Showing posts with label strategies. Show all posts
Showing posts with label strategies. Show all posts

Thursday, 5 September 2013

Councils are developing coherent, long-term public health strategies

Ringo Starr Local authorities can now relate to the Beatles' Ringo Starr when he sang 'How do I feel by the end of the day?' Photograph: Jon Super/AP

Now councils have a major new role in public health, they once again have the chance, as Ringo Starr didn't quite put it, to help their residents feel better at the end of the day.

The report I have written for Localis clearly shows councils exploring new and innovative ways to tackle the wider social, cultural and environmental determinants of health, following April's switch of £2.7bn of public health funding from NHS control to the hands of local authorities. New health and wellbeing boards were created, enhancing the role of councils in the planning and oversight of all local health services.

With NHS acute treatment costs on a seemingly unsustainable, upwards trajectory, this shift in emphasis towards prevention and tackling the "causes of the causes" of poor health could not be more timely.

Housing, transport, children's services, leisure services and employment (among others) have all been demonstrably linked to health outcomes. It is refreshing, then, to see councils showing real innovation in pushing through short-term public health projects with the potential to deliver instant benefits. Barnet borough council told us that this year it has rolled out green gyms, "forging a closer integration between public health and leisure providers".

Alongside such "quick wins", it is inspiring to see councils developing coherent, long-term public health strategies. A mass of evidence links employment to a person's health and wellbeing, and Kent county council's long-running apprenticeships programme offers businesses grants of up to £2,000 to take on an unemployed 18-24 year-old as an apprentice.

Critics argue that the £2.7bn public health budget transferred to local authority could prove a little leaky, accusing councils of using the money to fill in holes in their budgets. But as Public Health England chief executive Duncan Selbie rightly observes, "ultimately these are local decisions".

Selbie is right to caution, however, that this approach should not be taken too far, offering reassurance that if money was spent on things "completely outside any reasonable view about what constitutes health then of course we'd have to be addressing that".

And where existing, traditional public health themes are demonstrably working, councils are continuing to support such measures. Persistent problems like smoking cessation, healthy eating, drugs, alcohol services and sexual health, are – quite rightly – still absorbing the overwhelming majority of public health budgets.

The return of public health responsibilities to the town hall is a golden opportunity to do things differently. But, crucially, restoring public health to the heart of local government requires fostering links and synergies with wider local government functions.

And to do this, councils will need more than a little help from their friends.

Gwilym Tudor Jones is a research fellow at thinktank Localis.

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Saturday, 17 August 2013

Prevention strategies the focus of first animal model for sexual transmission of HIV

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs
Article Date: 17 Aug 2013 - 0:00 PDT Current ratings for:
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Infection by human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS), a debilitating disorder in which progressive weakening of the immune system makes affected individuals more susceptible to potentially life-threatening infections and chronic diseases. Despite advances in the treatment and management of AIDS, there is no cure, and HIV infection remains a major global health problem. According to the WHO, there were an estimated 34 million infected individuals in 2011. Over the last three decades, a number of animal models have been developed to study aspects of HIV infection, pathogenesis and control. However, the currently available models do not recapitulate the physiological environment of the most common route of HIV transmission worldwide, vaginal intercourse. Now, Mary Jane Potash and colleagues from St. Luke's-Roosevelt Hospital Center and Columbia University Medical Center in New York, NY, have developed an approach for modelling heterosexual transmission of HIV in vivo. Their work was published recently in Disease Models & Mechanisms.

The work stems from an earlier collaboration between Potash and David J. Volsky (also from Columbia University); they established a chimeric HIV clone with a genetic modification that allows the virus to propagate in rodents instead of humans. Infection of mice with these viruses has been successfully applied to study aspects of HIV neuropathogenesis and to evaluate antiretroviral drugs and potential HIV vaccines. In their latest study, Potash and colleagues describe the efficient and reproducible transmission of chimeric HIV from infected male mice to uninfected females via mating, providing the first report of HIV transmission by coitus in an animal model. Treatment of females with antiretroviral drugs prior to mating prevented transmission of the virus, in line with observations in humans. Intriguingly, the efficiency of viral transmission declined during estrus in mice, providing evidence that the hormonal environment in the female reproductive tract can impact on host susceptibility to HIV infection. This finding has implications for HIV infection in humans, where it has been suggested that vulnerability to viral infection could vary during the menstrual cycle.

The model described here has several advantages compared with previous experimental approaches for investigating sexual transmission of HIV. For example, transmission occurs during mating, in contrast with earlier systems in which viral stocks need to be applied manually to the vaginal surface; thus, the system preserves features of the male and female reproductive tracts. This is important, as previous work has shown that host factors and cells in the seminal fluid activate cells in the female reproductive tract and enhance HIV infection, yet the underlying mechanisms remain poorly understood. Similarly, as indicated in this study, the local environment in the female reproductive tract can influence the rate and efficiency of HIV sexual transmission. By preserving the physiological features of coitus, the approach allows the dynamic aspects of viral sexual transmission to be investigated in vivo. Furthermore, the system can be used to investigate the efficacy of new interventive strategies aimed at preventing the most frequent route of HIV transmission.

"We developed this system to study HIV spread by mating in mice with the hope that it can be applied to promote practical approaches to prevent HIV sexual transmission to people at risk" explained Dr Potash, when asked about the goals of this research.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Thursday, 1 August 2013

"Super Mouse" created in the UK may lead to novel treatment strategies for breast cancer

Main Category: Breast Cancer
Also Included In: Genetics
Article Date: 31 Jul 2013 - 0:00 PDT
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"Super Mouse" created in the UK may lead to novel treatment strategies for breast cancer
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It appears tiny and inconsequential enough, but the "super mouse" - created by researchers at the University of Kentucky Markey Cancer Center some six years ago - has spawned plenty of new research into preventing and/or treating many types of cancer.

Back in 2007, cancer researcher Vivek Rangnekar and his team announced that they discovered a gene - known as Par-4 - that specifically kills cancer cells without killing normal cells. Rangnekar's team used this gene to develop cancer-resistant mice that become known as "super mice" for their ability to stay healthy and tumor-free compared to normal mice.

Since that initial discovery, researchers across the country have built upon Rangnekar's discovery, including a team at the University of Pennsylvania, who recently published findings on how Par-4 downregulation affects breast cancer recurrence.

In a new article for Cancer Cell, UK researchers including Rangnekar as well as Tripti Shrestha-Bhattarai and Nikhil Hebbar discuss a recent study and how its findings may lead to the development of novel treatment strategies for breast cancer.

Breast cancer is the second leading cause of cancer death in women. Even with treatment, one in five patients will relapse from the disease within 10 years, and patients who have triple-negative breast cancer have an especially high risk of both local and distant recurrence. Treatment for these aggressive cancers is difficult because they tend to be resistant to "standard of care" therapies.

The study performed by the UPenn team showed that in women who experienced breast cancer relapse, the Par-4 protein was suppressed. These low levels of Par-4 allowed the cancerous cells to survive and multiply even after a full course of treatment. Conversely, tumor cells that have high levels of Par-4 are eliminated by apoptosis (cell death) following treatment. These new findings may provide insight into deciding which patients are at the highest risk for cancer recurrence.

"What this tells us is that low Par-4 may act as a predictor of breast cancer recurrence," said Rangnekar, associate director for the UK Markey Cancer Center. "This is important, because although this group studied only breast cancer, their observations may be relevant to recurrence in a broad range of cancer types because Par-4 is a general tumor suppressor gene."

Using Par-4 levels as a biomarker prior to treatment - and knowing whether that patient is at an elevated risk of recurrence - would give physicians another tool to use in determining the best course of treatment. Additionally, their findings may provide the basis for the development of novel treatment strategies for breast cancer.

Other 'tumor suppressor' genes exist, says Rangnekar, but what makes Par-4 so special is that it is not mutated as frequently as other known suppressors, and it's "selective" in its actions in that Par-4 will only kill cancer cells and not normal cells. Par-4 can become 'suppressed' or inactivated, leading to tumor re-growth, but Par-4 can be 'activated' again - and one of the next major steps is developing a safe and effective way to activate Par-4 in the cancerous cells.

"If Par-4 is still present in the cells, the strategy should be to try and utilize that Par-4, so as to restore it's apoptotic function and bring about apoptosis of the cancer cells," Rangnekar said.

Researchers are still years away from being ready to test these theories in clinical trials, but Rangnekar says they have already begun looking at agents, both natural and synthetic, that may help restore the expression of Par-4 in human cells, allowing the cancerous cells to become susceptible to treatment. Each new study on Par-4 brings researchers one step closer to developing a powerful method for both treating and preventing many of the deadliest types of cancers.

The findings in the cancer-resistant mouse have stimulated several collaborative projects on Par-4 at UK. Several UK investigators are now examining the role of Par-4 in diverse types of tumors: recently, Rangnekar and UK cancer biologist and immunologist Subbarao Bondada were jointly funded by the National Institutes of Health to study the role of Par-4 in chronic lymphocytic leukemia; UK pathologist Craig Horbinski's group is investigating Par-4 in aggressive brain tumors called glioblastomas; and UK chemist David Watt and cancer biologist Chunming Liu are developing small molecules that can activate Par-4 and kill cancer cells.

"Our multi-disciplinary team, working together, uses a multi-faceted strategy in our research," Rangnekar said. "This allows us to gain a better understanding of the complexities of cancer in order to effectively kill recurrent tumor cells, especially those that have spread from their origin to distant tissue sites."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our breast cancer section for the latest news on this subject.

Par(-4)oxysm in Breast Cancer, Tripti Shrestha-Bhattarai, Nikhil Hebbar, Vivek M. Rangnekar, Cancer Cell, Volume 24, Issue 1, 3-5, 8 July 2013, doi: 10.1016/j.ccr.2013.06.010

University of Kentucky

Please use one of the following formats to cite this article in your essay, paper or report:

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University of Kentucky. ""Super Mouse" created in the UK may lead to novel treatment strategies for breast cancer." Medical News Today. MediLexicon, Intl., 31 Jul. 2013. Web.
31 Jul. 2013. APA

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'"Super Mouse" created in the UK may lead to novel treatment strategies for breast cancer'

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View the original article here