A new study of a popular HIV drug could ease concerns about its link to depression. Researchers in Uganda found that efavirenz, once feared to lead to depression and suicide, did not cause the expected negative side effects in their patients.
Efavirenz is an affordable, once-a-day pill used around the globe to treat and prevent HIV/AIDS. It’s “the treatment of choice” in most of the world, according to Africa Health Research Institute’s Mark Siedner, “especially [in] countries that depend on global aid to treat HIV.”
But some fear that efavirenz may come with a cost.
Some studies in the United States and Europe found the drug increased patients’ risk of depression or suicide, although other studies did not.
The mixed results prompted many doctors in the United States to prescribe more expensive but potentially safer drugs.
Siedner wanted to take another look at the risk of depression, this time in an African population. From 2005 until 2015, he and a team of Ugandan and U.S. doctors tracked 694 patients who took either efavirenz or another antiretroviral medication. They regularly asked the patients whether they experienced depression or suicidal thoughts.
Their analysis, published in the Annals of Internal Medicine, showed there was no difference between the two treatments. Siedner told VOA, “In other words, efavirenz was not associated with a risk of depression. If anything, there seems to be a signal that potentially it was associated with a decreased risk. But it wasn’t a strong enough [signal] for us to say that.”
The authors also reported that of the 17 participants who died in the course of the study, not a single death was a suicide.
Siedner has two possible explanations for why their findings differed from those in Western countries. “One potential cause is that every single ethnic group in the world, of course, is different, and different in many different ways — different socially, different environmentally, and in this case they may be different genetically.” His team is looking at whether the genes that control metabolism of the drug have a role to play in this story.
A second explanation could be the effectiveness of the drug. Because efavirenz is so potent, it could be keeping people healthier than they expected, so patients are less likely to report negative emotions.
The study is important, said Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases, because it pushes back against “the initial observation of suicidal ideation and suicide and depression” as caused by efavirenz. He told VOA, “I think now what you’re seeing is that with these conflicting reports, it’s likely someone will come in [with] the proposal to do a randomized study and take a look. So the story isn’t ended with this paper.”
As more research on the safety of efavirenz is conducted, new and cheaper drugs that might replace it are on the horizon. One of them, dolutegravir, might also pose a risk, however. A study in Botswana found dolutegravir was linked to neural tube defects in embryos, meaning it might not be safe for pregnant women. As always, further research is needed to confirm whether this is a common problem or specific to the population studied in Botswana.
“I think the whole field right now is in a bit of a holding pattern,” Siedner said when asked about dolutegravir and the future of HIV medication.
The suicide rate in the U.S. is rising. A new government report shows nearly 45,000 Americans killed themselves in 2016, more than twice the number of homicides. In fact, the suicide rate, particularly among young people ages 15 to 34, has been rising at an alarming rate for almost three decades, well before the recent high profile suicides of designer Kate Spade and celebrity chef Anthony Bourdain. Reporter Daria Dieguts takes a look at a trend that has many health professionals worried.
Kids exposed to tobacco smoke in the womb and early in infancy could have double the odds of developing hearing loss compared with children who were not exposed to tobacco at all, a Japanese study suggests.
While previous research suggests that adult smokers are at greater risk of hearing loss than nonsmokers, less is known about how much smoke exposure during infancy or pregnancy might impact hearing.
For the current study, researchers examined data on 50,734 children born between 2004 and 2010 in Kobe City, Japan. Overall, about 4 percent of these kids were exposed to smoking during pregnancy or infancy, and roughly 1 percent had tobacco exposure during both periods.
Hearing tests done when kids were 3 years old found that 4.6 percent of the children had hearing loss. They were 68 percent more likely to have hearing loss if they were exposed to tobacco during pregnancy, and 30 percent
more likely if they inhaled secondhand smoke during infancy, the study found.
When kids had smoke exposure during both periods, they were 2.4 times more likely than unexposed kids to have hearing loss.
“Patients with the greatest risk of hearing impairment are those who are directly exposed to maternal smoking in the womb,” said Dr. Matteo Pezzoli, a hearing specialist at San Lazzaro Hospital in Alba, Italy.
“Interestingly, the exposure to tobacco in early life seems to further strengthen the prenatal toxic effect,” Pezzoli, who wasn’t involved in the study, said by email.
When pregnant women smoke, it may harm fetal brain development and lead to auditory cognitive dysfunction, Pezzoli added. Tobacco smoke may also damage sensory receptors in the ear that relay messages to the brain based on sound vibration.
Globally, about 68 million people have a hearing impairment that is thought to have originated in childhood, Koji Kawakami of Kyoto University in Japan and colleagues note in Paediatric and Perinatal Epidemiology. Kawakami didn’t respond to requests for comment.
Researchers assessed children’s hearing using what’s known as a whisper test. For these tests, mothers stood behind their kids to prevent lip reading, then whispered a word while the kids had one ear covered.
While this test is simple and considered an accurate way to assess hearing in adults and older children, there’s some concern about how reliable the results may be in young kids. It’s considered more reliable when it’s done by trained
clinicians and specialists and less reliable when it’s done by primary care providers, researchers note. It’s unclear how accurate study results based on tests administered by the children’s parents would be, researchers acknowledge.
The study also wasn’t a controlled experiment designed to prove whether or how tobacco exposure during pregnancy or infancy might directly cause hearing loss in kids.
“There was no standardized medical evaluation of hearing or examination of the ears by ear specialists,” said Dr. Michael Weitzman, a pediatrician and hearing researcher at New York University who wasn’t involved in the study.
“Moreover, the severity of hearing loss could not be ascertained in this study, and it did not follow up the children throughout their childhood, so we do not know if what they found attenuated or got worse over time,” Weitzman said by email.
Still, the results add to the evidence linking tobacco exposure to hearing problems in kids, Weitzman said.
To protect children against hearing problems caused by cigarette smoke, it’s important for women to quit before they become pregnant or as soon as they discover they’re pregnant, said Huanhuan Hu, a researcher at the National Center for Global Health and Medicine in Japan who wasn’t involved in the study.
“To minimize the chance that their baby will be exposed to tobacco smoke in the womb, other family members should also quit, or at least not smoke at home or nearby the pregnant women,” Hu said by email.
The International Labor Organization (ILO) says urgent action is needed to avert a global crisis as the number of people, including children and elderly, needing care rises, The warning is part of a new ILO report on care work and care jobs unveiled Thursday in Geneva.
The ILO cautions that the global care crisis will become a reality in coming years without a doubling of investment. Authors of the report say $5.5 trillion was spent in 2015 on education, health and social work. They say that amount must be increased to $18.4 trillion by 2030 to prevent the care system from falling apart.
The report finds the majority of care globally is done by unpaid caregivers, mostly women and girls, and that it is a major barrier preventing women from getting paid jobs. It says this reality not only hampers their economic opportunities, but stifles development prospects.
Lead author Laura Addati tells VOA 606 million women, compared to 41 million men, are unable to get paid employment because they have to care for a family member.
“This pool of participants who are lost to the labor force could be activated, … [put in] jobs that could benefit society. A part of these jobs could be career [caregiver] jobs, so as we well pointed out, there could be basically an activation process to sort of replace some of those jobs, so making those who were unpaid, paid care workers,” she said.
Addati says more people nowadays are part of nuclear families, eroding the concept of extended households, which used to play an important role in caring for family members. She says that is increasing the demand for more caregivers in smaller households.
The report finds that more than 380 million people globally are care workers. It says two-thirds are women. In Europe, the Americas and Central Asia, three-quarters of all care workers are women. The report notes long-term care services are practically non-existent in most African, Latin American and Asian countries.
The ILO says about 269 million jobs could be created if investment in education, health and social work were doubled by 2030, easing the global care crisis.your ad here
Many elementary schools around the United States have started gardens to give their young students hands-on experience with growing and eating vegetables, learning about nutrition and nature in the process. The Ecology Club at P.B. Smith Elementary School in Warrenton, Virginia, started its garden a couple of years ago. As Faiza Elmasry tells us, the school’s beautiful, green space got a valuable addition last year, a garden filled with plants that attract butterflies. Faith Lapidus narrates.
A Japanese space explorer arrived at an asteroid Wednesday after a 3 1/2-year journey and now begins its real work of trying to blow a crater to collect samples to eventually bring back to Earth.
The unmanned Hayabusa2 spacecraft reached its base of operations about 20 kilometers (12 miles) from the asteroid and some 280 million kilometers (170 million miles) from Earth, the Japan Space Exploration Agency said.
Over the next year and a half, the spacecraft will attempt three brief touch-and-go landings to collect samples. If the retrieval and the return journey are successful, the asteroid material could provide clues to the origin of the solar system and life on Earth.
The mission is challenging. The robotic explorer will spend about two months looking for suitable landing places on the uneven surface. Because of the high surface temperature, it will stay for only a few seconds each time it lands.
The asteroid, named Ryugu after an undersea palace in a Japanese folktale, is about 900 meters (3,000 feet) in diameter. In photos released by JAXA, the Japanese space agency, it appears more cube-shaped than round. A number of large craters can be seen, which Project Manager Yuichi Tsuda said in an online post makes the selection of landing points “both interesting and difficult.”
The first touchdown is planned for September or October. Before the final touchdown scheduled for April-May, Hayabusa2 will send out a squat cylinder that will detonate above the asteroid, shooting a 2-kilogram (4.4-pound) copper projectile into it at high speed to make a crater.
Hayabusa2 will hide on the other side of the asteroid to protect itself during the operation and wait another two to three weeks to make sure any debris that could damage the explorer has cleared. It will then attempt to land at or near the crater to collect underground material that was blown out of the crater, in addition to the surface material from the earlier touchdowns.
The spacecraft will also deploy three rovers that don’t have wheels but can hop around on the surface of the asteroid to conduct probes. Hayabusa2 will also send a French-German-made lander to study the surface with four observation devices.
Asteroids, which orbit the sun but are much smaller than planets, are among the oldest objects in the solar system. As such, they may help explain how Earth evolved, including the formation of oceans and the start of life.
Hayabusa2 was launched in December 2014 and is due to return to Earth at the end of 2020. An earlier Hayabusa mission from 2003 to 2010 collected samples from a different type of asteroid and took three years longer than planned after a series of technical glitches, including a fuel leak and a loss of contact for seven weeks.
NASA also has an ongoing asteroid mission. Its Osiris-Rex spacecraft is expected to reach the asteroid Bennu later this year and return with samples in 2023.
Warming waters have reduced the harvest of Alaska’s prized Copper River salmon to just a small fraction of last year’s harvest, Alaska biologists say.
The runs of Copper River salmon were so low that the Alaska Department of Fish and Game shut down the commercial harvest last month, halting what is usually a three-month season after less than two weeks. Earlier this month, the department also shut down most of the harvest that residents along the river conduct to feed their families.
The total commercial harvest for Alaska’s marquee Copper River salmon this year after it was halted at the end of May was about 32,000 fish, the Alaska Department of Fish and Game reported. That compares with the department’s pre-season forecast of over 1.2 million and an average annual harvest of over 1.4 million fish in the prior decade.
State biologists blame warming in the Gulf of Alaska for the diminished run of Copper River salmon, prized for its rich flavor, high oil content and deep-red color.
The fish spend most of their lives in the ocean, and those waters were 3 to 5 degrees Celsius (5 to 9 degrees Fahrenheit) warmer than normal, thanks to a warm and persistent North Pacific water mass that climate scientists have dubbed “the Blob,” along with other factors, said Mark Somerville, a biologist with the Alaska Department of Fish and Game.
Warmer temperatures caused the metabolism of the fish to speed up, Somerville said. “They need more food for maintenance,” he said. “At the same time, their food source was diminished.”
Other important salmon runs are also struggling, including those in the Kenai River — a world-famous sport fishing site — and along Kodiak Island. Others have had good numbers, though the returning fish are noticeably reduced in size, Somerville said.
In Alaska, where wild salmon is iconic, Copper River fish hold a special status.
Their high oil content is linked to their ultra-long migration route from the ocean to their glacier-fed spawning grounds. They are the first fresh Alaska salmon to hit the market each year. Copper River salmon have sold for $75 a pound.
Chris Bryant, executive chef for WildFin American Grill, a group of Seattle-area seafood restaurants, worries about trends for Alaska salmon beyond the Copper River.
“The fish are smaller, which makes it harder for chefs to get a good yield on it and put it on the plate,” he said.
Suicide is now the 10th leading cause of death in the U.S., according to the Center for Disease Control and Prevention. Two teenagers have come up with a way to try and reduce the suicide rate with a smartphone app. VOA Correspondent Mariama Diallo sat down with the inventors, who recently received an award in Washington from the community based non-profit Mental Health America.
Malnutrition is the “challenge of our time,” with diet-related disease afflicting almost every country in the world, the winners of a $250,000 prize dubbed the Nobel for agriculture said Monday.
David Nabarro and Lawrence Haddad, who were jointly awarded this year’s World Food Prize, are credited with cutting the number of stunted children in the world by 10 million by lobbying governments and donors to improve nutrition.
Stunting is caused by malnutrition in infancy and hinders cognitive as well as physical growth. Experts say the effects are largely irreversible and stunted children generally complete fewer years of schooling and earn less money as adults.
Malnourished children also tended to become malnourished mothers, perpetuating the cycle, said Haddad, who heads the Global Alliance for Improved Nutrition.
Levels of obesity, diabetes and hypertension were “skyrocketing in pretty much every country … and the center of all these things is diets,” he said.
“People can’t get enough nutritious food because it’s too expensive or unavailable and the stuff that they shouldn’t be eating a lot of, stuff that’s high in sugar, salt and fat, is really cheap and available,” he told Reuters by phone. “This is the big challenge of our time. It’s not about how to feed our world. It’s about how to nourish our world.”
Haddad was joint winner of the award with Nabarro, a British doctor and former U.N. Special Representative for Food Security and Nutrition.
Between them they have persuaded governments, donors and others to set up policies and programs that decreased the number of stunted children globally to 155 million in 2017 from 165 million in 2012, the World Food Prize organizers said.
Nabarro said good nutrition in the first 1,000 days from conception to a child’s second birthday was “absolutely key.”
“There is work still to be done to get a widespread understanding of the importance of the right kind of diet,” he said.
About 815 million of the world’s 7.6 billion people go hungry daily while 2 billion are overweight or obese, according to the U.N. Food and Agriculture Organization.
The winners were honored in a ceremony at the U.S. Department of Agriculture.
Past recipients of the annual prize, founded in 1986 by Nobel laureate Norman Bourlag, include John Kufuour, a former president of Ghana, and Grameen Bank founder and Nobel laureate Muhammad Yunus of Bangladesh.