As people age, they may experience a condition called “sarcopenia,” which involves gradual muscle loss. This can make older individuals more susceptible to injuries and serious falls. Fortunately, there are ways to reverse this process. Watch this video to learn more.
“Understanding Monotropism and Its Connection to Autism”
Monotropism is a person’s tendency to focus their attention on a small number of interests at any time, often leading them to overlook things outside of this narrowed focus. This cognitive strategy has been suggested as a central underlying feature of autism. Dinah Murray, Wenn Lawson, and Mike Lesser developed the theory of monotropism in the 1990s and first published it in 2005.
The rising popularity of Ozempic and Wegovy among privately insured patients could exacerbate disparities.
A new study from USC suggests that individuals with public insurance who could benefit from new drugs for diabetes and obesity are less likely to receive them compared to those with private insurance.
Prescription fills for the drug known as Ozempic or Wegovy, also called semaglutide, surged by over 400% from January 2021 to December 2023, according to new research in JAMA Health Forum.
Semaglutide was initially approved for type 2 diabetes and later for weight loss. Studies have shown that it also improves blood pressure and reduces the risk of cardiovascular disease, which are common issues for millions of Americans. However, the majority of prescriptions for semaglutide were given to individuals with private insurance.
“Considering the established cardiovascular advantages of Ozempic and Wegovy for treating diabetes or obesity, and the higher prevalence of diabetes and obesity in Black/Latinx Medicaid and Part D populations, these results indicate that their limited use in Medicaid and Part D could exacerbate disparities in diabetes and obesity outcomes,” explained Dima Qato, who is an associate professor at the USC Mann School of Pharmacy & Pharmaceutical Sciences and a senior scholar at the USC Leonard D. Schaeffer Center for Health Policy & Economics.
“While the media focuses on semaglutide’s anti-obesity effect, we should not overlook its significant role in treating diabetes. This medication has allowed me to help some of my patients reduce their reliance on insulin,” explained Christopher Scannell, a physician and postdoctoral researcher at the Schaeffer Center. He also highlighted the importance of ensuring broader access to these medications beyond just those with private insurance or more comprehensive health plans, as this is an issue of equity affecting a large portion of the U.S. population.
Please take note of the following information:Ozempic and Wegovy are both administered via once-weekly injections. Another form of semaglutide, Rybelsus, is available in the form of a daily pill. Ozempic was approved in 2017, followed by Rybelsus in 2019, both intended for the treatment of type 2 diabetes. Wegovy, approved in 2021, is a higher-dose version specifically designed for weight loss. As for pricing, Ozempic’s sticker price is approximately $1,000 per month, while Wegovy is listed at around $1,350.
For the study, researchers utilized data from IQVIA’s National Prescription Audit PayerTrak, which captures 92% of prescriptions filled and dispensed to individuals at retail pharmacies in the United States.
They calculated monthly medication fills for semaglutide under different drug brands (Ozempic, Wegovy, and Rybelsus) and payment methods (commercial insurance, Medicaid, Medicare Part D, and cash) from January 2021 to December 2023.
- Please make a note of the following text: In 2023, Medicaid accounted for less than 10% of semaglutide prescriptions across all three drug brands. According to Scannell, access to these drugs through Medicaid is determined at the state level. Whether or not the drugs are covered depends on the budget and politics of your specific location. It’s important to note that Medicaid provides assistance to low-income individuals, the elderly, and some people with disabilities.
- In 2023, Medicare Part D represented 28.5% and 32.9% of Ozempic and Rybelsus fills, respectively. However, it only made up 1.2% of Wegovy fills. It’s important to note that Medicare Part D does not cover drugs for obesity unless a patient also has a co-morbidity such as cardiovascular disease, which both Wegovy and Ozempic can help prevent.
- Approximately 1% or less of all semaglutide fills went to people paying cash in 2023.
In the context of treating obesity, Scannell stated, “If Medicare only covers these drugs for patients who have obesity and a co-morbidity, it may force patients who only have obesity to develop additional chronic conditions before they can access the medications. It’s like saying, ‘You have to be sick enough, then we’ll cover that medication for you.’”
The researchers suggested that future studies should investigate how changes in Medicare Part D and Medicaid coverage restrictions impact disparities in access to these important medications. Additionally, further research could explore individual-level variables like age, race, and ethnicity, as well as whether the drugs were prescribed for obesity or diabetes.
The psychological impact of war on autistic children
A recent study uncovered concerning results about the psychological effects of terrorism on autistic children and their parents in the aftermath of Hamas’ attack on Israel on October 7th, 2023. Within 30 days of the attack, both autistic and non-autistic children displayed significant symptoms of post-traumatic stress. Autistic children exhibited a more pronounced response, and their parents experienced higher levels of depression, anxiety, and stress. This emphasizes the pressing need for specialized mental health services for these families. These initial findings underline the critical necessity for immediate and ongoing mental health support for all children and parents affected by the conflict.
In the first-ever study of autistic children and their parents in the context of war, Dr. Judah Koller from the Seymour Fox School of Education at the Hebrew University of Jerusalem and his team, led by doctoral student Shir Rozenblat, found alarming preliminary findings on the impact of terrorism and war on this population. The study, which focuses on the psychological aftermath of Hamas’ October 7th, 2023 attack on Israel, underscores the urgent need for tailored support services for autistic children and their families during times of conflict.
Within 30 days of the attack, both autistic and non-autistic Israeli children displayed significant post-traumatic stress symptoms. Autistic children showed more severe symptoms, indicating their increased vulnerability. Parents of autistic children also reported higher levels of depression, anxiety, and stress compared to parents of non-autistic children. These levels were 2-4 times higher than those reported by a separate group of parents of autistic children assessed before the war in a study conducted by the Azrieli National Centre for Autism and Neurodevelopment Research at Ben Gurion University.
“Autistic children’s dependence on routine and predictability is significantly disrupted during terrorist attacks and warfare, which appears to heighten their stress responses,” said Dr. Koller. “Parenting a child during wartime is a universal challenge, but our findings indicate that autistic children and their parents need targeted mental health support that considers their unique characteristics.”
The study used online questionnaires filled out by caregivers to quickly and efficiently collect data from a large and diverse population. The researchers recognize that the findings may not be widely applicable due to the limited sample size and specific characteristics of the participants. However, they highlight the significance of these initial results as an essential first stage in a year-long longitudinal study.
The research team has finished gathering data for a comprehensive study that uses a variety of methods and includes a broader range of both autistic and non-autistic children, as well as their parents. The study, done in collaboration with Dr. Yonat Rum from the School of Education, involves detailed examinations of parental post-traumatic stress and resilience, as well as qualitative data on families’ experiences. Dr. Koller explained, “Our aim is to gain a thorough understanding of the ongoing impact of war on these vulnerable groups and to advocate for the necessary support services.”
These findings emphasize the urgent and ongoing need for mental health support for children and parents impacted by the conflict. The study urges policymakers and healthcare providers to prioritize the unique needs of autistic children and their families, not just in Israel but in conflict-affected areas around the globe. This project is a joint effort involving ALUT, the Israeli Society for Autistic Children and Adults, Bar-Ilan University, and Ben-Gurion University.
Barriers complicate exercise for disability community
An exergame is type of accessible exercise equipment with a video game component that keeps users engaged while monitoring their activity Photo courtesy UT Arlington
An estimated 16% of people worldwide live with a significant disability that impacts their daily life. Of this population, only about 40% engage in aerobic activity. Due to this lack of exercise, people with disabilities (PWD) are more likely to suffer from chronic conditions such as heart disease, stroke, diabetes, or cancer and are at higher risk of mental illnesses like depression and anxiety.
“Many PWD struggle with psychological issues such as low self-esteem and negative body image, which can further reduce their motivation to participate in exercise activities, especially in public places like gyms,” said Alexandra Jamieson, research scientist at The University of Texas at Arlington Research Institute (UTARI) and lead author of a new peer-reviewed study on adaptive exercise technologies for PWD. Former UTARI student researcher Helara D. Wijesundara is also an author on the paper.
Even PWD who are interested in exercising face challenges, as most commercial gyms lack adaptive equipment and properly trained staff to ensure their safety. Jamieson found that although some nonprofit organizations aim to promote fitness for PWD, there are few commercial efforts to reach the wider community to encourage exercise.
“The biggest barriers to fitness are accessibility and cost,” said Jamieson. “Standard gyms are not legally required to have adaptive machines for users of differing abilities. Plus, there is generally a lack of data about the demand for these adaptive machines that would help gyms justify the higher costs of adding them.”
She also noted that transportation to and from the gym can be an issue for PWD. Although ride-sharing and disabled transit options exist, they are not always reliable, and many are not equipped for PWD.
Home gyms are a popular option for PWD, but a lot of adaptative exercise equipment is produced by smaller manufacturers and has higher production costs, making it cost-prohibitive for individuals to purchase it. Jamieson suggests expanding government assistance programs around acquiring adaptative exercise machines for home use.
“Medicaid does have purchasing assistance programs for PWD to buy assistive technology, but they are not well known and only cover exercise machines that are deemed medically necessary by an individual’s doctor,” she said. Raising public awareness among physicians and PWD about how to apply for assistance to acquire adaptive exercise equipment could be a way to help.
To improve adaptive exercise options, Jamieson is working with colleagues from UTARI, the Department of Kinesiology, and the Department of Art to create an adaptive exergame machine, a type of accessible exercise equipment with a video game component that keeps users engaged while monitoring their activity. The team is currently recruiting individuals to participate in a pilot study of the technology. Please contact Jamieson if you would like additional information.