Category Archives: Alternative Medicine

Pfizer is voluntarily recalling some lots of its blood pressure pill Accuretic that have elevated levels of nitrosamine, an impurity that can increase the risk of cancer.

The company said in a statement that it is recalling six lots of brand-name Accuretic tablets with nitrosamine levels above the acceptable daily intake, along with several lots of generic versions of this blood pressure drug.

Everyone is exposed to some level of nitrosamines, which are found in water as well as foods including cured and grilled meats, dairy products, and vegetables, Pfizer said in its recall notice. Many medicines contain low levels of nitrosamines, and people can take them daily for decades without increasing their cancer risk.

But nitrosamine levels in the recalled medicines were high enough that daily pills might eventually raise users cancer risk.

These impurities may increase the risk of cancer if people are exposed to them above acceptable levels over long periods of time, Pfizer said.

Studies have linked nitrosamines to an increased rate ofdeath by certain cancers, including malignancies of the esophagus, oral cavity, and pharynx.

Pfizer said it is not aware of any adverse events associated with nitrosamine impurities in the recalled lots of Accuretic tablets.

There is no immediate risk to patients taking this medication, Pfizer said in its recall notice. Patients currently taking the products should consult with their doctor about alternative treatment options.

There are many reasons why nitrosamines might be found in prescription medicines, according to the U.S. Food and Drug Administration (FDA). Sometimes these impurities are present because of a drugs chemical structure, the way it's manufactured, or how its stored or packaged.

Nitrosamine impurities have previously been found in a wide range of medications, including blood pressure medicines known as angiotensin II receptor blockers (ARBs), the heartburn drugs ranitidine and nizatidine, and the diabetes drug metformin, according to the FDA.

When impurities are detected, companies are required to take steps to prevent distribution of medicines containing nitrosamine levels above the acceptable intake limit set by the FDA of 26.5 nanograms per day (ng/day). This can include voluntary recalls.

Pfizer has previously recalled lots of its smoking cessation drug Chantix because of high nitrosamine levels, according to the FDA. Sandoz Inc. issued a voluntary recall of its orphenadrine citrate extended release tablets, a treatment for pain from muscle spasms, the same day that Pfizer recalled Accuretic.

Patients taking brand-name or generic versions of Accuretic should consult with their doctor to determine if their medication is covered by the recall, Pfizer advised. People who suspect they have a recalled lot of this medicine can call 888-843-0247 during weekday business hours to get information on how to return the pills and get a refund.

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Pfizer Recalls Blood Pressure Drug That Contains Potential Carcinogen - Everyday Health

Sophomore Hannah Petersen when dressed for this years Valentines Day, she wears a pink dress with red hearts and neon pink eyeliner. She is one example of the way students break out of the traditional clothing expectation. Photos courtesy of Hannah Peterson

The walk across Mullin Town Square or to class can evolve into a catwalk, inspired by a multitude of subcultures ranging from Y2K to goth and everything in between.

Many students said they believe college allows them the chance to experiment away from the expectations of parents and the environments they grew up in. One of the many ways Pepperdine students experiment is with uniquely curated outfits, precise colorful eyeliner and bright hair colors.

The environment I grew up in was very conservative, sophomore Hannah Petersen said. Both at school and at home, they allowed self expression as long as it agreed with what they thought. So after exiting high school and entering college, it was like, Wow, theres so much freedom. I dont have to answer questions about why I choose certain colors, patterns or levels of midriff showing.

Petersen, who has always experimented with her makeup and style of dress, said college finally gave her the excuse to dress and look how she wanted. While she doesnt identify with any particular subculture, she said she is very inspired by TikTok and makeup influencers. Her style uses a lot of bright colors, patterns and fun eyeliner that matches the colors of her clothes.

Petersen said it can sometimes be hard to dress non-traditionally. Despite the support she receives from her roommates and friends, Petersen said many people treat her differently because of her style of dress.

There is a very popular demographic within Pepperdine, if you dont necessarily fall into it, it can be really hard to find acceptance, Petersen said. If I do my makeup darker and heavier I tend to get less receptive responses. But if I do something more colorful, experimental or feminine I get a lot of compliments, but it really does depend who I talk and interact with.

As a feminine person studying Sports Medicine and planning to attend medical school, Petersen said a lot of people are surprised by the way she dresses. A big struggle from this year has been learning how to express herself and feel good about herself, while also presenting as professional and being accepted by her department.

Junior Anna Skupin identifies as goth and also plans on going to medical school after undergrad.

She also agreed with Petersens struggle with femininity and professionalism.

Dressing feminine in STEM is just this whole big thing, Skupin said. Youre expected to keep your head down, focus on your work and if you have any personal style youre out the window, you and your work arent valid.

Skupins experience in alternative fashion has been very different than Petersens. She said she always gravitated toward darker aesthetics. It wasnt until she was doing classes remotely and seeing the rise of alternative styles like the E-Girl and gothic-inspired outfits on both TikTok and her friends that she decided to embrace the style fully.

Skupin said her experience at Pepperdine has felt accepting of her fashion choices, but she also cites that her decision to study Psychology as being the main reason for that.

Nobodys gonna make fun of you in the field of psychology, Skupin said. When you dress differently, you do stand out here because so many people wear just jeans and a T-shirt. But I think people appreciate the variety.

Both students offered similar advice to others interested in experimenting with their fashion. They suggested starting small with one piece of clothing and seeing how it makes them feel and how the people around them react. If the reactions and feelings are positive, continue to add pieces that nurture those feelings.

Additionally, both Petersen and Skupin encouraged people to be themselves and dress however they want.

More variety in clothes and alternative fashion styles is good for everyone. Skupin said. You can be free to finally express yourself the way you want to and wear things that are flattering and make you feel comfortable and confident. Just go for it, dont be afraid to buy alternative clothes you like because you might end up discovering something new to incorporate in your daily style.

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Email Hope Lockwood: hope.lockwood@pepperdine.edu

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Students Get Creative With Alternative Fashion Trends - Graphic

According to the World Health Organization, tuberculosis or TB remains one of the worlds deadliest infectious killers as each day, over 4,100 people lose their lives to it and close to 28,000 people fall ill with this preventable and curable disease. It is the 13th leading cause of death and the second leading infectious killer after Covid-19 (above HIV/AIDS) and is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.

About one-quarter of the world's population has a TB infection, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit it. In an interview with HT Lifestyle, Dr Rohini Kelkar, Senior Consultant Infectious Diseases and Clinical Microbiology at Metropolis Healthcare Ltd. revealed, Since the discovery of Streptomycin, in 1943 for the treatment of tuberculosis, several new drugs have been added to the medicinal armamentarium. The philosophy and science for better patient outcomes is based on early diagnosis and accurate identification of the drugs that are most effective for individual patients.

She added, "This is achieved through conventional culture techniques and drug susceptibility tests which are time-consuming; or sophisticated molecular and rapid laboratory tests that identify the genes/mutations that contribute to drug resistance. Multi-drug therapy based on laboratory results of "next-generation sequencing" with standard protocols and drug dosages, under the supervision of medical specialists, is the best way forward to support the " End TB campaign"."

Dr Deepak Mittal, Founder of Divine Soul Yoga, shared, Despite the availability of an antibiotic regimen, TB has been an India-specific burden due to our huge below-the-poverty-line population. With the emergence of multi-drug-resistant TB, an increasing need has been felt to find adjuvant therapies and herbal remedies that can aid patient recovery and contain the toxic effects of chemical-based drugs. Therefore, by investing time in practicing specific alternative therapies and thus in a healthy lifestyle, it can be more easily avoided than it can be treated."

Medicinal and alternative therapies to treat TB:

Asserting that it is only through a strong immune system that one can avoid getting sick even if the body harbours the TB bacteria, Dr Deepak Mittal said, People with a weak immune system are at increased risk of getting infected with TB. The alternative therapies like Yoga, Meditation, Pranayama, healthy diet play an important role in boosting immunity and strengthening the body and defences against viruses and bacteria and act as a preventive bulwark against Tuberculosis. These practices clear the respiratory passages, minimising risks of infections and allergies in the respiratory system which improves the lung function.

According to him, alternative therapy cannot cure TB but it can definitely prevent it. He stressed, "With preventative treatments and AYUSH protocols integrated, hopefully, the over-burdened Indian health care system can breathe a sigh of relief. There is a need for more awareness, training as well as cross talks between modern medical clinicians and alternative medicine practitioners. The situation also needs reforms in medical education and regulation.

Referring to a study published in Respirology, Dr Babina NM, Chief Medical Officer at Jindal Naturecure Institute, shared, Yoga has a complementary role in TB management. It combats the disease by opening-up the chest and maximizing the intake of oxygen through deep inhalation. The ancient practice also supports and strengthens the immune system, besides reducing stress, a major reason for a weak immune system. While there are various medications and treatments available for tuberculosis, the cogency of such treatments can be enhanced to a great extent by the use of yoga and naturopathy.

She highlighted that unfortunately, drug resistance is intensifying in people each passing day and that there is an urgent need to start capitalising on the best therapies from all orientations to combat tuberculosis in a robust way. Dr Babina NM advised, Some of the yogic poses to practice for those suffering from tuberculosis are: Kapalbhati Pranayama, Trikonasana, Bhujangasana. These asanas improve the function of the immune system and strengthen liver function. In addition to all this, a proper diet, fresh air, exercise, sunshine and the right mental attitude, all play their part in keeping the body and mind fit. Sunflower seeds, nuts, chia seeds, pumpkin seeds and flaxseeds are great sources of zinc. They provide the body with large amounts of nutrients to fight against diseases like TB. Crushed black pepper, mint, garlic can help in the treatment of TB.

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Tuberculosis: Medicinal and alternative therapies to treat TB - Hindustan Times

Complementary and Alternative Medicine Market research added by the Absolute Markets Insights, offers a comprehensive analysis of growth trends prevailing in the global business domain. This report also provides definitive data concerning market, size, commercialization aspects and revenue forecast of the industry. In addition, the study explicitly highlights the competitive status of key players within the projection timeline while focusing on their portfolio and regional expansion endeavors.

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Brazil complementary and alternative medicines was valued at US$ 2,498.24 million in 2022 and is expected to reach US$ 9,759.38 million by 2030, growing at an estimated CAGR of 16.4% over the forecast period.

Global Complementary and Alternative Medicine Market is expected to develop at a substantial CAGR in the coming years. The report also encloses the crucial aspects connected with the recent events such as new product launches, mergers & acquisitions, and alliances. It proclaims the addition of another new dimension to this industry explaining the performance of the major players. The market has also been segmented on the basis of the provincial players, out of which some are well established while some have newly entered the global market.

The Prominent/Emerging Players in The Complementary and Alternative Medicine Market Research Include:

Optum, Inc., Ach, Quantum-Touch, and Herboflora.

Brazil Complementary and Alternative Medicines Market:

Worldwide Complementary and Alternative Medicine Market Analysis to 2030 is a specialized study of the Complementary and Alternative Medicine industry with a focus on the global market trend. The report aims to provide an overview of global Complementary and Alternative Medicine market with detailed market segmentation by product & services /application and geography. The global Complementary and Alternative Medicine market is expected to witness high growth during the forecast period. The report provides key statistics on the market status of the Complementary and Alternative Medicine players and offers key trends and opportunities in the market.

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Regional Analysis covered in the Report are:

The Structure of The Complementary and Alternative Medicine Market Report Can Be Categorized into the Following Sections:

Section 1: Scope of the Report & Research Methodology

Section 2: Key Takeaways

Section 3: Market variables & their impact on growth and analytical tools providing High-Level Insights into the Market Dynamics and Growth Pattern

Section 4: Market Estimates and Forecasts (with the base year as 2020, historic information of 2015 & 2019 and forecast from 2022 to 2030). Regional and Country Level Estimates and Forecasts for each category are summed up to form the Global Market.

Section 5: Competitive Landscape. Attributes such as Strategy Framework, Competitor Categorization are included to provide elaborate details on the Market Structure & Strategic Undertakings as well as their impact.

The Complementary and Alternative Medicine Market Company Profiles are individually represented for all major participants and indices such as Financial Performance, Strategic Initiatives, Product Portfolio & Company Overview.

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Massive Growth of Global Complementary and Alternative Medicine Market by 2030| Optum, Inc., Ach, Quantum-Touch, and Herboflora - Digital Journal

Suzhen Chen,1,2 Zhi Xu,1,2 Yinghui Li,1,2 Tianyu Wang,1,2 Yingying Yue,1,2 Zhenghua Hou,1,2 Linlin You,1,2 Na Lu,1,2 Yingying Yin,1,2 Xiaoyun Liu,1,2 Liangliang Tan,1,2 Houcheng Ji,3 Yaoran Shi,1,2 Xiaoyun Xin,1,2 Wenhao Jiang,1,2 Yonggui Yuan1,2

1Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Peoples Republic of China; 2Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, Peoples Republic of China; 3Department of Psychiatry, The Second Peoples Hospital of Jiangning District, Nanjing, Peoples Republic of China

Correspondence: Yonggui Yuan, Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, Peoples Republic of China, Tel +86-25-83285124, Email [emailprotected]

Purpose: Shumian capsule (SMC) is a patent Chinese herbal medicine that can soothe the liver and relieves depression, quiet the spirit. Here, we aimed to investigate the efficacy of SMC for treating insomnia using both scales and polysomnography (PSG).Patients and Methods: A randomized, double-blind, placebo-controlled trial was performed. Twenty-six insomnia patients randomly received SMC (n = 11) or placebo (n = 15) for four weeks. Pittsburgh Sleep Quality Inventory (PSQI), Insomnia Severity Index (ISI), 9-items Patient Health Questionnaire (PHQ-9), 7-items Generalized Anxiety Disorder (GAD-7), 17-item Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Rating Scale (HAMA) were applied at the baseline and the 2nd, 4th week after treatment. Treatment Emergent Symptom Scale was used to assess adverse reactions. We used PSG to record and analyze sleep features at baseline and after four weeks.Results: PSQI, ISI, PHQ-9, HAMD-17, and HAMA scores decreased significantly after SMC treatment. Also, the total sleep time, rapid-eye-movement (REM) sleep latency, stage 2 sleep, deep sleep, REM sleep, and sleep efficiency improved significantly after SMC treatment. In the placebo group, the only significant change was the decrease of PHQ-9 at week-2. Furthermore, both SMC and placebo reported no adverse events.Conclusion: SMC could safely improve sleep quality with depression and anxiety remission in insomnia patients.

Keywords: Chinese herbal medicine, shumian capsule, insomnia, polysomnography, clinical trial, randomized and double-blind method

Insomnia is a widespread sleep disorder that can lead someone with sufficient sleep time hard to fall asleep, frequent awakening, waking up too early, and falling asleep again hard after waking up. According to a report of JAMA, the prevalence of insomnia disorder is nearly 10% to 20%, of which about 50% have a chronic course, which further affects their mood, social functioning, and quality of life.1,2 Consistent with this, a survey from the Chinese Ministry of Health also shows that the insomnia rate is as high as 10% to 20%, and the insomnia people in China have reached 1.2 million to 1.4 million person-time.3

Insomnia is a risk factor for functional impairments, other medical and mental disorders development, and healthcare costs increasing.1 Insomnia can increase the risk of depression and anxiety.46 Baglioni et al7 pointed out that non-depressed people with insomnia have a twofold risk of developing depression compared to people with no sleep difficulties. Also, insomnia can predict suicidality and substance use.8,9 In addition, a study found that 40% of insomnia patients have a combined mental disorder,10 while 40% of patients with depression, anxiety, and comorbidity reported insomnia;11 and the effective treatment of insomnia in patients with depression would positively affect mood.12 Except for mental disorders, insomnia is also an independent risk factor for acute myocardial infarction,13 coronary heart disease,14 heart failure,15 hypertension,16 and diabetes.17 Therefore, insomnia has become a worldwide public health problem and a main induced cause of various diseases.

Cognitive behavioral therapy (CBT) and pharmacotherapy are effective treatments for insomnia.18 CBT is strongly recommended as the first choice for the few side effects, and it is cost-effective.19 However, it also has inevitable limitations, including a shortage of trained therapists and a relatively low response rate.20 Two-thirds of insomniacs might fail to reach full remission after CBT, and 1926% even have no response.21 Moreover, the efficacy of CBT highly depends on patients commitment and self-efficacy,22 suggesting that CBT is not suitable for everyone. That is, in some cases, CBT may not be a compelling enough treatment to improve insomnia nor suitable for widespread use. Instead, benzodiazepines have become the first treatment choice over the past three decades and are widely used for insomnia because of their quick onset and apparent effects. However, their use has been limited currently due to drug resistance, dependence, hangover effect, psychomotor impairment, cognitive impairment, withdrawal reaction, and many other adverse reactions. Thus, a new treatment with fewer side effects and a higher benefit ratio is needed for insomnia.

Chinese herbal medicine (CHM) originated in ancient China and has treated insomnia for thousands of years. Currently, CHM is recognized as good treatment effect, fewer side effects,23,24 and alternative medication choice.25 With the continuous improvement of CHM dosage forms and technical levels, many CMH patents are widely used in clinical practice. Shumian capsule (SMC) is a common CHM for treating insomnia whose effectiveness has been demonstrated by several randomized controlled clinical trials (RCT).26 However, all these studies included only scales to assess insomnia and treatment effects. None of the RCT in the SMC used polysomnography (PSG) to assess subjects sleeping features, though PSG is considered the gold standard for detecting sleep-related disorders and evaluation.27,28 Therefore, this study aimed to evaluate the clinical efficacy of SMC for treating insomnia using both scales and PSG to measure sleep improvement.

This clinical study was a randomized, double-blind, placebo-controlled trial, and the double-blind treatment lasted for four weeks and was conducted between June 2019 and May 2021 in the Affiliated ZhongDa Hospital of Southeast University, Nanjing, China. The trial used the two-group parallel design. Patients who met the inclusion and exclusion criteria were planned to randomly assign 1:1 to either the SMC group or placebo group to receive the corresponding treatment for a total of four weeks. The patients would receive SMC or placebo capsules immediately according to the randomization schedule as soon as they were recruited. Unfortunately, however, we had to stop the study early because of the coronavirus disease 2019 (COVID-19), and only 26 insomnia patients were recruited at the end, among whom were 11 patients in the SMC group and 15 patients in the placebo group. Patients subjective sleep and mood changes were assessed using the scales at baseline and 2- and 4-week after treatment. Meanwhile, objective sleep was measured using the PSG test at baseline and 4-weeks after treatment. According to the Helsinki Declaration, all the participants were given a detailed description of the study and then written informed consent was obtained. The Ethical Committee of the Affiliated ZhongDa Hospital of Southeast University approved the protocol of this study (Approved number: 2019ZDSYLL054-P01), and the study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1900024117).

Subjects were from insomniacs who came to ZhongDa hospital because of insomnia or were recruited through recruitment advertisements, and they also met the following inclusion criteria: (1) aged between 1865 years old; (2) the diagnosis of insomnia according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); (3) Pittsburgh Sleep Quality Inventory (PSQI) 8 and 17-item Hamilton Depression Rating Scale (HAMD-17) < 17 and Hamilton Anxiety Rating Scale (HAMA) < 14; (4) had no other serious systemic complications; (5) have not taken any medication that may affect sleep before the trial for two months; (6) must sign the written informed consent before the trial. The exclusion criteria were as follows: (1) secondary insomnia (caused by or co-morbid with moderate depression or anxiety or acute stressful events et al) and other sleep disorder such as sleep apnea syndrome; (2) pregnant or lactating women; (3) a history of alcohol or drug dependence or abuse; (4) serious physical diseases such as malignant tumors, severe abnormal heart, liver or renal function; (5) had been taken antidepressants, anti-anxiety or hypnotic medications; (6) allergic to any component of SMC.

According to a random number table, all enrolled subjects received either SMC or identical placebo capsules randomly for four weeks treatment and were required back to the hospital every two weeks for evaluation. All patients were instructed to take three capsules respective after supper and one hour before going to bed. The 4-week dose of SMC or placebo capsules were distributed to patients in two separate rounds, one on the day of enrollment and one at the end of two weeks treatment, by other personnel not participating in the patients enrollment and evaluation. SMC and shumian simulation capsules that are provided by Guizhou Dalong Pharmaceutical Co. Ltd.; batch numbers are 20190307 and 20190308, respectively. Shumian simulation capsule contains the same color but nonpharmacological brown powder as SMC. In addition, any drugs (including herb medicine), health care products, foods or drinks that may cause hypnotic or insomnia effects were not allowed to use during the treatment.

The PSQI,29 the Insomnia Severity Index (ISI),30 the 9-items Patient Health Questionnaire (PHQ-9),31 and the 7-items Generalized Anxiety Disorder (GAD-7)32 were self-rating scales, and the first two scales were employed to assess the patients severity of insomnia while the last two were applied to respectively evaluate the severity of depression and anxiety. While the HAMD-1733 and Hamilton Anxiety Rating Scale (HAMA)34 were used for researchers to assess the patients severity of depression and anxiety, respectively, the Treatment Emergent Symptom Scale (TESS)35 was used to assess treatment safety. All these scales were administered at baseline and 2- and 4-weeks after beginning treatment.

All the insomnia patients underwent overnight PSG (580-G2CGSS, Bio-Logic, USA), and the recordings were analyzed according to the American Academy of Sleep Medicine (AASM) criteria.36 The main PSG monitoring measurements included the sleep latency, the sleep efficiency, the sleep maintenance efficiency, the rapid-eye-movement (REM) sleep latency, the total sleep time, and the time of each sleep stage (stage 1 and 2 sleep, deep sleep and REM sleep). The PSG monitoring was performed twice at baseline and four weeks after treatment for each subject, and every monitoring time must be no less than eight hours.

All data were analyzed by SPSS 22.0 (IBM, Armonk, NY, USA). Data were examined for normality using the KolmogorovSmirnov test. As applicable, the numerical variables were described as mean standard error (M SE) or median (interquartile range). Independent-samples t-test and MannWhitney U-test were used to compare the normally distributed and nonnormally distributed data between the SMC and placebo groups. At the same time, the paired-sample t-test was applied to compare the numerical data within the group. Categorical variables were expressed as numbers and were compared by chi-square (x2) between the two groups. Differences were considered statistically significant at a two-tailed P < 0.05.

A total of 26 insomnia patients were finally included in the study, among whom 11 patients were assigned to the SMC group and 15 patients to the placebo group; the detailed flow was described in Figure 1. One patient in the SMC group and two patients in the placebo group dropped out for lacking efficacy after two weeks of treatment, and the dropout rates were not significantly different between the two groups (9.09% vs 13.33%, P = 0.369). There were respective another two (both were due to self-withdrawal) and two (one for self-withdrawal, the other for protocol violation) patients in the SMC and placebo groups who dropped out after four weeks of treatment, and the difference of the dropout rate was also not significant (27.27% vs 26.67%, P = 0.973). Ultimately, eight patients in the SMC group and 11 in the placebo groups completed all three-time assessments and two PSG monitoring sessions, among whom the efficacy analysis was performed.

Figure 1 Flow diagram of the progress through the phases of a parallel randomized trial of two groups (that is, enrolment, intervention allocation, follow-up, and data analysis).

The baseline demographic and clinical data of all enrolled subjects are shown in Table 1. There were no significant differences between the two groups in terms of sex, age, education years, marital status, age of onset, insomnia duration, family history of insomnia or other mental disorders, scores of various scales including PSQI, ISI, PHQ-9, GAD-7, HAMD-17 and HAMA, and the PSG-related indicators including the sleep latency, sleep efficiency, REM sleep latency, total sleep time, and time of stage 1 and 2 sleep, deep sleep, and REM sleep (P > 0.05). However, the sleep maintenance efficiency of patients in the placebo group was found significantly better than that of patients in the SMC group (P = 0.002).

Table 1 Baseline Clinical Data of Study Subjects

As presented in Figure 2 and Table 2, the PSQI scores in the SMC group were significantly decreased after 2- and 4-weeks treatment (P < 0.001 and P = 0.040, respectively), while the ISI scores were only significantly decreased after 2-weeks treatment (P = 0.002). However, within the placebo group, whether the scores of PSQI and ISI after 2 weeks or 4 weeks treatment, there were both no statistical differences compared with the scores at baseline (P > 0.05).

Table 2 The Scores of Various Scales of Pre- and Post-Treatment in the Shumian Capsule Group and the Placebo Capsule Group

Figure 2 The scores of (A) PSQI and (B) ISI in the shumian group and the placebo group pre- and post-treatment.

Abbreviations: PSQI, Pittsburgh Sleep Quality Inventory; ISI, Insomnia Severity Index.

After treatment for 4-weeks, none of the PSG indicators was significantly changed in the placebo group (Figure 3 and Table 3; all P > 0.05). As expected, however, several PSG indicators in the SMC group improved significantly. Specifically, the total sleep time, stage 2 sleep time, deep sleep time, REM sleep time, and sleep efficiency were significantly increased (P < 0.05), while REM sleep latency was significantly shortened (P = 0.021), as shown in Figure 3 and Table 3.

Table 3 The PSG Indicators of Pre- and Post-Treatment in the Shumian Capsule Group and the Placebo Group

Figure 3 The PSG indicators in the shumian group and the placebo group pre- and post-treatment. The PSG indicators are respective (A) Total sleep time. (B) Sleep latency. (C) REM sleep latency. (D) Stage 1 sleep time. (E) Stage 2 sleep time. (F) Deep sleep time. (G) REM sleep time. (H) Sleep efficiency. (I) Sleep maintenance efficiency.

Abbreviations: PSG, polysomnography; REM, rapid-eye-movement.

Figure 4 and Table 2 displayed the changes of various scales related to the mood of patients in the SMC group and the placebo group. The scores of PHQ-9, HAMD-17, and HAMA in the SMC group were significantly decreased both after 2- and 4-week of treatment (P < 0.05). However, in the placebo group, only PHQ-9 scores declined at the end of week-2 compared with the scores at baseline (P = 0.046). The scores of GAD-7 in both the SMC and the placebo groups were not changed significantly after 2 weeks and 4 weeks treatment (all P > 0.05).

Figure 4 The scores of (A) PHQ-9, (B) GAD-7, (C) HAMD-17, and (D) HAMA in the shumian group and the placebo group pre- and post-treatment.

Abbreviations: PHQ-9, 9-items Patient Health Questionnaire; GAD-7, 7-items Generalized Anxiety Disorder; HAMD-17, 17-item Hamilton Depression Rating Scale; HAMA, Hamilton Anxiety Rating Scale.

No adverse events were reported during the study period in either the SMC or placebo groups. In addition, among seven patients who dropped out of the study, none of them were due to adverse events.

To our knowledge, this is the first randomized, double-blind, placebo-controlled trial using PSG to explore the efficacy of SMC in adult insomnia. In the present study, SMC exhibited better treatment efficacy than placebo after four weeks, and it significantly improved sleep structure. Notably, SMC also improved patients mood compared with baseline.

The observed treatment effects on insomnia might connect to the herbal formula of SMC. It is formulated from Semen Ziziphi Spinosae, Radix Bupleuri, Radix Paeoniae Alba, Flos Albiziae, Cortex Albiziae, Bombyx Batryticatus, Periostracum Cicadae, and Medulla Junci.37 The whole formula was believed to soothe the liver, relieve depression, and quiet the heart.37 The recent study reported that SMC might improve insomnia by increasing -aminobutyric acid levels, decreasing glutamate levels in the brain, and up-regulating the hippocampal 5-hydroxytryptamine 1A receptors protein expression.38 Among all the compounds, Semen Ziziphi Spinosae and Radix Bupleuri were the main ingredients to improve sleep.39,40 Importantly, the Guideline for the evaluation and treatment of insomnia in Chinese adults (2017) pointed out that the essential goals of insomnia treatment should improve sleep quality and structure and avoid adverse effects.41 The PSG showed that the total sleep, REM sleep latency, stage 2 sleep, deep sleep, REM sleep, and sleep efficiency were significantly improved after 4-weeks of treatment in the SMC group. In addition, we did not record any adverse events. In summary, as CHM, SMC might be a safe choice in addition to current benzodiazepines, which might lead to tolerance and addiction,41 changes in sleep structure, and declines in sleep quality.42

Besides sleep improvement, the present study found significantly decreased PHQ-9, HAMD-17, and HAMA in the SMC group compared with the placebo group after treatment. It indicated that SMC could improve insomnia patients depressive and anxious moods. The result of a recent study that focused on sleep and mood disorders caused by the COVID-19 also supported our findings, and this study reported that SMC significantly improved depression and anxiety of patients with COVID-19 during the recovery phase.43 Also, the findings were consistent with a variety of previous clinical studies.4447 The mechanism of mood symptoms improvements might be related to the Semen Ziziphi Spinosae, Radix Bupleuri, and Bombyx Batryticatus. These compounds were rich in tryptophan, which was the precursor of serotonin.48,49 It might indicate that SMC improved serotonin deficiency and balanced the levels of neurotransmitters, then restored patients autonomous sleep with better quality, and improved depression and anxiety simultaneously.37,48,49

The strengths of this study were: (1) We used the scales to assess patients subjective feelings and applied PSG to evaluate patients actual sleep changes pre-and post-treatment, which was helpful for a more comprehensive evaluation of the efficacy of SMC. (2) SMC or placebo monotherapy was administered randomly with a double-blind method, which could help avoid the effects of sleep-affecting medicine and the subjectivity of the informed evaluators. (3) Only patients with insomnia were enrolled in the present study, which could help ensure more accurate evaluations of efficacy for SMC within a single diagnosis.

However, the strict inclusion criteria and trial requirements resulted in a relatively small sample size. Also, due to the small sample size, we were unable to explore gender differences on the indicators of PSG between male and female insomnia patients, although most researchers state that females are more prone to insomnia than males. In addition, there is a lack of follow-up after withdrawal, making it impossible to know whether the effects of SMC can continue after withdrawal. In the future, repeating the study in a larger sample, dividing patients into different gender groups, and adding a follow-up after drug withdrawal will be very useful for confirming the preliminary findings and whether gender plays an important role in insomnia.

In conclusion, SMC could improve insomnia after four weeks treatment, which was reflected in the subjective scales and the objective sleep indicators, especially in increasing the total sleep and deep sleep time and sleep efficiency. Furthermore, depression and anxiety were also significantly improved after treatment with SMC. During the four-week study period, the patients were well-tolerated in both SMC and placebo groups. Briefly, the present study demonstrated that SMC could improve subjective and objective sleep and the accompanying depression and anxiety symptoms of insomnia patients with low side effects. Future studies should focus on further evaluating the efficacy and safety of SMC in improving insomnia and its concomitant symptoms such as depression and anxiety in a large sample of insomnia patients.

The data and material supporting the results of this article are included within the article.

We thank all the people who participated in the study, and we thank Guizhou Dalong Pharmaceutical Co. Ltd. for providing shumian capsules and placebo capsules for free.

Yuan Y was the principal investigator, designed the study protocol, and was involved in the recruitment of subjects and the revise of the manuscript. Chen S collected the samples of the subjects, performed the experiment, analyzed the statistical analysis, and wrote the manuscript. Xu Z, Li Y, Wang T, Yue Y, Hou Z, You L, Lu N, Yin Y, Liu X, Ji H, and Shi Y collected the samples from the subjects. Tan L and Xin X were involved in the experiment. Jiang W revised the manuscript. All authors contributed to data analysis, drafting, or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

The study was funded by Guizhou Dalong Pharmaceutical Co. Ltd. However, the funder had no role in the study design, data collection, analysis, and interpretation, in writing the report, or in the decision to submit the article for publication. The authors report no other conflicts of interest in this work.

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Efficacy and safety of the Chinese herbal medicine | NDT - Dove Medical Press

COMMENTARY

As the most recent wave of COVID-19 recedes, we can begin to learn from the example of vaccine avoidance how to help frightened, grieving, and misinformed patients who are vulnerable to hyperfocus on rare risks as a form of helplessness avoidance. Integrating specialty expertise via conversationfor example, between infectious disease specialists and psychodynamically informed psychiatristscan help vulnerable patients become immunized against vaccine avoidance driven by fear and helplessness. Integrating expertise across specialties can also help us communicate effectively when participating in media-enabled public health education.

For example, the widespread alarm over news about the occurrence of blood clots in a tiny percentage of individuals who have received the Johnson & Johnson COVID-19 vaccine1 provides a useful, if troubling, lesson about how wishful thinking undermines rational choice.Wishful thinking, including magical thinking such as perfectionism compounded by hindsight and our understandable wish for certainty to avoid mortal danger at any cost, has created unintended mortal risks of its own.2

It is wishful thinking to insist that any medical remedy be free of side effects or a magic bullet with 100% effectiveness. In clinical practice, we regularly inform patients of substantial side effects, the benefit/risk ratios, and available alternative treatments. When new data emerge, the benefit/risk ratio may change, and patients should be so informed. That is very different from the governments pause of the use of the Johnson & Johnson vaccine for patients of all ages, irrespective of their vulnerability to side effects, the potential benefits, and what alternatives were practically available. This blanket measure, intended to reassure the public, had the opposite effect.A where there is smoke, there is fire response cascaded through the Internet and clouded both the benefit/risk ratio for the Johnson & Johnson vaccine and its efficacy relative to the other available vaccines in preventing COVID-19 morbidity and mortality. This is in the United States, where approximately a million people have died of COVID-19 in a population of 330 million,3 a death rate of about 1 in 330 (the risk for any individual varies by age and other factors).

Rationally, we should welcome any vaccine that dramatically reduces this risk.Yet in fast-moving cyberspace, our tunnel-vision focus on a newly reported, frightening yet isolated cluster of cases is likely to outrun daily reports of the all too familiar, and thus normalized, larger number of no less tragic deaths from COVID-19. Contrast this reaction with risk levels that individuals ordinarily accept, such as having children in the face of thealasstill present risk of maternal mortality.4

This situation has many other analogues in medicine.For instance, some of us, when we are patients, worry about Guillain-Barr syndrome after influenza immunization, even though the risk of Guillain-Barr is much higher after infection with influenza than after immunization.5 Ideally, such comparisons of risks and benefits should be simple and straightforward to make.Why, then, when it comes to threats to our health, are they not?When we are frightened that our survival is somehow at stake, powerful feelings distort our reasoning to avoid feeling helpless.

When we feel in danger, we simplify.We tend to pay more attention to information that is recent or more readily available. The newly reported risk of a tragic yet rare side effect potentially related to vaccination all too often obscures the greater risks, both long- and short-term, of the ravages of the COVID-19 pandemic.Once we fixate on what is new and potentially dangerous, it tends to remain on our mental radar screen, regardless of data to the contrary.Moreover, individuals can all too easily avoid potential risks of vaccination by not being vaccinated, whereas even with masks and other precautions, we feel far greater helplessness relative to avoiding the risks of COVID-19.To avoid feeling helpless, it is easier and thus all too convenient to focus on easily avoidable yet low vaccination risks than on the far less easily avoidable yet high COVID-19 risks.In addition, we tend to feel greater shame when we do something that turns out badly than when we do not do something and it turns out badly. Thus, deaths due to inaction (not getting vaccinated) seem less frightening than deaths due to action (getting vaccinated).

Especially in the midst of fear and tragedy, we want to avoid helplessness at any cost, which makes us susceptible to wishful thinking and fantasies of omnipotence and the perfection of 20-20 hindsight.That susceptibility is compounded by internet transmission of misinformation and fear-mongering. It is no news that bad news beats good news in the marketplace of attention.Moreover, misleading reductionism typically carries the day (the curse of the sound bite).Now, on the small screens of mobile phones, we too often read the screaming headlines without getting to potentially reassuring qualifiers in the body of an article.Asking avoidant patients what information they have, where they get their information, and what it means to them is vital. In the same vein, asking about any individual or family history of adverse interactions with medications or the medical system may be helpful.

To be effective, public education about risk assessment must recognize this emotional component of our mental functioning. For the informed consent process of vaccination to be meaningful and effective, it helps to recognize the way fear in the midst of a pandemic intoxicates sober cognition with perfectionism and magical thinking.Therefore, when we communicate about newly emergent questions as to vaccination-related side effects, it will also help to keep in mind that our own public and social media communication may have side effects far greater than the vaccine side effects we seek to reduce.

Dr Bittner is a faculty member at Creighton University School of Medicine, and an infectious diseases physician who practices in Omaha, Nebraska, locale of one of the first cases of the suspected Johnson & Johnson COVID-19 vaccine-related blood clots.Dr Bursztajn is a faculty member at Harvard Medical School, and a practicing psychiatrist in Cambridge, Massachusetts, with a longstanding interest in decision-making under conditions of trauma and uncertainty.

References

1.Oliver SE, Wallace M, See I, et al. Use of the Janssen (Johnson & Johnson) COVID-19 vaccine: updated interim recommendations from the Advisory Committee on Immunization Practices - United States, December 2021. MMWR Morb Mortal Wkly Rep. 2022;71(3):90-95.

2. Bursztajn HJ, Feinbloom RI, Hamm RM, Brodsky A. Medical Choices, Medical Chances: How Patients, Families, and Physicians Can Cope With Uncertainty. Routledge; 1990.

3. Coronavirus in the U.S.: Latest map and case count. New York Times. Accessed March 4, 2022.

4. Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022. Accessed March 4, 2022.

5. Vellozzi C, Iqbal S, Broder K. Guillain-Barre syndrome, influenza, and influenza vaccination: the epidemiologic evidence.Clin Infect Dis. 2014;58(8):1149-1155.

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Vaccination Avoidance as Risk Avoidance Driven by Fear and Helplessness - Psychiatric Times

Cavalry Audio, the podcast division of Cavalry Media, announced today it will premiere its new limited series podcast, The Awakened Underground with filmmaker Cody Blue as its host. The investigative talk show is comprised of 10 episodes and will explore the ancient art of healing yourself with shamanic plant medicines and psychedelics.

On the podcast, Blue will sit with experts in the field of psychedelic medicines including shamans, scientists, doctors, athletes, and celebrities who have healed themselves with psychedelics to explore the ancient healing techniques in a way that the western mind can consume. Blue will draw from his own personal experiences, having healed a variety of issues through psychedelic plant medicines including depression, anxiety, ADHD, using the alternative medicine techniques.

Whether youre someone who is already on this path to healing or its your first time hearing about it, Im looking forwarding to broadening the minds of all our listeners, said Blue. As someone who struggled with the many side effects of traditional pharmaceutical medications, my hope is this show will lead people to better understand the benefits of shamanic plant medicines and psychedelics as well as question the real motives behind the traditional medications being pushed by major pharmaceutical companies.

Blue is the son of Twisted Sister front man Dee Snider and Calvary Audio says the podcast will become a family affair when Blue welcomes his famously straight edge dad onto the podcast to try and convince him to use this new path to healing. Both Blues mom, Suzette Snider, who is also straight edge and his younger sister Shy, a fashion influencer, will be on the first episode to talk about how they were able to heal various maladies with psychedelic medicines. The Snider family had previously been the subject of the A&E reality show Growing Up Twisted and most recently featured on Celebrity Family Feud in 2021.

The Awakened Underground series premieres Tuesday (March 29) with the release of its first three episodes. The podcast is directed by Tanya Dahl, produced by Blue and Cavalrys Jeff Apple with company principals Dana Brunetti and Keegan Rosenberger serving as Executive Producers, and is distributed by the iHeartPodcast Network.

The podcast is the latest in the line of successful releases from Cavalry Audio, including the recent releases The Pink Moon Murders and The Shadow Girls. Cavalry Audio podcasts have collectively achieved more than 22 million downloads yearly.

Cody Blue is repped by Verve and Circle of Confusion.

Continue reading here:

Cody Blue And The Snider Family Return To Media Spotlight. This Time In A Podcast. - Inside Radio

The internet is full of health advice, alternative medicine suggestions and well-being fads (have you seen the latest TikTok trends?). And recently, fulvic acid has been making the social media rounds as a healthy supplement. But as with every wellness trend, caution should be taken before diving in.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

According to Functional Medicine Medical Director Elizabeth Bradley, MD, there are promising signs that fulvic acid could be beneficial for people who have diabetes, Alzheimers disease and inflammatory issues. But there isnt enough research yet to conclusively say its safe or truly beneficial. Heres a breakdown of what we do know.

Fulvic acid is a chemical compound thats formed when microorganisms in soil break down plant material over long periods of time. In some cases, this process can take centuries. You can find fulvic acid in clay, sand, mountain rocks and mud and it can have different properties depending on where you source it from. Fulvic acid from sand in Israel may have different properties than peat moss in Canada or mountain rock in Colorado, for example.

Fulvic acid has most commonly been found in shilajit, a tar-like sticky substance found in Himalayan mountain rocks. For thousands of years, shilajit has been used in traditional, Eastern and Ayurvedic medicine in India and Nepal for its rejuvenating and anti-aging properties. This is assumed to be the case because shilajit contains high amounts of fulvic acid, which has antioxidant properties and helps with inflammation.

The problem is that shilajit has been shown to be safe, but the dosing tends to not be regulated, says Dr. Bradley.

The lack of regulation and limited scientific research in humans in Western medicine makes it hard to determine exactly what benefits happen with fulvic acid when taking different doses. That means theres not a lot of information about how much is too much. When taken at higher doses, fulvic acid could have some serious side effects.

Past research, including animal studies, suggest fulvic acid could help with:

Most notably, its been shown to have potential for preventing chronic inflammatory diseases like diabetes. It also shows potential with neurodegenerative disorders because it may interfere with the buildup of proteins that speed up the development of brain diseases like Alzheimers disease.

But, according to Dr. Bradley, fulvic acid could increase oxidative damage (cell and tissue damage caused by free radicals in your body) at higher doses and have an adverse effect on your immune system, too.

It has two sides of a coin. It can have antioxidant capabilities, but then it also has oxidant capabilities so it can cause oxidative damage instead of preventing it, explains Dr. Bradley.

Although some studies of fulvic acid have shown little to no side effects, those studies have remained largely small in scope. Plus, because products with fulvic acid arent regulated, theres no telling what you might get.

If youre ingesting this from a source that you dont know how pure it is, you could be ingesting heavy metals like mercury and arsenic, explains Dr. Bradley.

In fact, thereve been studies that show an increase in lead, mercury and arsenic in Ayurvedic medicines and issues with lead poisoning. For this reason, Dr. Bradley suggests waiting until more research is done before seeking fulvic acid from a functional medicine doctor. Instead, she suggests relying on other products like fish oil, which has been shown to have positive anti-inflammatory effects on conditions like rheumatoid arthritis.

I personally would look at other products that would create similar outcomes instead of specifically going right to fulvic acid only because the studies have not been 100% conclusive in terms of knowing how much you should take, advises Dr. Bradley.

Its too early to tell if fulvic acid will be beneficial for the condition youre looking to treat. Until Western medicine catches up on the scientific research and human clinical trials needed, its best to avoid fulvic acid supplements. Instead, stay on top of the current research and ask your family healthcare provider or functional medicine specialist if there are other treatments or supplements that can work in similar ways.

I wouldnt have patients take this just because they read something on the internet, says Dr. Bradley. There havent been enough human studies showing a true, positive effect. But there is potential and I think it should be studied.

See the rest here:

What Is Fulvic Acid? And Is It Worth the Hype? - Health Essentials from Cleveland Clinic

Youre never too young to start a business. Take it from Condoleezza Semien, a 16-year-old entrepreneur who started her own business, Beluga Bliss, when she was in the eighth grade.

Semiens mother battles lupus and struggles with aches from the chronic condition. At the age of 13, determined to soothe her mothers pain, Semien started researching which essential oils and herbs had the scientific components to treat her moms symptoms.

Soon, she was blending her own essential oils, naming them based on the blends intentions and sharing them with her family. She now sells her products under the brand name Beluga Bliss on her website and at Zen-Jus, a wellness shop in Zachary.

Since using the brands oils, her mother has been able to take less pain medicine.

My mother introduced me to essential oils, Semien says. I wanted to make certified organic oils with no fragrance or harmful ingredients. My mom needed an alternative medicine that didnt include opioids, so I created three different oil blends.

Semiens brand includes specific blends of aromatic oils designed to have different effects for the user. The oil blend aimed at improving sleep, for example, includes lavender and lemongrass. The oils are sold as roll-ons to apply to the skin or in droppers to add to diffusers, baths or pillows.

Since launching her business, the Baton Rouge native has been recognized around the nation. She pitched her business at the Young Entrepreneurs Academy Investor Panel Presentation in 2019, where she won the Saunders Semifinalist award. She then advanced to the Young Entrepreneur Academys Saunders Scholarship Competition in New York, where she won the Peoples Choice Award.

As the multitalented high school student makes plans for her future, she wants to continue expanding her business, hold pop-up events and eventually open her own storefront. Her next step is to become a certified aromatherapist and licensed herbaliston top of balancing school, dance, theater and community service work as the president of the Outstanding Mature Girlz organization.

My advice to the youth who want to start a business is to start a business with a purpose in mind that is not money, Semien says. Money will come, but the purpose behind your business will bring out ambitions and will remind you why you started (it).

This article was originally published in the April 2022 issue of 225 magazine.

Read more:

Meet the teen behind Beluga Bliss, a Baton Rouge aromatherapy brand - Greater Baton Rouge Business Report

With just over a month until we host the2022 Maryland State of Reform Health Policy Conference, our team is hard at work bringing together the speakers, topics, and conversations that were sure stakeholders from all siloes will find valuable.

Were excited to announce that Chuck Milligan, chief operating officer at Health Management Associates, will join us as the host of our conference this year! Chuck previously served as Deputy Secretary of Health Care Financing (Medicaid Director) at the Maryland Department of Health after the passage of the ACA, and as Executive Director of the Hilltop Institute at UMBC between 2004-2011.You can find more information on our upcoming conference below!

Emily BoergerState of Reform

Ben Steffen is the executive director of the Maryland Health Care Commission, which designatesthe states health information exchangetheChesapeake Regional Information System for our Patients(CRISP). Inthis Q&A, Steffen reflects on the role CRISP played in mapping the COVID-19 pandemic and shares his thoughts on the future utilization of HIEs to strengthen Marylands public health infrastructure.

The value of health information exchanges took on a new dimension with the onset of COVID, says Steffen, as CRISP was able to provide accessible portals for public health and clinical leaders to access outbreak and testing information. CRISPs ability to gather information across the entire clinical landscape and assemble it in ways that could help decision makers more broadly, was really recognized. Looking forward, Steffen says the state will need to think about if, how, and to what extent it utilizes CRISP in its public health infrastructure.

In case you missed it, we recently released the Topical Agendafor the2022 Maryland State of Reform Health Policy Conferencecoming up on May 4. Its a set of topics pulled together from scores of hours of conversations with ourConvening Panel, key stakeholders, and sponsors. During the conference, well take up issues related to behavioral health, health equity, workforce challenges, and COVIDs impact on the population health financing model.

Be sure to also be on the lookout for our Detailed Agenda, which well release next week. This agenda will include the full list of over 60 confirmed and invited speakers who will join us at the event. If you havent already registered,wed be honored to have you join us!

Less than two weeks remain until the end of session, and lawmakers are hard at work pushing health-related legislation forward. Facing last weeks chamber crossover deadline, several billsincluding legislation related toadult Medicaid dental servicesand the988 Trust Fund passed out of their chamber of origin.

Two health workforce billssponsored by Del. Ariana Kelly also recently crossed over to the opposite chamber.House Bill 625, which would establish the Commission to Study the Health Care Workforce Crisis in Maryland, is currently in the Senate Education, Health, and Environmental Affairs Committee.HB 1208, which has a committee hearing scheduled for this afternoon, focuses more on policies that would specifically address the statesnursing workforce shortage.

The legislature is nearing final discussions on the $58.2 billion operating budgetfor FY 2023. Afterunanimously passing in the Senate, Republicans attempted to pass several amendments last Thursday in the House, including funding for alternative medicine within the Department of Veteran Affairs and an amendment requiring the collection of abortion-related information. The amendments failed and the budget ultimately passed the House on a 113-15 vote.

However, the Senate refused to concur with other changes from the House, including a$46.5 million appropriation to support the legalization of cannabis in the state. A conference committee is set to work out final negotiations between the two chambers.

Del. Kirill Reznik is currently pursuinga bill that aims toimprove the continuum of care for foster children housed in emergency departments or other acute-care settings. Reznik says the lack of post-acute placements for this population has resulted in children getting stuck in EDs for weeks or months after receiving care.House Bill 406 would put in place new restrictions and procedures related to these placements, and would establish a task force to study current ED overstays among foster children.

According to the bills analysis, DHS estimates it incurs expenditures of approximately $36.5 million annually for costs associated with youth overstay expenditures. HB 406 is scheduled to be heard in the Senate Budget and Taxation Committee tomorrow afternoon.

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5 Things Maryland: Health in the budget, Detailed Agenda, Workforce legislation - State of Reform - State of Reform