Latest / Morning Medical with Dr. Chow / Veteran Mental Health, RSV Vaccine Updates, and King Charles' Fitness Regimen

Transcript

Veteran Mental Health, RSV Vaccine Updates, and King Charles' Fitness Regimen · Morning Medical with Dr. Chow

• 0:00
  Welcome to Morning Medical with Dr.
• 0:01
  Chow, where we bring you the latest medical and health news from around the world.
• 0:06
  I'm your host, Dr.
• 0:08
  Chi-Ming Chow.
• 0:10
  Today, we're going to discuss a significant and often overlooked issue: the mental health of
• 0:15
  our veterans, especially highlighted on Remembrance Day.
• 0:22
  Remembrance Day serves as a time to honor those who have served in the military and to reflect
• 0:28
  on the sacrifices made by our veterans.
• 0:31
  However, it also brings to light the mental health struggles that many veterans face.
• 0:37
  It's a challenging topic, as those who have served often find it hard to reconcile their
• 0:42
  experiences and the expectations of being seen as heroes with their own mental health needs.
• 0:49
  One such story is that of Adam Moore, who began his military service as a teenager.
• 0:55
  His journey was fraught with physical injuries and the internal battle of feeling undeserving
• 1:00
  of the resources available for mental health support.
• 1:04
  Adam's story is a poignant reminder of the silent battles many veterans face, even after
• 1:10
  leaving the military.
• 1:11
  He shared that upon leaving the army, his life took a drastic turn, leading to personal
• 1:17
  hardships like divorce, exacerbated by the COVID-19 pandemic.
• 1:22
  This highlights the ongoing challenges veterans can face in civilian life.
• 1:27
  Another veteran, Kevin Roth, a master sailor on the HMCS Vancouver, bravely shared his own
• 1:34
  struggles, including contemplating suicide.
• 1:38
  His story is a stark reminder that the journey to mental health recovery is often long and
• 1:44
  arduous, beginning with the difficult admission of needing help.
• 1:48
  Kevin emphasizes the importance of reaching out and seeking help, as the hardest step is often
• 1:54
  admitting to oneself that help is needed.
• 1:57
  Jason Trenholm, another veteran, found himself lost after leaving the military, questioning
• 2:03
  his identity without the uniform.
• 2:05
  His experience underscores a common issue among veterans: the struggle to find purpose and
• 2:10
  identity in civilian life.
• 2:13
  Jason now works with OSI-CAN, an organization that offers peer-to-peer support, helping
• 2:19
  veterans and first responders connect and heal through shared experiences.
• 2:25
  These personal stories reflect a broader issue of stigma and limited resources that prevent
• 2:30
  many veterans from seeking the help they need.
• 2:34
  The perception of veterans as unwavering heroes can often hinder their ability to express
• 2:39
  vulnerability and seek mental health support.
• 2:42
  But as we hear from these veterans, acknowledging vulnerability can be a powerful
• 2:46
  step towards healing.
• 2:49
  It's crucial for us as a society to create an environment where veterans feel safe to express
• 2:54
  their struggles without fear of judgment.
• 2:58
  On this Remembrance Day, let's not only honor the sacrifices of our veterans but also commit
• 3:03
  to supporting their mental health needs.
• 3:06
  Remember, if you or someone you know is in crisis, resources are available, including
• 3:12
  mental health hotlines and support networks.
• 3:16
  As King Charles marks his seventy-sixth birthday, there's been a lot of buzz about his
• 3:21
  exceptional fitness regimen.
• 3:23
  Known for his commitment to health and wellness, King Charles continues to defy
• 3:27
  expectations with his active lifestyle, even as he steps into his late seventies.
• 3:32
  Queen Camilla affectionately refers to him as a "mountain goat" due to his impressive stamina
• 3:39
  and ability to outpace others during walks.
• 3:42
  She lauds him as perhaps "the fittest man of his age" she knows, highlighting his dedication
• 3:47
  to staying fit.
• 3:50
  In a recent conversation with sprinter Desiree Henry, King Charles revealed that he exercises
• 3:55
  twice a day, incorporating squats and pull-ups into his routine.
• 4:00
  These exercises are particularly beneficial for older adults, as they help improve upper body
• 4:05
  strength, grip, and core stability, which are crucial for daily tasks and preventing falls.
• 4:12
  Personal trainer Chloe Thomas emphasized the wide-ranging benefits of pull-ups, especially
• 4:16
  for those in their seventies.
• 4:17
  Pull-ups not only enhance upper body and grip strength but also support shoulder and joint
• 4:23
  health.
• 4:24
  Chloe notes that these exercises are vital for small daily activities, such as opening jars or
• 4:30
  maintaining balance, because they bolster grip strength.
• 4:34
  This is crucial as one ages and becomes more susceptible to injuries.
• 4:39
  King Charles also incorporates squats into his daily routine, which Chloe points out are often
• 4:45
  associated with aesthetic benefits but are incredibly important for functional strength.
• 4:51
  Squats strengthen the legs, hips, and glutes, enabling older adults to perform daily
• 4:58
  activities independently.
• 5:01
  Strong leg muscles are essential in the seventies to reduce the risk of falls, a common
• 5:06
  concern for older individuals.
• 5:09
  King Charles' commitment to fitness is not only about maintaining his physique but also about
• 5:14
  addressing past injuries.
• 5:16
  He has a history of back pain from a polo accident in the nineteen-nineties, making his
• 5:21
  focus on strength and stability even more pertinent.
• 5:25
  His dedication serves as an inspiring example of how maintaining a consistent workout routine
• 5:31
  can greatly enhance quality of life, even in one's later years.
• 5:35
  Let's turn our attention now to a crucial topic for older adults: the respiratory syncytial
• 5:41
  virus, commonly known as RSV, and the importance of vaccination for those at high
• 5:47
  risk.
• 5:48
  Recently, the Centers for Disease Control and Prevention updated their recommendations,
• 5:54
  advising that all adults aged seventy-five and older receive a single dose of any Food and
• 5:59
  Drug Administration-approved RSV vaccine.
• 6:02
  This guidance also extends to adults aged sixty to seventy-four who are at increased risk of
• 6:08
  severe illness from the virus.
• 6:10
  The Centers for Disease Control and Prevention's updated recommendations come after
• 6:16
  real-world data confirmed the effectiveness of RSV vaccines in their first season.
• 6:21
  This data showed that the vaccines significantly reduced hospitalizations,
• 6:26
  critical illness, and emergency department visits among adults sixty and older, including
• 6:32
  those who are immunocompromised.
• 6:34
  This is a shift from the previous guidance which encouraged adults to discuss with their
• 6:39
  healthcare provider whether they should get the vaccine.
• 6:42
  Now, there is a clearer directive for those at higher risk.
• 6:46
  So, who exactly falls into the high-risk category among the sixty to seventy-four age
• 6:52
  group?
• 6:53
  The Centers for Disease Control and Prevention lists several conditions, including chronic
• 6:58
  lung or respiratory diseases, severe obesity, chronic cardiovascular disease, moderate or
• 7:05
  severe immune compromise, and living in a nursing home.
• 7:09
  Other conditions include end-stage renal disease or dependence on hemodialysis, diabetes
• 7:16
  with comorbidities, certain neurological or neuromuscular conditions, chronic liver
• 7:21
  disease, chronic hematologic conditions, and any other chronic conditions deemed risky by a
• 7:26
  healthcare provider.
• 7:28
  Interestingly, the Centers for Disease Control and Prevention allows individuals to
• 7:34
  self-attest to conditions that place them at high risk of severe illness from RSV.
• 7:40
  Dr.
• 7:40
  Angela Branche from the University of Rochester Medical Center highlights that age is not the
• 7:45
  only risk factor.
• 7:47
  Often, RSV exacerbates underlying health conditions such as chronic heart and lung
• 7:52
  problems, which can lead to hospitalization.
• 7:55
  In many cases, it's not the virus itself causing the hospitalization, but the flare-up
• 8:00
  of an existing condition like heart failure or chronic obstructive pulmonary disease following
• 8:05
  an RSV infection.
• 8:08
  Currently, all three RSV vaccines—GSK's Arexvy, Pfizer's Abrysvo, and Moderna's mRESVIA—are
• 8:16
  approved for all adults aged sixty and up.
• 8:20
  Notably, Pfizer's Abrysvo is also approved for use in pregnant women to help protect their
• 8:26
  newborns.
• 8:27
  These vaccines have recently received expanded indications for use in younger populations at
• 8:31
  higher risk of severe RSV disease.
• 8:34
  For example, Arexvy is now approved for at-risk adults aged fifty to fifty-nine, and Abrysvo
• 8:40
  for those aged eighteen to fifty-nine.
• 8:44
  However, the Centers for Disease Control and Prevention has not yet included these younger
• 8:48
  age groups in its official recommendations due to insufficient evidence.
• 8:53
  The Advisory Committee on Immunization Practices noted that more data is needed to
• 8:58
  make informed recommendations for adults aged fifty to fifty-nine who are at increased risk
• 9:03
  of RSV disease.
• 9:05
  This includes further analysis of vaccine safety, duration of protection, and immune
• 9:10
  response after revaccination, as well as data on immunogenicity in immunocompromised adults.
• 9:16
  During a recent meeting, the risk of Guillain-Barré syndrome following RSV
• 9:20
  vaccination was discussed.
• 9:23
  Fortunately, it appears to be rare, with fewer than ten cases per million vaccinations.
• 9:29
  Dr.
• 9:30
  Branche emphasized the need for more real-world evidence on vaccine efficacy in younger groups,
• 9:36
  especially since clinical trials may not be feasible due to ethical concerns.
• 9:41
  The Centers for Disease Control and Prevention intends to continue monitoring RSV vaccine
• 9:46
  effectiveness in future seasons, which should provide valuable data on vaccine protection
• 9:51
  duration and efficacy.
• 9:54
  Let's dive into a fascinating and impactful study that highlights the potential of virtual
• 9:58
  mental health care in reducing suicide-related events among veterans.
• 10:03
  Conducted by the Boston University School of Public Health, this research sheds light on how
• 10:08
  telehealth can play a significant role in supporting veterans' mental health, especially
• 10:13
  during their transition back to civilian life.
• 10:17
  The study, "Virtual Mental Health Care and Suicide-Related Events," published in JAMA
• 10:21
  Network Open, analyzed data from the Veterans Health Administration.
• 10:25
  It focused on veterans diagnosed with major depressive disorder, substance use disorder, or
• 10:31
  posttraumatic stress disorder.
• 10:33
  The cohort included over sixteen thousand veterans and more than sixty-six thousand
• 10:37
  observations between March 2020 and December 2021.
• 10:42
  Researchers found that for every one percent increase in virtual mental health visits, there
• 10:47
  was a two-point-five percent decrease in suicide-related events.
• 10:51
  This is particularly significant given the rising rates of suicide in the United States,
• 10:57
  where rates increased by thirty-five percent from 2000 to 2018.
• 11:02
  Veterans, due to service-related stress, are especially vulnerable to such events.
• 11:09
  The study employed a quasi-experimental instrumental variable probit model, adjusting
• 11:15
  for confounding factors like mental health severity and access to care.
• 11:21
  Broadband access was used as an instrumental variable, correlating with the likelihood of
• 11:26
  receiving virtual mental health services but theoretically unrelated to the outcome of
• 11:31
  suicide-related events.
• 11:34
  The findings indicated that virtual mental health visits accounted for an average of
• 11:38
  forty-four-point-six percent of all mental health visits in the sample.
• 11:42
  Veterans in rural areas, where access to health care facilities is limited, particularly
• 11:47
  benefited from these virtual services.
• 11:50
  The researchers concluded that the increased telehealth capacity during the pandemic
• 11:54
  contributed positively to suicide prevention among veterans.
• 11:58
  Although the study highlights the potential of virtual mental health services, further
• 12:02
  research is needed to confirm these findings across different veteran demographics and
• 12:07
  beyond the unique circumstances of the pandemic.
• 12:10
  Expanding mental telehealth options within the Veterans Health Administration could reinforce
• 12:14
  broader mental health policies aimed at high-risk populations.
• 12:19
  As we wrap up today's episode, it's clear that virtual mental health care holds promise in
• 12:25
  reducing suicide-related events among veterans.
• 12:29
  This study underscores the importance of embracing technology in mental health care,
• 12:34
  especially for those who face barriers to accessing traditional in-person services.
• 12:39
  Thank you for joining us on Morning Medical with Dr.
• 12:42
  Chow.
• 12:43
  Until next time, take care and stay informed.