Will the wellness tourism trend change your holiday plans? – Telegraph.co.uk

Finding a lounger by the pool might be easier than ever before this summer. Why? Because everyones pulling on their fit kit and getting hooked on holidays with health benefits. Otherwise known as wellness tourism, a study from 2018 forecast 7.5% per cent growth in this sector with dedicated retreats debuting across the world. Established chains are getting in on the act too, with athletic curricula and healthy upgrades to recharge, reboot and restore your mind and body. So which healthy holiday is right for you?

They say happiness is in the journey, not arriving at your destination, so test this theory yourself with a cycling tour. The Netherlands is a good bet for riding rookies its flat and extremely bike-friendly. Or if you already have an active lifestyle, try Drakensberg and Kruger in South Africa, where youll pedal hard up gruelling mountains before being rewarded with spectacular views and perhaps an opportunity to take a dip in a waterfall.

Lately, canny hotels are going a step further than providing guests with a keycard for the gym. Rooms at Even Hotels (ihg.com) in the US come with fitness equipment such as exercise balls and yoga mats for in-room workouts and beds are topped with natural eucalyptus fibre bedding for a restful nights sleep. Meanwhile bathrooms at Stay Wells hotels, also across the US, (staywellrooms.com), have vitamin-infused showers, plus air purification and a dawn simulator to gently awaken you with light and sound.

Youll nail your 10,000 steps a day with ease if you book a hiking holiday. Enjoy a staycation in the Scottish Highlands, where youll clamber up ascents such as the Devils Staircase with other intrepid walkers. For a more gentle stroll, explore the pretty villages of Las Alpujarras in southern Spain with self-guided walks that last a couple of hours and take in flower meadows, citrus orchards and olive groves.

If downward dogs and pigeon pose are your thing, then you cant go wrong with a holiday that factors in daily yoga practice to tone, strengthen and condition your body as well as de-stress your mind. Many also cater well for solo travellers if you fancy some me-time. Thailand has an abundance of picturesque retreats that cater for every fitness level; many, such as Chiva-Som or Soneva Kiri offer spa facilities and other holistic options such as meditation and pranayama (awareness of ones breath and energy). Closer to home, head to Portugals picturesque Atlantic coast, where many retreats combine yoga and surfing.

Fancy making a court appearance on holiday? You should consider it a game of singles can burn around 414 calories per hour, while doubles is somewhat more sedate, at 288 per hour. Activity holiday specialists such as Mark Warner, Club Med and Neilson have extensive tuition programmes and camps, and even bring in ex-pros to train guests. You may want to consider packing Centrum MultiGummies as these high-quality multivitamins include B6 and B12 that help release energy from your food. Serve!

To help you support your health and well-being outside and in, Centrum has partnered with Telegraph Spark to help you make small yet effective changes*.

Centrum wants to motivate you to boost your health in a simple, enjoyable and sustainable way. Working with leading experts and nutritionists, exercise and wellness brands, we have curated a wealth of tip-packed, easy-to-follow content from healthy eating ideas to on-trend activities and ways to de-stress and relax. Centrums range of multivitamins is specially tailored to help support you every day based on your age, gender, lifestyle and nutritional needs.*

To find out more, and discover which Centrum is right for you, visit centrum.co.uk

*Multivitamins are intended to supplement your diet and should not be regarded as a substitute for a varied diet and a healthy lifestyle. Centrum contains vitamin D, which contributes to the normal function of the immune system, and vitamin B12, which contributes to the reduction of tiredness and fatigue.

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Will the wellness tourism trend change your holiday plans? - Telegraph.co.uk

Antioxidants and healthy living: the role of 100% fruit juice – Guardian

Previously, consumption of food was traditionally viewed as a necessity for good growth, strength, and energy. While these factors are still very relevant, food is now also considered on the basis of its physiological, psychological and medical effects on the human body.

Does it reduce the risk of cardiovascular diseases? Could it lead to or prevent cancer? How does my diet affect the probability of developing obesity or diabetes? These are common questions associated with food. These and other similar questions are becoming more important in view of growing concerns for health and wellness. Recent rising costs of health care have also generated a growth in health and diet conversations in recent times.

Eating food is an object of pleasure for some people, a health remedy for others, and a matter of life and death for some unfortunate few. Food is a source of the key nutrients the body needs for growth, development and maintenance of body tissue carbohydrates, proteins, fats and oil, vitamins, minerals, and water. The way food is consumed has huge consequences for the body. Food must be eaten adequately, timely, in the right quantities, in proper combinations, and in line with the recommended dietary allowances, for the body to derive maximum benefit and obtain good health.

Closely related to good food is the topic of antioxidants and its benefits or impact on health. Growing interest in this topic has emerged in recent times, drawing extensive research from a wide range of experts.

Antioxidants and their benefits to the human bodyResearch shows that fruits (which include 100% or pure fruit juices) and vegetables are the primary sources of antioxidants in our diet. Antioxidants are essential for preventing premature ageing, vision loss, mood disorders, and heart diseases.

According to betterhealth.vic.gov.au, antioxidants are found in certain foods and may prevent some of the damage free radicals cause in the human body by neutralizing them. Oxidative stress occurs when there are more free radicals than antioxidants in the body. Free radicals are oxygen-containing molecules, which have an irregular distribution of electrons. Oxidative stress has been linked to heart disease, cancer, arthritis, stroke, respiratory diseases, immune deficiency, emphysema, Parkinsons disease, and other inflammatory conditions. Antioxidants lessen or prevent the effects of free radicals by donating electrons to the free radicals, thereby reducing their reactivity.

Evidence has shown that certain nutrients present in the diet play an important role in fighting against nutritional oxidative stress. (Prasad, S., Gupta, S. C., & Tyagi, A. K. (2017). Reactive oxygen species (ROS) and cancer: Role of antioxidative nutraceuticals. Cancer Letters 387; 95-105). Examples of antioxidants include vitamins C and E, selenium and carotenoids such as beta-carotene, lycopene, lutein, zeaxanthin, flavonoids, flavones, catechins, polyphenols, and phytoestrogens; which are found in fruits and vegetables.

Antioxidants in fruit juiceMany fruit juices are high in antioxidants, packed with vitamins and minerals, and beneficial in diverse ways. These fruits include peaches, raspberries, strawberries, red currants, figs, cherries, pears, guava, oranges, apricots, mangoes, red grapes, watermelon, and papaya. 100% fruit juice contains bioactive compounds with antioxidant properties. As such, fruit juices have the potential to improve the antioxidant status in the body.

A systematic review of nutritional literature published between 1995 and 2013 was conducted using PubMed database to evaluate associations between intake of 100% fruit juice, markers of antioxidant/oxidant status, and blood lipid levels in healthy adults. Data extraction and analysis was conducted according to the Academy of Nutrition and Dietetics Evidence Analysis Process. The results from ten clinical trials meeting inclusion/exclusion criteria suggest potential improvements in a variety of antioxidants after consumption of 100% fruit juice.

As humans we all desire a healthy life, and as such, we rely heavily on the nutrients, vitamins and minerals derived from our daily food consumption to stay healthy. Regardless of your motive for food consumption, be it for pleasure or remedy, one of the best measures to building and sustaining a healthy lifestyle is to regularly complement mealtimes with antioxidant-rich food and beverages such as vegetables and 100% fruit juice.*Olusola Malomo is a registered Dietitian (Association of Dietitians in Nigeria ADN). Twitter: @malomoolusola

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Antioxidants and healthy living: the role of 100% fruit juice - Guardian

Euthanasia – American Life League

When we talk about euthanasia, what exactly do we mean? Today, we usually hear about euthanasia in the health care context. For our purposes, euthanasia amounts to doing, or not doing, something to intentionally bring about a patients death. Because theres so much confusion surrounding the term, lets make sure we understand what euthanasia is not.

It is not euthanasia to administer medication needed to control painthats called good medical care. It is not euthanasia to stop treatment that is gravely burdensome to a patientthats called letting the patient exercise the moral option to refuse extraordinary medical means. It is not euthanasia to stop tube-feeding a patient whose diseased or injured body can no longer assimilate food and waterthats called simply accepting death.

In these circumstances, pain control, refusing extraordinary means, and stopping feeding may all allow death. Butand this is crucial to our understandingunlike euthanasia, their purpose and intent is not to bring about death.

Actually, euthanasia could be called a form of suicide, assisted suicide, or even murder, depending on the patients level of involvement and consent. To define euthanasia this way, though, seems to diminish its threat. After all, arent there laws or, at the very least, strong social taboos against suicide, assisted suicide, and murder?

Unfortunately, when it comes to the sick and disabled, this is no longer entirely true. And, the rationale and cultural forces behind the movement that brought this about threaten even more to tear down the legal and social barriers to killing.

Most of us know about Jack Kevorkian and his efforts to help ailing people commit suicide. Many of us may not realize, though, that Kevorkians maverick image masks a serious crusade that is building on emerging legal and cultural trends. Our society is poised to accept euthanasia on demandand worse. What we dont know about that could kill us.

In sum, it is vitally important to understand that everyones most basic rightthe right to lifeis in jeopardy when our law and collective morality no longer view all persons as equally worthy of life, solely on the basis of our common humanity. Not only is it the right thing to do, it is also in our own best interests to protect and cherish weak and vulnerable members of our human family.

In order to do that, we must educate ourselves and others about the growing threat of euthanasia, vigorously oppose its legalization, and pray for the wisdom and compassion to properly comfort, care for and dissuade those considering suicide.

The information on euthanasia is a PowerPoint Presentation (2007) prepared for American Life League by Julie Grimstad, Executive Director of Life is Worth Living, Inc.

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Euthanasia - American Life League

Euthanasia – Simple English Wikipedia, the free encyclopedia

Euthanasia is when a person's life is ended because of disease or pain, which has made them suffer. This is different from assisted suicide, where a person helps someone kill themselves. It is also different to murder, where the reason is not suffering, but to kill for the killer's own ends. Euthanasia can be voluntary, where the person who dies asks for help in ending their life. Where the person is unable to make their decision known, it is usually called non-voluntary euthanasia. Where someone is killed against their will, it is usually called murder.

Euthanasia is illegal in most countries. It is permitted in a small number of countries, such as the Netherlands, Belgium and Victoria, Australia.[1] Where it is permitted there are many rules, and only in cases where the patient is terminally ill. Though euthanasia is not legal in the United States, doctors can assist people to kill themselves. This is legal in Washington, Oregon, and Montana. Physician Assisted Suicide (PAD) is different to euthanasia; it is about who gives the medication to end a patients life. The World Federation of Right to Die Societies says physician-assisted suicide means "making lethal means available to the patient to be used at a time of the patients own choosing." In these cases the patient takes the legal dose of poison themselves, it is not given by the doctor. It is euthanasia when the doctor has the main role in ending the patients life by giving the poison.

Euthanasia can be active or passive, and voluntary, non-voluntary and involuntary. Many people see important differences and they can accept some types but not others.

Passive euthanasia means letting a person die. A terminally ill person is allowed to die, even if treatment could help them to live longer. This includes removing life support, such as a ventilator which is being used to keep the person alive, or by not giving them food or water. Active euthanasia means doing something to end a person's life. This could be giving them an injection or pills that will cause their death.[2]

Some people see passive euthanasia as a more acceptable choice, because it is not a deliberate act to kill. However, others argue that once someone has decided to allow another person to die, they should make it as fast and as painless as possible, and then act to bring about their death. This is also known as mercy killing.[3]

Voluntary euthanasia is when someone asks to be allowed to die or to be killed. This is often seen as the best option by people who believe in euthanasia, because it is clear that the person wants to die. If the person can not say that they want to die, but people think that they would ask to die if they could, then it is non-voluntary euthanasia. Non-voluntary euthanasia is a choice for people who are in a coma or who are very young, as they can not say what they want. Involuntary euthanasia is when someone is killed even though they asked not to die, or when they could have asked to die but did not.[4] Many people think that this is murder, not euthanasia.[5]

These types of euthanasia can be mixed. If someone asks to die, and another person gives them an injection that will kill them, then it is active voluntary euthanasia. Someone in a coma who is kept alive with a ventilator, and the doctors turn it off and they die, would be passive non-voluntary euthanasia.[6]

Some people believe that euthanasia should be allowed, and some people think that it should not.

Some people believe that allowing euthanasia will result in bad things happening. If it is allowed for people asking to die, then it might be allowed for people who are very sick but are not able to ask to die. If that happens, then maybe it would be allowed for people who are very sick and will not recover, but do not want to die. This is called the "slippery slope" argument.[7]

People who believe in the slippery slope argument point to times when this happened. In Germany, Adolf Hitler allowed disabled children to be killed, and called it euthanasia. People now agree that this was wrong, but if euthanasia was allowed it could happen again. They think it is too big a risk to allow euthanasia at all.[7]

Other people say there is a big difference between killing a very sick person who asks to die, and killing a child with a disability. They do not think euthanasia will lead to bad things. They say that Hitler's actions were not euthanasia.[7]

The American Medical Association (AMA) and other doctors believe it is a doctor's role to help, not kill people.[source?] In one study 76% of doctors said they would not carry out euthanasia, even if it was legal.[source?] They feel patients would not trust them. In the Netherlands where euthanasia is legal, 60% of older people in one study were scared that their their doctors would kill them.[source?]

Palliative care is when people who are ill and going to die are given special care to make them more comfortable. It may include hospice care, when the patient is sent to a special hospital for people who are dying. Palliative care can involve pain relief and help for the patient and family to come to terms with death. In some cases, doctors will give patient drugs which make them stay asleep, so that they will not feel pain.[8][9]

Palliative care is not perfect, and so it is not always seen as a replacement for euthanasia. There is still some pain, and there can be other side-effects, where the patient can still feel very sick. Palliative care is not available for all people, and not all people who wish to die through euthanasia are so sick that they will die soon. Some people have healthy bodies, but they are suffering in other ways, and palliative care will not always help them.[7]

The principle of double effect was first described by Thomas Aquinas over 700 years ago. It says that it is sometimes alright to do a bad thing if something good happens, and if a bad ending was not wanted.[10] Aquinas used the example of self defense: sometimes a person will kill someone who attacks them, but killing was not what the person was trying to do. They only wanted to protect themselves. So even though killing someone is bad, wanting to protect themselves was not.[11]

Some people say that doctors may treat a person to reduce the their pain, and as a result the person will die sooner. If the doctor gives the treatment in order to help the patient die, then it is euthanasia. But if the doctor gives the treatment in order to stop the pain, and does not intend for the patient to die, then it may not be euthanasia, even if the doctor knew that the treatment would kill the patient.[11]

Suicide is when a person kills themselves. Sometimes when a person is very sick they need help to die, and this is called assisted suicide.[12] In some countries people are allowed to help as long as they do not kill the person,[13] and it can be seen as a more acceptable option because it must be the person's own decision.[12] Because the assisting person did not kill, it is not always considered to be euthanasia. [7]

[1]

Originally posted here:

Euthanasia - Simple English Wikipedia, the free encyclopedia

Right to euthanasia for people tired of life supported by most Dutch – The Irish Times

For the first time a majority of the Dutch population supports the idea of euthanasia for those who say theyre tired of life although they remain physically healthy, a survey shows.

In 2002 the Netherlands became the first country in the world to legalise euthanasia as a form of painless escape for terminally ill patients with the emphasis on those experiencing hopeless and unbearable suffering.

The procedure remains tightly controlled. Two doctors are required to agree independently in each case that the legal conditions have been met. However, theres a growing debate about whether or not availability should be broadened to include those who feel their lives are at an end.

As a result, controversial new legislation is to be tabled in parliament by the centre-left party D66 early next year that would make euthanasia available to citizens over 75 who believe their lives are complete and who wish to have control over how and when they end.

The new representative survey by the national statistics agency will be good news for D66 because it shows clearly for the first time that public attitudes to euthanasia are changing, and that that change is very much in line with the partys proposed new guidelines.

They survey shows the same overwhelming support for euthanasia as before, with 87 per cent of the population favouring its availability in certain controlled circumstances, 8 per cent opposed to it in all circumstances and 5 per cent with no opinion.

In religious terms, the greatest support for the procedure at 98 per cent comes from those who describe themselves as non-religious, with the greatest opposition from Muslims and orthodox Protestants.

However, within those broad parameters theres been an important shift, with 55 per cent of those surveyed now of the view that euthanasia should be available in cases where people feel tired of life while being in good physical health. Thirty-two per cent remain opposed to this.

As regards other specific hard case situations, 80 per cent agreed with its provision in cases of advanced dementia where the wish had been made known in advance.

Seventy-five per cent were in favour for terminally ill children and people with severe mental disorders.

The lower age limit for assisted suicide is currently 12, and while a third of respondents said they believed the age should be lowered to include younger children in distress, roughly half said they felt age should play no role in the decision at all.

The survey confirms that although it remains controversial and some cases become high profile, euthanasia is still used infrequently. There were 6,126 deaths by euthanasia in 2018, amounting to 4 per cent of the people who died in the Netherlands last year.

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Right to euthanasia for people tired of life supported by most Dutch - The Irish Times

Is there tikanga around euthanasia? – RNZ

Debate has emerged as to whether euthanasia has a place in te ao Mori, with some saying it doesn't sit with the Mori worldview of death, and others saying whnau should have the choice.

A Taranaki urup. Photo: RNZ / Robin Martin

The End of Life Choice Bill, which would allow people to end their lives if they have six months or less before they die, passed its third reading last week, with the public set to vote at a referendum next year.

Maata Wharehoka, from Parihaka, has been reviving traditional methods of death and burial, with her whnau-run business, Kahu Whakatere Tppaku.

She said that based on the knowledge of her whnau, there was a form of euthanasia in pre-colonial Mori society, which involved speeding up death for people who had become wholly dependent on others for their needs.

"They didn't have food and water, and they were put outside and regardless of the weather, that's where they were placed, now, what I do know, if they didn't die immediately they were then put out into wharemate, and the wharemate was built for them to die in."

She supports legalisation of euthanasia because it would help the wairua of the person dying, leave the world faster with less pain and suffering.

"I believe that we should never have to endure the pain that some people have to go through, that we should be able to choose a time to pass over."

Ngti Porou anglican priest, Reverend Chris Huriwai, who opposed the bill, said euthanasia went against the Mori worldview on death.

"When I hear conversations and krero around euthanasia, straight away my mind flicks to how we as Mori frame our tangihanga rituals, how we understand death, and fundamentally this idea of death as something that is unwanted, something that is an aitua or an accident or something unfortunate, and I wonder how that impacts on our tikanga when we start to express more agency in that space.

"So if a whnau or a person elects for that to take place, then how do we reconcile that with our acceptable practice and tikanga around tangihanga as it stands now."

The End of Life Choice Bill passed its third in Parliament last week and puts the issue to a referendum next year. Photo: RNZ / Dom Thomas

He said that from what he had learned from the tohunga Papa Amster Reedy, euthanasia was foreign to the tikanga of Tairwhiti, but he said this might not necessarily be the case for Mori across the country.

"I think it's important we don't just call it all tikanga Mori, because tikanga Mori doesn't exist."

"We're diverse, we're fluid, we're not a homogenous group of people, so those conversations need to happen on levels smaller than tribal levels, so hap conversations need to happen and whnau conversations need to happen around what our accepted tikanga is."

Dame Iritana Twhiwhirangi agreed there was no one tikanga, and she supported the right for whnau to make a decision for themselves.

"Our people, from what I remember, made the decision together. They didn't rely on outside determinations for them and together that was their tikanga, that's what they focused on, they made their decisions and I support that."

New Zealand Nurses Organisation kaiwhakahaere Kerri Nuku said Mori nurses were polarised on the issue, but agree that it should be up to whnau Mori.

Mori nurses were looking to set up hui at different marae after Christmas, where Mori could discuss what legalisation of euthanasia would mean for them and their whnau, similar to consultation that occured around changes to the Coronial Act.

Whangarei MP Shane Reti said during the third reading debate that he opposed the bill, both as as a doctor and a Mori.

Tmaki Makaurau MP Peeni Henare supported the bill Photo: RNZ / Richard Tindiller

He singled out many of the Mori Labour MPs who supported the bill, asking them what their "Mori heart' was saying.

Tmaki Makaurau MP Peeni Henare responded by saying that historically, Mori had ways of speeding up the process of death if a disease or sickness was incurable.

He said that to him, tikanga is mana motuhake - Mori being to make the decision which is right for them.

MP for Te Tai Hauuru Adrian Rurawhe said that the overwhelming majority of people in his electorate told him at eight public hui they did not want this bill.

"We talk about kaupapa Mori, terms that just roll of our tongue - manaakitanga, rangatiratanga, aroha - it even frames our international identity but will it frame what we want for our families in this bill, I say it will not, because it is fundamentally opposed to those kaupapa."

List MP Willie Jackson told Parliament that three high-profile Mori leaders, he had spoken with said "they were tired of hearing this was a violation of our culture".

"All were unanimous that in their view tikanga evolves, tikanga changes and there is no one tikanga," he said.

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Is there tikanga around euthanasia? - RNZ

Opinion | Life is special, nobody has the right to end their own – The News Record

The approval of the principle "right to die" is dangerously trending up.

In August, New Jersey became the seventh state to legalize assisted suicide. Euthanasia is now responsible for 4.5% of deaths in the Netherlands, with many of those including people who werent terminally ill.

These are old people who may have health problems, but none of them are life-threatening, bioethicist Scott Kim told CBS. They're old, they can't get around, their friends are dead and their children don't visit anymore. This kind of trend cries out for a discussion. Do we think their lives are still worthwhile?"

Assisted suicide is often conflated with euthanasia, which has different motives, but with the same results. Assisted suicide is usually defined as helping a person end their life. Euthanasia is essentially a nicer sounding version of assisted suicide. Amazingly, euthanasia has 73% of American support in a 2017 Gallup poll. This is downright horrifying.

Assisted suicide and euthanasia in bare-bone terms, is the practice of helping people kill themselves. The principle in favor of assisted suicide and euthanasia is known as right to die, that one is entitled to end their life.

Objectively, if one wants to deny themselves life sustaining treatment, I feel that is understandable. We didnt have these life sustaining devices until recently. Denying themselves life sustaining treatment is just letting life go through its intended course. The National Health Service distinguishes this from euthanasia. The BBC says The NHS says withdrawing life-sustaining treatment can be part of good palliative care and should not be confused with euthanasia.

But to me, you arent ending your life; youre letting life carry itself on which is very different from euthanasia or assisted suicide.

I have much sorrow for those who are terminally ill. However, that doesnt mean you should end your life.

Does one have the right to die? Well philosophically speaking, no. If you believe that people have the right to be born, then yes, one has the right to die. You have to be born to die. But since most believe the right to choose outweighs that, then the right to die isnt a philosophically consistent one.

People often forget how the practices of the right to die, euthanasia and assisted suicide are seen in the eyes of the society: murder. In the majority of states, the preservation of life is considered the biggest priority.

In terms of law, the Supreme Court has ruled that from FindLaw, the government's interest in preserving life and preventing intentional killing outweighed the patient's interest in the liberty to choose to die, regardless of the patient's condition.

Supreme Court Justise Neil Gorsuch once said, Once we open the door to excusing or justifying the intentional taking of life as 'necessary,' we introduce the real possibility that the lives of some persons (very possibly the weakest and most vulnerable among us) may be deemed less 'valuable,' and receive less protection from the law, than others."

The right to die forgets how special life really is.

Continued here:

Opinion | Life is special, nobody has the right to end their own - The News Record

Kent Co. Animal Shelter is overflowing due to high intake numbers coupled with lower euthanasia rate – WZZM13.com

GRAND RAPIDS, Mich The Kent County Animal Shelter took in 678 cats and dogs during the month of October alone.

"We've been steadily increasing since July," said KCAS program supervisor Namiko Ota-Noveskey. "We can't really explain why that is."

On top of a high intake number, the shelter has also been working to bring down its euthanasia rate, which means there are more animals in the shelter at any given time.

"We are moving animals as quickly as we can, but we are struggling to maintain the overall health of a large number of animals," Ota-Noveskey said.

Read more: Kent County shelter euthanized most dogs and cats in Michigan during 2017

KCAS gained attention last year for having one of the highest euthanasia rates in the state during 2017. Ota-Noveskey, who was brought on in May of this year, said they are constantly working to reduce that rate.

She said the current live release rate for cats is nearly 80% and the live release rate for dogs is close to 70%.

A 90% live release rate is the requirement for shelters that are considered 'no-kill.'

With help from rescue groups and other shelters, KCAS has been able to transfer animals more frequently to keep up with intake. The shelter has also offered fee waivers on cats for months at a time. With dogs, Ota-Noveskey says the staff is doing more extensive behavior assessments to determine the best type of home for each pet.

The longer the animals stay at the shelter, though, the more prone they are to things like upper respiratory infections and stress, Ota-Noveskey said.

"We are doing what we can," she said. But, they need adopters.

Bissell Pet Foundation is hosting an Empty the Shelters event on Nov. 22 and 23 solely to help KCAS adopt out more animals.

"Shelter dogs are not damaged dogs," Ota-Noveskey said. "I am pretty certain you will find one you like, and they all need a home. A shelter is just a temporary place this cannot be a home."

Long term, Ota-Noveskey hopes the shelter can work with community members to understand why intake numbers continue to be so high.

"Are people losing housing? Are they not financially able to care for [their pet]? Are landlords still discriminating against certain breeds? There are some things I think we can address as a community," Ota-Noveskey said.

HOW TO HELP:

Click here to learn about volunteering at KCAS

Click here to learn about adopting from KCAS

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Kent Co. Animal Shelter is overflowing due to high intake numbers coupled with lower euthanasia rate - WZZM13.com

Euthanasia referendum best approached with a cool head and open mind – Stuff.co.nz

OPINION:Now that New Zealanders have been passed the responsibility of decidingwhether euthanasia is to be legalised it is time to take the passion out of an impassioned debate.

Between now and when the referendum is held next year we have a moral duty to put aside our prejudices andlisten with an open mind to all sides.

We need to be conscious there will be those in thisdebateseeking to hijack ouremotions. Yet we also need to understand they'll be doing sofrom a position of absolute sincerity.

At its most basic it appears an easy choice. Should we be allowed to end our lives when we are terminally illand death is just six months away, or should we not.

READ MORE:* Euthanasia bill passes 69-51,the final decision a referendum* Historic right to die bill passes first hurdle* Should Kiwis have the right to die with 'dignity'?* Jackson: Dying with dignity should be a right

The issue is much deeper than that. Itbelies the simple yes or no answer a referendum requires.

It's the right to dignity in your final days versus therisk of being coercedinto ending it.It's individual freedom versus thestate's duty to protect the individual and the ability of medical scienceto keep us alive versus a subjective judgment on what quality of life we must have to make it worth living.

ROSS GIBLIN

David Seymour celebrates his euthanasia bill passing on Wednesday night. It will now be included on a referendum at next year's election.

It could also bethat once you've familiarised yourself with the details of the billyou realise you support euthanasia yetreject thisapproach as flawed. The same could be true for the reverse.

Thereare certainly cases where denying someone theability to end their own life appears cruel and unusual. Few could argue lawyer Lecretia Seales' last days alive weren't made more painful by her inability to end it.

The manner of herdeath was heartbreaking. Not just because of the pain she was inbut also because of how much she sacrificed pushing for change, even when it was clear she would never benefit from that change.

Her death will certainly be used to argue for the right to end your life. Suffering like that endured by Sealesis often compared to how we treat sick animals, a demonstration that animals are treated more humanely.

Yet such a statement that so aggressively grabs for your sense of outrage must also include that this "humanity" is largely extended to avoid personal cost.

Each year millions of animals die grislydeaths in this country. From any objective viewpoint they are not treated better than humans. Not even close.

Being open to understanding the gravity of this decision meansacknowledging the validity of qualified opinions, no matter how much they clash with your values.

As a GP, National MP Shane Reti's views must be recognised as having insights those outside the medical field may not be able to appreciate.

When he says he would not want the spectre of euthanasia hanging over every consultation, we should take that on board as reasonable and consider how this bill could change the doctor-patient relationship.

Yet his other comment that the world would have lost some "brightness" had Beethoven ended his life six months earlyto relievethe suffering his cirrhosis was causing, is an appeal to our emotions rather than our logic.

Euthanasia will not result in a dearth of high culture. And surely, as a nation, we don't want to prolong an individual's suffering simply to increase the range of amusements available to us.

Whatever decision the referendum yields, that we are even having it shows the current system is not meeting our needs.

It is time to talk about what those needs are. Strip away the fears, strip away the emotions, look past the simplistic arguments, keep it reasonedand be prepared to listen.

Then let your decision come from that.

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Euthanasia referendum best approached with a cool head and open mind - Stuff.co.nz

Long Beach City Council to consider increasing allowed pets from 4 to 6 to reduce animal euthanasia – Signal Tribune

The City of Long Beach may soon allow residents to have up to six pets in their homes, two more than it currently allows.

Gerardo Mouet, director of Long Beachs Parks, Recreation and Marine Department, stated in a Nov. 15 memo to the city manager that next month the city council will consider amending an ordinance to increase allowed pets from four to six and also regulate animals brought into the city for adoption.

The purpose of the amendments is to promote the Long Beach Animal Care Services (LBACS) Compassion Saves approach designed to minimize the number of animals euthanized, Mouet said.

According to the memo, LBACS already reduced the number of its animals euthanized by 82% between 2010 and 2018, dropping from 5,651 to 1,044. It also increased pet adoptions by 370% from 144 to 677 during that period.

Courtesy City of Long BeachA table from a Nov. 15 memo to the Long Beach city manager showing how Long Beach Animal Care Services (LBACS) reduced animal-euthanasia rates and increased adoptions between 2010 and 2018.

As recent as 2012, LBACS started seeing less animals coming into the shelter due to effective population-control efforts, Mouet said in the memo, adding that it reduced euthanasia rates with the help of a 2015 spay-and-neuter ordinance and partnering with adoption organizations.

Mouet further stated that city staff plans to work with spcaLA (the Los Angeles Society for the Prevention of Cruelty to Animals) which is housed in the same facility as LBACS in negotiating a memorandum of understanding (MOU) to maximize the effectiveness of LBACSs Compassion Saves approach.

That approach stems from an April 16 LBACS study session showing the positive impact of animal population-control efforts. The City had created a task force the previous October following results of a two-phased city-auditors report on LBACS completed last year. The City also hired a new LBACS manager, Staycee Dains, last February.

Along with deficiencies in LBACS operations, the audit noted that though they maintain separate leadership and identities, both LBACS and spcaLA are housed at the P.D. Pitchford Companion Animal Village in Long Beach, with a 55-year lease-back agreement expiring in 2053. LBACS leases part of the facility from spcaLA for its shelter operations and the City pays spcaLA 50% of the total facilitys operating expenses, according to the audit.

And though LBACSs live-release rates (LRR) of animals have increased, the audit found that the LRRs and impound improvements strained LBACSs resources and spread thin the shelters staff.

It also found deficiencies in LBACSs standard-operating procedures, resulting in inconsistent decision-making, conflicting shelter practices and changes implemented without proper direction and explanation.

No killThough Mouet said the three proposed steps are designed to aid LBACSs effectiveness in reducing euthanized animals, Dr. Patricia Turner of No Kill Long Beach, an advocacy group calling for no animal to be put down unless it has untreatable pain or illness, told the Signal Tribune that the steps are too limited.These actions dont go far enough, Turner said, adding that the real problem is LBACSs physical and operational proximity to spcaLA.

The MOU must establish LBACSs independence from spcaLA [] as its own entirely city-operated animal shelter and facility so that they can operate at scale to meet the needs of the people of Long Beach, she said.

Turner said that such a separation would allow LBACS to operate full-service adoption and foster programs and a robust volunteer program.Ideally, spcaLA would not be associated with the City of Long Beach, she said. They are on taxpayer land.

Turner also said that the MOU should require transparency by spcaLA about the outcome of animals under its care, such as how many it euthanizes or sends out to adoption, foster care or to other shelters.

That MOU is the most important thing, Turner said when comparing the three steps.

The step of limiting the number of animals brought into the city for adoption is a response to the general perception that spcaLA brings in animals from other places, Turner said, but noted that the memo doesnt specify that organization as the problem.

Nothing in this memo, in regards to animals being brought into Long Beach, mentions spcaLA, she said. It applies to anybody.

Turner said therefore a person who finds a kitten in Lakewood couldnt by law bring it to the Long Beach shelter, nor could a rescue organization that finds a dog in neighboring Compton bring it in for adoption.

It places a burden on these rescue organizations who are already overburdened, under-resourced and theyre doing the work that LBACS should be doing of adopting animals out, she said. LBACS is not adopting large numbers of animals out because spcaLA doesnt want them to. Its just foisting the problem back on the community.

She remarked that the 677 adoptions LBACS reports is small next to comparable cities like Sacramento, whose shelter managed 5,000 adoptions. That citys website states that the shelter sent out 5,037 dogs and cats for adoption last year and 4,321 as of October this year.

And regarding the proposed ordinance amending the number of pets people can have, Turner said her organization advocates for eight rather than six but said such laws dont impact animal welfare by themselves.

If youre concerned about animal welfare, the laws dont do anything in terms of changing human behavior except to deter responsible people who would take good care of a larger number of animals from having them, she said, adding that Sacramento allows up to 10 pets per household. Sacramentos website states that residents can harbor up to three dogs and seven cats.

Public opinion supports a no-kill policy and stronger adoption efforts, Turner said, but also noted that LBACS and spcaLA practices affect all pet owners.If your dog gets out, your dog could go to the shelter, Turner said. And if he gets sick, [] he could be killed.

Shelter progressDespite these concerns, Staycee Dains, LBACS manager, told the Signal Tribune that she collaborated with Mouet on the steps and is hopeful for continued progress.She said that the City has already made great strides in reducing its stray-animal population following the four-year-old spay-and-neuter ordinance.

Courtesy City of Long BeachGraph from Phase 2 of the City of Long Beachs audit of its animal-care services showing increases in live-release rates of animals in recent years

The City increasing its limit of how many pets residents can have will further reduce the stray-animal population, she said.The idea is to allow people to have more animals so they can adopt more animals from the shelter, she said.

Dains said she is also hopeful that the MOU with spcaLA will formalize the ways in which their operations work together, especially as LBACS has evolved over the past decade.

We really want to make sure our efforts are collaborative and make sure whatever were putting into place is going to be definitely beneficial for the LBACS shelter animals she said. Im very hopeful that we will be able to come up with a memorandum of understanding.

Dains added that LBACS will begin negotiations as soon as possible and expects the process to be short, hoping to complete the agreement early in 2020.

Dains said she is also confident in LBACSs Compassion Saves model to ensure the animals in its care get everything they need and especially an appropriate outcome, whether that means being returned to an owner, adopted, placed in foster care or sent to a rescue organization.

We want to make sure that were making excellent outcome decisions for them, Dains said. Making sure that animals are getting to their outcome as soon as possible is a really important part of the Compassion Saves model.

Dains said she is also pleased with reforms allowing volunteers to come on board faster.

Weve streamlined some of our training so that those who can come to the shelter and go through the screening process and be trained has been thankfully truncated, she said.

She added the City has opened up the window of time it can screen volunteer candidates by contracting with another organization to provide such services as fingerprinting.

People wont have to wait from their orientation to their processing time, which for some people could be weeks, Dains said. Weve definitely seen an increase in volunteer retention from going to that process.

More volunteers have allowed LBACS to develop new programs, such as behavior rehabilitation for dogs, Dains said.

Prior to starting this program, [some dogs] were not getting their needs met and so would languish in the shelter [and] their behaviors would become increasingly concerning because they werent getting the right type of enrichment, like getting out of their kennels and getting the right type of handling, Dains said.

She noted that a lot of the dogs at the shelter have been through trauma and need someone to guide them through that experience through specific activities with volunteers, such as educational training that helps them cope with the shelter environment.

It has made a huge difference in the stress level of our dogs in our kennels and the ease of volunteers being able to handle the dogs, she said.

As for cats, Dains said her own office has become the place for especially scared cats to calm down before continuing into the shelter.

People have been so invested and have really made a lot of personal sacrifices to see our animal-services department succeed, Dains said. Were very excited to keep up the momentum and progress that everyone in our community has worked on for so many years.

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Long Beach City Council to consider increasing allowed pets from 4 to 6 to reduce animal euthanasia - Signal Tribune

Reality check: Most changes to WA’s assisted dying bill now not Goiran’s – Sydney Morning Herald

Of the 142 amendments still on the notice paper, only 53 are from Mr Goiran.

The rest a total of 89 are from other MPs and include 12 proposed by the government itself, including six announced by Health Minster Roger Cook just yesterday.

Just a few weeks ago, Premier Mark McGowan said Mr Goiran's behaviour was "disgraceful", accusing him of "just trying to wreck the bill with these ridiculous, endless amendments".

But if the government's bill was as pure as the driven snow, why did it need more amendments yesterday? And this doesn't include five the upper house has already agreed to, including a variation of one previously proposed by Labor MP Margaret Quirk in the lower house?

As 6PR's Gareth Parker pointed out on Twitter: "I know Nick Goiran is supposed to be public enemy no.1 with horns growing out of his forehead, but is anyone going to reflect on the fact the McGowan Government now WILL amend its supposedly unimpeachable VAD Bill in the Upper House?"

Before yesterday, the government's bill as it stood would have permitted any health practitioner to suggest euthanasia to a dying patient. That included optometrists, pharmacists, a podiatrist, a dental hygienist or a Chinese medicine practitioner.

Of the five amendments agreed to by the upper house on Tuesday, only one was from the government.

An amendment moved by Mr Goiran to ensure people in the regions had the same level of access to palliative care as those in Perth came close to passing, falling short by a hair-raising one vote.

Luckily for the government, Nationals MPs came to the rescue to oppose it.

Also under scrutiny are claims by the government that the Australian Medical Association is now supporting its euthanasia bill.

President Andrew Miller has not said his association supports the legislation.

"There's a range of things that the AMA suggested in amendments that the government are saying would be more appropriate to address in the guidelines or the implementation phase, so we'll have a look at that," Dr Miller said.

"The AMA hasn't pledged anything, what we've said is we're welcoming these amendments.

"We're not going to tell anyone how to vote, we're just saying we're hear to provide information, we're here to provide feedback from doctors on the ground and we want it to be safe for patients."

Far from a glowing endorsement of the bill from the profession who will be expected to implement it.

And while the government has introduced an amendment to reduce the number of people who can propose euthanasia, the change still falls short of Labor MP Tony Buti's proposal to bring the laws into line with Victoria's.

Dr Buti, a supporter of the bill, wanted the laws to prevent anyone proposing euthanasia to a sick patient, including doctors and nurses.

"I've spoken to Tony Buti and explained to him the amendments that go to the heart of his concerns. He's very pleased with the compromise that's been struck," Mr Cook said on Tuesday.

"He said that while he prefers his amendment, but in the event that that is not successful he's very satisfied with the actual compromise that's now been reached."

This would be astonishing, given Dr Buti proposed the change to protect people with disabilities and Aboriginal people considered vulnerable because of language or cultural differences.

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All this just goes to show the upper house still has its work cut out dealing with this legislation.

The state government's bill is complex, not perfectly understood even by the government itself, which is still discovering reasons it needs to be changed and some upper house MPs are waveringin their support.

Putting pressure on MPs by forcing it through by Christmas might make tactical sense for the government, which hasn't really been able to explain the rush, but it might make for bad legislation.

Let's pray the upper house takes its time to get the balance right.

Nathan is WAtoday's political reporter.

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Reality check: Most changes to WA's assisted dying bill now not Goiran's - Sydney Morning Herald

End of life and legalising cannabis referendums make for a complicated election – Stuff.co.nz

OPINION:Next year's general election just got a whole lot more complicated, voters.

Not only are we going to be drowned in the usual tub-thumping rhetoric and "pick me" bluster that comes with a national election, we're now going to be caught up in a maelstrom of two referendums.

The first follows last week's historic decision in Parliament to allow a referendum on voluntary euthanasia; the second is on the regulation of cannabis.

These two issues not to mention a general election are major, and, if followed through the way that is seemingly expected, will fundamentally change New Zealand.

READ MORE:* Labour and the referendums of dread* MPs pass the buck to the public* Is a referendum democracy at work or abdication of political will?

Both the voluntary euthanasia and cannabis issues need, and deserve, enough time and information for us to get to grips with them, if we're going to be asked to vote on them.

For those of you who read these columns regularly, you'll know that I have already developed an aversion to referendums since watching the damage done to the United Kingdom over the farce that is Brexit.

ROSS GIBLIN/STUFF

ACT MP David Seymour's euthanasia bill was passed by Parliament.

That's been a great example of what happens if you ask people to vote on issues when they really have no clue what's going on and don't have the time, access or the will to search out enough information to make a good decision.

I know we all have a duty to make ourselves fully aware of these issues, but most of us won't, because we have other stuff going on. We'll get half informed and go with our gut instinct when faced with the moment we have to put an 'X' in the box.

Those who shout loudest, have the deepest pockets and have the least regard for truth will do well, if the UK is anything to go by.

I can't think of two more emotive issues for the public to decide on than death and drugs.

Two countries and 11 US states have legalised cannabis, but the exact details of laws and regulations varies from place to place.

Groups who want the vote to go one way will become more strident, vocal, political and polarised; as will those on the opposing side.

Both viewpoints may be valid, but polarised behaviour is how referendums work they push people into opposing positions where they start shouting over each other to make their points heard so they can 'win'.

And politicians will be at the forefront of this as they jump on these issues to get air-time, increase their profile and, of course, gain votes.

These are huge issues to decide on and people are going to feel really strongly: just look at the interest already on the euthanasia bill.

GETTY-IMAGES

legalising cannabis will probably become an also-ran issue when put into a two-horse referendum race with euthanasia, but it deserves a thorough hearing in its own right.

The End of Life Choice Bill passed by a relatively slim margin of 69 votes to 51, after two years of fierce arguments. It gained a record 39,000 submissions from the public during its passage through Parliament.

By comparison, legalising cannabis will probably become an also-ran issue when put into a two-horse referendum race with euthanasia, but it deserves a thorough hearing in its own right.

These issues need plenty of clear air to be properly considered by the general public who are being asked to vote on them.

SUPPLIED

Sue Allen says both referendums will need plenty of clear air to be properly considered by the general public who are being asked to vote on them.

This is all aside from a general election, which is when we have to work out who we want to run the country. And that's a whole can of worms for us: getting to the bottom of issues around education, health, the economy, housing.That list goes on and on.

My plea, though I'm sure no one will hear it, is that if we want informed debate and voting behaviour, then the Government needs to invest some serious time and money into ensuring we lesser mortals fully understand what it is we're voting on.

Sue Allen has worked in journalism, communications, marketing andbrand management for 15 years in the United Kingdom and New Zealand.

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End of life and legalising cannabis referendums make for a complicated election - Stuff.co.nz

Expanding the Availability of Controversial Medical Procedures Need Not Interfere with the Religious Freedom of Doctors and Nurses – Mosaic

A set of regulations by the Department of Health and Human Services, intended to go into effect tomorrow, would have expanded the right of medical professionals to refuse, as a matter of conscience, to perform certain procedures or provide certain drugs. But, earlier this month, a federal court struck down the rules, which would apply, for instance, to a doctor who doesnt wish to perform euthanasia in a state where it is legal to do so or to a nurse who doesnt wish to administer a vaccine manufactured from fetal tissue. Without objecting to the largely technical grounds on which the court invalidated the regulations, Moishe Bane and Nathan Diament argue in favor of such protections:

American law, both legislative and judicial, has a magnificent tradition of accommodating the rights and needs of individuals with conflicting interests. Surely, such mutual accommodations should be the aspiration of regulations regarding health and medical care. Sadly, in certain contextssuch as regarding womens reproductive rights and euthanasiaachieving a balanced approach to competing rights is not the goal of some judges and legislators who instead seek to diminish, and [even] to dismiss, the rights of those Americans committed to abide by their religious tenets.

Even in controversial contexts, legislators have successfully found a middle ground to provide rights to services for some individuals while simultaneously ensuring protections for those unable to provide those services on religious grounds. . . . Unfortunately, [however], respect for the conscience rights of healthcare providers (and other Americans of faith) has been persistently attacked.

The denigration and dismissal of religious belief is frequently advanced in association with both abortion and LGBT rights. Rather than seeking to ensure that these legal rights are balanced with the competing, authentic religious rights of others, many abortion and LGBT advocates frame values borne of religion as illegitimate and undeserving of respect, let alone entitled to legal protection. They assert that any accommodation of religious belief is tantamount to using religion as a sword to harm others. Experience has now shown that the preservation of religious-conscience protections need not impose significant burdens on others.

Our courts and our culture must be reminded that America was founded by those who were seeking religious freedom; that is why they enshrined its protection in the First Amendment. A devout Jewish doctor who declines to issue an assisted-suicide prescription shouldnt be forced to choose between her career and conscience any more than a faithful Catholic attorney who doesnt want to work on a death-penalty case, or a committed feminist web designer who doesnt want to build a pornographic website.

Read more at Washington Times

More about: Abortion, American law, Euthanasia, Freedom of Religion, Medicine

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Expanding the Availability of Controversial Medical Procedures Need Not Interfere with the Religious Freedom of Doctors and Nurses - Mosaic

Townsville Bishop says Church will never accept assisted suicide because it is intentional killing – Catholic Leader

Life is sacred: Townsville Bishop Tim Harris has spoken out strongly against euthanasia.

TOWNSVILLE Bishop Tim Harris has spoken out strongly against euthanasia and defended comments he made likening a push to allow voluntary assisted dying in Queensland to a mentality that existed in Nazi Germany.

Bishop Harris said it was an important time to have a conversation on the grim topic following the Queensland Governments committee hearings, which could result in new laws being presented to parliament early next year.

He joined other Catholic leaders across Queensland, including Brisbane Archbishop Mark Coleridge, in observing Dying Peacefully No Euthanasia Sunday on November 17, advocating against the introduction of so called voluntary assisted dying.

It reminds me of Nazi Germany; these are some of the things that people did because if someone was not 100 per cent, crippled, if they had something wrong with them, if they were aged or not of use to society any more the state then would select certain people and say well experiment on you or well kill you because youre not worth anything, he told parishioners during Mass at Sacred Heart Cathedral, Townsville.

Bishop Harris said he was not surprised media picked up on his comments, and he stood by them.

Everyone is referring to the reference with the Nazis. It (VAD) has that feel about it, for sure. Its not exactly the same but its got that feel about it, he said.

A shiver goes up my spine with this whole matter.

Both my parents had palliative care in the last couple of years of life and it never entered my mind that we would somehow have a law that would allow them to end their life prematurely.

They wouldnt have wanted it, we didnt want it.

The point was the more chances Ive got to say I love you, to me its worth every second of every day.

During his cathedral comments, Bishop Harris said he was not suggesting any evil intent from people with a different view.

Good people are believing that voluntary assisted (dying) is the way to go and I respect their views, but Ive also got to be in there and say there is another way and challenge it, just as theyll be challenging me, he said.

The Church wants to emphasise that we are created in the image and likeness of God and because of that it puts us right up there at the top in terms of Gods creations.

Our bodies are the temple of God and his Holy Spirit and you dont muck around with that, you respect it to the very end.

I believe to assist someone to die in an intentional manner is clearly intentional killing and the Church does not believe in intentional killing.

Instead, Bishop Harris said there should be more attention on improving palliative care services.

A state-sanctioned voluntary assisted suicide can have all the safeguards it likes but even then things can go wrong; the best safeguard is not to do it, he said.

Archbishop Coleridge said Catholic support for better palliative care was grounded in the common good of society.

Better end-of-life care begins with better conversations about death and dying, and how we can die well in ways that do not undermine the foundational values of our society, he said.

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Townsville Bishop says Church will never accept assisted suicide because it is intentional killing - Catholic Leader

Citizens and activists seek to end gas euthanization of shelter animals – Universe.byu.edu

A former gas chamber from the Heber City Animal Services in Heber, Utah. (Jim Urquhart/AP Images for The Humane Society of the United States)

An online petition to end the practice of gas chamber euthanization of shelter animals in Missouri, Ohio, Wyoming and Utah has gained momentum among activists and citizens.

The petition aims to create a federal ban on the euthanization of shelter animals by asphyxiation in a gas chamber, a practice that can include putting multiple animals in the same chamber for gassing and that can take half an hour or more. Proponents of the petition say they favor safer and cleaner methods, such as euthanization by injection.

According to a statement by the Humane Society of the United States, animal welfare experts agree that if an animal needs to be euthanized, the most humane way is by injection.

Gas chambers cannot provide humane euthanasia for shelter populations, the statement said. Old, ill, injured or otherwise circulatory-compromised animals may suffer from medical conditions that delay the effects of gas, causing them to experience distress prior to unconsciousness.

Instead of banning the gassing practice on a shelter-by-shelter basis, proponents of the petition hope to gain Congressional support to create a federal ban.

For years, efforts to create a ban have had little success in the Utah Legislature, however.

Instead of going to the capitol again, the Humane Society of Utah aims to educate shelter employees of the superiority of injection euthanization over gas chamber euthanization.

Deann Shepherd, director of marketing and communications at the Humane Society of Utah, helps educate shelter workers by explaining to them that injection is less expensive, faster, painless, more humane and safer for staff members since they arent exposed to carbon monoxide when they get an animal out of the gas chamber.

She said that much of the training is well-received by shelter employees who face the often difficult task of euthanizing animals.

We have found through our research that they know that it is better for the animal to be euthanized by injection, Shepherd said. They feel better knowing that they ended the animals life in a humane way instead of putting them in a chamber.

The South Utah Valley Animal Shelter is one of four shelters in Utah that the Humane Society said still practices euthanization via gas chamber.

Kierstan Munford, the executive director of the shelter, said that in some instances, its better to euthanize via gas chamber.

If were dealing with a fractious animal or a mean dog, its safer for our staff to handle the animal for the least possible amount of time, Nord said.

Nord said that if a federal ban were to be placed on gas euthanization, the shelter would need to implement new euthanization procedures.

While the practice of gas euthanization is still in place in Utah, many pet owners are in favor of either creating a ban on gas euthanization or using educational measures to stop it.

Former Provo council member and pet owner Laura Cabanilla is a staunch denouncer of gas chamber euthanization.

Gas chamber euthanization is inhumane, Cabanilla said. I feel like there are so many better ways to deal with fractious animals or feral cats.

The owner of several animals herself, Cabanilla recalled an experience of having to put a cat of her own down by means of injection, a euthanasia practice she is strongly in favor of.

It was such as peaceful experience, Cabanilla said. We got to hold our friend while she just dozed off.

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Citizens and activists seek to end gas euthanization of shelter animals - Universe.byu.edu

Nanoparticle therapy shows promise for treatment of rare cancer – The Brown Daily Herald

This month, a paper published by University researchers Richard Terek and Qian Chen highlighted a potential nanotechnology therapy that targets chondrosarcoma, a rare type of bone cancer. Using nanoparticles, the team effectively delivered therapies directly into tumor cells and observed decreases in tumor volume and prolonged survival in mouse models.

Chondrosarcoma currently has no FDA approved treatments. The complex makeup of these cancer cells makes them uniquely difficult to treat. Specifically, one challenge to (drug) delivery in chondrosarcoma is the negatively charged proteoglycan-rich extracellular matrix that needs to be penetrated to reach the tumor cells, according to the study.

Terek, the chief of musculoskeletal oncology at Rhode Island Hospital, an orthopedic oncology surgeon with the Lifespan Cancer Institute and a professor of orthopedic surgery at Warren Alpert, studies chondrosarcoma and collaborated with Chen, a molecular and nano-medicine researcher, director of the NIH-funded Center of Biomedical Research Excellence in Skeletal Health and Repair at Rhode Island Hospital and a professor of orthopedic research and medical science, on this study. The pair aimed to develop a nanopiece delivery platform capable of penetrating the convoluted chondrosarcoma matrix.

We develop nanomaterial (that) we call nanopieces and we found that it can deliver nucleic acid therapeutics to tissues that normally are very difficult to be penetrated, Chen said.

In addition to getting drugs to the tumor tissue, the researchers also studied the biology of how chondrosarcoma spreads. The other thing is we dont totally understand what drives cancer cells to metastasize. That part of the work involves trying to disentangle which types of pathways have gone awry, Terek said.

The underlying principle of the therapy is that miRNA, short 21-nucleotide sequences, are overexpressed in chondrosarcoma tumor cells. These miRNA end up functioning in a way similar to oncogenes, genes which drive cancer formation, by indirectly affecting other genes in the cancer pathway.

Tereks work over the past decade has culminated in the identification of the cancer-causing, or oncogenic, miRNA involved in chondrosarcoma formation. That process involved microarray analysis of primary human tumor tissues. We used a variety of screening techniques to identify which miRNA were overexpressed in tumors, Terek said.

These detrimental effects of the oncogenic miRNA can be prevented by synthesizing a molecule of the opposite sequence of nucleotides. Once delivered into the cell with the nanoparticles it will counteract and annihilate the overexpressed miRNA Terek said.

Once the target miRNA was identified, the small, opposing sequence of RNA needed to be delivered, a process that is normally very difficult because of the charge and structure of the matrix formed by the tumor. What we do in the lab is formulate this nanomaterial specifically for penetrating into the matrix, Chen said.

The laws kind of break down when you get to these nano levels. At the nano level, these particles somehow get through the cell wall and into the cell, even though the cell wall is classically thought of as this impenetrable structure around the cell, Terek said.

The nanomaterial delivery vehicle is composed of a small molecule, weighing about 400 daltons, which assembles into a nanotube structure that contains RNA. The molecule itself is biomimetic. Its half composed of nucleic bases and half of the molecule is amino acids, so its fused together. Because of that it also has a very low level of cell toxicity, Chen said. The nanoparticle is designed to be comparable to a natural biological structure, enabling the particle to be generally accepted by cells, so it can enter and affect them.

In previous studies, Chens lab has shown successful use of nanoparticle therapy in the treatment of multiple other diseases, including rheumatoid arthritis. Recently, they also received a grant from the National Institutes of Health funding research on the treatment of Alzheimers disease using a similar nanopiece delivery system that can traverse the blood brain barrier.

In further developing this drug therapy, Terek said one possibility is to combine multiple miRNA sequences with these nanoparticles to impact more pathways and get maximal inhibition of tumor spread. This involves both counteracting overexpressed miRNA, and restoring beneficial cancer suppressor miRNAs to combine multiple therapeutics with one dose of the nanoparticles.

Another potential approach is to pair the miRNA therapy with other cancer drug therapies. Since some miRNAs prevent the effective use of typical cancer treatment drugs, this approach can be used to reverse drug resistance, allowing for the use of conventional therapies, like chemotherapy.

In order for nanoparticle therapy development to succeed, investors, pharmaceutical companies, biotech companies and other collaborators need to give time and money to projects like this, Chen said. As far as moving it into the clinic, thats always a big hurdle, Terek said. One intermediate step the team might take is to collaborate with veterinarians allowing them to incorporate their treatment method beyond mouse models.

Brown and Lifespan have helped establish a startup called NanoDe so that we can continue the process, Chen said. Moving forward, the team will continue to work on collaborating with other researchers and developers to advance this drug therapy for chondrosarcoma.

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Nanoparticle therapy shows promise for treatment of rare cancer - The Brown Daily Herald

Nanotherapies for Rheumatoid Arthritis: Advantages, Challenges, and Future Direction – Rheumatology Advisor

Despite recent advances in the treatment of rheumatoid arthritis(RA) attributed to biologic medications, only a minority of patients achieve andmaintain disease remission without the need for continuous immunosuppressive therapy.1Complicating the treatment of RA further is the development of tolerance over timeor failure of patients to respond to currently available therapies.1Thus, the development of new treatment strategies for RA remains a priority.

Nanotherapies for RA have received increasing attention in the past decade because they offer several potential advantages compared with conventional systemic therapies.2 Nanocarriers are submicron transport particles designed to deliver the drug at the site of inflammation the synovium thereby maximizing its therapeutic effect and avoiding unwanted systemic adverse effects.1 This targeted drug delivery approach also has the potential to minimize the amount of drug required to control joint inflammation3 and increase local bioavailability by protecting it from degradation in the circulation.1

In essence, nanotechnology enables the redesign of alreadyeffective rheumatologic medications into nanoformulations that may confer greaterspecificity, longer therapeutic effect, and more amenable safety profile.4Nanoencapsulated nonsteroidal anti-inflammatory drugs (NSAIDs),5 liposomaland polymeric preparations of glucocorticoids,6 and nanosystems thatdirectly inhibit angiogenesis are just several examples of nanotherapies that havebeen tested in experimental models of inflammatory arthritis.7

Despite the promising findings observed in studies to date, further development and subsequent integration of nanotherapies in the management of RA remains hampered by the lack of efficacy and toxicity studies in humans. In an interview with Rheumatology Advisor, Christine Pham, MD, chief of the Division of Rheumatology at the Washington University School of Medicine in St Louis, discussed the advantages and challenges of applying nanotherapies in RA.

RheumatologyAdvisor: How can nanotechnology be applied in the treatment of RA?

ChristinePham, MD: Nanotechnology is a multidisciplinary approach aimed at the deliveryof therapeutic agents using submicron nanocarriers. In RA, the vessels at the siteof inflammation are leaky, allowing passage of these nanocarriers from the circulationto specific target sites in the joint environment.

RheumatologyAdvisor: Which RA drugs are suitable forthis approach?

DrPham: Many conventionalantirheumatic drugs such as methotrexate, glucocorticoids, and NSAIDs have beensuccessfully delivered by nanocarriers to mitigate inflammatory arthritis in experimentalmodels.

RheumatologyAdvisor: Whatare the main advantages of using nanotherapy/nanocarriers, as opposed to systemictherapy, in the treatment of RA?

DrPham: The mainadvantages are selective drug delivery to desired sites of action through passiveor active targeting, which can lead to increased local bioavailability and potentiallycan reduce unwanted off-target side effects. In addition, nanocarriers may increasethe solubility of certain drugs and protect therapeutics against degradation inthe circulation.

RheumatologyAdvisor: Howfar has the medical community gotten in developing (and testing) nanotherapies forRA? Which nanotherapies have shown the most promise?

DrPham: A numberof nanotherapeutics have been developed and tested in animal models of RA. Mosthave shown disease mitigation, however, none has so far made it to the clinic.

RheumatologyAdvisor: Whatneeds to happen before nanotherapies can get fully integrated into clinical practiceand treatment of patients with RA?

DrPham: Insufficientdata regarding long-term toxicity and optimal therapeutic efficacy have hamperedtheir integration into clinical practice. Anticytokine biologics have been verysuccessful, so nanotherapeutics need to show clearly that they have higher efficacyand lower toxicity for pharmaceutical companies to invest in their development forthe clinic.

Rheumatology Advisor: Are any other promising treatment strategies for RA currently under investigation?

DrPham: RNA interference(RNAi) has recently emerged as a specific way to silence gene expression. The invivo delivery of small interfering RNA (siRNA), however, remains a significant hurdle,given the short half-life of the molecule in the circulation. We have used a self-assemblingpeptide-based nanosystem that protects the siRNA from degradation when injectedintravenously and which has shown to mitigate experimental RA.8,9 siRNAworks by knocking down NFkappaB p65, asubunit of NF-kappa-B transcription complex which plays acentral role in inflammation in general and in RA in particular. This platform promisesto have real translational potential.

References

1. Pham CTN. Nanotherapeutic approaches for the treatment of rheumatoid arthritis. Wiley Interdiscip Rev Nanomed Nanobiotechnol. 2011;3(6):607-619.

2. Dolati S, Sadreddini S, Rostamzadek D, Ahmadi M, Jadidi-Niaragh F, Yousefi M. Utilization of nanoparticle technology in rheumatoid arthritis treatment. Biomed Pharmacother. 2016;80:30-41.

3. Rubinstein I, Weinberg GL. Nanomedicine for chronic non-infectious arthritis: the clinicians perspective. Nanomedicine. 2012;8(Suppl 1):S77-S82.

4. Henderson CS, Madison AC, Shah A. Size matters nanotechnology and therapeutics in rheumatology and immunology. Curr Rheumatol Rev. 2014;10(1):11-21.

5. Srinath P, Chary MG, Vyas SP, Diwan PV. Long-circulating liposomes of indomethacin in arthritic ratsa biodisposition study. Pharm Acta Helv. 2000;74:399-404.

6. Metselaar JM, Wauben MH, Wagenaar-Hilbers JP, Boerman OC, Storm G. Complete remission of experimental arthritis by joint targeting of glucocorticoids with long-circulating liposomes. Arthritis Rheum. 2003;48:2059-2066.

7. Koo OM, Rubinstein I, nyuksel H. Actively targeted low-dose camptothecin as a safe, long-acting, disease-modifying nanomedicine for rheumatoid arthritis. Pharm Res. 2011;28:776-787.

8. Zhou H-F, Yan H, Pan H, et al. Peptide-siRNA nanocomplexes targeting the NF-kB subunit p65 suppress nascent experimental arthritis. J Clin Invest. 2014;124:4363-4374.

9. Rai MF, Pan H, Yan H, Sandell L, Pham C, Wickline SA. Applications of RNA interference in the treatment of arthritis. Transl Res. 2019;214:1-16.

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Nanotherapies for Rheumatoid Arthritis: Advantages, Challenges, and Future Direction - Rheumatology Advisor

At 9.6% CAGR, Healthcare Nanotechnology Market Global Industry to Reach Valuation over 306100 Million USD by 2025 – Markets Gazette 24

Healthcare Nanotechnology Market delivers a succinct analysis on industry size, regional growth and revenue forecasts for the upcoming years. The report further sheds light on significant challenges and latest growth strategies adopted by manufacturers who are a part of the competitive spectrum of this business domain.

In 2018, the global Healthcare Nanotechnology (Nanomedicine) market size was 160800 million US$ and it is expected to reach 306100 million US$ by the end of 2025, with a CAGR of 9.6% during 2019-2025.

The key players covered in this study

Amgen

Teva Pharmaceuticals

Abbott

UCB

Roche

Celgene

Sanofi

Merck & Co

Biogen

Stryker

Gilead Sciences

Pfizer

3M Company

Johnson & Johnson

Smith & Nephew

Leadiant Biosciences

Kyowa Hakko Kirin

Shire

Ipsen

Endo International

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It is defined as the study of controlling, manipulating and creating systems based on their atomic or molecular specifications. As stated by the US National Science and Technology Council, the essence of nanotechnology is the ability to manipulate matters at atomic, molecular and supra-molecular levels for creation of newer structures and devices. Generally, this science deals with structures sized between 1 to 100 nanometer (nm) in at least one dimension and involves in modulation and fabrication of nanomaterials and nanodevices.

Nanotechnology is becoming a crucial driving force behind innovation in medicine and healthcare, with a range of advances including nanoscale therapeutics, biosensors, implantable devices, drug delivery systems, and imaging technologies. The classification of Healthcare Nanotechnology includes Nanomedicine, Nano Medical Devices, Nano Diagnosis and Other product. And the sales proportion of Nanomedicine in 2017 is about 86.5%, and the proportion is in increasing trend from 2013 to 2017.

This report focuses on the global Healthcare Nanotechnology (Nanomedicine) status, future forecast, growth opportunity, key market and key players. The study objectives are to present the Healthcare Nanotechnology (Nanomedicine) development in United States, Europe and China.

Market segment by Type, the product can be split into

Nanomedicine

Nano Medical Devices

Nano Diagnosis

Other

Market segment by Application, split into

Anticancer

CNS Product

Anti-infective

Other

The study objectives of this report are:

To analyze global Healthcare Nanotechnology (Nanomedicine) status, future forecast, growth opportunity, key market and key players.

To present the Healthcare Nanotechnology (Nanomedicine) development in United States, Europe and China.

To strategically profile the key players and comprehensively analyze their development plan and strategies.

To define, describe and forecast the market by product type, market and key regions.

In this study, the years considered to estimate the market size of Healthcare Nanotechnology (Nanomedicine) are as follows:

History Year: 2014-2018

Base Year: 2018

Estimated Year: 2019

Forecast Year 2019 to 2025

For the data information by region, company, type and application, 2018 is considered as the base year. Whenever data information was unavailable for the base year, the prior year has been considered.

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At 9.6% CAGR, Healthcare Nanotechnology Market Global Industry to Reach Valuation over 306100 Million USD by 2025 - Markets Gazette 24

World Pancreatic Cancer Day: increasing awareness and inspiring action – UNSW Newsroom

Pancreatic cancer is an insidious disease itis often diagnosedat an advanced stage, with about 90% of patients dying within five years of diagnosis.New projections suggest pancreatic cancer will be the second leading cause of cancer mortality by 2025.

This World Pancreatic Cancer Day, we are celebrating some of the many UNSWresearchers who are dedicated to changing those statistics. Cancers with poor outcomes like pancreatic cancer are a key focus area in UNSW Medicine's cancer theme.

Associate Professor Phillips is the Head of the Pancreatic Cancer Translational Research Group and Deputy Director of the Adult Cancer Program at the Lowy Cancer Research Centre at UNSW Medicine.

This year, A/Prof Phillips was a key driver in establishing the Pancreatic Cancer Research Hub, which aims to double the survival of patients with pancreatic cancer by 2030.

She says World Pancreatic Cancer Day is a powerful advocacy event to increase community and government awareness of pancreatic cancer.

It is also a time to reflect on the progress we have made in understanding this terrible disease and focus on the next steps to overcome current clinical challenges to ensure our research efforts bridge the gap and, as in other cancers, improve the outcomes for our patients with pancreatic cancer.

I know that we are on the brink of overturning the unacceptable statistics. Uniting researchers with the community who, unlike in other cancers, dont often get to be a strong voice advocating for themselves and Government will ensure Australian researchers continue to make positive change for pancreatic cancer patients globally.

A/Prof Phillips group has developed a novel cutting-edge way to keep pieces of human pancreatic tumours alive in the laboratory for two weeks after surgical resection.

Our capacity to grow human tumour tissue in the laboratory provides a valuable new clinical tool to test how a patients tumour responds to different chemotherapies and has the potential to immediately inform patient treatment options. Our unique tumour model is superior to other models because it is human in origin and it contains the complex tumour environment present in patients.

In 2016 A/Prof Phillips had a major breakthrough, successfully developing a novel nanomedicine a tiny drug delivery vehicle consisting of a state-of-the-art nanoparticle that can package gene therapy to inhibit any tumour-promoting gene in pancreatic cancer.

With the generous support from the Brian O'Neill Pancreatic Cancer Fundraising Dinner held last night the team will be able to perform essential preclinical studies to test the therapeutic potential of their nano-gene therapy in combination with a clinically approved drug. They also plan on using their expertise to improve the bioavailability of the clinically approved drugs using a nanomedicine approach.

Professor Minoti Apte was the first in the world to isolate and characterise pancreatic stellate cells, a cell type that is now known to play a major role in the progression of both chronic pancreatitis and pancreatic cancer. Coming up with ways to target these cells to prevent them from doing harm is now a major focus of her teams research.

The group has now shown that interrupting the cross-talk between cancer cells and surrounding cells in the microenvironment by targeting a certain signalling pathway reduces tumour growth and eliminates metastasis in early as well as advanced pre-clinical models of pancreatic cancer.

We have also shown that targeting this pathway reduces the risk of recurrence and progression after surgical resection of pancreatic cancer in a mouse model, and are currently working on possible pathways to take our laboratory findings to the clinic, Professor Apte says.

To me, World Pancreatic Cancer Day is a great opportunity to raise awareness in the community about this deadly cancer, but it is also a day to admire the courage and resilience of patients and their carers. These are the people that spur us researchers on to continue working hard to develop new therapeutic approaches to improve outcomes.

Last year, Professor Apte received the Gastroenterological Society of Australia (GESA) Distinguished Researcher Prize 2018. In 2014 she was awarded the Medal of the Order of Australia (OAM), after being named the NSW Woman of the Year in 2015. She was also the 2016 recipient of the Professor Rob Sutherland AO Make a Difference Award at the NSW Premiers Awards for Outstanding Cancer Research an award that recognises highly successful research that is actively changing cancer treatment and improving patient survival.

Dr Angelica Merlot, who is based at the Childrens Cancer Institute, focuses her research on developing new anti-cancer drugs that target drug resistance and suppress cancer spread.

This year, the cancer researcher has won the 2019 NSW Young Woman of the Year award for her achievements and research into treatments for pancreatic and brain cancer. She also won a 2019 Young Tall Poppy Science Award and the 2019 NSW Early Career Researcher of the Year (Biological Sciences) at the NSW Premiers Prizes for Science & Engineering.

Dr Merlot says today is an important day to raise awareness about one of the world's toughest cancers.

This is crucial as it broadens community knowledge, inspires action and supports further research funding for this cancer. It's also a time to remember those whom we have lost and those currently fighting this disease, she says.

Although we've seen a small improvement in the current survival rate, a lot of progress is still required. Further translational research means that there is a greater likelihood that the survival rates can be increased and the journey and treatment of those affected by the cancer can be improved.

Dr Merlot became focused on cancer research as an undergraduate. Her interest in aggressive cancers, such as pancreatic and brain cancer, was motivated by lack of improvement in survival rates over the past decades, largely due to late diagnosis, a lack of screening programs, low awareness of symptoms and a lack of treatment options.

After moving to UNSW Medicine as a Scientia Fellow in 2018, Dr Merlot focused on understanding the mechanisms by which cancer cells grow and adapt to their environment, why drugs become less effective and the development of nanoparticles to improve drug delivery.

Dr Merlots current projects are investigating part of a human cell called the endoplasmic reticulum (ER). The ER is a type of organelle, or subunit within a cell, that has been shown to help cancers grow, spread and develop drug resistance.

Dr Ying Zhu will lead a team of researchers from UNSW to discover much needed early detection methods for pancreatic cancer patients: the UNSW Medicine researcher today received $100,000 grant from the Avner Pancreatic Cancer Foundation. A/Prof Phillips is a co-investigator on this grant.

As current approaches to this research are time and labour intensive, the team will develop an integrated and small device based on nanotechnology for rapid and sensitive exosome analysis. The team will define a set of biomarkers that can differentiate between cancer and non-cancer subjects from cells and plasma carrying early signs of human pancreatic cancer. This novel technology will also be applicable for doctors monitoring the development and customising the treatment of a patients tumour.

Pancreatic cancer is difficult to diagnose in the early stages. Early tumour cant be observed during routine physical exams as the pancreas is deep inside the body. Most patients are diagnosed when the cancer has become very large or has spread to other organs. A method to detect pancreatic cancer early on is urgently needed, Dr Zhu said.

My project team aims to develop a blood test to detect pancreatic cancer in the early stages. The team will target exosomes, which are nanosized fragments released by cancer cells. Exosomes are important for communicating messages and transporting materials between cells. Exosomes have been identified as more accurate and promising biomarkers, or biological clues for pancreatic cancer diagnosis, Dr Zhu continued.

We are pleased to award funding to this innovative project, said Michelle Stewart, CEO of the Avner Pancreatic Cancer Foundation. We are encouraged by the high calibre of the research and believe that investment into projects like these will help us to increase survival for people diagnosed with pancreatic cancer.

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World Pancreatic Cancer Day: increasing awareness and inspiring action - UNSW Newsroom

Bankrupt biopharmas are rare. 2019 has some worried that’s changing. – BioPharma Dive

Editors note: This is part of a series about bankruptcy in the biopharma industry. Click here to see a running list of 2019 biopharma bankruptcies, and click here to see 31 biopharmas at high risk of bankruptcy for 2020.

Six years ago, Bind Therapeutics was flying high, with little idea how hard it would soon crash.

Headed into a public stock offering in 2013, the biotech, founded by top MIT and Harvard researchers, generated buzz with its lofty scientific ambitions. Company executives believed its nanomedicine platform, while only through Phase 1 tests, represented the next advance in cancer therapies.

Those dreams came undone within three years. As its experimental therapies struggled in clinical testing, Bind was punished by the market, and debt repayments forced the company into bankruptcy in 2016.

Bind may be a cautionary story in todays life sciences ecosystem, one that features biotechs going public at earlier stages and with heightened ambitions.

While bankruptcy is a rare outcome for biopharmas, 2019 has bucked that trend with an uptick in Chapter 11 filings. Eleven companies have declared bankruptcy so far this year, compared to an average of four per year during the past decade, according to a review of data tracked by the firm BankruptcyData.

That increase may forewarn of more companies falling to zero, industry experts said in interviews with BioPharma Dive, especially at a time of rising legal and political headwinds for the sector. After a decade of booming growth, the ballooning ranks of newly public biotechs may struggle to withstand market pressures.

I think theres a turning point now, said Andrew Hirsch, the former CEO of Bind, in an interview. I think its not sustainable.

Hirsch highlighted the rising prominence of early-stage platform companies, like Bind, going public in greater numbers and at larger valuations. That can bring steeper downside, he warned.

Things arent always going to work the first time, thats just the rule in this industry. A lot of times, companies are valued for perfection, said Hirsch, now Agios Pharmaceuticals chief financial officer.

If they are lucky and it works, thats great. But if you have a setback because youre doing novel things, the public markets can be a cruel place to be.

Biotech vastly outperformed the broader stock market over the past decade, and a steady inflow of capital supported more companies going public at rich valuations.

But those tides have turned. A leading biotech index has fallen more than 15% since peaking in the summer of last year, while the S&P 500 has ticked up nearly 13% in the same timeframe. The capital required for funding biopharmas ambitions is leaving too, with one Wall Street firm calculating $8.7 billion in net capital outflows this year rivaling a stretch in late 2015 and early 2016.

After years of outperformance, biotech has lagged the market for the past year

Price per share of a leading biotech index (XBI) and the S&P 500 (SPX) from January 2018 to October 2019 (indexed)

The base value of the index is trading value on Jan. 2, 2018.

Nami Sumida/BioPharma Dive

Investor anxiety is rising at a time when more companies are fighting for funding than in past decades. Evercore ISI analyst Josh Schimmer said this year hes noticed a marked shift in investor attitudes.

When they stumble, the markets are more unforgiving than ever, Schimmer said in an interview. They arent given second chances the way they used to be given. That may be a factor that does lead to a higher rate of bankruptcies.

And small biotechs arent the only ones facing elevated bankruptcy risk. The weight of thousands of lawsuits related to opioid marketing has already taken down Purdue Pharma and Insys Therapeutics. Several others, like Teva Pharmaceutical, Mallinckrodt and Amneal, are at risk of joining them.

The legal uncertainty has made these companies perceived as uninvestable, SVB Leerink analyst Ami Fadia said in an interview. Additionally, many of these pharmas are highly leveraged and face issues in generating cash going forward, she added.

Its pretty obvious that some of these companies are at high risk of bankruptcy, said Fadia, who covers several of these drugmakers including Mallinckrodt and Amneal.

To be sure, the effect of opioid liabilities is constrained to a comparatively small set of companies. But heading into an election year with drug pricing as a top issue, worries about capital fleeing the industry and a legal crackdown on opioid makers could be exacerbated by political threats as well.

Industry lobbyists have blasted HR3, the leading Democratic drug pricing proposal, saying it would trigger a nuclear winter by eroding the upside of biopharmas high-risk, high-reward investment premise.

If HR3 becomes law, it is lights out for a lot of very small biotech companies that are pre-revenue and depend on attracting capital, PhRMA CEO Stephen Ubl said at a recent media briefing.

Industry-specific concerns, of course, come against the backdrop of fears of a broader economic slowdown. Financial analysts have flagged recession signals in the U.S., which, if materialized, would further squeeze the industry.

It may be coming, in which capital itself is scarcer for companies, said Bob Eisenbach, a lawyer at Cooley specializing in bankruptcies. And when that happens, it puts pressure even on good companies.

Biopharmas are structured to avoid bankruptcies. Pre-revenue companies typically carry little debt and have little to restructure through a bankruptcy court if their pipeline fizzles.

Privately held biotechs that suffer clinical failures can also avoid bankruptcy by having their financial backers buy them out, saving face for those venture capitalists.

It just disappears into this great maw of the biotech universe, said Kevin Kinsella, a venture capitalist and founder of Avalon Ventures, referring to distressed biotechs in an interview.

Having launched more than 100 biopharmas, including prominent names like Vertex, Neurocrine and Onyx, Kinsella said hes been lucky enough to avoid getting entangled in any bankruptcies.

Someone absolutely failing, shutting the doors and turning off the lights, you dont really see that a lot in our industry, he said.

Drug companies, both young and old, derive value from ideas and hope more than tangible assets or resources. Just last year, early-stage platform companies like Moderna Therapeutics and Rubius Therapeutics went public with multi-billion dollar valuations despite lacking profits and significant clinical data.

But investor attitudes appear to have shifted. Rubius stock, for instance, has dropped more than 70% since its IPO. While up this month, shares in Moderna are 30% off their 52-week high in May.

Speaking generally about platform companies, Binds former CEO said market sentiment has turned.

Investors have lost their appetite for companies going public with preclinical data, Hirsch said.

Youre probably going to see more of these situations going forward, where a company is preclinical, went public and is left on their own and has to raise additional money from the public markets and they flounder.

Yet even floundering biotechs can persist for years, even decades. Long-standing industry veterans like Xoma, Novavax and Geron have survived in as-yet fruitless searches for their first drugs, suffering clinical failures along the way. Despite accumulated deficits exceeding $1 billion, these companies can find the necessary capital to keep chugging along.

Theres always someone else whos willing to bet the next discovery is around the corner, or the next asset, or if we get this clinical trial enrolled and finished, all will be good, Kinsella said. Theres always hope.

Besides selling hope, biopharmas, like all businesses, have practical options to stave off bankruptcy. Restructuring and raising cash are the main focuses, turnaround experts said.

Corporate restructurings typically shrink the business, either by laying off employees, selling assets or killing off R&D projects. Raising capital can include licensing rights to experimental therapies, taking on debt or tapping the public markets for secondary stock offerings.

If those options are exhausted, M&A can be another way out for shareholders. Firms like Deerfield Management, Hercules Capital and Highbridge Capital Management often aid distressed biotechs in such endeavours.

Deerfield, for instance, reached deals to finance R&D costs for Dynavax and helped fund Melinta Therapeutics acquisition of an infectious disease business.

A last resort can be merging with another struggling biotech, or becoming the shell in a reverse merger for another company seeking an easy path to a public listing.

Both happened in just the past few weeks. Foamix Pharmaceuticals and Menlo Therapeutics merged into one dermatology company, while NewLink Genetics was the shell through which Lumos Pharma joined public markets.

These strategies act as moats that insulate a high-risk industry from bankruptcy. In recent years, they have worked tremendously well. Among the 333 biopharmas that have gone public since 2012, just 3% filed for bankruptcy while 6% became reverse merger shells and 10% exited via M&A, according to data tracked by Evercore ISI.

But with 2019 looking shaky for biopharma, some have begun to wonder how markets will respond.

The last few years have featured record levels of capital raising, according to the investment bank Jefferies, which tallied 100 initial public offerings and 270 follow-on raises in 2018 and 2019 that drummed up tens of billions in cash.

At the same time, the number of public small and mid-sized biotechs has doubled in the past decade. There arent just more of these smaller firms; they also are worth more and consume more capital on average. From 2010 to present, these companies have seen their typical market values double, R&D budgets triple and cash burn rates quadruple, Jefferies found.

The annual burn rate for these biotechs, which includes market values from $200 million to $5 billion, has increased from $20 million to $80 million. Jefferies analyst Michael Yee credited that to free-flowing capital, more platform companies and an arms race in oncology.

Biotechs impressive market performance has made that possible. A leading biotech index, for instance, outperformed the S&P 500 by 30% since the market bottomed out in March 2009.

But of late, biotech has struggled, creating a tougher environment to raise cash.

The question is whether this is sustainable if market and macro conditions get tougher and political uncertainty gets more obvious, forcing companies to tighten their belts to ride out 2020, Yee wrote.

2019 has brought an uptick in industry bankruptcy filings

Credit: Data from Bankruptcy Data

Conditions have clearly worsened by some metrics, such as the amount of money invested in healthcare- or biotech-dedicated funds. Data tracked by a Piper Jaffray found $8.7 billion in investment has left such funds in 2019. Ten of the past 12 weeks have registered net capital outflows, a streak a Piper Jaffray analyst called seemingly the new normal.

Billions of dollars flowed out of biotech in 2015 and 2016, too, at a time when many biotech shares were falling and the prospect of a Hillary Clinton presidency had raised investor fears on drug pricing.

Biotech weathered that storm, with few companies entering bankruptcy, and has grown since. Going forward, a critical question will be gauging whether the sector is on a new trajectory or if it will emerge from this period relatively unscathed.

Getting investor attention is harder than ever to begin with, said Evercores Schimmer. For a company that has faltered, even if they are doing the right thing, its a struggle.

Continued here:

Bankrupt biopharmas are rare. 2019 has some worried that's changing. - BioPharma Dive