Sunday, September 30, 2012
"...the people behind the laws had changed, and so the laws counted for nothing." (HT:TH)
The Roman Republic fell, not because of the ambition of Caesar or Augustus, but because it had already long ceased to be in any real sense a republic at all. When the sturdy Roman plebeian, who lived by his own labor, who voted without reward according to his own convictions, and who with his fellows formed in war the terrible Roman legion, had been changed into an idle creature who craved nothing in life save the gratification of a thirst for vapid excitement, who was fed by the state, and directly or indirectly sold his vote to the highest bidder, then the end of the republic was at hand, and nothing could save it. The laws were the same as they had been, but the people behind the laws had changed, and so the laws counted for nothing."
- President Theodore Roosevelt
New Tracking Frontier: Your License Plates (HT:GB)
http://www.blogger.com/blogger.g?blogID=8110358795032690358#editor/target=post;postID=2740259875973672395
New Tracking Frontier: Your License Plates
BY JULIA ANGWIN AND JENNIFER VALENTINO-DEVRIES
For more than two years, the police in San Leandro, Calif., photographed Mike Katz-Lacabe's Toyota Tercel almost weekly. They have shots of it cruising along Estudillo Avenue near the library, parked at his friend's house and near a coffee shop he likes. In one case, they snapped a photo of him and his two daughters getting out of a car in his driveway.
Zombie allusions: They just keep on coming-bashing Milton Friedman
http://www.businessspectator.com.au/bs.nsf/Article/US-flow-of-funds-debt-inflation-economy-growth-pd20121001-YMPXT?OpenDocument&src=sph
America's suspended animation
Published 7:20 AM, 1 Oct 2012
Money, we are told, is unimportant to the economy: what matters are relative prices, not absolute ones.
This delusion has been part of economic mythology for centuries, but as is so often the case, the person responsible for reviving this zombie idea in modern times was Milton Friedman.
.................
That seems to be about as far as most economists read, which is a pity – since immediately after it, Milton throws in a little qualification which makes a mockery of the whole “money neutrality” proposition:
"Provided that all other nominal magnitudes (prices of goods and services, and quantities of other assets and liabilities that are expressed in nominal terms) are also multiplied by 100."
Ahem. Since your debts are not increased by 10 per cent when the CPI rises 10 per cent, Milton’s logic proves the opposite of what he asserts: the nominal amount of moneydoes matter, because of its relation to the outstanding level of debts. Economists who ignore the monetary data in the Flow of Funds are not being wise by avoiding “Money Illusion”, but are acting under the “Barter Illusion” that capitalism can be best understood by ignoring banks, debt and money – three things which most non-economists actually think economists are experts about because to non-economists, economics is “about money”.
Growing obesity problem affects joints
http://www.dispatch.com/content/stories/local/2012/09/30/health/growing-obesity-problem-affects-joints.html
Growing obesity problem affects joints
It might not rival that creak in your knee, but the truth still hurts:
We might blame genetics or age for our joint pain, but often it’s caused by those excess pounds we carry around.
Doctors say that’s especially the case with osteoarthritis — chronic degeneration of cartilage — in weight-bearing joints such as hips and knees.
“The relationship between obesity, diabetes, metabolic syndrome and the development of arthritis has been very well-defined,” said Dr. Richard Iorio, an orthopedic surgeon and a spokesman for the American Academy of Orthopaedic Surgeons.
"A year from now, ten, they'll swing back to the belief that they can make people…better. And I do not hold to that."
http://en.wikiquote.org/wiki/Serenity_(film)
Mal: This report is maybe twelve years old. Parliament buried it, and it stayed buried till River dug it up. This is what they feared she knew. And they were right to fear because there's a whole universe of folk who are gonna know it, too. They're gonna see it. Somebody has to speak for these people. You all got on this boat for different reasons, but you all come to the same place. So now I’m asking more of you than I have before. Maybe all. Sure as I know anything I know this, they will try again. Maybe on another world, maybe on this very ground swept clean. A year from now, ten, they'll swing back to the belief that they can make people…better. And I do not hold to that. So no more running. I aim to misbehave.
Serenity (film)
Serenity is a 2005 space western film which continues the canceled Fox science fiction television series Firefly, taking place about two months after the events of the final episode.
- Directed and written by Joss Whedon.
Mal: This report is maybe twelve years old. Parliament buried it, and it stayed buried till River dug it up. This is what they feared she knew. And they were right to fear because there's a whole universe of folk who are gonna know it, too. They're gonna see it. Somebody has to speak for these people. You all got on this boat for different reasons, but you all come to the same place. So now I’m asking more of you than I have before. Maybe all. Sure as I know anything I know this, they will try again. Maybe on another world, maybe on this very ground swept clean. A year from now, ten, they'll swing back to the belief that they can make people…better. And I do not hold to that. So no more running. I aim to misbehave.
Neuroeconomics
http://chronicle.com/article/The-Marketplace-in-Your-Brain/134524/
But an analysis of mainstream economics journals by Clement Levallois, a researcher at Erasmus University Rotterdam, in the Netherlands, is more pessimistic. He found about 200 articles, published over a recent 10-year period, that mentioned concepts in neuroscience or biology. But the terms they focused on were concepts like "genetics," rarely anything strongly tied to neuroeconomics, like specific parts of neuroanatomy that have been linked to decision-making, or words like "dopamine."
The reluctance isn't surprising, says Michael Woodford, a noted monetary theorist and professor of economics at Columbia University. "Economics is a field where there is a core of ideas developed during the 19th and 20th centuries that people agree are important," he says. "If you want to argue that something should be part of that core, the bar is going to be higher than in many other fields." For neuroeconomics, he adds, "that's a promise that has yet to be delivered on."
That's from someone who is beginning to use neuroeconomics in his own research. Woodford studies how people rank alternatives when making choices. So he has become very interested in perception—what information the brain gets about those choices. "That's the first step, happening before a decision is made," he says. "I'm trying to build mathematics into models that accounts for variance in people's perceptions." He's actually working on ways that backgrounds affect perceptions of brightness, but the principle could apply to how some people focus on the nicely sized bedrooms of a house that's for sale, for instance, while others fixate on its tiny yard. "Standard economic theory treats these things as anomalies, and we shrug it off. But what if we treated these as phenomena that help make sense of these choices?"
September 24, 2012
The Marketplace in Your Brain
Neuroscientists have found brain cells that compute value. Why are economists ignoring them?
By Josh Fischman
But an analysis of mainstream economics journals by Clement Levallois, a researcher at Erasmus University Rotterdam, in the Netherlands, is more pessimistic. He found about 200 articles, published over a recent 10-year period, that mentioned concepts in neuroscience or biology. But the terms they focused on were concepts like "genetics," rarely anything strongly tied to neuroeconomics, like specific parts of neuroanatomy that have been linked to decision-making, or words like "dopamine."
The reluctance isn't surprising, says Michael Woodford, a noted monetary theorist and professor of economics at Columbia University. "Economics is a field where there is a core of ideas developed during the 19th and 20th centuries that people agree are important," he says. "If you want to argue that something should be part of that core, the bar is going to be higher than in many other fields." For neuroeconomics, he adds, "that's a promise that has yet to be delivered on."
That's from someone who is beginning to use neuroeconomics in his own research. Woodford studies how people rank alternatives when making choices. So he has become very interested in perception—what information the brain gets about those choices. "That's the first step, happening before a decision is made," he says. "I'm trying to build mathematics into models that accounts for variance in people's perceptions." He's actually working on ways that backgrounds affect perceptions of brightness, but the principle could apply to how some people focus on the nicely sized bedrooms of a house that's for sale, for instance, while others fixate on its tiny yard. "Standard economic theory treats these things as anomalies, and we shrug it off. But what if we treated these as phenomena that help make sense of these choices?"
From the CDC: Health behaviors and cancer screening among Californians with a family history of cancer
http://www.ncbi.nlm.nih.gov/pubmed/23018750
Genet Med. 2012 Sep 27. doi: 10.1038/gim.2012.118. [Epub ahead of print]
Health behaviors and cancer screening among Californians with a family history of cancer.
Source
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract
Purpose: The purpose of this study was to compare health behaviors and cancer screening among Californians with and without a family history of cancer.
Methods: We analyzed data from the 2005 California Health Interview Survey to ascertain cancer screening test use and to estimate the prevalence of health behaviors that may reduce the risk of cancer. We used logistic regression to control for demographic factors and health-care access.
Results: Women with a family history of breast or ovarian cancer were more likely to be up to date with mammography as compared with women with no family history of cancer (odds ratio = 1.69, 95% confidence interval (1.39, 2.04)); their health behaviors were similar to other women. Men and women with a family history of colorectal cancer were more likely to be up to date with colorectal cancer screening as compared with individuals with no family history of cancer (odds ratio = 2.77, 95% confidence interval (2.20, 3.49)) but were less likely to have a body mass index <25 kg/m(2) (odds ratio = 0.80, 95% confidence interval (0.67, 0.94)).
Conclusion: Innovative methods are needed to encourage those with a moderate-to-strong familial risk for breast cancer and colorectal cancer to increase their physical activity levels, strive to maintain a healthy weight, quit smoking, and reduce alcohol use.
Brian Liang and Tim Mackey: Hit and run pharmacies
http://abcnews.go.com/Health/fda-warns-consumers-dangers-buying-prescription-drugs-online/story?id=17352895#.UGhwXrSzqSq
Just how easy is it to set up an online pharmacy?
Two University of California, San Diego medical researchers showed ABC News how they set up their own fake drug store using search engines, Facebook and Twitter to draw potential buyers, and no pharmaceutical degree or any medical license, is required to set up any of these websites.
Timothy Mackey, a doctoral student in the joint doctoral program between San Diego State University and the University of California, San Diego created a fake pharmacy in less than 15 minutes and for less than $80.
"We basically created a Web app which is very descriptive and has a medical professional, a picture of a person that we just purchased, and we were able to post it online without any verification or requirements at all," Mackey said.
A hit-and-run pharmacy is lightning fast to start and even faster to disappear -- all before authorities can catch up.
"The bad guys know when they're getting chased, so they just shut down with a minute, and then literally within another hour they've set themselves right back up again," said Brian Liang, head of the Center for Patient Safety at the University of California, San Diego School of Medicine. "What it's telling us is that there's clearly no enforcement, and Facebook and others in this space are making money off of illicit drug sales."
FDA: Beware Buying Prescription Drugs Online
Two University of California, San Diego medical researchers showed ABC News how they set up their own fake drug store using search engines, Facebook and Twitter to draw potential buyers, and no pharmaceutical degree or any medical license, is required to set up any of these websites.
Timothy Mackey, a doctoral student in the joint doctoral program between San Diego State University and the University of California, San Diego created a fake pharmacy in less than 15 minutes and for less than $80.
"We basically created a Web app which is very descriptive and has a medical professional, a picture of a person that we just purchased, and we were able to post it online without any verification or requirements at all," Mackey said.
A hit-and-run pharmacy is lightning fast to start and even faster to disappear -- all before authorities can catch up.
"The bad guys know when they're getting chased, so they just shut down with a minute, and then literally within another hour they've set themselves right back up again," said Brian Liang, head of the Center for Patient Safety at the University of California, San Diego School of Medicine. "What it's telling us is that there's clearly no enforcement, and Facebook and others in this space are making money off of illicit drug sales."
From Laval U-Quebec: Lay people's interpretation of ethical values related to mass vaccination
http://www.ncbi.nlm.nih.gov/pubmed/23016511
Health Expect. 2012 Sep 28. doi: 10.1111/hex.12005. [Epub ahead of print]
Lay people's interpretation of ethical values related to mass vaccination; the case of A(H1N1) vaccination campaign in the province of Quebec (French Canada).
Source
Department of Anthropology, Laval University, Quebec City, QC, Canada.
Abstract
BACKGROUND:
Pandemic influenza ethics frameworks are based on respect of values and principles such as regard for autonomy, responsibility, transparency, solidarity and social justice. However, very few studies have addressed the way in which the general population views these moral norms.
OBJECTIVES:
(i) To analyse the receptiveness of the population of French-speaking Quebecers to certain ethical principles promoted by public health authorities during the AH1N1 vaccination campaign. (ii) To add to the limited number of empirical studies that examine the population's perception of ethical values.
DESIGN:
Eight months after the end of the AH1N1 vaccination campaign in the Province of Quebec (Canada), 100 French-speaking Quebecers were assembled in ten focus groups. Discussions focussed on the level of respect shown by public health authorities for individual autonomy, the limits of appeals for solidarity, the balance between vaccination efficiency and social justice towards non-prioritized subpopulations, vaccination as a demonstration of civic duty and social responsibility.
RESULTS:
The population acknowledged a high level of individual responsibility towards family members and agreed to vaccination to protect children and ageing parents. However, the concepts of civic duty and solidarity did not elucidate unanimous support, despite the fact that social justice stood out as a dominant value of public morals.
CONCLUSION:
The ethical principles promoted in influenza pandemic ethics frameworks are subject to reinterpretation by the population. An ethic of public health must consider their understanding of the fundamental values that legitimize mass vaccination.
From Tarbiat Modares U-Iran: Exploring families' experiences of an organ donation request after brain death
http://www.ncbi.nlm.nih.gov/pubmed/22990425
Nurs Ethics. 2012 Sep;19(5):654-65.
Exploring families' experiences of an organ donation request after brain death.
Source
Faculty of Medical Sciences of Tarbiat Modares University, Iran.
Abstract
This qualitative research study with a content analysis approach aimed to explore families' experiences of an organ donation request after brain death. Data were collected through 38 unstructured and in-depth interviews with 14 consenting families and 12 who declined to donate organs. A purposeful sampling process began in October 2009 and ended in October 2010. Data analysis reached 10 categories and two major themes were listed as: 1)serenity in eternal freedom; and 2) resentful grief. The central themes were peace and honor versus doubt and regret. The findings indicated that the families faced with an organ donation request of a brain-dead loved one experienced a lasting effect long after the patient's demise regardless of their decision to donate or refusal to donate. In conclusion, this study highlights the importance of family support and follow-up in an efficient healthcare system aimed at developing trust with the families and providing comfort during and after the final decision.
Learning from Taiwan patient-safety reporting system
http://www.ncbi.nlm.nih.gov/pubmed/22999224
Int J Med Inform. 2012 Sep 19. pii: S1386-5056(12)00158-X. doi: 10.1016/j.ijmedinf.2012.08.007. [Epub ahead of print]
Learning from Taiwan patient-safety reporting system.
Source
Department of Computer Science and Information Engineering, Healthy Aging Research Center, Chang Gung University, Taiwan. Electronic address: cclin@mail.cgu.edu.tw.
Abstract
OBJECTIVE:
The aim of this study is to create a national database to record incidents that endanger patient safety. We try to identify systemic problems in hospitals in order to avoid safety incidents in the future and improve the quality of healthcare.
METHOD:
The Taiwan Patient Safety Reporting System employs a voluntary notification model. We define 13 types of patient safety incidents, and the reports of different types of incidents are recorded using common terminology. Statistical analysis is used to identify the incident type, time of occurrence, location, person who reported the incident, and possible reasons for frequently occurring incidents.
RESULTS:
There were 340 hospitals that joined this program from 2005 to 2010. Over 128,271 incident events were reported and analyzed. The three most common incidents were drug-related incidents, falls, and endo tube related incidents. By analyzing the time of occurrence of incidents, we found that drug-related incidents usually occurred between 8 and 10am. Falls and endo tube incidents usually occurred between 4 and 6am. The most common location was wards (57.6%), followed by intensive care areas (13.5%), and pharmacies (9.1%). Among hospital staff, nurses reported the highest number of incidents (68.9%), followed by pharmacists (14.5%) and administrative staff (5.5%). The number of incidents reported by doctors was much lower (1.2%). Most staff members who reported incidents had been working for less than five years (58.1%).
CONCLUSION:
The unified reporting system was found to improve the recording and analysis of patient safety incidents. To encourage hospital staff to report incidents, hospitals need to be assisted in establishing an internal report and management system for safety incidents. Hospitals also need a protection mechanism to allow staff members to report incidents without the fear of punishment. By identifying the root causes of safety incidents and sharing the lessons learned across hospitals is the only way such incidents can be stopped from happening again.
Why do patients engage in medical tourism?
http://www.ncbi.nlm.nih.gov/pubmed/23007007
Maturitas. 2012 Sep 21. pii: S0378-5122(12)00274-5. doi: 10.1016/j.maturitas.2012.08.011. [Epub ahead of print]
Why do patients engage in medical tourism?
Source
Globalization and Health Equity Research Unit, Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada.
Abstract
Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients' unmet need, the nature of services sought and the manner by which treatment is accessed. In order to beneficially employ the opportunities medical tourism offers, and address and contain possible threats and harms, an informed decision is crucial. This paper aims to enhance the current knowledge on medical tourism by isolating the focal content of the decisions that patients make. Based on the existing literature, it proposes a sequential decision-making process in opting for or against medical care abroad, and engaging in medical tourism, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care. Accordingly, it comments on the imperative of access to health information and the current regulatory environment which impact on this increasingly popular and complex form of accessing and providing medical care.
Method for developing national quality indicators based on manual data extraction from medical records
http://www.ncbi.nlm.nih.gov/pubmed/23015098
BMJ Qual Saf. 2012 Sep 26. [Epub ahead of print]
Method for developing national quality indicators based on manual data extraction from medical records.
Source
Inserm U988, Institut Gustave Roussy, Villejuif Cedex, France.
Abstract
Developing quality indicators (QI) for national purposes (eg, public disclosure, paying-for-performance) highlights the need to find accessible and reliable data sources for collecting standardised data. The most accurate and reliable data source for collecting clinical and organisational information still remains the medical record. Data collection from electronic medical records (EMR) would be far less burdensome than from paper medical records (PMR). However, the development of EMRs is costly and has suffered from low rates of adoption and barriers of usability even in developed countries. Currently, methods for producing national QIs based on the medical record rely on manual extraction from PMRs.We propose and illustrate such a method. These QIs display feasibility, reliability and discriminative power, and can be used to compare hospitals. They have been implemented nationwide in France since 2006. The method used to develop these QIs could be adapted for use in large-scale programmes of hospital regulation in other, including developing, countries.
Not your decision
http://www2.insidenova.com/news/2012/sep/30/marsha-mercer-nanny-state-vs-national-security-ar-2246266/
Marsha Mercer: Nanny state vs. national security
By: Marsha Mercer | Inside NoVA
Published: September 30, 2012
Published: September 30, 2012
"Does anyone really need more than 16 ounces of a soft drink at a time? The original Coca-Cola bottle held about 6 ounces. If you’re still thirsty, drink water."
Zombie allusions: They just keep on coming-Mais Oui!
http://www.ellookdelasfamosas.es/noticia/-ataque-zombie-en-paris_a1215/1
¡ATAQUE ZOMBIE EN PARÍS!
domingo 30 de septiembre 2012 - 15h42
Halloween está a la vuelta de la esquina, así que el desfile de Greth Pugh durante la Fashion Week de París nos ha parecido el lugar perfecto para empezar a buscar algo de inspiración estilo gore. Este particular desfile fue toda una nueva visión sobre el apocalipsis zombie...
Estilo parisino zombie-chic
El maquillaje de ojos rojo puede ser difícil de llevar bajo circunstancias normales, pero en un desfile o en una fiesta de Halloween se convierte más bien en un trato de belleza que en truco. La prueba: vimos al maquillador Karim Rahman crear un look similar total rojo para el desfile de Cédric Charlier esta semana... Ojos rojos, de una manera o de la otra, ¡parece que están de moda en la Fashion Week de París!
Evidentemente, el color combina perfectamente con el de la sangre falsa de los disfraces de Halloween. Lo que es más, si no estas preparada para apostar por un look totalmente apocalíptico, un maquillaje de ojos rojo bien aplicado puede darte ese toque zombie sutil que hará de ti la estrella de la fiesta.
The complex architecture of mycobacterial promoters
http://www.ncbi.nlm.nih.gov/pubmed/23017770
Tuberculosis (Edinb). 2012 Sep 24. pii: S1472-9792(12)00164-3. doi: 10.1016/j.tube.2012.08.003. [Epub ahead of print]
The complex architecture of mycobacterial promoters.
Source
DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 19063, Francie van Zijl Drive, Tygerberg 7505, South Africa. Electronic address: maen@sun.ac.za.
Abstract
The genus Mycobacterium includes a variety of species with differing phenotypic properties, including growth rate, pathogenicity and environment- and host-specificity. Although many mycobacterial species have been extensively studied and their genomes sequenced, the reasons for phenotypic variation between closely related species remain unclear. Variation in gene expression may contribute to these characteristics and enable the bacteria to respond to changing environmental conditions. Gene expression is controlled primarily at the level of transcription, where the main element of regulation is the promoter. Transcriptional regulation and associated promoter sequences have been studied extensively in E. coli. This review describes the complex structure and characteristics of mycobacterial promoters, in comparison to the classical E. coli prokaryotic promoter structure. Some components of mycobacterial promoters are similar to those of E. coli. These include the predominant guanine residue at the transcriptional start point, conserved -10 hexamer, similar interhexameric distances, the use of ATG as a start codon, the guanine- and adenine-rich ribosome binding site and the presence of extended -10 (TGn) motifs in strong promoters. However, these components are much more variable in sequence in mycobacterial promoters and no conserved -35 hexamer sequence (clearly defined in E. coli) can be identified. This may be a result of the high G+C content of mycobacterial genomes, as well as the large number of sigma factors present in mycobacteria, which may recognise different promoter sequences. Mycobacteria possess a complex transcriptional regulatory network. Numerous regulatory motifs have been identified in mycobacterial promoters, predominantly in the interhexameric region. These are bound by specific transcriptional regulators in response to environmental changes. The combination of specific promoter sequences, transcriptional regulators and a variety of sigma factors enables rapid and specific responses to diverse conditions and different stages of infection. This review aims to provide an overview of the complex architecture of mycobacterial transcriptional regulation.
HIV/AIDS in South Africa: "Few very young children accessed ART in either clinic and those who did were already very ill"
http://www.ncbi.nlm.nih.gov/pubmed/23014517
AIDS. 2012 Sep 25. [Epub ahead of print]
Cost and outcomes of paediatric antiretroviral treatment in South Africa.
Source
aCenter for Global Health and Development, Boston University, US bHealth Economics and Epidemiology Research Office (HE2RO), Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa cDepartment of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa dEmpilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Johannesburg, SouthAfrica eWits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
Abstract
OBJECTIVE:
Little is known about the cost of paediatric antiretroviral treatment (ART) in low- and middle-income countries. We analysed the average cost of providing paediatric ART in South Africa during the first two years after ART initiation, stratified by patient outcomes.
METHODS:
We collected data on outpatient resource use and treatment outcomes of 288 children in two Johannesburg public hospitals, Empilweni Services and Research Unit (ESRU) and Harriet Shezi Children's Clinic (HSCC) from 2005 and 2009. Patient-level resource use was estimated from patient records. Unit cost data came from site accounts and public-sector sources. Patient outcomes at month 12 and 24 after initiation were defined based on weights, CD4 cell counts/percentages, viral loads, and the presence of new WHO stage 3/4 conditions.
RESULTS:
Median age/mean CD4 percentage at initiation were 4.03 years/13.23% in ESRU and 5.84 years/14.61% in HSCC, respectively. 62% and 91% of patients remained in care and responding to treatment at month 12 in ESRU and HSCC, respectively, and 68% and 80% at month 24. The average cost per patient in care and responding was $830 in year 1 and $717 in year 2 in ESRU and $678 and $782 in HSCC. ARV drugs comprised 33-52% of total cost, clinic visits 23-31%, lab tests 12-16%, and fixed costs 8-18%.
CONCLUSIONS:
Costs varied between the two clinics but were comparable to those of adult ART. Few very young children accessed ART in either clinic and those who did were already very ill, emphasizing the importance of early infant treatment.
Hospice-palliative care: "many countries still have no provision"
http://www.ncbi.nlm.nih.gov/pubmed/23017628
J Pain Symptom Manage. 2012 Sep 24. pii: S0885-3924(12)00334-X. doi: 10.1016/j.jpainsymman.2012.05.011. [Epub ahead of print]
Mapping Levels of Palliative Care Development: A Global Update.
Source
International Observatory on End of Life Care, Lancaster University, Lancaster, United Kingdom. Electronic address: t.lynch@lancaster.ac.uk.
Abstract
Our purpose is to categorize palliative care development, country-by-country, throughout the world, showing changes over time. We adopt a multi-method approach. Development is categorized using a six-part typology: Group 1 (no known hospice-palliative care activity) and Group 2 (capacity-building activity) are the same as developed during a previous study (2006), but Groups 3 and 4 have been subdivided to produce two additional levels of categorization: 3a) Isolated palliative care provision, 3b) Generalized palliative care provision, 4a) Countries where hospice-palliative care services are at a stage of preliminary integration into mainstream service provision, and 4b) Countries where hospice-palliative care services are at a stage of advanced integration into mainstream service provision. In 2011, 136 of the world's 234 countries (58%) had at least one palliative care service-an increase of 21 (+9%) from 2006, with the most significant gains having been made in Africa. Advanced integration of palliative care has been achieved in only 20 countries (8.5%). Total countries in each category are as follows: Group 1, 75 (32%); Group 2, 23 (10%); Group 3a, 74 (31.6%); Group 3b, 17 (7.3%); Group 4a, 25 (10.7%); and Group 4b, 20 (8.5%). Ratio of services to population among Group 4a/4b countries ranges from 1:34,000 (in Austria) to 1:8.5 million (in China); among Group 3a/3b countries from 1:1000 (in Niue) to 1:90 million (in Pakistan). Although more than half of the world's countries have a palliative care service, many countries still have no provision, and major increases are needed before palliative care is generally accessible worldwide.
"The past 2 decades have heralded notable success in efforts to control sleeping sickness...in Africa"
http://www.ncbi.nlm.nih.gov/pubmed/23017376
Emerg Infect Dis. 2012 Oct;18(10):1686-7. doi: 10.3201/eid1810.111213.
Trypanososma brucei rhodesiense Sleeping Sickness, Uganda.
Abstract
TO THE EDITOR: The past 2 decades have heralded notable success in efforts to control sleeping sickness (human African trypanosomiasis [HAT]) in Africa. HAT is a neglected tropical disease with major public health and economic effects in sub-Saharan Africa, and its effects on livestock productivity and development are considered major constraints to alleviating poverty in this region (1,2). Because of concerted and coordinated continental control efforts, its incidence has steadily decreased.
"the malaria parasite, Plasmodium vivax, is endemic in west and central Africa, a region from which it was previously thought to be almost completely absent"
http://www.ncbi.nlm.nih.gov/pubmed/23017235
Int J Parasitol. 2012 Sep 24. pii: S0020-7519(12)00219-6. doi: 10.1016/j.ijpara.2012.08.005. [Epub ahead of print]
African Plasmodium vivax: Distribution and origins.
Source
Malaria Unit, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan. Electronic address: richard@nagasaki-u.ac.jp.
Abstract
There is increasing evidence that the malaria parasite, Plasmodium vivax, is endemic in west and central Africa, a region from which it was previously thought to be almost completely absent due to the very high prevalence of the Duffy negative phenotype in the local human populations. Furthermore, P. vivax, or very closely related parasites, has been identified in both chimpanzees and gorillas from this region. In this review, we discuss the implications of these findings for the current understanding of the origins of P. vivax as a human parasite. With the support of new evidence from mitochondrial genome sequencing, we propose that the evidence is consistent with current, extant P. vivax populations having their origins in Africa.
"late presentation and tuberculosis continue to fuel the HIV/AIDS pandemic in Africa"
http://www.ncbi.nlm.nih.gov/pubmed/23019521
AIDS Res Treat. 2012;2012:940580. Epub 2012 Sep 17.
Morbidity and Mortality Patterns of Hospitalised Adult HIV/AIDS Patients in the Era of Highly Active Antiretroviral Therapy: A 4-year Retrospective Review from Zaria, Northern Nigeria.
Ogoina D, Obiako RO, Muktar HM, Adeiza M, Babadoko A, Hassan A, Bansi I, Iheonye H, Iyanda M, Tabi-Ajayi E.
Source
Department of Medicine, Niger Delta University, PMB 071, Amassoma, Bayelsa State, Nigeria ; Department of Medicine, Ahmadu Bello University Teaching Hospital, PMB 06, Zaria, Kaduna State, Nigeria.
Abstract
Background. This study, undertaken in major tertiary hospital in northern Nigeria, examined the morbidity and mortality patterns of hospitalised adult HIV/AIDS patients in the HAART era.
Methods. Between January 2006 and December 2009, admission records and causes of deaths of hospitalised medical HIV-infected patients were retrieved and analysed according to antiretroviral (ART) status.
Results. Of the 207 HIV/AIDS patients reviewed, majority were newly diagnosed (73.4%), and most were hospitalised and died from various AIDS-defining illnesses, mainly disseminated tuberculosis and sepsis. Immune-inflammatory-reconstitution-syndrome, ART-toxicity and ART-failure, contributed to morbidity and mortality in patients receiving ART. Sixty six (31.9%) patients died, with higher mortality in males and in those with lower CD4-cell count, lower PCV, and shorter hospital stay. However, hospital stay ≤3 days and severe anaemia (PCV < 24%) were independent predictors of mortality.
Conclusion. In the current HAART era, late presentation and tuberculosis continue to fuel the HIV/AIDS pandemic in Africa, with emerging challenges due to ART-related complications.
Frailty in HIV-infected adults in South Africa
http://www.ncbi.nlm.nih.gov/pubmed/23018372
J Acquir Immune Defic Syndr. 2012 Sep 26. [Epub ahead of print]
Frailty in HIV-infected adults in South Africa.
Source
1International Centre for Eye Health, Dept of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. 2MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK 3Dept. of Ophthalmology, Faculty of Health Sciences, University of Cape Town, H53 Old Main Building, Groote Schuur Hospital, Observatory 7925, Cape Town, SouthAfrica. 4Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa. 5Dept. of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Abstract
OBJECTIVES:
Some evidence suggests that HIV infection is associated with premature frailty -a syndrome typically viewed as being related to ageing. We determined the prevalence and predictors of frailty in a population of HIV-infected individuals in South Africa.
DESIGN:
Case-control study of 504 adults over the age of 30 years, composed of 248 HIV-infected adults and 256 age- and gender- frequency-matched HIV-seronegative individuals.
METHODS:
Frailty was defined by standardized assessment comprised of ≥3 of: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Independent predictors of frailty were evaluated using multivariable logistic regression.
RESULTS:
The mean ages of the HIV-infected and HIV-seronegative groups were 41.1±7.9 years and 42.6±9.6 years respectively. Of the HIV-infected adults, 87.1% were receiving antiretroviral treatment (ART) (median duration, 58 months), their median CD4 count was 468 cells/μL (IQR:325-607 cells/μL) and 84.3% had undetectable plasma viral load. HIV-infected adults were more likely to be frail than HIV-seronegative individuals (19.4% vs.13.3%;p=0.07), and this association persisted after adjustment for confounding variables (adjusted odds ratio [OR] 2.14; 95% confidence interval [95%CI]: 1.16-3.92, p=0.01). Among HIV-infected individuals, older age was a strong predictor of frailty, especially among women (women: OR=2.55 per 10-year age increase; men: OR=1.29 per 10 year age increase, p-interaction=0.01). Lower current CD4 count (<500 cells/μL) was also independently associated with frailty (OR=2.84;95%CI:1.02-7.92, p=0.04).
CONCLUSION:
HIV infection is associated with premature development of frailty, especially in women. Since higher CD4 counts were associated with lower risk of frailty, earlier initiation of ART may be protective.
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