interviewed Lea Davis, an associate professor of medicine in the Department of Medicine at Vanderbilt University Medical Center and an investigator in the Vanderbilt Genetics Institute, on a recent study she co-authored that was published in 

 on the epidemiology of functional seizures among adults treated at a university hospital.

During the discussion, Davis explains what functional seizures are and why better understanding them can help to address medical stigma for patients who experience them.

So, Dr. Davis, what are functional seizures, and why were you and your research team interested in investigating them further?

 So functional seizures are seizures that occur in the absence of aberrant electrical activity happening in the brain, which is typical of epileptic seizures. Functional seizures have been really understudied.

So, I actually became interested in understanding more about functional seizures and their etiology (so what causes them), what other kinds of conditions are they associated with, [and] what's the biology behind the development of functional seizures after hearing a story on NPR that was really the patient perspective. So, they interviewed several people who experienced functional seizures, and I think the thing that spoke to me the most in this patient population was the stigma that they experienced even within the medical system.

So, I think that actually speaks to me at a personal level. As a kid, my mom had Crohn disease and while Crohn disease is really well understood now, back in the early 90s it was not so well understood, and she actually had doctors telling her that it was all in her head, and that she needed to see a psychiatrist instead of an internal medicine doctor.

And so, hearing [that] patients [are] kind of still experiencing difficulty with medical stigma and the lack of knowledge on functional seizures, it occurred to me that this was something that a) we really needed a lot more research on, and b) we were actually in a really good position to be able to do this research at Vanderbilt because we have an incredible neurology department and a really active research relationship with them.

So, I basically contacted some colleagues in neurology and said, ‘Hey is this something that you guys would be willing to consult with us on and work with us in a collaboration,’ and they said yes, and so that's where we went.

Videos

Contemporary Clinic ® interviewed Lea Davis, of Vanderbilt University Medical Center and the Vanderbilt Genetics Institute, on what functional seizures are and why better understanding them can help to address medical stigma for patients who experience them.

Understanding Functional Seizures In Order to Better Treat Patients

interviewed Carrie Cuttler, PhD, an assistant professor in the Department of Psychology at Washington State University, on a recent study she co-authored that was published in the 

 on the use of cannabis in treating symptoms of obsessive-compulsive disorder (OCD).

What were the findings of this most recent study that you published?

 Yes, actually, I'm just going to briefly mention the methodology, and that's because we use kind of an unconventional methodology for this study as well. So, for this study, we were really looking at the acute effects of cannabis on intrusive thoughts, compulsive behaviors, and anxiety in people with OCD, and we were really able to accomplish this for the generous support of Strainprint, which is a Canadian company with a real-world technology platform and journaling application that allows medical cannabis patients to indicate their conditions and symptoms and rate the severity of those symptoms immediately before and then again shortly after cannabis use.

Further, patients can provide information about the strains of cannabis they're about to use, including THC and CBD concentrations method of administration and dose. The Strainprint app was really developed to help medical cannabis patients find the strains and doses of cannabis that reduce their symptoms the most, but they were generous enough to freely and openly provide us with some of the global back data from this application.

Specifically, they provided us with symptom ratings of intrusions, compulsions, and anxiety made by individuals self-identifying with OCD before and after over 1800 cannabis-use sessions. They also provided us with data on doses, methods of administration, and, again, THC and CBD content in the strains.

So, we use some advanced modeling methods to examine changes in the severity of these symptoms from before to after use, and we found on average that intrusions were reduced by about 49%, compulsions were reduced by 60%, and anxiety was reduced by 52%, indicating that acute cannabis use is associated with about a 50% reduction in the perceived severity of symptoms of OCD.

Contemporary Clinic ® interviewed Carrie Cuttler, PhD, an assistant professor in the Department of Psychology at Washington State University, on a recent study she co-authored on the use of cannabis in treating symptoms of OCD.

Acute Cannabis Use Associated With Reduction in OCD Symptoms

Based on earlier research showing that depression, stress, loneliness, and poor health behaviors can weaken the body’s immune system and lower the effectiveness of certain vaccines, a new report suggests that the same may be true for the coronavirus disease 2019 (COVID-19) vaccines.

Vaccines are among the safest and most effective advances in medical history, according to the report published in 

. Their success, however, depends on ensuring that a critical percentage of the population is effectively vaccinated to achieve herd immunity.

Despite rigorous testing showing that the COVID-19 vaccines approved for distribution in the United States are highly effective and safe, not all recipients will experience the full benefit. Environmental and genetic factors, as well as factors such as physical and mental health, can weaken the body’s immune system and slow the response to the vaccine.

These effects are concerning as COVID-19 continues to spread, triggering a concurrent mental health crisis caused by isolation, economic stress, and uncertainty about the future. These stressors are the same factors that have been shown in earlier research to weaken vaccine efficacy, particularly among elderly patients. Fortunately, the report authors said it is possible to reduce these negative effects with simple steps like exercise and sleep.

“In addition to the physical toll of COVID-19, the pandemic has an equally troubling mental health component, causing anxiety and depression, among many other related problems,” said lead author Annelise Madison, a PhD candidate at Ohio State University, in a press release. “Emotional stressors like these can affect a person’s immune system, impairing their ability to ward off infections. Our new study sheds light on vaccine efficacy and how health behaviors and emotional stressors can alter the body’s ability to develop an immune response. The trouble is that the pandemic in and of itself could be amplifying these risk factors.”

Vaccines work by creating an innate, general immune response on the cellular level as the body recognizes a potential biological threat. This response is eventually helped by the production of antibodies, which target specific pathogens. The continued production of antibodies helps determine how effective a vaccine is at conferring long-term protection.

“In our research, we focus most heavily on the antibody response, though it is just one facet of the adaptive immune system’s response,” said senior author Janice Kiecolt-Glaser, PhD, director of the Institute for Behavioral Medicine Research at Ohio State University, in a press release.

According to the researchers, the good news is that the COVID-19 vaccines already in circulation are approximately 95% effective. However, these psychological and behavioral factors can lengthen the amount of time it takes to develop immunity and can shorten the duration of effectiveness.

“The thing that excites me is that some of these factors are modifiable,” Kiecolt-Glaser said. “It’s possible to do some simple things to maximize the vaccine’s initial effectiveness.”

The researchers noted that one potential strategy could be to engage in vigorous exercise and get a good night’s sleep in the 24 hours before vaccination, to ensure the immune system is operating at peak performance. This may help encourage the best and strongest immune response.

“Prior research suggests that psychological and behavioral interventions can improve vaccine responsiveness,” Madison concluded. “Even shorter-term interventions can be effective. Therefore, now is the time to identify those at risk for a poor immune response and intervene on those risk factors.”

Depression and Stress Could Dampen Efficacy of COVID-19 Vaccines: Interventions and Health Behavior Changes Could Boost Immunity [news release]. Association for Psychological Science; January 13, 2021. Accessed January 19, 2021. 

https://www.psychologicalscience.org/news/releases/2021-jan-depression-covid-vaccines.html

Articles

Environmental and genetic factors, as well as factors such as physical and mental health, can weaken the body’s immune system and slow the response to the COVID-19 vaccine.

Experts Warn Depression, Stress Could Lessen Efficacy of COVID-19 Vaccines

New research from the University of Saskatchewan suggests that cleaning surfaces with commercially available hydrogen peroxide-based disinfectants raises the level of airborne hydrogen peroxide to dangerously high levels, potentially leading to respiratory, skin, and eye irritation.

, found that cleaning a floor with the bleach alternative disinfectant raised the level of airborne hydrogen peroxide to more than 600 parts per billion, or approximately 60% of the maximum level permitted for exposure over 8 hours, and 600 times the level naturally occurring in the air.

 The study authors noted that the coronavirus disease 2019 (COVID-19) pandemic has led to increased demand for cleaning products, including bleach alternatives containing hydrogen peroxide.

“When you’re washing surfaces, you are also changing the air you are breathing,” said senior author Tara Kahan, PhD, in a prepared statement. “Poor indoor air quality is associated with respiratory issues such as asthma.”

Kahan noted that the team could not research this topic at the beginning of the pandemic because hydrogen peroxide solutions were out of stock.1 According to the United States’ National Capital Poison Center (NCPC), hydrogen peroxide splashed onto the skin could cause the skin to whiten for a short time and it could feel tingly. If this occurs the area should be rinsed with running water, and the same should be done if hydrogen peroxide is splashed into the eyes.

Hydrogen peroxide used to be used to disinfect skin wounds, although this is no longer recommended. Researchers have found that hydrogen peroxide can irritate or damage the cells needed for wound healing, according to NCPC.

In the new study, investigators sprayed a vinyl floor in a simulated room environment with 0.88% hydrogen peroxide disinfectant and wiped it dry with paper towels either immediately or after letting it soak for an hour. The investigators then tested the air at human head height.

Kahan said there are several ways to reduce risks when cleaning, including using soap and water rather than a disinfectant. According to the Canadian university, soap and water are known to kill the virus that causes COVID-19. Kahan also said ventilation is important, whether through opening a window, turning on a range hood, or using a central air system. Proper ventilation can dramatically reduce the levels of pollutants circulating in the air and can remove particles carrying the virus.

Despite the concerns around hydrogen peroxide, Kahan said it is still safer than bleach-based products. The impact of hydrogen peroxide on children and pets is not yet known, although it should be noted that they are physically close to the disinfected surfaces.

“The real risk is for people who get repeatedly exposed, such as janitors and house cleaners,” Kahan concluded. “We washed the floor and collected measurements at face height—the concentrations will be even stronger at the floor or at the level of a countertop.”

Bleach-alternative COVID-19 surface disinfectants may pollute indoor air: USask research [news release]. University of Saskatchewan; December 1, 2020. 

https://news.usask.ca/articles/research/2020/bleach-alternative-covid-19-surface-disinfectants-may-pollute-indoor-air-usask-research.php

National Capital Poison Center. Hydrogen Peroxide; updated October 27, 2020. 

https://www.poison.org/articles/2012-jun/hydrogen-peroxide

There are several ways to reduce risk of indoor air pollution when cleaning, including using soap and water rather than a disinfectant.

There are several ways to reduce risks when cleaning, including using soap and water rather than a disinfectant.

Hydrogen Peroxide-Based Disinfectants Could Pollute Indoor Air, Pose Health Risk

interviewed Carrie Cuttler, an assistant professor in the Department of Psychology at Washington State University, on a recent study she co-authored that was published in the 

So Dr. Cuttler, I understand that your prior research has examined the effects of cannabis on various mental health conditions. What led you to investigate the use of cannabis in treating OCD?

 Yes. thank you. Before I started studying cannabis, I was actually studying links between memory and OCD, as it's a condition that has always been of interest to me. Also, my PhD student, Dakota Mauzay, who is the first author on this manuscript, he also has strong interests in OCD and spends a lot of time treating OCD as a clinical psychology graduate student.

Also, while many studies have examined cannabis in relation to various mental health conditions like depression, anxiety, PTSD, and psychosis, we found that very little research had actually examined either links between cannabis use and OCD, or the effects of cannabis on OCD. And to us, that represented a significant gap in the research that we thought really needed to be filled. Also, we knew that cannabis has effects on anxiety and, given the role of anxiety in OCD, we figured there would be good reason to suspect that cannabis may have some effects on this condition.

The Potential Role of Cannabis in the Treatment of OCD Symptoms

Favipiravir may be a beneficial treatment for mild-to-moderate coronavirus disease 2019 (COVID-19), according to a study published in the 

International Journal of Infectious Diseases

The COVID-19 pandemic has caused over 1.39 million deaths and there have been more than 59.2 million confirmed cases worldwide, according to the World Health Organization.

 Favipiravir is an RNA-dependent RNA polymerase (RdRp) inhibitor that is approved in Japan and China for the treatment of novel influenza virus.

Currently, 2 other trials have demonstrated that favipiravir has an advantage over other antivirals in treating COVID-19. Additionally, it is estimated that over 80% of patients with COVID-19 experience mild-to-moderate illness. However, very little antiviral research has investigated therapeutic interventions in this patient group.

The randomized, open-label phase 3 study took place across 7 sites in India. Study participation had a maximum treatment period of 28 days. Care was provided past the 14-day mark based on investigator judgement. The control arm received standard of care alone while the study group received standard of care plus favipiravir. Drugs with suspected antiviral activity against SARS CoV-2, including hydroxychloroquine, were prohibited.

Patients treated with favipiravir met the primary end point of median time to RT-PCR negativity 28.7% sooner than those treated with standard of care alone. However, according to the study, the median time to viral clearance was shorter in the control group (7 days) than in the study group (11 days). The statistically significant endpoint was not achieved.

“Faster viral clearance would be expected to reduce the duration of infectivity during the early course of disease, which would yield critical reductions in the secondary attack rate, duration of quarantine, and burden on health care providers and facilities,” study authors write.

Favipiravir was found to be well tolerated, and no adverse events led to drug discontinuation. One patient in the control group died of acute respiratory distress syndrome.

1. Udwadia, Zarir, et al. Efficacy and Safety of Favipiravir, an Oral RNA-Dependent RNA Polymerase Inhibitor, in Mild-to-Moderate COVID-19: A Randomized, Comparative, Open-Label, Multicenter, Phase 3 Clinical Trial. November 8, 2020. 

https://doi.org/10.1016/j.ijid.2020.11.142

2. WHO Coronavirus Disease (COVID-19) Dashboard

. The World Health Organization. Accessed November 25, 2020. 

The drug, which is approved for use in Japan and China, may help those with mild-to-moderate COVID-19. 

Favipiravir May be an Effective COVID-19 Treatment

A new study from researchers at the University of California (UC) Davis found that eating Ataulfo mangoes, also known as honey or champagne mangoes, may reduce facial wrinkles in older women with fairer skin.

Postmenopausal women who ate a half cup of Ataulfo mangoes 4 times a week saw a 23% decrease in deep wrinkles after 2 months and a 20% decrease after 4 months, according to the study authors.

“That’s a significant improvement in wrinkles,” said lead study author Vivien Fam, RDN, LDN, a doctoral student in the UC Davis Department of Nutrition, in a press release. “Women who ate a cup and a half of mangoes for the same periods of time saw an increase in wrinkles. This shows that while some mango may be good for skin health, too much of it may not be.”

The pilot study involved 28 postmenopausal women with Fitzpatrick skin types 2 or 3, or skin that burns more easily than it tans. The women were divided into 2 groups, with 1 group consuming a half cup of mangoes 4 times a week for 4 months, and the other group consuming a cup and a half of mangoes for the same period of time. Facial wrinkles were evaluated using a high-resolution camera system, according to the study authors.

“The system we used to analyze wrinkles allowed us to not just visualize wrinkles, but to quantify and measure wrinkles,” said study author Robert Hackman, PhD, professor in the Department of Nutrition, in a press release. “This is extremely accurate and allowed us to capture more than just the appearance of wrinkles or what the eye might see.”

Additionally, the study looked at the severity, length, and width of fine, deep, and emerging wrinkles. The study authors noted that the group that consumed a half cup of mangoes saw improvements in all categories.

Further research is needed to learn the mechanisms behind the reduction in wrinkles, considering the beneficial effects of carotenoids and other phytonutrients that could help build collagen, according to the study authors.




Can eating mangoes reduce women’s facial wrinkles? UC Davis. 

https://www.ucdavis.edu/news/can-eating-mangoes-reduce-womens-facial-wrinkles/

. Published November 19, 2020. Accessed November 23, 2020.


Although women who hate half a cup of mangoes 4 times a week saw a reduction in wrinkles, women who ate more mangoes saw an increase, suggesting that too much may have the opposite intended effect. 

Study: Eating Mangoes Can Reduce Women’s Facial Wrinkles

Officials with the FDA expanded the approved indication for baloxavir marboxil (Xofluza; Genentech) to include post-exposure prevention of influenza for patients aged 12 years and older, after contact with an individual who has the flu. The therapy previously available only in tablet form, is also now available as granules for mixing in water.

Baloxavir marboxil was originally 

 for treating uncomplicated flu in patients aged 12 years and older who have been symptomatic for no more than 48 hours. Its’ indication was first 

 for patients aged 12 years and older who are at high risk for developing influenza-associated complications.

Baloxavir marboxil’s safety and efficacy for post-flu exposure prevention is supported by a randomized, double-blind, controlled trial in which 607 subjects, aged 12 years and older who were exposed to a person with influenza in their household, received either a single dose of baloxavir marboxil or a single dose of a placebo. Of these 607 subjects, 303 received baloxavir marboxil and 304 received the placebo.

According to the FDA, the trial’s primary endpoint was the proportion of subjects who were infected with influenza virus and presented with fever and at least 1 respiratory symptom from day 1 to day 10. Of those who received baloxavir marboxil, 1% of subjects met these criteria, compared to 13% of subjects who received a placebo for the clinical trial.
The most common adverse effects of baloxavir marboxil include diarrhea, bronchitis, nausea, sinusitis and headache. Additionally, hypersensitivity, including anaphylaxis, can occur in patients taking baloxavir marboxil.

Patients should be advised not be co-administer baloxavir marboxil with dairy products, calcium-fortified beverages, or laxatives, antacids, or oral supplements containing calcium, iron, magnesium, selenium, aluminum or zinc.

Flu is a contagious respiratory illness caused by influenza viruses. According to the FDA, treating flu patients with antiviral drugs within 48 hours of their becoming sick can reduce symptoms and duration of the illness. An annual seasonal flu vaccine is the best way to protect against the flu.






FDA Expands Approval of Influenza Treatment to Post-Exposure Prevention [news release]. Silver Spring, MD; November 23, 2020: FDA. Accessed November 23, 2020. 

https://www.fda.gov/news-events/press-announcements/fda-expands-approval-influenza-treatment-post-exposure-prevention

Officials with the FDA expanded the approved indication for baloxavir marboxil (Xofluza; Genentech) to include post-exposure prevention of influenza for patients aged 12 years and older, after contact with an individual who has the flu.

FDA Expands Indication of Antiviral Therapy to Include Post-Exposure Influenza Prevention

Contemporary Clinic spoke with Daniel R. Wilson, MD, PhD, President of Western University of Health Sciences, about the impact that COVID-19 is having on the brain.

Wilson explained how certain people with COVID-19 are experiencing post-COVID-19 symptoms of cognitive changes, such as clarity in thinking and memory. 

In addition, Wilson also discusses the importance of focusing on the cognitive long-term effects of the virus and specific trials regarding this topic. 

The Neurological Impact of COVID-19

, patient with diabetes Phyllisa Deroze, PhD, and Joseph Delahunty, Global Head of Communications at Ascensia Diabetes Care, said that supporting patients’ mental health is just as important as their physical health, especially when it comes to chronic conditions, such as diabetes.

Deroze is a participant in Ascensia Diabetes Care’s 2020 World Diabetes Day campaign, which promoted the theme “Nurses Make the Difference for Diabetes” by sharing videos of 28 patients with diabetes who have written letters to their nurses to express their appreciation and gratitude. Deroze said she wrote about a nurse who gave her the skills and confidence to administer her own insulin and supported her during the emotional period following her diagnosis.

“[Nurses] really are a key and central part of diabetes management,” Delahunty said. “Some of the key messages this year are not just highlighting the important role that they play, but also the need to have more nurses and the importance in investing in education and training for nurses so that they have the right expertise to help people with diabetes.”

Supporting patients’ mental health is just as important as their physical health, especially when it comes to chronic conditions, such as diabetes.

Nurses Can Support Diabetes Patients Both Medically, Emotionally

The FDA has approved sodium sulfate, magnesium sulfate, and potassium chloride tablets (Sutab; Sebela Pharmaceuticals) for colonoscopy preparation.

A colonoscopy is the most common method of colorectal cancer detection. Prior to a colonoscopy, patients need to complete a liquid bowel preparation.

The tablets offer patients an alternative, especially for those who have trouble completing the liquid bowel preparation. Colorectal cancer is one of the leading causes of cancer-related deaths, and screening is crucial for effective management. Every year, 19 million colonoscopies are performed in the United States.

The approval was based on 2 trials in which 92% of patients achieved successful bowel cleansing by using the tablet. Cleansing in all segments of the colon, including the proximal colon, was achieved in 92% to 95% of patients.

In one of the trials, the tablets were deemed easy and tolerable to consume in 91% of participants. A significant majority of participants, 78%, said they would use the tablets again for a future colonoscopy.

“Successful bowel prep is critical for gastroenterologists to clearly see any polyps or abnormalities, yet the immense volume of liquid prep solutions can prevent patients from adequately completing their regimens. Tablets provide a welcome alternative for successful prep completion and visualization of the colon,” said Douglas K. Rex, MD, director of Endoscopy at Indiana University Hospital and Professor, Department of Medicine, Division of Gastroenterology and Hepatology, University of Indiana School of Medicine, in a press release.

Compared with the competitor, more patients taking the tablets reported nausea and vomiting, according to the press release. More than half of patients, 52%, reported at least 1 selected gastrointestinal adverse reaction.

Sebela Pharmaceuticals Receives FDA Approval for SUTAB® Tablets for Colonoscopy Preparation [News Release] November 10, 2020; Braintree, MA. Accessed November 11, 2020.

Sutab tablets provide an alternative to traditional liquid bowel preparation, which is hard to complete for some patients.

FDA Approves Alternative to Traditional Colonoscopy Preparation

Researchers at Tampere University and LUT University, both in Finland, studied exoskeleton vests worn by nurses to discover how the new technology would suit the special requirements of patient care. These investigators found that exoskeletons can reduce physical strain.1,2

The studies come from the increased use of wearable exoskeletons in physically demanding jobs to support good ergonomics and augment muscular strength, according to results published in the journal 

"This message from the field led us to investigate what conditions exoskeletons would need to meet in order to reform nursing," said Tuuli Turja, postdoctoral research fellow at Tampere University, in a prepared statement. "Currently, exoskeletons are mainly used in manufacturing and logistics. Isn't it high time to introduce exoskeletons in female-dominated sectors, where musculoskeletal disorders are rampant?"2

Exoskeleton-type technology is generally utilized in rehabilitation settings, where patients wear the skeleton of a walking robot, for example. The latest study article focuses on 2 studies involving users of the Laevo Exoskeleton, a wearable back support vest, which alleviates lower back strain by 40 to 50%, according to the manufacturer.1,2

The first study found pairs of nursing students assisted geriatric patients in moving from a hospital bed into a wheelchair with and without the exoskeleton, whereas the second study found 7 nurses tested the exoskeleton vest in a real care environment for a week.1,2

The study results showed that due to the special characteristics of patient care, exoskeletons need to be developed further before being completely suitable for everyday nursing work. In addition, nurses are willing to use exoskeletons to assist their work if the devices are comfortable and effortless to use and product development considers the requirements of nursing, such as interactive features and safety, in hectic work situations, according to the study authors.1,2

Turja T, Saurio R, Katila J, Hennala L, Pekkarinen S, Melkas H. Intention to Use Exoskeletons in Geriatric Care Work: Need for Ergonomic and Social Design. 

. 30, September 2020. doi:10.1177/1064804620961577

Exoskeletons can reduce strain also in health care. Tampere University. 

https://www.tuni.fi/en/news/exoskeletons-can-reduce-strain-also-health-care

. Published November 10, 2020. Accessed November 11, 2020.

The studies come from the increased use of wearable exoskeletons in physically demanding jobs to support good ergonomics and augment muscular strength.

Study Finds Exoskeletons Can Reduce Strain in Health Care

A paper published recently in the journal 

 found that nurses and other health care providers should talk to patients about their cannabis use the same way they discuss other habits, such as smoking and drinking, routinely and without judgment.

The shared decision-making model starts with either the patient or the provider bringing up the topic of cannabis use then moving on to specifics about the patient’s situation, benefits, and risks of cannabis use based on research and evidence, and finally formulating a plan, according to the paper.

“Central to patient-centered conversations is understanding the top priorities of patients,” wrote Marian Wilson, RN, associate professor at the Washington State University College of Nursing, in the paper. “Researchers have suggested that clinicians should ask ‘What matters to you?’ as well as ‘What is the matter?’”

Certain studies have suggested cannabis use is beneficial to patients with chronic pain who are using opioids, since so many in the patient population are using cannabis or considering it. This reason is why the study authors found it important for providers working in pain management to discuss the subject, even though patients may be reluctant to disclose cannabis use because they might have been penalized in the past.

Wilson noted that providers face real challenges in obtaining current, evidence-based information on benefits and risks of cannabis use. The paper calls for the creation of a centralized, noncommercial, scientific repository of information, research, and best practices on cannabis use.

“We want providers to ask people about their cannabis use and we want patients to feel comfortable talking about it, but right now many don’t,” Wilson said in the paper.

Paper urges healthcare providers to routinely ask patients about cannabis use. Washington State University. 

https://news.wsu.edu/2020/11/05/paper-urges-healthcare-providers-routinely-ask-patients-cannabis-use/

. Published November 5, 2020. Accessed November 6, 2020.

Certain studies have suggested cannabis use is beneficial to patients with chronic pain who are using opioids, since so many in the patient population are using cannabis or considering it.

Research Paper Urges Health Care Providers to Routinely Ask Patients About Cannabis Use

Contemporary Clinic spoke with Teri Moser Woo, PhD, ARNP, CPNP-PC, CNL, FAANP, about Antibiotic Awareness Week.

Woo addressed that this week, which takes place from November 18-24, is a good time to reflect on what health care providers are actually prescribing, the appropriateness of what they are prescribing, and to know if each antibiotic is the right one for the pathogen that you are treating. 

Woo also discussed the COVID-19 pandemic, stewardships, the threat of antibiotic resistance, and the future of nurse practitioners with antibiotics. 

What to Know Ahead of Antibiotic Awareness Week 2020

A University of California, Los Angeles-led review of 9 years of social media posts with the hashtag #BCSM suggests that Twitter can be a useful resource not only for patients, but also for physicians and researchers, according to a press release.

The hashtag, an acronym for “breast cancer social media,” first appeared on Twitter in 2011 and was used to curate a weekly informational chat for people with breast cancer.

The research found that between January 1, 2011, and January 1, 2020, #BCSM was used more than 830,000 times by more than 75,000 unique Twitter accounts, generating 4 billion impressions. Further, the hashtag was used 145,600 times in 2019 alone, an increase of 424% from 2011 when it appeared 27,700 times.

The study was intended to help researchers understand the impact of the community that grew around the Twitter chat. The results revealed that the rise of social media in everyday life paralleled with the growing popularity of #BCSM demonstrated that an increasing number of people with breast cancer are turning to online communities for support and education, according to the study.

“The #BCSM online community has experienced tremendous growth since its inception because it has helped fulfill a need among patients who were searching for information and support on the platform,” said lead study author Deanna Attai, MD, assistant clinical professor of surgery at the David Geffen School of Medicine at UCLA, in a press release.

Attai added that it has helped physicians gain insight into the patient perspective and has given them a better understanding of their many issues.

“We often see patients in a much different setting. Compared to our exam room interactions, online is a more raw, unvarnished look into what patients are really going through,” Attai said.

The #BCSM platform has given health care professionals the opportunity to correct misconceptions, provide guidance to people with breast cancer, and steer them toward credible resources, according to the study. Using Symplur, a health care-focused analytics program commonly used to study trends on Twitter, data were compiled on the use of the hashtag.

The study noted that the inclusive nature of the #BCSM hashtag has contributed to its popularity, since it is not restricted by gender or people’s stage of diagnosis. However, its extent may limit how sustainable the online community will be. As cancer therapy becomes more personalized, people may increasingly seek out support groups that are more closely aligned with their own clinical situations.

How a Twitter hashtag provides insights for doctors and support for people with breast cancer. UCLA Newsroom. 

https://newsroom.ucla.edu/releases/bcsm-twitter-breast-cancer-support

. Published October 22, 2020. Accessed October 27, 2020.

A UCLA-led review of 9 years of social media posts with the hashtag #BCSM suggests that Twitter can be a useful resource for patients, physicians and researchers

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