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Why Sitting May Be Bad For Your Brain

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Taking a walk every 30 minutes can restore blood flow to the brain when you’re sitting for hours.

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Western News – Research eyes role stress plays in mental illnesses

Western News – Research eyes role stress plays in mental illnesses
— Read on news.westernu.ca/2018/08/research-targets-role-stress-plays-mental-illnesses/

4 Tools to Boost Your Mental Health at School – Mental Health First Aid

Young people can face a variety of mental health conditions. Knowing how to recognize and provide assistance tailored to the individual’s needs is important. To learn more about how to support students’ mental health at school, register for a Youth Mental Health First Aid course near you.
— Read on www.mentalhealthfirstaid.org/2018/08/4-tools-to-boost-your-mental-health-at-school/

Lexi Thompson on her mental and emotional break from golf: “I was just struggling with myself” – Golf Digest

Lexi Thompson on her mental and emotional break from golf before Women’s British Open: “I was just struggling with myself”
— Read on www.golfdigest.com/story/lexi-thompson-on-her-mental-and-emotional-break-from-golf-i-was-just-struggling-with-myself

How Retail Mental Health Could Be Medicine’s Next Frontier

Retail mental health clinics and urgent care centers are beginning to emerge across the U.S.
— Read on www.forbes.com/

Throughout his residency and his last three years as a physician in psychiatry training at Mather Hospital in New York, Dr. Tamir Aldad saw upfront how thousands of mental health patients each year were sent home from the emergency room knowing they might not get follow-up treatment for several weeks.

Despite the urgency of care needed amid the nation’s opioid epidemic and related mental health crisis, millions of Americans like the patients Aldad sees are treated first in an ER, but often aren’t able to see a psychiatrist even after being screened for anything from substance abuse or phobias to PTSD or potential risk of self-harm. Aldad says they aren’t sick enough to be admitted so they “boomerang back to the ER in a couple weeks with the same or worse problem than they came in for in the first place.”

“There are 70% of patients with mental illness who are sent home because their symptoms aren’t severe enough to be admitted, but they don’t meet criteria for admission,” says Aldad citing New York City hospital statistics.

In New York alone, Aldad says the wait to see a psychiatrist in an outpatient clinic or doctor’s office is four to eight weeks. And it may be worse in other parts of the U.S. given there is a nationwide shortage of doctors and psychiatrists in particular.

“You could go through the phone book and beg psychiatrists to see them or they could get an appointment to see a psychiatrist on Park Avenue today, but you would need $500 to $600 to see them,” Aldad says.

To fill these potentially life-threatening gaps in U.S. healthcare, the 33-year-old physician and University of Chicago Booth Executive MBA student has developed an award-winning startup called Mindful Urgent Care staffed by a team of mental health professionals including psychiatrists to increase mental health access and speed quality and affordable treatment to a population of patients with unmet needs.

For his efforts, Aldad won $140,000 in the University of Chicago Booth School of Business’ New Venture Challenge and Global New Venture Challenge competitions that have launched startups like online food delivery service Grubhub and payment processor BrainTree. He says he’s also landed another $500,000 in funding from additional backers to help him open his first 3,000 square-foot retail clinic in September in New Hempstead, NY. A second 2,000 square foot clinic will open in midtown Manhattan in 2019.

He’s also hearing from additional potential investors he’s not ready to publicly disclose, which could be key to a business plan he has to open 35 centers in the greater tri-state area surrounding New York City in New York, Connecticut and New Jersey in the next five years.

It’s a unique approach to a market not tapped yet by big retailers. Though pharmacy chains like CVS Health and Walgreens Boots Alliance are big into retail health clinics, both confirm they don’t for now have plans to build out or add mental health services.

Such facilities cannot open fast enough. For years now, the U.S. health system has lacked enough primary care providers like family physicians and internists as more Americans with a pent up demand for treatment gained the ability to pay under the Affordable Care Act. And mental health needs in communities across the country are becoming as critical, with no way of filling the void in sight. Behavioral health facilities, hospitals and addiction centers cannot find the psychiatrists they need.

“We face a broad range of mental health issues, including the acute problems of opioid addiction and increasing rates of depression and suicide,” Dr. Darrell Kirch, a psychiatrist and chief executive of the Association of American Medical Colleges said in a report earlier this year on the psychiatrist shortage. There are 28,000 psychiatrists in the U.S., but three in five are 55 years of age or older, AAMC data shows.

But Aldad’s strategy is to meet patient need through a mix of psychiatrists and “physician extenders” like nurse practitioners and physicians assistants with mental health and psychiatric specialties to better triage patients in order to replicate the consumer-friendly Mindful Urgent Care model that will be open 15 hours a day and seven days a week.

Though big chains haven’t yet jumped on the retail mental health clinic concept, there have been other public and private urgent care centers open up in the space.

Psychiatric urgent care pioneers include Broadlawns Psychiatric Urgent Care in Des Moines and a new state-funded effort in North Carolina launched by Alliance Behavioral Healthcare, a managed care organization that asked a group of therapists in Durham to create a clinic, according to a report earlier this year in North Carolina Health News.

“Because we use physician extenders and not strictly psychiatrists, we are able to scale our model,” Aldad says. “By no means are we trying to compete for business and take away from psychiatrists in their practices, but we want to get these patients treatment. We want to give medication and provide simple symptom stabilization so you as a patient has relief.”

For now, Mindful Urgent Care has contracts with more than 30 health insurance companies through the New York psychiatrists that will be staffing and supervising the staff at the retail clinics.

But Aldad is hopeful the model will be attractive to health insurers on a broader scale given the move away from fee-for-service medicine that emphasizes volume of medical care delivered. Instead, insurers emphasize value-based care that encourages patients to get better treatment upfront in a doctor’s office.

Such value-based models measure and reward providers based on how well they care for patients, treating them more holistically.

Value-based models reach out into the community to make sure patients get the right care, in the right place and at the right time so it’s quality and low cost. Health insurers like UnitedHealth Group, Anthem and Aetna and many others are now paying out more than half of their reimbursements to doctors based on such value-based formulas so Aldad’s idea should have merit with health plans.

Prices Mindful Urgent Care plans to charge are expected to cost $175 for an initial visit and $80 for follow-up care based on the average of what Medicare and private insurance pays, Aldad says. Most patients have coverage so they would likely pay significantly less based on their co-payments, deductibles and related out-of-picket costs.

“In value-based care, patient outcomes really matter and what we are instead seeing now is that patients in mental health are costing more and more,” Aldad said. “It’s even more costly if that hospitalization for mental illness is preventable because they couldn’t get in for a medication refill or they couldn’t get into their doctor’s office for an appointment. We have an opioid crisis and we have to proactively trend and work on how to prevent illness.”

Microbiome seen as key factor in resilience/immunity equation

Microbiome seen as key factor in resilience/immunity equation
— Read on www.nutraingredients-usa.com/Article/2018/08/16/Microbiome-seen-as-key-factor-in-resilience-immunity-equation

Press Announcements > Statement from FDA Commissioner Scott Gottlieb, M.D., on advancing the science and regulation of live microbiome-based products used to prevent, treat, or cure diseases in humans

FDA announces workshop on advancing the science and regulation of live microbiome-based products used to prevent, treat, or cure diseases in humans.
— Read on www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm617168.htm

FDA Statement

Statement from FDA Commissioner Scott Gottlieb, M.D., on advancing the science and regulation of live microbiome-based products used to prevent, treat, or cure diseases in humans

For Immediate Release

August 16, 2018

Statement

Over the last several years, there’s been growing scientific and public interest in the role of microorganisms in the maintenance of overall health and prevention and treatment of disease.

Today, more so than ever before, consumers are familiar with the phrase “good” or “helpful” bacteria and the expectation that it will aid in treating or preventing various illnesses. As the field advances, the U.S. Food and Drug Administration is playing a key role in sorting through the science and the science fiction of this evolving field.

We know that certain medical issues, such as bacterial infections and their treatment with antibiotics, may disrupt the normal complement of microorganisms that naturally live within the body. Microbiota, the collection of organisms in and on our body, may also affect how patients respond to certain drugs, as some research has shown the possibility of manipulating the microbiota to improve cancer treatment. There is also some preliminary evidence suggesting that certain microorganisms or “good bacteria” given proactively may help prevent some diseases.

For example, researchers are studying whether the administration of certain microorganisms in the form of probiotics can help prevent a serious disease in premature infants called necrotizing enterocolitis, which has been associated with systemic infection and death. With the health and safety of this most vulnerable population in mind, more research is needed as to whether this is a viable treatment.

The data collected so far in premature infants are difficult to interpret because different probiotic preparations have been studied, often in conjunction with other interventions. Understanding whether the use of probiotics for premature infants can have a clinically significant beneficial effect, and which types of probiotics may be most effective, is important, as serious side effects have been reported with their use in this population. We are very concerned by these potential risks and are actively monitoring these uses. These risks underscore the need for more definitive evidence showing benefit in preventing serious diseases. We need to make sure that the products are delivering benefits that justify any potential risks. This is especially important as these products are being used in vulnerable patients. We will consider taking action when we see unsafe or violative products.

In 2016, the FDA issued a guidance document that explains how researchers studying probiotics as drugs can meet the manufacturing requirements necessary for early clinical trials. More work and continued partnership between the FDA and various stakeholders is needed to advance the clinical science necessary to appropriately understand the safety and effectiveness of these products. We are committed to these goals.

The FDA has also not approved any probiotic as a live biotherapeutic product (LBP), a biological product other than a vaccine that contains live organisms used to prevent or treat a disease or condition in humans. However, there are FDA-regulated foods, including dietary supplements, containing probiotics that are legally available, though these products cannot lawfully be marketed to cure, mitigate, treat, or prevent any diseases. The 2016 guidance also clarifies how some LBPs that are lawfully marketed as a food or dietary supplement can also be studied for investigational use.

The FDA is also considering ways to provide additional clarity on information provided on the supplement facts label for declaring colony forming units of probiotics and weight. We understand that there continues to be growing interest in the potential benefits of probiotics in foods, including dietary supplements, and we are committed to working with industry on efforts to provide information that can help consumers make more informed choices about these products.

Given the strong interest and rapidly evolving science in this field, the FDA is convening a workshop co-hosted with the National Institutes of Health on September 17 that will discuss microbiome-based products and how manipulation of the microbiome may potentially be used to prevent or treat a variety of different diseases. Presentations will be given on a variety of topics including: the regulatory framework for live microbiome-based products; safety and effectiveness of live microbiome-based products used to prevent, treat, or cure diseases in humans; and strain selection for live microbiome-based products to prevent, treat, or cure diseases in humans. The workshop will also include panel discussions. We look forward to the robust scientific conversations that are certain to ensue.

This workshop is part of our broader effort to advance regulatory science in this field, and make sure we establish modern, efficient policies for how we evaluate products that fall under our different regulatory authorities. We recognize the potential benefit offered by these products, but we also have identified certain risks. We need to make sure that these are properly evaluated when these products are marketed and used as drugs, and that consumers have good information on which to base decisions when probiotics are used in conventional foods and dietary supplements. By doing our part in facilitating the conduct of well-designed clinical trials, the FDA and NIH hope that the full potential of the new science of the microbiome can be realized to benefit both individual and public health.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

microbiome drives variation in cognition | Philosophical Transactions of the Royal Society B: Biological Sciences

microbiome drives variation in cognition | Philosophical Transactions of the Royal Society B: Biological Sciences
— Read on rstb.royalsocietypublishing.org/content/373/1756/20170286

Abstract

Research into proximate and ultimate mechanisms of individual cognitive variation in animal populations is a rapidly growing field that incorporates physiological, behavioural and evolutionary investigations. Recent studies in humans and laboratory animals have shown that the enteric microbial community plays a central role in brain function and development. The ‘gut–brain axis’ represents a multi-directional signalling system that encompasses neurological, immunological and hormonal pathways. In particular it is tightly linked with the hypothalamic–pituitary–adrenal axis (HPA), a system that regulates stress hormone release and influences brain development and function. Experimental examination of the microbiome through manipulation of diet, infection, stress and exercise, suggests direct effects on cognition, including learning and memory. However, our understanding of these processes in natural populations is extremely limited. Here, we outline how recent advances in predominantly laboratory-based microbiome research can be applied to understanding individual differences in cognition. Experimental manipulation of the microbiome across natal and adult environments will help to unravel the interplay between cognitive variation and the gut microbial community. Focus on individual variation in the gut microbiome and cognition in natural populations will reveal new insight into the environmental and evolutionary constraints that drive individual cognitive variation.

The next therapeutic frontier may be in your gut

Scientists are trying to harness the microbiome for healing
— Read on massivesci.com/articles/microbiome-manipulation-prebiotics/

Tales from the Lab – Science Writing Prize 2018 – The human microbiome and cancer: friend or foe? – The Institute of Cancer Research, London

Tales from the Lab – Science Writing Prize 2018 – The human microbiome and cancer: friend or foe? – The Institute of Cancer Research, London
— Read on www.icr.ac.uk/blogs/tales-from-the-lab/page-details/science-writing-prize-2018-the-human-microbiome-and-cancer-friend-or-foe

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