Johns Hopkins Bloomberg

Baltimore, MD, United States

Johns Hopkins Bloomberg

Baltimore, MD, United States
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News Article | May 23, 2017
Site: www.prnewswire.com

It is estimated that approximately 1 in 50 advanced pancreatic cancer patients have MMR in their tumors that make them candidates for this type of therapy. Pembrolizumab (anti-PDI) is the first cancer drug based on a predictive cancer marker, rather than tumor type, to be approved by the FDA. A study conducted at the Johns Hopkins Bloomberg-Kimmel Institute, funded in part by the Lustgarten Foundation, demonstrated that a small group of patients with advanced cancers had a significant response to pembrolizumab (anti-PD1) immunotherapy. The responsive tumors had a mismatch-repair deficiency, resulting in a large number of genetic mutations that stimulate an immune response. However, this native immune response is too weak to reject the tumor. Treatment with pembrolizumab energized this response, resulting in dramatic tumor shrinkages with minimal side effects relative to traditional chemotherapy. "This is an incredibly important step forward and we are delighted to have had a key role in its success," said David Tuveson, M.D, Ph.D., Director of Research for the Lustgarten Foundation. "Patients have responded very well to this drug. This is the beginning of personalized medicine for pancreatic cancer patients." John Shinnick was diagnosed with pancreatic cancer at age 72 and didn't think he'd survive the three months of chemotherapy originally recommended to him. After getting a second opinion and a Whipple procedure to remove a portion of his pancreas, John sought treatment at the Johns Hopkins Bloomberg-Kimmel Institute where he tested positive for MMR and was put in the clinical trial for pembrolizumab in June of 2016. John is still in the trial and doing well. "Being diagnosed with pancreatic cancer was terrifying.  I am grateful to be receiving the best possible treatment," John said. "I have a very high quality of life. I don't feel sick; I feel good." The Lustgarten Foundation encourages all patients to get screened for microsatellite instability.  If the test is positive, patients should ask to be treated with Pembrolizumab. The Lustgarten Foundation is America's largest private foundation dedicated to funding pancreatic cancer research. Based in Bethpage, N.Y., the Foundation supports research to find a cure for pancreatic cancer, facilitates dialogue within the medical and scientific community, and educates the public about the disease through awareness campaigns and fundraising events. Since its inception, the Lustgarten Foundation has directed $132 million to research and assembled the best scientific minds with the hope that one day, a cure can be found. Thanks to private funding, 100 percent of every dollar donated to the Foundation goes directly to pancreatic cancer research. For more information, please visit www.lustgarten.org. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/fda-approves-pembrolizumab-for-pancreatic-cancers-with-mismatch-repair-deficiency-300462874.html


News Article | May 25, 2017
Site: www.eurekalert.org

A new cost-benefit analysis conducted by the Johns Hopkins Bloomberg School of Public Health and others suggests that $6 million in costs related to the opioid epidemic could be saved each year if a single "safe consumption" space for illicit drug users were opened in Baltimore. It would also reduce overdose deaths, HIV and hepatitis C infections, overdose-related ambulance calls and hospitalizations - and bring scores of people into treatment, they found. Carefully monitored "safe consumption" spaces, which are not legal in the United States but have been used in dozens of cities around the world, provide a clean indoor environment in which people can use their own drugs with medical personnel on hand to reverse overdoses should they occur. These facilities serve as access points to substance use disorder treatment and other vital social services for drug users, such as medical care and housing. The authors of the study, published this month in the Harm Reduction Journal, say that the findings add economic evidence to the body of research that already links such spaces to a reduction in fatal drug overdoses and an increase in people seeking treatment. "Safe consumption" spaces are especially critical right now: Last year, the United States hit a record for the number of people who have died from drug overdose, and fentanyl, a more dangerous and powerful drug than heroin, is increasingly being added to heroin in places like Baltimore. "No one has ever died from an overdose in a safe consumption space," says the study's senior author, Susan G. Sherman, PhD, MPH, a professor in the Department of Health, Behavior and Society at the Bloomberg School. "Thousands of lives have been saved. There are lots of doors people can walk through when they are addicted to drugs. We want them to walk through a door that may eventually lead to successful treatment - and keep them alive until they are ready for that." Says Amos Irwin, MA, the study's lead author and program director at the Law Enforcement Action Partnership in Washington, D.C.: "Today, thousands of Baltimoreans are risking their lives to inject drugs instead of seeking treatment. We estimate that more than 100 new people would enter treatment every year if the city had a supervised injection facility. Bringing these people into a safe space actually helps reduce drug use, not increase it." For their study, the researchers looked at the costs of operating a safe consumption space in Vancouver, the only one in North America. Then they estimated the impact on several health outcomes, based on Baltimore data. They determined that running a 1,000-square-foot, 13-booth space in Baltimore for 18 hours a day would cost $1.8 million a year. Insite, the Vancouver facility, serves about 2,100 unique individuals a month, who perform roughly 180,000 injections per year in a space the same size. Based on research done at Insite, they estimate that a Baltimore facility would generate $7.8 million in annual savings, preventing four HIV infections, 21 hepatitis C infections, 374 days in the hospital for skin and soft-tissue infections, six overdose deaths, 108 overdose-related ambulance calls, 78 emergency room visits and 27 overdose-related hospitalizations. At the same time, an estimated 121 additional people would enter treatment. "Six million dollars is a lot of money for one facility to save," Irwin says. "It is almost a third of Baltimore City's entire budget for HIV, sexually-transmitted infections and substance abuse treatment and prevention." A bill allowing safe consumption spaces failed in the Maryland General Assembly this year. Last month, the Massachusetts Medical Society recommended opening safe consumption spaces in that state. These supervised injection facilities are a widely used public health intervention in 11 countries, mostly in Europe. Sherman says many drug users in Baltimore are injecting on the streets or in abandoned houses, exposing them to possible violence, arrest and overdose death. Safe consumption spaces would provide clinical supervision and a clean environment, and they allow health professionals to connect drug users to critical health services. Such spaces maintain a strict prohibition on drug sharing or selling. These programs are not condoning illicit behavior, she says. They are meeting people where they are and connecting them with lifesaving resources. The researchers did not estimate how many safe consumption spaces would be needed to service Baltimore's drug using population. "We know what doesn't work when it comes to the so-called 'War on Drugs' in the United States because we have an opioid epidemic that is only getting worse," Sherman says. "The stakes are even higher now with so much heroin and other drugs adulterated with fentanyl. You can keep doing what you are doing or you can try something that has been proven by evidence and is considered usual care in a dozen nations." "Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility" was written by Amos Irwin, Ehsan Jozaghi, Brian W. Weir, Sean T. Allen, Andrew Lindsay and Susan G. Sherman. Other collaborating institutions include the Criminal Justice Policy Foundation and the University of British Columbia. The research was supported by grants from the National Institutes of Health's National Institute of Allergy and Infectious Diseases (P30AI094189) and the National Institute on Drug Abuse (T32DA007292) as well as Amherst College, the Criminal Justice Policy Foundation, the Law Enforcement Action Partnership and the Canadian Institutes of Health Research Postdoctoral Fellowship.


News Article | May 26, 2017
Site: www.sciencedaily.com

A new cost-benefit analysis conducted by the Johns Hopkins Bloomberg School of Public Health and others suggests that $6 million in costs related to the opioid epidemic could be saved each year if a single "safe consumption" space for illicit drug users were opened in Baltimore. It would also reduce overdose deaths, HIV and hepatitis C infections, overdose-related ambulance calls and hospitalizations -- and bring scores of people into treatment, they found. Carefully monitored "safe consumption" spaces, which are not legal in the United States but have been used in dozens of cities around the world, provide a clean indoor environment in which people can use their own drugs with medical personnel on hand to reverse overdoses should they occur. These facilities serve as access points to substance use disorder treatment and other vital social services for drug users, such as medical care and housing. The authors of the study, published this month in the Harm Reduction Journal, say that the findings add economic evidence to the body of research that already links such spaces to a reduction in fatal drug overdoses and an increase in people seeking treatment. "Safe consumption" spaces are especially critical right now: Last year, the United States hit a record for the number of people who have died from drug overdose, and fentanyl, a more dangerous and powerful drug than heroin, is increasingly being added to heroin in places like Baltimore. "No one has ever died from an overdose in a safe consumption space," says the study's senior author, Susan G. Sherman, PhD, MPH, a professor in the Department of Health, Behavior and Society at the Bloomberg School. "Thousands of lives have been saved. There are lots of doors people can walk through when they are addicted to drugs. We want them to walk through a door that may eventually lead to successful treatment -- and keep them alive until they are ready for that." Says Amos Irwin, MA, the study's lead author and program director at the Law Enforcement Action Partnership in Washington, D.C.: "Today, thousands of Baltimoreans are risking their lives to inject drugs instead of seeking treatment. We estimate that more than 100 new people would enter treatment every year if the city had a supervised injection facility. Bringing these people into a safe space actually helps reduce drug use, not increase it." For their study, the researchers looked at the costs of operating a safe consumption space in Vancouver, the only one in North America. Then they estimated the impact on several health outcomes, based on Baltimore data. They determined that running a 1,000-square-foot, 13-booth space in Baltimore for 18 hours a day would cost $1.8 million a year. Insite, the Vancouver facility, serves about 2,100 unique individuals a month, who perform roughly 180,000 injections per year in a space the same size. Based on research done at Insite, they estimate that a Baltimore facility would generate $7.8 million in annual savings, preventing four HIV infections, 21 hepatitis C infections, 374 days in the hospital for skin and soft-tissue infections, six overdose deaths, 108 overdose-related ambulance calls, 78 emergency room visits and 27 overdose-related hospitalizations. At the same time, an estimated 121 additional people would enter treatment. "Six million dollars is a lot of money for one facility to save," Irwin says. "It is almost a third of Baltimore City's entire budget for HIV, sexually-transmitted infections and substance abuse treatment and prevention." A bill allowing safe consumption spaces failed in the Maryland General Assembly this year. Last month, the Massachusetts Medical Society recommended opening safe consumption spaces in that state. These supervised injection facilities are a widely used public health intervention in 11 countries, mostly in Europe. Sherman says many drug users in Baltimore are injecting on the streets or in abandoned houses, exposing them to possible violence, arrest and overdose death. Safe consumption spaces would provide clinical supervision and a clean environment, and they allow health professionals to connect drug users to critical health services. Such spaces maintain a strict prohibition on drug sharing or selling. These programs are not condoning illicit behavior, she says. They are meeting people where they are and connecting them with lifesaving resources. The researchers did not estimate how many safe consumption spaces would be needed to service Baltimore's drug using population. "We know what doesn't work when it comes to the so-called 'War on Drugs' in the United States because we have an opioid epidemic that is only getting worse," Sherman says. "The stakes are even higher now with so much heroin and other drugs adulterated with fentanyl. You can keep doing what you are doing or you can try something that has been proven by evidence and is considered usual care in a dozen nations."


News Article | May 24, 2017
Site: www.techtimes.com

Keytruda (pembrolizumab), Merck & Co.’s immunotherapy drug, emerges as the first cancer medication approved by the U.S. Food and Drug Administration (FDA) based on the patient’s particular genetic feature or biomarker, no matter where the tumor originated in the body. The bold move is seen as a major progress in precision medicine, a field where these biomarkers, not the kind of cancer, may steer the cancer therapy forward. In the future, genetic data may clue in on which patients will most certainly benefit from certain treatments. “This is an important first for the cancer community,” said Dr. Richard Pazdur, director of oncology products at the FDA’s Center for Drug Evaluation and Research, in a statement. Prior to this development, the FDA has approved cancer therapies based on where the cancer began, such as in the lungs or breast, Pazdur added. The accelerated FDA approval was intended for solid tumor cancers no longer fit for surgeries or have metastasized or spread in those identified with a biomarker known as microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). Certain tumors with these traits most commonly appear in endometrial, colorectal, and gastrointestinal cancers but could also be seen in breast, prostate, pancreas, bladder, and thyroid cancers. Keytruda works by targeting the cellular pathway called PD-1 or PD-L1, which are proteins located on the body’s immune cells and certain cancer cells. It inhibits this pathway that tumors use to avoid being detected by cancer-scouring cells. At present, there are five PD-1 or PD-L1 inhibitor drugs for different types of cancer. Across the five clinical trials conducted to determine Keytruda’s safety and efficacy, there were 15 cancer types identified in 149 patients enrolled. Of these participants, 39.6 percent exhibited a partial or complete response, and for 78 percent of those patients, the response lasted six or so months. “This was one of those eureka trials where it didn’t take a lot of patients to see this was going to be something major,” said Dr. Drew Pardoll, Johns Hopkins Bloomberg-Kimmel Institute director and lead investigator of the trial leading to Keytruda’s approval. According to Pardoll, around 4 percent of advanced cancer cases, or up to 20,000 U.S. cases every year, have the genetic features involved in the FDA approval. Testing for these specific gene defects cost $300 to $600. This recent approval positions Merck at the center of immune system-focused cancer therapies. Last year, Keytruda’s survival as first treatment option for advanced NSCLC or non-small cell lung cancer was extended. The drug was formerly approved for the treatment of advanced NSCLC, advanced melanoma, classical Hodgkin lymphoma, and head and neck cancers. It was also recently approved for bladder cancer and awaits FDA approval for gastric cancer. Common side effects include fatigue, itchy skin, diarrhea, rash, decreased appetite, fever, cough, dyspnea or difficulty breathing, nausea, muscle and joint pain, and constipation. Patients experiencing severe reactions are advised to stop taking it, while pregnant or breastfeeding women should avoid Keytruda to prevent harm to developing or newborn baby. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.


News Article | May 23, 2017
Site: motherboard.vice.com

Turns out raccoons might have the right idea: we could all use a little more trash in our diet. Researchers at the Johns Hopkins Bloomberg School of Public Health recently published a study that calculated the nutritional value of the roughly 60 tons of food we waste every year. They found that if we ate these foods instead of throwing them away, we could close the nutritional deficiency in millions of Americans' daily diets. "When asking how much nutrients are wasted, we knew the answer was probably going to be 'a lot,'" said Marie Spiker, a health researcher at Johns Hopkins and lead author of the study. "But the magnitude of it was striking to us." Spiker and her colleagues were specifically interested in looking at nutrients that Americans don't typically get enough of, such as vitamin C, dietary fiber, and calcium. They compared a database of average nutritional values of certain food items to the Department of Agriculture's estimates for how much of eat food commodity is thrown out each day to determine how much of these nutrients we're missing out on by throwing them in the trash. Overall, the study found that on an average day, the food we throw away contains enough nutrients to provide every American with an additional 1,217 calories, 33 grams of protein, 6 grams of fiber, 286 milligrams of calcium, and 880 milligrams of potassium. In a single day, American food waste contains an average 1.8 billion grams of dietary fiber, for example. American women typically under-consumer fiber by 8.9 grams per day, which means the fiber found in our trash would provide enough to close the gap in daily intake requirements for 206.6 million adult women. "For Vitamin C, the food we throw away in a given day contains enough vitamin C to provide to full recommended intake for almost 60 percent of the entire adult population," Spiker said. "Over half of people could have their full vitamin C intake provided for just from the stuff we're throwing away." Lots have studies have already measured the magnitude of our wood waste problem, showing that we throw away roughly 40 percent of our food. And we're not throwing out junk food and rotten eggs; we're mostly throwing out nutrient-dense fruits, vegetables, and dairy products. Spiker told me there are a lot of things that contribute to food waste, but some of the biggest fixes we could make to curb the problem would be standardized food date labeling (because what does "best before" mean anyhow?) and better systems to help wholesalers and supermarkets transfer excess food to those who can use it, like food banks. Other lifestyle changes, include being more realistic at the grocery store (if you usually only cook dinner one night a week, what makes you think you'll make a five-course meal every night this week?) and making the effort to use the ingredients we do buy. "Once we've made a decision and brought food into our home, we should try to incorporate those foods into meals and eat leftovers, even when it would be so much easier to order takeout," Spiker said. Subscribe to Science Solved It , Motherboard's new show about the greatest mysteries that were solved by science.


A peer-support program launched six years ago at Johns Hopkins Medicine to help doctors and nurses recover after traumatic patient-care events such as a patient's death probably saves the institution close to $2 million annually, according to a recent cost-benefit analysis. The findings, published online in the Journal of Patient Safety, could provide impetus for other medical centers to offer similar programs -- whose benefits go far beyond the financial, the Johns Hopkins Bloomberg School of Public Health researchers say. Clinicians who aren't able to cope with the stress or don't feel supported following these events, often suffer a decrease in their work productivity, take time off or quit their jobs, they say. "We often refer to medical providers who are part of these stressful events as 'second victims,'" says study leader William V. Padula, PhD, an assistant professor in the Department of Health Policy and Management at the Bloomberg School, using a term coined by Johns Hopkins professor Albert Wu, MD. "Although providers often aren't considered to be personally affected, the impact of these events can last through their entire career." In 2011, Johns Hopkins Medicine started the Resilience In Stressful Events (RISE) program. The program relies on a multidisciplinary network of peer counselors -- nurses, physicians, social workers, chaplains and other professionals -- who arrive or call a fellow clinician in need within 30 minutes after they request help following an emotionally difficult care-related event, such as a patient in extreme pain, dealing with an overwhelmed family, or a patient being harmed through a medical error. At large, academic medical centers such as Johns Hopkins, with a complicated and often very sick patient population, such events happen on a daily basis, Padula says. Although Padula says that he and others involved in the RISE program believe in its importance regardless of cost, the program does require Johns Hopkins to redirect some resources. For example, he says, although the peer counselors all volunteer their time, that's time taken away from other billable work, such as patient care. For Johns Hopkins to continue to invest in the program, he explains, showing a financial benefit is key. To explore whether such a benefit exists, Padula and his colleagues developed a model focused just on the nursing population to investigate the likely financial outcomes of a year with or without the RISE program in place. The model used data from a survey delivered to nurses familiar with the RISE program on their probability of quitting or taking a day off after a stressful event with or without the program in place. It also used Johns Hopkins human resources data as well as the average cost of replacing a lost nursing employee available in published literature, among other data. After inputting this information into the model, the researchers found that the annual cost of the RISE program per nurse was about $656. However, they found that the expected annual cost of not having the program in place was $23,232. Thus, the RISE program results in a net cost savings of $22,576 per nurse. Expanding that out to all users of the system -- including doctors, who have a much higher cost per billable hour and dramatically higher replacement costs -- the total savings to the entire institution in one year was expected to be about $1.81 million. The savings alone is an attractive reason to implement a program like RISE at other large, academic medical centers, Padula says. However, he says, helping clinicians get through a stressful event is the right thing to do, regardless of cost. "It's hard to put a true price on the emotional support and coping mechanisms this program provides for clinicians after tragic events," he says. Other Johns Hopkins researchers who participated in this study include Dane Moran, MPH; Albert W. Wu, MD; Cheryl Connors, MS; Meera R. Chappidi, MPH; Sushama K. Sreedhara, MBB; and Jessica J. Selter, MD. Funding for this study was provided by the Josie King Foundation and the Maryland Patient Safety Center.


News Article | May 15, 2017
Site: www.eurekalert.org

Discarded food contains a significant amount of nutrients that could be used to help many Americans meet daily requirements, according to a new study in the Journal of the Academy of Nutrition and Dietetics Philadelphia, PA, May 15, 2017 -- The extent of food waste in America is a cause for serious concern. It is estimated that around 1,217 calories per person per day are squandered. A new study in the Journal of the Academy of Nutrition and Dietetics looks beyond the caloric value of food waste and focuses on the nutritional value of the food we throw away. Investigators found that discarded food contains large amounts of key nutrients like vitamin D, fiber, and potassium that could help people get the food they need to meet their daily recommended intake. In 2014, 14% of American households suffered from food insecurity and an additional 5% experienced a shortage of resources that forced them to skip meals or reduce their food consumption. Across the population, Americans are not getting the recommended intakes of certain nutrients including dietary fiber; calcium; potassium; and vitamins A, C, D, and E. At the same time, Americans continue to waste food at an alarming rate throughout the food supply chain. It's estimated that 31-40% of the post-harvest food supply is discarded. This study was the first to demonstrate the substantial amount of nutrients, including many under-consumed nutrients, wasted due to food discarded at the retail and consumer levels of the U.S. food supply. Quantifying the loss can motivate related investments and support the case for registered dietitian nutritionist engagement with these efforts. The estimates can additionally serve as a baseline for tracking intervention impacts. Data from the National Nutrient Database for Standard Reference were used to calculate the nutritional value of retail and consumer level waste of 213 commodities in the USDA Loss-Adjusted Food Availability data series for 27 nutrients in 2012. The study, led by Roni A. Neff, PhD, Program Director at the Johns Hopkins University Center for a Livable Future (CLF), and Assistant Professor, Department of Environmental Health & Engineering, and Marie L. Spiker, MSPH, RD, CLF-Lerner Fellow and Doctoral Candidate, Department of International Health, Johns Hopkins Bloomberg School of Public Health, found that losses of under-consumed nutrients were significant. Food wasted at the retail and consumer levels of the U.S. food supply in 2012 contained 1,217 kcal, 33 g protein, 5.9 g dietary fiber, 1.7 mcg vitamin D, 286 mg calcium, and 880 mg potassium per capita per day. Using dietary fiber as an example, 5.9 g dietary fiber is 23% of the RDA for women. This is equivalent to the fiber RDA for 74 million adult women. Adult women in 2012 under-consumed dietary fiber by 8.9 g per day, and the amount of wasted fiber is equivalent to this gap for 206.6 million adult women. Data points like this highlight the need for diverse interventions including standardized date labeling (use by, sell by) and consumer education, so that people can utilize the nutrients instead of throwing them in the trash can. According to the authors, perishable foods such as fruits and vegetables are lost at particularly high rates, leading to exceptional losses of under-consumed nutrients. Changes to our food system can reduce agricultural and pre-consumer waste, and play an important role in shaping the amount of food consumers discard. Cultural shifts are also needed to change consumer and industry attitudes. Even if only the top seven most cost-effective food recovery activities were scaled up and only an additional 1.75% of food waste was recovered, this would translate into 2,000 calories per day for 3.3 million adults. "Although only a portion of discarded food can realistically be made available for human consumption, efforts to redistribute surplus foods where appropriate and prevent food waste in the first place could increase the availability of nutrients for Americans, while saving money and natural resources," concluded the authors. "The U.S. has established a target of halving food loss and waste by 2030. This research supports the case for action and for registered dietitian nutritionists to bring their expertise to the effort."


News Article | May 15, 2017
Site: www.eurekalert.org

A new study describes an ambitious but feasible path toward what may have seemed unachievable just a decade ago: an end to the AIDS epidemic in the U.S. Using prevention surveillance data to model rates of HIV incidence, prevalence and mortality, investigators at Brigham and Women's Hospital and Johns Hopkins Bloomberg School of Public Health set targets, specifically a decrease in new infections to 21,000 by 2020 and to 12,000 by 2025, that would mark a transition toward ending the HIV/AIDS epidemic. Their findings are published in The American Journal of Preventive Medicine. "Achieving these targets will require a sustained and intensified national commitment to ending the epidemic," said Robert Bonacci, MD, MPH, of the BWH Department of Medicine and lead author of the study. "But if the U.S. does achieve a reduction to 12,000 new HIV infections by 2025, it could mark an important turning point in the U.S. HIV epidemic: a decline in the total number of people living with HIV in the U.S., and the beginning of the end of the U.S. AIDS epidemic." Using Centers for Disease Control and Prevention surveillance data for 2010 to 2013, the team modeled many key indicators including incidence and prevalence rates, transmission rates, death rates and more through 2025. Taking into account goals set forward by the U.S. National HIV/AIDS Strategy (NHAS), they estimated the potential trajectory of the epidemic if those benchmarks in care were met. The NHAS goals for 2020 included that 90 percent of people living with HIV would know their status; 90 percent would receive quality care; and 90 percent of people on antiretroviral therapy would achieve viral suppression (the "90/90/90" goals). Extending beyond 2020, they evaluated an achievement of those goals at 95 percent levels by 2025 (the "95/95/95" goals). With this framework in place, the authors evaluated whether reducing new HIV infections to 12,000 by 2025 would be achievable. Using mathematical modeling, they found that the U.S. could achieve a 46 percent reduction in HIV incidence by 2020 and a nearly 70 percent reduction in HIV incidence by 2025, provided that the U.S. implements a 90/90/90 HIV program framework by 2020 and 95/95/95 framework by 2025. In addition, the HIV transmission rate, (one measure of how fast the epidemic is spreading) would decrease from 3.53 in 2013 to 0.98 in 2025; HIV-related deaths would decrease from 16,500 in 2013 to 12,522 in 2025; and the total number of people living with HIV in the U.S. would increase from 1,104,600 in 2013 to 1,220,615 in 2025. The authors note the importance of achieving these goals across the U.S., most especially in communities that have been disproportionately affected by HIV, including gay men, young people, transgender persons, black and Hispanic Americans and those who live in southern states, and of tracking progress in real time. "Providing HIV services to our most disproportionately affected communities is fundamental to future success," said David Holtgrave, PhD, of the Johns Hopkins Bloomberg School of Public Health and senior study author. "In an era of limited funding and competing priorities, it is critically important that we intensify our national commitment to addressing the HIV epidemic over the next decade." Researchers report no external funding for this work.


News Article | May 9, 2017
Site: www.eurekalert.org

Persecution by the Islamic State of Iraq and Syria (ISIS) against the Yazidi population of Sinjar, Iraq has been the focus of attention recently following the United Nations' recognition of these ongoing actions as genocide. The extent of the killings and kidnappings as well as the demographics of those targeted has until now remained unclear. In a new study published in PLOS Medicine, Valeria Cetorelli of the Johns Hopkins Bloomberg School of Public Health, USA, and the London School of Economics and Political Science Middle East Centre, UK and colleagues report findings from their retrospective household survey of displaced survivors in the Kurdistan Region of Iraq, providing documented insight into the extent of the attack and in particular the disproportionate burden of killings and kidnappings of children. The researchers present a compelling and disturbing account of the events that occurred over a few days in the area of Mount Sinjar in August 2014. Their survey, conducted in November and December, 2015, covered a random sample of 1,300 displaced households sheltered in camps in the Kurdistan Region of Iraq. Information about reported killings and kidnappings of household members was recorded. Using these data, the authors estimate that 9,900 Yazidis were either killed or kidnapped (95% confidence interval (CI): 7,000 - 13,900), amounting to 2.5% of the entire Yazidi population of Sinjar. Of these, an estimated 3,100 (CI: 2,100 - 4,400) were killed, with nearly half of them executed by gunshot, beheading or being burned alive, while the rest died from lack of water and food or injuries during the ISIS siege on Mount Sinjar. The authors estimated that 6,800 (CI: 4,200 - 10,800) were kidnapped, with over one third still missing at the time of the survey. In one of the most distressing aspects of the study, which distinguished between children and adults as well as males and females, the authors reveal that children were disproportionately affected: children accounted for nearly all those who died on Mount Sinjar during the ISIS siege and children were also much less likely to escape captivity following kidnapping compared to adults. Reports from escapees documented torture, sex slavery and forced religious conversion once kidnapped. The authors suggest that their analysis may have underestimated the actual toll of killings and kidnappings because of the unknown number of families who were captured in their entirety with no one surviving to report. Limitations of the study include inference from a surveyed sample of displaced households to the whole Yazidi population of Sinjar, and uncertainty of that population's exact size at the time of the attacks. This study provides systematically obtained evidence of the extent of violence against the Yazidis, most of whom remain displaced in the Kurdistan Region of Iraq. Such evidence is important to keep attention focused on the rescue, assistance and protection of this minority population. The authors note: "Combined with other existing evidence, these estimates can support a formal genocide investigation by an appointed judicial authority." This study was funded by the Emirates Foundation for Philanthropy through the LSE Middle East Centre. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that no competing interests exist. Cetorelli V, Sasson I, Shabila N, Burnham G (2017) Mortality and kidnapping estimates for the Yazidi population in the area of Mount Sinjar, Iraq, in August 2014: A retrospective household survey. PLoS Med 14(5): e1002297. https:/ Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:


News Article | May 15, 2017
Site: www.eurekalert.org

Researchers at the Johns Hopkins Bloomberg School of Public Health's Center for a Livable Future calculated the nutritional value of food wasted in the U.S. at the retail and consumer levels, shining a light on just how much protein, fiber and other important nutrients end up in the landfill in a single year. These lost nutrients are important for healthy diets, and some -- including, dietary fiber, calcium, potassium and vitamin D -- are currently consumed below recommended levels. Nutrient-dense foods like fruits, vegetables, seafood and dairy products are wasted at disproportionately high rates. Previous research estimated that as much as 40 percent of food is wasted nationally, but it wasn't clear before this study how nutritious that food was. While not all wasted food is consumable, a sizeable amount is, leaving researchers and policymakers looking for ways to minimize the amount of good food that gets tossed as millions of Americans go hungry, do not get enough nutrients or do not have access to healthy food options. The U.S. Department of Agriculture (USDA) and Environmental Protection Agency have set a goal of reducing food waste by 50 percent by 2030. The findings will appear online May 15 in the Journal of the Academy of Nutrition and Dietetics. "Huge quantities of nutritious foods end up in landfills instead of meeting Americans' dietary needs," says study lead author Marie Spiker, MSPH, RD, a CLF-Lerner Fellow at the Johns Hopkins Center for a Livable Future and a doctoral candidate in the Bloomberg School's Department of International Health. "Our findings illustrate how food waste exists alongside inadequate intake of many nutrients." For their study, the researchers calculated the nutritional value of the retail- and consumer-level food waste of 213 commodities in 2012, using data from the USDA's Loss-Adjusted Food Availability data series. The research team, looking at 27 nutrients in all, found that food wasted in the U.S. food supply that year contained 1,217 calories, 33 grams of protein, 5.9 grams of dietary fiber, 1.7 micrograms of vitamin D, 286 milligrams calcium and 880 milligrams potassium per person, per day. Nutrient loss estimates provided by this study could contribute to a baseline for measuring future progress, the authors say. The study also highlights how the amount of nutrients lost to waste compares to nutritional deficits in the typical American diet. For example, dietary fiber is important for maintaining digestive health and is found in grains, vegetables and fruits. Researchers estimate that, in 2012, food wasted each day contained upwards of 1.8 billion grams of dietary fiber, which is comparable to the full recommended intake for dietary fiber for 73.6 million adult women. American women under-consumed dietary fiber by 8.9 grams per day in 2012. The study found that the daily amount of wasted dietary fiber is equivalent to the amount needed to fill this nutritional gap for as many as 206.6 million adult women. Many factors contribute to food waste at both the retail and consumer levels, including the disposal of food due to aesthetic standards, large portion sizes, and management of perishables in fridges and pantries. There is currently great energy around efforts to address waste of food. Preventing waste at the source is considered to be the optimal approach. Strengthening food recovery efforts that bring surplus food to food banks and pantries is also an important area of effort, innovation and impact. "This study offers us new ways of appreciating the value of wasted food. While not all food that is wasted could or should be recovered, it reminds us that we are dumping a great deal of high quality, nutritious food that people could be enjoying," says Roni Neff, PhD, an assistant professor in the Bloomberg School's Department of Environmental Health and Engineering who oversaw the study and directs the CLF's Food System Sustainability & Public Health Program. "We should keep in mind that while food recovery efforts are valuable, food recovery doesn't get to the heart of either the food insecurity problem or the waste problem. We need strategies addressing these challenges at multiple levels." "Wasted Food, Wasted Nutrients: Nutrient loss from wasted food in the US and comparison to gaps in dietary intake" was written by Marie L. Spiker, Hazel A. B. Hiza, Sameer M. Siddiqi and Roni A. Neff. This research was funded by the GRACE Communications Foundation. M. L. Spiker and S. M. Siddiqi were also supported by the CLF-Lerner Fellowship.

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