Children’s Hospital of Philadelphia offers help and cure for picky eaters

Families dealing with the stress and frustration of their child’s overly picky eating habits may have a new addition to their parental toolbox. Pediatric researchers recently described a brief group cognitive-behavioral therapy program that provides parents with specific techniques to improve their child’s mealtime behaviors and expand the range of foods their children will eat. Although the study size was small, the parents involved reported “life-changing” improvements.

Researchers from Children’s Hospital of Philadelphia (CHOP) and The University of Pennsylvania published this study in the August 2019 issue of Cognitive and Behavioral Practice.
“Our research shows the acceptability, feasibility and positive outcomes of the Picky Eaters Clinic, a seven-session, parent-only, group-based intervention intended to train parents of children with Avoidant/Restrictive Food Intake Disorder (ARFID),” said study leader Katherine Dahlsgaard, Ph.D., ABPP, Clinical Director of the Anxiety Behaviors Clinic at CHOP. “In the Clinic, parents are taught to act as behavioral therapists who promote long-term improvements in food acceptance and positive mealtime behaviors.”
This study included 21 patients and their parents, who were referred to the Picky Eaters Clinic at CHOP. Families, including the child, attended a diagnostic evaluation and were assessed for treatment eligibility. The children ranged in age from 4 to 12 years and were diagnosed with ARFID, due to excessive picky eating and associated functional impairment.
The families reported that picky eating caused considerable stress. Parental stress resulted from: diet containing less than 20 foods; refusal of entire food groups (typically vegetables, meats or fruits); the need to make a separate meal; difficulty traveling, socializing or going to restaurants; high child distress/refusal to eat when presented with a new or non-preferred food; and lack of child’s motivation to change or unwillingness to receive treatment.
The seven clinic sessions occurred over a 6-month period. The first four sessions were held one week apart; the fifth and sixth were spaced two 3 to 4 weeks apart, allowing families time to practice the assigned behavior strategies at home. Children were challenged at home to chew and swallow a portion of a new or non-preferred food and a successful challenge resulted in a post-meal reward. The majority chose screen time.
The seventh “reunion” session was held 3 months later, to allow parents to catch up and share gains. The researchers administered post-treatment feeding measures and a parent satisfaction survey at the last sessions.
Dahlsgaard is interested in the long-term effects of the treatment and wants to follow up with the families, now that at least 2 years have passed since treatment. “I occasionally receive emails from the parents, telling me that their children are trying everything or eating in restaurants with no problem,” Dahlsgaard says. “But I’m interested to research this systematically and report on the long-term outcomes for all the families.”

---

Explore further

Picky eating may mask larger issues

---

More information: Katherine K. Dahlsgaard et al, The (Extremely) Picky Eaters Clinic: A Pilot Trial of a Seven-Session Group Behavioral Intervention for Parents of Children With Avoidant/Restrictive Food Intake Disorder, Cognitive and Behavioral Practice (2018). DOI: 10.1016/j.cbpra.2018.11.001

https://medicalxpress.com/news/2019-10-children-hospital-philadelphia-picky-eaters.html

Healthcare SPAC GreenVision Acquisition files for a $50 million IPO

GreenVision Acquisition, a blank-check company targeting the healthcare industry in Asia or North America, filed on Monday with the SEC to raise up to $50 million in an initial public offering.

The Shanghai, China-based company plans to raise $50 million by offering 5 million units at a price of $10. At $10, GreenVision Acquisition would command a market value of $63 million. Each unit consists of one share of common stock, one warrant, and one right to receive one-tenth of a share of common stock.
The sponsor GreenVision Capital Holdings (19% post-IPO stake) is an affiliate of the SPAC’s officers and directors.
The Shanghai, China-based company was founded in 2019 and plans to list on the Nasdaq. I-Bankers Securities is the sole bookrunner on the deal.

Relevant Profile: GAC.RC

https://www.renaissancecapital.com/IPO-Center/News/65544/Healthcare-SPAC-GreenVision-Acquisition-files-for-a-$50-million-IPO

Edit

Colorectal and pancreatic cancer rates up 10% in last 30 years

The results of a major study across 195 countries, presented today at UEG Week Barcelona 2019, indicate that global death rates for pancreatic cancer and incidence rates for colorectal cancer both increased by 10% between 1990 and 2017.
The Global Burden of Disease study, is the first to provide comprehensive worldwide estimates of the burden, epidemiological features and risk factors of a number of digestive diseases. Funded by the Bill & Melinda Gates Foundation, the study has also been published today in The Lancet Gastroenterology & Hepatology.
Key findings also include:
– The number of pancreatic cancer cases increased by 130% over the 27-year study period, from 195,000 in 1990 to 448,000 in 2017
– Gastric (stomach) cancer dropped from the second leading cause of cancer death worldwide to the third, behind both lung and colorectal cancer
– The number of cases of inflammatory bowel disease (IBD) increased 84%, from 3.7 million in 1990 to 6.8 million in 2017
Commenting on the study, Professor Herbert Tilg, Chair of the UEG Scientific Committee, stated, “This analysis provides the most comprehensive picture of the global burden of digestive disease to date. Examining these cross-populational trends offers vital information on the changing burden of disease and aids the correct allocation of resources to improve patient outcomes.”
Pancreatic cancer patients more likely to survive in 1990 than today
As well as an increase in pancreatic cancer cases, the number of deaths also rose from 196,000 in 1990 to 448,000 in 2017. Whilst some of this increase can be explained by the rising population and longevity, even after accounting for population changes, age-standardised incidence and death rates for pancreatic cancer increased by 12% and 10% respectively. Of note, the highest incidence and death rates were found in higher-income countries.
Experts believe the increase is related to a rise in the prevalence of obesity and diabetes, as reflected by the risk factors of high BMI and higher blood glucose levels which are two of the leading risk factors for pancreatic cancer.
Professor Reza Malekzadeh, lead author of the study, commented, “Pancreatic cancer is one of the world’s deadliest cancers, with an overall five-year survival rate of just 5% in high, middle and low-income countries. Major risk factors for the disease, such as smoking, diabetes and obesity, are largely modifiable and present a huge opportunity for prevention.”
Screening key in reducing the burden of colorectal cancer
From 1990 to 2017, age-standardised incidence rates for colorectal cancer increased 9.5% globally but, by contrast, age-standardised death rates decreased by 13.5%. The researchers believe that this is due to the introduction of colorectal cancer screening programmes, leading to earlier detection and an increased chance of survival. Similarly, in countries where screening programmes were established two or three decades ago, reductions in death rates were observed, supporting the benefits attributable to screening interventions.
The study also indicated that the risk factors for colorectal cancer are different in males and females, and should therefore be considered in national policy and prevention programmes. Alcohol use, smoking and diets low in calcium, milk and fibre had a considerable burden on males. For females, dietary risks, but not alcohol use or smoking, were found to be the most attributable risks.
Experts recommend local strategies to tackle gastric cancer
Age-standardised incidence and death rates for gastric cancer decreased steadily between 1990 and 2017. However, this decline has not necessarily led to a lower burden on the health system in high-risk countries and experts believe that specific local strategies should be tailored to each country’s risk factor profile.
“This research shows how gastric cancer presents vast geographical variations, and understanding these differential trends is essential for formulating effective preventative strategies”, commented Professor Reza Malekzadeh. “Beyond the current decline in incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the cases and deaths occur, is further reduced.”
https://www.eurekalert.org/pub_releases/2019-10/sh-cap102119.php

House panel to consider vaping tax bill this week

The House Ways and Means Committee is scheduled to consider a bill on Wednesday that would impose a tax on the nicotine used in vaping, Chairman Richard Neal (D-Mass.) announced Monday.
The panel will mark up a bipartisan bill introduced by Reps. Tom Suozzi (D-N.Y.) and Pete King (R-N.Y.), under which nicotine from vaping products would be taxed at the same rate as nicotine from cigarettes.
The Joint Committee on Taxation estimates that the bill would raise nearly $10 billion over a decade. Suozzi’s office said that the revenue raised by the vaping bill would be used to offset the cost of other bills the Ways and Means Committee is considering Wednesday that would require certain high-deductible health plans to cover the cost of inhalers, and that would allow people to use tax-advantaged accounts to purchase over-the-counter medications and menstrual-care products.

The announcement of the markup comes as policymakers have expressed concerns about vaping products in light of the spike in teen vaping and the spread of a mysterious respiratory illness that has sickened more than 1,000 people and led to more than 30 deaths.
“I applaud Chairman Neal and my colleagues on the Ways and Means Committee for acting swiftly and decisively to get vaping products out of the hands of young people,” Suozzi said in a statement. “We must address this public health crisis now rather than waiting years to do so, as we did with cigarettes.”
King said that the mark up “is an important step in ensuring Congress explores a means to end this epidemic and ensure the well-being of our youth.”
Bills on taxing e-cigarettes have also been introduced in the Senate.
The Trump administration said in September that it is seeking to ban non-tobacco flavors of e-cigarettes.
Juul, a leading maker of e-cigarettes, announced last week that it’s suspending sales of its fruity flavors.
https://thehill.com/policy/finance/466749-house-panel-to-consider-vaping-tax-bill-this-week

Private equity-funded doctor group puts $4M on ‘surprise’ medical bill lobbying

A coalition of doctors groups owned by private equity firms and investment groups spent more than $4 million lobbying Congress last quarter on legislation that would end “surprise” medical bills.
Physicians for Fair Coverage spent $4.1 million between July 1 and Sept. 30, when the debate over surprise medical bills was heating up in Congress, according to lobbying disclosure reports filed Monday.

It’s a record-high amount for the relatively new coalition, which spent less than $5,000 on lobbying during the same time period last year. The group spent $120,000 between April 1 and June 30 and $25,000 from Jan. 1 to March 31.
The lobbying campaign comes as Congress seeks to pass legislation banning providers from billing patients for costs not covered by insurance companies.
The practice can result in patients receiving costly bills, even if they seek care at in-network facilities but are unknowingly treated by doctors who don’t participate in insurance networks and are employed by staffing firms.
Physicians for Fair Coverage, a coalition of doctor staffing firms that includes ApolloMD and Vituity, is fighting a House bill that would end that practice by setting the rates insurers would pay doctors.
The coalition instead supports a bill, sponsored by Reps. Raul Ruiz (D-Calif.) and Phil Roe (R-Tenn.), both doctors, that would have an outside arbiter help set the payment rate.
The doctor staffing companies that make up the coalition are funded by private equity groups such as ValorBridge, New Enterprise Associates, and Welsh, Carson, Anderson and Stowe, according to Kaiser Health News.
When asked about the increase in lobbying spending, the group did not provide details and instead directed The Hill to its website.
The House Energy and Commerce Committee in September launched an investigation into the role private equity firms play in surprise billing, sending letters to three companies, including Welsh, Carson, Anderson and Stowe.
“We are concerned about the increasing role that private equity firms appear to be playing in physician staffing in our nation’s hospitals, and the potential impact these firms are having on our rising health care costs,” Chairman Frank Pallone Jr. (D-N.J.) and Rep. Greg Walden (Ore.), the top Republican on the committee, wrote in the letters.
https://thehill.com/policy/healthcare/466756-doctors-coalition-funded-by-private-equity-spends-41-million-lobbying-on

Four states announce $48 billion settlement framework in opioid lawsuits

Four attorneys general announced Monday a framework for a $48 billion settlement with five prescription drug companies over their alleged role in the opioid epidemic.
The settlement, which would involve Cardinal Health, McKesson, AmerisourceBergen, Johnson & Johnson and Teva, would include $22 billion in cash and $26 billion worth of a generic opioid addiction treatment, product distribution and data tracking measures.
The framework is an “agreement in principle” and has not been finalized.
“The opioid epidemic has ripped through our communities and left a trail of death and destruction in its wake,” said North Carolina Attorney General Josh Stein.
“This agreement is an important step in our progress to help restore people’s lives. Not only will it provide significant funds and treatment drugs to help people get healthy, it will go a long way in preventing the pill mills that fed so many people’s addictions in North Carolina and around the nation.”
Attorneys General Herbert Slatery (Tenn.), Josh Shapiro (Pa.) and Ken Paxton (Texas) also agreed to the framework.
Under the agreement, each state and its local governments will receive a share of the $22 billion in cash to provide addiction treatment, paramedic services and telehealth treatment.
McKesson, a drug distribution company, would pay $6.68 billion over 18 years, the highest amount of all the companies in the settlement.
Cardinal Health and AmerisourceBergen, also drug distributors, would pay about $5.6 billion each over 18 years.
Johnson & Johnson, a drug manufacturer, would pay $4 billion over two to three years, while Teva would pay $250 million over 10 years.
Teva would also supply $23 billion of its generic suboxone product over 10 years.
McKesson, Cardinal Health and AmerisourceBergen also reached a $260 million settlement with two Ohio counties Monday.
https://thehill.com/policy/healthcare/466786-four-states-announce-48-billion-settlement-framework-with-five-companies-in

Aerpio may hang the ‘for sale’ sign up, axes CEO after eye drug flop

In a classic plot line for biotechs, Aerpio Pharmaceuticals is seeking a “strategic review” for its business and assets after being hit by a trial failure for its leading med earlier this year.
The micro-cap biotech, with a market cap worth less than $20 million and trading in penny stock territory, said its board is “exploring the potential for an acquisition, company sale, merger, business combination, asset sale, in-license, out-license or other strategic transaction.” The chief executive, Michael Rogers, is also out the door.
Aerpio added that it “does not intend to make any further disclosures regarding the strategic review process unless and until a specific course of action is approved,” so don’t expect any more press releases until some sort of deal is done—or not, as the case may be.

As well as looking to potentially sell off some or all of the company, Aerpio’s already slimming down, or, as it puts it, “streamlin(ing) operations in order to preserve its capital and cash resources.” It had under $50 million at last count in June.
Joseph Gardner, Ph.D., its current president (and founding CEO of Akebia Therapeutics), will now lead the dwindling C-suite team as Rogers alongside Chief Financial Officer Stephen Hoffman “have transitioned from their roles,” the biotech said in a brief update.
Back in May, shares in Aerpio were more than halved after the failure of its leading drug candidate.
The midstage test, known as the TIME-2b study, was assessing its drug AKB-9778 in diabetic retinopathy but missed its primary endpoint of a two-step reduction in its diabetic retinopathy severity score score when pitted against a dummy treatment.
The percentage of patients achieving this endpoint for the injectable AKB-9778 twice daily and placebo were 9.6% and 3.8%, respectively (p=0.270). Across all eyes, those achieving this endpoint was 8.6% and 2.7%, for AKB-9778 BID and placebo, respectively (p=0.158). That was a hard fail, and one that sent its shares into a free fall from which it has not recovered.
https://www.fiercebiotech.com/biotech/aerpio-may-hang-for-sale-sign-up-axes-ceo-after-eye-drug-flop