Insulin Resistance
Take care!
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Radical Remission – by Dr. Kelly Turner
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First, what this is not:an autobiographical account of the “I beat cancer and you can too” pep-talk style.
What it is: a very readable pop-science book based on the author’s own PhD research into radical remission.
She knew that a very small percentage of people experience spontaneous radical remission (or quasi-spontaneous, if the remission is attributed to lifestyle changes, and/or some alternative therapy), but a small percentage of people means a large number worldwide, so she travelled the world studying over 1,000 cases of people with late-stage cancer who had either not gone for conventional anticancer drugs, or had and then stopped, and lived to tell the tale.
While she doesn’t advocate for any particular alternative therapy, she does report on what things came to her attention. She does advocate for some lifestyle changes.
Perhaps the biggest value this book offers is in its promised “9 key factors that can make a real difference”, which are essentially her conclusions from her PhD dissertation.
There isn’t room to talk about them here in a way that wouldn’t be misleading/unhelpful for a paucity of space, so perhaps we’ll do a main feature one of these days.
Bottom line: if you have (or a loved one has) cancer, this is an incredibly sensible book to read. If you don’t, then it’s an interesting and thought-provoking book to read.
Click here to check out Radical Remission, and learn about the factors at hand!
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Oral vaccines could provide relief for people who suffer regular UTIs. Here’s how they work
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In a recent TikTok video, Australian media personality Abbie Chatfield shared she was starting a vaccine to protect against urinary tract infections (UTIs).
Huge news for the UTI girlies. I am starting a UTI vaccine tonight for the first time.
Chatfield suffers from recurrent UTIs and has turned to the Uromune vaccine, an emerging option for those seeking relief beyond antibiotics.
But Uromune is not a traditional vaccine injected to your arm. So what is it and how does it work?
9nong/Shutterstock First, what are UTIs?
UTIs are caused by bacteria entering the urinary system. This system includes the kidneys, bladder, ureters (thin tubes connecting the kidneys to the bladder), and the urethra (the tube through which urine leaves the body).
The most common culprit is Escherichia coli (E. coli), a type of bacteria normally found in the intestines.
While most types of E. coli are harmless in the gut, it can cause infection if it enters the urinary tract. UTIs are particularly prevalent in women due to their shorter urethras, which make it easier for bacteria to reach the bladder.
Roughly 50% of women will experience at least one UTI in their lifetime, and up to half of those will have a recurrence within six months.
UTIs are caused by bacteria enterning the urinary system. oxo7051/Shutterstock The symptoms of a UTI typically include a burning sensation when you wee, frequent urges to go even when the bladder is empty, cloudy or strong-smelling urine, and pain or discomfort in the lower abdomen or back. If left untreated, a UTI can escalate into a kidney infection, which can require more intensive treatment.
While antibiotics are the go-to treatment for UTIs, the rise of antibiotic resistance and the fact many people experience frequent reinfections has sparked more interest in preventive options, including vaccines.
What is Uromune?
Uromune is a bit different to traditional vaccines that are injected into the muscle. It’s a sublingual spray, which means you spray it under your tongue. Uromune is generally used daily for three months.
It contains inactivated forms of four bacteria that are responsible for most UTIs, including E. coli. By introducing these bacteria in a controlled way, it helps your immune system learn to recognise and fight them off before they cause an infection. It can be classified as an immunotherapy.
A recent study involving 1,104 women found the Uromune vaccine was 91.7% effective at reducing recurrent UTIs after three months, with effectiveness dropping to 57.6% after 12 months.
These results suggest Uromune could provide significant (though time-limited) relief for women dealing with frequent UTIs, however peer-reviewed research remains limited.
Any side effects of Uromune are usually mild and may include dry mouth, slight stomach discomfort, and nausea. These side effects typically go away on their own and very few people stop treatment because of them. In rare cases, some people may experience an allergic reaction.
How can I access it?
In Australia, Uromune has not received full approval from the Therapeutic Goods Administration (TGA), and so it’s not something you can just go and pick up from the pharmacy.
However, Uromune can be accessed via the TGA’s Special Access Scheme or the Authorised Prescriber pathway. This means a GP or specialist can apply for approval to prescribe Uromune for patients with recurrent UTIs. Once the patient has a form from their doctor documenting this approval, they can order the vaccine directly from the manufacturer.
Antibiotics are the go-to treatment for UTIs – but scientists are looking at options to prevent them in the first place. Photoroyalty/Shutterstock Uromune is not covered under the Pharmaceutical Benefits Scheme, meaning patients must cover the full cost out-of-pocket. The cost of a treatment program is around A$320.
Uromune is similarly available through special access programs in places like the United Kingdom and Europe.
Other options in the pipeline
In addition to Uromune, scientists are exploring other promising UTI vaccines.
Uro-Vaxom is an established immunomodulator, a substance that helps regulate or modify the immune system’s response to bacteria. It’s derived from E. coli proteins and has shown success in reducing UTI recurrences in several studies. Uro-Vaxom is typically prescribed as a daily oral capsule taken for 90 days.
FimCH, another vaccine in development, targets something called the adhesin protein that helps E. coli attach to urinary tract cells. FimCH is typically administered through an injection and early clinical trials have shown promising results.
Meanwhile, StroVac, which is already approved in Germany, contains inactivated strains of bacteria such as E. coli and provides protection for up to 12 months, requiring a booster dose after that. This injection works by stimulating the immune system in the bladder, offering temporary protection against recurrent infections.
These vaccines show promise, but challenges like achieving long-term immunity remain. Research is ongoing to improve these options.
No magic bullet, but there’s reason for optimism
While vaccines such as Uromune may not be an accessible or perfect solution for everyone, they offer real hope for people tired of recurring UTIs and endless rounds of antibiotics.
Although the road to long-term relief might still be a bit bumpy, it’s exciting to see innovative treatments like these giving people more options to take control of their health.
Iris Lim, Assistant Professor in Biomedical Science, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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