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Human Behavior

How Deforestation Drives The Emergence Of Novel Coronaviruses – Forbes

Scientists approach a bat cave in Queen Elizabeth National Park in Uganda in this 2018 file photo. ... [+] The CDC scientists gathered 20 bats that reside in Maramagambo Forest as part of a research project to determine how Marburg virus finds its way to humans. (Photo by Bonnie Jo Mount/The Washington Post via Getty Images)

Scientists have been warning that deforestation may be creating an accidental laboratory for the emergence of new viruses in environments that have been disturbed by humans.

In the wake of HIV, Ebola and SARS, scientists documented a potential path for viruses from bats through other mammals to humans. Some scientists and doctors have further argued that path is paved by deforestation.

Deforestation and the sale of live wild animals or bushmeat, such as bats and monkeys, make the emergence of new viruses inevitable, while population growth, dense urbanization and human migration make their spread easier, said Dr. Seth Berkley, head of the GAVI Alliancea non-profit international vaccine initiativewriting in Scientific American.

In 2018 a group of European scientists warned in an opinion article of the role of deforestation:

The biological problem of viral emergence has not fundamentally changed, but the probability of occurrence of the risk is increasing owing to environmental change and higher environmental pressure, wrote Aneta Afelt, Roger Frutos, and Christian Devaux from the universities of Warsaw, Montpellier, and Marseilles.

Bats host more viruses than other mammals while displaying a heightened immunity to them. In the natural environment, bat populationsand the viruses they carryare limited by their ecosystems, according to the European authors, but in disturbed environments displaced bats can find anthropized environmental niches.

Houses and barns provide shelter to bats, lights attract insects they feed upon, while orchards and fields feed fruit-eating bats:

This attractive effect of anthropized environments on bats with differing biological needs results in a higher concentration and biodiversity of bat-borne viruses.

In these disturbed environments, multiple species of bats mingle, roost, hunt, and encounter the intermediate hostssuch as civet cats, monkeys, camels and horsesthat may bridge a transmission to humans.

But bats are not the enemy, the scientists agree. Their immune systems may hold the answer to viral epidemics, they are not the primary carrier of these viruses to humans, and when the viruses do reach humans, it is typically through human activity.

The COVID-19 novel coronavirus has been traced to a Wuhan market that sells live wild animals, such as civets, who are considered by some a culinary delicacy. Viruses similar to the one that causes Covid-19 have been found in Chinese horseshoe bats, and may have mutated in civets.

SARS is believed to have passed through civets as well, MERS through dromedaries or camels, the Australian Hendra virus through horses.

"The underlying causes of zoonotic spillover from bats or from other wild species have almost alwaysalwaysbeen shown to be human behavior," Andrew Cunningham, Professor of Wildlife Epidemiology at the Zoological Society of London told CNN. "Human activities are causing this."

Human activity makes the emergence of viruses more difficult to predict, according to the European group. The emergence of a virus is an extremely low probability event resulting from a stochastic combination of low probability independent events, they write, but environmental disturbances like deforestation create conditions for such events:

The increased probability of encounter and occurrence of an emergence-leading chain of events yielded by anthropized environments must be considered seriously.

A policeman watches over a civet cat captured in the wild by a farmer in Wuhan, central China's ... [+] Hubei province, in this 2003 file photo. Civets are a suspected source of the leap of both COVID-19 and SARS to humans in South China. (Photo by STR/AFP via Getty Images)

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How Deforestation Drives The Emergence Of Novel Coronaviruses - Forbes

Human Behavior

John Rosemond: Tackling the dreaded ARFID | John Rosemond – Index-Journal

Blaise Pascal (162362) said there is no idea so bizarre that a philosopher has not advanced it. These days, the philosophers in question are psychologists and the bizarre ideas are their explanations of human behavior. Said explanations are bizarre because (trust me on this, I am one) psychologists wear, as a rule, ideological blinders that prevent them from accurately understanding what makes humans tick. Unable to see human behavior for what it truly represents, they justify their existence by inventing and marketing diagnoses as if giving something a name is equivalent to understanding and knowing what to do about it.

The latest manifestation of this fraud is Avoidant Restrictive Food Intake Disorder, or ARFID, formerly known as picky eating. Lots of university health centers and independent practitioners offer therapy for people of all ages whose parents never taught them that not eating what someone else, including ones mother, has taken the time to prepare and serve is rude.

One psychologist points out that most of the ARFID sufferers she sees eat the same stuff: macaroni and cheese, pizza, chicken nuggets, French fries and grilled cheese sandwiches. Lots of folks will recognize those foods as the very ones they wanted their parents to serve at every meal. I know I did. Staring at several tablespoons of steamed broccoli for three hours before I decided I wanted to get up from the table was one of the most therapeutic experiences of my childhood. My next therapy session involved Brussels sprouts. That session lasted only minutes.

Now, instead of picky eating being narcissistic and just plain rude, it is a psychological disorder that some people have. This ARFID thing has become big business, mind you. Google ARFID therapy and you will discover just how big. Some of the therapy programs for picky eating children are residential and cost more than what most people earn in a good year.

One psychologist, quoted in an online article, claims that picky eaters have control issues. Thats right. They have control over whether they eat broccoli and Brussels sprouts or not. They choose to be rude because they seek constant affirmation that their almighty feelings represent universal truths to which everyone else should genuflect.

A true story: Once upon a time, a child became infested with ARFID demons at an early age. He would begin gagging and sobbing at the very sight of a food that caused his tongue to feel even slightly less than fully happy. His parents bless their hearts catered to the ARFID demons by feeding him only macaroni and cheese, French fries and fried chicken nuggets. Sure enough, the ARFID demons grew increasingly clamorous.

By the time the parents sought my advice, the child was certifiably insufferable when it came to food. He was well on his way to becoming an adult whom no one wanted to be around if the event involved eating. I told the parents to (a) feed him only what they were eating, but in half-teaspoon portions; (b) set a timer for 15 minutes; (c) put him immediately to bed if he didnt clean his plate before the time expired; and (d) let him have seconds of anything on his plate if he ate everything within the time allotted. Within a week, the ARFID demons had fled demons cannot tolerate common sense and said child was eating everything on his plate and asking for seconds.

My parents invented that therapy, by the way. It costs nothing.

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John Rosemond: Tackling the dreaded ARFID | John Rosemond - Index-Journal

Human Behavior

Yes, you can still order takeout this and other questions answered | News, Sports, Jobs – The Adirondack Daily Enterprise

Customers step into the Little Italy Restaurant in Saranac Lake for a take-out early Friday evening.(Enterprise photo Lou Reuter)

Gov. Andrew Cuomo announced on Friday that effective Sunday, all non-essential businesses are mandated to close and people are being asked to remain inside their homes to slow the spread of the coronavirus. Non-essential can sound vague, so heres a look at what you can and cant do:

Can I still order takeout?

Yes. Cuomos decision last week to transition all bars and restaurants to only takeout and delivery remains in effect. You can still support your favorite eateries in this hectic time.

Can I go to the bank?

Most area banks have switched to just drive-thru, ATM and online services. Lobby services are now only available by appointment with a lot of banks, so call ahead.

Can I go to the grocery store?

Yes. Before this virus broke out, the state initiated a plastic bag ban and many people switched to reusable bags. However, coronavirus can live on those reusable bags. Make sure you clean them with a disinfecting spray or wipe before going to the supermarket.

Should I buy latex gloves and face masks?

You probably shouldnt. There are shortages across the world for these medical supplies. Save them for the doctors, nurses and patients who need them.

Can I use public transportation?

No. Both Essex and Franklin County canceled their bus services.

Can I go outside?

Yes, but social distancing needs to be respected, and Cuomo recommends going out alone. Isolation can cause depression, anxiety and mental fatigue. Go out for a walk, a run, a hike or a bike. Be careful with hiking, though. Going up Mount Baker alone and with a cellphone isnt the worst idea, but hiking the High Peaks during mud season can be dangerous.

Can I go to the gym?

Nope. Youve got to work out at home or outside by yourself.

Can I go to the movie theater?

Nope. Nows the time to invest in a streaming service.

Can I go to the library?

Nope. But the New York Public Library has free e-books available on its website.

Can I get my hair or nails done?

Nope. Too much touching going on at the salon. Let the hair grow, and clip your nails at home. Cuomo ordered closing salons and barber shops.

Can I get a tattoo?

Nope. Again, too much touching and Cuomo ordered those closed, too.

What is the coronavirus?

The novel coronavirus is in the same family of viruses as the SARS, MERS and the common cold. The symptoms of the coronavirus are fever, shortness of breath, a sore throat and a dry cough. If the infection worsens, you can go into respiratory failure and require a breathing ventilator.

Who can get it?

Anybody. Dont think just because youre a spry 20-something you cant get infected. Yes, seniors and those with compromised immune systems will likely feel worse effects, younger generations can get it and spread it.

What if I think I have it?

Dont leave your home and dont rush over to Adirondack Medical Center without warning. You can infect more people that way. Stay calm and call the hospital at 518-897-2462 to see if you qualify to be tested.

Is there a cure?

No, not currently. Treating the coronavirus is like treating the flu or a cold. The best way to handle it at home is with rest, hydration and isolation. If the symptoms are severe, then call the hospital.

How can I stop the spread?

This is important. The U.S. Centers for Disease Control and Prevention has a list of guidelines, but people should go above and beyond that.

Because there is no cure in the form of a vaccine or medication, human behavior can slow the spread. Wash your hands with soap and water for 20 seconds at time. Thats roughly one round of the ABC song or two rounds of Happy Birthday. Or have fun with it. Sing the chorus to the Killers Mr. Brightside.

The virus is encased in a layer of fatty lipids. Soap destroys those lipids, and water washes the virus away.

Add some hand sanitizer that contains at least 60% alcohol to the mix.

Dont touch your face. Viruses get into our bodies through our eyes, noses, ears and mouths. They cant diffuse through our hands.

Cough and sneeze into elbow, not your hands.

Social distance from other people.

If youre sick, self-quarantine. The world will forgive you for missing work.

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Yes, you can still order takeout this and other questions answered | News, Sports, Jobs - The Adirondack Daily Enterprise

Human Behavior

Why you can’t stop touching your face, according to science and psychology – CNBC

Most of us touch our faces way too much. Studies have shown that people touch their faces 23 times an hour and that's a big problem amid the COVID-19 pandemic.

The eyes, nose and mouth are essentially portals for infectious diseases to enter. COVID-19 is believed to spread through respiratory droplets from someone coughing or sneezing. But if you come into contact with COVID-19, then touch your unwashed hands to any of these areas on your face, you run the risk of infecting yourself.

So wash your hands of course, but staying healthy sounds like a great rationale to stop touching your face. Yet the messages from the Centers for Disease Control and other public health authorities to stop don't making quitting any easier.

"When people say don't touch your face, what happens? We touch our face," L. Kevin Chapman, clinical psychologist and founder and director of theKentucky Center for Anxiety and Related Disorders, tells CNBC Make It.

So why is quitting so hard?

There are a number of reasons why we're so attached to this "uniquely human habit," Chapman says.

First, some face touching is almost automatic. For example, neuroscientifically, scratching an itch on your face (or anywhere else) is an automatic reflex, meaning you do it without thinking. When you have an itch, it registers as a complex pain-like sensation. Scratching or touching an itch feels good because it temporarily interrupts the discomfort. When we're in pain, our instinct is to withdraw, but when we itch, our reflex is to scratch, according to the American Academy of Asthma, Allergy and Immunology.

Touching your face can also be a habit.

Like with other ingrained habits, from biting your fingernails to cracking your knuckles, when you've repeated a behavior enough times, a part of the brain called the basal ganglia takes over. Once that happens, the behavior is almost instinctive and "the brain starts working less and less," Charles Duhigg, author of "The Power of Habit" told NPR.

Interestingly, there are also psychological reasons you touch your face. Besides typical itching and grooming habits, studies suggest that touching your face is a self-soothing tactic.

"In some sense, it's a way to regulate emotions, and it's a way to kind of tap into how we're feeling at any given moment," Chapman says.

We also do it to "convey certain facets of our identity to people," he says.

Touching your face can be a nonverbal way to communicate your feelings or emotions. For example, you might touch your face when you feel awkward or uncomfortable, or when you're trying to flirt with someone, he says.

"Ultimately, it's a habit-forming behavior because it represents so many different things for us," Chapman says.

Here are some strategies that may help keep your hands off your face, according to Chapman.

1. Shift your thinking

You're more likely to change your habits when you allow your thoughts to be flexible rather than punitive, Chapman says.

So, instead of thinking, "don't touch your face," you should tell yourself, "I'm going to be more aware of touching my face today." You can even set reminders with that message on your phone to go off every few hours.

"If you do that consistently, you're programming your brain to make that thought salient, and therefore you're more conscientious of not doing it," he says.

Whenyou slip up, use it as a reason to wash your hands and start fresh.

2. Distract yourself

The most obvious way to curb your face-touching would be what Chapman calls "distraction techniques," such as holding onto a trinket when you get the urge to touch your face. For example, you might want to keep a "fidget spinner," small toy or stress ball by your desk to play with when you're stressed or just need something to do with your hands.

Other studies on "body-focused" repetitive behaviors (such as hair pulling disorder and skin-picking) suggest that simply clenching your fists or sitting on your hands for a minute can help you resist the urge.

3. Use accessories strategically

Some people who have long hair might feel extra tempted to touch their face to move stray hairs. Chapman suggests securing your hair in a bun to prevent yourself from playing with it.

It also might be useful to wear your glasses to dissuade yourself from touching your eyes.

Similarly, wearing any kind of gloves can keep you from touching your face, he says. But they don't absolve you from having to wash your hands for COVID-19 prevention.

Check out: The best credit cards of 2020 could earn you over $1,000 in 5 years

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Why you can't stop touching your face, according to science and psychology - CNBC

Human Behavior

Published together: The human-animal bond and social distancing – Rapid Growth

As someone who was part of a team of creatives, business leaders, education institutions, and philanthropists, we all banded together in what can only be described as a midwife-of-a-situation to bring Rapid Growth, a solutions-based journalism magazine to life in April 2006.

Since that time we have had many creative folks work alongside of us as we sought to bring unique stories to our community, and also those looking at our city as a destination for fun, relocated for work, or a place simply to call home.

So as we face an unprecedented time in our planet's history that is impacting so many lives, we decided to leverage our community-partners in dialogue to produce a series of stories that reflect our time together.

The first to kick off this series we call Published Together and is a labor of love from a local businesswoman who, after our one-on-one conversation, set off to write a piece that showcases how we as locals together are helping address problems ... even during this moment of COVID_19.

Please welcome, Jenn Gavin of A Pleasant Dog.

-Tommy Allen, Publisher

---

Social distancing is hard on primates. We are designed to live in groups with each other. To look in each others eyes, feed each other, and touch each other (especially faces)! We are all starting to feel the strain of coming together by staying apart, and it looks like we might be hunkering down for a while.

Heres where your pet comes in. The human animal bond is an incredible thing. Those soulful eyes and soft fur have a real, tangible benefit. Science has definitively proven that petting a dog or cat lowers blood pressure and can help with anxiety like the anxiety that social distancing is causing in all of us. Doesnt it feel good to have physical contact with somebody? Let that somebody be your pet during this time. If you cant be with the one you love, love the one youre with!

Whats more, many of the behavioral problems people come to A Pleasant Dog to resolve are at least in part due to modern humans having little time to properly exercise and train their companion animals. So, this time of social distancing can in many ways be a gift to the furry one with whom you share your life.

Go ahead and enjoy this time. Take a stroll. Every day. Twice a day. Three times if you like. Be present in the moment. Watch your furry one sniff the breeze. And the trees. And the spot where Mrs. Smiths poodle whizzed this morning. Find pleasure in stroking a furry head by the fireside. Take advantage of those furry ears to rant about missing your birthday party. He cares. He really does (even if he doesnt quite understand every word).

You can also train and learn together! Behavior problems dont give two whits about a virus, so if youve been struggling with separation anxiety, reactivity, leash pulling, counter surfing, jumping up, or any other behaviors, take a few moments out of your day to train your dog (using positive reinforcement only please. Nobody needs negativity now). A Pleasant Dog will continue to offer free training tips via our social media throughout the crisis, as well as discounted virtual private training sessions (yes, they are a real thing, and they work).

Tricks are a great way to bond with your pet. Heres a simple one that works with cats and dogs (and most quadrupeds, really). Take out a selection of treats your pet cant live without. Tiny, pea-sized stinky things are best. Cheese and hot dog make good treats and are just 6 feet away in the fridge.

Starting on a non-skid floor, ask your pet to sit (or lure them into a sit), then place a treat directly on your pets nose, slowly raising it over their head and back toward the base of their skull a bit (instead of straight up in the sky). As soon as your pets front feet leave the floor, say yes or good and give the treat. Repeat five to 10 times, per session, slowly getting those feet higher and higher by raising your hand incrementally each time.

If your dog jumps, you moved your hand up too quickly. Once your pets sit pretty has reached the level of awesome you like, give your cue before luring them up. I use sit pretty, but you can call it anything you like.

And half the fun can be in finding a clever cue. Over time, you can fade the lure until youre just using an empty cookie hand and your verbal cue to get the same behavior (but still praise and treat after, because no one likes to work for free all the time).

Dont have a pet to share your home? Mosh Pit, Luv n Pupz, and Fetch MI Home are all reputable local rescues who pull animals from local shelters (instead of bringing them from other communities). If youre heading toward the lakeshore, Pound Buddies in Muskegon pulls needy pets from that area. And those are just a few. Consider reaching out to see if they might be able to place a foster pet in your care temporarily while you shelter at home. Fostering saves lives, especially in a time when people are less and less able to venture out to assist pets in shelters. Most foster programs provide veterinary care. All you provide is food, love, and shelter. Ready for a commitment? Bissell is sponsoring $25 adoptions at participating shelters throughout the community.

A final plea: if you are one of the lucky ones with ample change to spare, consider a donation to Pleasant Hearts Pet Food Pantry. Pleasant Hearts fills a huge need in the community already, providing needy families with pet food and care essentials to keep pets in their families, and that need is only going to grow as this time of COVID-19 lengthens. They welcome your donations here.

_______________________

Jenn Gavin, CPDT-KA, is the owner and head trainer of A Pleasant Dog. For over twenty years, Gavin has learned from and taught dogs and their people. Since opening A Pleasant Dog, Gavin and her team have helped thousands of dogs from West Michigan and throughout the country. A Pleasant Dog specializes in City Dog & People Training using evidence-based, scientifically proven methods, and a lot of love. Its practice offers everything from private lessons for common behavior issues, focused behavior consultations for aggression and anxiety, stay and train programs for busy families, and group classes.

Photos Courtesy Amy Carroll Photo and A Pleasant Dog.

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Published together: The human-animal bond and social distancing - Rapid Growth

Embryology

Its really upsetting when you have put your body through so much: how it feels to undergo IVF through coronavirus – Stylist Magazine

Stylist spoke three women who had been affected by the situation and explored why there is not clearer guidance from the UKs regulatory body, the Human Fertilisation and Embryology Authority (HFEA).

Caroline, 32, from Manchester, was told her cycle was cancelled three weeks into a gruelling routine of daily injections. I was three weeks in to my fourth IVF cycle so thats three weeks of injections and menopausal symptoms. I was due to have a scan yesterday to confirm that I can start my next lot if medication ready for transfer in just over two weeks.

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Its really upsetting when you have put your body through so much: how it feels to undergo IVF through coronavirus - Stylist Magazine

Embryology

Coronavirus pandemic spurs halt to fertility treatments – The Globe and Mail

Ash Mogg, 36, who has had IVF cancelled due to COVID-19, outside her home in Toronto on March 20, 2020.

Tijana Martin/The Globe and Mail

Ash Mogg and her partner waited nearly a year on a list for provincially funded IVF in Ontario. Ms. Mogg, who is 36 and has a low egg reserve, was finally about to start the process in two weeks, but on Wednesday a nurse phoned with heartbreaking news. With all the uncertainty around COVID-19, the Toronto hospital was cancelling infertility treatments indefinitely.

I cried for five hours," Ms. Mogg said. "This whole situation, with COVID, in some ways it has the same feeling as infertility. Everything is so uncertain theres nothing to hold onto.

In the past few days, fertility clinics across Canada have been informing patients that new treatment cycles are being put on hold. They made the move after the Canadian Fertility and Andrology Society, which is not a regulatory body but provides guidance to the industry, issued a recommendation on Wednesday to postpone new insemination, in vitro fertilization and frozen embryo transfers until further notice, citing concerns about health-care resources. (The only exception would be for urgent cases involving cancer patients.)

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Read also: IVF was my last hope to have a baby. All Canadians deserve that hope, too

The American Society for Reproductive Medicine released a similar advisory. And in Europe, the European Society of Human Reproduction and Embryology has cautioned that all fertility patients considering or planning treatment should avoid becoming pregnant at this time, citing the lack of information around how the novel coronavirus that causes COVID-19 affects early pregnancy.

For all the jokes about a forthcoming COVID-19 baby boom as couples around the world isolate in their homes some health professionals are raising red flags about whether its wise to get pregnant amid the outbreak. This alarming warning is driven by concerns about the strain on an already stretched health-care system, a lack of data around how the virus affects the first and second trimesters, and unease about whether hospitals will have the capacity to provide proper care for pregnant women and newborns.

For people like Ms. Mogg, the idea of having to press pause on starting a family is yet another devastating layer to this crisis.

When everything started shutting down, I kind of suspected something like this was going to happen, but it was still a blow, she said. Timing is obviously critical for me.

Fiona Mattatall, a Calgary-based obstetrician and gynecologist, said given all of the uncertainty around COVID-19, she would suggest families consider delaying attempts at getting pregnant until more is known.

This is only a virus weve known about for months, not years, Dr. Mattatall said. When it comes to the first-trimester exposure, it is a giant question mark.

One good bit of news is that an analysis of amniotic fluid and cord blood from nine infected woman who delivered at Zhongnan Hospital of Wuhan University in China this year didnt detect the virus.

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This is hopeful, early information that babies may be protected it the womb, Dr. Mattatall said, adding its still too early to say for certain. (Researchers also determined the virus was not present in breast milk.)

As for the risk to mothers, reports from China suggest that the majority of pregnant woman with confirmed cases suffered just mild to moderate symptoms, and babies born to infected mothers have also done well.

Vanessa Poliquin, co-chair of the infectious disease committee of the Society of Obstetricians and Gynaecologists of Canada, said the absence of information isnt necessarily a bad thing. The virus has been spreading around the world for months now. Its conceivable, said Dr. Poliquin, that women are being infected while pregnant in their first trimester.

And we havent heard of a spike in miscarriages and we havent heard of a spike in rates of abnormalities being seen on anatomy scans, she said. This was not the case with the Zika virus, she said, where health providers saw problems and sounded the alarm.

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So far SOGC has not issued any warnings about delaying pregnancy, but the agencys chief executive officer, Jennifer Blake, said it may be worth considering.

The big unknown is how the pandemic will affect our health-care system and the ability to give routine pregnancy care. For example, will you be able to get an ultrasound when and where you might normally expect, she said. If its an option you may want to wait. If thats not an option, we will make sure you get the care you need.

Tom Hannam, founder of Hannam Fertility in Toronto, said part of the problem is no one knows how long the outbreak will last.

Were looking at something that could be three months or seven months or a year and a half. None of us knows, he said. Whats it going to be like going to a hospital nine months from now? Is it going to be a healthy and safe birth experience?

Some clues can be gleaned from other cities.

Edith Cheng, chief of maternal-fetal medicine at University of Washington hospital in Seattle, one of the early North American epicentres for the outbreak, said theyre currently trying to sort through complicated logistics.

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At present, the hospitals policy is that patients who are positive for COVID-19 cannot have guests. So an infected woman in labour would need to be alone.

Just 12 hours ago [our] pediatric leaders said we are now going to have to recommend, for sure, that [positive] moms and babies are separated because of some limited and new data that reports that babies less than a year old are potentially at higher risk, Dr. Cheng said.

Mothers are able to refuse this recommendation, but what happens at that point is still under discussion.

The complications around infected mothers means it takes more staff resources to handle safely. A delivery earlier this week required 13 staffers.

London is another city thats experiencing a crush of new COVID-19 cases. Last week, we had no cases at my hospital, said Rosemary Townsend, who works at a hospital in the citys south end. This week we have over 30 confirmed.

Hours earlier, her unit delivered its first baby to a mother suspected of being COVID-19 positive. (The confirmation test is pending.)

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In that case, the woman knew she was symptomatic and called in advance. An official met her and her partner in the parking lot and put masks on them. Usually women are moved to different parts of the maternity ward before and after delivery, but in this case the patient was in an isolated area.

Asked if she thinks families should postpone plans to try and get pregnant, Dr. Townsend said she just had this conversation with a friend who happens to work in health care.

Shes 38. She decided that she doesnt want to wait. The risk of waiting and delaying pregnancy is greater than the risk of getting pregnant in the middle of whats going on, Dr. Townsend said.

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Coronavirus pandemic spurs halt to fertility treatments - The Globe and Mail

Embryology

Guidance for the care of fertility patients during the coronavirus COVID-19 pandemic – BioNews

20 March 2020

The British Fertility Society (BFS) and the Association of Reproductive Clinical Scientists (ARCS) have announced new guidelines for fertility patients during the coronavirus pandemic.

Summary

UK COVID-19 epidemic continues to escalate.

Whilst pregnant women can be generally reassured they are asked to consider themselves a vulnerable group.

It is expected that UK licenced fertility centres will now be working to suspend treatments.

UK fertility centres must establish the requirements to maintain a minimum service, which may include non-elective fertility preservation.

Centres are expected to keep communication open with patients for advice and reassurance.

Centres are expected to minimise their impact on National Health Service (NHS) resources.

Background

A novel coronavirus infection that can cause serious disease (COVID-19) in a minority of affected people has taken on pandemic proportions, leading to extraordinary measures being introduced across the world.

The situation with respect to the number of affected persons and UK government advice on measures to increase social distancing is evolving. As of 18 March 2020: 56,221 people have been tested in the UK of whom 2662 tested positive for coronavirus, and 104 have died as a result of the illness. The government has advised against non-essential social contact and non-essential travel. Self-isolation has been advised for anyone with symptoms of coronavirus along with their household. The NHS has imposed restrictions on elective surgical and outpatient work, other than in situations where this is needed for the treatment of cancer or the purpose of saving life. The NHS has put in place plans for using medical and nursing staff from different areas in the most efficient way to deal with anticipated patients. This includes block-buying capacity in private hospitals. The aims of these measures are to free-up the maximum possible inpatient and critical care capacity, to prepare for anticipated large numbers of COVID-19 patients who will need respiratory support and to support staff and maximise their availability.

This guidance builds on the initial response from BFS and ARCS to this unprecedented challenge to the UK health system and the health of the population. It is designed to help all UK fertility clinics, regardless of their setting, to prioritise and organise their activities during the outbreak, whilst complying with their clinical, ethical, regulatory and social duties. Few UK licenced clinics will be able to close down completely, since virtually all will have embryos and gametes in storage banks which must be properly maintained in accordance with the law. Centres are advised to plan a flexible local policy which allows for prioritisation and a number of eventualities. Policies must take into account local conditions, breadth of work undertaken and clinic resources (including financial resilience). The overriding priority is for centres to act in a socially responsible manner.

Policies to take into account include the national strategy led by the chief scientific advisor and chief medical officer. Hospital-based clinics will be influenced by their own trust pandemic strategy which is likely to mirror national plans. Clinic groups may develop an overarching strategy, whilst individual centres will need to consider local prevailing conditions.

In developing their local policies, clinics must take into account their duty to abide by regulations arising from the Human Fertilisation and Embryology Act 2008, and laid out by the Human Fertilisation and Embryology Authority (HFEA) in its Code of Practice. HFEA guidance to clinics is available and updated as required. In all this, clinicians retain an ethical responsibility of beneficence and non-maleficence to their patients. A wider social responsibility of promoting public health and preventing harm from infection exists for all citizens, but especially health care providers. All clinics, whether in the state or private sector, should be mindful of their wider responsibilities, including the need to promote social distancing and to consider the potential effects of their work on local NHS services, which are likely to be stretched to an unprecedented extent.

At the time of writing, it is not thought that the infection causes miscarriage or fetal abnormality, and pregnant women do not appear to be at increased susceptibility to the infection or to developing complications. However, in the Prime Minister's bulletin on 16 March 2020, it was made clear that pregnant women were considered a vulnerable group, because this is a new infection and data on effects in pregnancy is limited. Further, there is concern for the potential care commitment required for any pregnant women with symptoms. The question arises whether the benefit of continuing to treat our infertile population may be outweighed by the additional concerns. It is reasonable that women who have risk factors for severe illness if infected, for instance those with diabetes or underlying respiratory disease or immunosuppression, should be advised against conceiving during the outbreak.

Fertility patients with symptoms of COVID 19

Pregnancy should be avoided in women who display symptoms of COVID-19. Patients who are in the stimulation phase of their treatment, but have not yet received the trigger, should be advised treatment cancellation. In such a situation, stopping follicle stimulating hormone (FSH) while continuing with gonadotropin-releasing hormone (GnRH) antagonist (or agonist as the case may be) is likely to protect against ovarian hyperstimulation syndrome (OHSS). Patients should be counselled against unprotected intercourse to avoid the risk of multiple pregnancy.

Patients who have received human chorionic gonadotropin (hCG) or GnRH agonist trigger may proceed to egg collection and freeze-all, if appropriate facilities are available and after a multi-disciplinary assessment of risk.

Patients who develop symptoms after oocyte collection should not have an embryo transfer.

Embryo transfer, or intra-uterine insemination should not be carried out in women with suspected or diagnosed COVID-19.

Stopping treatment programmes

For the reasons above, it is expected that, as the UK epidemic is now proceeding, all centres will stop initiating new fertility treatments, including in vitro fertilisation (IVF), frozen embryo transfer, surgical sperm retrieval, insemination and ovulation induction. This is also in keeping with recommendations from other professional bodies in the field of fertility treatment (Ref 4 and 5). When such a decision is made, it is reasonable for clinics to complete treatment that has already commenced in patients who remain well and where the centre's resources allow this to be done safely. However, clinics should be mindful both of their duty to minimise spread and of the impact of any complications on the NHS. Moderate or severe OHSS, which is often managed in an NHS emergency care setting, has been reported in 3.1 to 8 percent of stimulated treatment cycles. The risk of OHSS is reduced by the use of GnRH agonist trigger and freeze-all. It is mandatory therefore to consider these measures in women currently in the process of treatment.

Fertility preservation

Where resources allow, it is appropriate to continue non-elective fertility preservation, for example sperm and oocyte or embryo storage for cancer patients, provided they show no symptoms of infection. It should be borne in mind that these patients may be immunocompromised, and shared decision-making involving the patient, oncologist and fertility specialist is key. Fertility preservation should only be carried out in patients who remain well during treatment, and provided sufficient resources are available to do this safely. Local arrangements will be needed to allow these procedures to take place.

Outpatient clinics and diagnostic work

As part of social distancing, it is reasonable to advise that all face-to-face work should pause, other than in emergency situations, and where delay would be detrimental to the prospects of patients. Where possible, clinics should facilitate telephone or video consultations. If patients are attending for face-to-face encounters, care should be taken to stagger appointment times to prevent large groups of people congregating in waiting areas. Group sessions and support group meetings should not go ahead while social distancing is in place. Staff who can work from home should be facilitated to do so where appropriate, by provision of remote access to electronic case records as confidentiality restrictions allow.

Patient support and communication

Clinics should be aware of the potential emotional impact of the disruption of treatment services on their patients, occurring on a backdrop of anxiety about the effects of the virus itself. Measures should be put in place to keep patients informed of changes to the service and the reasons for these. Patients are likely to have concerns about the effect of delay on their chances of success and eligibility for NHS funding. It is likely that the ongoing uncertainty about the length of delay will compound these worries. All members of the clinical team have a role to play in supporting patients, with a special emphasis on the role of trained counsellors. It is recommended that usual facilities for answering phone call queries be enhanced to account for increased demand around short notice changes in service provision. Clinic websites and apps have a role in keeping patients informed and allaying anxieties in a difficult time.

Issues concerning funding and eligibility

Clinics should establish liaison with commissioners of NHS services to clarify their position on funding of treatment cycles that are cancelled, and the eligibility of patients who reach age thresholds without receiving treatment, due to the coronavirus outbreak. Significant numbers are likely to be affected, and it is likely that individual Exceptional Funding requests will not be appropriate for the circumstances we recommend that commissioners make timely decisions to guarantee treatment in the future for all currently eligible fertility patients negatively affected by the COVID-19 pandemic, to minimise distress and facilitate pathways once treatment resumes.

Staffing

Centres should work to identify the minimum number of staff that are necessary to maintain urgent services such as fertility preservation for oncology patients. It is likely in NHS settings that a large proportion of medical and nursing staff will need to be redeployed to other areas, however measures should be taken to try to ensure that staff with the requisite skills and training to deliver urgent treatments are available at all times. If sufficient staff are not available due to illness, then centres should seek support through their reciprocal support agreements with other centres or networks.

Sufficient scientific staff should be in place to maintain and ensure the ongoing safety of gamete and embryo storage banks. To guard against the risk posed by significant numbers of scientific staff becoming ill and forced to self-isolate, centres should ensure that sufficient scientific staff are available and are cross-trained to deliver all key tasks including ongoing quality control and maintenance.

Appropriate levels of staffing should be determined by the person responsible, taking advice from nursing, medical and scientific professional leads within the centre. It is incumbent upon public relations (PR) to ensure that services are reduced in keeping with available levels.

Diagnostic services

Where assisted conception centres undertake diagnostic activities, such as semen analysis or post-vasectomy testing and these involve attendance at the clinic, these should be suspended in order to minimise social contact.

Where diagnostic services are part of NHS pathology (or other) departments, the above also applies and staff may be asked to redeploy during the epidemic.

Resuming services

Whilst every effort must be made to reduce services over coming weeks and months, it is necessary to think forwards towards a resumption of services. Maintaining contact with patients whose treatment has been disrupted or deferred is important, and consideration should be given to prioritisation when services are able to recommence. The timing of this will be dependent on ongoing Government advice, resumption of NHS normal working practices as well as centres' own staffing and other resources.

The BFS and ARCS continue to monitor the ongoing pandemic and advice from national authorities. Further guidance will follow as appropriate, with the ultimate aim of resuming normal services as soon as possible.

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Guidance for the care of fertility patients during the coronavirus COVID-19 pandemic - BioNews

Embryology

Inquisitive Professors: Decades of Teaching and Learning – The Hilltop News

Alexis Westrick

There are many aspects of LaGrange College that appeal to potential students. There are dozens of great organizations and clubs, diverse majors to choose from, and a strong sense of community. But what really makes LaGrange special is the staff and professors who have dedicated their time and effort to help their students achieve their goals.

Recently, Dr. William Paschal, Dr. John Cook, and Dr. William Yin have all celebrated 25 years with the college, and Dr. Nina Dulin- Mallory has just celebrated 35 years. Susan Laforet, the secretary for the Science and Mathematics departments, has also been at LaGrange College for 25 years. Although she could not be contacted for this interview, her time and dedication to LaGrange is deeply appreciated.

Dr. Cook is a professor of religion and philosophy. He has taught Scriptures, American Christianity, Political Philosophy, and many other classes during his time at LaGrange. When asked if he preferred religion or philosophy, he said that he liked both, but it was refreshing to teach philosophy, because it involves more reason. He actually audited a physics class at the college and has taught a class on the philosophy of physics. Some people would not be able to find the connection, but he claims that you can see the hand of God in these theories.

Dr. Paschal describes Human Anatomy as his bread and butter, but his PhD is in Neurobiology. He also teaches a Paleoanthropology course and Vertebrate Embryology. Dr. Paschal teaches students from an assortment of majors including Biology, Nursing, and Exercise Science. Its a diverse lot, he says. Its a lot of fun to teach people I wouldnt normally meet.

Dr. Yin has the privilege of mentoring all of the math majors on campus, because while Analysis is his expertise, he also teaches classes like Probability, Calculus, and Problem Solving. He says that he really enjoys Problem Solving, because he gets to meet students from all areas of study. He explained that each major has a different perspective and a different way to tackle a problem.

Dr. Dulin-Mallory has been LaGrange Colleges Medieval expert for 35 years now, and, as she says with a laugh, everything else gets too complicated. Her favorite class to teach is Chaucer, because she was influenced by people who were enthusiastic when she was a student. She said, The energy and warmth with which they taught influenced how I feel about the subject. Anyone who has been in one of her classes knows exactly what that energy feels like.

LaGrange College has many gifted professors, and while they could have pursued careers at larger institutions, these four professors have remained dedicated to this institution and its students for decades. When asked why he chose to stay at LaGrange for over two decades, Dr. Cook immediately said, When I see a student come alive in class, start participating and asking questions. When a student with a lot of personal problems is able to turn that around and come out at the very top of the course. Its nice to see transformation like that. Its something that the college does well.

The Delta Tau Delta fraternity recently celebrated their 50th anniversary at LC. Dr. Paschal has served as the faculty advisor for the Delts for 25 years, so the 50th celebration was the perfect place catch up with alumni that he has known since their freshman year. When I knew them, they were kids, he explained. The greatest teaching moment is not something that you get all the time. Its not tangible. Its not something that you can measure. Its when you run into a student years later. I know I only played a small part in their time here, but I still feel like a proud papa when I see them all grown up. He went on to say that LaGrange Colleges small size is what makes it special. It allows students and faculty to build relationships, rather than limiting them to large lecture halls filled with a sea of 200 students.

Dr. Dulin-Mallory agreed, saying, The best connections take place, not in great halls, but in small spaces. The things that we take away happen in a conference, not in a room with a projector. She went on to say that she takes great pleasure out of the kind of students that come to LaGrange College, because they are curious and want to ask questions. Dr. Dulin-Mallory raised her family in LaGrange, and for thirty years she has lived across the street from the college.

Dr. Yin chose to stay at LaGrange College because of the interactions he has with the students. He mentioned one student in particular who went on to get his PhD from the University of Florida, and now that student runs his own company. Years later, Dr. Yin ran into this student and his girlfriend. As Dr. Yin and the student conversed about his former classmates, his girlfriend looked on in awe. Do you know all of your students? she asked. And Dr. Yin simply shrugged and said, Yeah. It is easy to forget how many students at larger institutions miss out on the opportunity to build personal relationships with their professors. At LaGrange College, the professors get to know their students, and they care about those students success.

Teachers at LaGrange College also get the opportunity to explore areas outside of their expertise. Many of them take full advantage of this fact, and they encourage their students to do the same. Dr. Cook explored a humanities class that was out of his area, where he was able to read The Odyessy and Platos Republic. He also taught a Jan-Term class about the writings of C.S. Lewis. He has held onto a phrase that LaGranges Reference Librarian, Dr. Arthur Robinson once said: Take a class in basket weaving. Dr. Cook explained, Take something completely out of your area just so you can have fun doing it. Life is going to be all work, and your job isnt going to be just your major, so finding other interests is important.

Dr. Yin agreed, saying, You have to think outside of the box of your own major. Problem Solving, if anything, is preparing students for life, because life will not always be within your major. Dr. Yin has taught a Bruce Lees Philosophy class with a former theater professor over Jan-Term where they discussed the acting and cinematic techniques behind Bruce Lees movies. Dr. Yin actually taught martial arts!

Anyone who is currently taking Shakespeare with Dr. Dulin-Mallory and Professor Barber Knoll this spring can tell that this duo has a blast teaching together. Dr. Dulin-Mallory teaches the evolution of the English language, while Professor Knoll explores the theater aspect of the study. Even though they are there to teach the students, they can also learn from each other. This is just gravy to do this with her, Dr. Dulin- Mallory says with a grin. We do thing like this out of joy and for the fun of it. Its an opportunity really, because its not particularly easy.

This past Jan-Term Dr. Dulin- Mallory explored another subject. She went to Iceland with a physicist from LaGrange College, where they saw the Northern Lights. She said it was great fun and that she learned a little about the science of that, but certainly not physics.

Dr. Paschal might be one of the professors that has ventured the furthest from his area of study. The crowded bookshelves in his office are not limited to paleontology and human evolution. They also host books about 19th century art, cave paintings, and Mayan ruins. There are even several Stephen King books in one corner. Ive always loved art, he explained, referencing the art book his parents kept on the coffee table. This book now lives on his bookshelf. I doodle and draw in class a lot. Not that theyre any good, he said, doubling over with laughter.

For his Jan- Term trip this past January, Dr. Paschal went to France with Dr. Joiner, LaGrange Colleges resident art historian. Together, they took students to famous Parisian museums such as the Louvre and the Muse dOrsay. They also explored the caves at Font de Gaume and Lascaux II and toured the French countryside. When he saw the cave paintings, Dr. Paschal expressed the endearing excitement and wonder of a child. Dr. Paschal has also been to Central America three times with the schools history department, where he was able to see the Mayan ruins, go bird watching, and see monkeys. There, he said, he learned about the emergence of our species and language.

Dr. Paschal encourages his students to also find joy in curiosity and exploration. He said, I think that a lot of students take a course, and if they dont see how it will help them in their chosen career, they think its not important. But theyre missing so much! Students need to open themselves up to new experiences. Find a way to enjoy it. Youll do a lot better in the course if youre curious, more active, and if you ask questions.

During their time here, these professors have seen students and colleagues come and go. Dr. Dulin- Mallory joked that her greatest accomplishment has been lasting. But she also says that being able to watch how things have changed has been a privilege. From pen and paper to computers and email, she has seen an arc of development. Perhaps it is her curiosity, and the curiosity of her colleagues, that has made the last couple of decades at LaGrange College so enjoyable. Many people think that there is no excitement in staying in one place, but they are not looking at it in the right way. These professors spend every day not only trying to spark their students interest, but also their own. They are teachers, but they also learn from their students and continue to grow along with them. And that is what makes it exciting. Dr. Dulin-Mallory had the answer to lasting when she said, Be curious. And never give up.

Alexis Westrick iscurrently a junior at Lagrange College. She is earning her undergraduate degree in English. She is also earning her BFA with a concentration in painting and drawing and graphic design.

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Inquisitive Professors: Decades of Teaching and Learning - The Hilltop News

Physiology

Identify the root of your symptoms using functional blood tests at RedRiver Health and Wellness – St George News

Stock image, St. George News

CONTRIBUTED CONTENT Have you seen your doctor because you suffer from fatigue, brain fog, hair loss, digestive issues, joint pain, or other symptoms, and you were told your blood test is normal? You may have even been given a prescription for antidepressants, because your tests dont seem to indicate you have a physical health problem.

You know something is wrong and that youre not supposed to feel this way, but what is the cause? At RedRiver Health and Wellness Center, we believe the reason your blood test didnt show anything wrong with you is because most doctors use lab ranges instead of functional ranges when evaluating the results.

A lab range identifies acute disorders and diseases, while a functional range uses parameters of optimal health and identifies problems that often can still be reversed. This allows you to do something about the problem before its too late.

For instance, using a functional range, you can identify hypothyroidism even though your primary thyroid marker is normal according to a lab range.

Address your health problem before its too late

In functional medicine, we identify and manage the root cause of symptoms instead of using drugs or surgery to stamp them out although medications or surgery may still be necessary in some cases. The most common analogy we use in functional medicine is that when the check engine light comes on, we look under the hood to diagnose the problem instead of turning off the engine light.

Functional blood test ranges, which outline the parameters of good health, are an important tool to help us with this.

What is the difference between functional ranges and lab ranges on a blood test?

For the most part, lab ranges are based on a bell-curve analysis of the people who had blood drawn at that lab over a certain period of time. Naturally, many of these people are getting their blood drawn because they have a health problem.As a result, lab ranges have broadened over the last 20-30 years as the health of the United States population has declined.

This means many people with health issues may be told nothing is wrong because their labs fit in with most people at that lab. If you want to evaluate your health in terms of what is optimal, then functional ranges are the way to go.

Looking for patterns on a functional blood test

With a functional blood test, we also look at patterns of markers instead of looking at each marker in isolation. This is based on understanding that various aspects of human physiology are interrelated and affect one another. Doing this allows us to see how different systems influence one another to cause a pattern of symptoms.

For instance, evaluating immune cells more broadly can give us clues as to whether inflammation is chronic or acute and whether it is caused by a virus, bacteria, allergies or parasites. Other patterns can help us spot fatty liver, leaky gut, different types of anemia or autoimmune disorders. This then helps us determine what types of testing are further needed.

Functional blood tests are more thorough

Functional medicine blood tests are also more comprehensive than a standard blood test.For example, a basic thyroid test from your doctor probably only looks at TSH, or thyroidstimulating hormone. However, because autoimmune Hashimotos, which attacks and destroys the thyroid gland, causes 90% of hypothyroid cases in the United States, we run autoimmunemarkers to screen for Hashimotos. We also look at other markers to see whether additional factors are contributing to your low thyroid symptoms.

Ask my office for more information regarding a functional blood test if you are struggling withchronic health symptoms that are sabotaging your quality of life.

Written by JOSH REDD, chiropractic physician atRedRiver Health and Wellness Center.

S P O N S O R E D C O N T E N T

About Dr. Josh Redd

Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. He also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing and more.

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Identify the root of your symptoms using functional blood tests at RedRiver Health and Wellness - St George News