| | | |   By Elizabeth Cooney | Good morning. Andrew Joseph follows up with people carrying on the legacy of intensive care nurse Michael Odell, who died by suicide a year ago — a poignant story of the pandemic's impact. | | | Many pharma companies get failing grades on clinical trials diversity 
STAT’s Usha Lee McFarling has this report: Few cancer trials included enough non-white or older patients to be truly representative, according to a new scorecard published in BMJ Medicine showing how well pharma companies diversify research studies. The nonprofit Bioethics International analyzed 64 pivotal trials conducted by 25 pharma companies of novel cancer therapeutics approved by the FDA between 2012-2017 to see how inclusive those studies were, and how transparent companies were in reporting participant demographics. They found: - 56% (14 of 25) companies included adequate numbers of women, and 25% (6 of 25) adequately included older adults, but just 16% (4 of 25) adequately represented patients who were not white.
- Nearly half the companies adequately represented Asian patients in their studies, but just 16% adequately represented Black patients, and no company adequately represented Hispanic patients.
The authors said they hope their new metric of “fair inclusion,” which combines both inclusion and transparency, will push companies lagging behind to do better. Only one company, United Therapeutics, received a perfect rating. Other gold ratings went to: Puma, Sanofi, Takeda, Amgen, Bristol Myers Squibb, Eli Lilly, and Merck KgaA. Companies ranked lowest were: Spectrum, Bayer, Exelixis, Boehringer Ingelheim, Roche, GlaxoSmithKline, Teva, and AbbVie. | Mpox has infected fewer women than men but with similar racial and ethnic disparities Mpox has faded from the headlines in recent weeks as the U.S. outbreak has subsided, but CDC’s weekly Morbidity and Mortality Weekly Report reminds us of a less visible population affected by the illness: women. Mpox has primarily hit adult gay, bisexual, and other men who have sex with men; women make up fewer than 3% of cases. Their racial gaps mirror the larger outbreak. Between May and Nov. 7, 2022, mpox was identified in 769 women over age 15 (2.7% of all reported cases); 44% were Black, 25% were white, and 23% were Hispanic.
Also similar to men, nearly three-quarters of the infected women said they’d recently had sex or close intimate contact with a man. There were 23 pregnant or recently pregnant women infected with mpox, four of whom required hospitalization but all of them recovered. Two newborns received oral treatment and also did well. Still, clinicians are urged to monitor risk in women. | Spouses of cancer patients more vulnerable to psychiatric disorders It seems intuitive that not just cancer patients but their spouses feel the brunt of that diagnosis in ways that harm their mental health. Taking a population-wide view, a new study in JAMA Network Open from Denmark and Sweden found that spouses of cancer patients face an increased risk of a psychiatric disorder requiring hospital-based care — depression, anxiety, stress-related disorders, substance use disorders — compared to other spouses. That risk was 30% higher in the first year following diagnosis but remained 14% higher for many years.
There seemed to be a “ubiquitous susceptibility to psychiatric disorders in this risk population,” but some groups were hit harder. Male spouses were more vulnerable, as were spouses with lower income. Risk was greater for spouses of patients whose cancers had a poor prognosis (esophageal, lung, pancreatic, liver), whose cancers were diagnosed at a later stage, and who died. The authors urge more clinical awareness to help these groups. | Home-based care: An old approach that’s transforming healthcare The pandemic created opportunities to rethink ways we provide healthcare to ensure everyone has access to high quality, affordable care on their own terms – one of those approaches is in-home healthcare. Andrew Agwunobi, M.D., MBA, President of Humana Home Solutions, discusses the benefits of proving care in the home including building more trusting relationships between patients and clinicians, allowing for more in-depth conversations and limiting exposure to illness and infection, especially among older adults. Read more. | Closer look: A nurse's legacy inspires a group building peer support  (COURTESY MICHAEL WALUJO) After intensive care nurse Michael Odell (above) died by suicide a year ago, his friends in the field and other nurses have advocated for health care worker well-being, calling for health systems to offer more support for nurses, who’ve historically received less consideration than doctors. They’ve also started an organization called Don’t Clock Out, which holds weekly online peer support meetings, one specifically for nurses (and nursing assistants and students) and one for health care workers generally.
The organization's goal is to start a peer support line available 24/7, staffed by volunteers trained to help other health care workers dealing with mental health challenges that the pandemic — and Odell’s death — brought into sharper focus. “There’s been more people than I ever realized out there in the health care world looking for support,” Josh Paredes, a nurse in San Francisco and Odell’s friend, told STAT’s Andrew Joseph. Read more. | Gaps mark Covid vaccination in kids and teens Covid vaccination coverage was highest among Asian and Hispanic children and adolescents, a new CDC report tells us, with rates rising with age. As of August, about one-third of children 5 to 11 had received at least one Covid vaccine dose while more than half of 12- to 15-year-olds and just over two-thirds of 16- and 17-year-olds had gotten their shots. Vaccination among Asian children ranged from 63% to 92%, followed by Hispanic children, from 35% to 77%. Among children ages 5 to 11, coverage among Black children was lower than among Asian, Hispanic, and other/multiple race children.
Other differences: - Vaccination was higher among children ages 12 to 17 whose mothers had a college degree, whose yearly household income was at least $75,000, who always or often wore a mask in public, and who got a flu shot.
- Parents of unvaccinated children had low confidence in vaccine safety, and few had a provider who recommended vaccination.
| Lessons from a long crusade to care for people experiencing homelessness At year’s end, STAT publishes its jealousy list, in which we pick out work from other publications we wish we'd created. (It's a bit meta, as it was Bloomberg’s idea first.) Even though it's only January, my pick for 2023 would be this profile by the lyrical writer Tracy Kidder. He rides along with Jim O'Connell, a Boston doctor who's been traveling the city's streets for three decades, winning the trust and treating the ills of people he calls “rough sleepers.”
Kidder takes you to O’Connell’s first days in a shelter, where a nurse told him to put his stethoscope away and start soaking feet. “Foot-soaking in a homeless shelter — the biblical connotations were obvious,” Kidder writes. “But for O’Connell, what counted most were the practical lessons, the way this simple therapy reversed the usual order, placing the doctor at the foot of the people he was trying to serve.” | | | | | If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988. | What we're reading - South Carolina constitution includes abortion right, state supreme court rules, New York Times
- How worried should we be about XBB.1.5? The Atlantic
- Biogen shakes up R&D chief role, makes Singhal permanent replacement, STAT
- Why we (still) can't find any children's Tylenol, Axios
- Opinion: Continuous manufacturing can help pharma companies save time, money, and more, STAT
| Thanks for reading! More Monday,  | | | | Have a news tip or comment? Email Me | | | | | | | | Kendall Square February 9 | | | | | | | |
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