Ever been tempted by a ‘sea change’ or ‘tree change’? Now might be your time!
The Rural Health Professionals Program (RHPP is a Federal Government initiative, funded by Health Workforce Australia (HWA , which aims to recruit and retain primary health care nursing and allied health professionals into rural, regional and remote areas of Australia.
RDN and the program
NSW Rural Doctors Network (RDN works in conjunction with HWA to deliver the program in country NSW. RDN acts like a recruitment agency, linking job applicants with suitable job opportunities; however, the service is at NO COST to the employer or the applicant.
RDN’s nursing and allied health recruitment team assists eligible applicants with:
Who’s eligible?
Nurses – includes all levels such as Practice Nurses, Nurse Practitioners, RNs and ENs.
Allied Health – includes OTs, Physios, Dentists, Podiatrists, Speech Pathologists, Dietitians, A&TSI Health Workers, Psychologists, Social Workers and more.
What positions are eligible?
The positions must have a predominant primary health care element (more than 50% , such as:
Which locations apply?
RA2-5 locations (according to Australian Standard Geographical Classification – Remoteness Areas (RA 2-5 . In NSW, these locations tend to be any areas outside of the metropolitan strip of Newcastle, Sydney, Wollongong and Tweed Heads (with a few exceptions . For more information, visit http://www.health.gov.au/internet/otd/Publishing.nsf/Content/RA-intro
Rewarding careers and improved lifestyles
Health professionals enjoy a variety and breadth of experience in rural practice that their urban peers miss out on. They also appreciate the sense of belonging that only rural communities can provide, the lack of traffic and travel time to reach work, collaboration with other health professionals for better patient outcomes, a more relaxed pace of life, improved family relationships, enhanced social opportunities, financial benefits, and more.
When Dietitian Melissa Pellow was on placement in Sydney, the traffic used to drive her crazy, taking her more than an hour to reach work. She’s now practising as an exercise physiologist and dietitian in Dubbo and has plenty of spare time up her sleeve to play netball, touch football and tennis. She and her partner are also in the process of buying a three-bedroom house for under $200,000.
Melissa’s dual qualifications are highly valued by rural communities where there are shortages of allied health professionals. She said, “It has a much more diverse patient base than the city, including Aboriginal health.” She’s also a big fan of the multi-disciplinary practice where she works. “We often see people with multiple health issues and it’s an advantage to bring in other professionals to help them,” she said. “It’s much more holistic care.”
GP Registrar Dr Zahraa Sadeq and her husband Dr Hayder Ridha, an ear, nose and throat specialist, also chose to settle in Dubbo where they value the sense of community that rural practice offers.
Originally from Iraq, Zahraa lived in Ireland before coming to Australia in 2005. After a stint in Darwin, she and Hayder moved to Dubbo where they are raising their three young boys. The fact that work is nearby and traffic snarls are non-existent is particularly important for Zahraa so she can be on time to pick up her youngest from day care. It also helps that everything is so close when Saturday sport is happening for her older boys.
The cost of living is another factor. “We can afford a house on big land with a pool–and a far better quality of life than in a big city,” she says. “The kids love it.”
Zahraa is also appreciating the variety of medicine she is experiencing in general practice in a rural centre as well as the sense of community with patients. “One of the beauties of being a rural GP is that sense of connection you develop with different generations of the same family,” she said. “You get to know the grandparents, mum, dad and the kids.”
While the thought of a move can seem overwhelming, good preparation is the key. If you have someone on your side like RDN to assist you, as well as some financial support, this can make all the difference.
Employer assistance
Employers in rural areas often struggle with their recruitment. This program enables rural employers to access a broader pool of applicants and provides a helping hand to manage the recruitment process.
RDN has a growing pool of UK-qualified applicants who are eager to get a start in Australia, many of whom already have registration but just need visa sponsorship. The process of sponsoring applicants is straightforward with RDN’s experience; we’ll help to increase the likelihood of finding the right person to fill your vacancy. At NO COST to you!
About NSW RDN
NSW Rural Doctors Network (RDN is a not for profit, non government organisation that develops and administers services and programs to improve the recruitment and retention of General Practitioners (GPs , nurses and allied health professionals throughout country NSW. RDN is the appointed body for implementing the RHPP in NSW, in conjunction with HWA, to improve access to primary health care professionals for those living in rural and remote areas.
Start your sea or tree change today!
Contact RDN’s Nursing and Allied Health Recruitment team to get you started. Phone: 02 4924 8000 Email: nah@nswrdn.com.au Web: www.nswrdn.com.au
Growing and supporting an allied health and nursing workforce for rural Australia
A significant proportion of the UK's small business bosses are risking burnout and ill health as they battle absence to keep businesses afloat, according to Bupa research.
Four in ten (40 per cent heads of small companies told researchers they continue to work from their sick beds when ill, rather than take time off to recover because there's nobody else to pick up their work.
They are also battling mental as well as physical strain. With financial pressure and a lack of resources hampering succession planning, a third of SME bosses (31 per cent said that their business would collapse if they were to take time off.
However, while small business owners put their own physical and mental health and wellbeing at risk, it seems their employees may be compounding the problem. Nearly two thirds (62 per cent of small business bosses say that employee absence is negatively affecting their business, and according to 46 per cent, high levels of employee absence are estimated to contribute up to a 10 per cent drop in turnover in small businesses.
Tony Wood, sales and marketing director at Bupa said: "Small business bosses are real troupers; they are totally committed to running their firms in sickness as well as health. However they need to think about how to take care of their health needs and those of their staff, as working through sickness isn't a long-term solution for anyone."
Four in ten (38 per cent bosses admit they spend more on office stationery than initiatives that support employee health and wellbeing, such as
flu jabs, cycle to work schemes and subsidised gym membership.
Dr Jenny Leeser, Clinical Director of Occupational Health, Bupa, suggests that small business heads should see investment in employee health and wellbeing as a beneficial long-term investment: "There are lots of things bosses can do to support staff and reduce the pressure of sickness absence. Staff benefits such as flu jabs or health checks can make a huge difference and are relatively low cost. Absence can be less of a burden if it is properly managed, for example through part-time return to work plans which can see staff return sooner. To get advice tailored to individual business needs, bosses should consult an occupational health specialist."
The Bupa research showed that the sectors worst affected by workplace absence are property and technology companies, with 77 per cent of small business bosses surveyed in each of these sectors agreeing that sick leave has a financial impact on business. Other sectors which said that unplanned leave caused their business to suffer significantly were hospitality (58 per cent and retail (50 per cent .
These figures come in the wake of Bupa's 2011 study that found over half (51 per cent of all HR managers claim that staff sickness absence puts additional
work related stress on those employees left to 'hold the fort'. One in three (31 per cent staff stated they had to take on extra overtime to pick up additional workload as a result of colleagues being off sick. The research was in response to the Government’s Sickness Absence Review in November which found that the way sickness absence is managed by businesses can radically alter the length of time someone is off work.
- Ends -
Notes to editors:
Research conducted by ICM Research. Total sample size was 250 business owners and members of senior management from UK-based Small Medium Enterprises. Fieldwork was undertaken between 14th – 23rd February 2012.
About Bupa
Bupa's purpose is to help people live longer, healthier, happier lives.
A leading international healthcare group, Bupa offers personal and
business health insurance, runs care homes for older people and hospitals and provides workplace health services,
employee health assessments and chronic disease management services, including health coaching, and home healthcare.
- American Journal of Health Studies
- Annali di Igiene
- Applied Health Economics and Health Policy
- Archives of Environmental & Occupational Health
- Asia Pac J Public Health
- Australian and New Zealand Journal of Public Health
- Australian Journal of Rural Health
- Biocontrol Science
- Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
- Cancer Epidemiology
- Central European Journal of Public Health
- Chronic Diseases and Injuries in Canada
- Ciência & Saúde Coletiva
- Critical Public Health
- Das Gesundheitswesen
- Disaster Medicine and Public Health Preparedness
- Eastern Mediterranean Health Journal
- Environmental Health
- Environmental Health and Preventive Medicine
- Environmental Health Insights
- Environmental Pollution
- Epidemics
- Epidemiologia e Prevenzione
- Epidemiology and Health
- Epidemiologie, Mikrobiologie, Imunologie
- Epidemiology and Psychiatric Sciences
- European Journal of Public Health
- Global Heal
“Human resistance to antibiotics could bring ‘the end of modern medicine as we know it’,” according to The Daily Telegraph. The newspaper says that we are facing an antibiotic crisis that could make routine operations impossible and a scratched knee potentially fatal. Similarly, the Daily Mail’s headline stated that a sore throat could soon become fatal.
The alarming headlines follow a new report by the World Health Organization (WHO , which set out ways to fight the growing problem of antimicrobial resistance (AMR . AMR occurs when infectious organisms, such as bacteria and viruses, adapt to treatments and become resistant to them. The publication specifically addressed the long-known problem of antibiotic resistance, where increasing use of antibiotics can lead to the formation of “superbugs” that resist many of the antibiotic types we currently have. It outlined a variety of measures that are vital for ensuring we can still fight infections in the future and described how other major infectious diseases, such as tuberculosis, HIV, malaria and influenza, could one day become resistant to today’s treatment options.
However, despite the future danger posed by antimicrobial resistance, the situation is not irretrievable. As Dr Margaret Chan, director general of WHO, said: “much can be done. This includes prescribing antibiotics appropriately and only when needed, following treatment correctly, restricting the use of antibiotics in food production to therapeutic purposes and tackling the problem of substandard and counterfeit medicines.” The report also highlighted successful cases where antimicrobial resistance has been tackled, demonstrating that we can safeguard the effectiveness of important antimicrobial medicines with dedicated, rational efforts.
Where has the news come from?
WHO has just published a new report (“The evolving threat of antimicrobial resistance - Options for action” that sets out a global strategy for fighting antibiotic resistance. It explores how over past decades, bacteria that cause common infections have gradually developed resistance to each new antibiotic developed, and how AMR has evolved to become a worldwide health threat. In particular, the report highlights that there is currently a lack of new antibiotics in development and outlines some of the measures needed to prevent a potential global crisis in healthcare.
This is not the first time WHO has set out such a strategy. In the 2001, WHO published its “Global strategy for containment of antimicrobial resistance”, which laid out a comprehensive list of recommendations for combating AMR. The current report looks at the experiences over the past decade of implementing some of these recommendations, the progress made, and what else should be done to tackle AMR.
What is antimicrobial resistance?
Antimicrobial resistance (AMR occurs when microorganisms, such as bacteria, viruses, fungi or other microbes, develop resistance to the drug that is being used to treat them. This means that the treatment no longer effectively kills or inactivates the microorganism. The term “antimicrobial” is used to describe all drugs that treat infections caused by microorganisms. Antibiotics are effective against bacteria only, antivirals against viruses, and antifungals against fungi.
The case of penicillin illustrates the AMR phenomenon well. When penicillin was first introduced in the 1940s, it revolutionised medicine and was effective against a wide range of staphylococcal and streptococcal bacteria. It was also able to treat infections that had previously been fatal for many people, including throat infections, pneumonia and wound infections. However, with increasing use of antibiotics over the decades, bacteria began to adapt and develop changes in their DNA that meant they were resistant to the actions of the once powerful antibiotic. These bacteria would survive and proliferate, which meant their protective genes would then be passed on to other strains of bacteria. As a result, new and stronger antibiotics had to be created to combat the resistant bacteria.
AMR is driven by many factors, including overuse of antimicrobials for human and animal health and in food production, which can allow microbes to adapt to antimicrobials they are exposed to. Poor infection-control measures, which fail to prevent the spread of infections, also contribute. In particular, the WHO publication reports what it describes as the five most important areas for the control of AMR, as recognised in its 2001 strategy:
- surveillance of antimicrobial use
- rational use in humans
- rational use in animals
- infection prevention and control
- innovations in practice and new antimicrobials
How big is the problem?
As the report describes, AMR makes it difficult and more expensive to treat many common infections, causing delays in effective treatment or, in the worst cases, an inability to provide effective treatment at all. Many patients around the world suffer harm because infections from bacteria, viruses, fungi or other organisms can no longer be treated with the common medicines that would once have treated them effectively.
The report presents some startling facts on major infectious diseases worldwide:
- Malaria: malaria is caused by parasites that are transmitted into the bloodstream by a bite from an infected mosquito. Resistance to antimalarial medicines has been documented for all classes of the drug, which presents a major threat to malaria control. The report describes that a change in national antimalarial treatment policy is recommended when the overall treatment failure rate exceeds 10%. Changes in policy have been necessary in many countries due to the emergence of chloroquine resistance. This means that alternative forms of combination therapy have to be used as first-line treatment.
- Tuberculosis: in 2010, an estimated 290,000 new multidrug-resistant tuberculosis (TB cases were detected among the TB cases notified worldwide, and about one-third of these patients may die annually. Inaccuracies in diagnosis also impede appropriate treatment.
- HIV: resistance rates to anti-HIV drug regimens ranging from 10% to 20% have been reported in Europe and the USA. Second-line treatments are generally effective in patients when the first-line therapy has failed, but can only be started promptly if viral monitoring is routinely available.
- Common bacterial infections: various bacteria can cause infections within the chest, skin and urinary tract bloodstream, for example, and the inability to fight these infections appears to a growing problem in healthcare. Estimates from Europe are that there are 25,000 excess deaths each year due to resistant bacterial hospital infections, and approximately 2.5 million avoidable days in hospital caused by AMR. In addition, the economic burden from additional patient illness and death is estimated to be at least ˆ1.5 billion each year in healthcare costs and productivity losses.
What can be done about AMR?
The five key areas that the report highlights could tackle the problem of AMR are as follows:
Surveillance of antimicrobial use
Tracking antimicrobial use (in particular antibiotic use and looking at the emergence and spread of resistant strains of bacteria is a key tactic in the fight against AMR. This can provide information, insights and tools needed to guide policy and measure how successful changes in prescribing may be. This can happen both locally and globally.
AMR is a global problem but, at present, there appears to be wide variation in the way regions and countries approach AMR surveillance. This means there is a long way to go before it can be carried out worldwide.
Rational use in humans
Antimicrobials can obviously be important or even lifesaving in appropriate situations, but it is just as important to prevent unnecessary use of antimicrobials, which can lead to resistance. Putting this into practice worldwide is said to be difficult, but rationalising antimicrobial use has had a demonstrable impact on AMR in some cases.
Rational use in animals
Antibiotics are said to be used in greater quantities in food production than in the treatment of disease in human patients. Also, some of the same antibiotics or classes are used in animals and in human medicine. This carries the risk of the emergence and spread of resistant bacteria, including those capable of causing infections in both animals and people.
The problems associated with the use of antibiotics in animal husbandry, including in livestock, poultry and fish farming, are reportedly growing worldwide without clear evidence of the need for or benefit from it. There are said to be major differences in the amounts of antimicrobials used per kilogram of meat produced in high-income countries, and actions need to be taken by national and international authorities to control this.
Infection prevention and control in healthcare facilities
The hospital environment favours the emergence and spread of resistant bacteria. The report highlights the importance of infection-control measures to prevent the spread of microbes in general, regardless of whether they are resistant to antimicrobials. Many facilities and countries are reported to have progressed well since 2001, implementing many recommendations on infection control and prevention, although gaps and challenges still remain.
Innovations
Lastly, the report describes how innovative strategies and technologies are needed to address the lack of new antimicrobials being produced. As the report says, while antimicrobials are the mainstay of treatment for infections, diagnostics and vaccines play important complementary roles by promoting rational use of such medicines and preventing infections that would require antimicrobial treatment. So far, new products coming on to the market have not kept pace with the increasing needs for improvements in antimicrobial treatment. However, current challenges to new research developments can be both scientific and financial.
Can these strategies really stop AMR?
While AMR poses a significant threat to health in the future, the situation does not appear to be irretrievable. The WHO report and an accompanying press release highlight some examples of success stories over the past years:
- In Thailand, the "Antibiotic Smart Use" programme is reported to have reduced both the prescribing of antibiotics by prescribers and the demand for them by patients. It demonstrated an 18–46% decrease in antibiotic use, while 97% of targeted patients were reported to have recovered or improved regardless of whether they had taken antibiotics.
- A pharmacy programme in Vietnam reportedly consisted of inspection of prescription-only drugs, education on pharmacy treatment guidelines and group meetings of pharmacy staff. These measures were reported to give significant reduction in antibiotic dispensing for acute respiratory infections.
- In Norway, the introduction of effective vaccines in farmed salmon and trout, together with improved fish health management, was reported to have reduced the annual use of antimicrobials in farmed fish by 98% between 1987 and 2004.
- In 2010, the University of Zambia School of Medicine was reported to have revised its undergraduate medical curriculum. AMR and rational use of medicines were made key new topics to ensure that graduates who enter clinical practice have the right skills and attitudes to be both effective practitioners and take a role in fighting AMR.
How can I help?
There are times when antibiotics are necessary or even vital. However, as patients and consumers, it is important to remember that antibiotics or other antimicrobials are not always needed to treat our illnesses, and we should not expect them in every situation.
For example, the common cold is caused by a virus, which means it does not respond to antibiotics. However, people may expect to be given antibiotics by their doctor when they are affected, even though they offer no direct benefit and could raise the risk of bacteria becoming resistant. Furthermore many common viral and bacterial infections such as coughs, throat and ear infections and stomach upsets, are “self-limiting” in healthy people, which means they will generally get better with no treatment at all.
If, on the other hand, you are prescribed an antimicrobial, it is important to take the full course as directed. Taking only a partial course of an antimicrobial may not kill the organism but may expose it to a low dose of a drug which can then contribute to resistance.
Links To The Headlines
Health chief warns: age of safe medicine is ending. The Independent, March 16 2012
Resistance to antibiotics could bring "the end of modern medicine as we know it", WHO claim. The Daily Telegraph, March 16 2012
Why a sore throat could soon be fatal: Bugs are becoming more resistant to antibiotics, warn health chiefs. Daily Mail, March 16 2012
Links To Science
WHO: The evolving threat of antimicrobial resistance - Options for action. March 16 2012
shows a correlation between literacy problems and health problems. Adults with trouble reading are twice as likely to die within five years as adults with no trouble reading. To be fair, what the study actually focused on was the ability of senior citizens to read and comprehend aspirin instructions.
More »
When it comes to working out, my main concern is staying fit, but looking cute while burning calories is a close second!
Put away those baggy tees and oversized exercise pants! From fitted track jackets to trendy board shorts, there are plenty of figure-flattering ways to show off the body you've worked so hard for!
Fitness expert
Nicole Glor gives GalTime the 411 on workout wear that will have you looking (and feeling good!
Fitted zipper jackets, like the
Lululemon Define Jacket ($99 , will help slim your arms
and
flattern your tummy. These styles are also great for keeping you warm during outdoor workouts or yoga sessions. Glor always wears fitted zipper jackets during her on-air fitness segments!
Longer tanks will also help minimize the stomach, and some can even camouflage that dreaded muffin top! Tanks like the
Lululemon Practice Freely Tank ($58 give you room to breathe, while hiding a larger midsection.Their loose, flowy fabric help you move around in style...and cool you down!
Related:
How to Find a Sports Bra that Fits
Supportive tanks, especially ones with built-in bras, are great for larger busts during workouts that involve jumping around. The extra support will hold the girls in place, so you can focus on getting your sweat on!
To help cover up a bigger chest, look for fitness tops like the
New Balance Shell Tank ($41.99 and choose your own bra size for the best fit.
Fitted tanks, like the
Under Armour Women’s PIP Ribbed Top ($14.99 include a racer back for support, while accentuating the chest and stomach. These tanks are great for any type of exercise, from outdoor workouts to indoor Pilates classes! Look for cotton fabrics that breathe.
Related:
Secrets to Having the Perfect Ponytail
Board shorts are perfect for playing up slim legs! These short shorts give you room to run around, and won’t get in the way during a tough workout. The
Nike 2” Boyshorts ($35 come in every color under the sun, and look fab on those toned hips!
Exercise leggings keep your butt and thighs tight, and flatter any size! Whether you’re working out indoors or outdoors, skintight leggings eliminate chafing– not to mention they’re totally cute!
Related:
Why We Need to Stretch
For extra support, check out the
YogaFit Cinch Tights ($39.95 . Curvier? Glor says your butt will look amazing in
YogaFit Stylized Stitched Leggings ($18.95, below , thanks to the pockets!
Yoga Pants are a great way to mix functional fitness gear with flattering style. Though tight around the hips, flared or boot cut bottoms balance out your thighs! These pants are perfect for hourglass figures because they draw attention to your hips and waistline!
Lucy Perfect Core Pants ($98 even have an extra layer of fabric to engage your core!
More from GalTime:
Couple Workouts: How to Stay Healthy and Intimate
Top Five Things/Excuses I Hear at the Gym
5 Must-Have Hair Gems (All Under $10!
Pieces of Jewelry EVERY Gal Should Own
NikkiFitness, Nicole Glor, is 34 year-old fitness expert on Fox and Friends, and the star of 7 fitness DVDs including new Hard Core Abs DVD, Fit Travel Workout DVD, Booty Camp, Red Carpet Runway Workout, Military Wife Workout, Baby Bootie Camp, and the Beach Bride Destination Wedding Workout (Amazon . Nikki's workouts have been featured in over 100 national media outlets. She is also an AFAA certified NYC personal trainer, group fitness instructor at Crunch in Manhattan, a 200 RYT YogaFit/Yoga Alliance trained yoga instructor, author of the upcoming book "Slimnastics", a fitness columnist for Military.com and a spokesperson for SilverSport antibacterial fitness products. Her "Slimnastics" workouts focus on multitasking toning and cardio intervals to cut workout time in half and boost metabolism. Get her newsletters, music playlists, video demos and DVDs at
www.nikkifitness.com Search for "NikkiFitness" on Facebook and Twitter!
Raise your hand if you're sick and tired of Republicans waging war on women.
Ah. I see there are a lot of you with your hands raised, including
Republican women:
“We all agreed that this seemed like a throwback to 40 years ago,” said Ms. Russell, 57, a retired teacher from Iowa City who describes herself as an evangelical Christian and “old school” Republican of the moderate mold. [...]When even Republican women—and Republican
“I didn’t realize I had a strong viewpoint on this until these conversations,” Ms. Russell said. As for the Republican presidential candidates, she added: “If they’re going to decide on women’s reproductive issues, I’m not going to vote for any of them. Women’s reproduction is our own business.” [...]
And in what appears to be an abrupt shift, some Republican-leaning women like Ms. Russell said they might switch sides and vote for Mr. Obama — if they turn out to vote at all. [...]
Deborah R. Stevens, a self-described “dyed in the wool” Republican, said she felt hopeless.
“I’m looking for a candidate that will be honest, that will come out and say, ‘Yes, I support women, I want you advanced and not trampled upon,’ ” said Ms. Stevens, 63, who lives near Myrtle Beach, S.C.
evangelical
women, at that—are sick of being attacked by their own party, you know the Republicans are in trouble. Which is why they're now trying to claim, with
an assist from Rush Limbaugh, that they don't want this war; it's those darned Democrats who tricked them into it by laying a trap Republicans are too stupid to avoid.
Too bad for them no one's buying it. And if Republicans don't figure out just how angry women are about their war, they're going to
find themselves in big trouble come election day. Because—oh my god, shocking!—there are a lot of women in this country. And they vote. And they
don't
want to vote for more war on their rights.
As we've discussed in this series before, it's one thing to fight back against bad legislation, but it isn't enough. We must go on
offense
and fight for
good
legislation that protects and expands women's rights. As Meteor Blades
wrote earlier this week:
Every fight requires defense and offense. This fight goes to the very heart of freedom for women. The enemies of that freedom have been hammering away at it for decades. And, as we have seen, they are succeeding in state after state. Not everywhere, but they don't quit when they lose. They find another path to victory. We can't let that keep happening. We can't let people who say this is a distraction we should ignore set the agenda. Stopping the enemies of reproductive freedom will not be accomplished by ignoring them. And meeting women's reproductive health needs cannot be done simply by defending against the attacks on it.So it's offense time. It's time to fight for the kind of legislation we want to see, the kind of legislation that will make women's lives better. It's time for
us
to take the fight to
them
—at the federal level and state by state. The anti-woman forces in this country aren't the only ones who can organize to pass legislation that affects women; we can do it too. And we should. Women—Republican women, evangelical women, Catholic women—aren't willing to sacrifice their basic rights just because some cranky, vagina-fearing Republican men think they should. Even "dyed in the wool" Republican women like Deborah R. Stevens believe it's time for politicians to say, "Yes, I support women, I want you advanced and not trampled upon."
So let's turn that belief, and the collective anger at the Republicans' war on our rights, into law.
- If you live in Washington,
click here to tell your state senators to pass the Reproductive Parity Act, which requires health insurance plans that cover maternity care to include the full range of reproductive health care options, including abortion.
- If you live in New York,
click here to tell your state senators to pass the Reproductive Health Act, which changes the state health code to protect women's rights to reproductive health care, including contraception and abortion.
- If you live in California,
click here to tell your state senators to pass the Safe Early Access Bill, expands the definition of who can provide abortion care to include nurse practitioners, midwives and physician assistants, ensuring that women do not have to travel great distances to obtain safe reproductive health care.
- And no matter where you live,
click here to tell Senate Republicans to reauthorize the Violence Against Women Act, to protect
all
victims of domestic violence and sexual assault.
They've had us on defense long enough. Time to take the fight to them.
This week’s good, bad and ugly below the fold.
Regarding healthful living many folks believe that as long as they're getting a little bit of exercise every day that's enough. You want to realise that while exercising is critical, the things you eat are also going to play a very important part in your general health. Even though you think your eating a good diet, you'll possibly find that a few of the foodstuffs you are eating are bad for your well-being. As you continue to read we're going to be deliberating foods that you should be eating each day in addition to things you must try to keep away from.
Australian politics has a strange 'centre' at the moment, and the dial seems increasingly to fall at the feet of Malcolm Turnbull.
His presence on shows like
Q&A results in both calls for him to
reassume the Liberal Party leadership, and the suggestion he is an
ALP member in disguise. Analogies are drawn with Don Chipp and he is
urged to create a new party of the centre. While some
celebrate his staring down of Abbott on climate change, others seem
seduced by his status as the likable one inside elite circles.
Yet far from a 'good sort' member of the 1 per cent, his celebrated small 'l' liberalism is little other than a continuation of the right-wing economic radicalism of the neoliberal era. Turnbull is committed to privatisation of the public sector, radical industrial relations policy, and solving serious social problems (such as climate change by leaving them to market mechanisms. He has even gone so far as to call building the National Broadband Network 'the
telecommunications version of Cuba'.
In the lead up to the last federal election, GetUp! chose the seat of Wentworth as one of only two seats in NSW to target leaflet on election day. The seat had
Labor for Refugees member and marriage equality supporter
Steven Lewis in the red corner, and carbon-price-loving and leather-jacket-clad Turnbull turning it on in the blue. While The Greens received their usual series of big ticks from GetUp!,
the leaflet encouraged voters to be prudent as 'Wentworth Is Different', they claimed.
I voted in the late afternoon when there were more GetUp! activists than party volunteers at the booth. They were in chorus screaming that Lewis agreed with me on ending marriage discrimination, and that Turnbull was on my team wanting to tackle climate change.
"The candidates want social justice - they're real liberals."
"These two disagree with their parties - they say what they really think."
As the
@GetUpWentworth campaign tweeted:
"
@LewisWentworth supports gay marriage, will cross floor over refugees.
@TurnbullMalcolm wants price on carbon. RT this important info!"
What were not part of the verbal volleys as I queued, nor discussed in the GetUp! leaflet, were any more fundamental questions about the economy despite the dire global outlook at the time. The leaflet talked about specific policy initiatives - around health, environment, refugees, and jobs and infrastructure - but disconnected from the overall management of the economy and the neoliberal economic orthodoxy of the major parties.
For example GetUp!'s leaflet indicated where the parties stood on an increase in the compulsory rate of superannuation, but said nothing on the catastrophic losses of people's retirement money in the Global Financial Crisis (as a result of it being gambled on the stock market . It scored the parties on increased funding for Indigenous, preventative and mental health, but said nothing on the growing share of health money going to private health care. Nor did it ask about the repeated failures to bring crucial allied health services (such as psychology, physiotherapy and dental fully under the Medicare umbrella and change fundamentally the economics of healthcare in this country.
So there I stood, close to the many corners of Kings Cross that house Sydney's homeless each night, angry about how little the GetUp! leaflet said about the Wentworth community's haves and have-nots. It was a gloomy bit of icing on an election where Abbott's record player was stuck on 'turn back the boats' and '
great big new tax'. An election where Gillard and Swan were trying to sell the story that 'we' escaped the GFC, at a time many Australians felt life was getting tougher and the ALP was caving in to the big end of town over the mining tax. An election where The Greens offered little in the way of an alternative outlook on economics, ignoring warnings from members and
progressive economists that they had given too much ground to neoliberal ideology.
That said, the 2010 election can also be seen as part of a longer-term trend to dumb down economic discussion and delink questions of equity and economics in Australia. The rise of the use of the term 'social justice' has seen the falling away of questions around inequality, to the detriment of both those individual issues and public debate. The media and politicians discuss public policy as if it were simply a series of moral questions, unconnected to wider economic strategy or principles. And the public are allowed to discuss whether something will be funded (or not funded as the case seems more often lately , but any discussion of the wider economic agenda the Government chooses to enact is out of bounds.
Turnbull is not in the wrong party, as some claim, and nor is he politically progressive. Rather, he is an extreme economic rationalist who doesn't believe in the greater redistribution of social wealth to ensure a more equal, more just, and fairer Australia. I say leave him where he is, in the party full of those who argue the market not the community should determine important social questions.
My favourite press release of Turnbull's is where he defends the interests of the 1 per cent while
condemning the ALP means testing of the private health insurance rebate. Turnbull decried that 'Residents in the Eastern Suburbs will carry a disproportionate burden of the cuts'. He is no fool, and clearly knows this is because the Eastern Suburbs of Sydney (where he and I both live is home to a 'disproportionate burden' of the wealthy, full stop. He lives amongst those who can most afford private health insurance, and those whose tax returns will indicate they earn above the rebate threshold. The electorate of Wentworth is home to the
three wealthiest suburbs in the country (Darling Point, Edgecliff and Point Piper with a mean taxable income of $186,202.
Turnbull himself slipped off the BRW Rich 200 list in 2011, but in 2010 his estimated net worth
was $186 million. Although he slid down 15 places on the list between 2009 and 2010, from 182 to 197, he actually got richer in that time. It is just that other members of the elite club around him were getting richer quicker and leapfrogged him.
So Turnbull is not really in the middle, or a centrist, at all. He is a man who poses enormous personal wealth, and is a politician who argues for an economic framework that will deliver the further concentration of wealth in the hands of the few.
And even then, while Turnbull is not as socially conservative as some others in the Liberal-National Coalition, he is far from a shining light of progressive 'social causes'. It still disgusts me that as the local representative for Darlinghurst, the host of the
Sydney Gay & Lesbian Mardi Gras, he fails to support the call for marriage equality in Australia. Though as Greg Jericho
pointed out, 'giving a "vibe" of being kinda sorta in favour of gay marriage seems to be enough for some' when it is in fact so very, very little.
Progressive people, including many activists, too rarely see issues of wealth inequality and hierarchies of power as key to social and political debates. For some raising these issues has come to be seen as 'outdated' or 'irrelevant', part of a past when class mattered. This is perhaps of most concern as we have been living through a period of dramatically increasing inequality
in Australia (see also
this and
this .
Economics is not something separate from politics, or something that is the exclusive domain of experts and technicians. While progressives have been speaking out on crucial social issues (from mandatory detention of refugees to tackling climate change , we have often done so in a way that fails to challenge the dominant economic framework that underpins these problems. We have let the rich and powerful pursue their economic agenda effectively unchallenged. In the process we have failed to put the greatest ethical questions of this decade front and centre - those being the increasingly unequal distribution of wealth and power, and the failure of neoliberalism to deliver fair and sustainable outcomes locally or globally. As
one Twitter user put it about Turnbull, we should not be 'swept away by his nice suits & crocodile smile on the idiotbox & forget he's part of the 1%'.
Elizabeth Humphrys is a Sydney-based writer and PhD candidate in political economy. She is a member of the Australian Greens, and was National Deputy Secretary of the party in 2009. She was previously a member of the Victorian ALP in the mid 1990s. View her full profile
here.
no more health care repeal votes, we should do some real work now.
Scene change to today on the other side of Capitol Hill, where, as David Waldman explained, the
big action the House is going to be taking this week, H.R. 5, is on a repeal bill. They call it the "Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH Act," though it has very little to actually do with health care. It's mostly about tort reform.
What's slightly different about
this bill is that it has both a repeal and, believe it or not, replace component. It would repeal one of the mechanisms for cost savings in Medicare—the independent Payment Advisory Board—and replace it with a totally non-proven cost-saver that wouldn't affect Medicare, but has been one of very few concrete "reform" ideas the Republicans have come up with: tort reform.
The repeal legislation enjoyed notable Democratic support until last week, when GOP leaders announced plans to link it to another proposal to limit certain medical malpractice awards.As with most of what the House has done, this is purely political posturing. They promised "repeal and replace," and this is what they came up with, hoping that they can make life uncomfortable for a few Democratic incumbents, have something to show the base, even while realizing it will die in the Senate. Where even Republicans aren't interested in having any more of these votes.
Still, the measures should attract support from Republicans and moderate/vulnerable Democrats to pass the House.
The House may as well have stayed in recess. They accomplish just as much when they're on vacation, and are a lot less destructive.
Cameron Health's lead-less implantable cardioverter defibrillator will get a date with an FDA advisory panel next month, a good sign for Boston Scientific and its pending Cameron Health acquisition.
Cameron Health landed an April date with the FDA's circulatory devices panel to review a pre-market approval application for its lead-free subcutaneous implantable cardioverter defibrillator, or S-ICD.
The S-ICD system, unlike traditional ICDs, sits just beneath the skin and does not rely on wires relayed through blood vessels and connected to the heart in order to provide heart rhythm therapy.
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Stockton, Calif., has been plagued with financial woes since the housing crisis began.
Updated 12 p.m. ET March 19
Poor Stockton. Last year*,
Forbes Magazine named the California town the most miserable city in the U.S. And now Stockton is on the verge of bankruptcy -- having built more than it could pay for and having promised pensions and health benefits to early retiring city employees. It's enough to demoralize a community that even now has a lot of pride and a fair amount to be proud of.
Stockton is the home of the University of the Pacific, which was called College of the Pacific when jazz artist Dave Brubeck went there in the last century. The city boasts a healthy agricultural economy, which has its ups and downs but nevertheless provides stability in the nation's most productive agricultural region, California's Central Valley. And Stockton has a modern port, built on a channel that comes inland from the San Francisco Bay. The port has done well of late, despite the economy. It has locally owned banks that didn't give loans to people who couldn't pay them back, and that remain solvent. So what's the problem?
The problem is one that more and more American cities and communities are facing. Stockton's city fathers and mothers believed and helped perpetuate all the hype emanating from developers and building contractors who constructed houses and shopping centers on cheap agricultural land that was almost within commuting distance of San Francisco. People came and bought the houses, whose prices were inflated. Then the national deluge hit; the new residents couldn't pay their mortgages, and the homes were foreclosed on. Prices dropped by as much as 65 percent. The shopping centers didn't have enough customers, so businesses closed and stores went vacant. The high-flying construction industry essentially collapsed, throwing people out of work. So down went income and property and sales tax revenue that Stockton was relying on to pay for what it had bought.
What it had bought in the boom years were a new ballpark, a city activities center, a new hotel, an ice rink, some parking garages and a lovely marina on that same channel the port uses. It had floated bonds to pay for all those goodies, many of which sit largely empty today. The bondholders -- and it's unclear exactly who they are since bonds often get traded -- may not get paid back; some of the bonds are already in default. But it wasn't just spending on buildings that pushed Stockton to the brink. Like most California cities, the city offers retirement at age 50 to police and firemen, at nearly (or in some cases more than their last year's pay. Plus, they decided that since so many city employees retire before they're eligible for Medicare, the city would provide health insurance as an additional retirement benefit.
Times were good when the city council voted for those plums. The tax revenues were coming in strong, and city officials confidently predicted the good times would roll on. But of course all that has changed. Today, for example, health care costs for retirees total more than it does for current city workers. And in the wake of all the trouble, Stockton residents and officials are at each other's throats. A recent front-page column in the Stockton Record began: "Stocktonians have been betrayed by irresponsible public officials and political toadies who steered the city toward a fiscal cliff and retired on a champagne pension."
Former City Manager Dwane Milnes, who was one of the targets of the column, vehemently disagrees. He argues no one could have foreseen the financial trouble on the horizon. Stockton spent prudently, he claims, and besides, most retirees are getting modest pensions and benefits they worked hard for.
But that hasn't calmed the waters. At a recent City Council meeting, some citizens vowed to kick out the entire council at the next election. One former councilman said the city isn't even close to bankruptcy. And retirees complained they were being blamed unjustly for the whole mess.
It is a mess. Stockton is a poor area to begin with, overshadowed by the nearby San Francisco Bay Area where technology is driving a vibrant economy, and even by Sacramento, the state capital to the north where state government keeps the city employed. Stockton has -- as one resident, a substitute teacher by the name of Ronald Schwartz, put it to me - "a non-diversified agricultural based economy." He and others consider the area akin to Appalachia. Unemployment is around 17 percent; income levels are very low. As Schwartz put it:
"I think that this is such a rough place that people who are highly educated use it as a springboard to get jobs in other places, and what it leaves behind is not the cream of the crop. The really smart people don't want to stay here. They don't want to be here with the violence and the crime and everything."
One thing builds upon another. The poor financial situation has forced the police force to drop by 27 percent recently. And that, of course, has made the already high crime rate go up even more.
So, yes, poor Stockton. As it tries to fight off bankruptcy, it realizes that the hole it is in seems to be getting deeper. And calling it the most miserable city in the country "is like bayoneting the wounded," claimed City Manager Bob Deis. He is negotiating with its creditors -- from bondholders to retirees and unions -- hoping for a break.
(Watch the segment on Stockton
here
*This sentence has been updated. Due to an editing error, the original version stated that Stockton was named the most miserable city this month. In fact, this year's version of 'most miserable cities' from Forbes places
Miami, Fla at number one. Thank you to
a commenter who pointed out the mistake.
WHO warned during a conference of infectious disease experts on Friday. According to
NewsCore reports, WHO Director-General Margaret Chan told those attending the meeting, which was held in Copenhagen, Denmark, that even ailments as simple as a scratched knee or a sore throat could someday become fatal. Furthermore,
Daily Mail reporter Mario Ledwith writes that Chan believes that the Earth was quickly approaching what she referred to as the "post-antibiotic era." As these disease-causing microbes become more and more resistant to the drugs meant to treat the conditions they cause, those injuries and illnesses will become increasingly harder to treat, thus making some "remedies more expensive, and some conditions… untreatable," Ledwith added. If this so-called post-antibiotic era does, in fact, happen, Chan said that it would result in the "end to modern medicine as we know it." This "post-antibiotic era" would "include many of the breakthrough drugs developed to treat tuberculosis, malaria, bacterial infections and HIV/AIDS, as well as simple treatments for cuts," says Hannah Furness of
The Telegraph. Any medicines that would replace existing treatments would not only become more costly, but would also take longer in order to have similar affects as today's antibiotics. "Some sophisticated interventions, like hip replacements, organ transplants, cancer chemotherapy and care of pre-term infants, would become far more difficult or even too dangerous to undertake," Chan said, according to Ledwith. "Antimicrobial resistance is on the rise in Europe, and elsewhere in the world. Replacement treatments are more costly, more toxic, need much longer durations of treatment and may require treatment in intensive care units." Chan's warning comes following the release of a WHO book on the topic. According to Furness, that book, which is entitled '
The Evolving Threat of Antimicrobial Resistance- Options for Action,' claims that "a crisis has been building up over the decades, so that today many common and life-threatening infections are becoming difficult or even impossible to treat, sometimes turning a common infection into a life-threatening one." The Daily Mail reports that while many countries have already introduced policies attempting to prevent the overuse of antibiotics, that the UN's public health group is seeking worldwide implementation of such measures. The UK paper says that the European Union has acknowledged that they are aware of the problem and have developed a five-year plan to slow down antibiotic use, while medical experts in developing nations are also attempting to find ways to stop the substances from being prescribed too often.
The House was not in session last week. They continue on their own merry way with their two weeks in, one week out schedule, uncoordinated with the other house, though that'll put them back in synch temporarily for the Easter/Passover break.
The Senate finally cut a deal on amendments and finished up its surface transportation authorization bill, culminating with a 74-22 vote on final passage, after spending over a month on the floor.
There was also some progress (slow and maddening, of course made on a raft of judicial nominations. Majority Leader Harry Reid (D-NV filed cloture motions on seventeen pending but stalled appointments, and was poised to call them up for votes one after the other, but an agreement was reached instead that allowed for votes on 14 of the 17 on a schedule stretched out over the two months. In exchange, Republicans get timely floor consideration for the minor (and bipartisan financial market deregulation bill recently redubbed the "JOBS Act."
The House returns to DC today, but as usual comes in late in the afternoon (actually a couple hours later than usual for a Monday , and will take up two suspension bills. Tuesday brings just one more suspension, which makes me wonder whether they're running low on the kind of non-controversial stuff that keeps the gears turning during the first part of a typical business week. In fact, Tuesday's pretty picayune across the board, with the only other piece of legislation being a bill instructing the Secretary of the Interior to facilitate the transfer of a parcel of federal land in Accomack County, Virginia to the local government there.
The rest of the week is given over to H.R. 5. Yes, 5, which makes it one of the first and highest priority bills introduced in the current Congress, even though you've heard absolutely nothing about it for a year and a half. Well, I guess you've
sort of
heard something about it, if you count the random, blustering threats from Republicans to beat up lawyers and stuff. H.R. 5 is the "Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH Act." It's a bit of a strain as acronyms go. Help efficient, accessible, low-cost, timely healthcare... do what? Well, if you have to ask, you're a socialist, I guess. BANANAS score: 4. What does it do in order to help... all this stuff do... whatever? Nothing. It's a "tort reform" bill. You know the drill: can't sue after three years, cap on non-economic damages, proportional liability, etc., etc., etc. Same old song and dance as ever. Why it took them a year and a half to plate this garbage up for us, I have no idea.
The Senate's schedule is uncertain (as usual beyond the planned consideration of the aforementioned financial deregulation bill, which Senate leadership is referring to as the "Capital Formation/IPO" bill. That's certainly a better description for it than "JOBS," which was always a stretch. No votes are expected today, but a cloture vote on a substitute amendment is set for Tuesday.
And though there's nothing on the schedule about them yet, the agreement on the judicial nominations was that another seven would come to the floor for votes before the upcoming April recess. That's in two weeks, so I'd expect to perhaps see a few of those nominations in the latter half of this week.
Full floor and committee schedules are below the fold.
The United States Department of Health and Human Services, Offices for Civil Rights (“OCR” and BlueCross Blue Shield of Tennessee (“BCBST” announced a settlement this week for $1.5 million for a breach of protected health information under the Health Information Portability and Privacy Act (“HIPAA” . In November 2009, BCBST submitted a Health Information Technology for Economic and Clinical Health Act (“HITECH” Breach Report to OCR regarding the theft of 57 hard drives containing encoded electronic data including member names, member ID numbers, diagnosis codes, dates of birth, and social security numbers of 1,023,209 individuals. The hard drives were taken from a data storage closet at a former call center. According to BCBST, there was no indication of any misuse of personal data on the stolen hard drives and the company spent approximately $17 million on the investigation, notification, and protection efforts.
In addition to the $1.5 million payment, BCBST agreed to a Corrective Action Plan wherein BCBST is required to:
- Submit a biannual report;
- Comply with the document retention requirements;
- Demonstrate distribution and implementation of policies and procedures to its workforce with access to ePHI;
- Conduct a risk assessment of potential risks and vulnerabilities to the confidentiality, integrity and availability of ePHI;
- Prepare a risk management plan that implements security measures sufficient to reduce risks and vulnerabilities;
- Prepare a facility security plan to limit access to electronic information systems and facilities where they are housed and to safeguard equipment containing ePHI from unauthorized physical access, tampering, and/or theft;
- Implement physical safeguards governing the storage of electronic storage media containing ePHI;
- Conduct random samples of BCBST workforce’s familiarity and compliance with the policies and procedures; and
- Conduct random samples of electronic storage media and devices.
The enforcement action by OCR against BCBST was the first resulting from a breach report required by the HITECH breach notification rule. This resolution agreement was the sixth to be entered into by OCR for HIPAA breaches with one entity receiving civil monetary penalties as well. Civil penalties for HIPAA violations range from $100 to $50,000 per violation with a maximum of $1.5 million for all violations of an identical provision in a calendar year.
On Friday, we closed on our new house. I can tell you, quite honestly, that I am overjoyed. I am thrilled with the prospects of painting and starting with a clean slate and doing whatever I want to a much bigger house in a much safer neighborhood. I am over the moon. I am elated.
I am crying as I write this.
We bought our first house when our oldest son was three-months-old. For the longest time, we didn’t have curtains because I couldn’t decide on what I wanted -- and shortly after I did break down and buy curtains, I changed my mind and bought new ones anyway. It was a small house, one that we outgrew rather quickly -- but it was our first house. It was our house.
It was the house where I fell in love with my sons -- and fell in love with being a mom.
Our older son took his first steps in the middle of our not-so-big living room. Thanks to his severe texture issues, he threw up his first strawberry (of a few on our dining room floor (which, at the time, was home to carpet; ew . He bathed in the deep, porcelain sink, eventually moved to the bathtub and, wouldn’t you know it, now he takes showers -- by himself -- in the remodeled bathroom that my husband did with his own two hands. Well, his grandfather’s hands helped, too.
Our younger son was,
ahem
, conceived here. I suffered through bed rest on the couch with a never-not-moving almost-two-year-old. I went into labor on that same couch -- though we don’t own that couch anymore. We left for the hospital with one son and came home with two; we became a family of four in this house. I became a mom of two sons.
I survived postpartum depression in the hollows of this house. I clung to my husband, to the walls, to the bed and to my precious baby boys. Eventually I made my way out of that darkness and, once again, fell in love with being a mom.
I played trains on the floor for endless hours. I danced to songs from
Blue’s Clues
and
The Freshbeat Band
and, uh, Katy Perry. I beat my kids at Mario Kart -- until they started beating me. I chased them down the hall, naked butts and giggles. I tucked them in, and tucked them in, and tucked them in, and tucked them in. And in and in and in. All on the same night. And after they were asleep, I squeaked open the door to check on them, just to make sure they were breathing.
I, under the guise of Santa Claus and with the help of my husband,
gave them the surprise of their young lives. I watched them smash cakes that I slaved over so that they would have “healthy” first birthday cakes. I learned to cook things that they would love -- and things that they would hate -- in the small kitchen. I helped, along with the boys, build a deck where we made so many more memories: blowing bubbles, throwing footballs, playing cars, shoveling snow.
I laughed and cried and yelled and whispered and became the mom I am today within the walls of this first house.
And now it’s time to say goodbye.
I also wonder, of course, if that means I get to say goodbye to the parts of this mom that I don’t like. Do I get to leave behind the one that loses her patience on Friday afternoons because she’s just trying to make deadline -- and thus yells? Do I get to leave behind the memories of the sleepless nights with clingy newborns? Do I get to leave behind the anxious new mom who let her past and self-loathing trick her into not breastfeeding her oldest son? Or does she follow me to the new house like the dust on nick-knacks already packed in boxes? Is there room for her at the new house? Will she take up too much space? I hope not. We have a finished basement; maybe she can hang out down there, in a corner or something.
I thought it would be a bit easier. I’ve been fed up with the lack of space and the drug-dealing, mufflerless, cussing neighbors and the feral cats pooping in my rose garden and the lack of parking and the mud and on and on and on for years. I thought I would run, skip and jump to the new house. And I did.
But there’s a part of me that looks back over my shoulder and whispers, “Thank you. Thank you for covering our heads and keeping us warm and dry over the years. Thank you for giving us a safe place, if only within our own walls, to learn to love one another. Thank you for allowing us to stretch out our legs and find our own wings within your walls. Thank you for being patient with me when I stomped my feet or slammed a door. Thank you for holding us tight while I figured out how to be a mom.”
Our new house will hold many more memories over the years, though not some of the firsts that won’t ever happen again. No first steps or first foods or first vomits of first foods. And my mothering will change there as well. At some point I will change from the mother of school-aged children into the mother of tweens and then teens and then... that house may become the house where I stand at the door, watching the car drive away from the house as my youngest flies the coop. Perhaps that’s why it’s so hard to leave this house. Choosing to leave is easier than being left behind, I guess.
I'm sure I'm not the only mom who has stood and looked back into an empty house with a bit of a heavy heart. Have you had a similar experience?
Family Section Editor Jenna Hatfield (
@FireMom blogs at
Stop, Drop and Blog and
The Chronicles of Munchkin Land. She is an editor, writer and photographer.
The US Supreme Court will not allow cameras from for oral arguments on the constitutionality of President Barack Obama's health care overhaul but will release audio recordings and written transcripts.
The outbreak total includes 33 children, ranging in age from 15 months to 18 years old. Three required hospitalization but have since been released. The children all attended one of seven schools or a single day care center.
Two of four ill adults appear to be part of the outbreak; two cases may be unrelated, the health department said in a news release.
Still no official word on what caused the outbreak of Salmonella poisoning, although the owner of The Lunch Lady catering company, implicated as the source, said earlier that investigators were looking at ground beef used to tacos and lasagna.
A young Dr. Charles Armstrong, fresh from fighting the world influenza epidemic that came with the Great War, was ordered by U.S. Surgeon General Rupert Blue to his home state of Ohio on July 1, 1919 to provide assistance to the state health officer.
Armstrong, just 33, returned home from war just six weeks before a county club banquet was held for more than 200 people near Canton, Ohio. Fourteen of those attending the banquet became stricken by botulism poisoning and seven of those victims died.
The coincidence of Armstrong's assignment to help out in Ohio meant he who would go on to worldwide recognition as virologist with his 1934 discovery of the virus he named lymphocytic choriomeningitis (LCM .
For the California olive industry, this meant the botulism outbreak of 1919 was going to be thoroughly and definitely tied around its neck. With a total of 19 botulism deaths in three states -- that were conclusively linked to canned California olives -- made the outbreak one of the deadliest outbreaks in the U.S.
The California olive industry owed it existence to those first olive trees planted in the mission orchards at San Diego, San Jose, Santa Clara and others before the American Revolution. For 20 years, it had been commercially viable, but the 1919 botulism outbreak was an unmitigated disaster. California olives did not recover for more than a decade.
Other U.S. states -- where those mission olive trees would never grow -- were the market for California canned ripe olives and now botulism in a can from California made for a pretty sensational story.
To make matters worse, California olive growers were not helped by the fact that, after 1919, the botulism outbreaks linked to olives did not really end until 1924.
The 1919 outbreak left dead in three states: Ohio (7 , Montana (5 , and Michigan (7 .
It is Ohio that always gets the most attention, however, because of the Armstrong's investigation and the unusual circumstances he found at the country club. He found that at the country club event attended, which was attended by more than 200 people, the botulism was all contained to people who sat at one table, the chef and two waiters.
"The guests who became ill were all members of a party given by Mrs. I.W.G., of Sebring, Ohio, and had been served at a separate table which shall hereafter be designed as the Sebring table," Armstrong wrote. "The two waiters who attended this table and the chef were also affected."
Armstrong reported the banquet menu included: cantaloupe, turkey, turkey stuffing, tomatoes and mayonnaise, crackers, scalloped corn and pimentos, browned potatoes, green olives, celery and pickles, rolls, butter, ice cream cake, water and coffee.
But he found the Sebring table did not get the green olives, celery, and pickles. Instead, Mrs. I.W.G. provided ripe olives, chocolate candy, Newport creams and candied almonds.
In the Dec. 19, 1919 edition of Public Health Reports, Armstrong includes the seating chart for the Sebring table that also includes the location of the three plates of ripe olives. Five of those in proximity to the olive servings died including Mrs. I.W.G.
Botulism also killed the chef and a waiter.
By the time his investigation got underway, six of the cases "had terminated fatally," according to Armstrong. While no illnesses occurred among those at other tables, Armstrong interviewed 15 of those guests and he also conducted a full blown epidemiological study to exclude all the items on the menu.
Of the 14 people who were ill, all ate olives. "When the dead are considered, it is found in a general way that those who died first who ate the most olives," Armstrong said.
Among those who were recovering, he said those who ate the least suffered were less severe cases. Those who survived reported the olives did not taste right. Asked to describe it, they said things like the olives "bit the tongue" and "stuck to the tongue" or just said they were "not fit to eat."
Armstrong found the ripe olives came from a vacuum-sealed jar and concluded, "something had occurred to destroy the vacuum in the jar, for, in opening it, the lid is said to have come off easily without having been punctured and without the use of instruments." The lid was discarded, but the recovered glass jar "was not cracked or defective in any way."
One of the waiters did not think the olives tasted right, and near the end of the banquet, he took them to the chef to get another opinion. The chef ate two, unwashed, and was among those who died. One of the two waiters for the Sebring table and a guest, both of whom survived credited the amount of whiskey they drank that evening as possibility saving their lives.
Pushing on, the investigation found the source of the contaminated olives to be the Ehmann Olive Company, formed in 1898 by Mrs. Freda Ehmann. She started California's commercial olive industry and credited with establishing the modern California ripe olive industry.
She arrived in California as a widow in the 1890's when olive planting was peaking. She lost her first investment in a ranch called Olive Hill Grove and then turned her attention to perfecting a recipe for pickled olives and selling it to grocers.
By 1900, Ehmann Olive Company was running 90 vats at a large processing plant in Oroville, CA.
Dr. Judith Taylor, who wrote the book "The Olive in California," interviewed Freda Ehmann's grand-daughter who said her grandmother never could come to terms about the company's role in the 1919 outbreak.
USDA's Bureau of Chemistry did a study of Ehmann's glass and metal containers in 1920, finding both could look normal but still contain pathogenic organisms, including Clostridium botulinus.
California canned foods have been the source of about 40 deaths in other states, according to the California Department of Public Health. The California State Board of Health responded to the 1919 outbreak with emergency regulation of olive production on Aug. 7, 1920, requiring sanitation through the processing facility and mandating a thermal process.
Heat treatment for olives after cans or jars are sealed to sterilize contents completely was required. Immersion in water at 240 degrees Fahrenheit for 40 minutes was the rule.
California canned olives continued to poison people in some scattered cases.
The emergency regulations under the California Pure Foods Act and limited staff to enforce them were not enough.
California responded with the Cannery Inspection Act of 1925. Both the State Board of Health and the National Canners' Association supported it, which by then even favored federal inspection.
California's Food and Drug Branch today inspects 200 licensed canners where regulated products are packed. It's primary goal remains preventing foodborne botulism. Tests for retort operators to determine qualifications to operate sterilization equipment are critical.
Dr. Armstrong continued to serve in the uniformed U.S. Public Health Service until 1950, ending up as Chief of the Division of Infectious Disease. In Warm Springs, GA, a sculpture of his likeness is found in the Polio Hall of Fame. He is recognized for being the first to adapt and transmit the human strain of poliovirus to small rodents from monkeys, a key step in the development of vaccines.
As for Mrs. I.W.G., her death by Botulism was probably known to her friends and neighbors in Sebring at the time, but she remains known 87 years later only by those initials assigned to her by Dr. Armstrong.
“The secret to staying slim may be all in your genes,” the Daily Mail has today reported, adding that scientists have uncovered a “greedy gene that makes you eat more even when you are full”.
Before any dieters lose hope and reach for the nearest biscuit, it’s important to note that this news is based on research looking at a mutant gene in mice, not humans. The study examined the impact of a mutated gene called BDNF and the role it plays in telling the body it is full. Normally, various organs and tissues will use hormones to tell the brain that no more food is needed, causing the brain to suppress appetite. However, when mice carried a mutant version of the BDNF hormone it appeared this fullness mechanism was blocked, which meant they carried on eating and gaining weight. Male mice carrying the mutation became nearly twice as heavy as their non-mutant counterparts, while females were 2.7 times heavier.
This study may provide a springboard for further research into the role of genetics in the development of obesity. However, this study was carried out in mice and the findings cannot be assumed to apply to humans, whose bodies may react differently to any similar mutation. It’s also not clear how many humans actually carry similar mutations, so it should not be assumed that all obesity is down to genetics.
Where did the story come from?
The study was carried out by researchers from Georgetown University Medical Center and the University of Colorado in the US. It was funded by the US National Institutes of Health and the American Diabetes Association.
The study was published in the peer-reviewed scientific journal Nature Medicine.
Generally, this research was covered well in the media, with the BBC and the Daily Mail emphasising that the study was carried out in mice, not humans. The Mail pointed out that even if the research leads to treatments for obesity, it will be years before they would be made available.
What kind of research was this?
This was animal study that examined the role of a gene called “brain-derived neurotrophic factor” (BDNF in the development of obesity. The researchers say mutations of this gene have been shown to cause overeating and obesity in humans, and the researchers wanted to investigate how the gene influences energy balance.
The researchers say that energy balance is controlled by several organs that send signals to the brain when certain chemicals (such as the hormones leptin and insulin are present in sufficient amounts. These signals cause several brain regions to react and control appetite and energy expenditure. The BDNF protein (which is generated using the BDNF gene in our DNA is involved in regulating how signals are transmitted through the brain. Mutations within the BDNF gene can lead to a different form of BDNF protein being produced, potentially causing different effects compared with a typical form of BDNF.
Animal studies are often used to conduct early, experimental research and to examine specific interventions or processes before research can be carried out in humans.
What did the research involve?
The researchers took two groups of mice, one with a mutated version of the BDNF gene and the other with a normal version of the gene. They then monitored the eating habits of the mice, measuring the amount of food consumed as well as bodyweight and the development of obesity.
In order to uncover the mechanism by which BDNF mutations affect obesity, the researchers also studied the role of certain chemicals including the “hunger hormone” leptin and its ability to activate the hypothalamus and suppress eating behaviours. The hypothalamus is normally activated by leptin, although once activated the hormone serves to suppress the appetite. The researchers looked at the role of leptin in mice with and without the mutation, injecting them with leptin three times over a day. They then measured changes in eating habits throughout the day.
This animal study can provide information on the probable role of BDNF mutations on the development of obesity, but it cannot be assumed that the results apply to humans.
What were the basic results?
The researchers found that by five-to-six weeks of age, mice with mutated copies of the BDNF gene developed severe obesity and had a higher body weight than mice that did not have a mutated version of the gene.
By 16 weeks of age, female mice with the mutation were 171% heavier than their non-BDNF mutation counterparts, and male mice were 90% heavier. The researchers further found that the development of obesity was due to eating more food, not to reduced activity levels. They found that the mice carrying a mutated version of BDNF ate 69%-80% more food than their counterparts.
When examining the role of leptin in the regulation of eating in mutant mice, the researchers found that the chemical did not activate the hypothalamus and inhibit eating as it does in mice who do not have a mutated version of BDNF. They found that the mice that did not carry a mutated version of BDNF reduced the amount of food they ate by 26% after being injected with leptin. The mice with the mutated form of BDNF, however, showed no changes in the amount of food they consumed after having leptin injections.
How did the researchers interpret the results?
The researchers concluded that mutations of the BDNF gene caused obesity due to overeating. They further concluded that, in mice carrying this mutation, leptin’s ability to activate the hypothalamus and regulate food consumption was impaired.
Conclusion
The number of obese people in the UK has been rising in recent years and this is likely to continue. Obesity is linked to several health problems, including diabetes and heart disease.
This study shows that BDNF mutations can cause obesity in mice and suggests a possible mechanism through which it might work. However, while it may lead to further investigations into the role of this gene in human obesity, the results cannot be directly applied to people. Firstly, the biological mechanisms and processes involved may not apply to the human body, and even if they did, human hunger and eating is unlikely to be solely influenced by a single mutation, with factors such as willpower and environment also involved. It is also not clear how many people carry the gene and whether it is found in a high proportion of obese people.
The researchers say that understanding the way in which communication circuits in the brain have an effect on energy balance and eating habits could lead to new strategies for addressing or treating obesity. However, the current study is at a very early stage, and is unlikely to lead to such strategies in the near future.
Several factors can contribute to the development of obesity in humans, including high food intake, low activity levels, genetics and socioeconomic factors. While research into the genetic factors that contribute to obesity is informative and may lead to the development of treatment options, there are strategies available now to treat obesity, such as exercising more and eating a healthy balanced diet high in fruit and vegetables and lower in sugars and saturated fats.
Analysis by Bazian
Links To The Headlines
Obesity gene's role revealed in mice study. BBC News, March 18 2012
‘Greedy gene’ that makes you eat more even when you are full is uncovered by scientists. Daily Mail, March 18 2012
Links To Science
Liao GY, Ji An J, Gharami K et al. Dendritically targeted Bdnf mRNA is essential for energy balance and response to leptin. Nature Medicine, Published online 2012
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