Month: May 2023

No more shocks? Study shows drug treatment for major depression just as effective as electroconvulsive therapy

By Gretchen Cuda Kroen: Complete Post through this link…

The anesthetic drug ketamine is at least as effective as electroconvulsive therapy for treating major depression and has fewer side effects, a study published Wednesday in the New England Journal of Medicine reported.

More than 21 million adults in the US are estimated to suffer from Major Depressive Disorder. For those whose depression fails to respond to anti-depressive drugs, ECT, which involves inducing a seizure via electrical stimulation of the brain, is one of the few treatments that can provide life-changing relief.

The clinical trial of 403 patientsis the largest study ever done comparing ketamine and ECT treatments for depression that has ever been done, and the only one that also measured impacts to memory, Anand said.

The trial, conducted overfiveyears across multiple institutions including the Cleveland Clinic, compared the outcomes of patients selected at random to either receive ECT three times per week or ketamine twice per week for three weeks. Following treatment, patients answered questions about their depressive symptoms and quality of life, along with a battery of memory tests for the next six months.

Investigators found that 55% of patients who received ketamine and 41% who received ECT reported at least a 50% improvement in their self-reported depressive symptoms and quality of life that lasted at least six-months and concluded that treatments with ketamine were as effective as ECT.

Polypharmacy Killed My Son. He’s Not Alone

BY ANDREA SONNENBERG: Complete Post through this link…

Five years ago, my 21-year-old son Bradley died of psychiatric drug interactions, after years of battling anxiety, depression, and an eating disorder. In most respects, Bradley was very much like many kids you know. He was funny, smart, and talented, constantly making people laugh with goofy impersonations, and starring in school plays and musicals. We—me, my husband, and Bradley’s siblings—deeply supported him in his challenges with mental health. He had access to the best healthcare available. But despite his privilege, we couldn’t save him.

At the time of his death, Bradley was taking a cocktail of medications prescribed by respected doctors. Bradley died unexpectedly in his sleep because of a practice called polypharmacy—the layering of multiple medications on top of one another, often without regard to what other doctors have already prescribed or the potential interactions between the drugs.

It is not uncommon for patients to receive psychiatric medication without being evaluated by a mental-health professional. Often, a primary-care physician will prescribe an antidepressant without considering various other evidence-based treatments that may be more effective and without possible side effects. There are also the financial incentives, whereby insurance companies are more inclined to pay for medications than therapy, and at a higher reimbursement rate. That’s not to say that medications can’t be helpful; often they are critical to treatment and produce miraculous results. But many medications come with serious side effects. When many medications are taken together, they can cause harmful drug interactions. Plus, there is the risk of taking the wrong dosage, either too high or too low, which can lead to potential withdrawal symptoms or accidental overdose.

Advocacy Pays Off Now That Full Senate Will Consider Safe Step Act

From PHA: Complete Post through this link…

Thanks to advocacy efforts by the Pulmonary Hypertension Association (PHA) and others, the Safe Step Act moves to the full Senate floor for the first time.

“This is a huge step in the legislative process,” says PHA President and CEO Matt Granato. “While there is more work ahead before this bill becomes law, PHA celebrates this milestone achievement, which wouldn’t have been possible without the tireless efforts of PHA advocates and the amazing PHA advocacy staff.”

Those who advocated for the legislation include people with pulmonary hypertension, caregivers and health care professionals, as well as other patient organizations.

The Safe Step Act aims to limit step-therapy requirements for people with pulmonary hypertension (PH) and other life-threatening conditions. Step therapy refers to insurance company policies that require people to try less expensive treatments than those their doctors prescribe. The insurance companies  authorize prescribed treatment only after the less expensive treatment fails.

Congress introduced the Safe Step in 2017, but this is the first time legislation has moved beyond committee. That means all members of the Senate will be able to review and eventually vote on the bill. The next step is for advocates to convince the House of Representatives Committee on Education and the Workforce to send its version of the bill to full House floor. Both the House and Senate must approve a bill before it can become law.

This Chrome Extension Helps Students Prove AI Didn’t Write Their Essays

BY DANIEL TROCK: Complete Post through this link…

As artificial intelligence systems continue to grow in popularity around the internet, the debate around them, and the nightmare scenarios that the technology could lead to, has only intensified. However, a more pressing concern today is that an AI bot can write anything with a quick prompt that individuals, be they adults or schoolchildren, could use to create written works that aren’t truly theirs. Unfortunately, this concern has also created an opposite problem — students who are exceptionally talented writers have found themselves under suspicion of writing their essays with AI assistance.

As it so happens, though, a Google Chrome extension released in February of 2022 has proven very beneficial in verifying the authenticity of students’ homework. It’s called Draftback, and it’s designed to outline a writer’s creative timeline from start to finish, showcasing in the process that there was no AI assistance involved. Whether you need a way to prove that your words are your own or you just need a way to trace back your weird ideas, Draftback can take you on a trip to the not-too-distant past.

US DEPARTMENT OF LABOR ANNOUNCES REPORT FINDING NEARLY HALF OF ACCOMMODATIONS FOR DISABLED WORKERS HAVE NO COST

From US DOL: Complete Post through this link…

The U.S. Department of Labor announced today that a new report finds that nearly half of workplace accommodations made for people with disabilities can be implemented at no cost to employers, and of those that do incur a one-time cost, the median expenditure has decreased when compared to previous reports to only $300.

The newly published report “Accommodation and Compliance: Low Cost, High Impact” by the Job Accommodation Network — a service of the department’s Office of Disability Employment Policy — analyzes survey data collected from employers from 2019 to 2022. The survey collected cost information from employers using online questionnaires, which increased the number and diversity of responses significantly. Before 2019, JAN collected cost information via one-on-one phone calls. These employers, representing a wide array of industry sectors and sizes, contacted JAN for information initially about workplace accommodations and/or the Americans with Disabilities Act.

In addition to gathering information about accommodations’ costs, the survey explores employers’ motivations for making them, their effectiveness and the benefits they produced. The report includes the following findings:

  • More than half of employers made accommodations to retain valued employees.
  • 68.4 percent of employers said the accommodations made were either very effective or extremely effective after consulting JAN. Another 18.3 percent of employers said accommodations were somewhat effective after consulting JAN.
  • The direct and indirect benefits of making accommodations included retaining valuable employees, improving productivity and morale, reducing workers’ compensation and training costs, and increasing workforce diversity.

“This report reinforces what Job Accommodation Network has repeatedly in its work observed, which is that accommodations for disabled workers are indeed a low cost, high-impact strategy for supporting and retaining valued talent,” explained Assistant Secretary for Disability Employment Policy Taryn M. Williams. 

Government-funded study creates first symptom-based long Covid definition, a step toward finding treatments

By Brenda Goodman: Complete Post through this link…

After more than two years and an investment of nearly $1.2 billion, researchers say they’ve come up with a list of 12 symptoms that can reliably classify someone as having long Covid, a working definition that should accelerate research into the disabling condition.

The study, which was published Thursday in the medical journal JAMA, is the first research to emerge from a large effort following more than 13,000 adults at more than 200 study sites as part of the National Institutes of Health’s RECOVER initiative, which stands for Researching Covid to Enhance Recovery.

With its massive budget and scope, the RECOVER initiative has been a great hope of people with long Covid, some of whom are too ill to leave a bed or a chair for long.

Census data suggests that 15% of US adults experienced new or lasting symptoms months after their initial infections, a phenomenon scientists have dubbed postacute sequelae of SARS-CoV-2 infection, or PASC. More than 200 symptoms have been reported by people with PASC or long Covid.

For the study, researchers asked nearly 10,000 adults – some who were previously infected and others who had never had Covid, based on antibody testing – to answer a detailed set of questions about 44 symptoms affecting all parts of the body. Symptoms that appeared in more than 2.5% of individuals were then considered, narrowing the list to 37.

From there, they gave each symptom a score. Twelve symptoms got a score of 1 or higher:

• Postexertional malaise, or the worsening of health after mental or physical activity

• Fatigue

• Brain fog

• Dizziness

• Gastrointestinal symptoms

• Heart palpitations

• Changes in sexual desire or capacity

• Loss of or change in smell or taste

• Thirst

• Chronic cough

• Chest pain

• Abnormal movements

The symptoms are weighted according to how likely they are to appear in people who have long Covid compared with those who don’t. Loss of smell or taste was given 8 points, for example, because it is really unusual in people who haven’t had Covid. Dizziness gets a score of 1.

People who scored a 12 or higher based on all their symptoms were defined as having long Covid.

Apple created its new voice feature for—and with—people with ALS

BY HARRY MCCRACKEN: Complete Post through this link…

Among the many challenges people living with amyotrophic lateral sclerosis (ALS) face is its impact on their speech. By weakening muscles in the throat and mouth, the progressive disease makes speaking increasingly difficult and lessens the ability to talk clearly and at a typical pace. Most patients contend with these symptoms and ultimately lose the ability to speak at all.

When talking for oneself becomes an issue, speech synthesis is an essential communication tool, whether for chatting with family and friends or just ordering a coffee at a café. For years, people with ALS have been able to plan for this eventuality by creating a digitized version of their own voice, a process known as voice banking. But while voice banking is best done before ALS has affected someone’s speech too much, it’s been daunting, sometimes costly, and tempting to postpone.

Four years ago, when Philip Green banked his voice, he had to record 1,500 phrases for training purposes, an arduous task that took him weeks to complete. So, he understands why others might avoid confronting it.

“To be honest, you have a lot more things on your mind than, ‘Oh, I should invest time in preserving a version of my voice that I may need in two years or six months or four years,’” says Green, a member of the board of directors at Team Gleason, a nonprofit that serves those with ALS. “You’re really not thinking about that. But what we are trying to do is make people aware. Do it as soon as you find out [your diagnosis], because it’s essentially an insurance policy that you hope you won’t have to use.”

Starting soon, people will be able to easily create and use a digitized version of their own voice using an approachable piece of equipment they already own: an iPhone, iPad, or Mac. That’s thanks to Personal Voice, a new accessibility feature Apple plans to ship later this year. It needs only 15 minutes of spoken phrases for training—which users can break into multiple recording sessions if they choose—and does all processing locally. The voices it produces work in Apple’s own apps as well as third-party augmentative and alternative communication (AAC) apps from companies such as AssistiveWare.

Chronic Pain Incidence Is High in the U.S.

by Judy George: Complete Post through this link…

New cases occur more frequently than other conditions, and often persist.

New cases of chronic pain — defined as pain experienced on most days or every day over 3 months — occurred more frequently than new cases of other common chronic conditions, U.S. survey data showed.

Chronic pain incidence was 52.4 cases per 1,000 person-years, reported Richard Nahin, MPH, PhD, of the NIH in Bethesda, Maryland, and co-authors.

This was higher than the incidence of diabetes (7.1 cases/1,000 person-years), depression (15.9 cases), and hypertension (45.3 cases), the researchers said in JAMA Network Openopens in a new tab or window.

Moreover, chronic pain was persistent: nearly two-thirds (61.4%) of adults with chronic pain in 2019 continued to have it in 2020.

The findings come from National Health Interview Survey (NHISopens in a new tab or window) data and are the first nationwide estimates of chronic pain incidence.

Recent NHIS data showed the prevalence of chronic painopens in a new tab or window in the U.S. was about 21%, affecting an estimated 51.6 million adults. High-impact chronic pain — pain severe enough to restrict daily activities — affected 17.1 million people.

“Understanding incidence, beyond overall prevalence, is critical to understanding how chronic pain manifests and evolves over time,” Nahin said in a statement. “These data on pain progression stress the need for increased use of multimodal, multidisciplinary interventions able to change the course of pain and improve outcomes for people.”

BREAKING NEWS: Medicare Covers Seat Elevation for Medicare Beneficiaries using Power Wheelchairs

From Independence Through Enhancement: Complete Post through this link…

We are thrilled to announce that CMS decided to cover seat elevation in all power wheelchairs for the purposes of performing all transfers or to improve reach in performing mobility related activities of daily living (MRADLs) in their homes. This is a major expansion of coverage from the preliminary coverage decision announced in mid-February and CMS attributed these coverage improvements to the 2,130 public comments received by wheelchair users, advocates, clinicians, and researchers. The final seat elevation Decision Memo can be viewed HERE.

For the first time, CMS determined that seat elevation in power wheelchairs is considered “primarily medical in nature” and is, therefore, covered durable medical equipment (DME) under both traditional Medicare and Medicare Advantage. Seat elevation will be covered in Groups 2, 3 and 5 Complex Rehabilitative Technology (CRT) power wheelchairs when a patient needs seat elevation to transfer from one surface to another, with or without caregiver assistance, assistive devices, or lift equipment or to improve one’s reach in order to perform MRADLs. Seat elevation will also be covered in non-CRT power wheelchairs when determined by Medicare contractors to be reasonable and necessary.  Individuals must undergo a specialty evaluation performed by a licensed/certified medical professional who has specific training and experience in rehabilitative wheelchair evaluations.

This decision is effective immediately but CMS will consider new coding and payment determinations in the future. Beneficiaries who are most likely to benefit from this decision include people with Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, spinal cord injury, paralysis, ALS, limb amputation, Lupus, rheumatoid arthritis, myositis, and other mobility-related conditions.

‘A System in Crisis’: Dysfunctional Federal Disability Programs force the Poor to pass up money

By Fred Clasen-Kelly: Complete Post through this link…

Brenda Powell had suffered a stroke and was in debilitating pain when she called the Social Security Administration last year to seek disability benefits.

The former Louisiana state office worker struggled at times to write her name or carry a glass of water. Powell, then 62, believed she could no longer work, and she was worried about how to pay for medical care with only a $433 monthly pension.

Although the Social Security Administration agreed that Powell’s condition limited the work she could do, the agency rejected her initial application for Supplemental Security Income. She had the choice to appeal that decision, which could take months or years to resolve, or take early retirement. The latter option would give her $302 a month now but might permanently reduce the full Social Security retirement payment she would be eligible for at age 66 and 10 months.

“I didn’t know what to do. These decisions are not easy,” said Powell, who lives in Alexandria, Louisiana, about 200 miles northwest of New Orleans. She decided to appeal the decision but take early retirement in the meantime.

“I had to have more money to pay my bills,” she said. “I had nothing left over for gas.”