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Canadian researchers to release recommendations for treating youth eating disorders online – CBC.ca

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Sarah White sets a timer to remind herself to eat. She sets it six times a day so that she eats three meals and three snacks.

White says she’s always been a “picky eater.” But when she started working from home, her routine was interrupted and her already difficult relationship with food became dangerous. It ultimately led to an eating disorder diagnosis during the pandemic. 

“I had all of the time in the world to eat, but I was finding I wasn’t eating nearly as much as I should have been,” White, 33, said during a physically distanced interview at her Halifax apartment. “It started to feel a lot more serious than it had in the past.”

There’s been an alarming spike in the number of people seeking help for eating disorders. The National Eating Disorder Information Centre says the volume of inquiries to its help line and online chat service has been up 100 per cent during the pandemic.

“There’s been literature coming out across the world really suggesting that the numbers are skyrocketing and we’re trying to understand why that is,” said Dr. Jennifer Couturier, principal investigator for the Canadian Consensus Panel for Eating Disorders. 

Pandemic research effort

In May, the panel, which consists of clinicians, policymakers, parents and youth, received a $50,000 federal grant to determine how best to treat eating disorders during a pandemic, particularly in children and young adults under 25. Couturier says she feels this age group hasn’t received a lot of attention when it comes to research generally. 

The operating grant from the Canadian Institute of Health Research is part of a larger government program to fund mental health research related to COVID-19. 

The panel’s recommendations, which are about to be published in the Journal of Eating Disorders, are intended to help doctors determine what kinds of treatments they should and should not be delivering virtually.

WATCH |  Sarah White explains on her eating disorder:

Sarah White, 33, was recently diagnosed with avoidant restrictive food intake disorder (ARFID). She discusses the role the COVID-19 pandemic played in her illness. 0:56

The guidelines say that while virtual care can be suitable in some circumstances when treating eating disorders, it cannot wholly replace in-person visits, and that special care must be taken to ensure patients have enough privacy to express themselves during online sessions. 

In the early days of the pandemic, Couturier’s clinic was closed. She was not able to see patients in person at all until services slowly opened up for more urgent cases. 

It’s part of what made her realize new guidelines for online treatment were necessary. 

In-person visits still necessary

Couturier, who is also the co-director of the eating disorders program at McMaster Children’s Hospital in Hamilton, Ont., says in-person visits are still necessary in some cases.

“It’s not just talking, therapy, that’s important with eating disorders,” she said. “There’s also checking weights and checking vital signs, which can’t be done virtually.”

But she says some established treatments — such as family-based treatment, which gives parents an active role, and cognitive behavioural therapy — can be conducted virtually with some adjustments.

“We often start off the session saying, ‘Are you in a private space? Are you feeling comfortable?’ Couturier said.

Dr. Jennifer Couturier, principal investigator for the Canadian Consensus Panel for Eating Disorders, says there are benefits to virtual care, but some care must still be provided in-person. (Submitted by Jennifer Couturier)

She noted it’s also important for doctors to ensure no one barges into the room on their end while they’re with patients, especially if they’re working from home.  

Couturier says virtual care can improve access because it eliminates geographic inequities, but it can also create barriers for those who don’t have access to a computer and the Internet. She says her team’s guidelines encourage physicians and hospitals to be mindful of both. 

They’ll also recommend hospitals don’t, “just broadly say, ‘OK, eating disorders can be treated totally virtually,'” as was the case in the early days of the pandemic. 

Benefits to virtual care

Shaleen Jones, executive director of Eating Disorders Nova Scotia, agrees virtual care can increase access for people, particularly patients who live in rural areas. 

Her organization, which provides support, not medical care, planned to help 250 people over the past year. It ended up helping about 1,000 people through online peer support programs. 

Eating disorders thrive in isolation and secrecy– Shaleen Jones, Eating Disorders Nova Scotia

Jones says 85 per cent of the people her organization has helped are from Nova Scotia, with the remainder joining virtual sessions via Zoom from other Canadian provinces, particularly, New Brunswick and Prince Edward Island.

“Across Canada, we’ve really seen a number of folks who are reaching out for support for an eating disorder, just really going through the roof,” she said. “Eating disorders really thrive in isolation and secrecy.” 

Liberating diagnosis

White attended a peer support group offered by Eating Disorders Nova Scotia in the early days of the pandemic. She now works for the organization, a role to which she brings valuable real-life experience.

In September, she was diagnosed with avoidant restrictive food intake disorder (ARFID), an eating disorder that involves selective eating. It’s similar to anorexia in that it involves limiting the amount of food consumed, but different in that it does not involve distress about body shape. 

She says it was the diagnosis she didn’t know she needed because it helped explain what she had been experiencing most of her life.  

“It was kind of liberating,” she said. “It makes sense. It wasn’t just me trying to be difficult or me being a picky eater. It’s a legitimate mental illness.” 

White lives in Nova Scotia, where COVID-19 rates have remained relatively low. She was able to meet her physicians and get a diagnosis in person.

Couturier says she expects virtual care to remain a part of her practice going forward.

“There are so many benefits to it that I think these guidelines will still be quite relevant and applicable even when the pandemic has passed,” Couturier said. 

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Austrian government proposes law to legalise assisted suicide

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Austria’s federal government has submitted a draft law to make assisted suicide for seriously ill adults legal, the federal chancellery said in a statement on Saturday.

The new law lays out the conditions under which assisted suicide will be possible in the future, following a ruling by Austria’s Constitutional Court last December according to which banning assisted suicide was unconstitutional because it violated a person’s right to self-determination.

“Seriously ill people should have access to assisted suicide,” the federal chancellery said in the statement.

The new law allows chronically or terminally ill adults to make provisions for an assisted suicide.

They have to consult two doctors who have to attest the person is capable of making his or her own decisions. A delay of 12 weeks also has to be respected that can be reduced to two weeks for patients in the final phase of an illness.

 

(Reporting by Silke Koltrowitz; Editing by Christina Fincher)

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Namibia suspends use of Russian COVID vaccine after S.Africa flags HIV concerns

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Namibia will suspend the rollout of Russia’s Sputnik V COVID-19 vaccine, its health ministry said on Saturday, days after the drugs regulator in neighbouring South Africa flagged concerns about its safety for people at risk of HIV.

Regulator SAHPRA decided not to approve an emergency use application for Sputnik V for now because some studies suggested that administration of vaccines using the Adenovirus Type 5 vector – which Sputnik V does – can lead to higher susceptibility to HIV in men.

South Africa and Namibia have high HIV prevalence rates.

Namibia’s health ministry said in a statement that the decision to discontinue use of the Russian vaccine was “out of (an) abundance of caution that men (who) received Sputnik V may be at higher risk of contracting HIV,” adding it had taken SAHPRA’s decision into account.

The Gamaleya Research Institute, which developed Sputnik V, said Namibia’s decision was not based on any scientific evidence or research.

“Sputnik V remains one of the safest and most efficient vaccines against COVID-19 in use globally,” the institute told Reuters, adding over 250 clinical trials and 75 international publications confirmed the safety of vaccines and medicines based on human adenovirus vectors.

Namibia said the suspension would take effect immediately and last until Sputnik V receives a World Health Organization Emergency Use Listing. But it will offer people who received a first dose of Sputnik V a second to complete their immunisation course.

Namibia received 30,000 doses of Sputnik V as a donation from the Serbian government, but only 115 had been administered as of Oct. 20.

Namibia has also been using COVID-19 vaccines developed by China’s Sinopharm, Pfizer, AstraZeneca and Johnson & Johnson, acquired through a mix of procurement deals and donations.

So far it has only fully vaccinated around 240,000 of its 2.5 million people, reflecting African nations’ difficulties securing enough vaccines amid a global scramble for shots.

 

(Reporting by Nyasha Nyaungwa in Windhoek and Polina Devitt in Moscow; Editing by Alexander Winning and Ros Russell)

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Britain reports highest weekly COVID-19 cases since July

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Britain recorded the highest number of new cases of COVID-19 since July over the past week, government figures showed on Saturday, a day after Prime Minister Boris Johnson played down the prospect of a return to lockdown.

Some 333,465 people in Britain tested positive for COVID-19 over the past seven days, up 15% on the previous week and the highest total since the seven days to July 21.

Daily figures https://coronavirus.data.gov.uk showed there were 44,985 new cases on Saturday, down from 49,298 on Friday. Daily death figures were only available for England, and showed 135 fatalities within 28 days of a positive test.

Deaths have risen by 12% over the past week, and the total since the start of the pandemic now stands at 139,461, the second highest in Europe after Russia.

While vaccination and better medical treatment have sharply reduced deaths compared with previous waves of the disease, hospitals are already stretched and Britain’s current death rate is far higher than many of its European neighbours.

Government health advisors said on Friday that preparations should be made for the possible reintroduction of measures to slow the spread of the disease, such as working from home, as acting early would reduce the need for tougher measures later.

Johnson, however, said he did not expect a return to lockdown.

“We see absolutely nothing to indicate that is on the cards at all,” he said on Friday.

 

(Reporting by David Milliken, Editing by Timothy Heritage and Christina Fincer)

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