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Why Pharmacists Still Can’t Prescribe ARVs, Months After Court Gave the Green Light

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Specially trained pharmacists will soon be allowed to dispense antiretrovirals without a doctor’s script. Photo by National Cancer Institute on Unsplash

By Catherine Tomlinson

A Supreme Court of Appeal ruling in October 2025 cleared the way for specially trained and permitted pharmacists to dispense antiretroviral medicines without a doctor’s script. Seven months later, no pharmacists are yet providing these services. Spotlight explores the reasons for the delay.

After a three-and a half year court battle between a group of private doctors and the South African Pharmacy Council (SAPC), the Supreme Court of Appeal (SCA) cleared the way for the SAPC to implement pharmacist-initiated management of antiretroviral treatment (PIMART) in October 2025.

The SAPC welcomed the ruling with a bullish press conference promising rapid implementation of PIMART. “The South African Pharmacy Council, together with stakeholders and the Department of Health, will work with speed to ensure that PIMART-trained pharmacists join other primary healthcare practitioners in providing primary care in relation to HIV and Aids,” said Mogologolo Phasha, president of the SAPC, at the time.

Vincent Tlala, CEO and Registrar of the SAPC, also in October 2025, said that the SAPC aimed to issue an e-note inviting pharmacists to apply for the PIMART permits in November. However, seven months later, this has still not happened and no pharmacists in the country are yet permitted to provide PIMART services.

What is PIMART?

PIMART stands for pharmacist-initiated management of antiretroviral treatment. It is a form of task-shifting that allows pharmacists to provide some limited HIV services that are currently only provided by doctors and nurses. The programme seeks to better utilise pharmacists in the country’s HIV response and relieve some of the burden on overcrowded and under resourced public clinics. It will also offer a route into treatment for people who are not willing or able to visit clinics.

It is intended that, under the PIMART programme, pharmacists that have completed a dedicated training programme and have received a special permit from the Director-General of Health will be authorised to provide first-line antiretroviral treatment to people with uncomplicated HIV without a doctor’s script. They will also be allowed to dispense HIV prevention medicines without a doctor’s script – this includes both pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). PrEP is taken prior to sex to prevent potential infection while PEP is taken shortly after a possible HIV exposure to prevent infection.

Why is PIMART needed?

PIMART was proposed by the SAPC in response to a request from the health department for the SAPC to design an intervention to enable pharmacists to take on a greater role in the country’s HIV response.

South Africa has adopted the UNAIDS 95-95-95 targets that aim to ensure that 95% of people living with HIV know their status, 95% of people diagnosed with HIV are on treatment, and 95% of people on treatment are virally suppressed (and therefore cannot transmit HIV onwards).

According to new estimates from Thembisa, the leading mathematical model of South Africa’s HIV epidemic, 7.9 million people are living with HIV in South Africa. Ninety six percent of people living with HIV know their status, yet only 82% of people who know they are HIV positive are on antiretroviral treatment.

While South Africa’s health system should be commended for the fact that around 6.2 million people are taking HIV treatment, it is concerning that 1.7 million people living with HIV are not yet on treatment. In recognition of this problem, the health department has launched the “Close the Gap” campaign.

The thinking behind PIMART is that pharmacies can help close the gap by providing an important third option to people who are disinclined or unable to access HIV treatment from public clinics or private sector doctors.

More urgent than ever following US funding cuts

While PIMART was always intended to help identify patients falling through the gaps between South Africa’s public and private health sectors and to link them to care, the need for this third option is now more urgent than ever. US funding cuts over the last 15 months or so have led to the closure of many NGO-run clinics that previously provided HIV treatment and prevention services to populations at high risk of HIV who often face stigma at traditional health facilities. These groups include sex workers, men who have sex with men, and people who inject drugs.

In addition to expanding access to HIV treatment, PIMART aims to increase access to PrEP and PEP to prevent new HIV infections. While the full impact of US funding cuts on these services remains unclear, the cuts likely contributed to the slight decline in PrEP use in South Africa seen in 2025, following seven years of steady growth in PrEP uptake.

Graph by Spotlight. Data courtesy of the Thembisa model.

Finger pointing and lack of accountability

Seven months after the Supreme Court of Appeal ruled that the SAPC could implement PIMART and the SAPC promised to move rapidly in implementing PIMART, pharmacists have still not been invited to apply for permits and no PIMART permits have yet been issued to pharmacists.

When asked why the programme remains unimplemented, the SAPC pointed to the Southern African HIV Clinicians Society’s (SAHCS) PIMART training course as the cause of the delay.

SAHCS is the only entity in the country providing PIMART training to pharmacists. In October 2025, Mokoena said several groups had expressed interest in becoming accredited to provide PIMART training. However, on 14 May 2026, Tlala told Spotlight: “While we have invited existing providers of pharmacy education in South Africa to offer (the course), the South African Pharmacy Council is yet to receive applications for the accreditation of the PIMART supplementary training course.”

He added: “Currently, the Southern African HIV Clinicians Society are the only approved provider for the PIMART short course.”

So, what’s going on with SAHCS’ PIMART training?

PIMART used to be on a very different timeline before it got tangled up in the court processes that led to the October 2025 SCA judgment. Back in July 2021, Spotlight reported that the launch of PIMART was imminent, and indeed, that was roughly the timeline the SAHCS training had been working toward.

In fact, the SAHCS has offered a PIMART training course for pharmacists that want to provide PIMART services since 2019. Professor Natalie Shellack, chairperson of the SAPC Education Committee, said in October 2025 that this course was developed jointly by SAHCS and SAPC.

Over a thousand pharmacists have completed SAHCS’s original PIMART training course as continuous professional development (CPD) training. But after the October 2025 SCA ruling, Lizeth Kruger, Dischem’s Clinical Executive, told Spotlight that due to the time lapse between the initial training and court ruling, Dischem pharmacists “will need to do a refresher course to ensure compliance and up-to-date knowledge”.

While SAHCS’s PIMART course has not yet been accredited by the SAPC as a PIMART course, it is accredited as a CPD course for pharmacists. Tlala told Spotlight in May that it has not been accredited as a PIMART course because of an identified “gap” in the course.

“The gap identified between the short course and the approved qualification standard meant that the approved provider of the short course, the Southern African HIV Clinicians Society, had to conduct a gap analysis and develop a bridging course to enable pharmacists trained in the short course to access the full PIMART scope of services,” said Tlala.

In response to questions about the “gap” in their training course identified by the SAPC, SAHCS’s CEO Dr Fiona Storie told Spotlight on 19 May: “SAHCS has completed a full review and update of the PIMART training course in line with the requirements for accreditation as a supplementary training course (i.e. not just a CPD accredited course).”

“As PIMART training was originally provided from 2019, there is a need for pharmacists to undergo refresher training since the field of HIV medicine is evolving and clinical recommendations change over time,” said Storie. She added: “SAHCS’ recommendation is that pharmacists undertake the newly updated PIMART training course as either a refresher/bridging course or, if not previously trained, as a new course.”

“SAHCS is engaging with SAPC to finalise the accreditation of the updated PIMART course as a refresher course and a new supplementary training course to make it available as soon as possible,” Storie said.

Limiting PIMART’s scope

Tlala told Spotlight that because of the “gap” in SAHCS’s training course, the SAPC has asked the Director-General of Health to grant limited scope PIMART permits.

“The Director-General: Health has been requested to issue a limited scope permit granting PIMART-trained pharmacists’ access to those services fully addressed in the short course previously delivered by the South African HIV Clinicians Society,” he said.

The health department confirmed to Spotlight that this request was received on 23 April 2026.

Neither the SAPC nor the Department of Health responded to Spotlight’s requests for clarification on which PIMART services the SAPC had proposed for inclusion in the limited-scope permits.

Angela Tembo, director of pharmacy health at the research centre Ezintsha, told Spotlight that she understands that the limited scope permits that the SAPC has requested the Director-General of Health to grant “will be limited to HIV prevention (PrEP and PEP) and not treatment”.

“Our understanding is that the delays [in implementing PIMART] relate to ongoing discussions around training requirements, accreditation processes, and the practical implementation pathway following the SCA ruling,” she added.

Tlala said as soon as the Director-General of Health approves the limited-scope permits, the SAPC will publicly communicate the launch of the PIMART programme and the services that may be accessed under such a permit.

“The full PIMART scope of services will only be available once the Southern African HIV Clinicians Society has finalised and submitted a bridging course following gap analysis or, alternatively, once another training provider is accredited to provide the PIMART Supplementary Training course,” he added.

Republished from Sptolight under a Creative Commons licence.

Read the original article.

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Which Genes Contribute to Early-onset Breast Cancer in Black Women?

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Photo by National Cancer Institute

Black women experience disproportionately elevated risks of developing and dying from early-onset breast cancer. New research published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, reveals the genes that are most likely to be mutated to contribute to these increased risks.

In the study of 686 young Black women diagnosed in Florida and Tennessee with invasive breast cancer at age 50 or younger in 2005–2018, genetic testing showed that 15.3% of the women carried a gene variant with a suspected link to breast and/or ovarian cancer, with most occurring in the BRCA1 and BRCA2 genes and fewer in PALB2, ATM, and other genes. A family history of breast cancer was common in women with mutations in BRCA1, BRCA2, and PALB2. Triple-negative breast cancers (one of the most aggressive forms) were most often seen in women with BRCA1 mutations. Also, most of the women with BRCA1 mutations were diagnosed at or below age 40, whereas the age at diagnosis was more evenly distributed up to age 50 for women with variants in the other genes.

The study’s findings point to the importance of breast cancer genetic testing for young Black women, a group that is less likely to receive such screening compared with other racial and ethnic groups. Such tests could identify women most likely to benefit from more frequent screening and preventive measures to safeguard their health.

“We must test at-risk women across all populations – testing is essential to personalise treatment strategies and enable life-saving prevention for future cancers, and it may empower at-risk family members to get tested so they too can benefit from this information,” said senior author Tuya Pal, MD, of Vanderbilt University Medical Center. “Equitable access to inherited cancer testing ensures that all women, regardless of race, can benefit from precision medicine and take control of their genetic health.”

Source: Wiley

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A 1940s-era Drug Reveals a New Renal Water Regulation Pathway

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Marla Broadfoot, PhD

Human kidney. Credit: Scientific Animations CC0

Mayo Clinic researchers have identified a previously unrecognised way the kidneys regulate water balance – an advance that could lead to improved treatments for polycystic kidney disease (PKD) and other disorders. The study, led by Fouad Chebib, MD, a nephrologist at Mayo Clinic, is published in the Journal of Clinical Investigation.

The findings build on decades of scientific understanding by revealing an additional pathway the kidney uses to control water balance. Until now, the body’s ability to concentrate urine – and prevent dehydration – has been thought to depend primarily on the hormone vasopressin. Dr Chebib’s team discovered an alternative mechanism that operates independently of that system.

“The kidney’s ability to regulate water is one of the most fundamental processes in the body,” Dr Chebib says. “It’s not every day that you uncover a new way it carries out that function.”

Polycystic kidney disease is a common inherited condition that causes fluid-filled cysts to grow in the kidneys over time, gradually reducing kidney function and often leading to kidney failure. It affects millions of people worldwide, including an estimated 140 000 people in the US with the most common form, autosomal dominant PKD (ADPKD). Many patients eventually require dialysis or a kidney transplant.

Watch: 1940s-era drug shows new promise for kidney disease

Dr Chebib’s team studies how kidney cysts grow in PKD using lab-grown cell models. As part of that work, they tested compounds expected to worsen the disease process by increasing cellular signals linked to cyst growth. One of those compounds was probenecid, a drug first used in the 1940s to conserve limited supplies of penicillin by reducing its urinary excretion.

“We thought this drug would make the disease process worse,” Dr Chebib says. “Instead, it did the opposite.”

Rather than promoting cyst growth, the drug slowed it. After repeating the experiments multiple times, the team realised they had uncovered something important.

Further investigation revealed that probenecid affects how kidney cells handle urate, a molecule commonly associated with gout. Inside the cell, urate acts as a signal – triggering a chain of events that helps move water channels to the cell surface. This allows the kidney to reabsorb water and concentrate urine without relying on vasopressin, the hormone traditionally thought to control this process.

“This represents a distinct pathway from what is described in traditional physiology models,” Dr Chebib says. “It demonstrates that the kidney has an additional mechanism to preserve water.”

For patients with PKD, the discovery could address one of the biggest challenges of current treatment. The only approved therapy, tolvaptan, works by blocking vasopressin, which slows cyst growth but causes patients to produce very large amounts of urine – often 6 to 7 litres a day. That side effect can be difficult to live with and leads some patients to stop treatment.

In preclinical studies and a small clinical trial, adding probenecid reduced urine volume and nighttime urination while preserving the treatment’s effectiveness.

After taking probenecid, patients’ urine volume dropped by about 30% on average, and they went from waking up several times a night to urinate to about once per night. Many also reported improved quality of life.

“The goal is to preserve the therapeutic benefit of tolvaptan while reducing its burden,” Dr. Chebib says.

Despite these promising results, researchers are not planning to rely on probenecid as a long-term solution. The drug is decades old, affects multiple systems in the body and is not widely available today. Instead, the team is using what they learned to design more targeted therapies.

“Probenecid helped us uncover the mechanism,” Dr Chebib says. “Our goal is to take this insight and develop therapies designed specifically for this pathway.”

For Dr Chebib, the work is rooted in early inspiration. He was drawn to kidney research after his father developed PKD.

“This has been a long and deeply purposeful journey,” he says. “It started with a personal motivation and led to something that could ultimately benefit patients.”

For a complete list of authors, disclosures and funding, see the study.

Source: Mayo Clinic

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Even Low Alcohol Consumption Linked to Cancer and Heart Risks

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Study provides much-needed benchmark with finding that alcohol consumption is associated with increased risk above one drink per day for both men and women

Photo by Pavel Danilyuk on Pexels

Even what many consider to be moderate drinking is linked to an increased risk of death, disability, and chronic diseases such as cancer and heart disease, according to a new study published in the Journal of Studies on Alcohol and Drugs.

“This study provides the most comprehensive US estimates to date of lifetime risks of alcohol-attributable mortality and morbidity, showing that even moderate levels of consumption increase the risk of premature death and disability,” said study co-author Katherine M. Keyes, PhD, professor of Epidemiology at Columbia University Mailman School of Public Health. “No protective effect of drinking was observed even at low levels,” noted Keyes, whose research focuses on alcohol use and other substances epidemiology across the life course.

The findings show mortality risk from alcohol of 1 in 25 for people who consumed an average of 14 drinks per week. In contrast, drinking up to 7 drinks per week was associated with only minimally elevated risks for most conditions.

“Even low levels of alcohol use come with health risks,” says first study author Kevin Shield, PhD, an associate professor at the University of Toronto and a senior scientist who leads the World Health Organization (WHO)/Pan American Health Organization (PAHO) Collaborating Centre in Addiction and Mental Health. “And that risk continues to increase the more someone drinks.”

The researchers, from the United States and Canada, aimed to estimate how lifetime drinking habits affect Americans’ risk of illness and death related to alcohol. After medical experts reviewed more than 7200 scientific articles on alcohol-related diseases and injuries to determine the level of risk for each condition, the researchers applied those risks to large national health data sets. They then used statistical modelling to estimate how different drinking levels influence long-term health outcomes.

The study offers more concrete guidance than the new US Dietary Guidelines, which currently advise Americans to “limit alcoholic beverages” without specifying how much alcohol is safe to drink. Previous guidelines recommended a daily limit of two alcoholic drinks for men and one for women. The definition of a ‘drink’ varies by beverage type, typically 12 ounces (340mL) for beer, 5 ounces (140mL) for wine, and 1.5 ounces (40mL)for spirits, although that too can vary by alcohol concentration.

While the new US Dietary Guidelines contain a useful ‘less-is-best’ message, they provide no quantitative framework, according to the authors. This study was designed to do just that across the drinking spectrum. 

It turns out that an average of two drinks per day, which might be considered ‘moderate’ from a social standpoint, is associated with a substantially elevated risk of a premature death caused by alcohol, they explain.

In addition to mortality risk, researchers examined how drinking patterns influence chronic and acute alcohol-related conditions such as cancer – including oesophageal, oral, and breast – cardiovascular disease, liver disease, and injury. 

The study overturns a common misconception that alcohol can protect health. The researchers did not observe a significant protective effect of alcohol on overall health at any level of consumption. They noted that at low levels, alcohol may be associated with a reduced risk of ischemic heart disease and stroke. But when you look across the full range of health outcomes, including cancer and other chronic diseases, those potential benefits are outweighed by the risks even at 7 drinks per week.

Statistical modelling used in the study to determine health risks was based on “the best possible data,” according to the team. But they caution one should not assume that means one person’s individual health risk is the same as what is reported here – that depends on other factors like lifestyle, genetics, drinking patterns, and other choices that differ person to person.

The researchers estimated risk for all health conditions known to be causally related to alcohol and then aggregated these estimates to determine the total health risk. Yet, new research continues to emerge that links alcohol with additional health conditions, such as pancreatic cancer. “Understanding those relationships, and how much alcohol contributes to those risks, is an area that still needs further work,” says Keyes and Shield.

By finding that alcohol consumption is associated with increased risk above one drink per day for both men and women, the study offers a much-needed benchmark.

“Having a clearer threshold helps people better understand what level of drinking is associated with increased risk and make more informed decisions when drinking.”

In an accompanying editorial, Robert M. Vincent, a former associate administrator for the US Substance Abuse and Mental Health Services Administration, discusses his view of the behind-the-scenes environment in which the study was produced. “The Alcohol Intake and Health report was explicitly invited to inform alcohol guidance during development of the Dietary Guidelines for Americans, 2025–2030,” he writes. “Despite the study’s adherence to its mandate, its findings were sidelined.”

See the paper for a full list of co-authors and their institutions.

Source: Columbia University Mailman School of Public Health

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A New Diagnosis of ‘Profound Autism’ Is on the Cards. Here’s What Could Change

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Kelsie Boulton, University of Sydney; Marie Antoinette Hodge, University of Sydney, and Rebecca Sutherland, University of Sydney

Photo by Peter Burdon on Unsplash

When it comes to autism, few questions spark as much debate as how best to support autistic people with the greatest needs.

This prompted The Lancet medical journal to commission a group of international experts to propose a new category of “profound autism”.

This category describes autistic people who have little or no language (spoken, written, signed or via a communication device), who have an IQ of less than 50, and who require 24-hour supervision and support.

It would only apply to children aged eight and over, when their cognitive and communication abilities are considered more stable.

In our new study, we considered how the category could impact autism assessments. We found 24% of autistic children met, or were at risk of meeting, the criteria for profound autism.

Why the debate?

The category is intended to help governments and service providers plan and deliver supports, so autistic people with the highest needs aren’t overlooked. It also aims to re-balance their under-representation in mainstream autism research.

This new category may be helpful for advocating for a greater level of support, research and evidence for this group.

But some have raised concerns that autistic people who don’t fit into this category could be perceived as less in need and excluded from services and funding supports.

Others argue the category doesn’t sufficiently emphasise autistic people’s strengths and capabilities, and places too much emphasis on the challenges that are experienced.

What did we do?

We conducted the first Australian study to examine how the “profound autism” category might apply to children attending publicly funded diagnostic services for developmental conditions.

Drawing on the Australian Child Neurodevelopment Registry, we examined data from 513 autistic children assessed between 2019 and 2024. We asked:

  • how many children met the criteria for profound autism?
  • were there behavioural features that set this group apart?

Because we focused on children at the time of diagnosis, most (91%) were aged under eight years. We described these children as being “at risk of profound autism”.

What did we find?

Around 24% of autistic children in our study met, or were at risk of meeting, the criteria for profound autism. This is similar to the proportion of children internationally.

Almost half (49.6%) showed behaviours that were a safety risk, such as attempting to run away from carers, compared with one-third (31.2%) of other autistic children.

These challenges weren’t limited to children who met criteria for profound autism. Around one in five autistic children (22.5%) engaged in self-injury, and more than one-third (38.2%) showed aggression toward others.

So, while the category identified many children with very high needs, other children who didn’t meet these criteria also had significant needs.

Importantly, we found the definition of “profound autism” doesn’t always line up with the official diagnostic levels which determine the level of support and NDIS funding children receive.

In our study, 8% of children at risk of profound autism were classified as level 2, rather than level 3 (the highest level of support). Meanwhile, 17% of children classified as level 3 did not meet criteria for profound autism.

Our concern

We looked at children when they first received an autism diagnosis. Children were aged 18 months to 16 years, with more than 90% under the age of eight years.

This aligns with our earlier research, showing the average age of diagnosis in public settings is 6.6 years.

From a practical perspective, our biggest concern about the profound autism category is the age threshold of eight years.

Because most children are already assessed before age eight, introducing this category into assessment services would mean many families would need repeat assessments, placing additional strain on already stretched developmental services.

Second, modifications will be needed if this criteria is going to be used to inform funding decisions as it didn’t map perfectly onto level 3 support criteria.

On balance, however, our results suggest the profound autism category may provide a clear, measurable way to describe the needs of autistic people with the highest support requirements.

Every autistic child has individual strengths and needs. The term “profound autism” would need to be promoted with inclusive and supportive language, so as to not replace or diminish individual needs, but to help clinicians tailor supports and obtain additional resources when needed.

Including the category in future clinical guidelines, such as the national guideline for the assessment and diagnosis of autism, could help ensure governments, disability services and clinicians plan and deliver supports.

What can you do in the meantime?

If you’re concerned your child requires substantial support, here are some practical steps you can take to ensure their needs are recognised and addressed:

Explain your concerns

Not all clinicians have experience working with children with high support needs. Be as clear as possible about behaviours that affect your child’s safety or daily life, including self-injury, aggression or attempts to run away. These details, while difficult to share, help give a clearer picture of your child’s support needs.

It can also be a challenge to find and access clinicians with appropriate expertise. Another potential benefit of having a defined category is that it can better help families navigate care.

Ask about support for the whole family

Our studies show that many caregivers want more support for themselves but don’t always ask. Talk with clinicians about supports for yourself as well, including respite, or family support groups.

Reach out

Coming together with other carers and families can reduce your own isolation and normalise many of the unique challenges you face. Connecting with like-minded people can provide a supportive, empathetic and empowering community.

Plan for safety

For children with high support needs, prioritise safety planning with your child’s care team. This can include strategies to reduce risks, as well as planning how best to support your child’s interactions with health, education and disability services over time.

Kelsie Boulton, Senior Research Fellow in Child Neurodevelopment, Brain and Mind Centre, University of Sydney; Marie Antoinette Hodge, Clinical Lecturer, University of Sydney, and Rebecca Sutherland, Lecturer & Speech Pathologist, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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90-120 Weekly Minutes of Strength Training May Be Optimal for Lowering Death Risk

On By ModernMedia

Specifically tied to significantly lower risks of cardiovascular and neurological disease deaths
Effects amplified by aerobic exercise, but no further risk reduction above 120 minutes

Photo by John Arano on Unsplash

Clocking up 90 to 120 weekly minutes of strength (resistance) training may be the sweet spot for lowering the risk of death, suggests a 30 year study, published online in the British Journal of Sports Medicine.

The effects were amplified by the addition of aerobic exercise, but no further benefit was apparent above 120 minutes a week of strength training – an amount that was specifically associated with, respectively, 19% and 27% lower risks of dying from cardiovascular and neurological diseases.

The benefits of aerobic physical activity on lowering the risk of death are well known, but less clear is the role of muscle strengthening exercise in reducing the risks of death from all and specific causes, solely or jointly with aerobic exercise, say the researchers.

To explore this further, they drew on 30 years of monitoring data from 3 large groups of study participants: the Health Professionals Follow-up Study, 1992–2022; the Nurses’ Health Study, 2002–21; and  the Nurses’ Health Study II, 2003–21, comprising a total of 147,374 participants (31,540 men and 115,834 women).

Participants were quizzed every 2 years on the amount of time they spent on strength training and aerobic exercise every week for up to 30 years. Aerobic exercise included brisk walking, running, jogging, swimming, cycling, tennis, squash, strenuous outdoor work and stair climbing, while strength training included exercises using weights or body weight, such as press ups, squats, and lunges.

The average age of participants at study entry was 54. Those who clocked up more strength training tended to be younger, weigh less, have a healthier lifestyle, and do more aerobic exercise than those who did no strength training.

Three quarters (74%) of participants did more than the recommended 150 minutes/week of moderate intensity aerobic exercise, measured as 7.5 MET hours over the long term. METs express the amount of calories expended per minute of physical activity, relative to calories expended at rest. And nearly half (46%) of participants did some strength training.

During the 30 year monitoring period, 35,798 study participants died. A higher weekly long term level of strength training was associated with a lower risk of death.

After adjusting for potentially influential factors, 90–119 minutes/week of strength training was associated with a 13% lower risk of death from any cause, with no further benefit observed above 120 minutes/week.

And 90-119 weekly minutes of strength training was specifically associated with a 19% lower risk of dying from cardiovascular disease, and a 27% lower risk of dying from neurological disease.

A reduced risk of cancer was seen only at lower levels: 1–29 mins/week (21% lower) and 30–59 mins/week (18% lower).

Compared with those participants with fewer than 7.5 MET hours/week of aerobic exercise and no strength training, those doing 1–59 and 60–119 mins/week of strength training alone had a 7–11% lower risk of death.

Aerobic activity alone at any level above 7.5 MET hours/week was associated with a 26–43% lower risk of death.

And the lowest risk was observed among those with both high aerobic activity and strength training levels every week: 45% lower risk for 30-44 MET hours/week of aerobic exercise plus 60–119 mins/week of strength training, and 53%-58% lower risks among those with 45+ MET hours/week of aerobic activity, irrespective of strength training level.

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge various limitations to their study.

These include the self reported nature of the data; the exclusion of strength training activities, such as calisthenics and Pilates; no information on the duration of each exercise session or the intensity of strength training, any or all of which might have influenced the findings.

Nevertheless they conclude: “Our findings on different dose-response relationships between long-term resistance training with all-cause and cause-specific mortality suggest that different amounts of resistance training may be needed to optimise benefits across outcomes.

“The observed pattern that adding resistance training further reduced mortality risk across all levels of aerobic activity up to 45 MET hours/week supports current recommendations encouraging both types of activity to maximise mortality benefits.”

Source: The BMJ Group

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Urine Test Could Help Detect Lung Cancer Years Before Symptoms Occur

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Urine samples. Credit: Cancer Research UK CC-BY4.0

Cambridge scientists hunting tell-tale killer ‘zombie’ cells that signal early lung cancer have developed a world-first urine test that could transform diagnosis and survival for thousands of patients.

[The test] could one day be used easily in GP surgeries and hospitals to help detect recurrence in this hard-to-treat cancer much earlier.

Ljiljana Fruk

As published this week in Nature Aging, the team has shown that this simple and affordable test could detect the earliest signs of lung cancer months, or even years, before symptoms appear, as well as monitor whether treatment is working and identify potential relapse.

 It works by identifying the presence of senescent cells in the lungs – so called ’zombie cells’ – that stop dividing but linger and release abnormal inflammatory signals that damage surrounding tissue and help create an environment that lowers the body’s ability to fight the cancer.

The study, funded by Cancer Research UK, marks a major leap towards more precise therapy and a test for early cancer and treatment efficiency that could be rolled out across the NHS one day.

Lung cancer is the UK’s most common cause of cancer death taking the lives of around 32,800 people every year. Thanks to huge strides in prevention, detection and treatment, in the UK, lung cancer has seen a 22% reduction in death rates in the last decade. And around two in three people (65%) with lung cancer in England survive their disease for five years or more when diagnosed at the earliest stage. But when diagnosed at the latest stage, this falls to 5 in 100 (5%).

This new test could save and improve thousands more lives in the future.  

The researchers created an injectable sensor that interacts with proteins released by senescent cells. When these proteins are present, the sensor triggers the release of a detectable compound that appears in urine – signalling the earliest biological signs of therapy resistance and lung cancer development.

The researchers say that early identification is critical to saving more lives, as the disease often relapses silently with few or no symptoms until it has already spread. By detecting signs of lung cancer development and therapy resistance early, their simple urine test can spot lung cancer and treatment resistance early, helping doctors to tailor and adapt the treatment to the patient and start that treatment earlier when it works best.

The team confirmed their results using real patient samples and large genetic datasets.

Professor Ljiljana Fruk, from the Department of Chemical Engineering and Biotechnology at Cambridge, said: “The sensor has not yet been tested in humans, next is the clinical trials and it is likely it will take few years to bring it to patients, but it is a first big step and it could one day used easily in GP surgeries and hospitals to help detect recurrence in this hard-to-treat cancer much earlier.”

Nearly half (46%) of lung cancers in England are diagnosed at the latest stage.

Professor Daniel Munoz-Espin from the Early Cancer Institute and co-lead for the Cancer Research UK Cambridge Centre Thoracic Cancer Programme, said: “Our previous studies showed that senescent cells in response to chemotherapy can cause treatment resistance and an aggressive lung cancer relapse. We also found that senescent immune system cells promote lung cancer development by causing immunosuppression.

“Our urine nano sensor may allow primary care detection of therapy resistance and lung cancer early development in future clinical settings.”

Professor Robert Rintoul of the Department of Oncology, and co-lead for the Cancer Research UK Cambridge Centre Thoracic Cancer Programme said: “Novel approaches for lung cancer detection and response to treatment are urgently needed to improve patient outcomes. This work forms the basis for testing within clinical trials with a view to future use in the clinic.”

Cancer Research UK’s spokesperson for the East of England, Patrick Keely, said: “With new technologies opening doors to new discoveries, we’re living in a golden age of research, which is powerfully underlined by this innovative new urine test to detect early lung cancer.” 

Adapted from a press release from Cancer Research UK

Reference

Hartono, M et al. Urinary detection of therapy-induced senescence and fibrosis using an injectable albumin-based nanoprobe. Nature Aging; 13 May 2026; DOI: s43587-026-01116-z

Republished from the University of Cambridge under a Creative Commons licence.

Read the original article.

Categories : Diet and Nutrition GastrointestinalTags : Leave a comment

Cutting Out Sucrose from the Diet May Disrupt Gut Microbiome

On By ModernMedia
Photo by Sharon Mccutcheon on Unsplash

Eliminating sugar from your diet may be more detrimental than previously thought, according to an animal study being presented Saturday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, Ill.

“Completely removing sucrose from a low-fat diet may unexpectedly disrupt gut health and promote inflammation and metabolic dysfunction, highlighting that balanced nutrition is more important than simply eliminating sugar,” said Rasheed Ahmad, PhD, principal scientist and head of the Immunology & Microbiology Department at the Dasman Diabetes Institute, in Kuwait City, Kuwait. The institute was founded by Kuwait Foundation for the Advancement of Sciences. Researchers investigated the effects of a sucrose-free low-fat diet compared to a sucrose-containing low-fat control diet in two groups of mice for 16 weeks. 

They evaluated glucose tolerance, insulin sensitivity, circulating metabolic hormones, the gut microbiome and inflammation in the colon and liver.

Mice fed the sucrose-free diet developed impaired glucose control, insulin resistance, gut microbial imbalance, intestinal inflammation and fatty liver changes, despite having no significant differences in body weight compared with control mice. 

“The findings suggest that complete removal of sucrose from a low-fat diet may negatively affect gut microbiota and metabolic health,” Ahmad said. “The study highlights the importance of maintaining balanced dietary carbohydrates to support gut and immune homeostasis.” 

Until now, the consequences of restrictive diets that eliminate sugar from a low-fat diet were unknown.

“This research may influence future dietary recommendations by emphasizing the importance of maintaining a healthy gut microbiome rather than focusing only on sugar restriction,” Ahmad said. “In the long term, these findings could help improve strategies for preventing and managing metabolic disorders, fatty liver disease and chronic inflammatory conditions.”

“Studies such as this reflect our institute’s commitment to advancing evidence-based scientific discoveries that improve public health outcomes and deepen our understanding of metabolic disease,” said Faisal Hamed Al-Refaei, MD, Acting Director General of Dasman Diabetes Institute.

Source: Endocrine Society

Categories : General InterestTags : Leave a comment

Strength Looks Like Care: The Male Nurse Redefining South African Fatherhood

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For Bafana Manyisa, strength doesn’t look the way most men are taught it should. It’s not toughness or stoicism or an unshakeable composure. Strength, he says, looks like sitting with a patient who needs reassurance. It looks like supporting a new overwhelmed father navigating the parenting journey for the first time. It looks like simply being present for your family when they need you most.

As a registered nurse, Operational and Outreach Team Leader at Dis-Chem and Dis-Chem Baby City Clinics, husband and father, Manyisa has spent his career learning what few South African men are encouraged to admit: that care is one of the most demanding forms of strength there is.

From mechanics to healthcare

Raised in Mohlakeng on Johannesburg’s West Rand, Manyisa’s path to nursing was unconventional. His childhood dream was mechanical engineering. He spent his early years studying motor mechanics, working in workshops, enjoying the technical precision of the work. But something was missing.

“I realised that what fulfilled me most was helping people,” he explains.

It took his older sister, a primary healthcare nurse practitioner to recognise what he didn’t yet see in himself,  a natural capacity for compassion. She urged him to apply for the R425 nursing programme. “From the moment I started training, everything aligned,” he says. “I fell in love with nursing because it gave me the opportunity to make a real difference in people’s lives, especially during their most vulnerable moments.”

The values that shaped his approach to healthcare were rooted long before he entered any clinical setting. Growing up in Mohlakeng taught him resilience, humility, and the importance of community lessons he says no textbook could replicate. “Our community taught us to look out for one another,” he reflects. “Simple acts of kindness, respect for elders, and serving others became part of who I am.”

The weight of witnessing

Those values were tested most severely during his time at Eyethu Yarona Clinic under the Gauteng Department of Health. Faced with water shortages, electricity interruptions and stock limitations, the clinic ran on compassion and improvisation. It was difficult work in difficult conditions, yet it was there that Manyisa experienced one of the defining moments of his career.

After helping an elderly patient collect her chronic medication, she paused and told him something that has stayed with him ever since: “You make a difference in our lives. You don’t just give us medication, you treat us with care.”

That moment crystallised his understanding of nursing and later, fatherhood. “It’s not about treatment alone,” says the father of one. “It’s about dignity, empathy, and human connection.”

A different kind of strength

Working in healthcare has given Manyisa an intimate view of the pressures South African men carry in silence. Financial stress. The relentless expectation to provide. The demand to always appear strong. He sees men shoulder these burdens alone, asking for nothing, showing nothing.

His message to them is direct: asking for help is not weakness. Vulnerability is not failure.

“Too many men believe they have to carry everything on their own,” he says. “Real strength comes from being honest, seeking support when you need it, and taking care of yourself so that you can take care of those who depend on you.”

The qualities that make a good healthcare professional – empathy, resilience, patience, and care are, he believes, the very same qualities that make a good father. This Father’s Day, he’s actively encouraging more men to recognise this, to become more involved in their families’ health and wellbeing. To support partners during pregnancy. To take an active role in their children’s healthcare journeys. To show up.

The strongest thing

“People may forget what you said or what you did,” Bafana reflects. “But they never forget how you made them feel. Nursing teaches you resilience and compassion in ways no salary ever could.”

His story challenges a narrow version of masculinity that has done South African men no favours. Men can be leaders and caregivers. They can be strong and compassionate. They can provide and nurture.

Perhaps, he suggests, the strongest thing a man can do is simply care.

Categories : Expert Opinion IT in HealthcareTags : Leave a comment

Opinion Piece: Healthtech is Only as Strong as the Hands that Shape It

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By Vishal Barapatre, Group Chief Technology Officer at In2IT Technologies

| 17 June 2026

Healthcare is investing heavily in technology, but outcomes do not always improve at the same rate or deliver the desired effect. The issue is rarely a lack of tools. More often, it comes down to the way those tools are designed, connected, and maintained. Health technology, often referred to as Healthtech, delivers real value not just when systems exist, but also when expert IT partners shape them to turn health data into meaningful, useful intelligence throughout the entire care journey.

In many healthcare environments, technology has accelerated rapidly over the past decade. Hospitals and clinics have introduced electronic medical records, diagnostic platforms, and telehealth systems, with enormous potential, the benefits are often uneven when systems operate in isolation or fail to align with the realities of clinical workflows. The difference between technology investment and measurable clinical improvement often lies in the design and integration that happens behind the scenes.

The promise of healthtech lives in the data

At its core, healthtech is about data. This includes how data is captured, stored, presented, and analysed to support better patient care. Every interaction between a patient and the healthcare system generates information that can guide more informed decisions. From recognising early signals for preventive care, tracking progress during rehabilitation, to ensuring complete and accurate information during operative procedures, effective use of data underpins every stage of the healthcare journey.

Yet data alone is not enough. Without systems designed to bring clarity to complexity, information becomes fragmented, inconsistent, and largely underused. This is where expert IT partners are essential. They do not just implement platforms; they create the right conditions for data to support better patient care.

Another challenge lies in the diversity of healthcare data sources. Clinical records, laboratory results, imaging systems, wearable devices, and patient engagement platforms, all generate valuable information. However, without thoughtful integration and governance, these data streams can quickly become disconnected. When aligned, they allow clinicians to see a more complete picture of a patient’s health, enabling earlier intervention and more personalised treatment decisions.

Intuition does not happen by accident

There is a growing expectation that healthtech should feel intuitive, where insights emerge naturally without creating additional friction in already demanding clinical environments. However, intuitive technology does not happen by chance. It results from thoughtful choices about structure, integration, and user experience.

What needs to be understood is that a system’s value is not determined by its technical features but by how well it fits into clinical workflows. The data must be available at the right time, in the right context, and in a way that supports judgment instead of overwhelming it. Without this insight and expertise, even the most advanced systems may become obstacles instead of assets.

This is particularly important in high-pressure healthcare environments where time is limited, and decisions are critical. If systems require excessive navigation, duplicate data entry, or complicated interfaces, clinicians may spend more time interacting with technology than with the patients. Well-designed systems quietly support decision-making rather than compete for attention, ensuring that technology strengthens clinical practice of disrupting it.

Continuity of care requires continuity of systems

To add, preventive, rehabilitative, and operative care are often treated as separate areas, yet they are part of a single patient journey. The true value of healthtech emerges when data flows smoothly across these stages, creating continuity instead of hand-offs.

This continuity does not happen on its own. It relies on systems that preserve data integrity over time, integrate seamlessly across different care settings, and evolve as patient needs evolve. Without it, technology investments risk becoming isolated solutions rather than truly transformative tools.

When healthcare providers can access consistent patient information across departments and care phases, they gain a more holistic understanding of health outcomes. This continuity helps reduce redundant tests, prevent information gaps, and support coordinated treatment plans. Over time, it contributes to a healthcare environment where patients’ experiences feel more connected and less fragmented.

Trust is built behind the scenes

To truly be transformative, healthcare must rely on trust between patients and clinicians, as well as between clinicians and the systems they depend on. Yet, this trust is fragile, as a single system failure, data inconsistency, or security issue can erode confidence across a healthcare facility.

Trust is built on reliability, resilience, and strong governance. Systems must perform well under pressure, safeguard sensitive information, and evolve safely over time. Although this foundation work often goes unnoticed, its impact is felt every time clinicians use technology with confidence and ease.

The growing digitisation of healthcare has also made cybersecurity and data protection essential pillars of trust. Healthcare data is among the most sensitive information an organisation can manage. Protecting it requires robust security architecture, continuous monitoring, and governance practices that evolve as threats emerge. When these safeguards are embedded into the system architecture, healthcare organisations can innovate confidently without compromising patient privacy.

The real differentiator is partnership, not platforms

As healthtech continues to evolve, access to tools will be less of a significant differentiator. What will matter more is how those tools are shaped, connected, and sustained. Technology alone cannot provide better care. It requires partners who understand both the technical and human aspects of healthcare.

This is where an IT partner can navigate and guide healthcare organisations through complexity, turning possibilities into practice and ambitions into results. Their role is not just supportive but foundational in demonstrating the true value of healthtech. The future of healthcare will belong not to those who adopt the most technology, but to those who build it wisely.