Exclusive: ‘Workplace wellness’ fails bottom line, waistlines – RAND

By robinlee ~ May 25th, 2013 @ 10:01 pm No Comments »


NEW YORK |
Fri May 24, 2013 6:39pm EDT

(Reuters) – A long-awaited report on workplace wellness programs, which has still not been publicly released, delivers a blow to the increasingly popular efforts, Reuters has learned, casting doubt on a pillar of the Affordable Care Act and a favorite of the business community.

According to a report by researchers at the RAND Corp, programs that try to get employees to become healthier and reduce medical costs have only a modest effect. Those findings run contrary to claims by the mostly small firms that sell workplace wellness to companies ranging from corporate titans to mom-and-pop operations.

RAND delivered the congressionally mandated analysis to the U.S. Department of Labor and the Department of Health and Human Services last fall.

The report found, for instance, that people who participate in such programs lose an average of only one pound a year for three years.

In addition, participation “was not associated with significant reductions in total cholesterol level.” And while there is some evidence that smoking-cessation programs work, they do so only “in the short term.”

Most large U.S. employers believe the programs improve workers’ health and reduce or at least keep the lid on medical spending. “Companies from the CEO on down feel that these programs are bringing value,” said Maria Ghazal, a vice president at the Business Roundtable, the association of chief executives of big companies. “The criticism is surprising, because companies are not hearing that internally.”

Some experts not involved with the new report say even the modest benefits RAND found need qualification.

“The strongest predictor of whether someone will lose weight or stop smoking is how motivated they are,” said Al Lewis, founder and president of the Disease Management Purchasing Consortium International, which helps self-insured employers and state programs reduce healthcare costs. “Since the programs are usually voluntary, the most motivated employees sign up. That makes it impossible to credit the programs with success in smoking cessation or weight loss rather than the employees’ motivation.”

For its report, RAND collected information about wellness programs from about 600 businesses with at least 50 employees and analyzed medical claims collected by the Care Continuum Alliance, a trade association for the health and wellness industry.

Industry experts noted that whenever researchers analyze hundreds of programs, there are inevitably more effective and less effective ones.

“Traditional workplace wellness barely scratches the surface,” said Keith Lemer, president of WellNet, which provides programs to Cumulus Media, Viking Range Corp and the Charlie Palmer Group of restaurants, among others. “Done right, (the program) requires the integration of clinical data, wellness, health coaching, and work flow.” The initiatives succeed if they have “senior level support and a high-degree of employee engagement in healthy behaviors,” he said.

SAVINGS OF $ 2.38 A MONTH

The report’s conclusions about the financial benefits of workplace wellness programs are also grim. In theory, the programs should reduce medical spending as employees become healthier and thereby avoid expensive conditions such as heart disease, cancer and stroke.

In fact, workers who participated in a wellness program had healthcare costs averaging $ 2.38 less per month than non-participants in the first year of the program and $ 3.46 less in the fifth year. Those modest savings were not statistically significant, meaning they could have been due to chance and not to the program.

More surprisingly, workplace wellness did not catch warning signs of disease or improve health enough to prevent emergencies. “We do not detect statistically significant decreases in cost and use of emergency department and hospital care” as a result of the programs, RAND found.

The RAND report was mandated by the Affordable Care Act, the healthcare reform law known as Obamacare. Two sources close to the report expected it to be released publicly this past winter. Reuters read the report when it was briefly posted online by RAND on Friday before being taken down because the federal agencies were not ready to release it, said a third source with knowledge of the analysis.

FROM SUBISIDY TO PENALTY

Starting next year, the healthcare reform law allows employers to reward employees who participate in workplace wellness programs with subsidies equal to 30 percent of the cost of insurance premiums, or about $ 1,620 annually per worker.

If wellness programs do not reduce healthcare spending, some employees could suffer financially. If an employer is subsidizing employees who use its program but is not reaping lower healthcare costs, it has three choices. It can absorb the costs, perhaps figuring it helps recruit or retain valued employees. It can raise healthcare premiums across the board. Or it can raise costs only to workers who do not participate, through higher deductibles or premiums, by at least that $ 1,620.

Cost-shifting seems especially unfair if wellness programs don’t deliver medically or financially, said senior counsel Dania Palanker of the National Women’s Law Center, which generally supports the programs: “We’ve seen plans that appear to cost-shift, with wellness programs rolled out at the same time that premiums or deductibles are increased.”

$ 6 BILLION INDUSTRY

Workplace wellness is a $ 6 billion industry in the United States, with an estimated 500 vendors now selling the programs. Fifty-one percent of employers with 50 or more workers offer one, the RAND report found. Medium-to-large companies now spend an average of $ 521 per employee per year on wellness incentives (gift cards for losing weight, for instance), double the $ 260 in 2009, according to a survey by Fidelity Investments and the National Business Group on Health released in February.

For many employers, wellness programs are a recruiting and retention tool, attracting the health-conscious employees they prefer. The programs also promise to control an employer’s healthcare spending. By getting workers to stop smoking they should reduce expensive emphysema treatments, for instance, and by nudging workers to get annual physicals they are expected to help companies avoid such financial black holes as cancer treatment and stroke rehabilitation.

Although the RAND report’s conclusions seem counterintuitive – how can wellness programs not improve health? – other recent studies agree.

This year researchers at the University of California conducted an analysis of dozens of existing studies of workplace wellness programs at the behest of the California state senate. Based on gold-standard studies, similar to those that evaluate a new drug, participating in work-based wellness programs does not lower blood pressure, blood sugar or cholesterol and rarely leads to weight loss, said Janet Coffman, a health policy expert at the University of California, San Francisco, Institute for Health Policy Studies.

“Even in studies that found statistically significant weight loss, it was not always sustained,” she said.

Similarly, after years in which vendors and others claimed that the programs return $ 3, $ 9 and more for every $ 1 invested, rigorous studies have found the opposite, also providing support for the RAND findings.

Earlier this year, economist Gautam Gowrisankaran of the University of Arizona and colleagues found that employees who participated in the wellness program at BJC Healthcare, a St. Louis, Missouri-based hospital system, had fewer hospitalizations for illnesses such as heart disease and diabetes. But their overall spending did not decrease, the researchers reported in the journal Health Affairs.

The main reasons, said Gowrisankaran, were that employees who fill out company surveys assessing their health risks (“what is your blood pressure?”) or get health screenings at company-sponsored health fairs (“you better see a doctor about that”) led to more office visits and medication use. In-patient costs fell $ 22 per employee per month, on average, but other costs rose $ 19. The program cost $ 500,000 per year.

“The wellness program just didn’t save money,” Gowrisankaran said.

To understand how that can be, experts offer the example of what happens when a workplace wellness program identifies hypertension (by requiring participants to get a physical) in someone who never suspected she had it. That might keep her from having a stroke in 20 years, but in the meantime it leads to physician visits and drugs to manage a condition that had gone untreated – and that therefore had previously cost the company or its insurer nothing, explained Vik Khanna, a benefits consultant in St. Louis.

Employers told RAND they were “overwhelmingly” confident that workplace wellness reduces medical costs. Yet only 44 percent have actually evaluated their efforts, and only 2 percent had precise savings estimates. Most leave those calculations to companies that sell them the programs, or to consultants, opening the door to creative accounting, say skeptics.

Tom Emerick, president of Emerick Consulting and former vice president of global benefits at Walmart, is one of them: “Many of the vendors reporting savings are making it up.”

Ghazal of the Business Roundtable acknowledged that calculating savings from wellness programs is tricky: “Sometimes the benefits are way down the road, when the person is not at that employer anymore.”

On the bright side, the RAND report says healthcare costs and use of expensive medical services rose more slowly for program participants than nonparticipants. That offers hope “that a reduction in direct medical costs would materialize if employees continued to participate.”

(Reporting by Sharon Begley; editing by Prudence Crowther)


Reuters: Health News

Medicaid Opposition Underscores States’ Healthcare Disparities — Los Angeles Times

By robinlee ~ May 25th, 2013 @ 6:54 pm No Comments »

“It turns out that we are only 10 percent human: for every human cell that is intrinsic to our body, there are about 10 resident microbes…To the extent that we are bearers of genetic information, more than 99 percent of it is microbial. And it appears increasingly likely that this ‘second genome,’ as it is sometimes called, exerts an influence on our health as great and possibly even greater than the genes we inherit from our parents. But while your inherited genes are more or less fixed, it may be possible to reshape, even cultivate, your second genome…This humbling new way of thinking about the self has large implications for human and microbial health, which turn out to be inextricably linked. Disorders in our internal ecosystem…may predispose us to…a whole range of chronic diseases, as well as some infections. ‘Fecal transplants,’ which involve installing a healthy person’s microbiota into a sick person’s gut, have been shown to effectively treat an antibiotic-resistant intestinal pathogen named C. difficile, which kills 14,000 Americans each year. (Researchers use the word ‘microbiota’ to refer to all the microbes in a community and ‘microbiome’ to refer to their collective genes.)…Our resident microbes also appear to play a critical role in training and modulating our immune system, helping it to accurately distinguish between friend and foe…Yet whether any cures emerge from the exploration of the second genome, the implications of what has already been learned…are difficult to overstate…Human health should now ‘be thought of as a collective property of the human-associated microbiota,’ as one group of researchers recently concluded…that is, as a function of the community, not the individual.”

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(Los Angeles Times, May 23, 2013)
“California received better-than-expected insurance rates for a new state-run marketplace…[as] the state unveiled the first details…on what many Californians can expect to pay for coverage from 13 health plans offering policies in the state’s exchange, in which as many as 5 million people will shop for coverage next year. Developments in California are being watched carefully around the country as an important indicator of whether the healthcare law can deliver on its promise to expand health coverage at an affordable price…The health plans selected by the state will sell uniform benefits, each offering four broad categories of coverage called Platinum, Gold, Silver and Bronze.”
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Related story:
Oregon’s 2014 Health Premium Filings Spark Relief, Questions

(The Oregonian, May 21, 2013)

US Won’t Mirror Massachusetts on Health Exchanges

(The Boston Globe, May 20, 2013)



(The New York Times, May 20, 2013)
“Emergency rooms [E.R.'s] account for about half of the nation’s hospital admissions and accounted for virtually all of the rise in admissions between 2003 and 2009…Although emergency rooms are widely considered expensive places for diagnostic care, physicians are increasingly relying on them to determine whether a patient needs to be hospitalized. The study’s findings raise important questions about how emergency rooms contribute to high health care costs in the United States and what their role will be in the future as the nation undergoes fundamental changes in health care delivery. One goal of the…health care law was to reduce reliance on costly emergency room care.”
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(Los Angeles Times, May 18, 2013)
“[M]ost state leaders who are fighting the Medicaid expansion have advanced few alternative plans to tackle their states’ health shortfalls. That means that…America’s unhealthiest states could fall even further behind as the Affordable Care Act is implemented…The architects of the 2010 healthcare law hoped it would help shrink many of these disparities by guaranteeing basic health protections to all Americans no matter where they live. Medicaid, which is jointly funded by state and federal governments, requires states to cover only certain vulnerable groups…Some states have expanded their programs while others have not, contributing to wide differences in health coverage.”
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Related graphic:
A Division on Healthcare
(Los Angeles Times, May 18, 2013)

See also:
Increase in Doctors’ Pay for Medicaid Services Off to a Slow Start


(The Washington Post, May 18, 2013)



(Associated Press, May 23, 2013)
“International efforts to combat a new pneumonia-like virus [called MERS for Middle East respiratory syndrome]…are being slowed by unclear rules and competition for the potentially profitable rights to disease samples, the head of the World Health Organization [WHO] warned…Dr. Margaret Chan, in a blunt warning to the U.N. agency’s annual global assembly, portrayed a previously little-known flap over who owns a sample of the virus as a global game-changer that could put people’s lives at risk…Saudi Arabia, which had the first case, said the patenting delayed its development of diagnostic kits and blood tests…Chan railed against any arrangement that could prevent rapid sharing of information or that would enable individual…[or] labs to profit.”



(The Wall Street Journal, New York, May 21, 2013)
“A 66-year-old Tunisian man who died after returning from a pilgrimage to the Saudi holy city of Mecca is likely to have been sickened by a SARS-like virus and two of his children tested positive for the virus, Tunisian and World Health Organization officials said…The cases mark the ninth country, and third continent, on which the year-old novel coronavirus has been confirmed. They also are the second time a pilgrim to Mecca has fallen ill with the virus…The new infections show the virus continues to spread into new countries, raising concern ahead of the peak Islamic pilgrimage periods…They also raise concerns over how easily the virus is being transferred between people.”
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(Reuters, May 21, 2013)
“The H7N9 virus appears to have been brought under control in China largely due to restrictions at bird markets, but caused some $ 6.5 billion in losses to the economy, U.N. experts said…Health authorities worldwide must be on the lookout to detect the virus, the experts said, which could still develop the ability to spread easily among humans and cause a deadly influenza pandemic. The new bird flu virus is known to have infected 130 people in mainland China since emerging in March, including 36 who died, but no cases have been detected since early May, Health Minister Li Bin told a meeting of the World Health Organization.”



(Associated Press, May 20, 2013)
“More than a decade ago, British parents refused to give measles shots to at least a million children because of a vaccine scare that raised the specter of autism. Now, health officials are scrambling to catch up and stop a growing epidemic of the contagious disease. This year, the U.K. has had more than 1,200 cases of measles, after a record number of nearly 2,000 cases last year. The country once recorded only several dozen cases every year…Last month, emergency vaccination clinics were held every weekend in Wales, the epicenter of the outbreak. Immunization drives have also started elsewhere in the country, with officials aiming to reach 1 million children aged 10 to 16.”



(The Detroit News, May 23, 2013)
“[The new] head [of] the [U.S.] Transportation Department vowed to keep up the government’s fight against distracted driving. Charlotte Mayor Anthony Foxx…said he would continue [Ray] LaHood’s aggressive campaign to convince drivers to stop texting and making hand-held calls behind the wheel…He noted that studies show about 10 percent of traffic deaths are linked to distracted driving…Last month, the National Highway Traffic Safety Administration released new guidelines that discourage carmakers from installing any devices that allow drivers to enter text for Internet browsing or text messaging. The guidelines also recommend against in-car devices that display Web page content, text messages and other similar content.”

See also:
Harvard Scholar Working With Hollywood to Curb Distracted Driving

(Boston Magazine, online, May 23, 2013)



(The Boston Globe, May 22, 2013)
“Boston bicycle advocacy officials said they will study safety concerns as enthusiasts demanded action after six riders were killed locally in the past year and a half — including a woman last weekend. The annual ['State of the Hub'] biking summit…also comes [days] after the city unveiled a number of recommendations to improve bike safety in Boston, prompted by a city-commissioned study that researched data on past bicycle collisions…The data seek to help Mayor Thomas M. Menino reach his goal of cutting the cyclist crash injury rate by 50 percent by 2020, and expand bicycling as a transportation mode to 10 percent by then.”
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Related story:
Boston Bicyclists Flex Political Clout

(Boston Herald, May 22, 2013)

Related opinion:
As Crashes Mount, City Must Get Serious About Bike Safety
(The Boston Globe, May 22, 2013)



(Associated Press, May 21, 2013)
“The decade-old law that transformed the battle against HIV and AIDS in developing countries is at a crossroads…The President’s Emergency Plan for AIDS Relief [PEPFAR] grew out of an unlikely partnership…[and] has come to represent what Washington can do when it puts politics aside — and what America can do to make the world a better place… [PEPFAR’s] future, however, is uncertain…funding for the relief plan’s bilateral efforts has dipped in recent years…The AIDS program is also trying to find a balance between its goals of reaching more people with its prevention and treatment programs and turning over more responsibility to the host nations where it operates.”



(The New York Times, May 19, 2013)
“A surge in H.I.V. infections on the Navajo reservation [in New Mexico]…has doctors and public health workers increasingly alarmed that the [human immunodeficiency] virus [HIV] that causes AIDS has resurfaced with renewed intensity in this impoverished region…new [HIV] diagnoses…[were] up 20 percent [in 2012] from 2011…[and] represents the highest annual number recorded among the tribe…And though the numbers are still comparatively low…the challenges of prevention are amplified…Mindful of those challenges, the Indian Health Service allocated $ 5 million over the past three years for communities to create H.I.V. prevention, treatment and education programs.”
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(The Wall Street Journal, New York, May 21, 2013)
“Salt Lake City-based nonprofit group of 22 hospitals and 185 clinics [Intermountain Healthcare] is launching the first major system of its kind to measure and report patients’ cumulative medical radiation exposure from tests that deliver the highest amount of radiation. This includes CT scans, nuclear medicine scans and interventional radiology exams for the heart. In addition to educating doctors and patients about the risks and benefits of medical radiation, Intermountain will allow them to access their exposure data via its electronic health record.”
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(The Wall Street Journal, New York, May 20, 2013)
“In women with the densest breasts, mammography misses about half of cancers. Ultrasound…catches two to four additional cancers per thousand women who get it — but at the price of many false alarms…California, Connecticut, Hawaii, Maryland, New York, Texas and Virginia…[each] have…dense-breast notification laws…of these states [some] require doctors to notify women in writing if their mammogram finds they have dense breasts, while others simply mandate that information about dense breasts in general be sent to [these] women…The larger question is whether women who are told they have dense breasts should get additional imaging to screen for cancer.”
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Related graphic:
Why It Matters
(The Wall Street Journal, New York, May 20, 2013)



(USA Today, May 23, 2013)
“Students should be doing at least 60 minutes of vigorous or moderate-intensity physical activity at school, with more than half of the activity occurring during regular educational hours and the remaining amount before and after school, says a report…by the [U.S.] Institute of Medicine…only about half of U.S. kids meet the government’s physical-activity guideline of doing at least 60 minutes of vigorous or moderate-intensity physical activity every day…School is the best place for kids to be physically active…[but at] many schools, physical-education [PE] classes and recess have been squeezed out because of increasing educational demands and tough financial times.”



(The Associated Press, May 20, 2013)
“Until now, the only way to find out what people in the United States eat and how many calories they consume has been government data…Researchers from the University of North Carolina at Chapel Hill are trying to change that by creating a…map of what foods Americans are buying and eating. Part of the uniqueness of the database is its ability to sort one product into what it really is — thousands of brands and variations…It’s a massive project that could be the first evidence of how rapidly the marketplace is changing, and the best data yet on what exact ingredients and nutrients people are consuming. That kind of information could be used to better target nutritional guidelines, push companies to cut down on certain ingredients and even help with disease research.”



(Inter Press Service, May 19, 2013)
“The disease itself may not discriminate on the basis of gender, but when it comes to healthcare for patients with diabetes, women in India find themselves at a disadvantage…[analyzing] gender roles, norms and values in a household…[the study] found women patients to be more vulnerable. And this vulnerability influences all phases of diabetic care…Of particular concern…in the country is Gestational Diabetes Mellitus (GDM), a form of the disease that affects pregnant women…And women with GDM were at higher risk of developing diabetes later in life…Close to 70 million people — half of them women — in this country of 1.21 billion are living with diabetes, and the number is predicted to go up to 101.2 million by 2030.”



(The New York Times, May 18, 2013)
“A growing body of mortality research on immigrants has shown that the longer they live in this country, the worse their rates of heart disease, high blood pressure and diabetes. And while their American-born children may have more money, they tend to live shorter lives than the parents. The pattern goes against any notion that moving to America improves every aspect of life. It also demonstrates that at least in terms of health, worries about assimilation for the country’s 11 million illegal immigrants are mistaken. In fact, it is happening all too quickly.”
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(The Tennessean, May 23, 2013)
“As sex trafficking has garnered newfound attention, Tennessee has developed one of the nation’s most comprehensive anti-trafficking programs. An additional 12 new laws approved by lawmakers this year include harsher criminal penalties on traffickers, an extended window of time for prosecutors to bring charges and the creation of a state trafficking task force to study and respond to the issue. The measures amplify a wave of attention since a statewide study in 2011 documented incidents of sex trafficking — which officials define as coercive adult prostitution and any sexual exploitation of children.”



(The Toronto Star, May 21, 2013)
“Suicide is contagious among youth for at least two years, a new study shows. When children commit suicide, their school peers are more likely to consider or attempt suicide, the study…concluded…Dr. Ian Colman, Canada Research Chair in Mental Health Epidemiology and senior author of the study, said the results were ‘shocking’ and should influence the way school boards handle grief counselling…The theory of ‘suicide contagion’ isn’t new, added Colman, but his study also shows it can last for more than two years, a frightening revelation.”


(The Economist, London, May 18, 2013)
“[T]he DSM [Diagnostic and Statistical Manual of Mental Disorders]…has become the global standard for the description of mental illness…[it's used by insurers] to decide whether or not to cover ailments. And diagnoses based on it determine whether people get special services…qualify for disability benefits…[or] even whether they are able to adopt children…The DSM’s purpose is to set strict criteria for identifying mental disorders…to make diagnoses more reliable…To that end, more than 1,500 experts have spent over a decade laboring [to complete the Fifth Edition (DSM-5)]…[but to] many critics it is a vehicle for misdiagnosis, overdiagnosis, the medicalisation of normal behaviour and the prescription of a large number of unnecessary drugs.”
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(CNN.com, May 23, 2013)
“[In] a culture where a woman’s status and dignity is decided by her ability to provide a husband with multiple children, it can be a fate worse than death…An obstetric fistula occurs when a woman withstands days of obstructed labor, when a baby’s head is constantly pushing against her pelvic bone during contractions — preventing blood flow and causing tissue to die. This creates a hole, or a ‘fistula,’ between a woman’s vagina and her bladder or rectum…an estimated 2 million women in Asia and sub-Saharan Africa live with untreated obstetric fistula…In most cases, a woman with a fistula doesn’t know what a fistula is or that it’s treatable with surgery. And if she does, she is far from any hospital and doesn’t have money.”



(The Republic, Arizona, May 22, 2013)
“The 9th U.S. Circuit Court of Appeals…ruled that Arizona’s law treads into territory that the U.S. Supreme Court has consistently kept off-limits since 1973’s Roe vs. Wade, including in a 2007 ruling. ‘Arizona simply cannot proscribe a woman from choosing to obtain an abortion before the fetus is viable,’ the three-judge panel wrote. The Arizona law, which Gov. Jan Brewer signed in April 2012, banned abortions after the 20th week of pregnancy. The only exception was for a medical emergency that would imperil the life of the woman…Since passage of the Arizona law, other states, including Arkansas and North Dakota, have enacted more-restrictive laws on abortion.”

Related story:
Arkansas Law Limiting Abortions at 12th Week Is Blocked


(Bloomberg, May 18, 2013)



(Inter Press Service, May 21, 2013)
“When thousands of participants from around the world gather in the Malaysian capital of Kuala Lumpur next week, the primary focus will be on health and empowerment of girls and women. The meeting…will zero in on a longstanding unanswered question: how does the international community meet the massive unmet needs for contraception by over 222 million women in the developing world? The U.N. Population Fund (UNFPA) points out that increased contraceptive use and reduced unmet needs for contraception are central to achieving three of the U.N.’s Millennium Development Goals (MDGs) — improving maternal health, reducing child mortality and combating HIV/AIDS.”

Related story:
Poor Countries Lack Modern Contraception

(Voice of America, May 20, 2013)


(The Economist, London, May 18, 2013)
“Even in rich countries childbirth is not a tidy affair. On an earthen floor in a dimly lit home in Bangladesh it can be a killer. Bangladesh has nevertheless reduced maternal deaths during childbirth by 40%…during the first decade of this century. It has done so in several ways: by encouraging women to give birth in hospitals and clinics; by giving better training to the women who act as informal midwives for those who give birth at home; and by improving obstetric treatment when things go wrong. When exactly things are going wrong, though, is not always obvious. In particular, the blood of a healthy birth can be hard to distinguish from the blood of a life-threatening haemorrhage.”
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(The Wall Street Journal, New York, May 21, 2013)
“The recent outburst of deadly tornadoes highlights the scientific scramble to detect these violent seasonal storms more quickly to add precious minutes to warnings. An alert from the National Weather Service…gave people in Moore, Okla., 16 minutes to take shelter before the tornado touched down and swept much of city off the map with its 200-miles-per-hour winds — about two minutes more than average, experts said…To give people more time to seek safety, scientists…are scouring storm systems this spring for reliable signals that can be used to predict a twister taking form inside the tumult of a fast-moving storm front.”
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(IRIN, May 21, 2013)
“Every year, hundreds of thousands of people are forced from their homes by violence or natural disasters…While the popular view of displacement is one of sprawling rural camps, displaced people are now just as likely to be living in urban areas, often hidden from view. The Humanitarian Policy Group (HPG)…has explored this phenomenon in a series of studies…[examining] eight urban centres around the world…Keeping displaced populations in refugee camps or internally displaced persons (IDP) camps simplifies administration for relief agencies. ‘Humanitarian operations in urban areas can be more costly and time-consuming,’ according to the UN Refugee Agency’s 2012 State of the World’s Refugees report.”



(The Christian Science Monitor, May 21, 2013)
“As rescue and recovery efforts continue in Moore, Okla., following the devastating tornado that struck [earlier this week,]…attention has focused, in particular, on the schools that were hit…It’s too soon…to know whether the emergency procedures that the schools had in place were the best they could have been. Experts that have helped schools hone tornado-preparedness plans and who have seen the devastation they’ve caused in other communities note that with a tornado as strong as this one…there often isn’t a perfect solution, or any way to guarantee complete safety — though a lot of things can make a difference.”

Related story:
Safe-Room Program ‘On Hold’ Before Monster Tornado Hit

(USA Today, May 22, 2013)

How Residents of Tornado-Struck Moore, Okla., Have Learned to Survive

(The Christian Science Monitor, May 22, 2013)


(IRIN, May 20, 2013)
“Gaps in the healthcare system in the Democratic Republic of Congo (DRC) are hampering the fight against malaria…Malaria accounts for about a third of outpatient consultations in DRC clinics, [according to] Leonard Kouadio, a UN Children’s Fund (UNICEF) health specialist…Malaria is also a leading cause of school absenteeism in DRC, and it may have other adverse effects…According to UN World Health Organization (WHO) estimates, out of about 660,000 malaria deaths globally in 2010, at least 40 percent occurred in DRC and Nigeria. In DRC, malaria accounts for about half of all hospital consultations and admissions in children younger than five, according to the government’s National Programme for the Fight against Malaria (NMCP).”



(Voice of America, May 17, 2013)
“Two new medical discoveries are raising hopes of containing malaria — the mosquito-borne parasitic disease that each year infects more than 200 million people and claims [the life] of an estimated [660,000 people]…Meantime, the World Health Organization [WHO] is warning about dire consequences if a drug-resistant form of malaria spreads beyond southeast Asia. Artemisinin has helped cut global malaria deaths by more than 25 percent over the past decade…Controlling malaria involves a range of strategies…in the last 10 years, 20 countries have brought the disease under control [according to the WHO]…promising research…involves introducing a strain of bacteria into the mosquito…[while another looks at] manipulating the mosquito’s genes.”



(BBC News, May 22, 2013)
“Vitamin C can kill multidrug-resistant TB [tuberculosis] in the lab, scientists have found. The surprise discovery may point to a new way of tackling this increasingly hard-to-treat infection…An estimated 650,000 people worldwide have multidrug-resistant TB. Studies are now needed to see if a treatment that works using the same action as vitamin C would be useful as a TB drug in humans. In the laboratory studies, vitamin C appeared to be acting as a ‘reducing agent’ — something that triggers the production of reactive oxygen species called free radicals. These free radicals killed off the TB, even drug resistant forms that are untreatable with conventional antibiotics such as isoniazid.”



(The Observer, London, May 19, 2013)
“[L]ast week…it was revealed that human cloning has been used for the first time to create embryonic stem cells from which new tissue — genetically identical to a patient’s own cells — could be grown. Scientists have been working on such techniques for some time but their work has been hampered by the difficulties involved in cloning human cells in the laboratory. But the team led by Shoukhrat Mitalipov, of the Oregon Health and Science University in Portland, got around this problem. By adding caffeine to cell cultures, their outputs were transformed…The development was hailed as a major boost for patients…who might benefit from tissue transplants. But the announcement was also greeted with horror.”

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(Reuters, May 19, 2013)
“When a sick Indonesian baby died after 10 hospitals in Jakarta turned her family away in February, critics blamed a pilot health insurance scheme that had overwhelmed the city’s public hospitals. The program, introduced in November, gave health insurance to around 5 million people in Jakarta categorized as poor. Long queues quickly formed at already stretched hospital emergency rooms as many patients…sought to take advantage of being covered for the first time. Some health experts said it was a sign of the chaos to come when the government begins rolling out a nationwide health insurance program early next year, especially since Jakarta, a city of 10 million people, has the country’s best public hospitals and doctors.”



(The Oregonian, May 21, 2013)
“For the fourth time since 1956, Portlanders…rejected a plan to fluoridate city water, 60 percent to 40 percent…In Portland [Oregon]…the fluoride debate created stark, and heated, divisions…Opponents were described as insensitive to equity issues, while proponents were accused of wanting to willingly pollute the city’s famously pure water. The issue also wound up politicizing a statewide health report that showed falling cavity and tooth decay rates in the state over the past five years…Portland finds itself back where it has historically been, as the only city among the nation’s 30 most populous to not approve fluoridation.”

Related story:
Tooth and Nail: Fluoride Fight Cracks Portland’s Left
(The Wall Street Journal, New York, May 19, 2013)

Related opinion:
Moving On from Fluoride Vote

(The Oregonian, May 22, 2013)

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World Health News

New bird flu strain may be capable of spreading from human to human – study

By robinlee ~ May 24th, 2013 @ 2:49 pm No Comments »
Chickens sit inside cages after a New Taipei City Department of Environmental Protection worker sprayed sterilising anti-H7N9 virus disinfectant around chicken stalls in a market in New Taipei City April 8, 2013. REUTERS/Pichi Chuang

Chickens sit inside cages after a New Taipei City Department of Environmental Protection worker sprayed sterilising anti-H7N9 virus disinfectant around chicken stalls in a market in New Taipei City April 8, 2013.

Credit: Reuters/Pichi Chuang


HONG KONG |
Fri May 24, 2013 7:25am EDT

(Reuters) – The H7N9 bird flu virus may be capable of spreading from human to human and can be transmitted not only through direct contact but also through airborne exposure, researchers at the University of Hong Kong have found.

The researchers found in a study, presented at a news briefing on Friday, that three ferrets – the main animal used for research into human influenza – that were placed in close contact with ferrets injected with H7N9 contracted the virus.

One out of three that were kept in different cages became infected through airborne exposure.

The World Health Organization (WHO) has previously said it has no evidence of “sustained human to human transmission” of the virus, which has killed 36 people in China.

“The findings suggest that the possibility of this virus evolving further to form the basis of a future pandemic threat cannot be excluded,” said the research team, led by bird flu expert and microbiologist Yi Guan.

The team also found that some infected animals did not develop fever and other clinical signs, indicating that asymptomatic infections among humans are possible. That would make the virus harder to detect and control.

The virus can also infect pigs, but could not be transmitted from pig to pig or from pigs to other animals, the study showed, although the team urged authorities to maintain surveillance to ensure the virus did not mutate into a more serious one.

The WHO called the study a good one but cautioned that people “have to be very careful about what’s going on the ground”.

“Studies like that are really helpful for increasing general knowledge and it’s really helpful to know that under lab conditions this thing could transfer from person to person,” WHO chief spokesman Gregory Hartl told Reuters.

“We’ve already seen maybe a few limited instances of human to human transmission within close family range, within close contacts, so this is another piece of the puzzle,” he said.

The findings come just days after the WHO said the H7N9 virus appeared to have been brought under control in China thanks to restrictions at bird markets.

H7N9 has relatively mild clinical signs in ferrets, according to the study. All the animals infected with the virus in the experiments presented symptoms for no more than seven days and all recovered from the disease.

The researchers said that cases where humans died or became extremely ill were triggered by additional causes.

“All the deceased or seriously ill patients, (their illness) are due to other causes,” said Dr Maria Zhu Huachen from the research team.

United Nations experts said this week the bird flu outbreak in China had caused some $ 6.5 billion in losses to the economy.

The H7N9 virus is known to have infected 130 people in mainland China since it emerged in March, but no cases have been detected since early May.

(Additional reporting by Sui-Lee Wee in Beijing and Tom Miles in GENEVA, Editing by Anne Marie Roantree and Ron Popeski)


Reuters: Health News

Last century: Western nations lost an average 14 IQ points

By robinlee ~ May 24th, 2013 @ 4:50 am No Comments »
From 1899-2004, Western nations dropped an typical 14 IQ details.
Sandra Day O Connor, Affiliate Justice of the United States Supreme Courtroom, switches her judicial robe for a graduation gown as she arrives with her speech on June 1, 2004 to obtain a Honorary diploma and deliver the graduation deal with at New York’s Benjamin Cardozo College of Law. (UPI Photo/Ezio Petersen) 

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BRUSSELS, May possibly 23 (UPI) — Because 1889 to 2004, IQ declined fourteen.one factors between individuals from Western nations, researchers in Europe say.

Michael A. Woodleya of Vrije Universiteit in Brussels, Jan te Nijenhuisc of the University of Amsterdam and Raegan Murphy of the College School Cork in Ireland conducted a meta-investigation of the slowing of easy reaction time — in sign of general intelligence.

“We tested the hypothesis that the Victorians had been cleverer than contemporary populations, utilizing high-high quality devices, specifically steps of basic visual response time in a meta-analytic study,” the researchers wrote in the review. “Basic reaction time actions correlate substantially with measures of general intelligence and are deemed elementary steps of cognition.”

The scientists utilised data of straightforward reaction time explained in a meta-examination of fourteen age-matched research from Western nations around the world executed from 1889 to 2004.

The examine, revealed in the journal Intelligence, located a drop in general intelligence of one.23 points for each decade.

“These findings strongly point out that with respect to standard intelligence the Victorians have been significantly cleverer than modern Western populations,” the review authors stated.

Previous investigation discovered in numerous Western countries females of higher intelligence experienced much less kids than females with decrease intelligence.

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