In the new competitive market for healthcare created by the Health and Social Care Bill it will become increasingly difficult to know what exactly is being done with public money.
UPDATE:
Seven out of ten hospital doctors voted to reject the NHS
shakeup in a poll released by the Royal College of Physicians yesterday.
In the new competitive market for healthcare created by the Health and Social Care Bill it will become increasingly difficult to know what exactly is being done with public money.
Claims of
“commercial confidentiality”
are already being used to prevent public scrutiny of the first contract with a private company to run an NHS hospital. In November 2011, the Government announced that
Circle Healthcare would be contracted to run Hinchingbrooke hospital, the first NHS hospital to have its management taken over by a private business.
Circle Healthcare is part owned by its employees. Its chief executive is former Goldman Sachs executive Ali Parsa. Circle began its management of the hospital, which will last for ten years, on 1st February 2012. The Hinchingbrooke contract was signed after a thirteen-month procurement managed by NHS Midlands and East, and a subsequent approval process from the Department of Health. Circle was selected from nineteen initial potential bidders from the public and independent sectors.
But it is not possible for the public to make a fully informed judgement about the contract, because both the Treasury and Department of Health have refused to release key information, despite requests by academic researchers at Queen Mary, University of London under the Freedom of Information Act (FoI . Both the Treasury and the Department of Health have said that a
“redacted”
version of the Full Business Case for the contract will be published at some unspecified future date, but have refused to release information on the financial models and methodology on which the contract is based.
The Government is claiming exemption from the FoI Act under Section 43 of the Act, which deals with commercially sensitive information. The Treasury letter setting out the reasons for this refusal says that
“the commercial interests of the NHS and/or Circle”
are more important in this case than the public interest in transparency and accountability in the use of public funds.
Ensuring that commercial confidentiality was not used as a reason to prevent public scrutiny of NHS contracts under the legislation was a key demand of the Liberal Democrat Spring Conference in 2011. And the February 2012 letter on amendments to the Bill from Nick Clegg and Shirley Williams stated that:
“no one should be allowed to spend public money without telling us how they are going to use it. That is why we have insisted that decisions about patient services and taxpayers' money must be made in an open, transparent and accountable way.”
In a letter to all peers dated 22nd December 2011 Earl Howe promised regulations covering healthcare commissioners would to ensure
“transparency in the commissioning process”
. However, he also wrote that these regulations would be based on the existing Principles and Rules for Co-operation and Competition in the NHS
“which we will retain to ensure continuity”
. These rules cover the Hinchingbrooke hospital contract.
It is always crucial to ensure proper accountability in the health system. But it will be even more important if the sprawling Health and Social Care Bill makes it to the statute book. In future healthcare will be arranged through tens of thousands of commercial contracts. The Bill as it stands does not ensure transparency and accountability in the use of public money. Ministers, civil servants, healthcare businesses and managers will be able to claim exemption from Freedom of Information legislation on grounds of commercial confidentiality. It would be outrageous if the Health Bill became law without this loophole being properly plugged.
Crossbencher Lord David Owen has agreed to deliver the Save Our NHS petition organised by 38 Degrees to the House of Lords before the Third Reading of the Health Bill on Monday 19 March. It will be carried into the House of Lords chamber just before the debate starts.
The petition will remind Lords of widespread public concern about the damage the Health Bill will do to the NHS. There is still time to
sign it.
Chronology of FoI requests
10th November 2011 Request made in writing for copy of contract by Professor Allyson Pollock under Freedom of Information Act.
3rd January 2012 Email sent by Dr. Vanessa Jessop requesting copy of contract to East of England NHS
17th January 2012 Response from FOI at NHS Midlands and East
Please find below the link to the franchise agreement for Hinchingbrooke Hospital Health Care NHS Trust.
https://www.eoe.nhs.uk/page.php?page_id=2231
30th January 2012 Complaint sent by email to foi@eoe.nhs.uk requesting internal review and additional information:
Please could you send the FBC, the contract and all the appendixes and addendum including financial models that underpin each document.
Emails sent to DH, Treasury and SHA requesting the same information.
Necessary to request internal review before complaint to FOI Commissioner can be made:
http://www.ico.gov.uk/complaints/freedom_of_information.aspx
22nd February 2012 Response from DH received
Disclosure of financial methods and methodology refused. Exemption claimed under S.43 of FOI.
Disclosure of Full Business Case refused under S.22.
23rd February 2012 Response from Treasury received
Disclosure of financial methods and methodology refused. Exemption claimed under S.43. A “redacted” Full Business Case to be published at an unspecified future date. Key quote:
“S 43 is a qualified exemption … we recognise that there is a public interest in transparency in the accountability of public funds … There is also an interest in knowing that the Government is achieving value for public money and that commercial activities are conducted in an open and honest way... However there is also a strong case for non-disclosure as we believe that release would be likely to prejudice the commercial interests of the NHS and/or Circle.”
“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 only, 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 blood stream 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 do my part?
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
Human 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
Most in-house systems can be considered more factual, lower-hyperbole versions of the claims food companies put on their packaging, i.e. "low-sodium" instead of "heart healthy."
How to use tt: If you generally go to the same store, learn their lingo and icons as way to recognize product features that matter to you. Just don't assume a product is healthy overall because the store touts some of its benefits. A low-sodium cookie is still a cookie.
NuVal has worked its way into several national chains, including Kroger, the nation's second-largest. The scores are 1 to 100 and based on an algorithm that considers protein quality, sodium, fats, refined sugars, and much more.
Background: The algorithm (the Overall Nutrition Quality Index was initially developed by scientists at the Yale-Griffin Prevention Research Center. NuVal is the algorithm's commercial face, and the company is partially owned by Topco, a private organization that is co-owned by grocery store chains, many of which are implementing NuVal scores into their stores.
How to use it: Melissa Schlenker, NuVal customer manager and mother of two, says her main use of the system is "trading up," or finding healthier alternatives for products she regularly buys within a category. "When I started looking at NuVal scores, I found out the frozen pancakes I was buying weren't very healthy, so now we buy whole-wheat pancake mix and freeze our own," Schlenker says.
Drawbacks: Like all one-size-fits-all nutritional grading, NuVal scores are generalized. For example, sodium content may be less important than sugar to someone eating low-carb, whereas sodium might be weighted much heavier for someone at risk for heart disease. Scores lose some utility when comparing across categories (haddock and chocolate soy milk score similarly, as do pork tenderloin and Cheerios , leaving customers to decide which categories of foods to choose from.
Background:
Guiding Stars was developed by and is currently owned by Belgian grocery retail corporation Delhaize, which owns Hannaford grocery chain (and several others in the United States. Guiding Stars has made their algorithm public and, broadly, it's very similar to NuVal: "good" nutrients such as vitamins and minerals are weighed against "bad" nutrients such as trans fats and added sugars.
How to use it: Avoid products that don't have a star rating. That means they don't meet the minimum nutritional standards to get a score. "The system is simple enough that children can follow it. A parent can tell her kids, ‘Pick out any cereal you want as long as it has two stars,'" says John Eldredge, director of brand and business development at Guiding Stars.
Drawbacks: The broad classifications don't create as many opportunities as NuVal for identifying "better" products within a category—similar products will likely have the same star rating. As with NuVal scores, the stars lose utility when comparing across categories, though both systems generally give their highest ratings to fruits and vegetables.
Background: The system was laid out in the book Eat for Health by Dr. Joel Fuhrman and adopted by Whole Foods. The ratings are reserved mainly for—not surprisingly—whole foods such as beans, grains, produce, and nuts.
How to use it: Like other scoring systems, ANDI is best for comparison shopping. Using the scores, you can see, for example, that you get more than double the nutrition for the calories out of a red pepper versus a tomato
Drawbacks: The ratings are reserved primarily for produce, beans, grains, and nuts. If you're eating only from those categories, your diet is probably healthy enough already that you don't need to split hairs between, say, kale and Brussels sprouts.
NutritionData.com's online nutrition database features plenty of information such as calories, macronutrients, and micronutrients, as well as their own ND Rating, a 1 to 5 score based on nutrient density similar to the ANDI score.
How to use it: To access ND ratings in-store, you'll need to use the web browser on a smartphone. The site's best use is as a diet tracker, entering what you've eaten and learning from the feedback, not evaluating foods at point of purchase.
Drawbacks: The fact that you have to look up each food rather than see ratings at a glance in the store means this system is best for those willing to do research at home before or after shopping.
Wal-Mart stores across the nation recently introduced a unique
nutritional labeling system called "Great for You," joining Guiding Stars, NuVal, ANDI score, and other non-governmental scoring programs. They all share the same goal: to create simpler labels that consumers will actually read (and hopefully make healthier selections . But the slew of different systems can actually create
more
confusion.
Healthiest place to eat: San Diego is home to more than a thousand restaurants so there's bound to be something for everyone, but the ultra-healthy can't go wrong with
Spread, a vegetarian restaurant that seeks to "challenge the culinary imagination" of its diners. The owners of the restaurant work only with locally sourced, organic food, and the menu often changes based on what's available at local farmers' markets.
Best place to work out: You're in San Diego—it'd be a crime to leave without surfing!
Del Mar is reportedly the best place for beginners. Sign up for lessons with the
San Diego Surfing Academy, which is open all year long. Not a surfer? Mix it up with
stand-up paddleboarding or another fun outdoor workout!
Healthiest place to eat:
Nourish offers gluten-free, egg-free, lactose-free, soy-free, nut-free, and vegetarian options, as well as plenty of menu items for "regular" eaters.
Best place to work out: Take a hike! A full-moon hike, that is. Temperatures in Arizona can reach 95 degrees and higher (yes, even in March , so conserve your energy indoors during the day and take your workout outside once the sun sets. There are multiple organizations that host different programs (scorpion hunting, anyone? so
find the one that fits your style best and have fun!
Healthiest place to eat:
Cooking Light
once wrote that the seafood at Mediterranean restaurant
Komi tastes as though it was just "pulled from the sea." If you're not into seafood,
Palena Cafe, a James Beard Award-winning Italian restaurant, is another big hit.
Best place to work out: If you like exercising outdoors, you'll love jogging, walking, running, or hiking at the
U.S. National Arboretum (Which workout burns the most calories?
Find out here! . Essentially a giant garden filled with plants from around the world, this is one workout in which you'll want to stop and smell the roses. Pets are welcome too, but they have to stay on leashes.
Yosemite's natural beauty. And there's no shortage of healthy activities to do in this national park.
Healthiest place to eat: Yosemite offers a variety of restaurants, most of which operate year-round for visitors and work with local farmers and businesses to bring the freshest flavors and foods to the table. The award-winning
Ahwahnee Dining Room is known as the crown jewel of Yosemite.
Best place to work out: You're visiting one of the world's greatest climbing areas! Contact the
Yosemite Mountaineering School and Guide Service to take a rock climbing class or guided climb (for beginners , or sign up for a multi-day ascent or camping adventure (if you're more advanced .
Healthiest place to eat:There are a handful of mom-and-pop business located on Lanai, but the island does boast a pretty impressive list of luxurious resorts. Try
Fresco at the Four Seasons, which features fresh, local seafood dishes with "Asian influences."
Best place to work out: Before you hit the beach for some sun (and to show off your killer bikini body, thanks to
this arms and abs workout , suit up and dive underwater for some snorkeling. Lanai Island offers a
full-service dive operation with activities fit for every experience level.
Healthiest place to eat: You can't go wrong with fresh Mexican food at
La Cocina de Luz. The restaurant uses only organic, additive-free, and locally grown ingredients to prepare traditional recipes, but non-Mexican food aficionados can find vegetarian and gluten-free options, as well as handmade ice cream and smoothies.
Best place to work out: Telluride is a
world-class mountain biking destination. Pick from 25 different trails of varying lengths and difficulty levels to explore the former mining town from all angles.
Healthiest place to eat:
Marina Seafood Restaurant was recently given a five-star rating by the
Jacksonville Times Union
. Easy on both your waistline and your wallet, the restaurant is a favorite among locals and visitors. Not a seafood fan? Try the
Cafe Karibo for a "world-famous" veggie burger or Turkey Cuban sandwich.
Best place to work out: Amelia Island is one of the few places in the U.S. you can ride horseback on the beach! Through the
Kelly Seahorse Ranch, you can take a guided beach ride solo or with a group.
Travel + Leisure
, offers antebellum mansions, cobblestone streets, scenic coastline, and plenty of Southern hospitality.
Healthiest place to eat: The owner of
McCrady's is so dedicated to the farm-to-table philosophy that he manages a farm for the restaurant.
FIG is another option that focuses on seasonally inspired dishes, local foods, and sustainable practices.
Best place to work out: Take a walk or jog through
Battery Park, which gets its name from its occupation during the Revolutionary War and the War of 1812. There are still piles of cannons and cannon balls remaining, which makes for some great butt-boosting climbing opportunities.
Ah, spring break...who says it's just for college students? For those of you who've left your
Girls Gone Wild
days behind but are still itching for a vacation, check out this list that Yahoo! put together of the
top spring break destinations. While some of the vacation spots are a little unconventional, each city offers a plethora of fun outings to enjoy.
Leading respiratory disease specialist warns of consequences if government fails to monitor and publicise the dangers of smog
Air pollution will become the biggest health threat in China unless the government takes greater steps to monitor and publicise the dangers of smog, the country's leading respiratory disease specialist warned this week.
Lung cancer and cardiovascular illnesses are already rising and could get worse in the future because of factory emissions, vehicle exhausts and cigarette smoke, Zhong Nanshan, the president of the
China Medical Association, told the Guardian.
The outspoken doctor – who won nationwide respect for revealing the cover-up of the Sars epidemic in 2002 – said the authorities are starting to learn the lessons of past health crises by being more transparent about the risks posed by contaminated air. Unless there is more openness, he said, public trust will be eroded.
"Air pollution is getting worse and worse in China, but the government data showed it was getting better and better. People don't believe that. Now we know it's because they didn't measure some pollutants," said Zhong. "If the government neglects this matter, it will be the biggest health problem facing China."
Earlier this month,
the government promised to be more open.
It has been a long time coming. Beijing and other major cities have experienced dire levels of air pollution for more than a decade, but the government has been reluctant to investigate and publicly disclose the medical consequences.
Zhong said he has been concerned about the problem for 10 years, but his efforts to press for official data have met with silence. During the run-up to the 2008 Beijing Olympics, he said he asked the environment department for information about ozone and carbon levels, but made no headway.
"They never answered. I understand this is because they did not collect such data. But it is also because they didn't want to announce this," Zhong said. "Maybe they are afraid of showing that levels are too high, which might have a negative impact on society."
Until recently, the government did not include ozone and small particulate matter known as PM2.5 in its air quality index, even though these two pollutants pose the greatest risk to human health.
Insiders say some cities quietly and selectively measured these pollutants for many years, but never made the results public. Scientific studies of this crucial public health issue have been notable by their absence.
Zhong says public awareness has come slowly because, compared to acute epidemics like Sars that results in sudden clusters of death, pollution is a chronic, slow-burning problem with consequences that are not apparent for many years.
But there is strong evidence of the risks. He said outpatient cases at his clinic in Guangdong province increase by 10% on hazy days. He also cited a US study that showed that cases of cardio failure increased by 1.28% for every increase of 10 micrograms of PM2.5 per cubic metre.
Understanding of the problems in China has been promoted by the US embassy in Beijing,
which has released its own hourly measurements of PM2.5. In response, Beijing, Guangdong and several other provincial and municipal governments has belatedly followed suit.
Zhong said state promises to introduce nationwide monitoring need to be quickly honoured. He also called for detailed epidemiological research into the problem. Controversially, he said it would be a good thing if every embassy in Beijing monitored and publicised pollution data.
"We need data. We don't have that," he said. "We need to do something. We should start an annual study."
It is difficult to separate the impacts of pollution and tobacco, which is also a major contributor to PM2.5. But Zhong said lung cancer rates are two or three times higher in cities than in the countryside, even though smoking rates are the same.
On heavily polluted days, he advised city dwellers to wear face masks and not to exercise. But he said there was ultimately little that individuals could do unless greater efforts were made to check the source of the pollution.
Although the nature of the health risk posed by smog is different from that of Sars, he said the two shared similarities in terms of the importance of information disclosure.
"It takes time to make local governments move on transparency," he said. "But the situation now is better than during Sars. At the very beginning of that epidemic, it was really terrible. We have learned a lesson."
He said the environment was now a key public health concern, which was not the case in the past.
After polluted air, he said contaminated water, food and the chemicals found in furniture were recognised as major risks in addition to those previously identified from smoking and alcohol.
"We all have to breathe. It's no longer enough just to have a good lifestyle. A green environment is one of the most important elements in deciding people's health. People are more aware of that. I'm happy about that."
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by Kim Krisberg
"CQ, CQ Celebrating National Public Health Week!" "CQ, CQ Celebrating National Public Health Week!"
If you're an aficionado of amateur radio -- or ham radio as it's also known -- this is the call you might hear coming out of Oklahoma City on April 6. In layman's terms, it means "Calling all stations, calling all stations! Celebrating National Public Health Week!"
In honor of this year's
National Public Health Week observance, which runs April 2-8, officials with the
Oklahoma City-County Health Department will hold a special drill in which all of its amateur communications equipment will be activated and users will attempt to make as many contacts as possible within 24 hours. It's not your typical National Public Health Week activity, but it may be the most unique.
"With amateur radio, the best way to learn to communicate effectively is to immerse yourself," said Dave Cox, deputy director of the Oklahoma City-County Health Department and a 25-year ham radio operator. "Our ultimate last option when everything else fails is amateur radio."
Amateur radio is part of the department's emergency response toolkit and allows officials to continue to communicate with staff in the field as well as fellow first responders in the event that a disaster disables traditional communication channels. As Cox said, "you can take everything else down...and ham radio still works." This is the second year the department has held a National Public Health Week-inspired amateur radio drill. Last year, Cox said operators made contact with fellow ham radio operators in 32 states and four different countries.
And what's the topic of discussion once fellow operators respond to the health department's call? Public health, of course.
"A lot of the people are curious about public health and about what we do," Cox told me. "National Public Health Week is a chance to practice our communications skills and promote the (Oklahoma City-County Health Department nationwide."
Read the comments on this post...
Ganapati Mudur
India’s controller of patents has granted the country’s first compulsory licence on a patented drug, allowing a domestic drug company to manufacture a generic version of Bayer’s sorafenib tosylate (marketed as Nexavar , used in chemotherapy for hepatic and renal cancers.
Natco Pharma asked for the right to manufacture sorafenib tosylate, saying that it would make available a generic version that would cost patients 8800 rupees (?110; ˆ135; $175 a month rather than the 280?000 rupees a month it costs for Bayer’s product. The controller granted the licence and ruled that Natco Pharma should pay Bayer a royalty fee of 6% on sales of the generic version.
Experts in public health who have been campaigning for better access to inexpensive generic drugs have hailed the controller’s decision, but sections of the pharmaceutical industry have said that compulsory licensing should be invoked only in public health emergencies and not to reduce the prices of drugs.
Bayer, which has the right to appeal, has said it is disappointed by the decision.
However, patient support groups are looking forward to more compulsory licences in other therapeutic areas. Yogendra Sapru, chief executive of the Cancer Patients Aid Association, said in a statement released after the controller’s decision this week, “Many other cancer medicines are sold at exorbitant prices in India.”
A single vial of patented trastuzumab (Herceptin , which is used in combination with paclitaxel to treat metastatic breast cancer, costs about 132?000 rupees in India, says a report from the Centre for Trade and Development, a policy think tank in New Delhi.
Malluparambil Santhosh, associate fellow at the think tank, said, “Herceptin chemotherapy in India is currently beyond the reach of the vast majority of patients who need it.”
A patented version of interferon used to treat hepatitis C virus infection is another example of a drug that most patients can’t afford, he said.
A senior health economist said that India will need to use all available tools to reduce prices of drugs given the government’s plans to introduce universal healthcare, including free drugs, announced last year (
BMJ
2011;343:d6774, doi:
10.1136/bmj.d6774 .
Sakthivel Selvaraj, an economist with the Public Health Foundation of India, New Delhi, said, “Compulsory licensing fits in with the goal of government procurement of drugs and distribution of free medicines for inpatient and outpatient healthcare.”
India changed its patent laws in 2005 to allow product patents on drugs, including the provision of compulsory licensing—as have other countries, as this is allowed under World Trade Organization rules. Brazil and Thailand have already used compulsory licences to make available antiretrovirals and anticancer drugs to their populations.
“India has been lagging behind on compulsory licensing despite huge expenses on drugs,” Dr Selvaraj told the
BMJ
. A nationwide survey of healthcare spending has shown that expenditure on drugs had accounted for about 68% of total personal spending on healthcare in India between April 2009 and March 2010.
The Organisation of Pharmaceutical Producers of India, which mainly represents international drug companies, has said that it has no objection to the use of compulsory licensing in a national emergency but believes that broadening its scope for “affordability” could result in the abuse of this provision.
India’s Association of Biotechnology Led Enterprises has said that it supports strong protection of intellectual property and opposes compulsory licences on “frivolous” grounds. “The government should clearly specify the criteria for issuing compulsory licences,” said Nandita Chandavarkar, its director of operations.
But health groups say that such reactions are predictable. “The idea that compulsory licensing should be limited only to emergencies is a myth promoted by multinational companies,” said Anand Grover, a director of Lawyers Collective, a non-government organisation that has represented cancer and HIV patients’ groups in court.
Mr Grover said that members of the World Trade Organization, including the United States and the European Union, had signed the Doha Declaration in 2001, which recognises the right to grant compulsory licences and the freedom to determine the grounds on which such licences are granted.
“India is likely to experience intense pressure from the developed countries and multinational corporations in the coming weeks to go slow on compulsory licensing,” said the Centre for Trade and Development’s Mr Santhosh.
Notes
Cite this as:
BMJ
2012;344:e2132
writes:
The statistics are stark. More than 1 in 3 Native American women will be sexually assaulted their lifetimes, a rate much higher than the general population. In one study, a stunning 92% of young women reported they had been forced to have sex against their will on a date.
One of the primary fears of any rape victim is an unintended pregnancy. The first line of defense against that possibility is, of course, the prompt administration of emergency contraception.
And this is where things get tricky for many Native women. Most receive their health care from the Indian Health Service and affiliated tribal health centers. Of 157 IHS facilities, only 10% surveyed stock Plan B in their pharmacies, and only 37.5% carried some alternative form of emergency contraception. In the Albuquerque Area, which covers almost all of New Mexico and Utah, only two of its 15 facilities stocked Plan B.
"If you are living on the reservation or on the Pueblos without insurance, or the money to pay for EC or transportation to get you to town, you are out of luck, because you do not have accessibility through our own health care provider," says Charon Asetoyer, a Comanche from Lake Andes, South Dakota and Executive Director of [the Native American Women's Health Education Resource Center].
And that assumes women even know to ask or find it. "A lot of women in our communities aren't aware that Plan B even exists or they associate it with the abortion pill RU486, they don't realize the difference because the media and the opposition have projected this: it's an abortion pill, when it really is a contraceptive," Asetoyer notes. [...]
The so-called “conscience clause” also comes into play. "We have had rape victims given prescriptions to get EC, but at IHS they wouldn't administer it, because the Pharmacy Director and her staff didn't believe in it, so she wouldn't administer EC," says Lisa Thompson-Heth of the Lower Brule Sioux Tribe in Fort Thompson, South Dakota. [...]
"It's not an aspirin; it's not cold tablets,” says Asetoyer. “It's withholding services from a victim.”
Blast from the Past. At Daily Kos on this date in 2010:
You may have already taken note of the gay-hating, immigrant-bashing, ignorance-promoting, climate change-denying, anti-choice, scofflaw attorney general of Virginia, Ken Cuccinelli II. Well, here's another of his finest moments. [...]
Question: What can we do about Obama and the birth certificate thing?
Cuccinelli: It will get tested in my view when someone... when he signs a law, and someone is convicted of violating it and one of their defenses will be it is not a law because someone qualified to be President didn’t sign it.
Q: Is that something you can do as Attorney General? Can you do that or something?
Cuccinelli: Well, only if there is a conflict where we are suing the federal government for a law they’ve passed. So it’s possible.
Q: Because we are talking about the possibility that he was not born in America.
Cuccinelli: Right. But at the same time under Rule 11, Federal Rule 11, we gotta have proof of it.
Q: How can we get proof?
Cuccinelli: Well... that’s a good question. Not one I’ve thought a lot about because it hasn’t been part of my campaign. Someone is going to have to come forward with nailed down testimony that he was born in place B, wherever that is. You know, the speculation is Kenya. And that doesn’t seem beyond the realm of possibility.
Hey, CNN, you can't say that Blagojevich's 15 minutes are up while you're simultaneously covering him.—
@porters via
Twitter for iPhone
High Impact Posts are
here. Top Comments are
here.
Think the Catholic Church doesn't care about women's health? Think again. Cardinal Dolan sets the record straight: http://t.co/...
—
@USCCB via
HootSuite
Having met earlier this week and
declared that regardless of public opinion, the Catholic bishops aren't giving up their losing war on women's health. Cardinal Timothy M. Dolan, archbishop of New York and the president of the United States Conference of Catholic Bishops, has come up with a
brand new rhetorical strategy to counter the growing consensus that the Church doesn't care about women, and it's sure to be a winner:
Nuh uh. No, really. That's the argument. Nuh uh:
When it comes to the health of women, their babies, and their children, the Catholic Church is there, the most effective private provider of such care anywhere around.Cardinal Dolan cites, as his nuh uh evidence, stirring tales of "fresh water projects" in "impoverished, thirsty countries throughout the third world," all because of the good work of Catholic Relief Services. These wells enable young girls to do other things with their lives—like go to school—instead of having to spend hours every day carrying water to their villages from the nearest water source. It's an important program, no doubt, but it doesn't exactly prove that the Church is "the most effective private provider" of health care for women.
But hey, it's evidence enough, according to the cardinal:
And now understand why Catholics rightly bristle when politicians and commentators characterize the Church as backwards and insensitive when it comes to women’s health.Actually, no. Because "Catholics" aren't bristling; they, like the rest of the country, oppose the Church's attempt to inject its dogma into our health care policies. The only "bristling" is from the bishops, who are frustrated that they can't even get their own laity to follow the Church's rules on sex.
But nuh uh, says the cardinal:
We just want to be left alone to live out the imperatives of our faith to serve, teach, heal, feed, and care for others. We cherish this, our earthly home, America, for its enshrined freedom to do so. Those really concerned about women’s health would be better off defending the Church’s freedom to continue its work.The Church is, of course, still perfectly free to "serve, teach, heal, feed, and care for others." No one forced it to
pull its funding from services for the homeless because the director supports marriage equality; the Church came up with that one all on its own.
The Church is still "free to continue its work," including spending
millions of dollars on lobbying and pursuing its new "
get tough" policy to shut down Survivors Network of those Abused by Priests (SNAP . No one is standing in the way there either.
The cardinal is even free to spend his time
using his blog to smear children who claim to have been molested by priests. Since that's apparently an important part of the Church's devotion to caring for women and children.
The cardinal's right about one thing, though:
We’re on the offensive when it comes to women’s health, education, and welfare, here at home, and throughout the world.At this point, does anyone really doubt that the Church
is
on the offensive when it comes to women's health? With all of its hand-wringing and multi-million-dollar lobbying against women's health care, it's actually perfectly clear just how
offensive
the Church really is.
In the words of Cardinal Dolan:
Case closed.
The other day I was at JKF about to board a flight to Los Angeles when I spotted almond milk ‘yogurt’ for sale alongside traditional dairy yogurt. I had to smile because in January I blogged about
healthy food trends for 2012 and the growth of plant-based dairy was one of them. These days, in addition to a variety of milks I’ve been seeing more dairy-free yogurt options.
While everyone else is gulping down green beer on Saturday, I’ll be making a point to celebrate St. Patty’s in a healthier way.
A new report by Dr Alexandra Wyke of PatientView
from the Economist Intelligence Unit, sponsored by Janssen
To unscramble the various perspectives on the ways to solve the healthcare financing conundrum, research was undertaken, which looks at the challenges facing healthcare today and the likely shape of healthcare by 2030. The five contrasting scenarios that emerge from this research largely reflect prevailing attitudes and beliefs today. The hope is that, by examining healthcare in this way, some consensus might emerge about how to save Europe's healthcare systems.
For more ....
http://bit.ly/eBqw90
March 14, 2012
,
2:26 p.m.
On Monday, researchers at the Harvard School of Public Health released study results showing that red meat consumption was associated with a higher risk of early death. The more red meat -- beef, pork or lamb, for the purposes of the research -- study participants reported they ate, the more likely they were to die during the period of time that data collection took place (more than 20 years .
So what is it in red meat that might make it unhealthy?
No one is sure, exactly, but the authors of the Harvard study mention a few possible culprits in their
paper in the Archives of Internal Medicine.
First, eating red meat has been linked to the incidence of
heart disease. The saturated fat and cholesterol in beef, pork and lamb are believed to play a role in the risk of
coronary heart disease. The type of iron found in red meat, known as heme iron, has also been linked to
heart attacks and fatal heart disease. Sodium in processed meats may increase
blood pressure, which is a risk factor for heart disease. Other chemicals that are used in processed meats may play a role in heart disease as well, by damaging blood vessels.
Red meat has also been linked to increased risks of colorectal and other
cancers. Again, heme iron could be a culprit — it is more easily absorbed into the body than other forms of iron, and can cause oxidative damage to cells — as could compounds that are created when meat is cooked at a high temperature. Preservatives used in processed meats also may play a role, scientists have said, because they convert into carcinogenic compounds in the body.
Copyright © 2012,
Los Angeles Times
Utah State University professor Leon Anderson, head of USU’s Department of Sociology, Social Work and Anthropology, has witnessed the transformation of treatment for the mentally ill through the experiences of the homeless on the streets, in jail and in mental health drop-in centers. He will discuss this shift in a talk “
The Criminalization of Mental Illness and the Promise of Mental Health Courts
” at the next Kiger Hour March 22.
“American history is filled with good intentions, high hopes — and dismal failure — in care of the mentally ill,” said Anderson. “We can do so much better. What I want to do is make people aware of how our treatment of the seriously mentally ill has changed over time and what the new movement of mental health courts can offer.”
Anderson worked in social services with troubled adolescents in Anchorage, Alaska, and was an award-winning writer for the “Anchorage Daily News” before becoming a professor. He co-authored the book
Down on Their Luck: A Study of Homeless Street People
that debunks stereotypes of who the homeless are and how they live by conducting hundreds of hours of interviews, observation and random tracking through social service agencies.
Anderson’s talk will trace the treatment of those with persistent mental illness from the large asylums of 19th and 20th centuries to the era of deinstitutionalization when patients were transferred from state-run hospitals to receive care at community-based mental health services.
However, some communities lacked the resources to adequately treat mentally ill patients, leading to a disproportionate number of homeless persons with mental illness. A 2008 report prepared for the Utah Commission on Criminal and Juvenile Justice found nearly a quarter of Utah prisoners are seriously mentally ill and at higher risk for incarceration and recidivism than individuals without mental illness.
In the 1990s, Anderson served as a research fellow with the Ohio Department of Mental Health during the years following the closing of that state’s large mental hospitals. He argues the establishment of mental health courts may be a step in the right direction for helping treat the mentally ill.
The courts help steer mentally ill criminal offenders towards recovery by opening up treatment under the eye of a judge. They enable people with severe and persistent mental health issues who commit crimes of a nonsexual, nonviolent nature to undergo monitored treatment rather than enter the prison system. The aim is to connect individuals with mental illness to support services that allow them to function in society.
Anderson will address the benefits of these courts and the role USU is playing to promote best practices of therapeutic jurisprudence. In July, the university will host the second annual Intermountain Mental Health Courts Conference, with the theme “
Criminal Justice and Mental Health: A Partnership for Recovery
.”
“Utah State University is at the forefront of bringing together judges, criminal justice personnel and social workers to develop new and effective ways to provide help to the mentally ill who currently cycle in and out of our country’s jails and prisons,” Anderson said. “I want to share the history and promise of this movement with our community.”
Prior to joining the faculty at USU, he was chair of the Sociology, Anthropology and Social Work Departments at Ohio University. Anderson has published widely on the topics of homelessness, social deviance and participant observation research methods.
Learn more about Anderson’s research and mental health courts at Kiger Hour, an intellectual program presented by Utah State University and sponsored by the College of Humanities and Social Sciences and the Caine College of the Arts. The event will be held Thursday, March 22, from 5:15 to 7 p.m. at Hamilton’s Steak and Seafood, 2427 N. Main St., Logan.
A buffet with appetizers, desserts and soft drinks, iced tea or coffee is available. Cost is $6.95 per person (plus tax and gratuity and billed on an individual basis. Guests can also order from the menu, and a cash bar is available. For planning purposes, please RSVP to Natalie Archibald Smoot in the college office, 435-797-2796, or email, natalie.archibald@usu.edu.
Related links:
USU Department of Sociology, Social Work and Anthropology
USU College of Humanities and Social Science
Writer: Kristen Munson, (435 797-0267, kri
sten.munson@usu.edu
Contact: Natalie Smoot, (435 797-2796,
natalie.archibald@usu.edu
Want to you can eat better and remain healthy? It’s easy but first you have to quit smoking because too much use of it can loss the feeling of your smell and taste that is caused by its harmful chemicals. Useful to you because there’s
blu cigs coupon code who can save you from this horrible thing and it's reaction on your health. Nutritious diet and healthy smoking should come together in order to live a healthy lifestyle.
"The lesson drawn from the outbreak is that even a most carefully supervised milk supply is open to the danger of grave infection from carrier or unrecognized cases of disease," wrote biology professor C.E.A. Winslow. "The only real safeguard against such catastrophes lies in pasteurization, carried out by the holding system and preferably in the final packages."
Professor Winslow made those recommendations 100 years ago, in the Journal of Infectious Diseases, about the 1911 Boston staphylococci or streptococci outbreak that killed 48 people. It was originally caused by drinking contaminated raw milk and spread because it was "communicable by contact," especially among people in the same household.
Winslow's 39-page article, titled "An outbreak of tonsillitis or septic sore throat in Eastern Massachusetts and its relation to an infected milk supply," records the details of one of the most significant public health events in U.S. history.
Winslow says the outbreak was first recognized at a medical meeting in Boston on May 11, 1911 when physicians attending realized they each had been treating at least 20 to 30, and in some cases as many as 60 and 70 patients, for "tonsillitis of a peculiar and characteristic type" within the last week.
Severe headaches, acute abdominal pains and high temperatures of 103 to 105 degrees were the common symptoms. "It was commonly called tonsillitis, but differed from ordinary tonsillitis in some respects, and was held by many physicians to be a new and peculiar pathological condition," Winslow wrote.
At the meeting, the physicians reported something else. Most of the families with illnesses were customers of a single milk supplier -- Dearfoot Farms.
Winslow says many of the doctors were "loath to believe" that Dearfoot Farms "could possibly be involved." The company had been supplying Boston and its suburbs with milk for 28 years, and "had been universally regarded as a pioneer in the work of dairy inspection and in the marketing of clean milk..."
In 1911, tonsillitis was not a "reportable" illness - doctors did not have to report it to health authorities. Wilson's investigation depended on the medical community volunteering information, and that's how he discovered that some areas with illnesses were not directly supplied by Deerfoot. He eventually collected more than 1,400 records directly from physicians.
"The disease was not ordinary follicular tonsillitis, but more nearly what the English recognize as septic sore throat," Winslow wrote. "In early stages there was merely a diffuse redness over the tonsils and adjoining regions, but follicular patches often appear later and in many cases a membrane simulating that of diphtheria."
Winslow said the disease was "severe," and "occasionally fatal among the old and the weak." He said there were actually two epidemics -- one centered in and around Boston, Brookline and Cambridge, and another in the area around Marlboro, 25 miles inland.
In his interviews with physicians in Boston, Winslow identified 1,043 outbreak-related cases, with the illnesses peaking on May 14 and "practically ceasing" after May 22. In 56 percent of the affected households, there was only a single case.
Two-thirds of the deaths were among people older than 55, and one-third of those were over 75. Adults suffered more than children; only 15 percent of the cases were under age 16. Females were infected at twice the rate of males.
Winslow discovered that the distribution of the epidemic "exactly coincided" with Deerfoot's two main milk delivery routes. His study of customer lists found that about one in four on the routes were infected.
In the Marlboro area, Winslow collected 392 case records from physicians. He learned that the outbreak there had not exploded suddenly, but that the inland illnesses had been spread out over April and May. Because there was no known case in that area involving direct exposure to the milk, Winslow suspected a "carrier case" had touched off the infections.
At a time when a microscope might have been a laboratory's only powerful tool, Winslow had to rely on guesswork. "All these symptoms point to streptococcus as the probable cause of infection, but there is as yet no definite information as to the bacteriology of the outbreak," he said.
"Throat cultures examined at the Boston Board of Health Laboratory and elsewhere showed no constant organism but Professor Theobald Smith, of the Harvard Medical School, has four cultures isolated from internal organs in the more severe cases, all of which are streptococci of apparently the same type," Winslow added.
Winslow also addressed rumors at the time that New York and Washington D.C. both experienced similar outbreaks, but found nothing more than the usual number of cases.
Newspaper reports greatly exaggerated the number of septic sore throat in other areas of Massachusetts. Worcester was said to have 2,000 cases, but Winslow's doctor survey turned up nothing unusual.
He did find an "interesting community outbreak" in Wellesley that included about 30 cases at a Roman Catholic academy. The school had its own dairy, and also raised most of its own food. The investigation pointed to "a local infection of some food supply within the institution, perhaps an unrecognized carrier case."
The 48 deaths included 17 males and 31 females. The victims lived in Boston (19 ; Brookline (6 and Cambridge (23 .
"Probability pointed to one of the two more universal vehicles, water or milk, and since the water supplies of the three communities are distinct, more particularly to milk supply," Winslow wrote.
Deerfoot Farms had two milk supplies, Southboro and Northboro, with a cream supply common to both. It was milk from Southboro that corresponded to the spread of the bacteria.
"On the whole, the general correspondence between Southboro milk and tonsillitis appears too close to be accidental," Winslow noted.
For Boston and Cambridge, 85 percent of the cases were on the Deerfoot Farms delivery list, and another 8 percent were believed by physicians to have consumed the milk.
Outbreaks early in the last century, like the one in Boston, eventually brought an end to the widespread distribution of raw milk, and most milk was pasteurized from then on to prevent the spread of disease and death.
In 1920, Winslow defined public health as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals."
His influence continues today with the C.E.A. Winslow Award, the highest award of professional achievement for public health professionals in Connecticut.
Researchers at Utah State University, who are part of the internationally recognized Cache County Study on Memory in Aging, were recognized in March by the Utah Alzheimer’s Association. The group, involving researchers in USU’s Colleges of Education and Human Services, Agriculture and Science, received the ALEXA “
A Lifetime of Exceptional Achievement
” Award at a gala chaired by Utah Lt. Gov. Greg Bell.
The award was presented to the group for its work in the area of Alzheimer’s research for the past 20 years. Maria Norton, principal investigator for the Cache County Study on Memory in Aging, accepted the award on behalf of the “wonderful group of colleagues” associated with the center’s efforts. The ALEXA award is given each year by the Utah Alzheimer’s Association to a single person or group of persons who have made substantial contributions to enhancing understanding of the causes of and possible protections against Alzheimer’s Disease.
The Cache County Study on Memory in Aging study began in 1992 with 300 seniors in Logan, Utah, who participated in a pilot. In 1994, Bonita Wyse, at that time dean of the former College of Family Life at USU, partnered with John Breitner at Duke University and together received the first grant funded by the U.S. National Institutes of Health to establish the study. One of very few such large, population-based studies of dementia in the world, the objectives were to study the prevalence and incidence of Alzheimer’s Disease and other dementias, and to identify genetic and environmental factors (and their interactions that affect dementia risk.
In 2001, Wyse established the Center for Epidemiologic Studies at USU, providing an inter-departmental (and inter-college center and infrastructure that would support the ongoing work of the study, as well as other multi-disciplinary epidemiologic studies. Investigators with the center span the departments of Psychology, Family Consumer and Human Development, Nutrition Dietetics and Food Sciences, Mathematics and Statistics and Sociology, Social Work and Anthropology.
Some 20 years after its beginnings, the center has expanded its focus and its investigators have received, during the center’s lifetime, $29 million dollars in total external funding from the National Institutes of Health, USTAR and the USDA.
The Cache County study has made major contributions to improving understanding of the causes of Alzheimer’s disease and the rate of clinical progression after diagnosis. Projects being developed include whole genome sequencing studies to find new genetic causes, studies of biological specimens to investigate how nutrition, diabetes and inflammation may affect Alzheimer’s, how stress alters genetic effects on Alzheimer’s risk and the role of family history, genetics and environmental factors in determining the risk of Alzheimer’s among the 11,000 adult offspring of the original Cache County Study participants.
USU investigators in the Cache County study have collaborated with colleagues at Johns Hopkins University, Duke University, the University of Utah, Brigham Young University, University of Gothenburg, Sweden, and the University of Washington.
For more information on the Cache County Study on Memory in Aging, visit the
website.
Contact: Maria Norton, 435-797-1599,
maria.norton@usu.edu
Last Friday, the Department of Health and Human Services
announced that they would be informing the State of Texas that the state would lose basic health and family planning services funding from Medicaid because it is in violation of federal law. The state wrote Planned Parenthood out of the state's Women's Health Program, a Medicaid-waiver program.
As of today, Texas has been officially informed that the funding is lost, via
this letter from HHS official Cindy Mann, director of the Center for Medicaid and State Operations (CMSO . Here's the key part:
Texas has elected to move forward with a State rule that restricts freedom of choice of health care providers for women enrolled in WHP effective March 14, 2012 Consistent with longstanding statutory provisions that assure free choice of family planning providers, the Demonstration does not provide the State the authority to impose such a limitation, and we advised the State in our December 12, 2011 letter that we had concluded that such authority would not be granted. We very much regret the State's decision to implement this rule, which will prevent women enrolled in the program from receiving services from the trusted health care providers they have chosen and relied upon for their care. Last year, nearly half of all the services under WHP were provided by clinics that are likely to be excluded from the program under the new rule.An HHS official
In light of Texas' actions, CMS is not in a position to extend or renew the current Demonstration, except for purpose of phasing out this Demonstration.
told reporters today:
“Medicaid law is very clear; a state may not restrict patients’ choice of providers of services like mammograms and other cancer screenings, if those providers are qualified to deliver care covered by Medicaid. Patients, not state government officials, should be able to choose the doctors and other health care providers that are best for them and their families. In 2005, Texas requested this same authority to restrict patients’ choices, and the Bush Administration did not grant it to them either.”The war on women's health just resulted in
130,000 casualties in Texas.
Public confusion about the status of the Affordable Care Act continues, according to this month's
Kaiser Health Tracking Poll [pdf]. Sadly, nearly 40 percent of the population either thinks that the Supreme Court has already overturned the law, or are unsure of its status.
Among those who are aware that the ACA is the law of the land, a two-thirds majority remains opposed to the individual mandate, "including 54 percent who feel “very unfavorable” (up from 43 percent last November ." That number tracks very closely with how respondents expect the Court to rule.
In line with these views, about half the public (51 percent thinks the Court should rule that the mandate is unconstitutional, while just under three in ten (28 percent think it should be ruled constitutional, and another one in five don’t know enough to say. Similarly, about half expect the Court to strike down the mandate as unconstitutional (53 percent while a third expect them to find it constitutional (33 percent .One really interesting aspect of the polling illuminates just how much the ACA has become a proxy for government itself.
There are a few upsides, here. Slowly, very slowly, seniors are becoming more supportive of the law to the point where as many are supportive (44 percent as opposed (42 percent . They've seen their prescription drug costs lowered, get more free screening and services, are not having to pay more for Medicare, and aren't being subject to death panels, which is perhaps why they're slowly coming around.
In the general population, the edge still goes to those who want to keep or expand the law, 47 to 41, and the majority wants Congress to keep working on making health care more affordable. "Six in ten say that in the wake of a ruling unfavorable to the ACA, lawmakers should focus on developing new proposals to improve Americans’ access to affordable health care, while a third say policymakers should stop talking about health care and focus on other national problems." Even a slim majority of Republicans thinks it's a priority.
The world is entering an era where injuries as common as a child's scratched knee could kill, where patients entering hospital gamble with their lives and where routine operations such as a hip replacement become too dangerous to carry out, the head of the World Health Organisation (WHO has warned.
There is a global crisis in antibiotics caused by rapidly evolving resistance among microbes responsible for common infections that threaten to turn them into untreatable diseases, said Margaret Chan, director general of the WHO.
Addressing a meeting of infectious disease experts in Copenhagen, she said that every antibiotic ever developed was at risk of becoming useless.
"A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child's scratched knee could once again kill."
The Bazaar
Healthiest dishes:
Mediterranean Mussels
olive oil, vinegar, pimenton
King Crab
raspberries, raspberry vinegar
Delta Farm Green Asparagus
labneh, macadamia nuts
Sauteed Wild Mushrooms
hazelnut praline
Sauteed Shrimp
garlic, guindilla pepper
Seared Scallops
romesco sauce
Seared Mary's Farm Chicken
honey dates mustard caviar, mustard greens
Baby Beets Salad
citrus, pistachio, olive oil goat cheese
The Blue Door
Healthiest dishes:
Ceviche of the Day
red onions, cilantro, jalapeno, smoked salmon mousse
Salmon Carpaccio
tapioca caviar, lemon, chives, olive oil
Caramelized Octopus
garlic, shallots, Dijon mustard, black olive potato salad
Chicken
simply roasted with herbs
Red Snapper
grilled, Antiboise sauce of tomato, black olives, capers, anchovy & basil, baby bok choy with garlic chips
Thon Thon
seared yellowfin tuna, marinated daikon, soy-lime-ginger dressing
Bartolotta
Healthiest dishes:
Cappesante Dorate Con Porcini
seared sea scallops, porcini mushrooms, Parmigiano-Reggiano
Gamberi E Cannellini
poached shrimp, cannellini beans, pomini tomato, basil
Insalata di Carciofi
porcini, ruchetta e pecorino sardo—sauteed artichokes and porcini mushrooms, wilted arugula, Sardinian pecorino
Brodetto di Pesce all'Abruzzese
Abruzzi-style seafood stew, scorpion fish, sea robin, clams, shrimp, scallops, cuttlefish
Pollo alla Rivier a Ligure
Ligurian-style roast chicken, artichokes, asparagus, porcini, olives, lemon herb sauce
L'Atelier de Joel Robuchon
Healthiest dishes:
Tomato Gazpacho
with croutons
Seared Day Boat Scallops
endive salad
Salmon
marinated with lemon and lightly-seared, cucumber capellini
Sauteed Amadai
Yuzu broth and lotus root
Pan-Seared Sea Bass
lemongrass foam and baby leeks
Steamed Dover Sole
baby leeks in a buttery shellfish sauce with lime and ginger
Seared Scallop
cooked in a shell, spicy chive oil
Walu Carpaccio
refreshed with Yuzu, delicate spices and garlic crisps
Clio and Uni
Healthiest dishes:
Fall Acorn Squash Soup
savory Chantilly, crunchy maple and aged sherry
Marinated Yellowtail and Yellow fin Tuna
opal basil, ginger and garlic
Salad of Fresh Hawaiian Hearts of Palm and Grilled Lobster Mushrooms
chrysanthemum greens, botarga and spruce vinegar
Buttermilk Braised Organic Chicken
foraged mushrooms, caramelized artichokes and wild rice
Crunchy Sauteed Atlantic Halibut
fragrant citrus ginger broth and spinach
Hot Smoked Wild Columbia River Salmon
granny smith apple, jasmine tea and white asparagus
Michael Mina
Healthiest dishes:
Tuna Tartare
ancho chile, sesame oil, pine nuts, mint 19
Crudo of Hamachi
geoduck, hearts of palm, sea beans, edamame, grape fruit
Heirloom Tomato & Burrata
chickpeas, herbal mesclun, olive, harissa
Wild Alaskan Halibut
ginger-carrot broth, steamed dumplings, snow peas
Duo of Wild Salmon
foie gras butter, green apple, king trumpet mushrooms
Pitman Farms Chicken 'Parmesan'
artichoke, carnaroli risotto, charred tomato
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