scholarly journals Probiotic Products in Canada with Clinical Evidence: What Can Gastroenterologists Recommend?

2008 ◽  
Vol 22 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Gregor Reid ◽  
Kingsley Anukam ◽  
Tara Koyama
Keyword(s):  
United States Of America ◽  
Clinical Evidence ◽  
Health Benefit ◽  
The United States ◽  
World Health ◽  
Therapeutic Effects ◽  
The Us ◽  
Health Organization ◽  
Health Canada

Probiotics, defined as ‘live microorganisms, which when administered in adequate amounts, confer a health benefit on the host’, are finally becoming an option for gastroenterologists in Canada, after being available for many years in Japan, Europe and the United States of America. Unfortunately, Health Canada and the US Food and Drug Administration have not controlled the use of the term ‘probiotic’ or put into place United Nations and World Health Organization guidelines. The net result is that a host of products called ‘probiotics’ are available but are not truly probiotic. The aim of the present review was to discuss the rationale for probiotics in gastroenterology, and specifically examine which products are options for physicians in Canada, and which ones patients might be using. It is hoped that by clarifying what probiotics are, and the strengths and limitations of their use, specialists will be better placed to make recommendations on the role of these products in patient care. In due course, more clinically documented probiotics will emerge, some with therapeutic effects based on a better understanding of disease processes.

scholarly journals Is COVID-19 the end of US hegemony? Public bads, leadership failures and monetary hegemony

2020 ◽  
Vol 96 (5) ◽  
pp. 1281-1303 ◽  
Author(s):  
Carla Norrlöf
Keyword(s):  
United States ◽  
Public Goods ◽  
The United States ◽  
World Health ◽  
The Public ◽  
The Us ◽  
Us Hegemony ◽  
Health Organization ◽  
Public Bads ◽  
The Relationship

Abstract COVID-19 is the most invasive global crisis in the postwar era, jeopardizing all dimensions of human activity. By theorizing COVID-19 as a public bad, I shed light on one of the great debates of the twentieth and twenty-first centuries regarding the relationship between the United States and liberal international order (LIO). Conceptualizing the pandemic as a public bad, I analyze its consequences for US hegemony. Unlike other international public bads and many of the most important public goods that make up the LIO, the COVID-19 public bad not only has some degree of rivalry but can be made partially excludable, transforming it into more of a club good. Domestically, I demonstrate how the failure to effectively manage the COVID-19 public bad has compromised America's ability to secure the health of its citizens and the domestic economy, the very foundations for its international leadership. These failures jeopardize US provision of other global public goods. Internationally, I show how the US has already used the crisis strategically to reinforce its opposition to free international movement while abandoning the primary international institution tasked with fighting the public bad, the World Health Organization (WHO). While the only area where the United States has exercised leadership is in the monetary sphere, I argue this feat is more consequential for maintaining hegemony. However, even monetary hegemony could be at risk if the pandemic continues to be mismanaged.

scholarly journals The COVID States Project #75: Attitudes toward COVID-19 boosters before and after Omicron

2021 ◽  
Author(s):  
Roy H. Perlis ◽  
Matthew Baum ◽  
Kristin Lunz Trujillo ◽  
David Lazer ◽  
Alauna Safarpour ◽  
...  
Keyword(s):  
District Of Columbia ◽  
The United States ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Dominant Form ◽  
The Us ◽  
Before And After ◽  
Control And Prevention ◽  
Health Organization ◽  
To Receive

Recognizing that the protection conferred by COVID-19 vaccines may wane over time, the US Centers for Disease Control and Prevention (CDC) has encouraged adults in the United States to receive booster shots that can augment their immunity to the virus. While the Biden administration sought to encourage all adults to receive boosters, the CDC initially authorized the shots only for higher-risk individuals. Subsequently, authorization was broadened to all adults, although only higher-risk individuals were encouraged to pursue boosters. Most recently, after substantial criticism, the CDC changed its language to encourage all adults to receive boosters.But regardless of the language, are US adults sufficiently convinced to seek booster shots? Will the same factors that contributed to COVID-19 vaccine hesitancy and vaccine resistance impact booster shots? The answers may have profound public health implications as the US enters the season during which respiratory viruses typically have the greatest impact, and the highly-transmissible Omicron variant rapidly becomes the dominant form of COVID-19, after being labeled a variant of concern by the World Health Organization on November 26th.Between November 3rd and December 3rd, 2021, the COVID States Project asked 22,277 adults in all 50 US states and the District of Columbia about their attitudes and behaviors regarding COVID-19. In particular, we asked about whether people are vaccinated or intend to be vaccinated, and whether they had sought booster shots or intend to seek a booster shot. In this brief report, we examine attitudes toward COVID-19 booster shots, and whether they differ across particular groups of people. Since the survey was ongoing when news about Omicron emerged in the US, we also take an initial look at whether these attitudes have begun to shift along with perceptions of the threat posed by COVID-19 subsequent to the November 26th announcement.

Sumatriptan Contraindications and the Serotonin Syndrome

1998 ◽  
Vol 32 (1) ◽  
pp. 33-38 ◽  
Author(s):  
David M Gardner ◽  
Larry D Lynd
Keyword(s):  
Serotonin Syndrome ◽  
Clinical Evidence ◽  
World Health ◽  
International Drug Monitoring ◽  
Concurrent Use ◽  
Il Y A ◽  
Interactions Médicamenteuses ◽  
Comprehensive Search ◽  
Health Organization ◽  
Health Canada

OBJECTIVE To determine the risk for serotonin syndrome associated with the concomitant use of sumatriptan and the currently contraindicated therapies, that is, the monoamine oxidase inhibitors (MAOIs), serotonin selective-reuptake inhibitors (SSRIs), and lithium. METHODOLOGY: A comprehensive search for reports of serotonin syndrome associated with sumatriptan use was conducted by using tertiary drug interaction literature, MEDLINE, EmBASE, Biological Abstracts, Current Contents, Reactions, ClinAlert, and the International Pharmaceutical Abstracts. In addition, related reports from the proprietary manufacturers, the Health Protection Branch of Health Canada, and the World Health Organization Collaborative Centre for International Drug Monitoring were also solicited. RESULTS The concurrent use of sumatriptan with an SSRI or lithium has been reported to cause symptoms suggestive of serotonin syndrome in 16 and 2 cases, respectively. There were no reports involving MAOIs. In general, the reports indicated a mild-to-moderate, self-limited course with some features consistent with the serotonin syndrome. We found published reports of sumatriptan use without adverse events involving 148 patients receiving SSRIs, 31 patients taking MAOIs, and a small number using lithium. CONCLUSIONS Clinical evidence supporting the strict contraindication of MAOIs, SSRIs, and lithium was not identified. The balance of documented clinical experience pertaining to the use of sumatriptan concurrently with SSRIs or lithium suggests that most patients tolerate this combination without incident. Because there is little reliable experience with sumatriptan in combination with MAOIs, we suggest that sumatriptan should continue to be avoided in patients taking these agents until further data demonstrating safety become available. OBJETIVO Determinar el riego de desarrollar el síndrome de la serotonina asociado al uso concomitante del sumatriptan con agentes inhibidores selectivos de la captura de la serotonina, inhibidores de la monoamina oxidasa (IMAO), y el litio. MÉTODOS Las fuentes de información incluyeron la literatura de interacciones medicamentosas, MEDLINE, EmBASE, Biological Abstracts, Current Contents, Reactions, ClinAlert, y International Pharmaceutical Abstracts. También reportes emanados por los fabricantes de estos medicamentos, la Rama de Protección de la Salud de Salud Canada, y el Centro Colaborativo de Monitoreo Internacional de Medicamentos de la Organización Mundial de la Salud. RESULTADOS Los resultados de la investigación sugieren la presencia del síndrome de la serotonina en 16 casos de pacientes que recibieron el sumatriptan con los inhibidores selectivos de la captura de la serotonina y en 2 casos de pacientes que recibieron el sumatriptan con el litio. No hubo reportes que involucrasen a los IMAO. Las manifestaciones clínicas de este síndrome están descritas en este artículo. En general, los reportes indican que el curso de este evento es de leve a moderado y auto limitante. Los autores consiguieron un número considerable de reportes de estas combinaciones que no condujeron a reacciones adversas. Estos incluyeron 148 reportes del uso del sumatriptan con inhibidores selectivos de la captura de la serotonina, 31 del uso del sumatriptan con IMAO, y un número pequeño del uso del sumatriptan con el litio. CONCLUSIONES No existe suficiente evidencia clínica de que los IMAO, los inhibidores selectivos de la captura de la serotonina o que el litio estén totalmente contraindicados en pacientes recibiendo el sumatriptan. La experiencia clínica documentada hasta el presente sugiere que la mayoría de los pacientes toleran esta combinación sin incidentes. Debido a que existe poca experiencia acerca del uso del sumatriptan con los IMAO, los autores sugieren que esta combinación sea evitada hasta que haya mayor información sobre su seguridad. OBJECTIF Préciser le risque d'apparition d'un syndrome sérotoninergique lié à l'emploi concomitant de sumatriptan et des inhibiteurs de la monoamine oxydase (IMAO), des inhibiteurs sélectifs de la recapture de la sérotonine (ISRS), ou du lithium. MÉTHODES Une recherche des rapports publiés sur le syndrome sérotoninergique lié à l'emploi du sumatriptan a été menée dans les sources d'informations spécialisées en interactions médicamenteuses, dans les banques informatisées MEDLINE et EmBASE, dans les revues Biological Abstracts, Current Contents, Reactions, ClinAlert, et International Pharmaceutical Abstracts. De plus, les données des fabricants, de la Direction Générale de la Protection de la Santé de Santé Canada, et du Centre de Collaboration pour la Surveillance Internationale des Médicaments de l'Organisation Mondiale de la Santé ont été révisées. RÉSULTATS L'emploi concomitant de sumatriptan et des ISRS ou du lithium a été associé à des symptômes s'apparentant au syndrome sérotoninergique dans 16 et 2 cas, respectivement. Il n'y a pas eu de cas rapporté avec les IMAO. En général, les symptômes rapportés étaient de légers à modérés, et quelques présentations concordaient avec un syndrome sérotoninergique. Les auteurs ont répertorié 148 patients ayant utilisé le sumatriptan et les ISRS qui n'ont eu aucun problème, 31 patients ayant eu des IMAO et quelquesuns ayant eu du lithium. CONCLUSIONS L'évidence clinique supportant une contre-indication absolue de l'emploi des IMAO, des ISRS, ou du lithium concomitamment à celle du sumatriptan n'a pu être démontrée. La plupart des patients tolèrent les associations sumatriptan et ISRS ou lithium sans incident. Comme il y a peu d'informations entourant l'utilisation concomitante du sumatriptan et des IMAO, les auteurs suggèrent qu'il serait prudent d'éviter cette association jusqu'à ce que des données supplémentaires montrent son inocuité.

Decentralization and Fiscal Disparities in the United States of America

1983 ◽  
Vol 1 (3) ◽  
pp. 259-272 ◽  
Author(s):  
P R Dommel
Keyword(s):  
United States Of America ◽  
The United States ◽  
Specific Method ◽  
Federal System ◽  
Intergovernmental Transfers ◽  
The Us ◽  
Fiscal Disparities ◽  
Fiscal Conditions ◽  
The Usa

This paper examines the increasingly important role of the states in the US federal system and the implications of that growing role for the allocation of intergovernmental transfers. The author argues that as intergovernmental funds become more scarce, as is occurring in the USA, the distribution of these funds needs to take more account of the relative fiscal conditions of the states and to direct a larger share of funds to the fiscally weaker states. Various approaches to altering allocation systems are presented and a specific method for adjusting for fiscal disparities among the states is offered.

scholarly journals Delay in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles to protect people from Covid-19

2021 ◽  
Author(s):  
David Gisselquist
Keyword(s):  
Vitamin D ◽  
The United States ◽  
World Health ◽  
Live Vaccines ◽  
The Us ◽  
Us Government ◽  
Vitamin D Supplements ◽  
Health Organization ◽  
Experimental Use ◽  
The Impact

Introduction: In March 2020, less than three months after China reported a cluster of pneumonia cases in Wuhan, the United States (US) government budgeted money to support development of Covid-19 vaccines. By mid-December 2020, two had been developed, tested, and received the US government’s experimental use authorization. Given evidence that vitamin D supplements and live vaccines for tuberculosis, polio, and measles reduce risks for acute respiratory infection, many experts hypothesized they might reduce risks for Covid-19 infection. Expedited randomized controlled trials, as done for Covid-19 vaccines, could have assessed their protection against C19 no later than end-July 2020. Methods: On 21 April 2021, I searched trial registries maintained by the US National Institutes of Medicine and the World Health Organization for trials with ≥400 participants to assess vitamin D or live vaccines to prevent Covid-19 infections (all or symptomatic). On 10-13 November 2021, I searched PubMed and medRxiv for results reported from these trials.Results: In April 2021, I found 32 trials (9 for vitamin D and 23 for live vaccines) proposing to assess the impact of these interventions on rates of new Covid-19 infections (all or symptomatic). Only 10 trials proposed to begin by June 2020, and only one to end in 2020. My search on 10-13 November 2021, almost 11 months after the US approved the first two Covid-19 vaccines, found results reported from only one of the 32 trials (live measles vaccine significantly reduced new symptomatic infections). Conclusions: If health experts had demonstrated similar urgency in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles as in developing Covid-19 vaccines, trials could have reported by end-July 2020. Depending on what trials reported, these interventions could have prevented a large percentage of more than 600,000 Covid-19 deaths reported in the US from August 2020 through November 2021. Delay in assessing vitamin D has racial implications as well, since vitamin D deficiency and Covid-19 deaths in the US have been far more common among Blacks and Hispanics compared to Whites. Going forward, depending on what trials report, these interventions could help people live with Covid-19 as an endemic virus.

scholarly journals Inclusive Policymaking Tools: A COVID-19 Pandemic Case Study

2020 ◽  
Vol 17 (01) ◽  
Author(s):  
Ans Irfan ◽  
Ankita Arora ◽  
Christopher Jackson ◽  
Celina Valencia
Keyword(s):  
Best Practices ◽  
United States Of America ◽  
The United States ◽  
World Health ◽  
Mortality And Morbidity ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Equity And Inclusion

World Health Organization (WHO) estimates indicate the United States of America has the highest novel Coronavirus disease (COVID-19) burden in the world, with over 5 million confirmed cases and nearly 165,000 associated deaths as of August 14th, 2020 (WHO 2020). As the COVID-19 mortality and morbidity has disproportionately impacted populations who experience vulnerabilities due to structural issues such as racism (Laurencin and McClinton 2020; Lin II and Money 2020; Martin 2020; Kim et al. 2020), it has become increasingly necessary to take this opportunity and intentionally codify diversity, equity, and inclusion (DEI) practices in the policymaking process. To encourage and facilitate this, we synthesize existing literature to identify best practices that can not only be used to inform COVID-19-related public policy activities but will also continue to inform inclusive policymaking processes in the future. We identify specific tools for policymakers at all levels of government to better operationalize the DEI framework and enact inclusive, equitable public policies as a result.

Rheumatic Fever Prevention in Industrializing Countries: Problems and Approaches

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 996-998
Author(s):  
Rachel Snitcowsky
Keyword(s):  
Rheumatic Fever ◽  
Cost Effective ◽  
The United States ◽  
World Health ◽  
Streptococcal Infections ◽  
Industrialized Countries ◽  
The World ◽  
Group A ◽  
Health Organization

Editor's Note The problems resulting from Group A streptococcal infections remain largely unsolved in many of the industrialized countries of the world at the close of the 20th century. The fact that Group A streptococcal infections had assumed almost the role of a nuisance in the United States and Europe, before the beginning of the mid-1980s and 1990s resurgence, stands in marked contrast to the spectrum of streptococcal-related diseases in other parts of the world. Confirmatory epidemiologic data are often difficult to locate, but there is little doubt about the existence and the general magnitude of the problem. Because of this, the World Health Organization (WHO) has targeted Group A streptococcal infections and their sequelae for additional attention. During the last decade the WHO has invested considerable effort toward their control. The need for cost-effective primary and secondary rheumatic fever public health prevention programs is greater in those countries where the magnitude of the problem may be inversely proportional to available resources. Approaches considered routine in North America, in Europe, and in some countries of Latin America and Asia often are nonexistent in industrializing countries where as little as less than $5 per person per year may be reserved for total health care. With these issues in mind, the following perspective was invited to bring these unique problems related to Group A streptococcal infections and their sequelae into focus and to offer suggestions for realistic approaches under less than ideal conditions. We are grateful to Dr Snitcowsky for her comments.

Synchronized movement between US lumber futures and southern pine sawtimber prices and COVID-19 impacts

2022 ◽  
Author(s):  
Jianbang Gan ◽  
Nana Tian ◽  
Junyeong Choi ◽  
Matthew Pelkki
Keyword(s):  
Value Chain ◽  
The United States ◽  
World Health ◽  
Southern Pine ◽  
Low Frequencies ◽  
Time Frequency ◽  
The Us ◽  
The World ◽  
Health Organization

We analyzed the synchronized movements of lumber futures and southern pine sawtimber stumpage prices in the United States since 2011 and their response to COVID-19 events using wavelet analysis and event study. We found that the sawtimber and lumber prices have followed complex comovement patterns in the time-frequency domain and both reacted to COVID-19 events with a higher response intensity of the lumber price. Although they reacted differently to the early COVID-19 episodes and vaccine news, the sawtimber and lumber prices responded similarly to the COVID-19 pandemic declarations by the World Health Organization and US president, the US Food and Drug Administration panel’s recommendation of the first COVID-19 vaccine, and economic stimulus legislation. The patterns of synchronized movements between the sawtimber and lumber prices varied with time and frequency, but their comovement at low frequencies (>64 weeks) has strengthened since 2014 and been led by the lumber futures price; COVID-19 episodes have not changed this trend. The different magnitude of response of the two prices to the COVID-19 related events, as well as the long-term dominance of the lumber price in the comovement, reveals asymmetric price negotiation power and benefit distributions among the agents of the lumber value chain.

The Role of Pharmacists in Addressing Vaccine Hesitancy and the Measles Outbreak

2019 ◽  
pp. 089719001989543
Author(s):  
Katelin M. Lisenby ◽  
Kruti N. Patel ◽  
Michelle T. Uichanco
Keyword(s):  
Cost Effective ◽  
The United States ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Evidence Based ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreak ◽  
The World ◽  
Health Organization

Vaccine hesitancy has been identified as a top threat to global health by the World Health Organization. The current measles outbreak in the United States places even greater emphasis on the relevance of this topic. Vaccination is one of the most cost-effective methods to avoid preventable disease and associated complications. Safety concerns and lack of education commonly contribute to vaccination refusals. By providing patients evidence-based facts and education, pharmacists have the opportunity to address common misconceptions influencing the antivaccination movement and prevent future outbreaks of vaccine-preventable diseases.

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