Last week the ALP government achieved one of its goals – the private health insurance rebate will be means tested from July 1, 2012.
For many this was a simple issue of removing middle-class welfare. Tanya Plibersek made the point that people earning $50,000 a year shouldn’t be subsidising the private health care of individuals on $250,000 a year.
Well said. Individuals on $50,000 shouldn’t be subsidising anyone. The problem is Plibersek’s argument works too well. Are we to believe that people on $50,000 are subsidising all government services that are not means tested? On that logic public education and public health could be means tested too.
Private health insurance is something of a bug-bear for social democrats who believe that everyone should have equal access to health care. That belief implies a fully public health system. Let’s be clear – that is perfectly respectable policy position. But it does raise some thorny problems.
A public health system must have politicians and bureaucrats making choices as to how much health care everyone gets. It must ignore the personal preferences of those who would like a little more and even those who would like a little less. Such a system is a wealth transfer from the young and healthy to the old and unhealthy. To be fair, however, that is a price social democrats are prepared to pay.
Public health systems are likely to be quite expensive. Not just in monetary terms. Money can be saved by having long waiting times for treatment. Economists can put a monetary value on pain and suffering, but that figure never turns up in a budget. So public health incurs a cost to the public purse, and imposes pain and suffering on patients who have to wait for treatment.
A private health system can relieve some of the pressure on a public health system. Those who are willing and able to pay more for their health care can exit the public system and incur less pain and suffering. Given the fewer patients in the public system waiting times are reduced (for a given level of expenditure and/or the monetary cost of public health is reduced too. Everyone is a winner.
It is this kind of logic that underpinned the private health insurance rebate. The government shared the budget cost saving with the taxpayer who generated the saving by buying private insurance. Some readers, of course, will view that argument with some suspicion. Quite rightly so. Yet in a
2003 analysis, Ian Harper produced an astonishing graph that supports that story.
The other criticism is that the Howard government never told that story – or if it did, didn’t tell it well. The rebate was always sold as being some sort subsidy to the private health care industry. All industry subsidies should be removed – not just for health care but the motor industry too.
So when evaluating means testing of private health care we need to consider what has actually happened. If this is eliminating an industry subsidy then it is good policy. But if there was a cost sharing arrangement in place then it might not be good policy.
For those who retain their private health insurance the cost of living has increased. There are three mechanisms driving that increase; the loss of the rebate, the potential for increased insurance premiums, and the increased monetary cost of the public health system.
There has been a lot of
schadenfreude
– social democrats sniggering that families on incomes more than $166,000 can’t really be doing it tough. Maybe not – but they vote and a minority government has to gain votes, not lose them. Essential Media reports that while 76 per cent of Labor voters support the policy only 33 per cent of the population intends voting Labor. Only 38 per cent of Coalition voters support the change.
What about those who drop out of private health insurance? (If thinking about doing so, you should first evaluate the impact of the Medicare levy surcharge. The ATO has some tax calculators that should assist in making the decision. You may find that even though you would like to drop out that financially you would worse off. If so, then your cost of living has increased.
For those people who do actually drop out, then the net cost or net benefit depends upon the interaction of the saving from not paying for private insurance against the increased cost of the public health system and the additional pain and suffering incurred by increased wait times in the public health system. Those who are young and healthy (and on low lifetime incomes may find a net benefit to dropping out.
Drop-outs, however, will impose a cost on those who remain (increased premiums and those already in the public system (increased pain and suffering while on waiting lists . The increased budget cost of public health gets shared across the tax system in proportion to the overall tax burden.
For those who never had private health insurance they now have to share the public system with those who drop out of the private system and, to the extent they pay tax, they will pay more for the public system.
So in summary – what is really happening? On the assumption the private health insurance rebate was a sharing arrangement, the means test is actually quite regressive. Everyone experiences an increase in the monetary cost of public health, those who remain experience an increase in the cost of private insurance, everyone else experiences an increase in pain and suffering while waiting for public health care. The drop-out rate, that the government hopes will be low, will determine how regressive the policy is, not whether it is or is not regressive.
If the objective of a public health system is to minimise the incidence of health related pain and suffering, this policy is unlikely to be good policy. If on the other hand the objective is to minimise the incidence of private health care and democratise pain and suffering in waiting lists, it is more likely to be good policy.
Sinclair Davidson is a professor in the School of Economics, Finance and Marketing at RMIT University and a senior fellow at the Institute of Public Affairs. Follow on Twitter @sincdavidson. View his full profile
here.
Turducken, a popular holiday dish of a whole chicken stuffed into a whole duck stuffed into a whole turkey, already serves up a totally indulgent, heart-stopping meal. Wrap it in strips of bacon and the meaty creation becomes a catastrophic calorie bomb. This turbaconducken may have carnivores drooling, but to us it's fatty meat overload!
Photo courtesy of
Bacon Today
If you're a bacon lover but can't justify (or stomach such a cholesterol-rich meal, try sneaking a few strips of turkey bacon into a homemade breakfast burrito. Make it as healthy as possible by using a whole-wheat tortilla and stuffing it full of wholesome veggies like peppers and onions.
Ingredients:
1 whole-wheat tortilla
2-3 slices turkey bacon
1/4 c. green and red peppers, sliced
1/4 c. onion, sliced
2 eggs, scrambled
Pinch of salt and pepper
Directions:
In a non-stick pan, cook bacon, peppers, and onions until bacon is lightly browned. Scramble eggs in the pan, and mix with bacon mixture. Season with salt and pepper. Place mixture inside a whole-wheat tortilla, roll up burrito-style, and serve. Add salsa and avocado if desired.
Photo courtesy of
Top Tenz
Less adventurous foodies can swap in creamy crab dip for bat paste. A squeeze of lemon juice gives the seafood spread a tangy kick, while fat-free cream cheese allows you to indulge (mostly guilt-free! The delectable dip tastes perfect paired with crackers or celery sticks.
Ingredients:
2 oz. fat-free cream cheese, softened
2 tbsp. green onions, chopped
2 tsp. lemon juice
Pinch of salt and pepper
2 8 oz. cans crab meat, drained
Directions:
Combine cream cheese and mayonnaise, mixing until smooth. Add green onionsl lemon, and a pinch of salt and pepper to the mix. Stir thoroughly. Stir in crab meat. Cover and refrigerate before serving. Serve on crackers or with veggies like celery.
Makes 12 servings of two tablespoons.
Mostly consumed in parts of Europe and Asia, black pudding is sausage made of the cooked blood of pigs combined with chunks of fat, onions, oats, bread crumbs, or other fillings. These congealed coils of black pudding are often fried up as part of a traditional English breakfast.
If feasting on blood sausage isn't your cup of tea, try this delicious and easy breakfast idea. Starring tasty instant grits and chicken sausage, which is healthier than fatty beef or pork versions, this satisfying recipe takes mere minutes to make.
Ingredients:
2 tbsp. instant grits
1 chicken sausage link
3/4 c. fat-free milk
Salt and pepper
Directions:
Combine grits, sausage, and milk in a bowl. Microwave the bowl until hot, then season with salt and pepper.
Makes one serving.
From the outside, balut appears like any typical hard-boiled egg. But don't be fooled: its contents contain a fertilized duck embryo, often enjoyed as street food in the Philippines. The yolk and young chick merged inside the shell are eaten straight from the egg.
Photo courtesy of
Top Tenz
Skip the fertilized duck embryo and enjoy a different kind of hard-boiled egg altogether: a healthy deviled egg! Garbanzo beans give the filling a smooth texture, and as a bonus, help keep the calorie count way down!
?Ingredients:
6 eggs
1/2 c. garbanzo beans, rinsed and drained
1 tbsp. red onion, chopped
1 tbsp. low-fat mayonnaise
1 tbsp. lemon
Salt and pepper
Put eggs in a pot, cover with water, and bring to a boil. After the eggs are fully cooked, soak them in a ice-cold water for 10 minutes. Peel the eggs and halve each one. Separate the egg whites and yolks. In a medium bowl, mash the yolks with the garbanzo beans, onion, mayonnaise, lemon juice, and salt and pepper until well combined. Spoon the mixture into each egg white half.
Makes a dozen.
Photo courtesy of
Ugly Food
A pitcher of cool, low-calorie sangria is the perfect alternative to baby mice wine! Not only is this drink light and fruity, it's easy to make too. Simply chop up some fresh fruits and add your favorite white wine to the mix for a refreshing glass.
Ingredients:
2 c. fruit of choice (such as peaches, melons, berries
1/3 c. sugar
1 bottle white wine
3/4 c. sparkling water
1/4 c. brandy
Ice cubes
Directions:
Stir fruit and sugar together, and pour into a pitcher. Pour wine, sparkling water, and brandy into the pitcher. Add ice cubes.
Makes six glasses.
Though we've got a healthy appetite for just about anything, we won't be trying these five dishes anytime soon. From the insanely fattening (a bacon-wrapped turducken to the downright unsavory (bat paste , these foods require uninhibited taste buds and an iron stomach! That's why we also included as healthy, and thankfully more palatable, alternative for each one.
Merlin
06 Mar 2012
Responsible To: Provincial Operations Manager Working With: Field medical and non medical team members Location: Birambizo health zone, Rutshuru territory, North Kivu Province, DRC Start Date: ASAP Duration: 12 months
Salary: ?27,980 - ?28,730 per annum (dependant on relevant experience , inclusive of annual Cost of Living Allowance Benefits: Insurance cover, accommodation, R&R, annual leave entitlement of 24 days per annum rising to 30 days at the completion of 12 months of continuous employment with Merlin.
Only short-listed applicants will be contacted. Due to the urgency of this position, applications will be short listed on a regular basis and we may offer this post before the closing date.
Please note that this is an unaccompanied position
Merlin Undaunted and determined, Merlin saves lives. We deliver medical expertise to the toughest places. And we stay to help build lasting health care.
Our mission is to end the needless loss of life in the poorest countries caused by a lack of effective health care. We help communities set up medical services for the long term including hospitals, clinics, surgeries and training for nurses and other health workers.
We do whatever it takes and we stay for as long as it takes.
Context and Background The Democratic Republic of Congo (formerly Zaire is the third largest country in Africa and The Democratic Republic of Congo is the second largest country in Africa and one of the poorest. Decades of dictatorship and civil war have left much of the national infrastructure destroyed. Merlin has been operational in DRC since 1997. Merlin teams have provided emergency medical care to the most vulnerable populations in Maniema, Kasai Oriental , North Kivu and Orientale Provinces. Activities have included emergency response, support to primary and secondary health care facilities (including supervision, supply of drugs, and the payment of incentives , reproductive health, institutional capacity building, immunisation campaigns, nutrition, WASH, and the rehabilitation of health facilities.
From 1 January 2012 Maniema and North Kivu will operate as autonomous programmes, each reporting direct to head office in London; they will be supported by country offices in Goma and Kinshasa. In North Kivu Merlin currently works in Rutshuru/Binza, Kayna, and Birambizu health zones, providing essential health care services to DPs and host populations; and will provide the health component of the rapid response to movements of population (RRMP mechanism throughout the province.
Main purpose of the role The Birambizo Project Coordinator will be responsible for managing the Nyanzale office, the Tongo sub-base and for overseeing Merlin project activities in the whole Birambizo health zone. This includes overseeing logistic activities, responsibility for security and ensuring proper financial procedures are followed for the project implementation. She/He is also responsible for the coordination, management and capacity building of national staff members.
Overall Objectives (scope • Base management • Project Management and Development • Administration and Finance • Human Resources • Security • Representation Responsibilities
Base Management • Ensure adequate information flow within Nyanzale and Tongo teams and between Nyanzale and Goma offices • Create/maintain a “team spirit” within the Merlin staff
Project Management and Development • Budget holding of the Merlin (sub- projects implemented in Birambizo • Plan and monitor project activities and outputs against project Logframes and budgets. This includes grant opening, grant closing and monthly grant monitoring meetings with all departments, as well as activity, procurement and financial planning. • Ensure the delivery of the project according to objectives and time-frames • Reporting – internal and external - for daily and weekly site communications. • Ongoing evaluation and development of proposals
Security • Responsible for the security of the Merlin team and assets in a changeable and volatile security environment, including initiating and organising evacuation if necessary • Ongoing monitoring of the security situation in the region • Prepare and update security guidelines and ensure that these are adhered to • Provide timely and accurate security/incident reports to the Project Coordinator and Goma Security Focal Point • Maintain regular contacts with key actors in relation to security (local authorities, the community, MONUC, OCHA, etc.
Logistics • Assure planning, procurement and follow-up of goods in line with project and base needs • Collaborate with Merlin Goma Logistics to assure planning, procurement and timely delivery of drugs and medical consumables to Merlin-supported Health Facilities, avoiding stock ruptures • Assure Merlin procurement and logistics procedures are followed • Manage, register and maintain Merlin assets • Manage and document warehouse and transport of Merlin goods according to Merlin procedures
Admin and Finance • Manage the program budget and ensure regular communication with the Finance Manager on all budget matters. • Manage cash on site, ensuring compliance with Merlin procedures in relation to cash security (on site and cash transfer . • Ensure activities in Birambizo comply with all legal and bureaucratic requirements of DRC • Prepare timely cash requests and transfers • Filing systems and record keeping • Prevent, and if necessary report and investigate fraud and misconduct within Merlin staff and partners
Human Resources • Supervise and directly or indirectly line-manage all Merlin staff in Birambizo • Ensure that Merlin recruitment and appraisal procedures are followed • To ensure that all staff management is carried out according to the Merlin internal regulations and the DRC labour code • To provide the HR dept in Goma with monthly staff information updates and keep them informed on all disciplinary matters • Organise and supervise capacity building and development of national staff
Representation • Represent Merlin and its activities to key stakeholders (community, authorities, donors, other (I NGOs, partners • Closely collaborate with MoH on Health Zone level and assure that Merlin projects effectively contribute to MoH capacity building and comply with MoH strategies
Other • Provide meaningful reporting on project activities to Goma office • Provide coverage for other posts when needed and carry out any other responsibilities as requested by the Country Director
Person Specification Essential Qualifications, experience and competences
• Experience and proven skills in budget holding and management • Experience and proven skills in Project Management • Experience of working in security and unstable environments • Strong communication skills, with excellent written and spoken English and French • Knowledge and understanding of project management tools (Logical Framework analysis, project cycle management, indicators etc. • Proven problem solving and organizational skills, flexible and calm under pressure • Strong leadership skills and a supportive management style • Good team worker, able to live and work closely with a small team • Computer skills (Word, Excel, E-mail • Experience of proactively identifying and addressing issues • An understanding of and commitment to Merlin’s mission and values
Desirable Qualifications, experience and competences
• Working experience in DRC / Central Africa • Experience in health care management in insecure and instable contexts
To apply for this position To apply for this job, please go to
www.merlin.org.uk/jobs and apply using our online recruitment system. In order to apply for a job with Merlin online you will need to complete a short registration process and create an account – the online recruitment system explains how to do this. Once your account has been created, you will be able to save the information that you have entered in your application and re-visit it at any time before you submit it.
If you are unable to apply online please contact:
applications@merlin.org.uk.
Please note that we do not accept CVs. Unfortunately due to the number of applications we receive, only shortlisted applicants will be contacted.
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February 21, 2012
The agriculture industry is trying to make it a crime to be an undercover investigator at a factory farm. Goodbye, whistleblowers! Farewell, freedom of speech! Big Farma Once Again Walking All Over Your Safety—and the ConstitutionFebruary 21, 2012 Join us on Editors
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As the economy slumps so do the workers
Work-related stress increases by 40% during a recession.
New research published in the scientific journal, Occupational Medicine, also shows that one in four workers experience work related stress during a slump, that the number of staff taking time off due to job stress increases by about 25% and total time off due to these types of psychological problems increases by more than a third.
The Society of Occupational Medicine say the findings are a stark warning to employees and employers at a time when Britain’s economic prospects suggest a ‘double dip’ recession. They say firms should use occupational health services or risk long term damage to their productivity.
'Occupational health provision is even more important in times of recession as specialists can help with the stress caused by mounting workloads, organisational change and job uncertainty. We can help businesses look at how they manage stress levels and improve the working environment for workers,' said Dr Henry Goodall, President of the Society of Occupational Medicine
The research is based on a large study by researchers at the University of Nottingham and University of Ulster of tens of thousands of civil servants in Northern Ireland. It compared the findings of two surveys. The first was conducted in 2005 prior to the recession and the second in 2009 whilst the economy was severely hit. Scientists looked at areas such as the demands of the job, control over work and the support workers felt they had from managers. They also measured workers perceptions of how stressed they were at work and how much time they had taken off because of work-related stress. The findings show the importance of focusing on looking after workers' mental health and wellbeing during austere
economic times.
This is one of the largest studies of its type and demonstrates clearly that good health begins at work. MHF CEO Peter Baker says: 'This study confirms that employers should invest more in occupational health services that support staff during stressful times. MHF has a track record of helping develop occupational health services that more effectively engage men and is willing and ready to help.'
Depression and anxiety
The Society of Occupational Medicine identify BT as one company that has recognized this as an issue and been proactive in this area. Catherine Kilfedder, BT group health advisor, said: 'BT has a wealth of information and support for its people and families on many aspects of health and wellbeing, including the impact of the recession and stress. When the recession first hit, we partnered with Relate to make additional support available to employees across the UK, in the form of a confidential web chat with counsellors. We continue to promote and develop our resources in these difficult times.'
Depression and anxiety are now the most common reasons for people starting to claim long-term sickness benefits. The Society of Occupational Medicine say that by investing in occupational health services, senior management teams can play a key role in helping people return to work. This will improve the overall performance of the organisation and of individual employees and reduce the costs of sickness absence.
Occupational health doctors and nurses are trained to assess whether someone is fit to do their job. By understanding the nature of the work and the specific tasks that someone does, they can help employers break down some of the barriers that prevent people returning to work. They are able to look at the context in which someone has become unwell and provide a holistic approach – something which is difficult to do in a short consultation at a GP surgery.
On the day the Prime Minister called a health “summit” at No 10 to try to create the impression of support for the floundering Health and Social Care Bill, demonstrators outside Downing Street made their case against the Bill. (See BBC footage
here . Meanwhile
the e-petition calling for the Bill to be dropped attracted more than 150,000 signaturesand is about to become the best supported of any on the Cabinet Office website.
The demonstrators handed in a letter to the Prime Minister, which pointed out that the summit invitation list
“pointedly excluded key organisations that represent the views of over half a million health professionals. In so doing you make it clear that you are not willing to listen to the views of the very people who you yourself have said are to be significant beneficiaries of the Bill and whose support is key to its implementation.”
Among the excluded groups are the Royal College of GPs and the Faculty of Public Health.
The letter goes on to say that what the excluded organisations have in common is that they believe the Bill will
“transform the NHS from a public service with a duty to provide a universal, comprehensive and equitable service to a market based system of competing private providers with greatly increased risks to patients.”
The loss of the Secretary of State for Health’s legal duty to provide and secure free and comprehensive healthcare for the public, combined with the sheer size and complexity of the Bill, will cause chaos and leave the health system wide open to charging for health care, means testing for public health services and state subsidy for private provision.
Before the General Election, David Cameron repeatedly promised “no more top down reorganisations” of the NHS. He promised that "with the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS", and this pledge was also included in the Coalition agreement.
The Prime Minister does not seem to be listening to public or professional opinion on the Bill. As the letter points out:
“If you were serious about safeguarding and improving the NHS you would listen to these critical voices, all telling you to abandon the bill … But doctors, along with the nurses and allied health professionals are more united each day in their opposition to the bill.”
The No 10 summit has put Mr Cameron at the centre of the row over the Health Bill. The demonstration outside Downing Street is one more sign that he may pay a heavy political price if he continues to give the Bill his support.
By Kim Krisberg
Friday wasn't a great day for public health.
That day, Congress voted to raid the Affordable Care Act's Prevention and Public Health Fund to the tune of $5 billion. The move comes as part of a
deal to delay scheduled cuts to Medicare physician payment rates and was part of a legislative package to extend the payroll tax cut and unemployment benefits. Both the Senate and House voted by wide margins to pass the bill, and President Obama is expected to sign it.
Of course, this was hardly the intent of the Prevention and Public Health Fund, which was created via the Affordable Care Act and represented a historic national investment in wellness and prevention. The money was intended to help reduce the growing burden of preventable and chronic disease; support proven, evidence-based public health interventions; and put the country on a path toward lowered health care spending.
Now, because of the Medicare payment fix, the flow of prevention fund dollars will slow significantly. According to
Kaiser Health News, "the fund was to receive $1.25 billion in fiscal 2013, $1.5 billion in fiscal 2014 and $2 billion in fiscal years 2015 and beyond. If the proposed cuts in the conference package become law, the fund won't hit the $2 billion mark until fiscal 2022."
Here's what public health advocates are saying about the unfortunate vote:
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JEFFREY BROWN: And next to India, a poor and populous country long plagued by polio, but now health officials have come close to wiping out the disease.
Special correspondent Fred de Sam Lazaro explains how that was accomplished.
FRED DE SAM LAZARO: In India, the battle against polio is being fought one mouthful at a time. Vaccinators have fanned out with coolers containing vials of the oral vaccine on a scale befitting a nation of 1.2 billion, says Lieven Desomer, a campaign strategist for the U.N.
LIEVEN DESOMER, UNICEF: One national round, we reach almost 75 million children, 150,000 supervisors, 1.2 million vaccinated.
FRED DE SAM LAZARO: They look for families especially at bus and train stations in the populous northern states, where polio is most endemic.
They look for young children, making sure first to check their pinkie fingers, where an indelible ink is placed once a child is immunized. Thousands of times, with little fuss, each vaccinator has administered the two-drop dose of vaccine. As a result, India, one of four countries where polio is still endemic, may soon become free of it.
It's easier to see how India can be a breeding ground for polio. Hundreds of millions of people lack proper sanitation, conditions that allow the virus to spread, usually attacking children, causing paralysis in some victims and in a few cases death.
In addition, it's difficult for public health workers to track the movements of India's huge nomadic and migrant populations. On any given day, 19 million people are on a train somewhere in India. That's why experts say the huge drop in polio cases -- they were up to 150,000 a year in the '80s -- is remarkable.
As recently as 2009, there were 741 cases of polio in India, more than any other nation. By last year, 2011, the number had dwindled to one solitary case, what campaigners hope will be the last one they will ever find in India.
LIEVEN DESOMER: I have to pinch myself once in a while to really realize that we actually -- we're almost there. And, for me, it's amazing being here, because it's part of history. We are making history here.
FRED DE SAM LAZARO: Desomer is with UNICEF, with, along the World Health Organizations, the U.S. Centers for Disease Control and Rotary International, partnered with the Indian government in the multi-year $2 billion-plus campaign.
He says a few years ago, many impoverished communities resisted the vaccine.
LIEVEN DESOMER: These were communities which have not benefited from all the progress in India. And they have no roads, no clean sanitation. And they would usually campaign to say, you can reach us with a drop of vaccine. Why can't you reach us with education and health and good water and sanitation? So, that is one thing.
FRED DE SAM LAZARO: So they were suspicious?
LIEVEN DESOMER: They were quite suspicious.
FRED DE SAM LAZARO: Suspicion that the vaccine wasn't what was claimed was particularly high among India's Muslim minority.
Mufti Mukarram Ahmed, imam of the Fatehpuri Mosque in substantially Muslim Old Delhi, says memories are still vivid of coercive attempts by the government in the '70s to sterilize people here.
MUFTI MUKARRAM AHMED, Imam (through translator : People thought that in the polio vaccine, they placed some medicine to sterilize people. They think that just like in the time of Sanjay Gandhi, when sterilization operations were going on, they think now, instead of doing operations, they can just give this medicine to the Muslim community and our men and women will not be able to have children.
FRED DE SAM LAZARO: He was among many religious leaders who were approached by doctors and the U.N. agencies, reassured of their intentions, and brought on board to endorse the polio campaign.
Also coaxed in were Bollywood megastars like Amitabh Bachchan. In this TV spot, he angrily tell parents to put aside excuses like the fear of caste or religious discrimination and immunize their children.
AMITABH BACHCHAN, actor (through translator : Have you lost your mind?
FRED DE SAM LAZARO: His co-star in the ad, Shahrukh Khan, is Muslim.
SHAHRUKH KHAN, actor (through translator : His anger is justified. What's the connection between caste or religion and polio? Any child can get this disease. That's why I too have vaccinated my kids against polio. Now you please go and do the same.
FRED DE SAM LAZARO: Perhaps the most significant buy-in that helped the polio campaign came from the government at all levels, according to this Dr. Hamid Jafari with the World Health Organization.
DR. HAMID JAFARI, World Health Organization: The government of India has funded the largest chunk of this program, you know, up to $250 million each year, which is unprecedented compared to other countries.
FRED DE SAM LAZARO: The government declared that any polio virus citing must be treated as a public health emergency. Jafari says that allowed for vigorous surveillance and response. Old reports of paralysis in children were investigated.
DR. HAMID JAFARI: In 2011, nearly 60,000 cases of acute flaccid paralysis were reported and investigated. And only one of those cases, the one that had onset on Jan 13., we were able to isolate polio viruses -- virus. The other cases were due to non-polio causes of acute flaccid paralysis. So that tells you how sensitive the civilian system is.
And there are international standards. And those standards are now being exceeded.
FRED DE SAM LAZARO: He says the big lesson from India for Nigeria, Afghanistan and Pakistan, three other countries where the virus is endemic, is that polio here became a huge, widely publicized national cause, much more than a public health campaign.
DR. HAMID JAFARI: You're talking about community leaders, religious leaders, academic leaders, opinion leaders, so just getting -- really turning it into sort of a national movement, so that everybody feels that they are part of this movement.
It's not only just the health department that has to deliver on this. And I think that's the kind of tipping point for Nigeria and Pakistan. I mean, these two countries have done a lot of good work and have made a lot of progress. It's what it is going to take to bring them to the tipping point where India is now.
FRED DE SAM LAZARO: For India, the challenge is to remain vigilant and polio free for two more years to officially fall off the list of endemic countries.
Government officials say they next want to use the polio system and teams to tackle other relatively neglected diseases, like measles. Longer-term, the challenge is to build basic sanitation and education systems, things that can prevent disease in the first place.
Fred's reporting is a partnership with the Under-Told Stories Project at Saint Mary's University in Minnesota.
On our website,
Hari Sreenivasan talks with two doctors from the Centers for Disease Control about curable and preventable illnesses.
Creamy rigatoni with broccoli and chicken?
Pasta with ricotta and spinach?
Ravioli Florentine?
Tuna noodle gratin?
The Republican Senate has a problem on their hands with their full throated support of Sen. Roy Blunt's amendment, which allows any employer to deny coverage of health services to their employees on "moral" grounds. From Senate Minority Leader
Mitch McConnell to
Sen. Scott Brown, Republicans are falling over themselves to strike a blow for "religious freedom." It's going to be an uphill climb for them.
Public Policy Polling for Daily Kos & SEIU. 2/16-19. Registered voters. MoE ±3.1% (no trendlines :
Q: Do you think employers should be allowed to deny health care coverage to their employees for doctor-recommended health care services if those services are contrary to the employer’s religious beliefs or moral convictions, or do you think all workers should be allowed access to all doctor-recommended health care services, regardless of their employer’s beliefs?The question uses the exact language of the
Employers should be allowed to deny coverage based on their beliefs ..........25%
All workers should be allowed to access health care services regardless
of their employer’s beliefs ......................................................................... 67%
Not sure .................................................................................................... 8%
Blunt amendment [pdf], with the phrase "religious beliefs or moral convictions." Incidentally, that's the part of the amendment that
Brown refuses to acknowledge.
Men, women, Democrats, Republicans, independents, all racial and ethnic groups and every income bracket believes employers should not be able to dictate their employee's health care on the basis of their personal beliefs. The single group that supports the premise of the Blunt amendment is the tea party, those protectors of personal freedom, at a margin of 51-39. Even self-identified conservatives are more narrowly split, 43-45, against Blunt.
Republicans are determined to try to make this about "religious freedom," all the while undoubtedly getting the quiet backing of the insurance industry, the U.S. Chamber of Commerce and other business groups. What this really about is money. It's the money insurers and employers can save by not having to provide comprehensive coverage to their workers.
While the GOP cries "religious freedom," the public, the voting public, will think about a different kind of freedom—not having their employers meddle in their private lives by means of their health insurance. They'll also be thinking about their pocketbook, and how much they'll have to pay out of their own pocket for the coverage their boss is denying. That's the argument
Elizabeth Warren is making, for good reason. It's an issue of economic and personal freedom for most Americans, not the "religious freedom" of their bosses.
University launches review of research, academics and health experts question impartiality of departmental review
News
Henry Gass — The McGill Daily (McGill University
MONTREAL (CUP — The research work of professor John Corbett McDonald, an emeritus professor in the department of epidemiology, biostatistics and occupational health at McGill, is now
under review after allegations of
research misconduct.
McDonald retired from McGill in September 1988, after more than two decades as a McGill epidemiology professor. According to a recent episode of CBC’s
The National
, McDonald received at least $1 million between 1966 and 1972 for research into the health effects of chrysotile asbestos from the Quebec Asbestos Mining Association, which received a large portion of its funding from the asbestos mining giant Johns-Manville.
McGill’s review is being lead by Rebecca Fuhrer, chair of McGill’s department of epidemiology, biostatistics, and occupational health. A group of academics and health experts published a letter earlier this month calling for an external review of McDonald’s research. McDonald’s research holds that chrysotile asbestos is less harmful than other forms of asbestos, and only deadly when a person is exposed to large quantities of it.
“Hardly anybody else but the McGill team believed that,” said lead signatory of the letter and professor emeritus of public health and preventive medicine at the Universite Laval Fernand Turcotte. “The rest of the world was really arrested by this,” he continued.
In a statement released Feb. 9, McGill dean of medicine and vice-principal of health affairs David Eidelman said, “Holding scientific views that are different from those of the majority does not constitute research misconduct.”
Imperial Tobacco is also believed to have paid McDonald to review a paper on the health effects of tobacco. An October 1988 letter from McDonald to Imperial Tobacco states: “As agreed, our fee for this work is $10,000.”
A postscript to the letter adds, “I would wish to emphasize that there must be no publication of any part of this review under [my] name.”
Turcotte worked with McDonald early in his career, and described him as “one of the superstars of public health in this country” at the time. This fact, Turcotte continued, jeopardizes the impartiality of Fuhrer’s review.
“Because I have worked with Corbett McDonald in the past, I would have refused that kind of mission, and God knows that I have worked [with him] much less than his immediate colleagues in the departments,” he said.
“When I got the documents that proved that he worked secretly for the tobacco industry, it took me months to overcome my depression,” said Turcotte.
Politicians at the federal and provincial level have called for an end to the Canadian production and exportation of asbestos, a policy long defended through McDonald’s research. Westmount-based company Balcorp Ltd. is also seeking a $58-million loan from the Quebec government to re-open the Jeffrey Mine in Asbestos, Que.
Roshi Chadha, a member of McGill’s Board of Governors and director of the export company Seja Trade Ltd., took a leave of absence from McGill two weeks ago. Seja Trade, which exported asbestos — primarily to India — from the Jeffrey Mine for 16 years before the mine closed operations last fall, is a subsidiary of Balcorp.
Kathleen Ruff, senior human rights adviser for the Ottawa-based Rideau Institute, told
The Daily
that McGill’s review was coming at a “critical moment” for the Quebec and Canadian asbestos industry.
“The global asbestos industry has used McDonald’s research constantly, and still today uses it to deny the harm caused by chrysotile asbestos,” said Ruff. “This is not an issue from the past.”
Another signatory to the letter criticizing McGill’s preliminary review, Edward Keyserlingk is a McGill professor emeritus of medical ethics & health law in the faculty of medicine. Keyserlingk lost his brother, Robert, to mesothelioma in December 2008. Robert’s widow, Michaela Keyserlingk, said he was exposed to asbestos on naval ships in the early 1950s.
“Forty years later, they suddenly found that he had fluid on his lungs,” she said.
“It’s a horrible death. They are really suffocating. And if you think we have all the morphine and all the opiates available to modern medicine to mask all these horrible symptoms, and nobody in India has that and these people must be dying the most excruciating death I can possibly imagine,” she said.
“I think McGill would do well choosing people outside of their own community. I think this is much too serious to have your own people investigating your own people,” Keyserlingk added.
-30-
Around 400 high profile doctors, medical researchers and scientists recently joined forces to form lobby group Friends of Science in Medicine (FSM in order to have "alternative medicine" degrees removed from Australian universities.
Chiropractic, osteopathy, Chinese medicine, naturopathy, iridology, kinesiology, reflexology, homeopathy and aromatherapy are some of the courses on their blacklist.
The issue has had significant media coverage, but one question has failed to be properly answered.
Why is a group of prestigious doctors and scientists who have the backing of the most profitable industry in the world according to Fortune 500 – the pharmaceutical industry – targeting a few poorly-funded natural medicine courses?
The official line of the group is that these "alternative medicines" are making Australia look bad and "trashing" the universities' reputation. But is that really the reason? With all the countries and all the universities in the world that provide alternative medicines?
A similar move was made in the UK recently – the British will no longer be able to study certain natural medicine degrees – this does not include chiropractic or osteopathy – at publicly-funded universities from this year. Yet natural medicine has been utilised across Asia and Europe for thousands of years.
The United States and Canada are pioneers of chiropractic as we see it today, providing university courses long before they were ever offered in Australia. Also, nearly 85 per cent of US medical schools offer elective courses in alternative medicines.
According to the World Health Organisation (WHO , 80 per cent of the world's population relies on natural therapies. The figures in Australia are much the same.
So why Australia? What is FSM so worried about?
The group seems to be particularly concerned about an increase in chiropractic courses after it was announced recently that Central Queensland University would be offering a new chiropractic science degree. The move could also be partly to do with the ruling in 2010 that all chiropractors in Australia may use the title 'Doctor'.
FSM has accused what it labels as Australia's "lesser" universities that offer alternative medicine courses of "putting the public at risk".
However, this is a difficult notion to fathom when you compare the tiny number of injuries inflicted on natural medicine patients compared to the hundreds of thousands of deaths recorded each year due to medical errors.
WHO estimates that one in 10 hospital admissions leads to an adverse event while one in 300 admissions leads to death. WHO puts medical errors as among the top 10 killers in the world. According to the US's Institute of Medicine, preventable medical errors kill 98,000 people in the US alone each year and injure countless more.
One of the group's biggest complaints, according to FSM co-founder Emeritus Professor John Dwyer from the University of NSW, is that natural medicine "doesn't strive to be tested". He says that modern medicine is "totally devoted" to taking an "evidence-based approach" and "do good science and do good research into the things we do to people".
The argument that modern medicine is evidence-based as opposed to other types of medicine is an argument that is often used by medical lobbyists, and tends to be generally accepted by the public. However, according to a report by a panel of experts assembled by the prestigious Institute of Medicine, "well below half" of medical care in the US is based on or supported by adequate evidence.
According to the report, between 1993 and 2004 there was a more than 80 per cent increase in the number of medications prescribed to Americans. The panel believes this boom in pharmaceuticals is outpacing the rate at which information on their effectiveness can be generated. "If trends continue, the ability to deliver appropriate care will be strained and may be overwhelmed," the report concluded.
What FSM fails to recognise is that natural medicine courses taught at universities incorporate a much higher level of evidence-based studies, such as health science and human physiology, than if they were to be taught outside of a university.
The Australian universities that have been criticised have all defended their courses, saying they are very much evidence and science-based.
In naturopathy, for example, on top of herbal medicine and nutrition, students also learn the same things that a physiotherapist, medical doctor or nurse learn. As well as chiropractic studies, chiropractors study biology, physiology, neuroscience, anatomy and pathology, for example. These are all scientific studies.
Acting head of RMIT's Health Sciences School Dr Ray Myers has defended its programs as "evidence-based education and practice", saying clinical research of natural medicine treatments are funded by the National Health and Medical Research Council (NHMRC .
If FSM really was so worried about public safety they would not be trying to exclude natural medicine from universities where they are taught with much more of a medical focus. Graduates of these courses are much more likely to refer patients to medical doctors when necessary.
As Nick Klomp, dean of the science faculty at Charles Sturt University, points out, thousands of practitioners already provide alternative medicine and they are very much in demand. "I could ignore them or I could train them better," he said. "We actually create graduates who are much better health care providers. It's all about evidence based, science based."
The other question to ask is just how representative the group is of Australian doctors. Dr Wardle, a NHMRC Research Fellow at the University of Queensland's School of Population Health conducted a survey of every rural GP in NSW and found a third did not refer to alternative medicine providers, a third were incredibly open to it, and a third would refer patients to practitioners that they knew achieved results.
The Australian Medical Association president has withdrawn his support from the lobby group. A number of researchers and doctors have also pulled out of FSM reportedly saying they were not aware of the full picture.
Many Australian medical doctors recognise their limits and refer to natural providers when necessary. However, others continue to believe that modern medicine – which is only 100 years old – is the only way of curing pain.
Natural therapies have been used for more than 10,000 years, and so they deserve a place in society, in Australian universities, and even in modern medicine. According to Australian trauma and general surgeon Dr Valerie Malka, former director of trauma services at Westmead Hospital, while modern medicine is revolutionary when it comes to surgery, particularly in emergencies, for pretty much everything else, traditional, natural or alternative medicine is much more effective.
She says in particular, modern medicine is completely unable to treat or cure chronic illness. Rather than focusing on symptom control, natural medicines work on the body's ability to heal the cause of the illness while modern medicine suppresses the body's healing mechanism with drugs that attack the body's natural defence mechanisms, throwing the immune system out of whack.
Dr Malka believes the attack on natural medicine has more to do with the threat to modern medicine's power base as well as its "unhealthy relationship" with the "trillion-dollar pharmaceutical industry".
This is not the first time natural medicines have been attacked by the medical industry.
Alternative healthcare professionals such as chiropractors, naturopaths, and midwives have been targeted by the American Medical Association (AMA for nearly a century, in spite of a federal court injunction against the AMA in 1987 for illegally trying to create a monopoly in the healthcare market.
Up until 1983, the AMA had held that it was unethical for MDs to associate with "unscientific practitioners" and they labelled chiropractic "an unscientific cult". They also had a committee on "quackery" which challenged what it considered to be unscientific forms of healing. Five chiropractors including Chester Wilk sued the AMA, claiming that the committee was established specifically to undermine chiropractic.
Wilk won the case, with Judge Susan Getzendanner ruling that the AMA had engaged in an unlawful conspiracy in restraint of trade "to contain and eliminate the chiropractic profession," also saying that the "AMA had entered into a long history of illegal behaviour".
If you look at the history of attacks on natural healthcare providers over the last 100 years, it is difficult not to associate this attack by FSM as the latest attempt to influence the public into believing that natural medicine is, as it says, "quackery" by spreading propaganda that most of the time is simply not true.
"It's just extraordinary that such undisciplined nonsense is being taught in universities around Australia," Mr Dwyer has said.
Why does this group feel that it has the right to talk this way about natural medicines that are ages old and used by 80 per cent of people across the world?
If FSM really was concerned about patient care and safety in Australia, then perhaps it would investigate medical practices which, unfortunately, seriously injure and kill thousands of people every year, rather than target natural medicine.
Sarah Schwager is an Australian journalist currently working in South America. View her full profile
here.
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Declare Moral Bankruptcy and Close the Heart Attack Grill
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'Shut It Down,' Doctors Tell Heart Attack Grill
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Chimpanzee Experiments Exposed on Prime-Time TV
Dr. Barnard's Blog | Feb. 2, 2012The NBC news magazine show
Rock Center
recently covered the issue of chimpanzees used in experiments. The Great Ape Protection and Cost Savings Act would permanently end the use of chimpanzees in invasive experiments.
Eating probiotics and
foods with healthy bacteria is all the rage these days. But one of them is stirring up some controversy: kombucha tea. Kombucha tea is a fermented tea that is brewed using a mix of tea, which is added to a symbiosis of bacteria and yeast called kombucha. The result? A slightly sour and tangy drink that is slightly carbonated.
A mid-February show of hands, please: how many of us are still sticking with our New Year's resolutions?
Honestly, I'm not sure I made any resolutions this year. If I did, well, they were fleeting and of the altruistic, yet unquantifiable variety, such as
“Be a kinder person.”
You know, the types of resolutions that were intended to elicit similar responses from our kids:
“I'll be nicer to my brother,”
or
“I'll help Mommy more around the house.”
Yep, we're not great about sticking with resolutions here.
Of course, because I'm a woman of a certain age whose metabolism flew the coop about five years ago, I always privately resolve to eat better and exercise more. I just don't speak those words out loud, because I know that the likelihood of me hitting the gym during the insanely busy spring growing season for my business is nil.
And, frankly, I refuse to deprive myself of red wine and chocolate.
So, imagine my shock when I became—inadvertently--a vegetarian.
This is a startling development for several reasons:
I grew up in a meat and potatoes family. Truly. Dinner centered around a roast beast, potatoes, white, squishy bread rolls, and maybe a salad. The overriding focus on meat was, I believe, a generational, socioeconomic attribute. Both of my parents grew up during the Depression. Our father often told stories of his life on the family farm, where the family celebrated the demise of a ill-fated chicken crossing the road with a rare fried-chicken dinner. He also raised a pet pig.
Trust me. You don't want to know what became of his pet.
I rarely ate a vegetable during my entire childhood. There's something to be said about being the baby of the family, particularly if you're a late-in-life, surprise baby. My siblings regaled me with dinner-table horror stories: gagging down ice cold, mushy peas until 10 p.m., eating a ketchup-covered banana that someone thought would be a creative way to avoid eating her fruit...
By the time I made an appearance, my parents were tired. It was easier to cater to my picky palate than deal with dinner drama. Thus, I became the pickiest eater in the Midwest. Not only did my mother make separate meals for me, I was never force-fed broccoli. Or peas. Or squash. My childhood vegetable consumption included:
Iceburg lettuce—plain, thank you. No dressing or weird additions to my crunchy pale green leaves, please.
Corn. With lots of butter and salt.
Potatoes. Honestly, I don't think potatoes even count. And all of the GMOs in the corn probably negates any health benefits the corn theoretically provided.
Embarrassingly, my vegetable phobia continued well into my adulthood. Yes, I added a few bits of green to my repertoire—cucumbers, real lettuce, asparagus, spinach salad—but until five years ago, I didn't even eat tomatoes.
Ironically, I now own an organic, heirloom plant nursery, specializing in 160 varieties of tomatoes.
As a mother, I created my family's meals much like my mother did—meat, starch, and occasional side of quickly microwaved peas. Yes, I added more veggies, but meat took center stage at every meal. Granted—our meat was pristine, raised humanely by local farmers, some of whom are now friends. Our meat originated from happy, healthy animals living happy, healthy lives. Free-range chicken, grass-fed beef, heritage turkeys—delicious, star quality dinner showpieces.
Then, a strange twist of fate.
A raccoon attacked our own backyard flock of hens. (You can read about it
here and
here.
It was traumatic. These girls are my daughter's pets. With names. And personalities. Fortunately, the raccoon only severely injured one hen, Salt, and after extensive consultation with our wonderful veterinarian, she sadly couldn't be saved.
In those moments of holding Salt, trying to assess her wounds and comfort her, something shifted.
My perception about food changed.
I suddenly found myself unable to eat meat.
I thought my aversion was temporary. After all, our daughter, who loves her chickens as if they are her children, still relishes Zaxby's even after the demise of her pet.
But as days passed, I found myself reading Alice Waters' books, heading to Whole Foods, leaving with a cart full of stunning produce, and then trying to figure out how to cook it. And you know what?
It. Was. Good.
Fresh eggs and Swiss Chard frittata. Mushroom risotto. Ratatouille.
Who knew? (Actually, I think many people knew. It was like discovering an amazing secret club, and I'd finally earned admittance.
Even the kids ate more vegetables. Put an asparagus spear on the plate of a six year old boy, and listen to the whines ensue...until you share the “stinky pee” secret.
It was amazing how much more appealing the asparagus became after divulging that crucial bit of info.
My husband joked that I shouldn't write about my emerging vegetarianism, because he knows my carnivorous ways too well. And who knows? Will it stick? Right now, after six weeks without meat, I'm optimistic. And I feel good. I'm not vegan—I eat seafood, dairy products, and eggs, so meal planning is fairly easy. Plus, it's not like I banned chocolate and wine from my life—that would never stick. Actually, eating my veggies and forgoing meat is surprisingly simple.
Last fall, our oldest son brought his new girlfriend home for dinner. Prior to their arrival, he informed me that she was—gasp!--a vegetarian. Panic! What could I cook? If I made risotto, could I use chicken stock, or should I run to the store for vegetable broth? Would she be offended by the steak I already prepared for the family? How much salad does a vegetarian eat? I made more, just in case...
And honestly, I worried. How could this relationship work? Our son is a serious carnivore, like me. He even owns this t-shirt to taunt his vegetarian friends:
Funny thing. Our son is now on his third meat-free week...and he likes it.
Love makes college boys do some crazy things, huh?
I'm not advocating vegetarianism. It's not my place to tell anyone what or how to eat. (Although I do hope you'll support your local farmers as much as possible, please. I still eat crap occasionally. I'm—shamefully--addicted to Diet Coke. (I know, I know...it's really bad for me. I promise, I'll work on it.
But this vegetarian thing? Well. It's pretty delicious.
My parents should have made me eat my peas, after all.
Bon appetit!
~Julie
Julie is the owner of
Garden Delights, an organic heirloom plant nursery specializing in edibles. She writes about growing gardens, growing green, growing locavores, growing kids, and growing one day at a time at
Growing Days.
All vegetable image credits: Julie Thompson-Adolf.
By
Joanna Douglas, Senior Fashion and Beauty Editor
There's so much more than
gorgeous gowns (and a few
hideous outfits at
New York Fashion Week. With backstage access and great seats to fashion shows we seized the opportunity to ask celebrities and designers for their top style and beauty tips. Now that the whirlwind of fashion week is over, we've rounded up all the tips into one informative and fun list! Enjoy.
We
bumped into Joan Rivers filming an episode of "Fashion Police" at Lincoln Center. We asked her how we could avoid getting arrested by her crew. "In this day and age my fashion police tip is MORE. When you think you're well dressed put on something glitzy. If you sparkle you're in for 2012."
Makeup maven Bobbi Brown shared her personal favorite makeup tip with us. "After I put lipgloss on, I often take it and put it on the cheek. It's nice and hydrating and it gives a nice glow." She said beauty really comes from within, and that you should be careful about what you put into your body. "Drink a lot of water. It makes a huge difference. And eat as healthy as you can 90% of the time. A lot of vegetables, clean proteins, and the other 10% of the time you can do "healthy junkie food" as I call it. It's all about taking care of yourself." ??
We asked Diane von Furstenberg, the stunning creator of the wrap dress, how to instantly look sexy. "Easy," she said. "Be yourself."
Singer/actress Kristin Chenoweth shared advice on dressing a smaller figure. "I think if you're petite, and that's obviously what I specialize in, is never leave home in a flat when you have an event and look for ways to lengthen yourself. I'm very little, so I don't overdo it with bulky items or accessories. If I overdo it it looks like I've dressed up from my grandmother's closet. A fashion inspiration of mine is Nicole Richie, a friend of mine. She is a little one too, so I look to her a lot for inspiration. I look at people who are my size for ideas." She told us in the end though to never take fashion to seriously. "Last year I was picked as one of New York's most fashionable people by New York magazine and I wore an Herve [Leger] skirt on backwards, so that just kind of says it all for me."
Kristen Chenoweth knows how to dress a petite figure (Andrew Evans/PR Photos
?Designer Erin Fetherston said, "I really think I like the tried and true advice my mom used to give me which is 'you wear the dress, the dress doesn't wear you.' To me I think that means it's great to be up on fashion and up on trends, but you should always be dressed to flatter your figure. It's more important to cultivate personal style than to be a trend chaser." ??
TV host Maria Menounos shared an awesome skincare tip for when you're in a pinch. "Baking soda is a really good last-minute exfoliator," she told us. "I ran out of exfoliator once and I had some baking soda and it was amazing. You just rub it with some water on your skin-it's insane how good it is. It's not glamorous so that's probably why we don't use it, but if you have it around it's so good."
Maria Menounos is resourceful when it comes to her beauty routine (David Gabber/PR Photos
?Supermodel Coco Rocha said, "my fashion tip, as cheesy as it sounds, is pretty much being confident. You could wear a Lady Gaga outfit if you have the confidence to pull it off. And you could have no confidence wearing H&M and be horrible looking in it." She also shared an impromptu beauty tip. "Today I used a black marker on my nail because I needed to fill in some polish chips." ??
Singing sensation Gloria Estefan shared her secrets for looking fab at 54: "I take very good care of my skin. I never ever ever go to bed no matter how tired I am with makeup on my face. I cleanse and I moisturize and I have good genes so I like to take care of my skin. Mainly that. I only wear makeup when I'm working and doing events. I don't do heavy foundation, I do a moisturizer base that breathes."
??Designer Rebecca Taylor shared a backstage trip for dressing the models. "We use rubber bands to hold their sleeves down when they put their coats on so they don't punch up," she told us. Already have a hair elastic on your wrist? That would work too. Taylor said she isn't one to follow trends and feels women shouldn't be slaves to what's in or out. In fact, there's one popular item she really dislikes. "I'm not big into the neon denim," she told us. "But maybe once the sun starts shining I'll feel differently." She also suggested one item ladies should purchase for spring. "Really lightweight leather jackets are really awesome I think just to throw on top. It's an investment piece, but it's classic and can last."
??"Descendents" star Shailene Woodley told us her top fashion resource. "Thrift stores! You can find things for two bucks and it's eco-friendly and they're so great because so many people get rid of so many nice clothes. Literally like 99.7% of my wardrobe is from thrift stores except for shoes." She said she was keeping an eye open for Oscar dresses at Fashion Week. On her wish list: "Something comfortable and something different than your average satin dress." ??
Actress Minka Kelly told us her fitness routine makes her feel beautiful. "I do yoga every day and I have an amazing trainer that kicks my butt several times a week," she said. When it comes to her beauty arsenal she said she couldn't survive without an eyelash curler and Aquaphor.
Minka Kelly reveals her stay-pretty necessities (Janet Mayer/PR Photos
?Former supermodel Christie Brinkley told us she stays in shape by dancing. ??
Angela Simmons, the designer/reality star/daughter of music legend Reverend Run, told us she thinks it's it's important to mix and match clothes for creative outfits. But the #1 thing she considers when dressing is confidence. "To me I think you can wear anything if you have confidence, so pick something out you feel good in. If not everyone can tell you don't love it." ??
Zoe Kravitz is an actress/singer/model and daughter of Lenny Kravitz and Lisa Bonet, and she has great individual style, so we asked her how she pulls off such unique ensembles. "I think you just have to follow your instincts and be comfortable," she said. "That's the most important thing. You should mix and match, try on lots of things and see what works." Her style icon: Sarah Jessica Parker. "From Sex and the City till now she's had the best style, I'm in love with everything she wears."
??And lastly, model/designer Erin Wasson joked about her must-have beauty product during a hectic time like Fashion Week. "There's a little thing called Visine..."
Losing is weight “twice as hard as previously thought”, according to media reports. Government weight-loss guidelines “mislead” overweight people about the effort needed to lose weight and dieting rules “don’t take into account changes in metabolism that occur when you lose weight”, several newspapers said.
The reports are based on a recent conference presentation in which obesity researchers reportedly said that current weight-loss guidelines fail to take into account the changes in metabolism the researchers identified. They said that this means weight loss takes twice the time predicted by current guidelines.
However, there is as yet no officially sanctioned way to work out a bespoke weight-loss programme for yourself, which is why if you’re worried about your weight it’s a good idea to have a chat with your GP.
The Independent said that there was a “slim chance” of the weight falling off with a reduction in calories. While this pun may have been hard to resist, it’s not particularly accurate; nor is the Financial Times’ assertion that “obesity experts [have] change[d] fat-loss guidance”.
What is the news based on?
The news reports stem from a presentation by Dr Kevin Hall, a researcher with the National Institutes of Health (NIH in the US, at the annual meeting of the American Association for the Advancement of Science (AAAS in Vancouver, Canada. Dr Hall reportedly said that dietary changes spark complex processes that alter the body’s metabolism and body composition and that this has made it difficult to assess the relationship between diet and weight changes. In a nutshell, he suggests that weight loss is not a straight line towards one’s target weight, but a downward curve that plateaus the closer you come to your goal.
Dr Hall’s presentation appears to be based on earlier work from the NIH in which a mathematical model was used to predict what happens when people of varying weights, diets and exercise habits try to change their weight. This model suggests that a reduction in energy intake of 100 kilojoules (about 24 calories a day for each person would eventually lead to a reduction in body weight of about 1kg. Half the weight loss would be achieved in about a year and 95% in about three years. The NIH says this is only half the weight loss claimed for calorie reduction in current guidelines. This is important because it “leads to unrealistically large weight-loss expectations”, Dr Hall is reported to have told the AAAS conference.
The NIH has developed an online tool designed to calculate the level of dieting needed to achieve a weight loss target, taking numerous factors into account including metabolism. It allows users to adjust their calorie intake as well as activity levels and see how much their weight, body fat and other measures are predicted to change over time if they stick to the tool’s plan.
Is there evidence for this model?
In a paper published in the Lancet in August 2011, NIH researchers, including Dr Hall, described a mathematical model for what happens when people of varying weights, diets and exercise habits try to change their weight. The NIH also developed an accompanying weight-simulation tool. The paper concluded that:
- Body-weight response to a change of energy intake is generally slow and depends on individual body composition and individual metabolic changes.
- Generally, an average overweight adult who reduced their energy intake by 100 kilojoules a day would eventually lose about 1kg. Half the weight change would be achieved in about a year and 95% of the weight change in about three years.
- Adults who are heavier have a larger expected weight loss for the same change of energy intake, although reaching a stable body weight will still take them longer.
It should be noted that this is not a clinical trial looking at real weight loss in people. It is a mathematical model that has been validated by comparing it to some actual changes in people. An NIH clinical trial comparing the effects of reducing fats and carbohydrates in obese adults is currently recruiting participants in the US.
What do current guidelines say?
In the UK, general guidance on losing weight for overweight or obese adults does not make detailed calculations of the relationship between calories in diet and weight change. Dietitians can help someone calculate the calorie loss needed to achieve a target weight over a certain period, but they would tailor this to the individual.
Overweight and obese adults are usually advised to follow a low-fat diet or one where the food eaten each day provides about 600 fewer calories than the body needs to stay the same weight. This is recommended by the National Institute for Health and Clinical Excellence (NICE based on thorough appraisal of the evidence available, rather than being a “rule of thumb” as suggested in several newspapers. Very low-calorie diets are sometimes recommended by professionals for short periods of time in specific circumstances.
Getting enough physical activity (150 minutes a week for adults is also usually crucial for most people who need to lose weight.
Do I need to change the way I diet?
This paper uses a mathematical model to advance the theory that for most people weight loss through dieting takes far longer to achieve than has previously been calculated. It doesn’t provide any evidence on the topic of specific diets and weight loss or advise specific changes to how people diet.
However, the news stories serve to remind us to set achievable weight loss goals, be realistic about our chances of reaching them and be determined in our efforts to do so.
Can I try the weight simulator?
The NIH online weight simulator tool allows people to input their age, sex and body weight and then calculate how many calories they’d need to cut from their diet in order to achieve their target weight loss. However, it is primarily a research tool. It includes no advice on diet or exercise and is not a substitute for personal medical advice on diet and weight loss. While the general principles of weight loss apply to all humans, this has been developed in the US, presumably for a US audience where the incidence of obesity is greater than that of the UK. As yet, it is not known whether a UK version will become available.
Where can I get weight loss advice?
If you think you need to lose a bit of weight, there’s a lot that you can do to help yourself. The key things you might consider are:
- Commit to changing your behaviour to lose weight.
- Understand calories and how the energy balance in your diet works.
- Follow these eight simple healthy eating tips.
- Find out how to get your recommended 150 minutes of activity every week. For example, you could try the NHS Couch to 5K running plan.
- Try to maintain a safe level of weight loss.
If your weight is becoming a real health problem for you, it’s best to see a healthcare professional such as your GP or a nurse at your GP surgery. He or she can measure your BMI and provide information and support about losing weight, the benefits of a healthier diet and doing more physical activity. They can also tell you about local organisations that can help people to lose weight.
For most overweight people, losing just 5% of your body weight can have health benefits such as lowering blood pressure and reducing the risk of diabetes.
Analysis by Bazian.
Links To The Headlines
Why the weight is so hard to shift: guidelines have been wrong all along. The Guardian, February 21 2012
Losing weight 'twice as difficult as diets claim'. The Daily Telegraph, February 21 2012
Losing weight is twice as hard as you may think... cutting calories slows down your body's metabolism. Daily Mail, February 21 2012
Obesity experts change fat-loss guidance. Financial Times, February 21 2012
Links To Science
AAAS Meeting 2012: The Calculus of Calories: Mathematical Modeling of Body Weight Dynamics. Kevin Hall, February 20 2012
Selective Reduction of Dietary Carbohydrate Versus Fat: Effects on Metabolism, Endocrine Physiology, Brain Activity and Reward Circuitry. NIH Clinical Research Studies
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