Egypt Independent: Science-Main news en Adults to be screened for depression, especially pregnant women <img src="" alt="" title="" class="imagecache imagecache-media_thumbnail" width="152" height="114" /><p>An influential US panel yesterday called for all adults to be screened for depression, including women during and after pregnancy, marking the first time it has urged a focus on maternal mental health.</p><p>The non-binding call was issued by the US Preventive Services Task Force, an independent, volunteer panel of experts that makes recommendations about the effectiveness of various health and counselling services.<br /><br />&ldquo;The USPSTF found convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings, including pregnant and postpartum women,&rdquo; said the statement in the&nbsp;Journal of the American Medical Association.<br /><br />It also found evidence that combining screening with &ldquo;adequate support systems&rdquo; may improve clinical outcomes by reducing or eliminating depression.<br /><br />The guidelines update those issued in 2009 which did not specifically mention depression in women of childbearing age, but called for adult screening for depression when and where support systems allowed.<br /><br />&ldquo;Depression is among the leading causes of disability in persons 15 years and older,&rdquo; said the latest report.<br /><br />It is &ldquo;also common in postpartum and pregnant women.&rdquo;<br /><br />The USPSTF &ldquo;found convincing evidence&rdquo; that treating adults with depression with antidepressants, psychotherapy, or both could improve patient outcomes.<br /><br />It also pointed to &ldquo;some harms&rdquo; associated with antidepressants known as selective serotonin reuptake inhibitors (SSRIs) because they may increase suicide risk and are associated with &ldquo;potential serious fatal harms.&rdquo;<br /><br />Since many questions remain about when to screen and how to treat depression, some experts are calling for increased responsiveness within the medical system.<br /><br />&ldquo;Until there are better methods to match patients with specific forms of treatment, the best hope to improve on a B grade for patients with depression may be to adapt care systems to respond more flexibly and decisively to key events,&rdquo; said an accompanying editorial by doctor Michael Thase of the University of Pennsylvania, Philadelphia.<br /><br />As many as one in seven women suffer from postpartum depression, according to the advocacy group Postpartum Support International.</p><p>&nbsp;</p> Tue, 21 Jun 2016 11:09:00 +0000 AFP 2470516 at sites/default/files/photo/2015/05/03/43/stock_headache2.jpg Inovio Pharma gets green signal to test Zika vaccine in human trial <img src="" alt="" title="" class="imagecache imagecache-media_thumbnail" width="152" height="114" /><p>Drug developer Inovio Pharmaceuticals Inc and its partner GeneOne Life Sciences Inc said they had received approval from U.S. regulators to start an early stage human trial testing their Zika vaccine.</p><p>The early-stage study will enroll 40 healthy subjects and evaluate safety, tolerability and immune response generated by the vaccine GLS-5700.</p><p>&quot;We plan to dose our first subjects in the next weeks and expect to report phase I interim results later this year,&quot; Inovio CEO J Joseph Kim said.</p><p>In February, the World Health Organization (WHO) declared Zika a global public health emergency. The virus has been associated with microcephaly, a birth defect characterized by an unusually small head and potential developmental problems.</p><p>Last week, U.S. health officials reported three babies born with birth defects likely linked to Zika infection in the mother during pregnancy.</p><p>French drugmaker Sanofi SA is likely to begin testing its own vaccine in humans next year.</p><p>India&#39;s Bharat Biotech is another company that is in the race to develop a vaccine for the mosquito-borne disease.</p><div>&nbsp;</div><p>&nbsp;</p> Mon, 20 Jun 2016 15:08:00 +0000 Reuters 2470517 at sites/default/files/photo/2016/02/03/503194/screenshot_2016-02-03_12.57.47.png Doctors blame many factors for futile care, themselves included <img src="" alt="" title="" class="imagecache imagecache-media_thumbnail" width="152" height="114" /><div>Doctors who were asked about causes of inappropriate care at the end of life didn&rsquo;t have to look far to place blame. They blamed themselves.</div><div>&nbsp;</div><div>Australian researchers interviewed 96 physicians from 10 medical specialties and asked them to describe situations when patients received end-of-life care that the doctors felt was inappropriate.</div><div>&nbsp;</div><div>Futile medical treatment at the end of life has been shown to harm patients, cause moral distress to clinicians and waste scarce resources, as the researchers note in the Journal of Medical Ethics.</div><div>&nbsp;</div><div>But 96 percent of physicians pointed to themselves &mdash; or &ldquo;doctor-related factors&rdquo; &mdash; as the main drivers of futile treatment. Poor communication, emotional attachment to patients and aversion to death were also among the causes they cited.</div><div>&nbsp;</div><div>Patient-related factors were important, too. Ninety-one percent of the doctors cited reasons such as family or patient requests for treatment, prognostic uncertainty and not knowing the patient&rsquo;s wishes as contributors to inappropriate care.</div><div>&nbsp;</div><div>&ldquo;The take-home message for patients and families is to have the conversation about what they want and don&rsquo;t want at the end of life,&rdquo; said study leader Lindy Willmott, of the Australian Center for Health Law Research.</div><div>&nbsp;</div><div>&ldquo;Doctors&rsquo; natural tendency is to treat in this way, and to take another path requires one or more conversations with the patient and family,&rdquo; Willmott told Reuters Health. &ldquo;Such conversations are difficult, and doctors are time-poor.&rdquo;</div><div>&nbsp;</div><div>Close to 70 percent of the surveyed doctors also cited hospital-related causes, such as specializations, medical hierarchy and time pressure, as factors in futile care.</div><div>&nbsp;</div><div>It isn&rsquo;t a matter of one doctor stepping back and considering the overall health of the patient, explained co-author Benjamin White, a law professor at the Queensland University of Technology.</div><div>&nbsp;</div><div>&ldquo;There are many specialists involved, each focused on a particular organ,&rdquo; he told Reuters Health. The narrow focus of the individual specialists can make it difficult to coordinate a patient&rsquo;s care, he and his colleagues noted in their report.</div><div>&nbsp;</div><div>Roughly one quarter of physicians said aggressive treatments are &ldquo;hard to stop once started.&rdquo;</div><div>&nbsp;</div><div>The difficulty of withdrawing treatment is a challenge that&rsquo;s all too common, agreed Dr. Eytan Szmuilowicz, a palliative care physician at Northwestern University&rsquo;s Feinberg School of Medicine in Chicago.</div><div>&nbsp;</div><div>Szmuilowicz, who was not associated with the study, added that doctors&rsquo; natural aversion to conflict complicates the issue further.</div><div>&nbsp;</div><div>&ldquo;We don&rsquo;t know how to manage or negotiate it,&rdquo; he told Reuters Health. &ldquo;It is easier behind the scenes to complain that a treatment may be inappropriate, but we haven&rsquo;t taken a step back to think if we are providing care that furthers a patient&rsquo;s goals.&rdquo;</div><div>&nbsp;</div><div>Szmuilowicz said he and many other physicians prefer to assess treatment in terms of &ldquo;benefit&rdquo; rather than &ldquo;futility.&rdquo;</div><div>&nbsp;</div><div>&ldquo;It comes down to what the patient values, and it&rsquo;s very hard to discuss what we think the patient values if we haven&rsquo;t talked about it,&rdquo; he said.</div><div>&nbsp;</div><div>Kayhan Parsi of Loyola University-Chicago&rsquo;s Neiswanger Institute for Bioethics sees young physicians struggle with such discussions. Parsi, who was not involved in the study, was not surprised that 44 percent of doctors cited &ldquo;inexperience with death and dying.&rdquo;</div><div>&nbsp;</div><div>As a member of his hospital&rsquo;s ethics committee, Parsi meets monthly with medical trainees. &ldquo;They feel pressure on them to comply with inappropriate treatment, and they don&rsquo;t know how to address it in an appropriate way,&rdquo; he said.</div><div>&nbsp;</div><div>Thirty percent of the Australian doctors said they or their colleagues had provided futile treatment due to worries about legal consequences. That factor looms even larger in the U.S., according to Thaddeus Pope, director of the health law institute at Mitchell Hamline School of Law in St. Paul, Minnesota.</div><div>&nbsp;</div><div>&ldquo;Researchers don&rsquo;t frame the issue in terms of patient safety, but that is a big implication of this study,&rdquo; said Pope, who tracks the issue on his Medical Futility Blog.</div><div>&nbsp;</div><div>Pope urges doctors to present medical options in even-handed ways.</div><div>&nbsp;</div><div>&ldquo;If physicians are too aggressive, families are going to fall in line,&rdquo; he told Reuters Health. &ldquo;It&rsquo;s emotionally hard for (families) to pass up what doctors say is a reasonable option. If they knew the real risks, benefits and alternatives, they may not pick the treatment they are receiving.&rdquo;</div> Sat, 18 Jun 2016 12:39:00 +0000 Reuters 2470467 at sites/default/files/photo/2015/02/15/484151/high_blood_pressure.jpg Here’s why you need to thank your father for your good mental health <img src="" alt="" title="" class="imagecache imagecache-media_thumbnail" width="152" height="114" /><div>Experts suggest that children with fathers who are involved in their health and development may grow into teens who are less at risk of depression, behavioural problems and teenage pregnancy.</div><div>&nbsp;</div><div>Researchers encourage fathers to play an active role in their children&rsquo;s lives and shed light on the main health and well-being benefits brought by quality paternal presence.</div><div>&nbsp;</div><div>For Father&rsquo;s Day, a recently published paper invites fathers of all kinds &ndash; whether living with their children or not, single fathers, stepfathers or any other kind of paternal figure in a child&rsquo;s life &ndash; to up their involvement in the health, development and education of their children in a reliable and constant manner. The study&rsquo;s authors underline the key role that fathers play in child development, a role that&rsquo;s far from redundant compared to mothers&rsquo; roles.</div><div>&nbsp;</div><div>The importance of the father&rsquo;s role in child development is by no means a new discovery. However, over time, the authors of a recent study were able to observe that children who grew up with a father figure involved in their lives tended to experience fewer symptoms of depression, behavioural problems and teen pregnancies. Preterm babies were also seen to gain weight more easily.</div><div>&nbsp;</div><div>The father&rsquo;s clichéd role as a more vigorous, risk-taking play partner was also corroborated. When playing with their children, fathers often encouraged them to explore and take risks, while mothers offered stability and security. Fathers who regularly play with their children effectively &ldquo;protect&rdquo; them from symptoms of anxiety and help develop their creativity, the study revealed.</div> Sat, 18 Jun 2016 11:59:00 +0000 AFP 2470462 at sites/default/files/photo/2015/08/13/43/111208034746-daddy-boot-camp-one-horizontal-large-gallery.jpg