Surging Healthcare Demand Makes Winners of India Hospital Stocks

 

• Rising insurance coverage, spend on healthcare are key drivers
• Demand tailwind for local hospital chains to persist: WhiteOak

Rising incomes, a growing aging population and higher spend on healthcare are setting the stage for another stellar year for India’s hospitals stocks.

A gauge of nine hospitals compiled by Bloomberg outpaced the broader equity index with a 55% surge over the last 12 months. Analysts expect the momentum to continue as an expanding insurance coverage provides hospitals another impetus to expand in a country that has just 1.3 hospital beds per 1,000 people.

https://www.bloomberg.com/news/articles/2024-01-16/surging-healthcare-demand-makes-winners-of-india-hospital-stocks

How Much Does Screentime Really Affect Child Development?

 France did it 5 years ago and now, from January 1, the Dutch have followed suit, banning devices such as mobile phones and tablets in classrooms unless needed during lessons, for medical reasons, or by students with disabilities. The ban aims to limit distractions during the school day. 

We could all surely do with some device detox, but the question remains whether too much screentime has an impact on child development. Karen Mansfield, a postdoctoral researcher on adolescent well-being in the digital age at Oxford University, told Medscape Medical News, "The evidence is definitely not set in stone. There have been some recent reviews of screentime effects on children, demonstrating very mixed findings."

The latest research, said Mansfied, is still young, lacking consistency in findings, and rife with misinterpretation.

Tiziana Metitieri, a cognitive neuropsychologist at the Meyer Hospital in Florence, Italy, echoed these sentiments, suggesting that the sheer quantity of screentime is an insufficient metric for understanding its impact on cognitive and psychological development. "There are two main reasons for this," she explained to Medscape Medical News. "Firstly, because the current measurements of screentime rely on self-report data, which can be affected by an overestimation or underestimation of objective usage due to social desirability bias. Secondly, because digital experiences differ in terms of content, device used, context, location, and individuals involved."

Are Politicians in Too Much of a Rush?

UNESCO's most recent report on technology in education highlighted a correlation between excessive mobile phone use and reduced educational performance and emotional stability.

The OECD report "Empowering Young Children in the Digital Age," rightly suggested there is a need to improve protection in digital environments, bridge the digital divide, and educate parents and teachers on safe digital practices.

But Mansfield said, "Currently, policy implementation is racing far ahead of the evidence, with similar suggestions to ban smartphones in schools in the United Kingdom and Canada. However, there is no available evidence on the long-term benefits of banning smartphones. Much of the research behind the OECD and UNESCO policies is observational in nature, which limits causal interpretation more than with interventions."

While most governments are not pursuing restrictive practices, Metitieri said that "their approaches are based on their political ideology, often using moral panic as a means to rally support, showing their heartfelt commitment to defending against the invasions of digital technology ruining human civilizations." 

Sakshi Ghai, Mansfield's fellow postdoctoral researcher at Oxford University, reiterated Metiteri's concerns, "Screentime as a concept has limitations, and policy guidance needs to be careful when drawing insights from such limited evidence. What do we mean by screentime? How can time spent on different activities be clearly delineated? An oversimplistic focus on screentime may overlook the nuances and complexity of digital media use."

The Key Is the What and Where

Digital screens can be productive for children, such as when used for educational purposes, be it to join a class over Zoom or partake in extracurricular educational activities. However, Ghai emphasized the importance of identifying what constitutes reasonable consumption of digital media. "Screens can help disadvantaged children achieve positive educational outcomes, particularly those with learning difficulties," said Sakshi. "Using media to interact with other children can also bring positive social connections to racially diverse children or those from the LGBTQ community, which reiterates why finding the balance that allows children to reap the benefits of digital technology while safeguarding their mental, physical, and social health, is crucial."

On the other hand, Metitieri explained that there is evidence that passive exposure to educational content does not necessarily lead to growth benefits. "The key is the relational environment in which these digital experiences occur," she said. 

Mansfield said a lot of research describes excessive use of digital media as a form of addiction. "Some studies have attempted to validate and test 'smartphone addiction' scales for adolescent. Besides pathologizing an increasingly common activity, such self-report scales are highly subjective, implying serious limitations when attempting to define 'cut offs' or diagnostic thresholds."

Previous efforts to determine benchmarks for screentime usage, focusing on the relationship between historical screen usage and present mental well-being, have overlooked the nature of the digital interaction and the social and technological backdrop. "Effects of screentime on children is a continuously changing, rapidly developing research field, and other contextual factors have been shown to play a greater role on mental health," explained Mansfield.

Are School Bans Too Restrictive?

Implementing nationwide policies that warrant a dramatic shift in how we approach activities that have become second nature, such as using a mobile phone, is profoundly difficult, particularly as evidence is inconclusive and inconsistent. "The long-term effects of different types of digital content on children's learning are yet to be clear, and most education-related research so far has been carried out with college students," said Mansfield.

For concerned parents and schools, Metitieri advised against overly restrictive approaches. "Children and adolescents can find ways around restrictions at home and school, meaning that an overly restrictive approach is limited in its effectiveness," she said. "The best way to adapt to the changes happening in education, relationships, work, and leisure is through a combination of experiences offline and digital education."

Mirroring Metitieri's outlook, Mansfield suggested, "Restricting the use of smartphones and other personal devices is one method to reduce distraction, but ultimately, children will need to learn to optimise their use of digital devices."

Recent Dutch media reports cited government ministers' consultations with neuropsychiatrist Theo Compernolle, who compared children's current smartphone usage patterns to addiction and suggested that such habits may hinder the development of the prefrontal cortex. However, Mansfield said, "There is no evidence to back up this claim." Although she acknowledged the potential short-term benefits of a screentime ban in enhancing classroom concentration, she said, "One study directly tested this hypothesis and found no association between social media use and brain development, meaning that any claims of long-term effects remain purely speculative."

The issue of children's screentime is complex. Understanding the content and context of screentime, educating parents and teachers, and integrating digital experiences with offline activities seem to be the way forward. While governments contend with the complexities of managing this rather modern challenge, the balance between digital engagement and cognitive development remains a critical topic for continued research and thoughtful policymaking. Metitieri summed it up, "As adult members of the digital society, it is important for us to educate ourselves on how to effectively use online platforms before sharing our experiences and concerns about the online world with children and adolescents."

https://www.medscape.com/viewarticle/how-much-does-screentime-really-affect-child-development-2024a10000x4

Doctors treating patients harmed by Covid vaccines predict 5 more years of concerns

 Friday, January 12, 2024, Georgia Representative Marjorie Taylor Greene held a historic US Congressional Panel in The Rayburn Building on Capitol Hill to learn why COVID-19 vaccination continues to cause record injuries, disabilities, and deaths, even years after the primary series in 2021.

The hearing was attended by Greene (R-GA), Senator Ron Johnson (R-WI), US Representatives Warren Davidson (R-Ohio), and Andy Biggs (R-AZ), and the witnesses were Dr. Peter McCullough adult internal medicine, cardiology, Dr. Ryan Cole, clinical pathology, and Dr. Kirk Milhoan, pediatrics, pediatric cardiology. All three manage various injuries occurring after COVID-19 vaccination. Approximately 75% of Americans took one or more shots, and of them, 94% received an mRNA product from either Pfizer or Moderna.

The two-hour session was nonstop, from opening statements and questions from our lawmakers to the experts. It was a live stream broadcast through many channels, and the press took interviews from Greene and Johnson. The audience included stakeholders who have suffered injuries from COVID-19 vaccination, students, corporate executives, independent media, and the Children’s Health Defense.

 

Dozens of citations were given for the Congressional Record from the peer-reviewed literature and safety databases, and slides were shown demonstrating the COVID-19 vaccine Spike protein doing widespread damage to the human body. The major systems at risk with proven complications and new disease syndromes include the heart, central and peripheral nervous systems, blood clotting, and immune system function.

An emerging area of concern discussed was de novo and reactivation of a variety of cancers. Dr. McCullough pointed out that for genetic products, the FDA regulatory window for safety concerns is five years. Experts told the panel that Americans are worried. A Rasmussen poll out on the day of the hearing reported that 53% of Americans think severe side effects from the vaccines are leading to large numbers of unexplained deaths.

Please take the time to review this hearing, and please share it widely with your family, friends, and colleagues. In the end, Senator Johnson made a plea to physicians and other healthcare workers to come forward, be honest about their missteps, and get on the right side of history. COVID-19 vaccination has been a biological safety catastrophe for the world. On January 12, 2024, all three witnesses called for market withdrawal of all COVID-19 vaccine products for safety concerns—it’s in the Congressional Record.

https://www.fda.gov/media/113768/download

https://www.rasmussenreports.com/public_content/politics/public_surveys/more_than_half_suspect_covid_19_vaccines_have_caused_deaths

https://rumble.com/v46tcwn-us-congress-learns-about-long-term-harms-from-covid-19-vaccination.html

• 
  Dr. Peter McCullough

  Dr. McCullough is an internist, cardiologist, and epidemiologist managing the cardiovascular complications of both the viral infection and the injuries developing after the COVID-19 vaccine in Dallas, TX, USA. Since the outset of the pandemic, Dr. McCullough has been a leader in the medical response to the COVID-19 disaster and has published “Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection,” the first synthesis of sequenced multidrug treatment of ambulatory patients infected with SARS-CoV-2 in the American Journal of Medicine and subsequently updated in Reviews in Cardiovascular Medicine. He has dozens of peer-reviewed publications on the infection and has extensively commented on the medical response to the COVID-19 crisis 

• https://www.americaoutloud.news/us-congressional-testimony-from-physicians-treating-patients-harmed-by-covid-19-vaccines-predicts-five-years-of-health-concerns/

'California Offers a Lifeline for Medical Residents Who Can't Find Abortion Training'

 Bria Peacock, MD, chose a career in medicine because the Black Georgia native saw the dire health needs in her community -- including access to abortion care.

Her commitment to becoming a maternal healthcare provider was sparked early on when she witnessed the discrimination and judgment leveled against her older sister, who became a mother as a teen. When the Supreme Court overturned Roe v. Wade in 2022, Peacock was already in her residency program in California, and her thoughts turned back to women like her sister.

"I knew that the people -- my people, my community back home -- was going to be affected in a dramatic way, because they're in the South and because they're Black," she said.

But even though Peacock attended the Medical College of Georgia, she's doing her obstetrics and gynecology residency at the University of California San Francisco (UCSF), where she has gotten comprehensive training in abortion care.

"I knew as a trainee that's what I needed," said Peacock, who plans to return to her home state after her residency.

Ever since the Supreme Court decision, California has worked to become a sanctuary for people from states where abortion is restricted. In doing so, it joins 14 other states, including Colorado, New Mexico, and Massachusetts. Now, it's addressing the fraught issue of abortion training for medical residents, which most doctors believe is crucial to comprehensive ob-gyn training.

A law enacted in Septemberopens in a new tab or window makes it easier for out-of-state trainees to get up to 90 days of in-person training under the supervision of a California-licensed doctor. The law eliminated the requirement for a training license and also permitted training at programs such as Planned Parenthood that are affiliated with accredited medical schools.

"By allowing physician residents to come to California, where there are more opportunities for abortion training, and by allowing them to be reimbursed for this work, we're sending a message that abortion care is healthcare and an essential part of physician training," said Lisa Folberg, CEO of the California Academy of Family Physicians, which supported the bill.

The question of how to provide complete ob-gyn training promises to become more urgent as the effects of abortion bans on medical education become clear: 18 statesopens in a new tab or window restrict or ban abortion to the point of effectively stripping 20% of ob-gyn medical residents of the opportunity to get abortion training, according to the Ryan Residency Training Programopens in a new tab or window in Abortion and Family Planning. That's 1,354 residents this year out of 5,962 ob-gyn residents nationwide.

The restrictions in some cases aim to reach beyond state borders, spooking medical students and residents who fear hostility from anti-abortion groups and right-wing legislators.

One ob-gyn resident in a state with abortion restrictions, who asked to remain anonymous for fear of reprisals, said she's keen on getting comprehensive abortion care training in California -- but can't.

"My program will not allow us to perform abortions in other states," she said.

She said administrators worry that doing so would subject residents to litigation because the program is state-funded.

"That is how my program is interpreting the law," she said. "They're being very conservative in order to protect us."

Pamela Merritt, executive director of Medical Students for Choiceopens in a new tab or window, pointed to a Kansas law that requires repayment of state medical school scholarships -- with 15% interest -- if residents perform abortions or work in clinics that perform them, except in cases of rape, incest, or a medical emergency.

Doctors point out that abortion training is not just about ending pregnancies. Peacock recalled a patient who started hemorrhaging badly shortly after a healthy delivery. Peacock and her team at UCSF performed a dilation and curettage -- a procedure commonly used to terminate pregnancy.

"If we did not have that skill set, and the patient continued to bleed, it could have been life-taking," said Peacock, chief ob-gyn resident at UCSF.

It's not yet clear how many spots will be available in California to train out-of-state medical residents as demand ratchets up. "Many sites were already at their training maximums and are unable to expand opportunities to others," said Michael Belmonte, MD, a fellow with the American College of Obstetricians and Gynecologists.

Between June 2022opens in a new tab or window, when Roe was overturned, and the end of June 2023, 125 out-of-state doctors did residencies in programs that use the Ryan Residency Training Programopens in a new tab or window model, according to Kristin Simonson, director of programs and operations. Ryan helps ob-gyn residency programs integrate comprehensive abortion care training.

Even when opportunities to learn abortion care are available, those seeking training are proceeding with caution. "Residents arranging to travel for abortion training, like patients who travel for abortion care, are making arrangements quietly so they do not draw unwanted attention or repercussions," said Janet Jacobson, MD, medical director and senior vice president of clinical services at Planned Parenthood of Orange and San Bernardino Counties, which just trained its first resident from a state with an abortion ban.

Statistics on harassment and attacks against abortion providers or disruption of their work back up such concerns, even in states where abortions are allowed. From 2021 to 2022, for example, there were upticks in stalking of personnel, bomb threats, assault and battery, and obstruction, according to the latest dataopens in a new tab or window from the National Abortion Federation.

Jessica Mecklosky, MD, a pediatric resident at UCSF, said she hopes to focus on adolescent medicine, including reproductive health, where she can offer young patients choices about their futures. Her medical school experience in Louisiana, she said, is a prime example of why abortion training in California and other states is so crucial.

She initially wanted to specialize in obstetrics and gynecology but switched to pediatrics, which also would involve reproductive healthcare. Although she knew Louisiana had abortion restrictions, she didn't realize how much those restrictions would interfere with her ability to learn: There were just three abortion clinics in the entire state, and as she soon found out, none were available for her training.

"I was actually not going to be able to see any elective abortion procedures throughout medical school, because we don't rotate through any abortion clinics," she said. There was an opportunity for a day's training in her third year, "but, unfortunately, Roe fell before I was able to do that."

Through Medical Students for Choiceopens in a new tab or window, a group that provides stipends of up to $1,200, Mecklosky got an abortion care rotation at Montefiore Medical Center in New York during her summer break.

Mecklosky is torn about where she'll land after her residency. She may return to Louisiana and advocate for legislative changes in reproductive health while attending to patients and making forays to other states to provide abortions.

She recounts an experience in New Orleans when the Dobbs v. Jackson Women's Health Organization decision, which undid Roe, was imminent that is etched into her memory. "I had actually seen a few patients who were minors, were pregnant, and wanted to terminate their pregnancies," she said, noting that they could not afford to travel for an abortion. "And I just remember having this sense of dread, just knowing that if we couldn't get them into an appointment in the next 24 or 48 hours, it was possible that they would not be able to do it."

Peacock, for her part, is adamant about returning to Georgia, where abortions are banned after 6 weeks. "I'm still going to provide abortions, whether that's in Georgia or I need to fly to a different state and work in abortion clinics for a week out of the month," she said. "It would definitely be a big part of my work."

https://www.medpagetoday.com/special-reports/features/108233

Trade union opposes possible split-up of Germany's Bayer

 Germany's trade union IG BCE has pushed back against a possible split-up of drugmaker Bayer, which it says is envisaged by some shareholders, arguing such a move would endanger jobs in Germany.

"For us, it's about keeping Bayer together," Michael Vassiliadis, leader of the IG BCE trade union, said in Berlin.

A split-up would weaken individual company segments, making them more prone to takeovers, he said, adding that it was unclear whether the pharmaceuticals business or the company's headquarters would stay in Germany in such an event.

Vassiliadis said CEO Bill Anderson's plans for a new management structure were currently being discussed. The trade union was not yet convinced of a reduction in middle management positions at Bayer, he said.

https://uk.finance.yahoo.com/news/trade-union-opposes-possible-split-124004805.html

Artificial heart maker Carmat misses 2023 revenue target

 French artificial heart maker Carmat reported full year revenue of 2.8 million euros ($3 million), missing its target after supply issues disrupted the company's production ramp-up, sending its shares down 6%.

The company had warned in September that it would miss a target of full-year sales of between 10 million and 13 million euros after it reported first-half revenue of only 600,000 euros.

Its second-half forecast had pointed to 2023 sales of between 4.6 million and 6.6 million euros.

The annual revenue corresponds to the sale of 17 of its Aeson prostheses, including 11 in the last quarter of 2023, confirming it accelerated the pace of implants.

It said it sees sales between 14 million and 20 million euros in 2024.

Carmat, which survived a cash crunch in mid-October, said it would soon launch a capital increase, estimated to raise at least 50 million euros ($55 million), to ensure it had enough financing for the next 12 months.

It confirmed a target to increase its manufacturing capacity to 500 hearts per year from early 2024, with the opening of a second production facility in Bois-d'Arcy.

Carmat expects this year to reduce its cash burn by around 20% in comparison with the previous year.

It also confirmed its objective of reaching breakeven in 2027.

The company affirmed its target of submitting a premarket approval application to the Food And Drug Administration by the end of 2026, enabling it to start the marketing of its flagship device in the United States in 2027.

https://news.yahoo.com/finance/news/artificial-heart-maker-carmat-launch-064956895.html

Philippines to develop islands in South China Sea - military chief

 The Philippines will develop islands in the South China Sea that it considers part of its territory to make them more habitable for troops, Manila's military chief Romeo Brawner told reporters on Monday.

The plans come amid heightened tensions between the Philippines and China, both of whom claim territory in the South China Sea and have traded accusations of aggressive behaviour in the strategic waterway.

Apart from the Second Thomas Shoal, locally known as Ayungin, the Philippines occupies eight other features in the South China Sea, and considers them part of its exclusive economic zone.

"We'd like to improve all the nine, especially the islands we are occupying," Brawner said after attending a command conference led by Philippine President Ferdinand Marcos Jr. at the military headquarters.

The features include Thitu island, the biggest and most strategically important in the South China Sea. Known locally as Pag-asa, Thitu lies about 300 miles (480 km) west of the Philippine province of Palawan.

The military wants to bring a desalination machine for troops living aboard a warship that the Philippines deliberately grounded on Second Thomas Shoal in 1999 to assert its sovereignty claim, he said.

Besides the Philippines, Brunei, China, Malaysia, Taiwan and Vietnam have competing claims of sovereignty in the South China Sea, a conduit for goods in excess of $3 trillion every year.

Also included in the military's modernisation plans is the acquisition of more ships, radars and aircraft as the Philippines shifts its focus to territorial from internal defence, Brawner said.

https://news.yahoo.com/philippines-develop-islands-south-china-065028910.html