Oklahoma seeks to exclude soda, candy from food stamp purchases
Oklahoma Gov. Kevin Stitt said Thursday the state is seeking federal permission to exclude soft drinks and candy from the list of items that can be purchased under the benefit for low-income Americans long known as food stamps.
Stitt made the announcement during an event at the Capitol with U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. as part of the 'Make America Healthy Again' initiative.
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New York Times
an hour ago
- New York Times
A Hospital Was in Critical Condition. Could $1.1 Billion Fix It?
During the past quarter century, more than a dozen New York City hospitals have closed. The causes of death have been many: changing economics, deregulation, less government support, a shift toward more outpatient treatment. It seemed likely that University Hospital at Downstate in East Flatbush, Brooklyn, would soon join that casualty list, especially when state officials began formulating a plan last year for the hospital's demise. After all, the medical center, part of SUNY Downstate Health Sciences University, had hemorrhaged money and patients for years. A far larger hospital sits directly across the street, ensuring that the neighborhood — plagued with high rates of diabetes, hypertension and kidney disease — would not be without medical care. But then something unexpected happened. The state decided to commit $1.1 billion to University Hospital for renovations and a new outpatient facility, a stunning reversal propelled by fervent local opposition to the closing of the 342-bed hospital. When the hospital's future was in doubt, state legislators and community activists demanded that the state find the money to keep it open. Pastors spoke about it in their Sunday sermons. Rallies to save the hospital drew speakers including the Rev. Al Sharpton and Randi Weingarten, the president of the American Federation of Teachers, a major union. And patients mobilized to save their hospital, even though the federal government gives it only one star out of five in its quality rating. By the end, the administration of Gov. Kathy Hochul enthusiastically came around to the idea of shoring up the hospital instead of shutting it down. 'Let's say that again, it sounds so good: $1 billion,' Ms. Hochul, a Democrat, said at a news conference this month at SUNY Downstate, announcing the sum that the state was providing for improvements. The money is expected to go toward renovating the hospital and expanding cancer and cardiac care. Want all of The Times? Subscribe.
Medscape
an hour ago
- Medscape
AAD Updates AD Guidelines With Four New Treatment Picks
The American Academy of Dermatology (AAD) recently issued a focused update to its guidelines on the management of atopic dermatitis (AD) in adults, strongly recommending four recently approved therapies: tapinarof cream, roflumilast cream, lebrikizumab, and nemolizumab (in combination with topical therapy). These additions reflect high-certainty evidence supporting both efficacy and safety, according to the workgroup's systematic review published in the Journal of the American Academy of Dermatology . Robert Sidbury, MD Asked to comment on the updates, one of the authors, Robert Sidbury, MD, cochair of the guideline committee and chief of dermatology at Seattle Children's Hospital, Seattle, called the rapid need for a guideline update 'a reflection of the extraordinary progress in AD care that is ongoing and is indeed revolutionizing care.' Having 'two new nonsteroidal topical therapies is quite significant,' he added in an interview with Medscape Dermatology . 'Patients have long been dissatisfied with topical options, which have been shackled by safety concerns, some real, some not, and intolerance, such as application site stinging.' The update comes just over a year after the release of AAD's 2023-2024 adult AD guidelines on treatment with topical and systemic therapies, underscoring the rapid pace of therapeutic development for AD. The update was initiated following the FDA approval of multiple new therapies and newly published high-certainty evidence supporting their use, prompting the AAD to incorporate this data into its existing guidance, according to the authors. Strong Recommendations for Four New Agents The guideline workgroup applied the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework to assess new data and formulate treatment recommendations. According to the authors, all four therapies received 'strong' recommendations based on high-certainty evidence: Tapinarof cream 1% : A nonsteroidal aryl hydrocarbon receptor agonist approved in 2024 for moderate to severe AD. In four trials (n = 1169), once-daily use over 8-12 weeks resulted in statistically and clinically significant improvements in investigator's global assessment (IGA), eczema area and severity index (EASI)-75, and itch scores. : A nonsteroidal aryl hydrocarbon receptor agonist approved in 2024 for moderate to severe AD. In four trials (n = 1169), once-daily use over 8-12 weeks resulted in statistically and clinically significant improvements in investigator's global assessment (IGA), eczema area and severity index (EASI)-75, and itch scores. Roflumilast cream 0.15% : A phosphodiesterase-4 inhibitor approved in 2024 for mild to moderate AD. Clinical trials (n = 1427) demonstrated significant improvements in IGA and EASI-75 after 4 weeks. : A phosphodiesterase-4 inhibitor approved in 2024 for mild to moderate AD. Clinical trials (n = 1427) demonstrated significant improvements in IGA and EASI-75 after 4 weeks. Lebrikizumab : An interleukin (IL)-13-targeting monoclonal antibody approved in 2024 for moderate to severe AD. In over 1700 patients, treatment with or without topical corticosteroids led to marked improvements in clinical and patient-reported outcomes. : An interleukin (IL)-13-targeting monoclonal antibody approved in 2024 for moderate to severe AD. In over 1700 patients, treatment with or without topical corticosteroids led to marked improvements in clinical and patient-reported outcomes. Nemolizumab (with topical therapy): An IL-31 receptor inhibitor approved in 2024 for patients aged 12 years or older inadequately controlled with topical therapies. In three trials (n = 1256), nemolizumab plus topical corticosteroids (with or without topical calcineurin inhibitor) led to significant reductions in itch and improvements in EASI-75 and Dermatology Life Quality Index. Updated Treatment Algorithm The guideline includes an updated treatment algorithm to help clinicians integrate these agents into clinical practice. It emphasizes: All four newly recommended therapies are indicated with strong recommendation symbols in the updated algorithm figure. Real-World Considerations Sidbury emphasized that having multiple high-certainty options creates new opportunities but also new challenges in decision-making. 'Such choice is a lovely problem to have,' he said, but he urged clinicians to look beyond efficacy. For example, 'a patient with baseline ocular difficulties would want to be aware that IL-4/13 or IL-13 biologics can cause or exacerbate conjunctivitis,' he explained. 'Nemolizumab or a JAK inhibitor, neither of which carries ocular risk, might be a good choice. Similarly, patients with cardiovascular risk may want to avoid JAK inhibitors due to their boxed warning.' Treatment selection, he said, should be rooted in shared decision-making: 'It's important to weigh evidence alongside a patient's comorbidities, preferences, and tolerability history.' Remaining Gaps and Considerations Despite the promising data, the authors acknowledged important limitations. Most trials were short-term (≤ 24 weeks), and the long-term safety, durability of response, and comparative effectiveness of these agents remain unknown. Cost is another factor. The authors noted, 'costs for the considered therapies may be prohibitive without adequate insurance coverage.' As such, they stressed the importance of a shared decision-making process that weighs efficacy, safety, and affordability. Clinical Impact and Future Directions The update is expected to have an immediate impact in clinical settings. 'Atopic dermatitis care has long been an 'off-label' affair,' Sidbury said. 'Prior to 2017, the only FDA-approved systemic therapy for AD was systemic steroids. Since then, we've seen numerous novel topical and systemic therapies approved with many more on the way. Better evidence plus more choices equals improved outcomes.' Still, more research is needed. Sidbury pointed to the importance of identifying which therapies may work best for specific patient subtypes — by age, race, gender, or AD phenotype. 'We don't know yet, but the answer is likely yes. This gets at personalized medicine — and that's where we're headed,' he said, noting that future treatment may be guided by inflammatory signatures or genotyping. While this focused update offers valuable clarity on incorporating new treatment options for adult AD, further research is needed, according to the authors. The workgroup called for real-world data, head-to-head trials, and longer-term outcome studies. The authors also noted pediatric guideline updates are expected in a future publication. This study was funded in total by internal funds from the American Academy of Dermatology. Sidbury disclosed he serves as an advisory board member for Pfizer, receiving honoraria; as a principal investigator for Regeneron, receiving grants and research funding; as an investigator for Brickell Biotech, and Galderma USA, receiving grants and research funding; and as a consultant for Galderma Global and Microes, receiving fees or no compensation. Other authors reported having financial disclosures with many pharmaceutical companies. : Biologics, JAK inhibitors, and immunosuppressants remain key choices for refractory disease.
CBS News
2 hours ago
- CBS News
Dozens protest Children's Hospital LA decision to end gender-affirming care
Dozens of people protested outside Children's Hospital LA and demanded that the medical center reverse its decision to shut down its gender-affirming programs. "I have so many people who are being affected by this," said teen Sage Pitchnik, who is transgender. "This place saved my life so many times. I wouldn't be here without it." In an internal email shared with CBS News Los Angeles, the CHLA administration stated that it had to close its Center for Transyouth Health and Development and terminate its gender-affirming surgical program in July due to the "increasingly severe impacts of federal administrative actions and proposed policies." In January, President Trump signed an executive order aimed at cutting federal support for certain types of gender-affirming care for people under 19 years old. "We had to sit down with my daughter today and it was hard," parent Jessie Thorn said. "It's hard to explain that there are people in the world who don't want her to see the doctor." CHLA provided care to more than 3,000 transgender youth and people up to 25 years old through its Center for Transyouth Health and Development. "In the end, this painful and difficult decision was driven by the need to safeguard CHLA's ability to operate amid significant external pressures beyond our control," the internal email from earlier this month stated. The Los Angeles LGBT Center organized rallies every Thursday leading up to the closure. Each rally will feature speakers from the community and families who have been affected by the closure. "LA County does not have enough gender care providers to address every patient and their individual case," community organizer Maria Do said. "This is going to put a big stress on our system." CHLA staff said it will help patients find new providers.
