News From The American Chemical Society, July 9, 2008

Detecting flu viruses in remote areas of the world



Researchers in Ohio and New Mexico are reporting an advance in the quest for a fast, sensitive test to detect flu viruses - one that requires no refrigeration and can be used in remote areas of the world where new flu viruses often emerge. Their new method, the first to use sugar molecules rather than antibodies, is in the July 2 issue of the Journal of the American Chemical Society, a weekly publication.



In the new study, Jurgen Schmidt, Suri Iyer, and colleagues point out that conventional tests for flu viruses - including bird flu - rely on antibodies, proteins produced by the immune system, to recognize viruses. But antibody-based tests can be expensive and require refrigeration to remain stable.



Their solution involved development of artificial forms of sialic acid, a sugar molecule found on the surface of cells that flu viruses attach to when they attack humans. In laboratory tests, the researchers showed that their highly-selective artificial sugars could be used to quickly capture and recognize two common strains of influenza viruses, H1N1, which infects birds, and H3N2, which infects pigs and humans. They used the molecules to differentiate between 2 strains (Sydney and Beijing) commonly found in human infections without isolating the viral RNA or surface glycoproteins. The sugars remain stable for several months, can be produced in large quantities, and exhibit extended shelf life. - MTS



ARTICLE: "Detection of Intact Influenza Viruses using Biotinylated Biantennary /S-/Sialosides"



CONTACT:

Jurgen Schmidt, Ph.D.

Los Alamos National Laboratory

Los Alamos, New Mexico 87545



Suri S. Iyer, Ph.D.

University of Cincinnati

Cincinnati, OH 45221-0172



Marine worm's jaws say "cutting-edge new aerospace materials"



Researchers in California and New Hampshire report the first detailed characterization of the protein composition of the hard, fang-like jaws of a common marine worm. Their work could lead to the design of a new class of super-strong, lightweight materials for use as construction and repair materials for spacecraft, airplanes, and other applications. Their study is scheduled for the July 14 issue of ACS' Biomacromolecules, a monthly journal.



In the new study, Chris C. Broomell and colleagues note that Nereis virens, also known as the sandworm or ragworm, is a burrowing marine worm found in shallow waters in the North Atlantic region. Researchers remain intrigued by the remarkable hardness of its jaws and long pincers, which rivals that of human teeth and exceed the hardness of many synthetic plastics. But little is known about the exact chemical composition of these structures.
















Broomell and colleagues collected the jaws of 1,000 worms and analyzed their protein content using high-tech instrumentation. They found that the primary chemical in the jaws and pincers of the worm is a unique protein, named Nereis virens jaw protein-1 (Nvjp-1), which is rich in the amino acid histidine. The researchers also characterized the chemical conditions needed for its formation, such as the presence of zinc, which could allow researchers to create synthetic versions of this super-hard, lightweight material. - MTS



ARTICLE: "Cutting Edge Structural Protein from the Jaws of Nereis virens"



CONTACT:

Chris C. Broomell, Ph.D.

University of California at Santa Barbara

Santa Barbara, California 93106



New "scrubber" speeds removal of powerful anthrax clean-up agent



Researchers in New Jersey report discovery of a fast, efficient method for removing a powerful pesticide used to sterilize buildings and equipment following anthrax attacks. Their chemical "scrubber" removes 99 percent of the pesticide following fumigation and could pave the way for its broader use in anthrax clean-up efforts, the scientists say. Their study is scheduled for the July 18 issue of ACS' Organic Process Research & Development, a bi-monthly journal.



In the new study, Roman Bielski and Peter J. Joyce note that the commonly used pesticide, methyl bromide, is superior to chlorine dioxide for destroying anthrax-causing bacteria and their spores. However, it is highly toxic to humans and may harm the environment by destroying the ozone layer. Researchers thus have sought an efficient method for removing this promising anthrax decontamination agent.



Bielski and Joyce documented the effectiveness of their removal method in experiments with an empty office trailer filled with air containing methyl bromide. They treated air exhausted from the trailer with a solution of sodium sulfide combined with a powerful catalyst. This chemical "scrubber" removed more than 99 percent of the methyl bromide from the air. - MTS



ARTICLE: "The Use of Methyltricaprylylammonium Chloride as a Phase Transfer Catalyst for the Destruction of methyl Bromide in Air Streams"



CONTACT:

Roman Bielski, Ph.D., and Peter J. Joyce, Ph.D.

Value Recovery, Inc.

Bridgeport, New Jersey 08014



Snake venom tells tales about geography



Just as people give away their origins by that southern drawl or New England twang, poisonous snakes produce venom that differs distinctly from one geographic area to another, the first study of the "snake venomics" of one of the most common pit vipers in Latin America has found. The study is scheduled for the August 1 issue of ACS' monthly Journal of Proteome Research.



In the new study, Juan J. Calvete and colleagues point out that researchers have known for decades that venom collected from snakes of the same species from different geographic locations can differ in terms of their biological effects and symptoms on snakebite victims. However, scientists know little about the chemical differences behind these geographically different venoms.



To find out, the scientists collected venom samples from adult and newborn specimens of the lancehead pitviper from two geographically isolated populations from the Caribbean and Pacific regions of Costa Rica. After a detailed laboratory analysis of the proteins found in the venom - so-called "snake venomics" - the researchers found major differences in the venoms collected from the two regions. They also found distinct differences in proteins collected from newborns and adult snakes. The study "highlights the necessity of using pooled venoms as a statistically representative venom for antivenom production" for human snakebite victims, the report states. - MTS



ARTICLE: "Snake Venomics of the Lancehead Pitviper Bothrops asper: Geographic, Individual, and Ontogenetic Variations"



CONTACT:

Juan J. Calvete, Ph.D.

Instituto de Biomedicina de Valencia

Valencia, Spain



'Electronic chemicals' pave the way for brighter, more energy-efficient future



From solar power to computer chips to advanced lighting, new materials developed by chemists are helping consumers reap the benefits of advanced electronics, according to an article scheduled for the July 15 issue of Chemical & Engineering News. Some of these electronics will soon appear on store shelves and offices near you.



In the C&EN cover story, writers Michael McCoy, Alexander Tullo, and Jean-Francois Tremblay point out that so-called 'electronic chemicals' play key roles in today's advanced electronics but go largely unnoticed by consumers. These unsung materials, part of a multibillion dollar electronic materials market, provide improved solar panels that crank out more fossil fuel-free electricity and new computer chips that are smaller and more energy efficient than ever. These materials also fuel the development of organic light emitting diodes (OLEDs) that promise energy savings and could render today's incandescent light bulbs and fluorescent bulbs obsolete, according to the article.



But making advanced electronics comes with a steep price. Chemical companies now invest billions of dollars to build new manufacturing plants to produce raw materials for advanced electronics. Manufacturers are also spending heavily on research and development, as new electronic advances demand innovative new chemicals, the article states.



ARTICLE: "Electronic chemicals"







The American Chemical Society - the world's largest scientific society - is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.



Source: Michael Woods


American Chemical Society


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Spreading The Computational Load To Monitor Heart Patients Remotely

The possibility of remote monitoring for chronically ill patients will soon become a reality. Now, researchers in South Africa and Australia have devised a decentralized system to avoid medical data overload. They describe the peer-to-peer system in a forthcoming issue of the International Journal of Computer Applications in Technology.



People with a range of chronic illnesses, including diabetes, high blood pressure, and heart problems can benefit from advances in monitoring technology. Such devices could send data on a person's symptoms directly to a centralized computer server at their health center. This would allow healthcare workers to take appropriate action, whether in an emergency or simply to boost or reduce medication in response to changes in the patient's symptoms.



However, as tele-monitoring is set to become widespread, there will inevitably be an issue of data overload with which a centralized computer will not be able to cope. Computer scientists Hanh Le, Nina Schiff, and Johan du Plessis at the University of Cape Town, working with Doan Hoang at the University of Technology, Sydney, suggest a decentralized approach.



Computer users are familiar with the concept of peer-to-peer (P2P) networks in which individual users share the workload across equivalent personal computers on a network. This avoids overloading any single server or swamping bandwidth on individual connections. The P2P approach is commonly employed by software companies and others to distribute large digital files, such as operating system updates, and high-definition movies.



A P2P network overlays a network on the individual peers, known as nodes, without a central control point and uses their idle processing cycles, storage, and bandwidth via the internet.



Le and colleagues have developed an application to demonstrate proof of principle of how a P2P network could incorporate patient sensors including thermometers, blood-pressure units and electrocardiograms (ECG). It is the latter on which the team has focused to build a P2P heart-monitoring network.



The system builds on the team's concept of a physically-aware reference model (a PARM). Their PARM acts as a small-scale, but scalable model of the kind of network overlay that could be built on the internet. Tests have already demonstrated that a continual and unintrusive heart monitoring application could be developed into a working e-health system quickly and simply at low cost using P2P.


Notes:



"A pervasive tele-health system for continual and low intrusive monitoring using peer-to-peer networks" in Int. J. Computer Applications in Technology, 2009, 34, 330-334.



Source: Hanh Le


Inderscience Publishers


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Medicine From Tobacco

Tobacco isn't famous for its health benefits. But now scientists have succeeded in using genetically modified tobacco plants to produce medicines for several autoimmune and inflammatory diseases, including diabetes. The research is published in the open access journal BMC Biotechnology.



A large team of scientists from several European research organizations have participated in the study as part of the Pharma-Planta project (pharma-planta/). Led by Professor Mario Pezzotti at the University of Verona, they set out to create transgenic tobacco plants that would produce biologically-active interleukin-10 (IL-10), a potent anti-inflammatory cytokine. They tried two different versions of IL-10 (one from a virus, one from the mouse) and generated plants in which this protein was targeted to three different compartments within the cell, to see which would work most effectively.



The researchers found that tobacco plants were able to process both forms of IL-10 correctly, producing the active cytokine at high enough levels that it might be possible to use tobacco leaves without lengthy extraction and purification processes. The next step will be to feed the plants to mice with autoimmune diseases to find out how effective they are.



The authors are keen to use the plants to see whether repeated small doses could help prevent type 1 diabetes mellitus (T1DM), in combination with other auto-antigens associated with the disease. The team has a particular auto-antigen in its sights - the 65-kDa isoform of the enzyme glutamic acid decarboxylase (GAD65) - which they have also produced in transgenic tobacco plants.



According to Pezzotti, "Transgenic plants are attractive systems for the production of therapeutic proteins because they offer the possibility of large scale production at low cost, and they have low maintenance requirements. The fact that they can be eaten, which delivers the drug where it is needed, thus avoiding lengthy purification procedures, is another plus compared with traditional drug synthesis."



Notes:



1. Viral and murine interleukin-10 are correctly processed and retain their biological activity when produced in tobacco

Luisa Bortesi, Marzia Rossato, Flora Schuster, Nicole Raven, Johannes Stadlmann, Linda Avesani, Alberto Falorni, Flavia Bazzoni, Ralph Bock, Stefan Schillberg and Mario Pezzotti

BMC Biotechnology (in press)


Article available at journal website: biomedcentral/bmcbiotechnol/


All articles are available free of charge, according to BioMed Central's open access policy.



2. BMC Biotechnology is an open access journal publishing original peer-reviewed research articles in the manipulation of biological macromolecules or organisms for use in experimental procedures or in the pharmaceutical, agrobiological and allied industries. BMC Biotechnology (ISSN 1472-6750) is indexed/tracked/covered by PubMed, MEDLINE, BIOSIS, CAS, Scopus, EMBASE, Thomson Reuters (ISI) and Google Scholar.



3. BioMed Central (biomedcentral/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.



Source: Charlotte Webber


BioMed Central


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Significant Health Benefits Result From Improving Doctor-Patient Communication

A UCSF research team has developed a simple tool that can improve the effectiveness of communication between doctors and patients about prescribed medications and result in dramatic improvements in health and safety.



The new communication tool involves a computer-generated weekly calendar with color images of the medication to be taken each day, combined with instructions written in English and in a patient's native language if the patient does not speak English. The researchers call it a VMS, for visual medication schedule.



"Improving communication has often been thought of as soft science, but our study shows significant clinical benefits when the information gap between physician and patient is bridged in the right way," says co-lead investigator Edward Machtinger, MD, assistant professor of medicine and director of the Women's HIV Program at UCSF.



Machtinger and co-lead investigator, Dean Schillinger, MD, associate professor of medicine at UCSF and director of the UCSF Center for Vulnerable Populations at San Francisco General Hospital Medical Center, developed the tool and conducted a study on its effectiveness. Research findings are reported in the October 2007 issue of the Joint Commission Journal on Quality and Patient Safety, published by Joint Commission Resources (jcrinc/).



The research team selected patients taking an anticoagulant (clot preventing or blood thinning) medication for stroke prevention known as warfarin. Most patients in the study suffered from atrial fibrillation, a common heart condition in which the heart pumps irregularly, leading to formation of clots in the heart that travel to the brain and result in stroke.



Atrial fibrillation affects over 2.5 million adults in the US and is responsible for 20 percent of all strokes. Treatment with warfarin, if taken correctly, can reduce the likelihood of stroke by 80 percent.



However, warfarin is a notoriously challenging medication for doctors and patients to manage, and complications from warfarin are the most common cause of adverse medication events in community settings, according to the lead investigators.



In previous studies, Schillinger and Machtinger found that nearly one half of patients on anticoagulants were not taking their medication accurately, but did not realize it. When describing the dose and frequency of the medication, patients and doctor often had two completely different understandings. These misunderstandings were more frequent among patients with limited literary skills, those for whom English was not their first language, and those with memory problems. Patients who had misunderstood their prescriptions were more likely to be under-anticoagulated and at risk for stroke, as well as over-anticoagulated and at risk for life-threatening bleeding.
















Based on these findings, the researchers developed a three-step communication approach for their current study and selected patients whose lab tests showed that their blood was not in the target range of anticoagulation. The three-step approach involves



1. Having the patient describe how much medication he/she is taking and how often (to identify misunderstanding),


2. Giving the patient a VMS along with written instructions both in English and the patient's native language, and


3. Asking the patient to "teach back" what he/she has just learned so as to ensure common understanding.



The study involved 147 patients, with half of the participants being randomized to receive the VMS along with brief, scripted medication counseling each time they came to clinic over 90 days, in addition to their standard care in an anticoagulation clinic. The other half received standard care, which includes medication counseling using non-standardized verbal and written instructions.



Study findings showed that the blood anticoagulation status of patients in the VMS group reached the target, safe level almost twice as fast as those patients who were in the standard group -- 28 vs. 42 days. In addition, the researchers found that the effect of the VMS tool was principally among those patients who, at the start of the study, had misunderstood their prescription instructions.



Among this "at-risk" subset of patients, the VMS worked even faster (28 vs. 49 days), presumably by helping to correct the original misunderstanding that led to them initially being out of target range, the researchers say. One notable finding, they add, was that the VMS tool was especially effective among Spanish-speaking patients, again suggesting that the tool is most effective for those with communication barriers.



Miscommunication between doctors and patients with regard to medication is common and often goes unnoticed, according to Schillinger. He and Machtinger began looking at the link between miscommunication and poor health about eight years ago when they realized that miscommunication could be a key, remediable cause of poor health outcomes and medication errors among vulnerable populations of patients.



"It was amazing to us that the final crucial step in a long pipeline of science and disease intervention--communication around the actual taking of medications--was being largely ignored," says Machtinger.



Their previous studies showed that problems at this final step were far more serious than the field had realized. These early studies were among the first to show a direct link between miscommunication and poor health, Schillinger says.



This approach, says Schillinger, provides the clinician with immediate feedback on the patient's understanding of his medication and the opportunity to correct misinformation, along with a visual aid-the take-home calendar and verbal reinforcement.



The idea for the visual part of the communications tool is not novel, the researchers say. For decades, doctors and pharmacists have often taped actual pills to hand-written sheets of paper to help educate their most vulnerable patients. This approach, however, is too time-consuming and impractical to carry out for every patient at every appointment.



The VMS is fast and inexpensive, can be printed in any language, and facilitates communication that happens naturally in the doctor's office, the researchers emphasize, and can be adapted to other clinical settings, including pharmacies.



The next step for the research team is to find ways to integrate the VMS and 3-step approach into everyday practice. "Having health systems adopt this communication tool on a long-term basis for anticoagulant care could translate into lots of strokes being avoided and lots of bleeding being prevented," says Schillinger.



"We hope, in the near future, that all vulnerable patients will have a VMS tacked to the refrigerator so they, and their caregivers, will know which pills they should be taking and how they should take them," says Machtinger.



In the meantime, the researchers emphasize that patients should be educated about the dangers associated with medication miscommunication and discuss how they are taking their medications with their doctor at every visit. While there are other reasons besides miscommunication that might affect whether a patient takes medication as prescribed, Schillinger believes that "for high-risk medications, we need to focus our energies on implementing standardized visual communication tools that accompany any prescription to ensure safety and quality."







The study was funded by the Academic Senate of UCSF, the American Heart Association, the Agency for Health Research and Quality, the National Center for Research Resources, and the Hellman Early Career Research Award.



Study co-authors were Frances Wang, MA, senior biostatistician; Lay-Leng Chen, MD, research consultant; Maytrella Rodriguez, research assistant, and Sandy Wu, RN, research assistant, all of the UCSF Center for Vulnerable Populations.



UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.



Source: Vanessa deGier


University of California - San Francisco



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Commentaries Discuss Evidence-Based Medicine; Report Examines States' Efforts To Insure Young Adults

Improving Patient Care by Linking Evidence-Based Medicine and Evidence-Based Management," Journal of the American Medical Association: In the commentary, Stephen Shortell of the University of California, Berkeley, School of Public Health and colleagues discuss the need for policy recommendations and interventions to create an integrated evidence-based approach to health care (Shortell et al., JAMA, 8/8).


Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help," The Commonwealth Fund: The report examines health care coverage trends for young adults and finds that young adults continue to represent the largest uninsured age group in the U.S. The report also discusses state laws to improve health coverage of young adults by allowing them to remain on their parents' health plans, as well as federal efforts that would allow states to increase access to SCHIP and Medicaid up to age 25 (The Commonwealth Fund release, 8/8).

"Toward Evidence-Based Policy Making and Standardized Assessment of Health Policy Reform," JAMA: In the commentary, J. Frank Wharam of the Department of Ambulatory Care and Prevention at Harvard Medical School and Harvard Pilgrim Health Care and Norman Daniels of the Department of Population and International Health at Harvard School of Public Health discuss the need for a framework for the structured assessment of health care initiatives. Such a framework should include standards in the areas of health outcomes, access and income spent on health care, according to Wharam and Daniels (Wharam/Daniels, JAMA, 8/8).



Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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Study Supports Seasonal Influenza Vaccine For Young Infants

Vaccination against seasonal influenza is safe and produces a protective immune response in infants as young as 6 to 12 weeks, concludes a study in the February issue of The Pediatric Infectious Disease Journal. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.


Although confirmatory studies are needed, the results suggest that seasonal flu vaccine could be included in the standard vaccinations for infants less than 6 months old, according to Dr. Janet A. Englund of University of Washington, Seattle, and colleagues.


Flu Shots Yield Good Immune Response with Few Adverse Events


In the study, 1,375 healthy U.S. infants were randomly assigned to receive two doses of the standard trivalent seasonal flu vaccine or an inactive placebo vaccine. ("Trivalent" means that the vaccine offers protection against three strains of circulating influenza virus.) The vaccines were given one month apart, in combination with standard recommended vaccines.


With close follow-up, the researchers found no differences in side effects or adverse events between infants receiving the active influenza vaccine versus placebo. In both groups, about 11 percent of infants developed a fever within three days after vaccination. Through one month, serious adverse events related to the study vaccine were rare.


Immunologic tests showed significant antibody responses to seasonal flu vaccine. Nearly half of infants receiving the trivalent vaccine developed protective antibodies against at least two of the three influenza virus strains covered. There was no evidence that influenza vaccine interfered with responses to the other routine childhood vaccinations.


Seasonal influenza vaccine is effective in preventing influenza, but no vaccine has been approved for prevention of influenza in infants less than 6 months old-a group at high risk for influenza and related complications. Trivalent influenza vaccine has been found safe and effective in infants over 6 months old, but very few studies have evaluated its use in younger babies.


The new study, in a large sample of American infants, suggests that seasonal influenza vaccines can safely be given to 6- to 12-week-old infants, in combination with routine childhood vaccines. The results show high rates of protective immune responses, which are likely to be effective in fighting influenza viruses.


"Based on the results of this study, potential protection against influenza could be safely obtained in infants less than 6 months of age who receive a standard infant dose of inactivated influenza vaccine," Dr. Englund and co-authors conclude. More research will be needed to confirm that vaccination is actually effective in preventing influenza in this young and vulnerable age group.


About The Pediatric Infectious Disease Journal


The Pediatric Infectious Disease Journal® is a peer-reviewed, multidisciplinary journal directed to physicians and other health care professionals who manage infectious diseases of childhood. The journal delivers the latest insights on all aspects of infectious disease in children, from state-of-art diagnostic techniques to the most effective drug therapies and other essential treatment protocols. The Pediatric Infectious Disease Journal is official journal of the Pediatric Infectious Diseases Society and the European Society for Paediatric Infectious Diseases.


Source
Wolters Kluwer Health: Lippincott Williams & Wilkins

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Premiums Rise 18% For Non-employer Health Insurance, USA

People who buy their own health insurance saw their average annual premiums rise 18 percent between 2002 and 2005, a modest increase compared to the 34 percent jump in average premiums for people insured through their employers, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.


But the annual cost of these non-employer policies are paid entirely out of pocket. Average annual premium for a one-person policy was $2,835 in 2005, up from $2,531 in 2002. Annual premiums for family policies were $5,568 in 2005, up from $4,442 in 2002.


The new AHRQ analysis also found that:


- Among those under age 65, about 12 million Americans, or less than 5 percent, were covered by policies purchased in the non-employer market in 2005. That compared to 174 million, or 67 percent, covered by employer-based health insurance.


- For people with company-sponsored insurance, average annual premiums paid out of pocket rose from $1,231 to $1,655 between 2002 and 2005.


- About 70 percent of non-employer policies were single coverage and 30 percent were for family coverage.


- Premiums for non-employer policies differ by age of policyholders. One-person premiums were $1,580 for policyholders under age 40 and $4,288 for policyholders aged 55-64.



AHRQ, which is part of the U.S. Department of Health and Human Services, works to enhance the quality, safety, efficiency, and effectiveness of health care in the United States. The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey, a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid. For more information, go to Premiums in the Individual Health Insurance Market for Policyholders under Age 65: 2002 and 2005.


ahrq

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Connection Between Job Loss And Poor Health Confirmed By New Research

Employees who lose their jobs because of their health suffer more significant depression and detrimental health outcomes than people who lose their jobs for non-health reasons, new research shows.



The study also suggests that people who are reemployed quickly have better health outcomes than those who remain unemployed.



It's not clear how many people involuntarily lose their jobs for health-related reasons, but shaping policy to meet the needs of this population of the unemployed is critical, a University of Michigan professor says.



"We need to know more about this population for intervention and policy reasons," said Sarah Burgard, assistant professor of sociology with appointments in the Institute for Social Research and the School of Public Health. "Re-employment appears to be key for mitigating these health effects for people who lose their jobs---either for health-related reasons or other reasons, say a layoff."



Much existing research suggests a link between involuntary job loss and health consequences, but those analyses don't account for an employee's pre-existing health or other outside factors, such as socioeconomic background, that may actually make the link spurious



People who have lost their jobs and want to get back to work may need the assistance of interim health insurance coverage, unemployment benefits, and re-employment programs. This may be particularly true for people who have health problems that caused them to lose their jobs. However, these traditional employment benefits were designed to meet the needs of workers in standard full-time jobs,



Increasingly, part-time, temporary or short-term service industry jobs are replacing the standard, full-time jobs disappearing from manufacturing and other industries, and the new jobs often lack health insurance coverage or unemployment insurance eligibility. This means that people working part-time or with other nonstandard employment contracts will face the greatest challenges getting back into the labor force if they experience a job loss; they don't benefit from these programs, Burgard says.



These findings underscore the social and economic importance of structuring health insurance, unemployment benefits, and re-employment programs to meet the needs of an evolving workforce, as nonstandard employment contracts become more common. For example, since health insurance is often tied to full-time, long term employment, the most vulnerable workers in the new service economy have no access to employer-sponsored health care while they are employed. After a job loss for health reasons, such workers would have few resources to aid recover and help with a new job search, she says.



Burgard and her co-authors, James House, professor at the U-M Institute for Social Research, the Ford School of Public Policy and the sociology department, and Jennie Brand, assistant professor of sociology at the University of California, Los Angeles, improved on existing research by distinguishing between health-related job losses and other involuntary job losses, such as layoffs, to reassess the effect of involuntary job loss on health. Burgard and her co-authors wanted to know if involuntary job loss caused the health decline, or if pre-existing poor health or an acute negative health shock caused the job loss, which then precipitated an even greater health decline.







The paper, "Toward a Better Estimation of the Effect of Job Loss on Health," appears in the December edition of the Journal of Health and Social Behavior.



Click here for more about Burgard.



For more about the SPH, visit: sph.umich.edu/.



For ISR, visit: isr.umich.edu/home/.



The University of Michigan School of Public Health has been working to promote health and prevent disease since 1941, and is consistently ranked among the top five public health schools in the nation. Faculty and students in the school's five academic departments and dozens of collaborative centers and initiatives are forging new solutions to the complex health challenges of today, including chronic disease, health care quality and finance, emerging genetic technologies, climate change, socioeconomic inequalities and their impact on health, infectious disease, and the globalization of health. Whether making new discoveries in the lab or researching and educating in the field, our faculty, students, and alumni are deployed around the globe to promote and protect our health.



Source: Laura Bailey


University of Michigan


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Health Reform Legislation Expected To Have Major Benefits For Women

The health reform law (HR 3590) that President Obama signed Tuesday could have an "especially large" impact on women in the U.S., who make the majority of family health care decisions and generally live longer than men, Forbes Woman reports. According to the Department of Labor, women make an estimated 80% of health care decisions for their families. Women also tend to require more medical care over longer periods of time, and they have unique health care needs, such as pregnancy care.

The immediate effects of the law include a prohibition on the insurance practice of "gender rating," or charging higher premiums on the basis of gender. National Partnership for Women & Families Vice President Kirsten Sloan said, "Every woman who has been overcharged because of her gender won a victory."

The law prohibits insurers from denying coverage based on pre-existing conditions, which in the past have sometimes been defined to include domestic violence, rape and previous caesarean sections. The law also requires health plans to cover certain maternity, newborn and pediatric care, including dental and vision care, according to the National Partnership. It also will expand the pool of Medicaid eligible individuals for a range of services, including family planning, as well fund a new home visitation program to pair new and expectant families with trained professionals to provide parenting information, resources and support during pregnancy and throughout their child's first three years.

Nancy Taylor, an attorney and former health policy director for the Senate Committee on Health, Education, Labor and Pensions, said the law will offer women more information and purchasing power for themselves and their families (Goudreau, Forbes Woman, 3/23).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

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Critical Mechanism Enables Blood-Borne Immune Cells To Sense West Nile Virus And To Neutralize And Clear Infection In The Brain

In animal studies, researchers at Cedars-Sinai Medical Center and Yale University have identified molecular interactions that govern the immune system's ability to defend the brain against West Nile virus, offering the possibility that drug therapies could be developed to improve success in treating West Nile and other viral forms of encephalitis, a brain inflammation illness that strikes healthy adults and the elderly and immunocompromised.



In a series of laboratory experiments and studies in mice, the research team found that a specific molecule and "signaling pathway" are critical in detecting West Nile virus and recruiting specialized immune cells that home to and clear infected cells. In mice genetically engineered to lack this molecular pathway, immune cells were detected at a distance but they did not home to brain cells infected by the virus, according to an article published online Feb. 5 in the Cell Press journal Immunity.



The key molecule in this process is Toll-like receptor 7, part of the innate immune system that recognizes pathogens entering the body and activates immune cell responses. Effective signaling is dependent on interleukin 23, a protein that stimulates an inflammatory response against infection. In West Nile encephalitis, according to these studies, Toll-like receptor 7 enables macrophages - immune system cells circulating in the blood - to sense the brain-penetrating virus. These macrophages then respond to interleukin 23 produced in the brain. This brain signal in turn promotes their infiltration and homing from the blood into the brain, where they neutralize and clear the virus.



Transmitted to humans by mosquitoes, West Nile virus is the most common cause of epidemic viral encephalitis in North America and has become a worldwide public health concern. While most healthy people who contract the virus have few if any symptoms, an infection can result in life-threatening brain disease - particularly in the elderly and those with compromised immune systems.



"There is no approved therapy for West Nile encephalitis in humans, in part because the mechanisms of the immune response to the virus are not completely understood. Our results suggest that drug therapy aimed at promoting this signaling pathway may enhance the immune response and thereby promote clearance of this potentially deadly virus," said Terrence Town, Ph.D., one of the article's lead authors and a research scientist at Cedars-Sinai's Maxine Dunitz Neurosurgical Institute. Town is an associate professor in the Department of Neurosurgery and the Department of Biomedical Sciences at Cedars-Sinai Medical Center. He holds the Ben Winters Endowed Chair in Regenerative Medicine at Cedars-Sinai.







Contributors to this study are supported by the National Institutes of Health and other grants. Town's research program is funded by the National Institutes of Health/National Institute on Aging and the Alzheimer's Association.



Citation: Immunity, "Tlr7 mitigates lethal West Nile encephalitis via interleukin 23-dependent immune cell infiltration and homing," Feb. 5, 2009.



Source: Sandy Van


Cedars-Sinai Medical Center


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Irritable Bowel Syndrome: I Feel It In My Gut

While more than six per cent of Canadians suffer from this troublesome disease characterized by on-going abdominal pain, discomfort, bloating, and severe bouts of either diarrhoea or constipation most Canadians, including many physicians, know little about it.


New Canadian research is exploring the causes of this disease, including bacterial infections from food or water poisoning, which lead to a chronic low-level infection that in turn results in IBS symptoms. The research is also providing some hope for potential cures, including the use of probiotics and treatments to reduce stress levels.


Experts:


The following CIHR-funded researchers are available to talk about IBS:


How pathogenic bacteria act to survive and thrive in the gut and how certain treatments, like probiotic yogurt can thwart them


Dr. Philip Sherman, Scientific Director, CIHR-Institute of Nutrition, Metabolism, and Diabetes (Toronto)


How food or water poisoning, can trigger chronic IBS, and on the potential of probiotics to treat it.

Dr. Stephen Collins, McMaster University (Hamilton)


The role of sex hormones in women suffering from IBS pain.

Dr. Serge Marchand, Sherbrooke University


How gut talks and listens to the brain and spinal cord and how the gut uses cannabinoids (chemicals related to the active ingredient in marijuana) to control its movements and sensations - including pain.

Dr. Keith Sharkey, Hotchkiss Brain Institute, University of Calgary


How food and stress interact as triggers to exacerbate IBS, and how low levels of inflammation may persist and contribute to IBS symptoms even though the bowel appears to be normal.

Dr. Stephen Vanner, Queen's University. (Kingston)


The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to nearly 12,000 health researchers and trainees across Canada.


Source: Canadian Institutes of Health Research (CIHR)


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Fifty Years Of The 'Light Fantastic:' Laser Advances Spark Scientific Progress

Fifty years after the first laser sparked a technological revolution, the "light fantastic" continues to impact people's daily lives - by playing DVDs, speeding Internet connections, and performing intricate surgery. As the golden anniversary of the announcement of the first laser approaches on July 7th, Chemical & Engineering News (C&EN), ACS' weekly newsmagazine, takes a special look at the past, present, and exciting future of this amazing invention.



C&EN Senior Editor Mitch Jacoby and Assistant Editor Lauren Wolf point out that the laser has come a long way since it was first demonstrated in 1960 by Theodore Maiman. Although few people at the time could have envisioned how the device would be used, he accurately predicted that lasers would impact diverse areas ranging from industry to science. Today, the laser has become a "workhorse tool" in modern chemistry. Scientists now use it to study climate change, ultrafast chemical reactions, and disease-related proteins. Researchers are also using lasers to see inside living cells.



More advances are on the way. Scientists are developing a laser-based system for remotely detecting nerve agents and other harmful chemical and biological warfare agents. Others are developing a laser-based medical instrument that could allow earlier detection of hard-to-diagnose diseases such as lung and bladder cancers. Only time will tell what the next 50 years will bring, the article notes.



Article: "Nifty at Fifty"



Source:

Michael Bernstein


American Chemical Society


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A Heart Attack Waiting To Happen? How Do You Know Your Risk?

Cardiac CT and MRI allow experts to see inside the heart and vessels and structures in detail. In addition to constructing a large heart imaging center at the UK Gill Heart Institute, the University of Kentucky is offering more patients access to this technology through a new cardiac CT service that begins in a few days at Rockcastle Hospital in Mount Vernon, in Rockcastle County, Kentucky.


As part of the university's outreach to rural areas of Kentucky, UK Gill Heart Institute physicians will begin Monday to work with radiologists on staff at Rockcastle Hospital to provide cardiac CT and coronary calcium scoring to their patients. The university is also building a large cardiac imaging center to provide the most detailed view of the heart possible.


Dr. Syed is available to discuss this rural health initiative and/or the accuracy and importance of cardiac CT in diagnosing heart disease and its impact on treatment decisions.


University of Kentucky

102A Mathews Bldg.

Lexington, KY 40506-0047

United States

temple.edu

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T Cell's Memory May Offer Long Term Immunity to Leishmaniasis

Researchers at the University of Pennsylvania have discovered a "central memory" form of "helper" T cells that can offer
immunity to leishmaniasis, a disease that causes considerable death and disfigurement across the globe and has been found in
U.S. military personnel returning from Afghanistan and Iraq.


In the October issue of Nature Medicine, the Penn researchers describe how the discovery can offer immunity to leishmaniasis,
even without the persistent presence of the parasite that caused the disease. Their findings encourage a new approach to
creating a vaccine against leishmaniasis and other immune cell mediated diseases such as tuberculosis and HIV/AIDS.


Attempts to create a vaccine for leishmaniasis have long been stymied by the fact that the helper T cells, which coordinate
the immune response against a pathogen, need constant stimulation from the pathogen in order to remain effective against the
disease.


"Without the persistent attack from the Leishmania parasite, the immune system does not keep protective CD4+ T cells in
place," said Phillip Scott, professor and chair of the Department of Pathobiology at Penn's School of Veterinary Medicine.
"The strategy of most vaccines, to 'teach' the immune system to remember a pathogen, just doesn work with leishmaniasis.



"We have found that a new form of long-term memory T cell will, if stimulated, turn into the sort of helper T cells that
mediate the immune response. We believe that, if we can stimulate the expansion of these central memory T cells, we ought to
be able to create an effective vaccine."


Leishmaniasis is a parasitic disease spread by the bite of sand flies infected with the protozoan Leishmania. While the
disease is most common in North Africa, the Middle East and Asia, it has been recently been seen in United States military
personnel who have served in Afghanistan and Iraq.


According to the Centers for Disease Control, each year the world sees 1.5 million new cases of cutaneous leishmaniasis,
which infects the skin, causing scarring boils, and 500,000 new cases of visceral leishmaniasis, which infects internal
organs, causing death if left untreated.


Particularly vexing to researchers has been the fact that while people who recover from leishmaniasis generally develop
lifelong immunity to reinfection, this has been thought to depend upon the continued presence of the Leishmania parasite.
Indeed, it has been shown in mice that if the parasite is entirely removed, the host can become reinfected with disease.



Scott and his colleagues wondered if, despite the apparent loss of immunity when the parasites disappeared, there were any T
cells that still retained memory of Leishmania. Recent studies have shown that memory T cells may be of more than one type.
One type, which is less activated and found in the lymph nodes, is called central memory T cells. Since little is known
about CD4+ T cell memory during chronic disease, the Penn researchers set out to find if such central memory cells exist in
leishmaniasis.


The hunt for the theoretical CD4+ central memory T cells began by transferring T cells from mice infected with leishmaniasis
to mice who had never faced the disease. According to Scott, some of the transferred T cells went to the lymph nodes, and had
the characteristics of central memory cells.


"We see that these central memory T cells but not the effector T cells persist in the absence of obvious parasites for as
long as five months," Scott said. "Since we still do not know much about these new T cells, our next step is to find out how
we can encourage the proliferation of central memory cells and stimulate them to fight disease."


According to Scott, a better understanding of central memory T cells may lead to the development of vaccines that fight off
a range of pathogens that respond well to a helper T cell response.


Funding for this research was provided through grants from the National Institutes of Health


Contact: Greg Lester

glesterpobox.upenn.edu

215-573-6604

University of Pennsylvania

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Public Health Officials Meet To Discuss Ways To Make HPV Vaccine Available To Women In Developing Countries

Sixty experts from public health agencies, pharmaceutical companies, nongovernmental organizations and philanthropic foundations on Tuesday met in London for a two-day conference to discuss ways to make human papillomavirus vaccines available to women in developing countries, the AP/Washington Post reports (Cheng, AP/Washington Post, 12/12). Merck's HPV vaccine Gardasil and GlaxoSmithKline's experimental HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine (Kaiser Daily Women's Health Policy Report, 8/29). Gardasil costs about $360 for the three-shot series (AP/Washington Post, 12/12). According to Reuters, Cervarix is expected to be priced similarly (Hirschler, Reuters, 12/12). According to the World Health Organization, 500,000 women worldwide are diagnosed with cervical cancer annually, 80% of whom live in developing countries (Gerlin, Bloomberg, 12/12). In addition, more than 95% of women in the developing world never have a cervical smear, and 80% of cervical cancer deaths occur in developing countries, BBC News reports.

Comments
Nothemba Simelela, a senior official at the International Planned Parenthood Federation, said there often is a "15-to-20-year delay between the time that new vaccines are approved in the West and the time they reach developing countries," adding, "The world cannot afford to wait 20 years to begin saving women from cervical cancer" (BBC News, 12/12). Howard Zucker, WHO assistant director-general for health technology and pharmaceuticals, in an e-mail statement to the meeting at the Royal College of Physicians said, "New vaccines against HPV in the developing world could save hundreds of thousands of lives if delivered effectively." Officials from GSK and Merck at the meeting said they had not set prices or agreed to sell their vaccines without profit in developing countries, Bloomberg reports.
Gardasil, which has been approved in 50 countries, will be sold by Merck at "dramatically lower prices" in developing countries, Gregg Sylvester, Merck senior medical director for adolescent health, said. Deborah Myers, GSK director of external and government affairs and public partnerships, said the company will implement a "tiered pricing" system for Cervarix that bases the price on a country's gross domestic product and the size of its orders (Bloomberg, 12/12). According to the AP/Post, some experts at the meeting said developing countries should be establishing their own vaccine manufacturing capacity. "By flooding the market with a cheap vaccine, countries can cut the price of a vaccine substantially," John Schiller of the National Cancer Institute said. Julian Lob-Levyt -- executive secretary of the Global Alliance for Vaccines and Immunization, an organization that purchases vaccines for developing countries -- said GAVI "would be prepared to subsidize the price [of HPV vaccines] in the short term, if in the long term it became affordable." Lob-Levyt added that a decision on whether to subsidize the vaccines would not be made until more data are available on the vaccines' potential impact in developing countries (AP/Washington Post, 12/12). The global health group PATH in June launched a five-year program that is using a $27.8 million grant from the Bill & Melinda Gates Foundation to conduct research in India, Peru, Uganda and Vietnam about ways to reduce potential hurdles for distribution of HPV vaccines in developing countries (Kaiser Daily Women's Health Policy Report, 6/8). "We have wonderful tools for preventing cervical cancer now," Jacqueline Sherris of PATH said, adding, "We know what to do. But the challenge is to move forward and develop the will to actually implement those strategies" (Bloomberg, 12/12).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.



View drug information on Cervarix [Human Papillomavirus Bivalent; Gardasil.

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Pericardial Fat May Be Early Indicator Of Coronary Disease

Researchers have found more evidence supporting the role of fat around the heart in promoting atherosclerosis, according to a study published online in the journal Radiology.



New results from the Multi-Ethnic Study of Atherosclerosis (MESA) show that pericardial fat is more strongly related to coronary artery plaque than either body mass index (BMI) or waist circumference.



When plaque forms in the arteries, it deposits in an irregular manner, causing thickening of the artery wall on one side, but not the other. The ratio of the thick side to the thin side is referred to as plaque eccentricity and is a strong indicator of heart disease.



According to the American Heart Association, heart disease is the leading cause of death in the U.S. In 2010, an estimated 785,000 Americans had a new heart attack, and about 470,000 had a recurrent attack. Every 60 seconds, one person in the U.S. dies from a heart attack.



While previous studies have looked at the relationship of pericardial fat to atherosclerosis in patients with severe coronary disease, this is the first study to determine the association of pericardial fat on coronary artery plaque burden in asymptomatic individuals.



"The individuals in this study had no symptoms and were otherwise healthy," said senior author David A. Bluemke, M.D., Ph.D., director of Radiology and Imaging Sciences at the National Institutes of Health (NIH) Clinical Care. "They did not have significant coronary artery narrowing. Yet, despite this, they had coronary plaque that could be detected by MRI."



For the study, 183 individuals without clinical cardiovascular disease were recruited from the Baltimore and Chicago field centers of MESA, a study funded by the NIH. Participants included 89 women and 94 men with a mean age of 61 years.



"The individuals were fairly representative of the U.S. population, although the majority were overweight," Dr. Bluemke said.



The researchers used magnetic resonance imaging (MRI) to measure coronary artery eccentricity (ratio of maximal to minimal artery wall thickness) as a measure of early-stage atherosclerosis and computed tomography (CT) to determine pericardial fat volume.



"Pericardial fat is located behind the sternum, around the heart, and we cannot see it except with CT or MRI," Dr. Bluemke said. "In some people, extra fat forms preferentially in this area. We do not know why. However, extra fat around the heart is generally associated with being overweight or obese."



The results showed that pericardial fat volume correlated significantly with the degree of plaque eccentricity in both men and women. After adjustment for BMI, waist circumference, traditional risk factors, C-reactive protein level and coronary calcium content, the relationship between pericardial fat and plaque eccentricity remained significant in men, but not in women.



"The findings indicate yet another reason that obesity is bad for us," Dr. Bluemke said. "It is particularly bad when the fat forms around the heart, since the heart fat appears to further promote coronary artery plaque."



"The Association of Pericardial Fat with Coronary Artery Plaque Index at MR Imaging: The Multi-Ethnic Study of Atherosclerosis (MESA)." Collaborating with Dr. Bluemke on this paper were Cuilian Miao, M.D., Shaoguang Chen, M.S., Jingzhong Ding, M.D., Kiang Liu, Ph.D., Debiao Li, Ph.D., Robson Macedo, M.D., Shenghan Lai, M.D., Jens Vogel-Claussen, M.D., Elizabeth R. Brown, Sc.D., and JoГЈo A. C. Lima, M.D.


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Focussing On Manufacturing Breakthroughs

Flexible plastic solar cells that can be printed like money, carbon fibres so thin they can be spun into yarns and a raft of new biomedical products to combating illness and injury are just some of the research breakthroughs being developed by the new CSIRO National Research Flagship for Future Manufacturing just launched.



The Flagship - a $A36.2 million research program designed to boost Australia's manufacturing capabilities - was launched in Melbourne by Innovation Minister, Senator Kim Carr.



"Australia's innovative and highly skilled manufacturing industry is one of the greatest hopes for our future prosperity and this flagship is an important addition to its arsenal," Senator Carr said.



"Manufacturing not only provides quality jobs, it drives innovation through mobilising new skills and creating new capabilities.



"Countries that don't have manufacturing industries are building them fast and those that have let their industries go are racing to get them back.



"Australia's manufacturing employs around one million Australians, generates 10 percent of GDP and exports over $A94 billion a year.



"Australian manufacturers are under increasing pressure from global competition, the rise of low-cost, low-wage manufacturing economies, and the changes that will need to be made to reduce emissions and become more sustainable.



"The future of our manufacturing industry is tied to its willingness and capacity to continue to innovate. It needs to focus on high technology, high-skill, and high-wage manufacturing where its strengths lie. This Flagship will help hone that focus."



CSIRO Deputy Chief Executive, Dr Alastair Robertson, said CSIRO's advances in the commercial development of flexible, large area, cost-effective, reel-to-reel printable plastic solar cells, supports this approach.



"Developed with our partners in the Victorian Organic Solar Cell Consortium, flexible plastic solar cells will be much cheaper and more efficient to produce, and have the potential to replace silicon in the next generation of solar collectors," Dr Robertson said.



"This is the kind of transformational, environmentally responsible technology the new Flagship has been established to create to support sustainable manufacturing into the future."



The Future Manufacturing National Research Flagship was launched at the Flagship's recently refurbished, state-of-the-art Flexible Electronics research facility at CSIRO's Clayton laboratories.



Flagship Director, Clive Davenport, said innovation is the key to positioning Australian manufacturing to meet the challenges of the future.



"Taking a holistic approach, encompassing innovation together with market integration, the Flagship will streamline the uptake of new technologies for Australian industry, which will be crucial to improving the future competitiveness of our manufacturing sector as well as generating new employment opportunities," Mr Davenport said.



"In partnership with industry we will focus on emerging manufacturing opportunities in flexible electronics, cleantech manufacturing, biomedical manufacturing and nanosafety, helping the Australian manufacturing sector address major national challenges in energy, health, climate and waste."



National Research Flagships



CSIRO initiated the National Research Flagships to provide science-based solutions in response to Australia's major research challenges and opportunities. The 10 Flagships form multidisciplinary teams with industry and the research community to deliver impact and benefits for Australia.



Source:
Tracey Nicholls


CSIRO Australia

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New Research Reveals Irish People Unaware Of Their Blood Pressure Reading

The results of new research on blood pressure

announced today reveal that despite Irish people getting their blood

pressure checked, the majority of them do not know what their reading is

(1). The research was commissioned by Boehringer Ingelheim in advance of

World Hypertension Day 2008 this Saturday, 17th May. High blood pressure,

or 'hypertension', is a very common disorder in Ireland and is associated

with an increased risk of coronary artery disease, stroke, heart attack,

kidney failure, and death. Unfortunately, there are no symptoms of

hypertension and the only way it can be diagnosed is by having one's blood

pressure measured at regular intervals. About half of Irish adults over 50

years of age have high blood pressure (2).





Over 80% of those surveyed claimed to have had a blood pressure measurement

in the last year, but only a quarter recall their results and of those,

only about half (i.e. 14%) can recall their measurement with any accuracy

(1). In relation to the appropriate blood pressure measurement for a

healthy adult, only 33% claim to know what the normal measurement should be

(1).





The normal level of blood pressure is usually about 120 (systolic) over 80

(diastolic), but this can vary with age, how a person feels and activity. A

person with blood pressure higher than 140 over 90 should be seen for

follow-up by their family doctor. Generally anyone over 30 years old should

have their blood pressure checked every two years, preferably by their

family doctor.





When asked to rate cardiovascular diseases in order of what would be most

frightening to them 50% surveyed said a stroke, 34% said a heart attack,

13% said heart failure, with only 2% saying high blood pressure (1).




"As high blood pressure is the most important risk factor in stroke, it is

a matter of concern that only 2% of people rate this as most frightening.

This finding indicates that there is a disconnect amongst people as to what

causes stroke. It is important to realise that, if left untreated, this

'silent killer' as it is often called, can cause a stroke. Allowing it go

untreated can potentially lead to this life threatening condition, amongst

other conditions such as heart attack, heart failure and kidney disease,"

said Dr. John Cox, a General Practitioner in Fethard-on-Sea with an

interest in hypertension. "Fortunately, high blood pressure is easy to

diagnose and usually controllable with lifestyle modifications (diet,

exercise & weight reduction) and for some, medication where necessary. I

would advise people to ask their GP or healthcare provider to give them

their blood pressure reading at the time it is taken, and to keep a record

of it for future reference. The main message is, check your blood pressure

and know you reading."

















When asked what time of day a person is most likely to have a

cardiovascular event, such as a heart attack or stroke, 80% of people

surveyed did not know that risk was greatest in the early morning hours

(1). The highest rise in blood pressure occurs in the early morning hours

(3), so for people with hypertension, the early morning hours pose the

largest risk (4, 5).




There is often no single cause of high blood pressure. A number of factors

can combine to raise blood pressure and high blood pressure tends to run in

families. Being overweight, having a high consumption of alcohol, poor

level of exercise, high stress levels and eating too much sodium (found in

salt) may lead to an increase in blood pressure. Blood pressure also

increases with age.




Another important finding was that 90% of those surveyed believe that in

most cases high blood pressure can be cured when treated. There is no cure

for high blood pressure, but it is controllable usually with lifestyle

modifications and medication if indicated. It was noted that there is a

general consensus over the broad descriptions of high blood pressure, with

96% agreeing that high blood pressure can lead to other problems such as

stroke, 93% agreeing that treating high blood pressure can reduce the

chance of a person having a heart attack or stroke and 86% believe high

blood pressure is often caused by poor diet and/or lack of exercise (1).





Of those surveyed about a third of adults (29%) aged 35+ have suffered high

blood pressure with the incidence most apparent among those aged 65+, in
the C2DE's and those in the rest of Leinster, excluding Dublin (1).

Interestingly Dubliners recorded the lowest incidence of high blood

pressure, at 17% (1).





World Hypertension Day, initiated by the World Hypertension League in 2005,

was established to highlight the serious medical complications of

hypertension and to communicate to the public information on prevention,

detection and treatment. Each year, May 17th is designated World

Hypertension Day (6).




Research Methodology



This survey was conducted through Behaviour & Attitudes' TeleBarometer

survey, which delivers a nationally representative sample of 1,000 adults

aged 15+. Quotas used reflect census distribution of population (gender,

age, class, region, etc). All interviewing was conducted via the telephone

in Behaviour & Attitudes' in-house Computer Assisted Telephone Interviewing

(CATI) unit. Fieldwork was conducted between April 2nd - April 13th 2008.

The survey delivered a sample of 645 adults aged over 35. All interviewing

was conducted in accordance with the standards established for market

research by ESOMAR (Europe), MRS (UK) and Marketing Society (Ireland).





Boehringer Ingelheim



The Boehringer Ingelheim group is one of the world's 20 leading

pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates

globally with 135 affiliates in 47 countries and 39,800 employees. Since it

was founded in 1885, the family-owned company has been committed to

researching, developing, manufacturing and marketing novel products of high

therapeutic value for human and veterinary medicine.





In 2007, Boehringer Ingelheim posted net sales of 10.9 billion euro while

spending one fifth of net sales in its largest business segment

Prescription Medicines on research and development.



boehringer-ingelheim



References:



1. 'Awareness of and Attitudes to Hypertension', Behaviour and Attitudes

TeleBarometer Research, April 2008



2. About half of Irish adults over 50

years of age have high blood pressure



3. Neutel, JM, et al. Magnitude of the early morning blood pressure surge

in hypertensive patients- pooled analysis. Poster presented at the 20th

Annual Meeting of the American Society of Hypertension, San Francisco,

14-18 May 2005.



4. Shimada, K, et al. Blood Press. Monit 2001; 6: 349-353.



5. Elliot, WJ, et al. Am. J. Hypertens. 2001; 14: 291S-295S.



6. World

Hypertension Day

Boehringer Ingelheim

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Asthma And Eczema Sufferers Have A Lower Risk Of Developing A Cancer

Men who had a history of asthma or eczema generally had a lower risk of developing cancer, according to a study carried out by researchers at INRS Institut Armand-Frappier, the Research Centre of the Centre hospitalier de l'UniversitГ© de MontrГ©al, and McGill University. The findings, published in the Annals of Allergy, Asthma & Immunology, show that male eczema sufferers had a lower risk of lung cancer while those with a history of asthma had a similar effect in relation to stomach cancer.


"Asthma and eczema are allergies brought about by a hyper-reactive immune system a state which might have enabled abnormal cells to have been eliminated more efficiently, thereby reducing the risk of cancer," explained Professor Marie-Claude Rousseau of the INRS Institut Armand-Frappier, one of the co-authors of the research.


The researchers analyzed information that was collected in a study on exposures in the workplace and the risk of developing cancer, undertaken between August 1979 and March 1986. It involved 3,300 men, between 35 and 70 years of age, who had been diagnosed with cancer in one of Montreal's 18 hospitals, and a control group of 512 people from the general population who did not have cancer. The researchers used the data from this study to determine if there was a link between allergies such as asthma and eczema and the incidence of eight most common types of cancer.


These findings contribute important knowledge to population health and provide new research leads. Although the study did not allow to identify which specific factors related to asthma and eczema were responsible for reducing the risk of cancer, it offers new angles for research into the molecular and immunological mechanisms that are involved in immunostimulation, a potentially promising strategy for cancer prevention.


The epidemiological study was undertaken by Mariam El-Zein, Marie-Г‰lise Parent, Yves St-Pierre and Marie-Claude Rousseau of the INRS; Khady KГў of McGill University, and Jack Siemiatycki of the Research Centre of the Centre hospitalier de l'UniversitГ© de MontrГ©al and of UniversitГ© de MontrГ©al. It received funding from Health Canada, the Institut de recherche Robert-SauvГ© en santГ© et sГ©curitГ© au travail du QuГ©bec, the Fonds de la recherche en santГ© du QuГ©bec, the Medical Research Council of Canada, the Canadian Cancer Society, and the Canadian Institutes of Health Research.


Source: McGill University

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House Panel Questions Ties Between Not-for-Profit Company Hired To Design New Drug Ad Web Site, Drug Marketing Firm

House Energy and Commerce Committee Chair John Dingell (D-Mich.) and Oversight and Investigations Subcommittee Chair Bart Stupak (D-Mich.) on Tuesday sent a letter to FDA inquiring about the agency's decision to employ a not-for-profit group with ties to a drug marketing firm to design a new agency Web site that aims to help consumers understand drug advertisements, CQ Today reports. The new Web site, "Be Smart About Prescription Drugs: A Guide For Consumers," was created by EthicAd, a not-for-profit organization funded by the drug marketing firm Shaw Science Partners, according to Dingell and Stupak. Shaw's clients include AstraZeneca, Merck, Pfizer, Eli Lilly, Bayer and Wyeth. According to EthicAd's Web site, EthicAd in November 2000 agreed to create FDA's drug ad information Web site. The information was compiled by EthicAd volunteers on a pro bono basis, and the FDA Web site was launched in September 2008.

EthicAd and Shaw are located in different suites in the same Georgia building but EthicAd lists no contact information on its Web site. Shaw President Michael Shaw serves as EthicAd's executive director, according to his 2001 testimony before the Senate Commerce, Science and Transportation Committee.

In the letter, Dingell and Stupak asked "why FDA sought the assistance of a pharmaceutical public relations firm to help it advise consumers on how to interpret ... advertisements." Dingell in a statement said he "had serious concerns that the leading pharmaceutical companies do not share our commitment to providing consumers with accurate information about drug therapies." Dingell and Stupak sent similar letters to Michael Shaw at EthicAd and at Shaw Science Partners. Michael Shaw could not be reached for comment on Tuesday (Armstrong, CQ Today, 10/14).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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How disease bacterium survives inside immune system cell - Scientists reveal

New research on a bacterium that can survive encounters with specific immune system cells has strengthened scientists'
belief that these plentiful white blood cells, known as neutrophils, dictate whether our immune system will permit or prevent
bacterial infections. A paper describing the research was released today online in The Journal of Immunology. Frank R. DeLeo,
Ph.D., of Rocky Mountain Laboratories (RML), part of the National Institute of Allergy and Infectious Diseases (NIAID) of the
National Institutes of Health, directed the work at RML, in Hamilton, MT, in collaboration with lead author Dori L.
Borjesson, D.V.M., Ph.D., of the University of Minnesota in St. Paul.


Scientists analyzed how neutrophils from healthy blood donors respond to Anaplasma phagocytophilum, a tick-borne bacterium
that causes granulocytic anaplasmosis in people, dogs, horses and cows. A. phagocytophilum is carried by the same tick that
transmits Lyme disease and was first identified in humans in 1996. Human granulocytic anaplasmosis (HGA) -- formerly called
human granulocytic ehrlichiosis -- is prevalent in Minnesota and along the East Coast. HGA typically causes mild symptoms
that include fever, muscle aches and nausea. Some 362 U.S. cases were reported to the Centers for Disease Control and
Prevention in 2003.


HGA is considered an emerging infectious disease, and Dr. Borjesson is working to understand how it affects blood cells --
and neutrophils in particular. "Few people know about this pathogen, but it is important because it is transmitted by ticks
and causes disease in both animals and humans," Dr. Borjesson says.


Neutrophils, which make up about 60 percent of all white blood cells, are the largest cellular component of the human immune
system -- billions exist inside each human. Typically, neutrophils ingest and then kill harmful bacteria by producing
molecules that are toxic to cells, including a bleach-like substance called hypochlorous acid. Once the bacteria are killed,
the involved neutrophils self-destruct in a process known as apoptosis. Recent evidence suggests that this process is vital
to resolving human infections.


A. phagocytophilum is unusual in that it can delay apoptosis in human neutrophils, which presumably allows some of the
bacteria to replicate and cause infection.


"This particular bacterium specifically seeks out neutrophils -- possibly the most lethal of all host defense cells -- and
remarkably, can alter their function, multiply within them and thereby cause infection," says NIAID Director Anthony S.
Fauci, M.D.


Dr. DeLeo says the findings contrast with what is known about other bacterial pathogens, most notably Staphylococcus aureus,
which is of great interest because of its increasing resistance to antibiotic treatment. S. aureus, often simply referred to
as "staph," are bacteria commonly found on the skin and in the noses of healthy people. Occasionally, staph can cause
infection; most are minor, such as pimples, boils and other skin conditions. However, staph bacteria can also cause serious
and sometimes fatal infections, such as bloodstream infections, surgical wound infections and pneumonia.


In their experiments, the research team compared the neutrophil response to A. phagocytophilum with that of a weak strain of
S. aureus. Using microarray technology that allowed them to compare about 14,000 different human genes, the researchers
discovered how the response to A. phagocytophilum deviates from that of S. aureus, and thus permits the HGA agent to survive.



"This study has given us a global model of how bacteria can inhibit neutrophil apoptosis," says Dr. DeLeo. "Our next step is
to look at specific human genes or gene pathways within this model and try to determine which of these molecules help prolong
cell life following infection." Information gathered from these and similar studies, he adds, could help researchers develop
therapeutics to treat or prevent bacterial infections.


Other RML collaborators included Jovanka Voyich, Ph.D., and Scott Kobayashi, Ph.D., now an assistant professor at the
University of Idaho.


RML is part of the National Institutes of Health (NIH). NIH is an agency of the U.S. Department of Health and Human Services.
NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other
sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID
also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies.



Reference: D Borjesson et al. Insights into pathogen immune evasion mechanisms: Anaplasma phagocytophilum fails to induce an
apoptosis differentiation program in human neutrophils. The Journal of Immunology 174(10):6364-72 (2005).


Press releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at niaid.nih.


Contact: Ken Pekoc

kpekocniaid.nih

406-375-9690

NIH/National Institute of Allergy and Infectious Diseases

niaid.nih

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How Do High-Folate Diets Protect Against Heart Disease?

As we all know, a healthy diet involves greens,
beans and fruits. Folate, a B vitamin abundant in each of these food
groups, may not be a household name, but a high folate diet is certainly
well-known to reduce the risk of heart disease and stroke. Interestingly,
scientists have never clearly understood the process by which folate fully
benefits us. In a new study published in this month's issue of the
scientific journal Circulation Research, MUHC investigators shed light on
the mysterious connection between folate and heart disease.


"We knew that a low folate diet could increase homocysteine-an amino
acid-in the blood," says lead researcher Dr. Rima Rozen, Scientific
Director of The Montreal Children's Hospital of the MUHC. "But there was a
missing link between the homocysteine and heart disease and stroke."


Using mouse models, and later confirming their results in humans, the
investigators used genetic analyses to map out the 'rollercoaster of
reactions'. "Our study reveals that low folate diets increase homocysteine,
which lowers HDL cholesterol-the so called 'good' cholesterol-which in-turn
increases the risk of heart disease and stroke," says Dr. Rozen.


The benefits of a high folate diet have been perceived for many years; both
the US and Canada have regulations requiring the addition of folic acid
(the synthetic form of folate) to breads, cereals, flours, corn meals,
pastas and rice to increase its intake in the general population. "Now we
can finally explain an important pathway that links folate to heart disease
and stroke, and we have yet another reason to eat plenty of greens, beans
and fruits," says Dr. Rozen.


The Research Institute of the McGill University Health Centre (RI MUHC) is
a world-renowned biomedical and health-care hospital research centre.
Located in Montreal, Quebec, the institute is the research arm of the MUHC,
a university health center affiliated with the Faculty of Medicine at
McGill University. The institute supports over 500 researchers, nearly 1000
graduate and post-doctoral students and operates more than 300 laboratories
devoted to a broad spectrum of fundamental and clinical research. The
Research Institute operates at the forefront of knowledge, innovation and
technology and is inextricably linked to the clinical programs of the MUHC,
ensuring that patients benefit directly from the latest research-based
knowledge. For further details visit: www.muhc/research.


The McGill University Health Centre (MUHC) is a comprehensive academic
health institution with an international reputation for excellence in
clinical programs, research and teaching. The MUHC is a merger of five
teaching hospitals affiliated with the Faculty of Medicine at McGill
University--the Montreal Children's, Montreal General, Royal Victoria, and
Montreal Neurological Hospitals, as well as the Montreal Chest Institute.
Building on the tradition of medical leadership of the founding hospitals,
the goal of the MUHC is to provide patient care based on the most advanced
knowledge in the health care field, and to contribute to the development of
new knowledge.

muhc

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Kaiser Daily Health Policy Report Feature Highlights Recent Blog Entries

"Blog Watch" offers readers a roundup of health policy-related blog posts.

The American Prospect's Ezra Klein notes that some unions oppose proposals being considered to tax health care benefits.

John Iglehart of the Health Affairs Blog looks at a new Business Roundtable report that looked at the difference in "value" of U.S. health spending compared with other nations and how it impacts competition.

Greg D'Angelo of the Heritage Foundation's The Foundry says changing the tax treatment of health care is a bipartisan issue.

Mike Feehan on Insure Blog explains why certain health plans are regulated by ERISA, in relation to the Healthy San Francisco plan.

Greg Scandlen on John Goodman's Health Policy Blog looks at out-of-pocket spending by Medicare beneficiaries and says Medicare is the source of "massive 'underinsurance,'" based on the common definition of spending more than 10% of one's income on health care.

Marilyn Werber Serafini of the National Journal's Health Care Expert Blog asks, "How serious are Medicare's financial problems? Can they easily be solved without jeopardizing the fundamental integrity of the program? What are the best and worst possible responses?" Responders include Drew Altman, Stuart Butler, Karen Davis, John Goodman, Len Nichols, Uwe Reinhardt, John Rother, Leonard Schaeffer and Kerry Weems.

James Capretta of the National Review Online's The Corner looks at news that Massachusetts is facing difficulty controlling health care costs and says, "If President Obama succeeds [in passing similar reforms], he and the Congress will be back in a year or two or three ... to say the financial future of the country depends on agreeing to government-imposed cost constraints, just as Massachusetts officials are doing today."

Uwe Reinhardt on the New York Times' Economix responds to some reader comments on his comparative-effectiveness post.

Linda Gorman of the State Policy Network Blog looks at a report that found CHIP had the highest rate of payment errors among government health programs.


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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Despite High Rates Of Health Insurance Coverage, Major Health Care Challenges Persist For D.C. Children

Despite high rates of health insurance coverage among children in the District of Columbia, children's access to health care is inadequate and poses a significant health problem for the city's young residents, particularly those who are publicly insured, according to a RAND Corporation study.



The study, conducted by RAND Health and funded by Children's National Medical Center, assesses health and health care among the more than 100,000 youth residing in Washington, D.C. Researchers suggest that health promotion efforts must focus on a partnership involving numerous private and public sector organizations that serve children, including schools, community-based organizations and child care centers.



The District of Columbia leads the nation in children with health coverage, with only 3.5 percent estimated to be uninsured in 2007. Nationally, an estimated 9.1 percent of children lack health insurance.



"But having health insurance in the District of Columbia does not automatically translate into access to health care," said Anita Chandra, the report's lead author and a behavioral scientist at RAND.



Access problems appear especially profound for children who have publicly funded insurance. The study finds that rates of well-child care among publicly insured children are substantially below national norms and more than one in four publicly insured children in the District receives care at a hospital emergency department at least once a year.



The study is the first to comprehensively focus on children's health issues and examine not only the health service delivery system, but the communities in which children live in the District of Columbia. Researchers aim to provide a foundation for District policymakers to examine children's health issues, as well as assist the Children's National Medical Center in allocating its community benefit resources.



The study finds that numerous barriers prevent residents from getting primary and specialty health care in non-hospital settings. One major factor is the uneven distribution of primary and specialty care providers across the District. Other barriers cited by District residents in the study include a perceived lack of provider understanding of cultural and neighborhood issues, as well as a limited availability of health care providers who speak languages other than English. The study also finds that particular health conditions and health behaviors require special attention because of their prevalence and potential severity. Although children are generally healthier than adults, researchers identified several chronic health conditions that are prevalent among District youth, including asthma, sickle cell anemia, HIV/AIDS and obesity.



"Children with asthma, in particular, are substantial users of hospital-based care," said Carole Roan Gresenz, a study co-author and senior economist at RAND. "District of Columbia leaders will want to focus on services that will help children manage their asthma and other chronic conditions before they end up in the emergency department or hospital."



Researchers find that socioeconomic, environment and safety conditions also are crucial issues facing District youth.



Though the rate of children in poverty in the District has declined in recent years, the percentage of children who live in poverty in the District remains higher than the national percentage (23 percent versus 18 percent).



Safety and violence are particularly important issues. The rate of dating violence in the District increased from 11 percent to 17 percent from 2005 to 2007, and rates of child abuse and neglect are twice the national average. As a result, far more children are in the District's foster care system than the national average.



The study includes a unique synthesis of information from previous research, including vital statistic reports and studies of school nursing and school mental health programs, along with original data analysis of existing survey and administrative information. The research also included information obtained from focus groups with parents, adolescents and health care providers.
The report's key recommendations include:
Develop and apply strategies that will increase children's access to primary and specialty care. This includes increasing the network of providers through better and faster reimbursement, and incentives such as support for electronic health record implementation.


Focus attention on children with the most prevalent chronic illnesses: asthma, sickle cell anemia, HIV/AIDS and obesity. Early preventive care will help children manage their conditions before they need the hospital or emergency department.


Give more attention to prevention and wellness programs across sectors. This would include violence prevention programs that address school safety issues, emotional wellness programs and sexual health interventions that combine discussions of risky sexual activity with life skills training.

"This report is an unprecedented review of pediatric-specific issues in the District," said Jacqueline D. Bowens, executive vice president at Children's National Medical Center. "Based on these findings, Children's National may take the lead on new issues, collaborate on others, and then play a supporting role on social and infrastructure development factors that ultimately affect children's health."



The study, "Health and Health Care Among District of Columbia Youth," can be found at rand. Other authors of the report are Janice Blanchard, Alison Evans Cuellar, Teague Ruder, Alex Chen and Emily Gillen.



Source:
Joe Dougherty


RAND Corporation

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Children's Health Suffers When Families Must Choose Between Basic Necessities And Paying For Medical Care

When the high cost of health care forces families to forgo paying for basic household expenses, such as rent, utilities or food, children's health suffers, according to research presented at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.



Medical care and prescriptions can be costly, even for families with health insurance. However, it is unknown whether health care costs are related to child health.



To explore this question, researchers from Children's HealthWatch, based at Boston Medical Center and Boston University Schools of Medicine and Public Health, interviewed 6,447 low-income caregivers with children ages 0-36 months. Caregivers were asked whether they needed to "trade off" paying for household expenses to obtain medical care, whether they had health insurance and about their child's health history. Children were weighed and measured, and their developmental risk was assessed using the Parents' Evaluation of Developmental Status.



Results showed that 5 percent of caregivers reported making trade-offs to pay for medical care. They most commonly did not pay utility bills (32 percent), rent/mortgage (25 percent) or went without food (21 percent).



Young children in these families, compared to similar families who did not have to make trade-offs, were at increased risk of fair or poor health, hospitalization, developmental delays and shorter stature (an indication of undernutrition), said Stephanie A. Ettinger de Cuba, MPH, lead author of the study and a researcher with Children's HealthWatch.



"Family hardships and high out-of-pocket health care costs are written on the bodies of babies," Ettinger de Cuba said.



Results also indicated that families who did without basic necessities to pay for health care had higher levels of education, and were more likely to be married and breastfeed. Their children also were more likely to be uninsured than children whose families who did not have to make trade-offs.



"This suggests that families who had to make trade-offs are experiencing a paradoxical situation in which caregivers do not earn enough to pay for private insurance for their children, nor do they earn so little that their children can qualify for public insurance, leaving them uninsured and unable to afford both medical costs and basic needs," Ettinger De Cuba said.



Public policies that broaden children's as well as families' access to assistance with health care costs and basic needs may reduce the need for families to choose between essential expenses, thereby improving children's health and development, the researchers concluded.



Source:

Susan Martin

American Academy of Pediatrics


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