The need to call out corporate corruption in health

“The tobacco and ultra-processed food industries exemplify the detrimental effects of corporate influence on public health. For decades, tobacco companies lobbied aggressively against health regulations, contributing to millions of preventable deaths worldwide. Despite still causing more than 8 million tobacco-related deaths annually, the tobacco industry now claims through its public-relations campaigns and selective science that it focuses on “harm reduction”, particularly by selling new products such as e-cigarettes. These tactics allow the industry to argue that it deserves a seat at the policy table, all while shifting to new types of addictive and harmful products, targeting youth, and continuing to oppose tobacco … Read More

Proteomic organ-specific ageing signatures and 20-year risk of age-related diseases: the Whitehall II observational cohort study

A research group assessed plasma proteins between 1997 and 1999 from over 6200 middle-aged (45-69 years) individuals. They followed these people for 20 years and tracked 45 age-related diseases and multi-morbidity. They used SomaScan version 4.0 and 4.1. In addition to proteins for overall organismal age, they had clusters of proteins for arteries, brain, heart, immune system, intestine, kidney, liver, lung and pancreas. “[Results] Over 123 712 person-years of observation (mean follow-up 19·8 years [SD 3·6]), and after excluding disease cases at or before baseline, higher organ age gaps were associated with an elevated risk of 32 out of the 45 … Read More

Optimizing placement of public-access naloxone kits using geospatial analytics: a modelling study

“We compared public-access naloxone strategies using more than 14 000 cases of opioid poisoning in Metro Vancouver over a 6-year period. We found that the 647 take-home naloxone sites were within a 3-minute walk to more than one-third of all opioid poisonings and had high coverage efficiency (Table 2) [the top five location categories for coverage efficiency were: government office, take-home naloxone site, convenience store, retail store and pharmacy]. In addition to existing operations that distribute take-home naloxone kits, which are likely taken elsewhere, take-home naloxone site locations appear generally well-aligned with where opioid poisonings occur, so they are also … Read More

For the Sake of 600,000 Children, Science Must Be Bold

“A report last week from the World Health Organization reveals that 597,000 people died of malaria last year, overwhelmingly children under age 5, and an estimated 263 million people were sickened. Thousands of families cradled a baby dying from a preventable fever; thousands of pregnancies ended in stillbirth or maternal death. For a time in the early 2000s, it seemed as if the world was gaining ground against malaria, but progress has stalled, cases have risen and the hopes for its near-elimination by 2030 have been scuttled. Global warming, armed conflict and lack of funding are all factors. And while new vaccines … Read More

AI Can’t Worry About Patients, and a Clinical Ethicist Says That Matters

JAMA interviewed Sarah C Hull, associate director of the biomedical ethics program at Yale. “[JAMA] [..] What are the biggest moral dilemmas that you think we’re facing with AI [artificial intelligence], especially within this area? [Hull] I think that we need to be very careful when deploying tools that act human vs tools that are decidedly not human acting. I think that ethically, it can become a lot more complex when you have really advanced generative AI that can seem very humanoid, but very importantly does not possess moral agency and does not have a fiduciary responsibility for the well-being … Read More

Implausibility of radical life extension in humans in the twenty-first century

“In 1990, it was hypothesized that humanity was approaching an upper limit to life expectancy (the limited lifespan hypothesis) in long-lived populations, as early gains from improved public health and medical care had largely been accomplished, leaving biological aging as the primary risk factor for disease and death; the rate of improvement in life expectancy was projected to decelerate in the twenty-first century; and e(0) [life expectancy at birth] for national populations would not likely exceed approximately 85 years (88 for females and 82 for males) unless an intervention in biological aging was discovered, tested for safety and efficacy and broadly … Read More

State Medical Boards and Interstate Telemedicine in the Courtroom

“Despite the convenience and value of telehealth, many states have rolled back COVID-19 pandemic–era flexibilities and reimposed strict licensure requirements for telemedicine. Thus, as it was prepandemic, so it is again that a physician, duly licensed in their home state, is prohibited from consulting or following up with an out-of-state patient via video or phone unless they are also licensed in the patient’s state. Penalties for doing so without that license can amount to tens of thousands of dollars in fines and potential imprisonment. Despite growing pressure to respond to patient preferences and widespread evidence of the benefits of interstate … Read More

Value-Based Payment and Vanishing Small Independent Practices

“An estimated 80% of physicians are now employed by hospitals, health systems, and corporations. Many factors have contributed to this shift away from independent practices, including rising administrative burdens, changing employment preferences, greater capital demands for health information technology, and favorable financial incentives (eg, site-differential payments). However, underappreciated among these factors is another important accelerant of corporate consolidation: the shift from fee-for-service to value-based payment models. [..] Evidence suggests that, on average, they [independent practices directly owned by clinicians] exhibit lower per-patient spending, fewer preventable admissions, and lower readmissions compared with their hospital-owned counterparts. [..] However, independent practices are often … Read More

How Psychedelic Research Got High On Its Own Supply

“First synthesized by the drug company Merck in 1912, MDMA, also known as the party drug Ecstasy or molly, has both stimulant and hallucinogenic properties. It also has the ability to foster feelings of connectedness and to seemingly dissolve a person’s mental boundaries, which advocates say can help patients revisit their trauma more comfortably during psychotherapy sessions in order to heal from it. Lykos has spent years conducting clinical trials testing whether MDMA-assisted psychotherapy could alleviate the symptoms of PTSD. Its most recent drug trial showed that more than 86 percent of people treated had a measurable reduction in symptom … Read More

The Future of Medicare and the Role of Traditional Medicare as Competitor

“The basic benefits package of Medicare — replete with deductibles and coinsurance — long ago began falling short of the promise of financial protection as articulated by President Lyndon Johnson in 1965. In 2019, out-of-pocket spending in traditional Medicare averaged $7,053 among all seniors and $12,315 in the top decile, which was equal to 25% of seniors’ mean after-tax income and to 69% of retirees’ mean Social Security income. [..] Over time, Medicare Advantage has evolved into a conduit for financing coverage expansion that is arguably overdue. Enrollees enjoy substantially lower premiums for supplemental and prescription drug coverage than they … Read More