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Chapter 1: What is the main topic discussed in this episode?
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Peptides are everywhere, social media feed, everyone's talking about them, should I be taking them, I've got patients asking me, friends who are considering it.
Huge international industry. You can order them online, not that we're advertising them. And you don't know what you're getting.
You don't know what you're getting. So you might think you're getting something, but when the product is tested, it's something else entirely. And there are real side effects to this. So one of them increases the risk of moles and potentially skin cancer. So not risk-free.
That's melanotan. And there are others. And they go in stacks, you know, like you've got an IT stack, you've got a peptide stack. And they go by names like Wolverine. There's a Wolverine stack. Jeez. God knows what it's doing for you. Anyway, that's coming up on The Health Report.
I'm Priya Alexander on Wurundjeri Land.
And I'm Norman Swan on Gadigal Land.
Also coming up on the show, a study that has looked at women's experience of pain with the insertion of intrauterine devices and could we be doing things better?
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Chapter 2: What are unregulated peptides and why are they a concern?
But a senior official did give a talk, a plenary talk. So there was a talk from NIH, National Institute of Health.
They replaced him. And when that talk was occurring, there was a group of researchers who were attempting to hand out an editorial piece that they had had published in Diabetes Care, which is a journal.
Of the American Diabetes Association, ironically. Yes.
Yes, I'm trying to make all these links because it's just fascinating. So the American Diabetes Association had published this piece in their journal. These researchers were attempting to hand it out and the piece, if you read it, and it's titled, we should read the title, Misguided Brushes of a Pen Continue to Dismantle and Destroy Biomedical Research in the United States.
We Can No Longer Afford Complacency and Fear. We Must All Act Now.
So this is about real and threatened cuts to the National Institutes of Health budget and all sorts of restrictions on NIH at the moment, international collaborations and so on. And, of course, they're so worried about woke. And if you're dealing with diabetes, you're dealing with disadvantaged populations.
We're no longer allowed to put that into their grant applications because it would be considered too woke for the research. So huge problems there that directly affect diabetes. But these people... who are very senior, got confronted by the police.
Their papers were, and you can go and look at this footage online if you would like to, but their papers were literally snatched off them and they were escorted off the premises. Some of the researchers were banned from attending the rest of the conference. There has been huge outrage from clinicians, researchers worldwide because the footage was very widely shared.
And as a result, some of the people who were leaders at the American Diabetes Association have resigned at the way that this has been handled. There's been an open letter published to the American Diabetes Association from researchers called Shame on You.
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Chapter 3: What does the latest study say about IUD insertion pain?
And health professionals, some, are importing and giving these to patients. People are retaining them off the internet and we don't actually know what's in them or specifically. the potential safety in humans. So that is what the TGA is cracking down on. And a response to one of our stories last week. Yes, so we covered the changes to bulk billing that's due to come in on the 1st of July.
We've actually covered it two weeks in a row from different perspectives. But we did approach the Department of Health to find out what they thought about some of the issues that we had raised on the show, particularly in Aboriginal health services, where it's very difficult to actually comply with the rules that are potentially coming in. I keep saying potentially, normally.
They will be coming in. And the point made by Professor Paul Torzillo last week was that they would have to abandon Medicare at a loss of $2 million a year funding for the service because they can't do this written form of assignment. And they'd had fairly...
Chapter 4: How is the peer review process for scientific grants changing in Australia?
banal responses. I'm using the word banal, but that was really responses from the department which didn't help. So we asked for a response from the department and we got pretty much the same response that the Aboriginal Health Service had got before, which is we're not going to change the way we do things. We think it's possible for Aboriginal services to get on with it and do it.
We're paraphrasing. If you want to make up your own mind about it, we will publish the letter from the Department of Health so you can see for yourself.
On ABC Radio National, you're with The Health Report. Norman, there's a rise in people wanting to consider genomic testing. And I think we need to be very clear that we're talking about a very specialised set of tests. This isn't something that I just order for you when you walk through the consulting room door. This is quite a process.
Yeah, I think people think, well, I'll have my whole genome done because I'm being told all the time it's so cheap. But people have no idea really what they're going to find when you do that and whether it means anything. But there are specific genes that might be quite handy to know about.
Yes, so specific genes for things like hereditary breast and ovarian cancer, for familial hypercholesterolemia, so where you get high cholesterol, it can significantly increase the risk of heart disease.
At a young age.
At a young age.
And death from heart attack as well.
So the question is, should there be population genomic screening, which is not currently available in Australia? And there's a study that has looked at this that's been published in Nature Health.
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Chapter 5: What are the implications of the TGA's crackdown on unregulated peptides?
And that's from the people who are doing the reviewing. They're saying, I got the right grants to review 90% of the time. So that is really important. The other bit of information that we had looked at across the years was the impact of the panel on the final score or the decision to fund or not fund.
And in fact, after the two spokespeople had spoken and scored on the panels... And just to explain that, the panels would choose somebody to lead on a particular grant proposal and they would lead the discussion and present to the panel...
Yes, yes. So we'd have a primary spokesperson and a secondary spokesperson. So two people on the panel would talk to the grant. Once those two people had spoken and given their scores, the panel very, very rarely changed the scores or changed the fundable outcome.
So this concept that panels were having in-depth conversations and changing scores and changing funding was not consistent with the data that we had. The next point that I'd like to make is that people talk about transparency, fairness and accountability, and they are really important points to us.
And we now, with our five allocated reviewers, those five allocated reviewers to an individual grant, see each other's scores, they see each other's comments, and they see each other's identity.
So they know who they are, they know what the scores are, and they know what the comments are, and they have an opportunity if one of them makes a really good comment about perhaps a fatal flaw in a grant, they can actually take that on board and adjust their scores. So That sense that this is sort of anonymous and unaccountable is actually now incorrect.
I mean, the other argument was that we're one of the few countries that has this system. So what you're saying is we're ahead of the pack rather than behind it.
I think we are. And just that's a really important point, Norman. When we look around the world and when I talk to the heads of funding agencies, the NIH, the MRC, funding agencies from around the world, they are all challenged by increasing application load. and challenged by decreasing success rates.
And success rates are purely a function of the number of applications and the amount of money you have to allocate to that grant call. And so all over the world, they're being challenged by this increase in application rate, which we think may be in part driven by AI. And they are being challenged on how to assess grants appropriately in that environment.
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Chapter 6: What impact does genomic testing have on disease risk assessment?
I'll keep my mouth to myself. See you next week.
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