Dirty Little Secret:
The Loo That Saves
Lives in Liberia
Diarrhoea kills more children than HIV/AIDS,
Tuberculosis,
and malaria combined -- and its main
cause
is
food
and
water contaminated with human waste.
Liberia's president is trying to change all that.
Rose George
(The Guardian, London, February 4, 2012)
"Liberia had suffered years of stunningly brutal civil wars…By 2003, when the Economist called Liberia the worst country in the world, it was wrecked…But the world's worst country has been busy. In 2006, it elected Ellen Johnson Sirleaf to be its president…Africa's first female head of state, Ma Ellen to three million or so Liberians and a president with a dizzying to-do list. Eighty-five per cent of Liberians have less than a dollar a day to spend…[but] rice costs $45 a bag…How do you fix a ruined country? Start with the money…basic nation-building. But there is also something that's not on most nation-building lists. Liberians elected a woman who understood that something basic could save millions of dollars, something most people don't want to talk about. Most people, but not Ma Ellen, the only serving head of state to have written in a major newspaper about the need for toilets…Sirleaf took a while to understand the place of good sanitation. Like countless Liberians, she grew up on the family farm, where the only toilet was the bush…Like the six out of seven Liberians who still do the same thing, or the 2.6 billion worldwide who have no toilet, Sirleaf didn't see what was wrong with it…Now she…knows that diarrhoea -- caused largely by people ingesting water or food contaminated by human waste -- kills more children worldwide than HIV/Aids, tuberculosis and malaria combined. She knows that even the greenest, widest forest can't prevent faecal particles being tramped into a village on feet and flies and fingers, to be dipped into food and water, to become diarrhoea, dysentery or cholera. She knows, as an economist should, that good sanitation could reap millions of dollars a year in savings. India, where two-thirds of the population are toiletless, loses $58bn a year in wages and medical bills to the 50 diseases that can travel in human excrement. Half the hospital beds in sub-Saharan Africa are filled with people suffering the consequences of bad sanitation. But, of course, the president sees endless statistics. Only when she looked into why so many Liberian women were dying in childbirth, and why children were dying of something as banal as the squits, did she realise 'there is a relationship with water and sanitation. I needed to understand why that was so, and partly it's because people don't have access to clean water. That was an eye-opener for us'…[in] Jaytoken, like…countless other villages…WaterAid brought in a Liberian NGO to perform a process known as community-led total sanitation (CLTS)…It has been hugely successful in many parts of the world. When it works, it works dramatically…But it doesn't always work. The trouble with sanitation is that it involves human nature."
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Noam N. Levey
(Los Angeles Times, February 10, 2012)
"Starting this fall, insurers and employers that offer health coverage will have to provide a six-page form that summarizes basic plan information, such as deductibles and co-pays, as well as costs for using in-network and out-of-network medical services. The forms will also include estimated out-of-pocket costs for two basic examples of care: delivering a baby and managing Type 2 diabetes. The changes are designed to allow consumers to assess how much their care would cost under different insurance policies, and to simplify the process of evaluating health plans…The simplified forms, known as the summary of benefits and coverage, were mandated by the healthcare law…The administration did put off the effective date until September, instead of March, and dropped a requirement that health plans include premiums on the forms…many employers were heartened by signals that the administration would try to ease other, more consequential requirements of the health law."
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Robert Weisman
(The Boston Globe, February 8, 2012)
"Massachusetts business and government leaders...[were] warned [by health insurers] that the main trend restraining bigger increases -- fewer people seeking health care in the past year -- already may be changing...Massachusetts insurers have been able to limit base rate premium increases…in part because the weak economy caused many people…to delay elective procedures…But as the economy strengthens, they expect more people will return to doctors and hospitals, driving up spending on medical care…Most health plans…estimated that their 'cost trend' increase -- a combination of overall medical claims and the price of doctors visits, tests, and procedures -- declined to between 6 and 8 percent during the past year but is likely to return to between 8 and 10 percent this year and next…Some executives said they hope premium increases could remain moderate even if underlying health costs rebound, citing changes in plan designs that boost copays and deductibles, narrow networks of physicians available to members, or ask members to pay more for care from higher-priced providers."
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Robert Pear
(The New York Times, February 6, 2012)
"House and Senate negotiators are deadlocked over how to prevent a deep cut in Medicare payments to doctors who treat millions of Medicare beneficiariesLawmakers in both parties said they wanted to give doctors a small increase, but could not agree on how to cover the cost. The issue…pits health care providers against one another -- doctors versus hospitals -- in a type of conflict that is most likely to become more common as the federal government tries to throttle back the growth of Medicare costs. The payroll legislation would also continue jobless benefits for many of the nation’s unemployed. In the absence of agreement, doctors’ fees will be cut 27 percent next month, and many doctors say they could not continue treating Medicare patients under the lower payments…An influential federal advisory panel has voted to recommend cutting Medicare payments to hospitals for some of the most common outpatient services, and House Republicans cite that recommendation to justify their plan."
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David Brown
(The Washington Post, February 6, 2012)
"The affordability of American medical care in the future will depend, in part, on the ability of physicians to simplify and economize, which are two things they’ve never been good at. With national health expenditures amounting to $2.6 trillion a year -- 45 percent of it paid by government -- prosperity and political stability may also be at stake. Different versions of this question are behind the debate about whether women should get mammograms annually or every other year…and whether curative surgery should be attempted in most cases of prostate cancer…The question is being posed to cardiology -- the medical specialty that treats heart disease, the nation’s leading cause of death -- in a most interesting way. At issue is how to treat about 500,000 Americans who each year develop 'stable angina,' which is chest pain that occurs in predictable fashion and is caused by blockages in the heart’s coronary arteries. There are two common treatment approaches. One is angioplasty with stenting…The other is medication and changes to lifestyle. In many people’s minds, this issue is settled. The answer came in a $33.5 million clinical trial called COURAGE, whose results were announced five years ago."
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(The Economist, London, February 4, 2012)
"Americans spent $2.6 trillion on health care in 2010...18% of GDP [gross domestic product]. Yet few of them have the faintest idea what any treatment costs or how it compares with any other treatment. Prices vary wildly and seemingly without reason…Barack Obama’s health reform requires hospitals to list standard prices each year, and more than 30 states have either proposed or passed laws to promote price transparency…None of these measures has come close to solving the problem. Few provide enough data to allow people to shop around. So private firms are having a go…[but they] face several obstacles. Health care is…complicated…Informed medical decisions require…[more nuanced] information [than other types of consumer products that offer pricing transparency models]. To make matters worse, health insurers are reluctant to share data about costs…Despite this, greater transparency seems inevitable. Smart insurers are hawking their own tools…Such experiments will serve insurers well. If Mr Obama’s health law stands, millions will soon shop for insurance on new exchanges. The easier the plan is to understand, the more people may pick it."
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Related opinion:
'Obamacare' Insurance Exchanges: Let's Get Going
Editorial
(Los Angeles Times, February 8, 2012)
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Jim Morris
(The Washington Post, February 6, 2012)
"Publication of a landmark government study probing whether diesel engine exhaust causes lung cancer in miners -- already 20 years in the making -- has been delayed by industry and congressional insistence on seeing study data and documents before the public does. A federal judge has affirmed the right of an industry group and a House committee to review the materials and has held the Department of Health and Human Services in contempt for not producing all of them. The much-anticipated study of 12,000 miners exposed to diesel fumes carries broad implications…But for the time being, at least, the results of the $11.5 million investigation by the National Cancer Institute and the National Institute for Occupational Safety and Health are under lock and key…The legal and political tangling over the diesel study began in the mid-1990s…Government researchers have written seven papers on the study, which is noteworthy not only for its large number of subjects but also because of its controls for factors such as cigarette smoking. Four of the papers -- describing only the study’s methodology -- were published…in 2010…Papers six and seven…detail the study’s results…[but] None of the last three papers can see the light of day until the legal dispute is resolved."
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(The Economist, London, February 4, 2012)
"[T]he Netherlands does not feel like a sink-hole of pollution. But the…water is brimming with nitrates and phosphates, and the air is clogged with particulate matter…[while] vast purchases of emission rights keep the Netherlands below its Kyoto [United Nations (UN) protocol] targets. There is broad agreement on the causes. The Netherlands has the highest numbers of livestock per head in Europe…is a transport hub…The Dutch [also] have many energy-hungry industries…With not much land and lots of people, pollution looks inevitable…the government does not seem worried about the big picture…The scary claim that particulate matter in the air knocks off 155,000 years of life amounts to just one month per person, says Pieter Boot of the Dutch planning bureau for the environment. The average Dutch person is taller and lives longer than most other Europeans. And although the country may be overpopulated and polluted, the UN’s human-development index ranks it as the third-best place to live in the world, after Norway and Australia. High living standards, good health care and low accident-mortality rates matter, says Mr Boot. In times of crisis, they may seem to matter more than the environment."
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Katy Daigle
(The Associated Press, February 10, 2012)
"Health industry workers and activists worry India may bow to EU [European Union] demands for strict intellectual property protections and investor guarantees, which could close down the world's generic drug supply. India's $26 billion drug industry has become an immense profit engine, growing at 15-25 percent a year -- but also a lifeline for millions of patients in poor countries, many in Africa, unable to pay sky-high Western prices to treat illnesses that include HIV, malaria, asthma and cancer. For HIV alone, India makes more than 80 percent of the world's medicines. The EU says it has suggested a clause in the free-trade pact 'to ensure that nothing in the proposed agreement would limit India's freedom to produce and export lifesaving medicines.' Despite the EU assurance, Indian drug makers and health workers say two broad provisions in the agreement…would make it much easier for international pharmaceutical giants to sue the Indian government, drug manufacturers and distributors. That, they argue, would dramatically curtail Indian production of many lifesaving drugs, or cause prices to rise to levels many cannot afford."
Rita Giordano
(The Philadelphia Inquirer, February 5, 2012)
"[An ongoing] shortage of common ADHD [attention-deficit/hyperactivity disorder] medications…and their generics…has sparked a congressional inquiry…And who is to blame depends on whom you ask. Most [ADHD] medicines…contain stimulants that are controlled substances and regulated by the federal Drug Enforcement Administration [DEA]…Each year, the DEA sets manufacturing quotas for the controlled substances in…medications. Factors considered include past quotas, changes in demand, and medical-need estimates…It also sets limits on how much of the active ingredients can be obtained by each pharmaceutical company. The Food and Drug Administration [FDA] says drug companies attribute the shortage of ADHD medications to those active-ingredient quotas and resulting production delays…The DEA has suggested manufacturers are at fault…Pharmaceutical firms can seek approval to obtain more of the substances, but that takes a while, and the manufacturing process can be months…The [ongoing shortage]…prompted...members of the House of Representatives wrote the DEA calling for an explanation of its quota-setting process. Letters also went to…major manufacturers of ADHD drugs, seeking details about their business practices and manufacturing decisions…The agency and firms are cooperating."
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Tiffany Gibson
(The Oklahoman, February 5, 2012)
"The Oklahoma Bureau of Narcotics and Dangerous Drugs Control started the [electronic Oklahoma prescription] monitoring program in 2006 to reduce prescription fraud, substance abuse and 'doctor shopping'…[now, new for 2012,] all dispensers are required to use the program to report dispensing of certain narcotics within five minutes of being delivered to the customer…Bureau Director Darrell Weaver said doctors have given positive reviews about the new requirement…The next step is getting more doctors to routinely check the list before issuing a prescription…According to the National Survey on Drug Use and Health, Oklahoma has the highest rate of nonmedical use for painkillers…the monitoring program is used more as a tool between practitioners, pharmacies and law enforcement agencies, said Mark Woodward, spokesman for the Bureau of Narcotics and Dangerous Drugs Control…the agency established its first drug-tracking program in 1990 and led the country in doing so. The program, called OSTAR, only monitored Schedule II drugs, such as morphine and methadone. In the past decade, prescription drug abuse and overdose deaths rose to new heights, both nationally and locally."
Shan Juan and Wang Qingyun
(China Daily, February 3, 2012)
"Analysis by Medicins sans Frontieres, an international health organization, suggests India now makes one-fifth of the world's generic drugs, with about 50 percent shipped abroad and sold (often illegally) at a fraction of the cost…To tackle the problem of illegally imported drugs, the State Council last year launched a special health campaign. 'It mainly aimed at Internet scams in which profiteers promoted and sold fake drugs or those sourced through illegal channels,' said Bian Zhenjia, deputy director of the State Food and Drug Administration, who added that medication designed for long-term use, such as treatments for impotence, diabetes, hypertension and cancer, are major targets for criminals…Jia Ping [a Beijing lawyer who specializes in public health cases] said he fears that the drugs market is not currently a priority for authorities in China…Although there is no legal barrier to such a system in China, 'no domestic pharmaceutical company has so far applied for compulsory licensing of a foreign patent drug,' he said, adding that Chinese manufacturers had a 'relatively poor understanding about World Trade Organization treaties and public health.'"
David Brown
(The Washington Post, February 8, 2012)
"The amount of trans fat in the American bloodstream fell by more than half after the Food and Drug Administration [FDA] required food manufacturers to label how much of the unhealthful ingredient is in their products, according to a new study. Blood levels of trans fat declined 58 percent from 2000 to 2008. FDA began requiring trans-fat labeling in 2003. During the same period several parts of the country -- New York most famously -- passed laws limiting trans fats in restaurant food and cooking. The makers of processed food also voluntarily replaced trans fats with less harmful oils. The decline, unusually big and abrupt, strongly suggests government regulation was effective in altering a risk factor for heart disease for a broad swath of the population. Researchers at the Centers for Disease Control and Prevention discovered the decline by analyzing blood drawn as part of the National Health and Nutrition Examination Survey, which interviews and examines a sample of Americans at least once a decade. The trend was seen in white adults; researchers are looking to see if it occurred in other ethnic and racial groups, too. Trans fats, which are used for deep-frying and as an ingredient in baked goods and spreads, increase the risk of heart disease."
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Jeff Gordinier
(The New York Times, February 7, 2012)
"In the eyes of some experts, what seems like the simplest of acts -- eating slowly and genuinely relishing each bite -- could be the remedy for a fast-paced…Nation in which an endless parade of new diets never seems to slow a stampede toward obesity. Mindful eating is not a diet, or about giving up anything at all. It’s about experiencing food more intensely -- especially the pleasure of it…The last few years have brought a spate of books, blogs and videos about hyper-conscious eating. A Harvard nutritionist, Dr. Lilian Cheung, has devoted herself to studying its benefits, and is passionately encouraging corporations and health care providers to try it. At the Food and Brand Lab at Cornell University, Prof. Brian Wansink…has conducted scores of experiments on the psychological factors that lead to our bottomless bingeing. A mindful lunch hour recently became part of the schedule at Google, and self-help gurus…have become cheerleaders for the practice…Could a discipline pioneered by Buddhist monks and nuns help teach us how to get healthy, relieve stress and shed many of the neuroses that we’ve come to associate with food?"
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Mike Stobbe
(The Associated Press, February 7, 2012)
"Bread and rolls are the No. 1 source of salt in the American diet, accounting for more than twice as much sodium as salty junk food…government report includes a list of the top 10 sources of sodium. Salty snacks actually came in at the bottom of the list compiled by the Centers for Disease Control and Prevention [CDC]…Breads and rolls aren't really saltier than many of the other foods, but people tend to eat a lot of them, said Mary Cogswell, a CDC senior scientist who co-authored the report. Salt is the main source of sodium for most people, and sodium increases the risk of high blood pressure, a major cause of heart disease and stroke. Health officials say most Americans get too much salt, mostly from processed and restaurant foods -- not added from the salt shaker. Experts have known that the sodium in breads and certain other foods can add up, but even CDC officials were amazed that just 10 foods are responsible for 44 percent of the sodium consumed."
Grace Rubenstein
(The Sacramento Bee, February 7, 2012)
"Diabetes rates have been rising for decades in the United States...about one in nine...have the diagnosis. The vast majority of those cases are type 2 diabetes, in which the body loses its ability to produce and use insulin, the hormone that controls blood-sugar levels. As with many chronic conditions, it strikes more ethnic minorities, more poor people, and more people who lack a high school diploma, compared to whites and those who are better off. Although blacks are diagnosed at slightly higher rates than Latinos overall…the rates vary when you look more closely at Latinos' country of origin. Mexican Americans…make up the majority of U.S. Latinos…More than 13 percent of Mexican American adults have been diagnosed with diabetes. Doctors and public health experts blame both genes and the social environment for those extra-high numbers…[but] Food factors in. The high-carbohydrate diet common in Mexico tends to get worse when immigrants arrive in this country…Add in some unhealthy aspects of American lifestyle -- the reliance on automobiles, the ready availability of cheap and fattening fast food, and the necessity in many families for both parents to work long hours -- and doctors say you've got a toxic combination for promoting obesity and disease."
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Related graphic:
Diabetes Rates
Mitchell Brooks
(The Sacramento Bee, February 8, 2012)
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Julie Deardorff
(Chicago Tribune, February 5, 2012)
"In response to the obesity epidemic -- and to concerns that their products may be contributing to it -- [big beverage companies]…have launched dozens of health and wellness initiatives designed to promote physical activity and movement. Stressing balance, moderation and sensible choices, the corporations are funding playgrounds and elementary school fitness centers as well as partnering with groups that advocate exercise…Critics of the industry's efforts say the companies' focus on exercise is an attempt to draw attention away from the role unhealthy foods play in obesity…Activity levels were dropping before 1980, the year obesity rates started to increase. The last two decades, meanwhile, have seen increases in portion sizes, eating out, soft-drink consumption and calorie intake. A common theme in company literature is finding the balance between 'calories in' (food and beverages) and 'calories out' (exercise). But it's very difficult to work off a bad diet. A 20-ounce soda, for example, has 17 teaspoons of sugar for 250 calories."
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Critics Pounce On Coke, Pepsi Health Initiatives
Julie Deardorff
(Chicago Tribune, February 5, 2012)
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Denis Campbell
(The Guardian, London, February 4, 2012)
"Foodstuffs and drinks need to contain less sugar, salt and fat in order to help combat the growing number of people developing cancer, campaigners against the disease have said. The call from the World Cancer Research Fund (WCRF) came as it released…analysis of the likely increase in cancer cases in all 27 EU member states by 2030 says that the UK will have the 16th biggest proportionate rise and Ireland the biggest with a predicted 72% jump, followed by Cyprus (55%), Luxembourg (53%) and Malta (49%). The WCRF identified the ageing population as the key factor behind the rise, because cancer affects mainly the over-60s. But it also said improvements in lifestyles, such as eating better, maintaining a normal weight and taking exercise could prevent as many as a third of all cancers…Cancer incidence is rising [in the UK], and experts expect it to keep rising, mainly due to ageing, but also obesity and alcohol misuse…The trend has prompted concern that the NHS may not be able to keep pace."
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Martine Powers
(The Boston Globe, February 6, 2012)
"A city councilor is pushing for new legislation that will use valet companies to keep intoxicated drivers off Boston roads, saying that parking attendants could serve as 'the last line of defense' against drunken-driving accidents…While some valet parking companies already have a 'keep the keys' protocol in place in cases of intoxication, the new law would establish a uniform policy for valets who encounter drunk patrons…Under the proposal…valet drivers would withhold car keys from those who seem intoxicated…[but] it remains to be determined whether they would be required to do so or just encouraged to do so. The car would be kept in the parking lot overnight without charging an additional cost…Joshua Lemay, director of operations at Ultimate Parking, said he…worries that the proposed ordinance could make valet attendants legally liable for the safety of their patrons if they fail to detect that a customer has had a couple of beers too many…The hearing…will help…iron out the details of the proposed ordinance…In one potential scenario, valet parking attendants would be required to notify a supervisor if they believe that a patron asking for a car is drunk. The supervisor may deny the patron his car keys or, if the patron argues, will call police to administer a breathalyzer test and determine if the patron is fit to drive."
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Jane E. Brody
(The New York Times, February 6, 2012)
"When it comes to moving people around in healthy ways, New York City already has a leg up on most cities and towns around the country. The city has sidewalks in all five boroughs; food stores and other shops are within walking distance of where most people live…City children have long been able to walk, skate or scoot to school…Because so many New Yorkers use their feet to get them from place to place, they weigh on average six or seven pounds less than those who live in suburban America, said Dr. Richard J. Jackson, professor of environmental health sciences at the University of California, Los Angeles…Despite a rising tide of pedestrians and cyclists, the number of traffic-related deaths on city streets fell last year to the lowest level in a century, declining 40 percent since 2001…Janette Sadik-Khan, the city’s transportation commissioner, attributes these improvements to an ambitious plan-in-progress to re-engineer city streets. Recent years have seen a plethora of projects to improve pedestrian and cycling safety…The city is also enhancing enforcement of traffic laws…But as Ms. Sadik-Khan acknowledges, this is only the beginning; a lot more must be done to make the city streets safer for people who wish to navigate them under their own steam."
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Bill Rankin
(The Atlanta Journal-Constitution, February 6, 2012)
"The Georgia Supreme Court…unanimously struck down a key provision of a state law that criminalized some assisted suicides, finding it violates free speech rights…Georgia's law is unconstitutional because it does not prohibit all assisted suicides and, instead, criminalizes only those in which someone advertises or offers to assist in a suicide and then takes steps to help carry it out. 'The State has failed to provide any explanation or evidence as to why a public advertisement or offer to assist in an otherwise legal activity is sufficiently problematic to justify an intrusion on protected speech rights,' Justice Hugh Thompson wrote for the court…In 2010, a Forsyth grand jury indicted [those in the Final Exit Network]…They were charged with violating the assisted-suicide law, racketeering and tampering with evidence. Because the provision of the assisted-suicide law was struck down, the entire case will be dismissed, [Forsyth District Attorney, Penny] Penn said. During pretrial hearings, defense lawyers challenged the constitutionality of the law. A Forsyth judge upheld the law, and they appealed to the state Supreme Court."
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Melissa Healy
(Los Angeles Times, February 6, 2012)
"The nation's 77 million baby boomers are not the first adults to care for their aging parents. But they are the first generation to care for parents who are living longer but with more chronic medical conditions -- and often far from their grown children. More than 43 million Americans provide care for someone older than 50 who is aging or disabled…For each of these grown children, there are moments when an aging loved one's safety seems to depend on that caregiver's ability to [convince a parent]…to make changes in the interest of his or her health and safety…The caregiver's aim may vary…Yet there is no accepted script…Of all the excruciating conversations a caregiver will ever initiate with an aging parent, the 'driving talk' is perhaps the worst. A loved one who has enjoyed all the rights, privileges and responsibilities of adulthood will not cede his or her independence and autonomy happily, nor perhaps willingly. Fear silences many grown children from having these conversations until it is too late for negotiation, experts say."
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Lisa Schlein
(Voice of America, February 6, 2012)
"United Nations, international and human rights organizations are calling for an end to female genital mutilation and appealing for tougher legislation to halt the practice on the Ninth International Day of Zero Tolerance to Female Genital Mutilation (FGM). FGM, a practice which dates back thousands of years, persists despite widespread recognition of its harmful physical and psychological effects on girls and women. Involving partial or total removal of the external female genitalia, FGM's immediate health complications include severe pain, shock and hemorrhage, and longer-term consequences such as cyst formation, infertility, increased risk of childbirth complications, and newborn deaths. Elise Johansen, a Medical Anthropologist for the World Health Organization (WHO), says that although traditional circumcisers remain the primary practitioners of FGM, doctors, nurses and other health-care providers are increasingly conducting the procedure, perpetuating the so-called medicalization of FGM."
Louise Radnofsky, Anna Wilde Mathews and Melanie Grayce West
(The Wall Street Journal, New York, February 4, 2012)
"The breast-cancer charity Susan G. Komen for the Cure, faced with harsh criticism from some supporters, has backtracked on a policy that would have cut off future funding to most Planned Parenthood affiliates. But the effects of the public spat, which has divided women's-health supporters, will continue to be felt for a long time. The two iconic organizations have been on the opposite ends of a social-media and political firestorm that erupted after Komen's original decision became public [last week]…Komen has contended that the public debate was distorting its policy, which banned funding for organizations that were under government investigation…That category included Planned Parenthood…Komen said that in the future, organizations would be disqualified only if they are the subjects of 'criminal and conclusive' investigations, not 'political' ones…The often-strident rhetoric on both sides of the issue, which spread rapidly through social-media channels, raised the question of whether Komen, a private charity, was caving in to political pressure in both its initial decision and when it backed off."
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Related Opinion:
Real Race in Cancer Is Finding Its Cause
Opinion, Dr. Susan Love, president of the Dr. Susan Love Research Foundation
(The New York Times, February 7, 2012)
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Sarah Kliff
(The Washington Post, February 3, 2012)
"When news broke this past week that the Susan G. Komen for the Cure foundation had pulled its funding for cancer-screening programs at Planned Parenthood, the public relations disaster boosted Planned Parenthood fundraising and energized supporters. Komen saw such a strong backlash that, within 72 hours, it reversed its decision. An aggressive assault that took the battle beyond abortion to contraceptives and preventive health care may have been just what the abortion rights movement needed. States passed 92 abortion restrictions in 2011…While the Hyde Amendment has long prohibited federal funding of abortion, antiabortion activists…turned to national and state legislators to bar abortion providers…from receiving funds for other services they provide, such as cancer screenings and contraceptives…the restrictions that passed in 2011…also…got…people involved. For years, abortion rights advocates have battled an intensity gap: Their supporters don’t feel as strongly about protecting abortion access as antiabortion voters do about restricting it."
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Charlie Dunmore
(Reuters, February 9, 2012)
"Europe's weak regulations on medical devices have been partly blamed for allowing French company Poly Implant Prothese (PIP) to manufacture substandard silicone breast implants for up to a decade, and be used by hundreds of thousands of women around the world…[European Union (EU) health and consumer affairs chief, John] Dalli said he had written to the bloc's 27 health ministers and urged them to make full use existing EU rules. He called for an urgent review of the 70 to 80 regulatory agencies responsible for approving high-risk medical devices in Europe, most of which are private companies. Within months, EU governments should ensure the agencies, known as notified bodies, are only authorized to assess and approve devices and technologies for which they have a proven expertise and competence, Dalli said…Responding…the industry body Eucomed, which represents about 22,500 medical technology companies in Europe, said it would support the Commission in strengthening medical devices legislation…The Commission said the measures would boost surveillance of a European market for medical devices and diagnostics…while it drafted a full overhaul of existing EU legislation in the coming months."
Amy Corderoy and Philip Chan
(The Sydney Morning Herald, February 4, 2012)
"Commercial tanning beds will be banned in NSW [New South Wales] under…new laws…announced by the government…NSW will be the only place in the world besides Brazil to institute a total ban on ultraviolet solariums tanning units when the laws come into place from December 31, 2014, and cancer groups hope other states and countries will follow…The Environment Minister, Robyn Parker, chose World Cancer Day to make her announcement, saying sun beds were carcinogenic and the International Agency for Research on Cancer had placed them in the same category of risk as asbestos. 'Sadly, Australia has the highest incidence of skin cancer in the world and this ban is long overdue,' she said. There are about 100 businesses with 254 commercial tanning units registered in NSW, and about 10 per cent offer UV tanning exclusively. That group would be offered help through the Department of Trade and Investment's business advisory services."
Andrea Petersen
(The Wall Street Journal, New York, February 7, 2012)
"The hunt is on for a so-called biomarker, a characteristic or substance -- or, more likely, several substances -- in the body that will indicate if someone is sleepy and, if so, how sleepy…to measure acute sleepiness in order to identify the risk of 'performance failure' before it happens…Research is also looking at chronic sleepiness…studies have found that not sleeping enough night after night raises the risk of health problems, including obesity, diabetes and heart disease. A biomarker could change the way people view the role sleep plays in their overall health, says Paul J. Shaw, an associate professor of neurobiology at the Washington University School of Medicine in St. Louis…This area of sleep research is in the early stages…It holds the promise of helping the average person make what could be crucial health decisions…People who are sleepy have slower reaction times, decreased attention and problems learning and processing information. What makes sleepiness especially dangerous is that most people are generally not aware of how sleepy -- and how impaired -- they actually are…Most adults need between seven and nine hours of sleep a night. But about a quarter of those age 19 to 64 say they get less than seven hours on weeknights, according to the…2011...poll."
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Related opinion:
Sleep, Perchance to Learn: Schoolchildren Need to Stay in Bed Longer
Opinion, John Norris, pediatrician and parent
(Pittsburgh Post-Gazette, February 5, 2012)
David Tuller
(The New York Times, February 6, 2012)
"When scientists reported in 2009 that a little-known mouse retrovirus was present in a large number of people with chronic fatigue syndrome, suggesting a possible cause of the condition, the news made international headlines. For patients desperate for answers, many of them severely disabled for years, the finding…seemed a godsend…In hopes of treating their condition, some patients even began taking antiretroviral drugs used to treat H.I.V., a retrovirus related to the murine leukemia viruses suddenly suspected of involvement in chronic fatigue syndrome. More recently, however, the hopes of these patients have suffered an extraordinary battering. In a scientific reversal as dramatic and strange as any in recent memory, the finding has been officially discredited; a string of subsequent studies failed to confirm it, and most scientists have attributed the initial results to laboratory contamination. In late December, the original paper, published in the journal Science, and one other study that appeared to support it were retracted within days of each other. As the published evidence for the hypothesis fell apart, a legal melodrama erupted, dismaying and demoralizing patients and many members of the scientific community."
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(The Economist, London, February 4, 2012)
"More than 2,700 researchers from around the world have so far signed an online pledge…promising not to submit their work to Elsevier’s journals, or to referee or edit papers appearing in…[they agree with Cambridge University mathematician Timothy Gowers] First, that Elsevier charges too much for its products. Second, that its practice of 'bundling' journals forces libraries which wish to subscribe to a particular publication to buy it as part of a set that includes several others they may not want. And third, that it supports legislation…that would forbid the government requiring that free access be given to taxpayer-funded research. Elsevier insists it is being misrepresented…[the] petition, though, is symptomatic of a wider conflict between academics and their publishers -- a conflict that is being thrown into sharp relief by the rise of online publishing…This situation has been simmering for years…And there have indeed been attempts to create alternatives to commercial publishing…But despite the enthusiasm…there are reasons for the continued dominance of traditional publishers…Commercial publishers have begun to experiment with open-access ideas, such as charging authors for publication rather than readers for reading. But...things could become more urgent. After all, publishers need academics more than academics need publishers."
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Kevin Sieff
(The Washington Post, February 5, 2012)
"Last year was the deadliest for civilians in the decade-long U.S.-led war in Afghanistan, according to a U.N. [United Nations] report…3,021 civilians were killed in 2011, an 8 percent increase from 2010. It was the fifth consecutive year that the number of deaths has increased. Insurgents were responsible for the vast majority of the casualties, at least 2,332, according to the report. Most of the victims were killed by makeshift explosives or suicide bombers. The use of both tactics increased sharply over the past 12 months. The report describes a deteriorating security situation as NATO’s war effort begins to ebb, and as the United States pursues negotiations with an insurgency that shows no sign of relenting. Meanwhile, Western officials have described the Taliban’s power as waning, pointing to a 20 percent decrease in the number of coalition troops killed last year. But the U.N. report suggests that the number of foreign troops killed is a poor indicator of the Taliban’s ability to foment unrest."
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Julie Robotham
(The Sydney Morning Herald, February 6, 2012)
"Under the target, which came into effect on January 1, [Australian] states have committed to annual incremental rises in the proportion of emergency patients they treat within the benchmark time, rising to 90 per cent by 2015. This year NSW's target is 69 per cent within four hours -- up from the 62 per cent achieved last year…But the NSW [New South Wales] faculty chairman of the Australasian College for Emergency Medicine, Richard…Paoloni said a shift in roles…might increase efficiency in emergency departments…But little else could be done to reduce the time needed to complete patients' treatment, and only radical reorganisation of in-patient wards to make more beds available to newcomers would ease the pressure…Over four years from this year, NSW will receive $96.9 million in assured funding from the federal government to help it achieve the four-hour target, plus $72.5 million for capital investment in emergency departments. But a further $63.6 million is contingent on annual improvements against the four-hour threshold…Doctors initially resisted the four-hour target, fearing it would pressure them to push patients out of emergency before they had been stabilised. But they have been reassured by the experience of Western Australia, which pioneered the practice."
Daniel Schearf
(Voice of America, February 6, 2012)
"The United Nations is praising Asia Pacific countries for their response to the HIV/Aids epidemic, but says there are still legal and social barriers that significantly set back eradication efforts…The U.N. Economic and Social Commission for the Asia Pacific opened a three-day meeting lauding impressive gains in recent years in the fight against HIV/AIDS. Noeleen Heyzer, the executive secretary of U.N. ESCAP, told officials and activists from 34 Asia Pacific countries that more people than ever had access to HIV treatment. She says new HIV infections are down 20 percent since 2001 and she is expecting to meet a goal to begin to halt and reverse the spread of HIV/AIDS by 2015...However, Heyzer notes the gains are uneven and there are still gaps in the goal of universal access to HIV treatment…The United Nations is urging countries to speed up efforts to curb HIV in the region. Officials say that 90 percent of Asia Pacific countries still have barriers to treating HIV, including laws that criminalize sex workers and injection drug users. They say the measures make it difficult for those groups to seek treatment. Many countries also reject, or even outlaw, homosexual and trans-gender people."
Opinion
Daniel Taylor, pediatrician and Drexel University College of Medicine associate professor
(The Philadelphia Inquirer, February 8, 2012)
"In the United States, we spend the most in the world on health care -- more than $8,000 per person. And yet, the World Health Organization in 2000 ranked the U.S. system 37th in overall performance, and 72d by overall level of health (among 191 nations studied). Many factors are involved. One rarely mentioned is poor health literacy. The government's standard of care...defines health literacy as having three components. A patient must be able to obtain, process, and understand basic health information and services; make appropriate decisions; and access/navigate the system. It's shocking how often this fails to happen…Science is extending the lives of many, but still too many continue to suffer, get worse, and even die prematurely. Many times patients and families just don't understand the disease, the treatments, or even the proper ways to give medicines and control toxic diets or environments…So what can we do to help?"
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