As more states legalize medical marijuana, two key groups — researchers whose job is it to understand its benefits and drawbacks, and physicians charged with advising potential users — are struggling to catch up with policymakers.Ilana Braun, an assistant professor of psychiatry at Harvard Medical School and chief of the division of adult psychosocial oncology at the Dana-Farber Cancer Institute, led a survey of cancer physicians around the country, exploring their attitudes and actions on medical marijuana.The survey was sent to 400 oncologists, with a 63 percent response rate. We asked Braun to outline her findings, which were published last month in the Journal of Clinical Oncology.Q&AIlana BraunGAZETTE: What are the highlights of the survey?BRAUN: I think the key messages from the data are, first of all, though almost half of oncologists surveyed recommend medical marijuana clinically, less than a third feel equipped with enough knowledge to make such recommendations.Our second key message is that medical marijuana is a salient topic in today’s cancer care. Eighty percent of oncologists we surveyed hold discussions with patients about medical marijuana. Sixty-seven percent believe it to be useful as an adjunct to standard pain management, and 68 percent for poor appetite cachexia [illness-related weight loss and frailty].The third key message is that there are some nonmedical variables that affect how oncologists approach medical marijuana, and these include region of practice, practice setting, and the number of patients they see.GAZETTE: So a significant percentage of oncologists who recommend medical marijuana to their patients also say they didn’t feel knowledgeable enough to do so. How do we make sense of that? I assume it’s not as simple as these folks being bad doctors.BRAUN: Right, and I don’t want to imply that. Unfortunately, our survey wasn’t designed to drill down into why this might be the case, but it’s definitely curious and we need to explore more.GAZETTE: Is this an education problem or a research problem?BRAUN: I think it’s probably a little bit of both. There isn’t a lot of high-quality research done in oncology regarding medical marijuana. So we probably need some clinical-effectiveness trials involving medical marijuana in oncology — and in other illnesses — and then I think we probably need more research in how to best inform medical professionals, particularly oncologists, who are frequently confronted with this issue.GAZETTE: How do physicians, once they become licensed and go out into practice, keep up on recent developments like the advent of medical marijuana?BRAUN: That’s a good question. We all take it upon ourselves to read scientific literature that comes out. We have journals like the New England Journal of Medicine, or our specialty journals. We try to read those. Then we’re obligated by licensing bodies to complete continuing medical education credits, otherwise known as CMEs. In that context, we go to national conferences or do online modules, so we are constantly trying to broaden our knowledge and keep current. And then many of us are obligated to retest at regular intervals, let’s say every 10 years.GAZETTE: Do we know whether there are CMEs specifically about medical marijuana?BRAUN: There certainly are. I believe that in the state of New York, in order to become a physician who can formally recommend medical marijuana to patients, you need to complete a four-hour CME requirement. It’s a state-organized curriculum. In Massachusetts, you have to complete two of what we call level 1 CMEs on medical marijuana, so a two-hour course.GAZETTE: What do we know about the medical benefits of marijuana, for pain, nausea, anxiety — some of these conditions that it’s potentially useful for?BRAUN: Randomized control trials of whole-plant medical marijuana haven’t been carried out in cancer patients, so oncology often draws from evidence in clinical trials carried out on other diseases and also from clinical trials carried out with pharmaceutical cannabinoids [the active compounds in marijuana]. Maybe pharmaceutical cannabinoids have one active ingredient, or two active ingredients — they may be synthetic, they may be herb-derived — but it’s different from marijuana. We extrapolate from those.In that context, the indication that probably has the strongest evidence base is pain. There have been more than half a dozen good, randomized control trials of whole-plant medical marijuana for pain management.GAZETTE: And they showed that it’s effective?BRAUN: They showed that it’s effective. And there are FDA-approved cannabinoid pharmaceuticals that you can get at the pharmacy, dronabinol being one of them. It’s FDA-approved for weight-loss cachexia. I’m sure oncologists are extrapolating from their knowledge of this drug that they use all the time in the clinic.GAZETTE: Why is it important that the usefulness of medical marijuana be tested specifically in an oncology setting?BRAUN: Other studies are usually done in very specific populations. It’s not clear you can generalize them to another disease.GAZETTE: Without the studies that you believe are still needed, is marijuana legalization premature?BRAUN: It’s a complex issue. Something like 30 states and the District of Columbia have comprehensive medical marijuana laws, and then many additional states have less-comprehensive but still some form of medical marijuana. Given that these medical marijuana laws are so popular on a state level, I think that we need to catch up with the science.GAZETTE: Why did you do this study?BRAUN: I worked clinically with cancer patients and found that the topic of medical marijuana comes up frequently in the exam room.Second, 30 states and the District of Columbia have these comprehensive medical marijuana laws, and the vast majority name cancer as a qualifying condition. Very few other conditions exist in almost every state law — cancer and HIV/AIDS — and yet the views of oncologists regarding medical marijuana had not been explored. So I thought this was a hole in the literature that should be plugged.This interview has been edited and condensed.
Reed Wood, assistant professor of political science at Arizona State University’s School of Politics and Global Studies, discussed the role and impact of women in armed conflict in a lecture Tuesday at the Hesburgh Center for International Studies. His research is one of the first large-scale systematic data collection of women’s participation in combat.Rosie Biehl | The Observer Wood, a Kroc Institute Visiting Research Fellow, opened the lecture by emphasizing that war and conflict are typically male dominated.“There is a large focus on war being men’s work,” Wood stated. “While occasionally women are seen as heroes, these stories are typically narrative accounts, in which the woman’s participation in war happens by chance, rather than her own decision.”Using his research, Wood aimed to revise the perception of women in armed conflict, demonstrating their roles and the importance of these roles. His research focused on two questions: what factors contribute to women’s participation in rebel groups in insurgencies and what impact do they have on group behavior and conflict outcome?To better understand what motivates women to enter into combat, Wood analyzed participation through two approaches. First, he looked at motivators that cause individuals to participate in combat. Next, he examined groups’ motivations for recruiting individuals. His findings showed that women, like men, typically join insurgency groups due to fear of violence and repression, revenge and the ideology of the group.“In general, men and women join insurgency groups for the same reason on an individual level,” Wood said.Finding this similarity, Wood examined female participation from the perspective of the group, by investigating what makes certain groups more likely to recruit women. On this level, Wood found that groups recruit women based on their demand for resources, tactical and strategic benefits and pre-existing ideologies.“Women are less likely to be scrutinized in society, and are therefore often used in covert operations,” Wood said.For this reason, terrorist groups are more likely to recruit women for operations like suicide bombings, in which the bomber must get close to the victim and remain unnoticed. Wood cited the Battle of Algiers, in which the National Liberation Front used women to plant bombs in crowded French cafes.After discussing what factors motivated women to join and to be recruited to armed conflict, Wood explored the direct and indirect impact that women have on armed conflict.In discussing the indirect impact that women have on conflicts, Wood highlighted the essentialist perspective approach, which focuses on the perceived inherent nature of women.“There is a general argument that women are less aggressive and violent and more compassionate and caring than men,” Wood said.Analyzing the impact of women through this essentialist perspective, Wood proposed that the inclusion of women in a group would make the group appear more favorable and less violent, consequently leading to earlier peace negotiations and help the group to gain more favor both nationally and internationally. Additionally, images of women in war can help to solicit international sympathy and alliances.In this sense, the inclusion of women could act as a sort of propaganda, demonstrating the legitimacy of the group’s cause.“It is hard to overstate the symbol of women in insurgent groups,” Wood said. “The inclusion of women can shape the public opinion, by demonstrating solidarity and legitimacy for the group.”Within a country, the inclusion of women can also be used to shame men into joining the cause, Wood said.“It send the message that if women are fighting, men should be fighting too,” he said.In contrast to the power of the essentialist view of women, factors such as socialization, selection effects and compensation could limit the impact that women have on changing violent dynamics of a group, Wood said.“In terms of selection effects, the women who show up to fight are the most likely to be more violent than other women,” he said.Additionally, given that war is seen as “man’s work,” women may feel the need to overcompensate and act more violently than men, Wood said. He concluded with the concession that the direct impact of women in combat is difficult to measure; however, although they are often overlooked, women greatly impact the outcome of conflicts.Tags: gender relations, Hesburgh Center for International Studies, Kroc Institute, kroc institute for international studies, war
Waitress Show Closed This production ended its run on Jan. 5, 2020 Some more Broadway faves are ready to serve up some pie alongside Tony winner Jessie Mueller in Waitress. Reprising their performances from the American Repertory Theatre run are Drew Gehling as Dr. Pomatter, Keala Settle as Becky, Dakin Matthews as Joe and Eric Anderson as Cal.Additionally, Tony nominee Christopher Fitzgerald and Orange is the New Black’s Kimiko Glenn will join the cast as Ogie and Dawn; the roles were played in Massachusetts by Jeremy Morse, who will appear in the ensemble, and Jeanna de Waal (currently in Kinky Boots).The show, which features a score by five-time Grammy nominee Sara Bareilles, will begin performances on March 25, 2016 at the Brooks Atkinson Theatre, where it will open on April 24. ART artistic director and Tony winner Diane Paulus helms the new musical.Settle earned a Tony nomination for Hands on a Hardbody; she most recently appeared on Broadway in Les Miserables. Gehling’s Broadway credits include Jersey Boys and On a Clear Day You Can See Forever. Matthews has appeared on the Main Stem previously in The Audience, Rocky The Best Man and A Man for All Seasons. Anderson returns to the Broadway stage after performing in The Last Ship, Rocky, Soul Doctor and Kinky Boots. Fitzgerald received Tony nods for Finian’s Rainbow and Young Frankenstein; his additional credits include An Act of God, Wicked and Chicago. Glenn will make her Broadway debut with Waitress; she appeared in Spring Awakening on tour and Freckleface Strawberry off-Broadway.In addition to Morse, the ensemble will feature Charity Angél Dawson and Stephanie Torns. Additional casting will be announced later.Waitress is based on the 2007 film by the late Adrienne Shelly and features a book by Jessie Nelson. It follows Jenna (Mueller), a small town waitress stuck in a loveless marriage. As a nearby baking contest approaches, she’s torn between her commitments and—thanks to her pie-making expertise—a chance at freedom. Jessie Mueller Related Shows Star Files View Comments
A troubling trend during the COVID-19 pandemic is an increase in calls to poison helplines about children drinking hand sanitizer and for exposure to cleaners and disinfectants.The American Association of Poison Control Centers reported 7,593 hand sanitizer exposure cases in children 12 years and younger in the first four months of 2020, with a sharp increase seen in March when stay-at-home orders began.To a child, a bottle of hand sanitizer sitting on the kitchen counter can look attractive. The container may be brightly colored, smell like food and could even contain glitter.If a child ingests more than a small taste, they may be at risk for alcohol poisoning.Most of the hand sanitizers people use are alcohol-based and contain 60% to 70% ethyl alcohol, more alcohol than most hard liquor. Alcohol poisoning can lead to confusion, vomiting and drowsiness, and in severe cases, death. You can reduce the risk by storing hand sanitizer out of reach and sight of children.Encourage children to thoroughly wash their hands and allow them to use hand sanitizer only with careful adult supervision. If you suspect someone has swallowed hand sanitizer, contact the Georgia Poison Center at 1-800-222-1222.As people clean and disinfect their homes more often, children and other family members also are being exposed to more household cleaners and disinfectants.The daily number of calls to poison centers increased sharply at the beginning of March for exposures to both cleaners and disinfectants, with bleach accounting for 62.1% of the increase in calls.Along with increased use, products may not be used properly. Chemical odors and aerosol sprays contribute to indoor air contaminants and may trigger allergies and asthma in some people.You can protect your family and reduce the risk of exposure by following these guidelines:Always read and follow the directions on the label.Dilute products using water at room temperature unless stated otherwise on the label.Avoid mixing chemicals, especially bleach and ammonia, which will create a chlorine gas.Use cleaning products in well-ventilated areas.Wear eye and skin protection.Store household cleaners, disinfectants, laundry products and pesticides out of sight and out of reach of children and pets.For more information, visit the Georgia Poison Center at georgiapoisoncenter.org/poisons/in-the-news/alerts-recent-trends/hand-sanitizer, the Centers for Disease Control at cdc.gov/mmwr/volumes/69/wr/mm6916e1.htm?s_cid=mm6916e1_w#F1_down and the American Association of Poison Control Centers at aapcc.org/track/hand-sanitizer.
Attachment: Decision on measures restricting social gatherings, work in trade, service activities and holding sports and cultural events The work of gyms, sports centers, fitness and recreation centers, all organized trainings, dance schools, children’s and other workshops is suspended. The suspension of religious gatherings is also valid. All public events and gatherings are canceled, work is suspended for all service activities that are not essential for the functioning of the community, such as museums, theaters, cinemas… As of Thursday at 0:01, a number of measures come into force aimed at ensuring stricter measures of social distancing, in order to mitigate the possibility of the epidemic spreading. The ban is valid for the next 30 days. The facilities that will work must ensure the greatest possible distance of workers and measures of social distance. They must also ensure ventilation of the space, measures of enhanced hygiene and daily cleaning of the space, and they must also provide points with disinfectants, as well as posters on proper hand washing and protection. In conclusion, only those activities that are necessary for normal functioning will work: food stores, gas stations, restaurants that have delivery, bakeries, grocery and hygiene stores, pharmacies. The operation of catering facilities of all categories is also suspended, with the exception of the preparation and delivery of food and the operation of soup kitchens. All stores will also be closed, except for: sales of food and hygiene items, pharmacies, gas stations, kiosks, bakeries, specialized stores with children’s equipment, sales of animal feed, sales of specialized orthopedic aids… We remind you that people in self-isolation must strictly adhere to it instructions given to them. “Everything that is not necessary is suspended”- concluded Bozinovic. Employers are obliged to organize work from home, organize teleconferences, cancel business trips, and prohibit workers suffering from acute respiratory diseases from coming to work. The National Civil Protection Headquarters announced new measures at 18.00 pm to reduce the possibility of transmission and protection against the spread of coronavirus.
A second Dutch worker has likely been infected with coronavirus on a mink farm, but the risk of further contagion remains low, the agriculture minister said Monday.The case follows a reported infection last week on one of two farms near the southern city of Eindhoven, where the disease was discovered in April among mink that are bred for their valuable fur.”A second case has become known where on one of the mink farms SARS-CoV-2 has been passed from a mink to a human,” Carola Schouten said. The Netherlands has so far recorded 5,830 human coronavirus deaths and 45,445 infections. Topics : “The case is similar to the previous one,” she said in a letter to the Dutch parliament.The infection happened before it was known that the mink were carrying the virus, meaning that workers did not wear protective clothing at the time.Dutch health authorities who assessed the risk of infection outside the shed where the mink were being kept believed it was “negligible,” Schouten said.Keeping mink for their fur has been a controversial issue in the Netherlands, with its highest court in 2016 ordering that all mink breeding must cease by 2024.
Coral BarryThursday 18 Apr 2019 11:36 amShare this article via facebookShare this article via twitterShare this article via messengerShare this with Share this article via emailShare this article via flipboardCopy link1.5kShares Advertisement Emery will have no more than £75m to spend (Picture: Getty)Emery is also keen on securing another striker with Danny Welbeck expected to leave the club when his contract expires this summer.Arsenal’s top four hopes hinge on the Gunners capitalising on their game in hand over Chelsea, who are also on 66 points.Emery’s side travel to Napoli on Thursday night for the second leg of their Europa League quarter-final tie.Winning the Europa League, something Emery did three times in a row as Sevilla boss, will guarantee a spot in next season’s Champions League.More: FootballBruno Fernandes responds to Man Utd bust-up rumours with Ole Gunnar SolskjaerNew Manchester United signing Facundo Pellistri responds to Edinson Cavani praiseArsenal flop Denis Suarez delivers verdict on Thomas Partey and Lucas Torreira moves Arsenal are not prepared to spend big money this summer (Picture: Getty)Unai Emery will have just £75million to spend in the summer even if Arsenal manage to secure Champions League football, reports say.Arsenal are currently in fourth place in the Premier League and remain in with a shot of winning the Europa League.Qualifying for next season’s Champions League would serve as a major boost to Emery, considering Arsenal have struggled for consistency this campaign.But Goal claim the achievement will not have a huge effect on the transfer budget, which will be set at around £75m.ADVERTISEMENT Comment Arsenal to hand Unai Emery £75m transfer budget if Champions League football secured Ramsey is joining Juventus this summer (Picture: GettyArsenal spent just over £71m last summer having missed out on Champions League football, spending the majority of that money on Lucas Torreira and Bernd Leno.AdvertisementAdvertisementEmery though will be motivated to avoid the possibility of having just £45m to spend should Arsenal miss out on a Champions League spot.Arsenal need a replacement for Juventus-bound Aaron Ramsey and Emery also wants to sign a left-back and wide attacker.More: FootballRio Ferdinand urges Ole Gunnar Solskjaer to drop Manchester United starChelsea defender Fikayo Tomori reveals why he made U-turn over transfer deadline day moveMikel Arteta rates Thomas Partey’s chances of making his Arsenal debut vs Man City Advertisement
New research measuring the impact of COVID-19 on the future life expectancy of older people in the surviving population has been published by The Pensions Institute.The paper – The Impact of COVID-19 on Future Higher-Age Mortality – focuses on England and Wales and assesses the implications of the pandemic for pension funds, insurance companies and academics who model and measure longevity risk. It also provides a framework for analysing future data on the virus.Its authors are Professor Andrew Cairns, department of actuarial mathematics and statistics, Heriot-Watt University; Professor David Blake, Cass Business School and director of the Pensions Institute; Amy Kessler, head of longevity risk transfer, Prudential Retirement; and Marsha Kessler, CEO of M Kessler Group, a speciality consulting firm focused on data-driven transformation in healthcare.While other COVID-19 research covers the spread and control of the virus, the authors of the study believe it is the first to cover mortality of the surviving population after the pandemic has abated. Research has found that COVID-19 seems to increase each cohort’s short-term mortality risk by a common multiplicative factorThey observed that some surviving patients who needed intensive care could acquire a new impairment such as kidney damage, which will reduce their life expectancy.Furthermore, many people in lockdown have not sought timely medical assessments for potential new illnesses such as cancer, with the consequence that mortality rates unrelated to COVID-19 could increase in future.Other indirect consequences include increased alcohol consumption, and poorer health and even suicides as a result of long-term unemployment.However, some people may retain healthier lifestyles adopted during lockdown, which could increase their life expectancy.PredictionsThe authors said their research provides not only data, but a simple and flexible modelling framework which will be effective using future data, without the need to change existing models.They also predict a total of 80,000 COVID-19-related deaths in England and Wales. However, the model’s flexibility means it can be applied to different levels of such deaths.Blake told IPE: “It can also be applied to different European countries. While the different parameters will have to be changed to match the circumstances of each country, the model itself does not have to be changed.”Such parameters could include patterns of infection and death rates at different ages, and the years of life lost by those who die from COVID-19, again at different ages.Kessler told IPE: “Whether for valuations, pricing or the underwriting of risk, the industry has been waiting for this kind of framework.”She continued: “There are three major challenges in working with data relating to the pandemic: adjusting experience data from the pandemic period; making assumptions about anti-selection risk going forward; and assessing volatility to come. The great thing is this research addresses all three challenges.”The research is available here.To read the digital edition of IPE’s latest magazine click here. The paper’s key finding is that COVID-19 seems to increase each cohort’s short-term mortality risk by a common multiplicative factor. In other words, if mortality rates rise temporarily at 10% in relative terms at one age, they will also rise by about 10% at other ages.Blake told IPE: “Unlike other research, our finding is that there is some early acceleration of death and that those who die would likely have done so within, say, a few years from other causes such as respiratory disease. That should, therefore, lead to fewer deaths in the short term from other causes.”The researchers also examined how socio-economic differences impact COVID-19 mortality.They found that once they controlled for regional differences in mortality rates, COVID-19 deaths in both the most and least deprived groups are proportional to the all-cause mortality of these groups.However, the groups in between have lower COVID-19 deaths – by around 10-15% – compared with their all-cause mortality.“The reason for this is not clear, although it might be because they were better able to adapt to lockdown and maintain more effective social distancing than the other groups,” said Blake.And current behavioural responses to the pandemic were also examined.
INDIANAPOLIS – Duke Energy is prepared to assist customers who may struggle to pair their winter energy bills.The company is contributing $700,000 for low-income customer energy assistance through its Helping Hand program. In addition, Duke Energy Indiana customers are contributing more than $87,000, raising this year’s total to approximately $800,000.Customers who need help paying their electricity bills can receive up to $300 toward their bill if their local Energy Assistance Program agency determines they are eligible based on need and other criteria.“During the past 30 years, the program has made the cold winter months warmer for customers in need,” said Duke Energy Indiana President Doug Esamann. “Last year, we were able to help more than 6,600 Hoosiers.”Customers who need help paying their electricity bills can receive up to $300 toward their bill if their local Energy Assistance Program agency determines they are eligible based on need and other criteria.Duke Energy Indiana partners with the Indiana Community Action Association and the Indiana Housing & Community Development Authority’s Energy Assistance Program, which distributes the company’s assistance funds.