School districts across the state have spent months consulting with attorneys and retooling their policies to ensure they are in compliance with the law passed in 2021. Senate Bill 99 requires parents to be notified at least 48 hours in advance about lessons related to sexual education, as well as other topics, including anatomy, intimate relationships, sexual orientation, gender identity, contraception, and reproductive rights.

Because of the law’s broad scope, some schools have decided to notify parents about topics that may not be obviously related to human sexuality. In Billings, for example, school administrators sent a notice to parents of high school students at the beginning of the school year that flagged literary works such as “The Great Gatsby” and “Romeo and Juliet” because they describe intimate relationships. History and U.S. government lessons involving civil rights and certain U.S. Supreme Court cases are on the list. So, too, are biology classes that involve sexual reproduction — even nonhuman reproduction.

“Frankly, it’s a pain to have to send out notices to parents of students in courses like biology where there may be a lesson taught on genetics because the lesson mentions testes, ovaries, sperm, egg, fertilization, etc.,” said Micah Hill, superintendent of the Kalispell school district.

State Sen. Cary Smith (R-Billings), who sponsored the bill, did not respond to requests for comment on how the law was affecting schools. Before the state Senate voted on the bill in 2021, Smith said the law was needed because today’s comprehensive sexual education encompasses much more than just biology and anatomy.

“This type of sex education deals with a lot of other issues, such as feelings, what’s normal, what isn’t normal, and a lot of times those teachings conflict with what we try to teach our children at home and in our churches,” he said.

The Kalispell school district determined that the law applied to health classes; science lessons that involve anatomy, genetics, or reproduction; advanced psychology courses whose curriculum includes human development; certain social sciences classes; and many more.

“There really is no end to what might be considered given the broad definition that came out of the state legislature,” Hill said.

Hill said that Kalispell schools and teachers send the notifications and that he did not have the number sent so far this school year. “I don’t track where teachers are at in their curriculum pacing, so if it hasn’t happened, it is probably a matter of time,” he said.

No school district has announced changes to their curricula as a result of SB 99. Local school boards generally set school curricula through a public process in which community members are invited to offer feedback. Schools also rely heavily on the grade-level content standards set by the statewide education agency, the Montana Office of Public Instruction.

Also in response to SB 99, schools are consulting with attorneys and combing through material for any mention of the topics that fall under the law’s definition of human sexuality.

Teachers must not only work with administrators and legal teams to determine which lessons might trigger notification under SB 99 but must also be careful that classroom discussions don’t stray into areas that require notification if none has been given.

“On the teacher side of this, it feels like an unnecessary layer of bureaucracy and overreach by the state to insert itself into locally controlled and elected school boards,” Hill said.

Smith said during the 2021 debate that the measure does not tell schools what they can teach. “We’re just telling them to let us know as parents and grandparents what is being taught so we can decide if we want our children to participate in those courses,” he said.

Missoula County Public Schools Interim Superintendent Russ Lodge said the district has sent parental notifications since the beginning of the school year. But he could not say how many or provide examples because he is not directly involved in the individual schools’ process. He said he wants his district, like Billings, to eventually include all subject matter that falls under SB 99’s notification requirement in a district-wide letter sent out every August.

“Whoever wrote it obviously broadened the definition out on purpose, and it covers a lot of ground,” he said.

Aside from the law’s effects on seemingly tangential subjects, critics said SB 99 threatens to stifle important classroom discussions on sexual health, gender identity, and personal development. Critics also said it could reduce the number of students who learn about contraception — knowledge that has been shown to help reduce rates of teen pregnancy — and about LGBTQ+ rights. The law could also discourage teachers from including certain subjects in their lessons or hinder their ability to respond freely to questions or comments from students, the critics said.

Montana’s education department mandates that schools’ sexual education programs “reflect the values of the community” and be abstinence-based and age-appropriate.

Pamela Kohler, an associate professor of global health at the University of Washington, said that the evidence “overwhelmingly shows that abstinence-only education is not effective at preventing sexual activity or pregnancy” and that “many of those at highest risk for unwanted pregnancy and STDs receive no or inadequate sex education.”

More than 40% of Montana high schoolers have had sex, according to the 2021 Montana Youth Risk Behavior Survey, and just under half of them are not using condoms regularly, which raises their risk of becoming pregnant and developing sexually transmitted diseases. A study from the University of Montana released in 2017 found that more than 80% of students did not know basic information about HIV transmission and prevention.

Failing to teach about gender identity, sexual health, intimacy, and other elements of human sexuality means young people may have trouble finding accurate information, said Michelle Slaybaugh, director of social impact and strategic communications for SIECUS, an organization that advocates for comprehensive sexual education. And it makes students grappling with their sexual or gender identity more vulnerable, Slaybaugh added.

“Relationships and sexuality education has been proven to keep young people safer from bullying, help manage their feelings, concentrate in school, and develop the long-lasting skills they need to have healthy, strong relationships,” Slaybaugh said.

SB 99 also prohibits people who work at a clinic or organization that provides abortions from speaking or teaching at schools across the state, even if their lesson has nothing to do with abortion. That stipulation may have led to the termination of at least one long-standing relationship between a school district and a provider.

Bridgercare, a nonprofit reproductive health organization based in Bozeman that this year beat out the state health department to administer the state’s Title X program funding for family planning, had partnered with Bozeman Public Schools for 25 years to provide comprehensive sexual education to students. The organization, which does not provide abortions, has not been invited to provide instruction to Bozeman campuses this school year, according to Bridgercare officials.

The Bozeman school district’s superintendent, Casey Bertram, declined to be interviewed about the law and Bridgercare’s ties to the district.

“Whether parents like it or not, teens are navigating the challenges of adolescence and all of the emotional challenges that can bring,” said Cami Armijo-Grover, Bridgercare’s education director. “The best thing we can do for our kids is to educate them on how their bodies work and give them tools to navigate the feelings and challenges that come with puberty and relationships.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Nine months after a promise that they would once more get a Government stipend to ease the financial burden of full time study, student nurses are yet to receive the money.

And the Barbados Nurses’ Association (BNA), management of the Barbados Community College (BCC) and student nurses themselves are hoping that the current administration will make good on its promise.

Last February, Minister of Health and Wellness Ian Gooding-Edghill announced that Government would re-introduce the stipend some eight years after it was stopped and at a cost to taxpayers of $2 million annually.

On Monday following a scholarship award ceremony at the college, members of the nursing community renewed the call for the financial help.

“Since 2017, we have been advocating as the Barbados Nurses’ Association for the stipend to recommence to nursing students so that it could assist them with their studies. Leaving school and coming to study is hard; they have to travel to different health institutions as part of their studies.

“Also, the books and the materials that you have to acquire when you want to be a nurse are not cheap. We were told that it would be reinstated so we are waiting for the stipend to be reinstated to the nursing students of all years,”said president of the BNA Valerie Francis-Miller.

Deputy principal of BCC Dr Cheryl Weekes said the campus had already submitted the necessary information to start the process.

She too conceded that it was difficult being a student nurse since the financial requirements of the study could put strain on them.

“What I can say from the college’s standpoint is that the ministry has indeed been in touch with us and we have provided the necessary information in terms of the names of the students and the information they require in order to process the stipend. We are thankful that this is going to be reinstated because we know that it will go a long way to help the students in their profession reaching that level,” she said.

“Being a student and studying nursing is very difficult. It is not an 8 a.m. to 4 p.m. kind of study programme in the sense that the students have to do clinicals and those clinicals can run till 9 p.m. because they try to work to shifts.

“It is difficult for a student to be here full time going into the clinical area and then working another job unable to sustain themselves.”

In February, Gooding-Edghill said in a press statement that first-year nursing students would be paid a stipend of $458.89 per month; second-years $578.53; third-years $698.16 and fourth-years $798.16.

To maintain the stipend, the nursing students would be required to maintain passing grades for all courses according to the criteria set by the BCC. They would also be placed on a two-year Government performance bond after completion of their four-year nursing degree.

The minister said he hoped the stipend would take pressure off the students and their families and lead to an increase in the number of nurses.

Weekes said that the stipend could encourage more people to study nursing especially in light of the on-going nursing shortage.

“It would be an incentive also, for more persons to join the profession to join the training, at least because they know that the challenges of not having the finances would be alleviated to a certain extent . . .  So this is coming at an opportune time when we know that we have a shortage of nurses. Having an incentive will encourage more persons, younger persons, to pursue nursing as a career.”

Francis-Miller said nurses also needed more incentives in the form of educational and career development opportunities.

“Migration is something that has been happening in Barbados for years. It has not just started. Nurses are continuing to migrate and we have, as a nurses’ association, been asking and advocating for incentives to help keep our nurses here. We would like some more incentives.”

Second year student nurse Aldaro Blackman agreed that the programme was financially difficult especially when travel costs and book and equipment expenses are factored in.

He said: “Nursing as a major is very expensive.”

There are close to 400 student nurses training at BCC.

sheriabrathwaite@barbadostoday.bb

The post Student nurses await ease appeared first on Barbados Today.

Guidelines by the National Comprehensive Cancer Network and other cancer groups recommend computed tomography (CT) scans every three to six months for patients who have had malignant lung tumors surgically removed.

But in a new study, researchers at Washington University School of Medicine in St. Louis have found no improvements in survival or recurrence rates among patients who followed the protocol, compared with those who were scanned every six months to one year.

"Our findings suggest that lung cancer treatment guidelines should consider less frequent surveillance imaging than current recommendations," said the study's senior author, Varun Puri, MD, a thoracic surgeon and professor of surgery. "Annual surveillance would simplify guidelines and may result in better, easier postoperative care for early-stage patients."

The study is published Nov. 28 in the Journal of the National Cancer Institute.

Non-small cell lung cancer accounts for 84% of all lung cancer cases, according to the American Cancer Society, and the overall five-year survival rate is 25%.

The researchers focused on the first two years after surgery since that is when the risk of lung cancer recurrence is highest. After two to three years, cancer organizations typically recommend annual scans until the end of life.

"Scanning too frequently can be associated with unnecessary anxiety for patients and increased health-care costs," said Puri, also a research member of Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "Patients who receive scans to check for recurrent cancer are understandably anxious, especially since it can take several days for results to be received. This phenomenon is sometimes called 'scanxiety.' It is obviously important to minimize scanxiety when it can be done safely."

For the study, the researchers analyzed de-identified medical records in a database maintained by the U.S. Veterans Health Administration, the nation's largest integrated health-care delivery system. The researchers examined information involving 6,171 patients with stage 1 non-small cell lung cancer who underwent surgery from Oct. 1, 2006, through Sept. 31, 2016. One patient group received scans every three to six months, and the other group every six to 12 months.

In all cases, more scans did not offer improved health, including among different tumor sizes, tumor stages and types of surgical procedures. Recurrence was observed in 22% of patients and did not differ based on the frequency of scanning. Similarly, overall survival remained the same between the two groups, with about 65% of patients surviving at least five years.

The average age of the patients was 67.5. The patients were predominantly male and white; however, statistical modeling controlled for different ages, genders and races.

"We found that certain patients had received more frequent CT scans, including patients who smoked and patients who had certain types of operations," said the study's first author, Brendan Heiden, MD, a surgical resident and research fellow at Washington University. "Conversely, we found that African-American patients received less frequent scans, which is a potentially concerning health disparity that warrants further research. Nonetheless, we were encouraged to find that patient outcomes were generally equivalent regardless of scan frequency."

Heiden continued: "The VA treats a unique patient population that consists mostly of males with significant smoking histories. Therefore, we believe that our findings are most applicable to veterans with lung cancer. However, prior studies examining non-VA patient populations have found similar results to ours, suggesting that the results may apply more broadly to the general population. More research is needed."

Reference:

Brendan T Heiden, MD, MPHS, Daniel B Eaton, Jr, MPH, Su-Hsin Chang, PhD, SM, Yan Yan, MD, PhD, Martin W Schoen, MD, MPH, Theodore S Thomas, MD, MPHS, Mayank R Patel, MD, Daniel Kreisel, MD, PhD, Ruben G Nava, MD, Bryan F Meyers, MD, MPH, Benjamin D Kozower, MD, MPH, Varun Puri, MD, MSCI1, Association between imaging surveillance frequency and outcomes following surgical treatment of early-stage lung cancer, JNCI: Journal of the National Cancer Institute, 2022;, djac208, https://doi.org/10.1093/jnci/djac208

Mumbai: Pharma major Cipla Limited and its wholly owned subsidiary Cipla USA Inc., today announced the launch of Leuprolide Acetate Injection Depot
22.5mg in US.

The product was approved by the United States Food and Drug
Administration ("US FDA") based on a New Drug Application (NDA) submitted under
the 505(b)(2) regulatory pathway.

Leuprolide Acetate Injection Depot contains 22.5 mg of leuprolide acetate for 3-
month administration given as a single dose injection.
It is supplied as lyophilized microspheres in a single dose vial as a kit with a prefilled
syringe containing 2mL 0.8% mannitol solution and an easy-to-use MIXJECT transfer
device for a single dose injection.

It is indicated for the palliative treatment of advanced
prostate cancer.

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Arunesh Verma, CEO – Cipla North America, said, "The launch of Leuprolide Acetate
Injection Depot reinforces our commitment as an organization to bring high quality
and affordable treatments to patients in the US. Enabling access to high-quality
treatments is core to our purpose of "Caring for Life". This launch aligns with our
strategy for growth in the complex product segment."

The active ingredient, route of administration, dosage form, and strength are the same
as LUPRON DEPOT 22.5 mg strength, from Abbvie. According to IQVIA, LUPRON
DEPOT 22.5mg had US sales of approximately $197M for the 12-month period ending
September 2022.

Read also: Cipla gets CDSCO Panel nod to manufacture, market COPD drug combination Aerosol for inhalation

Cipla Limited is an Indian multinational pharmaceutical and biotechnology company headquartered in Mumbai, India. The Company was founded by Khwaja Abdul Hamied in 1935 in Mumbai.

Cipla primarily develops medicines to treat respiratory, cardiovascular disease, arthritis, diabetes, weight control, depression, and other medical conditions.

Read also: Dr Reddy's Labs, Cipla facilities join World Economic Forum Global Lighthouse Network

WHO recommends new name for monkeypox disease

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bbVie) compared with adalimumab (Humira, AbbVie) through 56 weeks using RAPID3 scores in patients with PsA, and how RAPID3 correlates with other clinical composite disease activity measures used