Antibiotics are Ineffective for Sinus Infections

British researchers are calling on doctors to cut back on prescribing antibiotics to patients with common sinus infections because the drugs don’t work. 

An analysis of nine trials published in the journal The Lancet found antibiotics were ineffective treatments even in people who had been ill for more seven days.
 
Sinusitis is an infection of the sinuses, small air pockets inside the cheekbones and forehead. Infected sinuses can cause blocked and runny noses, sinus pain, and high temperature. It is a very common occurrence, and often follows a cold or flu. According to BBC News, 1-5% of adults are diagnosed every with a sinus infection, around 90 percent of which are given antibiotic prescriptions.   

Current guidelines advise doctors to prescribe antibiotics only when the patient has been ill for seven to ten days, since an illness of this length was thought to indicate a bacterial rather than viral infection.

But the latest research, which examined how long 2,600 patients were ill before receiving treatment, found the time duration of the illness is not a good predictor of whether antibiotics will be effective.

Based on their work, the researchers concluded that antibiotics are not justified, even in patients who have been ill for longer over a week, because of the side-effects, costs and the risk of resistance. The data supported their conclusion, finding that 15 patients would need to be treated before even one would be cured with antibiotics.

Dr Jim Young from the Basel Institute for Clinical Epidemiology in Switzerland, the study’s leader, told BBC News, “If a patient comes to the GP and says they have had the complaint for seven to 10 days that’s not a good enough reason for giving them the antibiotic.”

He added that a rational approach for doctors would be to advise their patients to return if symptoms continue or got worse for another week.

This week, the National Institute for Clinical and health Excellence (NICE) published a draft guidance advising doctors against prescribing antibiotics or issuing delayed prescriptions that patients can use only if they do not improve over time.

Dr Ian Williamson, the study’s co-author, a GP in Southampton and researcher at Southampton University, said sinusitis was a terrible condition and people expected to get antibiotics from their GP to help them.

“Antibiotics really don’t look as if they work.

“We have found that antibiotics aren’t effective for sore throats and ear infections but sinusitis, which is similar, is the one that people are slightly more die hard about.”

Professor Steve Field, chair of Britain’s Royal College of GPs, said doctors had been working hard to reduce antibiotic use for sinusitis in recent years, but the drug was likely still overprescribed. 

“This gives reassurance to GPs that even if patients have specific symptoms, it’s unlikely antibiotics are going to make a dramatic difference.”

He recommended that those suffering from sinus infections might relieve symptoms with steam, paracetamol and rest.

“You don’t need to see the GP unless you’ve been ill for a week.”

North Castle Partners Invests in World Health Club, Inc. Increasing Its Presence in the Fitness Industry

GREENWICH, Conn., and CALGARY, Alberta, March 14 /PRNewswire/ — North Castle Partners, along with its co-investors, announced today that it has acquired the assets of International Fitness, Inc. (“World Health Club” or the “Company”). World Health Club is a leading operator of fitness clubs in the province of Alberta, Canada. North Castle is a leading private equity firm focused exclusively on investments in consumer-driven product and service businesses that benefit from “Healthy Living and Aging” trends. The terms of the investment were not disclosed.

North Castle’s investment in World Health Club further extends the firm’s expertise in the Fitness and Recreation sector. North Castle currently holds investments in Octane Fitness Holdings, Inc., a leading designer and distributor of premium low-impact cardio fitness equipment, Cascade Helmet Holdings, a leading provider of premium athletic protective headgear, and Performance, Inc., the largest independent bicycle dealer and direct marketer of bicycles and cycling accessories in the United States. North Castle previously owned Equinox Fitness Holdings, a leading operator of upscale fitness clubs, which it sold to The Related Group in 2006.

“We are excited to reenter the world of fitness club operators with Rob Leach, our partner and the CEO of World Health Club,” said Doug Lehrman, a North Castle Managing Director and developer of the firm’s Fitness and Recreation vertical. “As World Health Club grows, we intend to apply the knowledge we have acquired from our successful investments in Equinox and Octane, and seek to add further value by leveraging our expansive network of industry leaders, including Augie Nieto, founder and former CEO of Life Fitness and John McCarthy, founding Executive Director of the International Health, Racquet, and Sportsclub Association (IHRSA).”

World Health Club currently operates 14 fitness clubs in Alberta’s two largest cities, Calgary and Edmonton. The Company provides health club services to approximately 40,000 members, offering fitness memberships and other ancillary services including personal training and group fitness classes. The World Health Club member value proposition is based on three key competitive drivers: value, convenience and personal training.

“It is with great pleasure that we enter this new era at World Health Club and our new partnership with North Castle,” said CEO Rob Leach. “North Castle brings a wealth of knowledge and expertise in business and health club operations which will provide an important competitive advantage as we grow the World Health Club brand across Western Canada and continue to build our business into a world class organization with a best practices commitment to excellence.”

Mr. Leach has maintained a significant portion of his investment in World Health Club, and he and other members of senior management will continue in their current positions.

This is North Castle’s fourth investment in nine months; three of these investments have been made in the Fitness and Recreation sector. In addition to the World Health Club investment, North Castle has acquired a controlling interest in Cascade Helmet Holdings, Atkins Nutritional Holdings, Inc., and Performance, Inc.

In 2007, North Castle recapitalized Octane Fitness (returning a dividend equal to 1.0x its 2005 investment) and sold three companies to strategic acquirers, the sale of Avalon Organics(R) and Alba Botanica(R) natural and organic personal care brands to The Hain Celestial Group, Inc., the Naked Juice Company to PepsiCo, and HDS Cosmetics Lab, Inc., the manufacturer and marketer of Doctor’s Dermatologic Formula (DDF) skin care, to The Procter & Gamble Company.

World Health was represented by Partnership Capital Growth (http://www.pcg-advisors.com/) as its exclusive financial advisor.

About North Castle Partners

North Castle Partners is a leading private equity firm focused exclusively on investments in consumer-driven product and service businesses that benefit from “Healthy Living and Aging” trends. North Castle is a hands-on, value- added investor in high-growth, middle market companies in the (i) aesthetics and personal care, (ii) consumer health, (iii) fitness and recreation, (iv) home and leisure and (v) nutrition industries.

North Castle’s current portfolio includes such well-known brands as Atkins Nutritionals, gloProfessional, Red Door Spas, Enzymatic Therapy, Performance Bicycle, Cascade Helmets and Octane Fitness. Prior portfolio company holdings include Equinox Fitness, EAS, CRC Health Group, Doctor’s Dermatologic Formula, Naked Juice Company and Avalon Natural Products.

North Castle is led by a seasoned investment team including 12 proactive operating advisors who bring a wide range of operational and investment capabilities as well as an extensive knowledge base and network. The strength of the North Castle team, combined with our focus and network, provides significant competitive advantages in building world-class companies. North Castle is headquartered in Greenwich, CT. For more information, visit http://www.northcastlepartners.com/.

About World Health Club

World Health Club is Alberta’s leader in offering convenient and affordable fitness services. The company is built on the philosophy of great service, convenient locations, state-of-the-art equipment and knowledgeable staff, all for an affordable price. The company’s goal is to be a part of our community by helping people to live healthy and active lives. With 14 clubs in Alberta to serve its community, we are changing lives each and every day. Learn more about World Health Club at http://www.worldhealthclub.com/.

    Contact:  Todd Fogarty              Kekst and Company              212-521-4854  

North Castle Partners

CONTACT: Todd Fogarty of Kekst and Company, +1-212-521-4854, for NorthCastle Partners

Web site: http://www.northcastlepartners.com/http://www.worldhealthclub.com/http://www.pcg-advisors.com/

Indonesia AirAsia to Spend RM200m on Developing New Routes

By Anna Maria Samsudin

JOGJAKARTA: Indonesia AirAsia, a 49 per cent subsidiary of AirAsia Bhd, will pump in RM200 million to develop more new routes to Malaysia from four of its points in Indonesia this year.

Instead of flying solely to Kuala Lumpur, the airline will be expanding its wings to other new destinations in Malaysia namely Kota Kinabalu, Kuching and Penang from its two hubs, Jakarta and Bali, as well as Medan and Jogjakarta.

To date, it has already obtained approval to fly to some of these destinations and expects to commence some of the flights as early as March 30.

AirAsia group chief executive officer Datuk Tony Fernandes said despite the huge investments and high risk involved, the airline is optimistic of making these new services profitable.

He pointed out that the budget airline has always been adventurous in introducing routes that have not been served by other airlines such as its Kuala Lumpur-Bandar Acheh and Kuala Lumpur- Bandung flights.

“I always believe that with the right marketing strategy as well as hard work and good planning, all routes can be profitable.

“Besides, I think operating routes not provided by others would enable us to widen our network and offer our passengers more destinations to go to,” he told reporters after the official launch of the Kuala Lumpur-Jogjakarta flight here on Wednesday.

Indonesia AirAsia president-director Captain Dhamardi said looking at its aggressive international route expansion, the airline is optimistic of making profits by this year.

In line with Visit Indonesia Year, the airline aims to see its international fights account for 50 per cent of the flights operated from 30 per cent last year.

Apart from Malaysia, he said the airline also plans to introduce more international routes such as Jakarta-Bangkok and Bali-Perth.

“Looking at our route expansion plan, we expect to see higher yield from our international flights. We are optimistic of becoming profitable this year,” he added.

Meanwhile, in addressing soaring fuel prices, Fernandes said the airline may need to review its fares if the need arises.

However, this would only be as a last resort measure after it has exhausted all of its options.

The four times weekly Kuala Lumpur-Jogjakarta flights, which is AirAsia’s 13th entry into Indonesia and started on January 13 2008, has already reached more than 75 per cent average load factor. AirAsia will mount daily flights on the Kuala Lumpur-Jogjakarta route by April 15.

Going forward, under Indonesia AirAsia, more routes will be operated via Jogjakarta namely to Jakarta, Bali and Singapore.

(c) 2008 New Straits Times. Provided by ProQuest Information and Learning. All rights Reserved.

Escalator Injuries Doubled For Older Adults

In the first large scale national study of escalator-related injuries to older adults, researchers led by Joseph O’Neil, M.D., MPH, and Greg Steele, Dr.PH., MPH, of the Indiana University School of Medicine, report that the rate of these injuries has doubled from 1991 to 2005. The results of the study are published in the March 2008 issue of the journal Accident Analysis and Prevention.

Using U.S. Consumer Product Safety Commission data, the researchers found nearly 40,000 older adults were injured on escalators between 1991 and 2005. The most frequent cause of injury was a slip, trip or fall resulting in a bruise or contusion. The most common injuries were to the lower extremities. However, most injuries were not serious. Only 8 percent of the 39,800 injured were admitted to the hospital after evaluation in an emergency department.

“Although escalators are a safe form of transportation, fall-related injuries do occur. Older adults, especially those with mobility, balance or vision problems, should use caution while riding an escalator and especially when stepping on or off. They should not try to walk up or down a moving escalator, carry large objects, or wear loose shoes or clothing while riding since these appear to be associated with an increased risk of falling,” said Dr. O’Neil, associate professor of clinical pediatrics at the IU School of Medicine.

Older adults who have difficulty walking or maintaining balance should use elevators rather than escalators, the study authors caution.

“What really surprised us was the reckless behavior exhibited by some older adults on escalators,” said Dr. Steele, associate professor of epidemiology in the IU School of Medicine’s Department of Public Health. “One emergency department reported a fall by an escalator rider who attempted to squeeze past an individual in a wheelchair and the individual’s attendant who were also on the escalator. Obviously, the wheelchair should not have been on the moving stairs. And of course the injured individual should not have attempted to beat them down the stairs.”

“People may wonder why a pediatrician is studying older adults, but it’s not really a stretch. Older adults have many of the same mobility and balance issues as young children,” said Dr. O’Neil, a developmental pediatrician at Riley Hospital for Children. He is an expert on injury prevention who says that injury should be considered as much a medical illness as heart disease, stroke or diabetes. “We have to stop thinking of unexpected injuries as accidents, which implies that they are unpreventable. Escalator injuries, like auto crashes and many other so-called accidents, can be prevented,” he said.

Co-authors of the study are Carrie Huisingh, MPH, of the Massachusetts Department of Public Health and Gary A. Smith, MD, DrPH, of Children’s Hospital, Columbus, Ohio.

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Accident Analysis and Prevention

U.S. Consumer Product Safety Commission

Dolphin Appears to Guide Whales to Sea

Most days, Moko the bottlenosed dolphin swims playfully with humans at a New Zealand beach. But this week, it seems, Moko found his mojo. Witnesses described Wednesday how they saw the dolphin swim up to two stranded whales and guide them to safety.

Before Moko arrived, rescue workers had been working for more than an hour to get two pygmy sperm whales, a mother and her calf, back out to sea after they were stranded Monday off Mahia Beach, said Conservation Department worker Malcolm Smith.

But Smith said the whales restranded themselves four times on a sandbar slightly out to sea from the beach, about 300 miles northeast of the capital, Wellington. It looked likely they would have to be euthanized to prevent a prolonged death, he said.

“They kept getting disorientated and stranding again,” said Smith, who was among the rescuers. “They obviously couldn’t find their way back past (the sandbar) to the sea.”

Then along came Moko, who approached the whales and appeared to lead them as they swam 200 yards along the beach and through a channel out to the open sea.

“Moko just came flying through the water and pushed in between us and the whales,” Juanita Symes, another rescuer, told The Associated Press. “She got them to head toward the hill, where the channel is. It was an amazing experience.”

Anton van Helden, a marine mammals expert at New Zealand’s national museum, Te Papa Tongarewa, said the reports of Moko’s rescue were “fantastic” but believable because the dolphins have “a great capacity for altruistic activities.”

These included evidence of dolphins protecting people lost at sea, and their playfulness with other animals.

“But it’s the first time I’ve heard of an inter-species refloating technique. I think that’s wonderful,” said van Helden, who was not involved in the rescue but spoke afterward to Smith.

Roy Rogers’ Granddaughter Keeps His Spirit Alive

By Ramon Coronado, The Sacramento Bee, Calif.

Mar. 13–Julie Ashley-Pomilia leads a double life.

By day, she teaches first- graders how to read and write at Woodlake Elementary School in North Sacramento.

At night, on weekends, and when school is not in session, Ashley- Pomilia is an emissary of sorts.

“I tell stories about what it was like growing up with Roy Rogers and Dale Evans,” said the granddaughter to the Hollywood Western stars.

“I am the ambassador for the Rogers family,” said the Arden Park woman, who is quick to admit that she is one of 16 grandchildren. Her parents, Tom and Barbara Fox, live in Carmichael.

“The grandkids called him (Roy Rogers) Grandpa and the great-grandkids called him Grampy,” she said.

Every other month for a couple of days, or longer on holidays, Ashley-Pomilia, 49, is on the road, attending Western festivals across the country.

She meets and greets people with other Hollywood celebrities or sits on panels with actors who were in television shows like “Wagon Train” and “Gunsmoke.” For several years, she appeared in the Rose Parade.

Once a year, she is in Branson, Mo., where the Roy Rogers — Dale Evans Museum and Happy Trails Theater is located.

Ashley-Pomilia and her two sisters, Mindy and Candy, also sing in a group they call the Rogers Legacy.

They have sung on the Grand Ole Opry television show and have appeared at Carnegie Hall in New York City.

Some of the songs they sing, like “Happy Trails,” are from their grandparents’ shows and performances that led to Rogers becoming known as “the king of cowboys” and Evans as the “queen of the West.”

The couple made movies in the 1940s and had a television show in the 1950s. Later, they appeared on national talk shows, and in the 1990s, Rogers made a music video with singer Clint Black. Rogers died in 1998, and Evans died in 2001.

“They were the same on-screen as they were off. There was no pretentious air. They blurred the lines of fantasy and reality,” Ashley-Pomilia said.

The Rogers loved children, she said. They adopted five of their nine children.

“For the poor kids in the nose-bleed seats, he would wear sequins so they could see him. He was the first rhinestone cowboy. He invented that look,” Ashley-Pomilia said.

Ashley-Pomilia grew up in the Los Angeles area. When she was in elementary school, she spent weekends at the Rogers’ ranch in Chatsworth.

“When I was a little girl, I thought everybody had a grandfather that made TV shows and movies,” she said.

Later, when the couple’s careers were at their height, the impact upon the young Ashley-Pomilia was huge, she said.

“Everywhere we went, people would come up and ask for autographs,” she said.

From those days, Ashley- Pomilia has collected stacks of boxes jammed with memorabilia, ranging from lunch pails to puzzles. Inside her home, she has posters and a glass cabinet filled with Roy Rogers and Dale Evans toothbrushes, collector cards and even a credit card in their name.

“They were the most merchandized celebrities, second only to Walt Disney,” Ashley-Pomilia said.

Ashley-Pomilia, who has three boys, ages 19, 15 and 13, said when her oldest was 5, she told him that his “Grampy” was so famous that a cocktail had been named after him. The Roy Rogers is a Shirley Templelike non-alcoholic drink.

Soon after, the little boy ordered the drink at a restaurant.

“I’d like a Grampy, please,” she said her son requested.

Despite the tremendous fame, the memory of Roy Rogers and Dale Evans has faded over the years, she said.

“The fan base is dying off,” she said.

But when she’s on the road, Ashley-Pomilia said. people like to talk about Trigger, Roy Rogers’ golden palomino, which was known for rearing on its hind legs upon command.

“Was he really stuffed?” a reporter asked.

“Everybody asks that question,” Ashley-Pomilia said.

The horse, whose skin was mounted on a Fiberglas form, is on display in the Rogers’ museum.

“He loved that horse, and he felt that the children would want to see him. But it is not the children who crowd around Trigger today, it’s the adult children,” Ashley-Pomilia said.

For booking information, go to [email protected].

—–

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Copyright (c) 2008, The Sacramento Bee, Calif.

Distributed by McClatchy-Tribune Information Services.

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NYSE:DIS,

Robot Helps Those With Degenerative Diseases

A robot named “El-E” that could help patients with degenerative diseases was unveiled Wednesday during an Amsterdam conference.

The robot’s Georgia Tech and Emory University creators designed the 5 ½-foot-tall El-E with a focus on interacting with humans. With two lenses for eyes and speaking zany catch phrases upon completion of various tasks, the robot aims to provide lower cost alternatives to service animals such as guide dogs and monkeys. One of the key attributes of the El-E is its ability to grab any object its user points to with a laser.

“The entire world becomes a point and click interface. Objects become buttons. And if you point at one, the robot comes to grab it,” said Charlie Kemp, the director of Georgia Tech’s Center for Healthcare Robotics and the robot’s designer. “It creates a clickable world,” he told Associated Press.

El-E will begin being tested this year in real-world environments with patients with degenerative diseases.    

To command the El-E, the user points a laser at something for a few seconds. The robot beeps as it zeros in on the target, using its mechanical arm to grab the object.  It begins the return trip after the laser is directed at the user’s feet, then looks for a human face before handing over the object.

Kemp said engineers are often too focused on making robots behave like people, instead of the way they actually interact with people.  

“How can you make robots that are actually useful? That was bugging me,” he said. “And it’s a hard question to answer “” that’s why I’m happy with this. We made technical contributions as well as something that actually helps users.”

Researchers said that during trials, the El-E successfully fetched its target objects off the floor 90 percent of the time.   The upcoming summer tests will involve patients who suffer from ALS, also known as Lou Gehrig’s Disease, a condition in which nerve cells responsible for movement no longer function.  

“It will give these folks at least a level of independence,” said Dr. Jonathan Glass, director of the Emory ALS Center and a part of the team developing the robot. “You don’t have to feed it, and you can train it to do anything you want to do,” he said in an Associated Press report.

Other scientists have taken notice of El-E’s novel design.

“It’s very impressive work,” said Oliver Brock, an assistant computer science professor at the University of Massachusetts Amherst. “It’s a serious and successful attempt to build a robot that can actually coexist with humans and successfully perform a task.”

El-E’s functionality is provided by dozens of sensors, lasers and cameras that help the robot locate target objects, and provide constant feedback for the proper grip needed to retrieve it. A mechanical crane that grabs objects from the floor or shelves dominates its petite body that rolls around on three wheels. And a lone Mac mini residing in its base powers it all.

Although it’s still a work in progress, researchers hope the laser-directed robot could someday open doors, switch light panels and guide patients.

For now, the robot’s arm can only carry objects weighing up to 1.2 pounds, and it has yet to be tested with sick patients.  And when the unit does malfunction, it can be a bit startling.

During recent tests, the El-E took a winding path on its attempt to pick up a coffee mug, stopping several times along the way. When Kemp and his students finally isolated the problem to a low battery, El-E regained its proper movement with only a slight stutter as it firmed up its grip on the cup. It spun around and paused shortly before detecting the user’s face and delivering the mug.

“Bob’s your uncle,” it blurted out.  And with that, the mission was accomplished.

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Ibuprofen Destroys Aspirin’s Positive Effects

Stroke patients who use ibuprofen for arthritis pain or other conditions while taking aspirin to reduce the risk of a second stroke undermine aspirin’s ability to act as an anti-platelet agent, researchers at the University at Buffalo have shown.

In a cohort of patients seen by physicians at two offices of the Dent Neurologic Institute, 28 patients were identified as taking both aspirin and ibuprofen (a nonsteroidal anti-inflammatory drug, or NSAID) daily and all were found to have no anti-platelet effect from their daily aspirin.

Thirteen of these patients were being seen because they had a second stroke/TIA while taking aspirin and a NSAID, and were platelet non-responsive to aspirin (aspirin resistant) at the time of that stroke.

The researchers found that when 18 of the 28 patients returned for a second neurological visit after discontinuing NSAID use and were tested again, all had regained their aspirin sensitivity and its ability to prevent blood platelets from aggregating and blocking arteries.

The study is the first to show the clinical consequences of the aspirin/NSAID interaction in patients being treated for prevention of a second stroke, and presents a possible explanation of the mechanism of action.

The Food and Drug Administration currently warns that ibuprofen might make aspirin less effective, but states that the clinical implications of the interaction have not been evaluated.

“This interaction between aspirin and ibuprofen or prescription NSAID’s is one of the best-known, but well-kept secrets in stroke medicine,” said Francis M. Gengo, Pharm.D., lead researcher on the study.

“It’s unfortunate that clinicians and patients often are unaware of this interaction. Whatever number of patients who have had strokes because of the interaction between aspirin and NSAIDs, those strokes were preventable.”

Gengo is professor of neurology in the UB School of Medicine and Biomedical Sciences and professor of pharmacy practice in the UB School of Pharmacy and Pharmaceutical Sciences. Results of the study were published in the January issue of the Journal of Clinical Pharmacology.

“We first looked at this issue way back in 1992 in a study conducted in normal volunteers, but it was published as an abstract only,” he said. “We never followed through with a manuscript, but another group published an elegant study in the New England Journal of Medicine showing this interaction at least seven years ago.

“When we began to assess this in our stroke patients, a surprisingly high percentage of a group of 653 patients, around 17 percent, were taking aspirin plus Motrin [a brand of ibuprofen].

“The prescription medication Aggrenox, which also is used for secondary stroke prevention and contains aspirin and extended release dipyridamole, is affected the same way as aspirin,” Gengo continued. “In preventing strokes, it is statistically a little better than aspirin but more expensive.

“However, one of the most common side effects when you first start taking Aggrenox is headache, so some physicians, pharmacists or physician assistants tell patients to take a Motrin so they don’t get a headache. This likely would negate the effects of the aspirin and extended release dipyridamole. Those patients might as well take this expensive drug and flush it down the toilet.”

Gengo and colleagues verified with urine testing that all 18 patients, six men and 12 women, were taking their aspirin or aspirin and extended release dipyridamole as directed. Information on the concomitant use of NSAIDS was obtained from patient interviews. Data from the earlier healthy volunteer study showed the magnitude and time course of each drug administered separately, as well as in combination.

The UB study provides important information, Gengo noted, because in most previous studies, measurements were taken only at one point in time, and that time point may have been during the 4-6 hour window when concentrations of NSAIDS were sufficiently high to inhibit aggregation.

“Our data report the entire time course of this interaction,” he said. “The results showed that platelets resumed aggregating within 4-6 hours when aspirin and ibuprofen were taken close together, leaving patients with no anti-platelet effect for 18-20 hours a day. Normally, a single dose of aspirin has an effect on platelet aggregation for 72-96 hours,” Gengo said.

“When I lecture to pharmacy students, I tell them ‘Please, you have a responsibility to the patients you care for. When you counsel a patient taking aspirin/extended release dipyrdamole to lower stroke risk, tell patients they may have some transient headaches, but to avoid ibuprofen. You may have prevented that patient from having another stroke.'”

This study was supported by the Dent Family Foundation.

UB/Dent personnel who also contributed to the study were Michelle Rainka, Pharm.D., UB adjunct instructor of pharmacy practice; Donald E. Mager, Pharm.D., UB assistant professor of pharmaceutical sciences, and Vernice Bates, M.D., UB clinical associate professor of neurology. Matthew Robson and Michael Gengo, research assistants at the Dent Neurologic Institute, and Lisa Rubin, Pharm.D., a former UB student, also contributed to the research.

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB’s more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. The School of Medicine and Biomedical Sciences, School of Dental Medicine, School of Nursing, School of Pharmacy and Pharmaceutical Sciences and School of Public Health and Health Professions are the five schools that constitute UB’s Academic Health Center. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

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FDA Issues Strong Warning on Tussionex Cough Medicine

The U.S. Food and Drug Administration (FDA) issued an alert Tuesday warning parents and doctors that the prescription cough medicine Tussionex, made by Belgium-based UCB, may have fatal side effects if used incorrectly.

The FDA issued its alert after receiving reports that doctors may be over-prescribing the drug, and after reviewing reports of health problems and deaths among children and adults who took Tussionex.

The report stated that some people may be taking the Tussionex Pennkinetic Extended-Release Suspension more frequently than the recommended interval of once every 12 hours.  Others may be giving it to children under age 6, which is not approved, the FDA said.  

Tussionex contains the narcotic pain reliever hydrocodone, which taken in excess can cause life-threatening respiratory problems.

Since its approval in 1987, five deaths have been reported among children under 6 who took Tussionex, UCB company spokesman Eric Miller said last Friday. He said the company had proposed a stronger warning for the medicine following the reports of the deaths.

Speaking Tuesday, Miller reiterated that the number of deaths in those under six remained at five.  

The FDA urged doctors and patients to follow prescribing instructions precisely, and to only use medical syringes or other devices designed to measure liquid medications since household spoons vary in size.

“There is a real and serious risk for overdosing if this medication is not used according to the labeling,” said Dr. Curtis Rosebraugh, acting director of the FDA office that regulates prescription cough medicines, in a statement.

The FDA statement said UCB will update the Tussionex label to address the concerns.

“The FDA’s alert is fully in line with our efforts to make sure this product is properly used,” a UCB spokeswoman told Reuters, adding the company had already taken steps to clarify the label of the product last year.

The spokeswoman said she did not anticipate that UCB would withdraw the product as the FDA alert only pertained to improper use of the medicine, adding that Tussionex sales in the U.S. totaled 114 million last year.

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Knowing When To Toss Canned Foods Can Be Confusing

It’s spring cleaning time. What about that can of beans or box of pancake mix sitting in your cupboard? Are these still edible?

And what about the food storage in the basement? Should you be eating food that’s older than your kids? Or even older than you?

Dates on the packages offer some clues, but these can be confusing because the United States doesn’t have a uniform system of food dating. Product dating isn’t federally required, except for infant formula and some baby food, according to a U.S. Department of Agriculture fact sheet. Also, stores aren’t legally required to remove food once a “sell by” date has passed.

If there’s a shelf-life date on a package, trust it. However, keep in mind that there’s a great variation with type of food, the temperature where it was stored, the original quality of the food, the amount of oxygen present and other factors, said Oscar Pike, the department chairman of nutrition, dietetics and food science at Brigham Young University, who has studied the shelf life of food.

“People would like it to be more consistent, but it just isn’t,” he said.

Here are the dates you are likely to find on your package and what they mean, according to the USDA:

— “Sell by” tells the store how long to display the product for sale. For best quality, people should buy the product before this date expires, but it doesn’t necessarily mean the product is bad once it reaches that date.

— “Best if used by (or before)” is recommended by the manufacturer for best flavor or quality. This is not a safety date, according to the USDA. If the date says March 11, 2008, and today is March 12, that doesn’t automatically mean you have to toss it. The products, in general, are still safe to eat, but some consumers may detect changes in product flavor, color, taste or texture.

— “Use by” is the last date recommended to use the product, such as “Do not use after March 12, 2008.” The date has been determined by the manufacturer.

— “Closed” or coded dates are packing numbers or dates, so that manufacturers know when and where the product was produced. This is helpful in the event of a recall. The product may be stamped with a date preceded by the letters “MFG.” This tells you the date it was packed. You may have bought the product a month ago, but this date could tell you that it has been sitting in a warehouse or on a store shelf for several months.

The manufacturers’ dates on packages and canned goods are conservative and based more on quality than safety, said Dr. Frost Steele, a BYU food science professor. “The quality deteriorates much sooner than safety will.”

However, you should toss out any cans or jars that are bulging, heavily dented, cracked, with broken seals, loose lids or “any compromise with the packaging,” Steele said.

While extremely rare, a botulism toxin is the worst danger in canned goods, and even tasting a tiny amount can be deadly, according to a USDA food-safety bulletin. In addition to the above warning signs, never use food with a foul odor or that spurts liquid when the can or jar is opened.

The bulletin also states that can linings might discolor or corrode when metal reacts with high-acid foods, such as tomatoes or pineapple. But as long as the can is in good shape, the contents should be safe to eat, although the taste, texture and nutritional value of the food can diminish over time.

There are discount stores that sell items past their “sell by” dates, and several Web sites, including one called the Freegan Kitchen (www.freegankitchen.com), are dedicated to the practice of foraging through grocery store Dumpsters for food that has been discarded, often because of an expiration date.

The Freegan Kitchen authors write that they have never become sick from anything they’ve eaten from the Dumpster.

But most of us tend to live more cautiously. If you choose to buy (or forage) items that are already past their sell-by date, it’s best to use them quickly.

Some low-moisture foods, such as dried apples, beans and rice, can be safe, edible and nutritious up to 30 years after being packaged, if properly stored, according to Pike. He recently conducted research to find out how long foods in long-term storage fared, asking for donations of food that had been stored for a number of years in large, restaurant-size cans.

“A lot of people were happy to get rid of their old food storage, so we received sufficient samples that we could look at the quality,” Pike said.

They tested the food for nutritional value and prepared samples for 50 taste-testers, in a cross-section of ages, to rate. They used a nine-point hedonic scale, with one being “dislike extremely” and going up to nine for “like extremely.”

“Our acceptable cut-off point was “dislike slightly, because this was food that people would be willing to eat in an emergency but that was still well-accepted in sensory perception,” Pike said.

In some cases, there were changes in flavor, appearance, texture or smell that some of the tasters disliked slightly. “But the wheat kernels hardly declined after 30 years. They made a great loaf of bread,” Pike said.

And the 30-year-old apple slices were so well-liked that people continued to nibble on them.

Wheat and white rice were deemed acceptable at 30-plus years. Pinto beans, apple slices, macaroni, rolled oats and potato flakes all were acceptable at 30 years, and powdered milk at 20 years.

Pike points out that these findings apply to the large, food- storage size cans, stored with oxygen-absorption packets, and stored at room temperature or below. Heat, light and air will cause the food products to deteriorate more quickly.

“It doesn’t apply to foods packaged or stored in other ways,” Pike said. They sampled dried milk stored in cardboard packages for 20 years, “and it was terrible, in both nutrition and taste,” Pike said.

He noted that in determining a “best if used by” date, manufacturers don’t go down to a “slightly dislike” level of acceptability. “They don’t want any decline in the quality, because they want to please their customers. They won’t stand behind the food after that date.”

All foods lose nutritional value, but nutrients are lost at a quicker rate than others. Vitamin C, in wet form, deteriorates rapidly. But in a dry pill form, it kept mostly intact after 20 years. Minerals and calories remain the same.

He suggests people rotate their food on a first-in, first-out basis. But if the “best if used by” date says March 13, that doesn’t necessarily mean you should pitch it on March 14.

“The rate of decline is not such that there’s something magic about it,” he said.

People who hate to waste food often think of donating it. But if it’s too old for you, it’s too old for the Utah Food Bank.

“Our rule of thumb is, if you wouldn’t eat it, we’d rather it not be donated,” said Jessie Pugh, a Utah Food Bank spokesman. “If it’s past the expiration (or ‘use by’) date, we can’t use it. If it’s a ‘best if used by’ date, we will accept it within a three-year window and look at the condition of the can.”

Volunteers examine the condition of all donated items, for bulging cans or lids, dents and so on.

The Food Bank will accept food packaged at a cannery where the ingredients are listed. But it won’t accept home-processed and self- packaged food.

“We tell people that by discarding food that doesn’t meet our criteria, you are protecting those who are at risk in the community,” she said.

AtStaff Announces That the Ohio State University Medical Center and Wake Forest University Baptist Medical Center Have Selected ClairVia(R) Staff and Demand Management Software Systems

AtStaff announces today that two prestigious academic medical centers — The Ohio State University Medical Center and Wake Forest University Baptist Medical Center — have selected AtStaff’s ClairVia® staff and demand management software systems.

“We are immensely proud that these two highly distinguished academic medical centers, with established reputations for improving people’s lives through innovation in research, education and patient care, have selected our ClairVia systems,” says Beth Pickard, President and Chief Executive Officer at AtStaff. “Our products support the mission of today’s leading healthcare organizations because they help caregivers improve each patient’s health and achieve positive patient outcomes.”

The Ohio State University Medical Center has selected to install ClairVia Demand Manager, ClairVia Outcomes-Driven Patient Acuity and ClairVia Staff Manager. Wake Forest University Baptist Medical Center has selected to install ClairVia Staff Manager.

“We are in the early stages of implementing these ClairVia solutions to support our objectives in delivering the highest quality, safe patient care,” says Mary G. Nash, Ph.D., FAAN, FACHE, Chief Nurse Executive and Associate Vice President for Health Sciences at The Ohio State University Medical Center. “As we sought evidence-based solutions designed to improve positive patient outcomes, ClairVia products offer the potential for helping us further our mission in improving people’s lives through personalized patient care.”

ClairVia Demand Manager allows staffing managers to measure and predict each patient’s need for staffing care — on a patient-by-patient basis. The software continuously tracks each patient’s real-time status against an outcomes-based target, continually guiding the patient to the best clinical outcome.

ClairVia Outcomes-Driven Patient Acuity integrates with ClairVia Demand Manager to calculate workload for staffing levels and skill mix based on patient-specific outcomes, supporting established standards of evidence-based nursing care and professional practice.

ClairVia Staff Manager is a comprehensive staff management solution, including enterprise scheduling and staffing, real-time decision support, personalized Web-based dashboards for all stakeholders, and advanced productivity measurement and reporting.

After an intensive market analysis and internal review process, Wake Forest University Baptist Medical Center (WFUBMC) selected ClairVia Staff Manager as its software solution to improve efficiency and resource utilization involved with nursing scheduling, staffing and productivity management.

“The current nursing shortage and the time-consuming processes involved with manual scheduling and staffing were among the key drivers in our need for an electronic staff scheduling and staffing system,” says Robin Hack, Director of Nursing Clinical Systems at WFUBMC.

Hack says ClairVia’s personalized dashboards, which provide real-time staffing and scheduling data and alerts for both managers and employees, “will ensure that the right information is always accessible for informed, point-of-need decision-making.”

Because employee schedules, schedule changes and staffing views are updated in real time, ClairVia Staff Manager makes it quick and easy to pinpoint instances of over-staffing and under-staffing. The software’s decision-support tools help staffing managers locate and assign available employees at the lowest cost and highest quality.

“The ability to see, at a glance, the staff that are working and where, and which staff will or will not incur overtime if allowed to fill a staffing gap will help control labor costs,” says Jerry Smith, Director of Finance for Nursing at WFUBMC.

Johnny Veal, the system’s Senior Nursing Operations Director, reports that nurses at WFUBMC have been actively seeking an automated tool to “improve scheduling and staffing and ClairVia is the preferred tool.”

“Our nurses are eagerly anticipating project implementation, and our nurse managers will benefit from the numerous reports they’ll gain regarding staffing and productivity management.”

Hack adds that in addition to providing advanced software technology, AtStaff delivers strong capabilities in customer service.

“The AtStaff team was extremely responsive during our decision-making process. They provided numerous demonstrations, client references, and conference calls, delivering absolutely great customer service.”

About The Ohio State University Medical Center

Located in Columbus, Ohio, The Ohio State University Medical Center is one of the largest and most diverse academic medical centers in the country and the only academic medical center in central Ohio.

Driven by a mission to improve people’s lives through innovation in research, The Ohio State University Medical Center saves lives and improves the quality of life by rapidly translating the latest discoveries from the research lab to the bedside. It educates a large percentage of the region’s physicians and provides advanced training and continuing education for clinicians.

The Ohio State University Medical Center is ranked as one of the top 5 academic medical centers in the U.S. by the University Health System Consortium for delivering high-quality, safe, effective care.

In addition to other distinguished achievements, the medical center:

Is one of 50 hospitals in the country named to the Leapfrog Group’s list of “Top Hospitals” for quality and safety.

Was named for the 15th consecutive year as one of “America’s Best Hospitals” by U.S. News & World Report.

Was the first hospital in central Ohio to achieve Magnet status for nursing excellence.

Is virtually self-sustaining financially with estimated fiscal year 2007 operating revenue of $1.84 billion, representing 51.3 percent of university revenue.

More information on The Ohio State University Medical Center can be obtained at http://medicalcenter.osu.edu/.

About Wake Forest University Baptist Medical Center

Wake Forest University Baptist Medical Center (WFUBMC) is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university’s School of Medicine. WFUBMC operates 1,154 acute care, psychiatric, rehabilitation and long-term care beds, outpatient services, and community health and information centers.

The system, which consistently ranks as one of “America’s Best Hospitals” by U.S. News & World Report, provides a continuum of care that includes primary care centers, outpatient rehabilitation, dialysis centers, home health care and long-term nursing centers, and 20 subsidiary or affiliate hospitals.

WFUBMC was among the first 14 hospitals in the nation to receive Magnet Recognition for Excellence in Nursing Service, and the first hospital system in North Carolina to earn Magnet designation and re-designation.

More information about Wake Forest University Baptist Medical Center can be obtained at http://www1.wfubmc.edu/.

About AtStaff and ClairVia® *

Healthcare management software systems from AtStaff serve more than 1,200 healthcare organizations, medical facilities, nursing departments and group practices.

The company’s set of ClairVia® demand management solutions for the hospital enterprise marketplace improves quality of care, patient safety and patient throughput by ensuring that patients receive the exact, clinically appropriate level and amount of staffing care from admission to discharge.

AtStaff markets four ClairVia solutions:

ClairVia Demand Manager

ClairVia Outcomes-Driven Patient Acuity

ClairVia Caregiver Assignment

ClairVia Staff Manager

More information on AtStaff and its ClairVia solutions is available at www.atstaff.com

* Patent Pending

Antibody Engineering Company F-Star Opens Second Research Site in Cambridge, UK

VIENNA, Austria, March 12 /PRNewswire/ — f-star, an antibody engineering company developing novel antibodies and antibody fragments based on its unique Modular Antibody Technology, announced today that it will open a research facility in Cambridge, UK in addition to its headquarters in Vienna, Austria. The facility will be located at the Babraham Research Campus, home to a number of biotech companies and close to the Medical Research Council’s Laboratory of Molecular Biology (LMB), the major center for antibody engineering in Europe.

The research site will start operations on April 15, 2008. The group located in Cambridge will mainly be responsible for lead generation based on the company’s Modular Antibody Technology as well as, in the future, for research related to the conduct of collaborative studies between f-star and its pharma and biotech partners.

f-star’s Cambridge site will start with a small group of highly experienced researchers in the field. The research group will be headed by Lutz Riechmann, a senior researcher with over 20 years of experience in antibody research in Sir Gregory Winter’s group at the LMB.

“We are excited to open up a lab at the epicenter of Europe’s antibody research and development community and to utilize the large pool of talent and experience concentrated in the Cambridge area,” says Gottfried Himmler, CEO.

About f-star

f-star is an antibody engineering company based in Vienna, Austria. The company develops improved therapeutic antibodies and antibody fragments based on its Modular Antibody Technology, which allows the introduction of additional binding sites into antibodies and antibody fragments by engineering the non-CDR loops of constant or variable domains. Using Modular Antibody Technology, antibody fragments with antibody functionality and long half-life but much smaller size (Fcab(TM)) or full antibodies with additional functionality (mAb2) can be created.

f-star was founded by a team of experienced antibody engineering and biotech executives in 2006. Seed-financed by Austrian government agencies and Atlas Venture, the company recently closed a Series A financing round with Aescap Venture, Atlas Venture and Novo A/S and has raised EUR 13.0m in total so far. In its advisory board, the company is supported by pioneers in the field of monoclonal antibodies. f-star has 18 employees at its headquarters in Vienna, Austria and recently opened a second research site in Cambridge, UK.

   For more information, visit http://www.f-star.com/    Company contact:    Dr. Eugen Stermetz   CFO   f-star Biotechnologische Forschungs- und Entwicklungs-GmbH   +43-72055-4215   Gastgebgasse 5-13   A-1230 Vienna, Austria   [email protected]    Media contact:   Frank Butschbacher   Investor Relations & Communications   +43-650-78 44 940   [email protected]   http://www.butschbacher.net/  

f-star

CONTACT: Company contact: Dr. Eugen Stermetz, CFO, f-starBiotechnologische Forschungs- und Entwicklungs-GmbH, +43-72055-4215,Gastgebgasse 5-13, A-1230 Vienna, Austria, [email protected]; Media contact:Frank Butschbacher, Investor Relations & Communications, +43-650-78 44 940,[email protected], http://www.butschbacher.net/

First Over-The-Counter Store Brand Omeprazole Offering in U.S. Market Creates New Option for Frequent Heartburn Sufferers

ALLEGAN, Mich., March 12 /PRNewswire/ — Beginning early March 2008, the nearly 30 million frequent heartburn sufferers nationwide will have a new treatment option available to them as retailers begin selling store brand Omeprazole, a proton pump inhibitor that will treat the same frequent heartburn symptoms as Prilosec OTC(R) at a significant cost savings for consumers.

“It is estimated that consumers could save more than $100 million annually by using store brand Omeprazole,” says Fred Eckel, professor at the University of North Carolina School of Pharmacy and editor-in-chief of Pharmacy Times. “The savings will be even greater [up to 90%] for those whose insurance carriers no longer cover prescription Prilosec(R) or generic prescription Omeprazole.”

“Store brand Omeprazole – which delivers the same medicine at the same dosage as Prilosec OTC(R) – is another example of how store brand over-the- counter medicines provide high quality healthcare products that are more affordable for consumers,” says A. Mark Fendrick, MD, practicing internist and value-based healthcare specialist at the University of Michigan.

According to a new survey,(1) 85% of the adults suffering from frequent heartburn in the last six months report taking a prescription or over-the- counter medication to manage it. Sixty-three percent take over-the-counter medications (other treatment methods include Rx medications at 29%, changing diet at 22%, losing weight at 16% and reducing stress at 8%).

Frequent heartburn is an issue that affects lifestyle, as well, according to this new survey. Of those who experience frequent heartburn issues, 42% report sleeping troubles, 31% miss being able to eat/drink what they want, 31% have had throat issues (cough, tickle, laryngitis due to frequent heartburn) and 29% feel that managing heartburn is a struggle.

Prilosec(R), Prilosec OTC(R) and store brand Omeprazole are all proton pump inhibitors (PPIs). They begin working on the first day and the therapeutic benefits get progressively better with each additional treatment. An earlier class of GI drugs, including H2 Blockers, offers more rapid relief, but lasts only six to 12 hours.

According to data compiled by Information Resources Inc (IRI) and WoltersKluwer Health, the PPI market is one of the largest pharmaceutical segments in the market today. Prilosec OTC(R) and new store brand Omeprazole are currently the only PPIs that can be obtained without a prescription.

“Many health plan sponsors have been shifting coverage from prescription drugs in favor of lower-priced OTC offerings,” says Dr. Fendrick. “Having a lower priced store brand Omeprazole offering frees up even more dollars for consumers to put toward other drugs and medical costs.”

The store brand Omeprazole delayed-release tablets, 20 mg will be available at mass market retailers, drug stores and supermarkets nationwide beginning in early March and will be sold in 14-count, 28-count and 42-count packages. Store brand Omeprazole should be used as directed for 14 days for treating frequent heartburn and is not for immediate relief.

For more information about frequent heartburn, speak to your doctor/pharmacist or visit http://www.treatmyheartburn.com/.

   (1) Survey Methodology: This heartburn survey was conducted online within       the United States by Harris Interactive on behalf of The Perrigo       Company, manufacturer of store brand medicines, between December 10-       12, 2007, among 2,082 U.S. adults aged 18 and over among whom 1,120       experienced heartburn and 274 experienced frequent heartburn in the       past six months. Results were weighted as needed for age, sex,       race/ethnicity, education, region and household income. Propensity       score weighting was also used to adjust for respondents' propensity to       be online.   

Available Topic Expert(s): For information on the listed expert(s), click appropriate link.

Fred M. Eckel, R. Ph.

http://profnet.prnewswire.com/Subscriber/ExpertProfile.aspx?ei=34491

The Perrigo Company

CONTACT: Laurie Lindenbaum, Robin Leedy & Associates, +1-914-241-0086,ext. 26, [email protected]

Web site: http://www.treatmyheartburn.com/

Covidien Launches Public Tender Offer for Outstanding Shares of Tissue Science Laboratories Plc

Covidien Ltd. (NYSE: COV, BSX: COV) and Tissue Science Laboratories plc (LSE: TSL) today announced that a subsidiary of Covidien Ltd. has launched a public tender offer in the United Kingdom for all of Tissue Science Laboratories outstanding shares held by UK residents. Covidien has received irrevocable commitments to accept the offer from Tissue Science Laboratories’ Board of Directors and connected persons, who represent approximately 23% of the share capital of Tissue Science Laboratories.

The Boards of Directors of both companies have approved the transaction, which calls for Covidien to pay 103.5 pence (approximately $2.10 USD) in cash per Tissue Science Laboratories share for a total of about $80 million. The transaction, which is subject to customary closing conditions, is expected to be completed in the second calendar quarter of 2008.

Tissue Science Laboratories is a medical device company dedicated to the research, development and commercialization of tissue implant products for surgical and wound care therapies. The Company’s core technology is Permacol® Surgical Implant, used for complex and recurrent hernia repair.

“The acquisition of Tissue Science Laboratories will provide Covidien with a leading tissue repair technology and accelerate our entry into the rapidly growing biologic hernia repair market,” said Scott Flora, President, Surgical Devices, Covidien. “The Permacol® product will complement our current soft tissue product offerings and will allow us to offer a full line of differentiated hernia repair products designed to improve patient outcomes.”

Patrick Paul, Chairman, Tissue Science Laboratories said, “Having successfully established Permacol® as a class leading material in the rapidly developing biologic implant market, we are delighted to have now found a company in Covidien which shares our vision for the future potential of our technology platform. We believe that the Offer represents both excellent value for shareholders and an outstanding opportunity for our employees and stakeholders.”

Assuming a second calendar quarter closing, Covidien expects this transaction to dilute fiscal 2008 earnings by less than $0.03 per share. However, the underlying strength of its existing businesses is expected to offset the dilution. As a result, Covidien does not anticipate this transaction will have a material impact on its fiscal 2008 sales or operating margin outlook.

ABOUT COVIDIEN LTD.

Covidien is a leading global healthcare products company that creates innovative medical solutions for better patient outcomes and delivers value through clinical leadership and excellence. Covidien manufactures, distributes and services a diverse range of industry-leading product lines in four segments: Medical Devices, Imaging Solutions, Pharmaceutical Products and Medical Supplies. With 2007 revenue of nearly $9 billion, Covidien has more than 43,000 employees worldwide in 57 countries, and its products are sold in over 130 countries. Please visit www.covidien.com to learn more about our business.

ABOUT TISSUE SCIENCE LABORATORIES

Tissue Science Laboratories plc is a medical device company dedicated to the research, development and commercialization of tissue implant products for surgical and wound care therapies. Headquartered in Aldershot, UK, the Company was admitted to the AIM market operated by the London Stock Exchange in December 2001. Tissue Science Laboratories’ core technology is Permacol®, a surgical implant based on collagen derived from porcine dermis which, when implanted in the human body, is designed to be non-allergenic and long-lasting, addressing clearly identified clinical needs in the surgical reconstruction, recontouring and repair of human tissue. More information is available at www.tissuescience.com.

FORWARD-LOOKING STATEMENTS

Any statements contained in this press release that do not describe historical facts may constitute forward-looking statements as that term is defined in the Private Securities Litigation Reform Act of 1995. Any forward-looking statements contained herein are based on our management’s current beliefs and expectations, but are subject to a number of risks, uncertainties and changes in circumstances, which may cause actual results or Company actions to differ materially from what is expressed or implied by these statements. The factors that could cause actual future results to differ materially from current expectations include, but are not limited to, our ability to effectively introduce and market new products or keep pace with advances in technology, the reimbursement practices of a small number of large public and private insurers, cost-containment efforts of customers, purchasing groups, third-party payers and governmental organizations, intellectual property rights disputes, complex and costly regulation, including healthcare fraud and abuse regulations, manufacturing or supply chain problems or disruptions, recalls or safety alerts and negative publicity relating to Covidien or its products, product liability losses and other litigation liability, divestitures of some of our businesses or product lines, our ability to execute strategic acquisitions of, investments in or alliances with other companies and businesses, competition, risks associated with doing business outside of the United States, foreign currency exchange rates, potential environmental liabilities or increased costs after the separation from Tyco International or as a result of the separation. These and other factors are identified and described in more detail in our filings with the SEC. We disclaim any obligation to update these forward-looking statements other than as required by law.

Myrrh: Nature’s Ancient Anti-Inflammatory Agent

It’s been used in the Middle East for thousands of years to treat infected wounds and bronchial complaints. In Mesopotamia and the Greek and Roman worlds, this powerful herb was considered a panacea for many human ailments-from lesions of the mouth to hemorrhoids. The Chinese even put it to work in treating psychiatric afflictions. MYRRH boasts a long history in Indian medicine for the treatment of mouth ulcers, gingivitis, throat infections, inflammation of the mouth, and respiratory catarrh. It’s topically applied to ulcers and may be used as a mouthwash or gargle. In East Africa, it serves as an anti-inflammatory and antirheumatic agent.

High Trade Value

In ancient times, the Egyptians imported great quantities of myrrh from Palestine. Because of its unique aromatic fragrance, it was highly valued as a trade commodity. The Ishmaelite travelers who purchased Joseph from his meanspirited brothers were journeying to Egypt with camels loaded with spices, balm, and myrrh (Genesis 37:25). It was believed that the Queen of Sheba brought great quantities of the herb and other spices from Yemen as gifts for King Solomon. The long-heralded “balm of Gilead” is a member of the myrrh family, known far and wide as a healing agent for wounds.

When the sons of Jacob returned to him with the request from Joseph to bring Benjamin to Egypt the old patriarch sent products from the land of Palestine in an attempt to appease the prime minister. The shipment included myrrh, along with almonds, pistachio nuts, honey, and spices (Genesis 43:11).

Precious Perfume

Myrrh was commonly used as perfume in the Middle East. In ancient Persia, when King Ahasuerus set about choosing a new queen to replace Vashti, the eligible girls had to complete 12 months of beauty treatments, including a six-month cosmetic regimen with the oil of myrrh (Esther 2:12). That oil is still used today during massage treatments.

The herb was one of the ingredients of the anointing oil used in the Jewish tabernacle and served as incense in religious rituals centered on ancient gods. It was proved effective as a fiimigant for homes and temples of the Old Testament.

But it is Christ’s life with which myrrh is most famously connected. The magi who visited Mary and Joseph at the birth of Jesus brought gifts of gold, frankincense, and myrrh (Matthew 2:11). That gift hinted at the future awaiting the tiny baby in the manger. Myrrh was commonly used as an embalming agent by Egyptians and others in the ancient world. After Jesus was crucified, Joseph of Arimathea and Nicodemus took His body and prepared it for burial using 75 pounds of myrrh and aloes (John 19:39).

Tree Bark Extract

Gum myrrh is the aromatic product that secretes from the bark of several species of Commiphora, a perennial shrub or small tree native to the Horn of Africa (Ethiopia and Somalia) and southwest Arabia (Yemen). Altogether, there are over 150 species of myrrh trees which are found throughout eastern Africa and Arabia. The composition of the gum that exudes from the bark of these trees varies slightly from one species to another.

When the bark of the myrrh tree is damaged, gum oozes out and forms yellow to reddishbrown small pearls or tear-shaped drops that may grow to the size of walnuts. The gum becomes hard and brittle when dried and then can be ground into powder. The extracted oil is used as a fragrance in various perfumes, ointments, soaps, and creams.

Properties and Uses

Myrrh has antiseptic, astringent and anti-inflammatory properties. It’s useful for the topical treatment of mouth and throat infections such as mouth ulcers, inflamed gums, sore throats, and tonsillitis. Normally, it’s dabbed onto the lesion two to three times a day. Its astringent properties make it beneficial for treating throat infections, nasal congestion, and coughs. The oil of myrrh can also serve as an astringent in mouthwashes and gargles.

Guggul-the resin from C. mukul, or Indian myrrh-is of great importance in Indian medicine for the lessening of joint pain in arthritis. In clinical research, guggul has not only been shown to boast anti-inflammatory properties; but its content of steroidal saponins allows it the added bonus of reducing serum cholesterol levels. A number of studies reveal the potential of guggul to treat rheumatoid arthritis and osteoarthritis.

Since 50 percent of myrrh is mucilage, it provides soothing properties to treat inflammations and ulcers. Its aldehydes and phenols stimulate a drying and cleansing action when applied topically. As a salve, the herb treats hemorrhoids, wounds, and bedsores. Myrrh also contains about 8 percent essential oil-a fraction rich in terpenoids-that creates – the characteristic odor of myrrh.

Official Recognition

In Germany, approval has been given for the use of myrrh in the topical treatment of inflammations of the throat gums, and mouth, as well as for prosthesis pressure marks. It’s also included in mouthwashes and balms for wounds and minor skin inflammations. In France, it has received approval for nasal congestion from the common cold.

Alliance Coal to Hire for New Mines Jobs, Gasification, Legislation Among Topics at Illinois Basin Conference

By CHUCK STINNETT, Gleaner staff 831-8343 or [email protected]

Alliance Coal Co. in August will start hiring several hundred people for the two River View coal mines it is developing in Union County, an employment official said here Thursday.

“It will pay $15.50 to $19 per hour and really good benefits,” said Ann Oldham, a business liason with the state’s West Kentucky Workforce Investment Board in Madisonville.

Alliance will open one mine in the No. 9 coal seam and a second mine in the No. 11 seam near Uniontown.

That, along with the 900 miners that Armstrong Coal hopes to hire for its mine in Ohio County, points to a sudden demand for miners in western Kentucky, Oldham said at the Illinois Basin Energy Conference here.

“I’ve got a stack of 1,000 applications for jobs,” she said. “We’ve got jobs. We’ve got applicants, but they’re nowhere near trained and ready.”

With the help of a $1.5 million U.S. Department of Labor grant, the workforce board has been subsidizing half the wages of new miners while they receive on-the-job training at mines in western Kentucky, Oldham said.

Also, William Higginbotham of the Kentucky Coal Academy said training is being provided at community colleges, including in Madisonville, using devices that simulate operating a continuous miner, a roof bolter, haul trucks, dozers and other equipment.

“The average age of our miners is 51 or 52, and half of our miners in the next five to seven years will retire,” Higginbotham said. “We really don’t have anybody trained to replace them.”

Among other matters discussed here Thursday:

* Coal gasification: “The infrastructure (in this area) to do a coal gasification project is tremendous,” said Michael Mujadin, a consultant who has studied the feasibility of gasification for the state of Kentucky.

Western Kentucky coal would make “an excellent feedstock,” and there are several potential plant sites along a river, such as one near Uniontown.

He estimated a gasification plant would cost $2.09 billion and consume 4 million tons of coal per year. A plant would convert 12,000 tons of coal per day into 175 million cubic feet of pipeline quality substitute natural gas.

Based on coal costing $30 per ton, he projected that the plant could produce gas costing $7.96 per million Btu, which he said “might be a bargain, long term.”

* Washington: The district director of U.S. Rep. Ed Whitfield blasted federal officials and legislators who oppose the increased use of coal in America.

“Coal is the one form of energy we have an abundant supply of,” Michael Pate said. “But it has gotten such a bad reputation.”

America has an estimated 250-year supply of coal, and coal can be converted into liquid and gas fuels, he said. “Yet in the public relations battle in Washington, we’re losing,” Pate said. “We’re losing across the country.”

Coal has opposition in the Bush administration, in the leadership of the Congress and elsewhere, he said.

He also criticized the “bureaucratic regulations” that coal operators face from the Clean Water Act.

* Conference center: Henderson County Judge-executive Sandy Watkins said the Henderson area is “looking to put together a partnership of cities, counties and private investors. We want to develop a totally green conference center, one of the first in the nation.”

* FutureGen: Thirteen energy and utility companies that comprise the FutureGen Industrial Alliance want to convince the U.S. government to reconsider its decision to withdraw from the proposed near-zero emission FutureGen power plant at Mattoon, Ill., alliance Chairman Paul Thompson said.

The U.S. Department of Energy, which was expected to pay 74 percent of the cost, withdrew its support in January, saying the cost at $1.8 billion was too much.

But Thompson, a senior vice president of E.on/U.S. in Louisville, said the alliance hopes to persuade the administration of the next U.S. president to reconsider.

“The coal industry needs a Manhattan Project, it needs an Apollo program” to develop a coal-fueled power plant with practically no emissions, he said.

* Power efficiency: While there is “no silver bullet,” the electric utility industry is trying to persuade consumers and industries to be more energy efficient, Mike Core, president and CEO of Big Rivers Electric Corp., said.

That would reduce or postpone the need for new power plants, he said.

Big Rivers, for instance, distributes compact fluorescent light bulbs that require only one-fourth the power than an incandescent bulb uses.

* Carbon sequestration: Research continues into the feasibility of capturing carbon dioxide from power plants and pumping it 8,000 feet underground into porous rock formations, where proponents hope it could be permanently stored, keeping it from becoming a greenhouse gas.

Existing coal-fired power plants could be retrofitted with equipment to remove carbon dioxide from smokestacks, but finding the best process is tricky. “You don’t want your electric bill to go up 40 to 50 percent, as predicted,” said Jim Neathery of the University of Kentucky Center for Applied Energy Research.

Hannes Leetaru of the Illinois Geological Survey is confident that permanent storage deep underground could work, noting that oil and natural gas “has been trapped in those same formations for 262 million years.”

* Algae: Arizona Public Service Co. continues its research in growing algae, which he called “nature’s champion” at absorbing carbon dioxide, the company’s Raymond Hobbs said.

The algae can then be converted into biofuels or, perhaps more profitably, into pharmaceuticals and other products.

However, he acknowledged that vast acreage would be required. To absorb all the carbon dioxide from a 750-megawatt power plant would require an algae farm encompassing 8,300 acres.

* Biomass: Brent Carman of The Center for Strategic Alliance described a technology it has available that can convert plastic bottles, manure, pecan shells, telephone poles or anything else with carbon and process it into a clean-burning gas.

The equipment can be used at factories, farms or landfills, he said.

* Students: Pat Shields, who was one of 16 architecture students who have studied projects in Henderson, gave a presentation proposing algae production vessels near the city’s Station One power plant on Water Street.

* Solar project: Four University of Kentucky students, including Hendersonian Joanna Grant, made a presentation on their plans to compete in the U.S. Department of Energy’s Solar Decathlon to design a solar-powered house.

(c) 2008 Evansville Courier & Press. Provided by ProQuest Information and Learning. All rights Reserved.

First Early-Detection Blood Test for Parkinson’s Shows Promise

Screen Uses “Metabolomic Profile” to Spot Disease-Linked Changes, Weill Cornell Team Reports

NEW YORK “” A test that profiles molecular biomarkers in blood could become the first accurate diagnostic test for Parkinson’s disease, new research shows.

The screen relies on changes in dozens of small molecules in serum. These “metabolomic” alterations form a unique pattern in people with Parkinson’s disease, according to a team led by researchers at the Weill Cornell Medical College in New York City.

They published their findings in the journal Brain.

“A reliable blood test for Parkinson’s disease would revolutionize not only the care of people with this debilitating illness, it would facilitate research as well,” notes study senior author Dr. M. Flint Beal, chairman and Anne Parrish Titzell Professor of Neurology at Weill Cornell Medical College, and neurologist-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

According to the National Parkinson Foundation, an estimated 1.5 million Americans have the neurodegenerative disease, and 60,000 new cases are diagnosed each year. Actor Michael J. Fox, boxer Muhammad Ali, and former U.S. Attorney General Janet Reno all suffer from Parkinson’s, which strikes men and women in roughly equal numbers.

“Right now, a Parkinson’s diagnosis is made solely on a clinical review of symptoms “” we have no biologic test,” notes Dr. Beal. At best, a symptom-based screen is still only 90 percent accurate, he adds.

“That can cause real problems, because that remaining 10 percent of patients “” who may have look-alike conditions such as multi-system atrophy or progressive supranuclear palsy “” end up getting treated with Parkinson’s drugs,” Dr. Beal says. “These medicines may appear to help them a little while, but in the meantime, they haven’t been getting the treatment that’s necessarily best for them.”

An early-detection test would also be enormously useful in tracking the health of patients who may be at higher risk for Parkinson’s, such as those with a family history of the disease.

Finally, the integrity of clinical trials is undermined by the lack of an accurate screen, Dr. Beal notes. “Every time you do a clinical trial into Parkinson’s and you have patients that are misdiagnosed, it enters ‘noise’ into the analysis, skewing the results. A truly reliable test could help eliminate that,” the researcher notes.

That’s why encouraging results for the new test “” based on a patient’s “metabolomic profile” “” are so important.

Metabolomics is the study of changes in thousands of distinct, very small molecules found in body fluids or tissues. “Anytime you have a genetic or environmental perturbation, these molecules are altered in specific ways,” Dr. Beal explains.

Because Parkinson’s treatment could itself trigger some of these alterations, the researchers first compared metabolomic patterns in the blood of Parkinson’s patients who were not undergoing treatment versus those who were medicated. “That gave us a ‘medication-free’ profile that we could use going forward,” Dr. Beal explains.

In the next stage of the research, the team compared blood samples from 66 patients with Parkinson’s disease against 25 healthy controls (most of whom were the patients’ spouses). The metabolomic analysis included over 2,000 small molecules found in the blood.

“We discovered a clear differentiation between the metabolomic profiles of the Parkinson’s disease patients versus those of the controls,” Dr. Beal says. “No one molecule was definitive, but a pattern of about 160 compounds emerged that was highly specific to Parkinson’s patients.”

The significance of many individual compounds to the disease remains unknown and will be the focus of future study. But changes in a few well-known metabolites linked to oxidative stress were clearly linked to Parkinson’s. These included low levels of the antioxidant uric acid; an increase in blood levels of another antioxidant, glutathione; and increased levels of a marker for oxidative damage called 8-OHdG.

“Together, these and other compounds were arranged into a metabolomic pattern that identified Parkinson’s disease with great accuracy,” Dr. Beal says.

He stressed that more work needs to be done to validate the finding, and a test that might be used routinely by doctors is still a few years away.

“We are currently enlarging the sample size and studying people at serial intervals, to see if this test might also serve as a benchmark for disease progression,” Dr. Beal says. “We are also looking at people who carry a gene for a familial form of Parkinson’s, but who do not have the illness now. We hope to track them over time to see if this metabolomic profile is predictive of disease onset.”

If those data prove as promising as this early trial, an early-detection blood test for Parkinson’s disease could someday become a reality. According to Dr. Beal, “That would be a big step forward for both the treatment and the study of this devastating illness.”

This work was supported by the Michael J. Fox Foundation, the Department of Defense, and Edwin and Carolyne Levy.

Co-researchers include lead researcher Dr. Mikhail Bogdanov, of Weill Cornell Medical College and Bedford VA Medical Center, Bedford, Mass.; Dr. Wayne R. Matson, of Bedford VA Medical Center; Dr. Lei Wang, of Weill Cornell and Bedford VA Medical Center; and Dr. Rachel Saunders-Pullman and Dr. Susan S. Bressman, of Albert Einstein College of Medicine, New York City.

On the Net:

Weill Cornell Medical College

Clinical Trial Shows Ubiquinol Has Significant Effect on Patients With Congestive Heart Failure

Patients suffering from advanced congestive heart failure exhibited significantly improved heart function after supplementing with ubiquinol, according to a recent clinical trial. Ubiquinol, only available in supplement form since late 2006, is the active antioxidant form of Coenzyme Q10 (CoQ10). CoQ10, a vitamin-like substance found in every cell in the body, plays a vital role in cellular energy production and protects cells from free radical damage.

In the first clinical trial evaluating ubiquinol effects on late-stage congestive heart failure, cardiologist Peter Langsjoen found that critically ill patients who supplemented with ubiquinol for just three months experienced a 24 to 50 percent increase in their hearts’ ability to pump blood. In some cases, patients’ plasma levels of CoQ10, which are key to overall heart health, more than tripled. At the start of the study, each of the patients evaluated had a life expectancy of less than six months. However, all demonstrated significantly improved heart function by the trial’s end, and survived past initial expectations.

“The effects of ubiquinol on late-stage heart failure patients resulted in striking improvements beyond anything I’ve seen in 25 years of cardiology practice,” said Dr. Langsjoen, who conducted the research in Tyler, Texas. “It is my strong feeling that this ubiquinol product is a major breakthrough.”

Scientists at Kaneka Corporation, the world’s largest manufacturer of CoQ10, developed the method to produce ubiquinol, commercially available as KanekaQH™, for supplemental use. Because the reduced ubiquinol reverts back to CoQ10 when exposed to air and light, the process of stabilizing the nutrient outside of the body took more than a decade to test and perfect before it was launched a little more than a year ago.

“Over the last several years, our team of scientists have documented that KanekaQH can be several times more absorbable than CoQ10, but to see that higher bioavailability translate into such staggering improvements in these patients’ lives is particularly gratifying,” said Dr. Robert Barry of Kaneka Nutrients, L.P., who recently released a book entitled The Power of KanekaQH™ (Ubiquinol): The Key to Energy, Vitality and a Healthy Heart in which he documents some of the most intriguing research to date on CoQ10 and ubiquinol in regards to aging and heart health.

The oxidized form of CoQ10, ubiquinone, was first used as a dietary supplement for cardiac patients in Japan 40 years ago. It has since gained popularity worldwide for the many health and condition-specific benefits identified in the thousands of studies conducted since its discovery in 1957.

Two forms of CoQ10: Ubiquinone and Ubiquinol

Both ubiquinone and ubiquinol are essential to generating cellular energy and sustaining life; however, the reduced form, ubiquinol, is responsible for the powerful antioxidant benefits associated with CoQ10. More than 90 percent of the CoQ10 found in a healthy person’s plasma is in its reduced ubiquinol form.

For the past 40 years, only ubiquinone was available as a supplement. KanekaQH™, the world’s only supplemental ubiquinol, has only been available for the past year. The ingredient, manufactured exclusively by Kaneka, is currently available in more than 30 consumer supplements and is the subject of a number of new trials expected to begin in 2008.

“Cardiovascular patients, those fighting age-related diseases and even healthy people over the age of 40 have a critical need to optimize plasma CoQ10 levels within their bodies,” explained Dr. Barry. “Because it’s so much better absorbed by the body, KanekaQH™ can raise CoQ10 levels more effectively and, as we’re seeing from Dr. Langsjoen’s study, can have tremendous health impact on those suffering from debilitating diseases.”

An abstract of Dr. Langsjoen’s supplemental ubiquinol study is available at www.kanekaqh.com/clinicaltrials. Full results of the study are expected to be published in a major scientific journal in 2008.

More information on supplemental ubiquinol is available at www.kanekaqh.com.

For more information on the numerous clinical research conducted on CoQ10 over the past 50 years, visit www.kanekaq10.com/clinicaltrials.

About Kaneka Nutrients

Kaneka Nutrients L.P. is a wholly-owned subsidiary of Kaneka Corporation (www.kaneka.co.jp/kaneka-e/), headquartered in Japan. The company, based in Pasadena, Texas, manufactures an array of unique nutritional ingredients for the supplement and food & beverage industries. Kaneka is the largest manufacturer of CoQ10 in the world, and the only company that manufactures CoQ10 in the U.S.

Nurses to Go on 10-Day Strike

By Tim Simmers

Thousands of registered nurses at 10 Bay Area hospitals — including two on the Peninsula — announced Monday that they are going ahead with a

10-day strike later this month.

The walkout, scheduled to begin March 21, will affect

4,000 nurses at 10 health care centers affiliated with Sutter Health, a network of hospitals.

In San Mateo County, up to 700 nurses represented by the California Nurses Association union are expected to be part of the walkout. Locally, the nurses have approved the strike at Peninsula Medical Center in Burlingame and Mills Health Center in San Mateo.

The nurses voted overwhelmingly last week to give their union the OK to call a strike. On Monday, the union gave the 10 hospital facilities a required

10-day notice of the strike.

Officials at Mills Peninsula Health Services, which operates Peninsula Medical Center and Mills Health Center, said it will be business as usual at the health care facilities during the strike.

We anticipate running operations as usual,” said Dolores Gomez, chief nursing executive at Mills Peninsula Health Services. “We’ll get some of the same replacement nurses back.”

Union and management have been unable to reach an agreement since contract negotiations began last May. The result has been two previous strikes, each lasting two days, in October and December. No new negotiations are scheduled.

Gomez said she did not know the cost of keeping the hospitals open with replacement workers. It depends on how many CNA nurses cross the picket lines and come to work, she noted. Nearly 40 percent crossed the lines in the last strike, Gomez said. CNA officials said it was under 10 percent.

The nurses and their unionrepresentatives say the dispute is about issues of patient care, staffing and their own health and retirement benefits. Salaries are not an issue.

The nurses complain that they don’t have enough staffing to help cover their meal and regular breaks. They also say that there is not enough help to lift patients so nurses can avoid back injuries.

“Sutter cannot expect RNs to sit idly by and watch the ongoing problems with patient care and safety at our hospitals,” said Sharon Tobin, a registered nurse at Peninsula Medical Center. “When there are not enough nurses, patients are put at risk, period.”

Tobin said the nurses don’t want a strike, but added that their “ethical obligation as patient advocates demands it.”

Hospital management maintains that the real issue is not over patient care and staffing, but over union organizing rights and a master contract that would allow the nurses association to talk with nurses at Sutter’s nonunion facilities and let them vote on whether they want to be in a union.

“(The CNA) is using issues like staffing, patient care and lifting, but it really wants to push organizing rights and a master contract,” Gomez said. Those organizing and master contract issues are subjects an employer is not required to bargain on in negotiations, and, therefore, cannot be the basis of a strike.

Officials at Sutter affiliates have long viewed the nurses association’s mission as growing union membership.

Genel Morgan, a nurse at Peninsula Medical Center, emphasized that the strike isn’t just about organizing rights. Though she admitted organizing rights are important, she held firm that the key is patient care, staffing and improving retirement and health benefits.

“We’re doing what is necessary to get them back to the table to really negotiate,” Morgan said. She added that management has “maintained a rigid line” in the two negotiating sessions since the last strike in December.

Gomez said she also wants to get back to negotiations.

The best scenario is getting back to the table,” she said. “We have an excellent mediator.”

Business writer Tim Simmers can be reached at 650-348-4361 or at [email protected].

Originally published by Tim Simmers, BUSINESS WRITER.

(c) 2008 Oakland Tribune. Provided by ProQuest Information and Learning. All rights Reserved.

Florastor(R) Receives ConsumerLab.Com Certification

SAN BRUNO, Calif., March 11 /PRNewswire/ — After undergoing intensive voluntary testing, Florastor(R), the world’s top-selling probiotic supplement, has been named to the list of Approved Quality products on ConsumerLab.com, the leading provider of independent test results and information to help consumers and healthcare professionals evaluate health, wellness and nutrition products.

(Photo: http://www.newscom.com/cgi-bin/prnh/20080311/NYTU032 )

“We are thrilled that Florastor has been recognized by ConsumerLab.com as an Approved Quality probiotic supplement,” says Mary Berry, U.S. marketing manager at Biocodex, Inc., the France-based manufacturer of the product. “Its passing status confirms our claims that Florastor contains 10 billion live probiotic organisms, which is essential in the product’s promotion of healthy intestinal function through the balance of intestinal flora.”

Prior to its testing of Florastor, ConsumerLab.com, which records more than three million Web site visits per year, had posted a report in December 2006 on quality testing done on a randomly selected group of probiotic supplements. The testing criteria included identifying the number of live microorganisms in the product to both determine that it matched the number noted on the product’s packaging and if there were at least one billion live microorganisms in the product (the generally accepted minimum amount needed to deliver any significant health benefit). The report revealed that only eight of 13 probiotic products selected by ConsumerLab.com actually contained the labeled amounts of live microorganisms, and several did not meet the one billion minimum.

Products were also tested for the lack of contaminating organisms, as well as the enteric protection of the product, meaning the microorganisms’ ability to survive as they make their way through stomach acid and into the small intestine where bacteria would flourish.

“Florastor is the most widely used probiotic in the world and is the product of extensive and ongoing research,” says Berry. “It is very important to us that its claims have been validated by a reputable third party so that U.S. consumers can have confidence in the product.”

Florastor, which utilizes a freeze-dried form of a beneficial yeast called Saccharomyces boulardii (S. boulardii), was voluntarily submitted for ConsumerLab.com testing and passed the organization’s review criteria by meeting its listed number of 10 billion probiotic organisms in a maximum suggested daily serving, as well as being free of microbial contamination and exhibiting sufficient enteric protection.

Florastor is supported by numerous clinical studies and is the only probiotic mentioned by the World Health Organization (WHO) for use in managing recurrent disease associated with the Clostridium difficile (C. diff) infection(1). It is clinically proven to be effective in helping to manage intestinal issues ranging from acute diarrhea to chronic inflammatory conditions (such as Crohn’s disease or ulcerative colitis). Florastor has also been clinically proven to be particularly effective in combating antibiotic-associated diarrhea, since, unlike bacteria-based probiotics, the beneficial yeast in Florastor cannot be killed by the antibiotic treatment itself.

Probiotics are defined by the Food and Agriculture Organization (FAO) of the United Nations, as “live microorganisms administered in adequate amounts, which confer a beneficial health effect on the host.” Florastor has shown in more than 50 years of extensive international use to be safe and effective, with an estimated 1.7 billion daily doses sold to date.

Florastor is available in most retail chain pharmacies, and at independent pharmacies. It can be purchased in bottles of 10 capsules for a suggested price of $9.95, or 50 capsules for a suggested price of $39.95. Florastor Kids is available in a box of 10 powder packets (which can be mixed with applesauce or beverages, including infant formula) for a suggested price of $11.95, or in a 20-packet box for a price of $19.95.

Visit http://www.florastor.com/ to find out where to purchase Florastor in your area. It is commonly found in the anti-diarrheal/stomach aid section, and can also be obtained by asking the pharmacist (many stores keep Florastor the product behind the counter). It can also be purchased online at http://www.newtimrx.com/florastor.html.

For more information on ConsumerLab.com testing, visit http://www.consumerlab.com/.

(1) Saccharomyces boulardii: a valuable adjunct in recurrent Clostridium

difficile disease? (1995) WHO Drug Information; 9;(1); 15-16.

Photo: NewsCom: http://www.newscom.com/cgi-bin/prnh/20080311/NYTU032PRN Photo Desk, [email protected]

Florastor

CONTACT: Anne Carlantone, [email protected], orChristina Occhipinti, both of Robin Leedy & Associates for Florastor,+1-914-241-0086, ext. 12

Web site: http://www.florastor.com/http://www.consumerlab.com/http://www.newtimrx.com/florastor.html

A Rare Presentation of Sarcoidosis, Back Pain and Spondylolisthesis

By Morgan, S S Aslam, M B; Mukkanna, K S; Ampat, G

A 48-year old man presented with back pain that was resistant to treatment. An MR scan showed spondylolisthesis at L4-5 and narrowing of the exit foraminae. He had a posterior fusion which did not relieve his symptoms. He continued to have back pain and developed subcutaneous nodules in both forearms. Biopsy from the skin revealed cutaneous sarcoidosis, and one from the lumbar spine showed sarcoidosis granulome between the bone trabeculae. A CT scan of the abdomen and chest revealed axillary lymphadenopathy, mediastinal enlarged nodes, apical nodular nodes and splenomegaly. The patient was started on large doses of methotrexate and steroids. His angiotensin-converting enzyme and calcium levels returned to normal and the back pain resolved. Sarcoidosis is a multisystem syndrome of unknown aetiology with variable presentation, prognosis and progression. Its histological hallmark is the noncaseating granulomata which disrupt the architecture and function of the tissue in which they reside.

Osseous involvement occurs in between 1% and 13% of cases commonly involving the hands and feet,1,2 However, vertebral sarcoidosis is exceedingly rare and very difficult to diagnose.

We present a patient with osseous vertebral sarcoidosis. He also had lesions affecting the lungs, skin, liver and spleen, but his initial presentation was with back pain and in the absence of any other manifestation of this multisystemic disease.

Case report

A 48-year-old man presented with a threemonth history of back pain radiating to the left leg. Examination revealed a positive straight leg raise test at 30[degrees] on the left side, but other than this, the examination was unremarkable. An MR scan showed bilateral narrowing of the L4-5 exit foraminae with spondylolisthesis and narrowing of the disc space (Fig. 1). He underwent L4-5 posterior fusion and decompression with pedicle screws. Following the operation he continued to have pain in his back and left leg. His inflammatory markers (white blood cell count, erythrocyte sedimentation rate and Creactive protein) were all normal. He continued to have intractable pain, which did not respond to Gabapentin and he developed sensory changes in the distribution of L4 and L5 changes and urinary retention. A further MR scan showed degenerative disc disease at L45, no evidence of nerve root compression, and a normal conus. In view of the persistent intractable pain, an attempt was made to carry out an anterior fusion at the L4-5 level, but this was abandoned because of excessive bleeding.

Three months later, he noticed gradual diffuse thickening of the skin in the forearms and legs with palpable lumps (Fig. 2). A biopsy showed the features of a sarcoid granuloma (Figs 3 and 4).

Fig. 1

T2-weighted sagittal MR scan, showing spondylolisthesis at L4-5 and disc space narrowing.

Fig. 2

Photograph of the forearm showing the cutaneous lesion with subcutaneous nodules.

Fig. 3

Photomicrograph of sarcoid granulomata present in the subcutis.

Fig. 4

Photomicrograph of sarcoid granulome present adjacent to a hair follicle in a section from the skin nodule.

Fig. 5

Photomicrograph of sarcoid granulorna present in between the bony trabeculae.

In view of the persistence of the back and leg pain, a biopsy was undertaken at the L4-5 level which showed a sarcoid granuloma between the bone trabeculae (Fig. 5). CT scans of the chest and upper abdomen showed axillary lymphadenopathy, enlarged mediastinal nodes, apical nodular nodes and splenomegaly, consistent with sarcoidosis. He was started on prednisolone 40 mg daily for eight weeks, which was then reduced to 30 mg daily and methotrexate 10 mg weekly. He did not tolerate the methotrexate, and this was stopped. However, he was continued on a maintenance dose of prednisolone. His subcutaneous nodules had disappeared by six weeks. His back pain started to improve and resolved by four months. The levels of angiotensin converting enzyme and the serum calcium reverted to normal.

Discussion

Sarcoidosis is a multisystem disorder characterised by noncaseating granulomatous infiltration. The most common sites of involvement are the lungs and lymph nodes, while the spleen, livei; skin, eyes, muscles, bones, central nervous system and salivary glands are less frequently involved.3

Osseous involvement is uncommon mostly affecting the long bones of the hands and feet2 and involvement of the lumbar vertebrae is exceedingly rare. The rarity of osseous and, in particular, vertebral sarcoidosis leads to a significant delay in diagnosis with only one third of patients diagnosed at the initial presentation.4,5

The mainstay of diagnosis is biopsy.4,6,7 Magnetic resonance imaging is non specific.8 In a few cases of vertebral sarcoidosis, MRI findings have been reported,9,10 but in our patient MRI failed to show any specific bony lesion, emphasising the importance of histological evidence.

Clear guidelines for the treatment of extrapulmonary sarcoidosis do not exist.11,13 Corticosteroids are the drug of choice, and long- term efficacy in osseous sarcoidosis has been suggested14 and is effective in correcting hypercalcaemia. The use of cyclophosphamide and methotrexate has also been reported to be effective in the management of sarcoidosis, particularly for patients who are refractory to standard therapy of corticisteroids or unable to tolerate high-dose corticosteroids because of side effects.6,16,17

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

References

1. Jelinkek JS, Mark AS, Barth WF. Sclerotic lesions of the cervical spine in sarcoidosis. Skeletal Radiol 1998:27:702-4.

2. Cohen NP, Gosset J, Staron RB, Lavina WN. Vertebral sarcoidosis of spine in a football player. Am J Orthop 2001;30:875- 7.

3. Newman LS. Rosa CS, Maier LA. Sarcoidosis. N Engl J Med 1997;336:1224-34.

4. Junger SS, Stern BJ, Levine SR, Sipos E, Marti-Masso JF. Intramedullary spinal sarcoidosis, clinical and magnetic resonance imaging characteristics. Neurology 1993;43:333-7.

5. Nesbit GM, Miller GM Baker H Jr, Ebersold MJ, ScheHhauer BW. Spinal cord sarcoidosis: a new finding at MR imaging with Gd-DTPA enhancement. Radiology 1989;173:839-43.

6. Zajicek JP, Scolding NJ, Foster O, et al. Central nervous system sarcoidosis: diagnosis and management. OJ M 1999;92:103-17.

7. Woanders F, von Hengel P, Krikke A, Wesselling J, Nieboer P. Sarcoidosis mimicking metastatic disease: a case report and review of literature. Neth J Med 2006;64:342-5.

8. Lisia D, Mitchell K, Crouch M, Windsor M. Sarcoidosis of the thoracic and lumbar spine: imaging findings with an emphasis on magnetic resonance imaging. Australas Radiol 2004;48:404-7.

9. Haluska P, Luetmer PH, Inwards CY, et al. Complications of therapy and a diagnostic dilemma case: case 3: diagnostic dilemma: sarcoidosis simulating metastatic malignancy. J Clin Oncol 2003;21:4653-4.

10. Ginsberg LE, Williams DW III, Stanton C. MRI of vertebral sarcoidosis. J Comput Assist Tomogr 1993;17:158-9.

11. Kidd D, Beynon HL The neurological complications of systemic sarcoidosis. Sarcoidosis Vase Diffuse Lung Dis 2003;20:85-94.

12. Baughman RP, Lower EE Therapy for sarcoidosis. Eur Respir Mon 2005;32:301-15.

13. Lexa FJ, Grossman RI. MR of sarcoidosis in the head and spine: spectrum of manifestations and radiographic response to steroid therapy. AJNR Am J Neuroradiol 1994;15:97382.

14. Gibson GJ, Prescott RJ, Muers MF, et al. British Thoracic society Sarcoidosis study: effects of long term cortocosteroid treatment. Thorax 1996;51:238-47.

15. Rizzato G. Clinical impact of bone and calcium metabolism changes in sarcoidosis. Thorax 1998;53:425-9.

16. Doty JD, Mazur JE, Judson MA. Treatment of corticosteroid- resistant neurosarcoidosis with a short-course cyclophosphamide regimen. Chest 2003;124:2023-6.

17. Zuber M, Defer G, Cesara P, Dogos JD. Efficacy of cyclophosphamide in sarcoid radiculomyelitis. J Neurol Neurosurg Psychiatry 1992;55:165-7.

S. S. Morgan,

M. B. Aslam,

K. S. Mukkanna,

G. Ampat

From Southport

Hospital, Southport,

England

* S. S. Morgan, MBBCh,

MRCS, Specialist Registrar In

Orthopaedics (LAT)

* G. Ampat, FRCS(Trauma &

Orth). Consultant Orthopaedic

Surgeon

Southport Hospital, Town Lane

Kew, Southport PR8 6PN, UK.

* M. B. Aslam, MBBS,

MRCPath, Consultant

Pathologist

Histopathology Department

Royal Blackburn Hospital,

Hasllngdon Road, Blackburn

BB2 3HH, UK.

* K. S. Mukkanna, MBBS, MD,

DNB, Trust Registrar,

Dermatology

Ormskirk District General

Hospital, Wigan Road,

Ormskirk L39 2AZ, UK.

Correspondence should be sent to Mr S. S. Morgan; e-mail: [email protected]

(c)2008 British Editorial Society of Bone and Joint Surgery

doi: 10.1302/0301-620X.90B2. 19917 $2.00

J Bone Joint Surg [Br] 2008;90-B:240-2.

Received 6 July 2007; Accepted 27 September 2007

Copyright British Editorial Society of Bone & Joint Surgery Feb 2008

(c) 2008 Journal of Bone and Joint Surgery; British volume. Provided by ProQuest Information and Learning. All rights Reserved.

Depending on Nature: Ecosystem Services for Human Livelihoods

By Mainka, Susan A McNeely, Jeffrey A; Jackson, William J

A new paradigm is emerging in the world of environmental conservation. Conservationists have traditionally spoken of conserving the building blocks of nature-genes, species, and ecosystems, along with the air, water, and land with which these interact. But this approach has not captured the interest of those who influence the activities that degrade these building blocks. The drivers of degradation-including habitat loss and fragmentation, overexploitation, invasive species, pollution, and climate change- continue their march, and the results have been documented regularly in updates of the IUCN Red List of Threatened Species and other reports on the status of the environment: continuing loss of biodiversity and accelerating threats to nature. Although the effects of climate change and the emerging challenge of how to address it are now making front-page headlines, the underlying role of biodiversity, both as victim and potential solution, has yet to receive adequate attention. Conservationists have been seeking language that will make the importance of a healthy environment more obvious and relevant to the politicians, economists, business people, and development specialists who make decisions upon which nature’s future depends. One such concept is embodied in the idea of ecosystem services as the benefits that nature provides to people. Ecosystem services incorporate the language of economics and business, through their valuation, and the language of development, through their support for human well-being. Efforts to support the long-term sustainable supply of those services are as important to human well-being and survival as they are for nature itself.

Although the building blocks and processes that sustain human life are nearly as old as our planet, regarding them as “ecosystem services” is a more recent concept. With the book Nature’s Services: Societal Dependence on Natural Ecosystems, Stanford University conservation biologist Gretchen Daily and coauthors popularized the concept a decade ago, and the Millennium Ecosystem Assessment, completed in 2005, brought it into the political mainstream.1 The latter adopted a framework that described these services, analyzed the current state of their delivery, and assessed the drivers that affected their delivery.

Why Are Ecosystem Services Important?

The benefits of ecosystem services come in many forms, from the tangible provision of the necessities of life-food, water, medicine, and clean air-to aesthetic inspiration for culture and society. These services are the foundation of daily life, and they are available without people necessarily being conscious of the many and complex processes involved in their production and delivery. The Millennium Ecosystem Assessment framework provides a clear understanding of the many ways nature supports human well-being (see Figure 1 on page 45). But these services are highly dependent on functioning ecosystems, including both biotic and abiotic components. Therefore, the quality of biodiversity, air, water, and land forms the bedrock of human welfare.

The State of the Environment and Ecosystem Services

The Millennium Ecosystem Assessment reported in 2005 that 60 percent of the world’s ecosystem services are degraded to the point that they no longer provide sufficient benefits to people. Human exploitation of ecosystems has resulted in increased production of a small number of services such as crops and livestock, but this has come at the cost of degradation of many other ecosystem services.2

For example, the assessment notes that more land was converted for crops from 1950 to 1980 than during the 150 years from 1700 to 1850. Since 1960, flows of reactive nitrogen have doubled, leading to increased eutrophication and extensive dead zones in many coastal areas. During the last several decades of the twentieth century, 20 percent of coral reefs and 35 percent of mangrove forests were lost or severely degraded.3

The experts involved in the Millennium Ecosystem Assessment warn that although evidence remains incomplete, the ongoing degradation of 15 of the 24 ecosystem services examined is increasing the likelihood of serious damage to human wellbeing. Negative impacts include the emergence of new diseases, sudden changes in water quality, the collapse of fisheries, and shifts in regional climate.4

To facilitate understanding how ecosystem services have deteriorated, it is useful to consider the status and trends in the biotic (biodiversity) and abiotic components that function together to provide these services. Such a review requires measuring quantity and quality of the components, including diversity. Evidence collected to date suggests that a diverse system will be more resilient when faced with environmental change and thus will show greater ecosystem adaptability. In essence, a greater diversity of species performing similar functions within an ecosystem is likely to result in a greater probability of ecosystem processes being maintained in the face of environmental change. For example, productivity and community stability in European grasslands were found to be tightly coupled to the functional diversity of fungi living among the roots of the plants in those grasslands-the plant biomass was much more stable when the fungi were highly diverse.5

Biodiversity at the Genetic Level

A systematic effort to measure diversity at the genetic level for all species has been impractical, though new advances in DNA fingerprinting are leading to new approaches. As just one example, sea water samples collected by a marine research vessel, Sorcerer II, collected gene fragments predicted to represent more than 6 million proteins, almost double the number of proteins listed in online databases.6 Moreover, the benefits of bioprospecting- searching for useful genetic resources in plants, animals, and microorganisms-has increased the attention being given to genetic diversity in recent decades.7 Bioprospecting has yielded very positive results for some people in terms of new medicines and food varieties but has also had some potential negative impacts. For example, in many areas, the economic benefits of the newly commercialized products do not reach the countries where the genetic materials were originally discovered, much less the local communities that may have been using the genes (such as those found in medicinal plants) for many generations. This has given rise to charges of biopiracy.8 In addition, widespread use of only a few commercial species or plant cultivars is resulting in the loss of genetic diversity in domesticated plants. Reduced genetic diversity, or increased inbreeding, ultimately leads to a loss of adaptation (evolutionary) potential, demonstrated through effects such as increased susceptibility to disease or reduced reproduction.9

Biodiversity at the Species Level

The 2007 IUCN Red List of Threatened Species reports that more than 16,000 species are threatened with extinction. (Key details about this list are highlighted in the box below, at right.) Using historical data from Red List compilations, IUCN and partners have developed the Red List Index that, for birds, shows a steady deterioration in threat status from 1988 to 200410 (see Figure 2 below). The situation is even more serious for amphibians, taxa for which a preliminary Red List Index indicates a substantial increase in threat status since 1980.11

An evaluation of major threats to species was conducted as part of the 2004 Global Species Assessment. Most species faced multiple threats. Habitat loss or degradation affected 83 percent of threatened mammals, 89 percent of threatened birds, and 91 percent of plants sampled. Direct loss or exploitation affected 34 percent of mammals, 37 percent of birds, and 7 percent of plants. Invasive alien species affected 30 percent of threatened birds (but 67 percent of threatened birds on islands), 11 percent of threatened amphibians, and 8 percent of threatened mammals. Hunting and trade activities affected 29 percent of mammals and 28 percent of birds but only 1 percent of plants.12 Estimates suggest commercial fishing has depleted predatory fish communities to 10 percent of their pre- industrial biomass.13 While the direct threats have been quantified, most of these threats are themselves a result of complex underlying socioeconomic factors, often linked to globalization.

Biodiversity at the Ecosystem Level

The Pilot Assessment of Global Ecosystems undertaken by the World Resources Institute in 200014 reported that conditions across all five ecosystems studied were uniformly declining (see Table 1 on page 47). Similarly, United Nations Environment Programme (UNEP) World Conservation Monitoring Centre inventoried the current understanding of global terrestrial, marine, and inland water biodiversity. Using the Living Planet index approach applied to data from the years 1970-1995, they reported a decline in marine biodiversity of 35 percent and a decline in inland water biodiversity of 45 percent.15

The Millennium Ecosystem Assessment, while focusing on ecosystem services, also reported on the status of ecosystems in 2005. Ecosystems that have been most significantly altered include marine and freshwater systems, temperate broadleaf forests, temperate grasslands, Mediterranean forests, and tropical dry forests. Dams have fragmented more than 40 percent of the large river systems in the world, and more than half of tropical dry forests have been lost.16 Air

Since the pre-industrial era, human activities have changed the chemical composition of the atmosphere and the physical properties of the land’s surface, which in turn affect air quality and climate and the ecosystem services to which these contribute. UNEP’s Global Environment Outlook 4 project reports that many areas suffer from excessive air pollution as a result of massive industrial expansion and levels of pollutants are increasing (see Figure 3 on page 49), especially in Asia.17 Long-range transport of a variety of air pollutants remains an issue of concern for human and ecosystem health and for the provision of ecosystem services. Ozone is increasing throughout the northern hemisphere and is a regional pollutant affecting human health and crop yields.18

Meanwhile, more than 1.6 million people, especially women and children, are estimated to die prematurely each year due to indoor air pollution resulting from use of traditional biofuels for heating and cooking.

Water

Challenges to maintaining the Earth’s supply of freshwater include pollution, habitat degradation, overexploitation, and climate change-a similar litany of ills that also plagues biodiversity. The recent UNEP Global International Waters Assessment confirmed that shortages of freshwater were a problem in most parts of the world, but especially in sub-Saharan Africa, where freshwater shortages affect 9 of 19 systems assessed and pollution (including transboundary pollution) affects 5 systems. Other problems include overfishing and habitat modification.19

In terms of water quality, one indicator is water Biochemical Oxygen Demand (BOD), the amount of oxygen that bacteria in water will consume in breaking down waste. A review of changes in water BOD during the past 20 years reveals that there has been progress in most regions (see Figure 4 on page 49). However, there has been a decrease in water quality for the Caribbean and Middle East.

Land

Meeting the nutritional needs of the world’s growing population will require concentrated efforts to deliver food crops, which provide more than 90 percent of daily caloric intake globally.20 However, capacity to improve productivity is limited. The International Food Policy Research Institute reports that soil degradation has already had significant impacts on the productivity of about 16 percent of the globe’s agricultural land. Combining updated maps with existing expert assessments of soil degradation suggests that almost 75 percent of cropland in Central America, 20 percent in Africa (mostly pasture), and 11 percent in Asia is seriously degraded, with soil nutrients insufficient to support the previous levels of plant production.21

Human Well-being and the Environment in 2007

While environmental status reports indicate an ongoing decline, the situation for human well-being is not so dire. A review of trends in the UN Development Programme’s Human Development Index over the past 30 years shows steady improvement in all regions except sub-Saharan Africa22 (see Figure 5 on page 50).

The human population quadrupled during the twentieth century, increasing from about 1.5 billion in 1900 to about 6 billion in 2000. During that time, consumption of natural resources increased by a factor of 16. With the global population expected to increase to more than 9 billion people by 2025, consumption of resources and equity in that consumption will underlie many of our future challenges, including food security and human health.23

For example, the Food and Agricultural Organization of the United Nations estimates that more than 850 million people are undernourished and the vast majority of those (815 million) live in the developing world, primarily in rural areas. The hunger problem is most serious in sub-Saharan Africa, where more than 40 percent of the population is undernourished. In most cases the problem is not one of malnutrition but of chronic hunger-a daily calorie or nutrient deficit that decreases the ability to lead a productive life. Nine million of the hungry live in the world’s richest countries, where, paradoxically, a high level of obesity is also a growing health problem. Projections indicate that the global numbers of undernourished people should decrease to less than 580 million by 2015, but some regions (such as Asia) are expected to make good progress, while others (particularly sub-Saharan Africa) are likely to lag behind.24

From the perspective of human health, the World Health Organization reports that environmental hazards are responsible for an estimated 25 percent of the total burden of disease worldwide. In sub-Saharan Africa, this figure is nearly 35 percent. Particular environmental issues with health impacts include vector-borne disease such as malaria, climate change, toxic substances, and natural hazards. However, the environment is not only a cause of disease, but also a source of treatment. A large proportion of people in developing countries rely on traditional medicines, mostly derived from plants. In developed countries, more than half of the most frequently prescribed drugs are derived from natural sources. Ongoing loss of biodiversity represents an opportunity cost for future solutions to emerging medical problems.

Biodiversity loss is also a question of economics. In the United States alone, botanical medicine sales were estimated at US$3.87 billion in 1998.25 Globally, over-the-counter sales of plant- derived drugs are worth more than US$40 billion.

Linking Poverty Reduction to Biodiversity Conservation

Recent estimates put the number of people living in extreme poverty at 1.1 billion, with the majority living in South Asia and sub-Saharan Africa.26 However, such statistics are often difficult to interpret, as poverty is often defined by income level, an indicator that ignores important dimensions such as lack of assets, powerlessness, and vulnerability.27

It is difficult to measure the long-term impact of biodiversity loss and impaired delivery of ecosystem services. While the total loss of such services would mean the end of life on Earth, on a more realistic level, any loss of ecosystem services will have an impact on human well-being. Unfortunately, those services are not adequately valued in economic terms, making it difficult to understand the tradeoffs that are made when allowing unbridled economic gain without incorporating social and environmental concerns.

According to the International Fund for Agricultural Development, 75 percent of the poor live in rural areas.28 These people depend heavily on natural resources for their livelihoods, and they are affected by development or conservation interventions that alter their access to ecosystem services and biodiversity. As the links between the environment and human well-being become more clearly articulated, so too are the threats that undermine both. In particular, climate change, invasive alien species, and unsustainable resource use are emerging as key issues that must be addressed.

Poverty Reduction and Human Well-being

Conservation can contribute to poverty reduction, particularly through restoring ecosystems and by improving the access of the poor to ecosystem services, thus contributing to secure livelihoods for the people who depend on them.29 However, achieving biodiversity conservation requires efforts beyond the scope of environmentalists in terms of politics, economics, and technology.

Since the launch of the World Conservation Strategy in 1980, “sustainable development” has become a key objective of the international community and has been reaffirmed several times, including in 1992 at the United Nations Conference on Environment and Development, in 2000 at the Millennium Summit, in 2002 at the World Summit for Sustainable Development, and in 2005 at the Millennium Summit +5.

The eight Millennium Development Goals (MDGs) agreed by the United Nations General Assembly in 2000 aim to “significantly improve the human condition by 2015.” Through MDG 7 (“ensure environmental sustainability”), the MDGs explicitly recognize the relationship between the environment and sustainable development, although each of the MDGs has a link to sound environmental management (see Table 2 below). Each of the MDGs are mutually dependent; achieving MDGs 1-6 will support delivery of MDG 7 and vice versa. Conversely, incomplete achievement of any of the MDGs is likely to hamper progress on achieving the others.

In addition to the discussions and agreements noted above, multilateral agreements such as the UN Framework Convention on Climate Change, the Convention on Biological Diversity, the UN Convention to Combat Desertification, the Kyoto Protocol, and the Montreal Protocol have entered into force, each providing more detailed actions for achieving the global objective of sustainable development. However, despite stated political commitment to the environment, inadequate investment has been made to converting these promises into reality. For example, reports at the 2007 meeting of the Conference of the Parties of the United Nations Framework Convention on Climate Change found that none of the signatories to the Kyoto Protocol was meeting its targets for reducing production of greenhouse gases.

And beyond these agreements with an explicit environmental objective, little attention is paid to these issues in other venues. For example, debates within the major multilateral institutions such as the World Trade Organization’s Doha Development Round and the Monterrey Conference on Financing for Development typically ignore environmental considerations.

In particular, lack of development finance remains a major problem for developing countries. Official development assistance to developing countries has increased to its highest level ever, reaching more than US$100 billion in 2006.30 While this increase is welcome, it still represents only 0.25 percent of the combined gross national income of the OECD Development Assistance Committee member countries and falls far short of the 0.7 percent target agreed in 2000. Official development assistance activities targeting the objectives of the Convention on Biological Diversity by 19 OECD countries for 1998-2000 indicated a slightly declining trend with US$1.09 billion, US$1.03 billion, and US$0.87 billion contributed each year respectively (see Figure 6 below).31

Some of the major sources of investment for biodiversity conservation come from the multilateral institutions-especially the Global Environment Facility (GEF) and the World Bank-and bilateral donor assistance. The GEF operates the financial mechanism of the Convention on Biological Diversity and as such provided significant funding for global biodiversity conservation. In its first decade of operation, GEF provided nearly US$1.1 billion for about 200 biodiversity projects with protected area components. For its third replenishment covering 2002-2006, GEF received commitments of US$3.1 billion, of which US$800 million was earmarked for biodiversity. Between 1988 and 2003, the World Bank Group approved 233 projects that fully or partially support biodiversity conservation. For these projects, the World Bank’s lending totaled about US$1.8 billion.32

At a more specific level, a recent estimate of global expenditure on existing protected areas is around US$6.5 billion per annum, mostly in the developed world.33 Although nongovernmental and private sector funding are becoming an increasingly important component of protected area finance, two sources-domestic government budgets and international donor assistance-provide the bulk of funding.34 In the developing world as a whole, one recent estimate suggests that public national park budgets amount to between US$1.3 and 2.6 billion per year.35 As a share of total government spending, these sums are relatively small.

Technology will be particularly important in dealing with some of the main threats facing reliable delivery of ecosystem services, namely climate change and invasive species. In both cases, tools and information are needed to effectively manage ecosystems that are vulnerable to these threats and to ensure sustainable livelihoods for those living in these areas.

Many governments are making major public investments in technology. Malaysia, for example, plans to spend US$8 billion on developing biotechnology over the coming decade or so, drawing on the ecosystem services that provide genetic diversity. Investments by the private sector may be even larger on a global scale. Important areas of technological innovation have been especially dramatic in the field of information technology, with the Internet now making it possible to download information on virtually any topic at any time. Related communications technology has put people easily in touch with each other, so that ignorance is no longer a significant constraint against action in favor of the environment. Even some of the remotest areas of the world are now connected through cellular phones using solar power. While modern communications technology is not yet universal, its rapid growth indicates that information flow will soon be a global phenomenon. Even now, the amount of information available is often overwhelming, and a major challenge is managing the overflow of information, as well as dealing with issues of proprietary rights.

Remaining Challenges

Biodiversity conservation and the resulting support to human well- being must be integrated into all actions intended to reduce poverty and achieve sustainable livelihoods. Achieving this integration will depend on continuing to explore and research the link between biodiversity, ecosystem services, and human welfare, particularly in economic terms. Better understanding the status and trends in ecosystems will lead to better decisions. While research and development are important, other aspects of knowledge management, such as support for knowledge-sharing networks and capacity building, will also be vital.

Addressing the drivers of change that are impairing delivery of ecosystem services requires action at three distinct levels:

* improving governance of natural resources (see the box on page 54),

* increasing investment in biodiversity for people (see the box on page 54), and

* adopting landscape-scale approaches and technology.

Improving Governance of Natural Resources

Efficient and reliable delivery of ecosystem services is an important component of poverty reduction and sustainable development. The Johannesburg Plan of Implementation described good governance as being “essential for sustainable development,” and successful achievement of the MDGs will certainly require improved coordination and partnership among all participating agencies and organizations. To that end, the potential role of the private sector and civil society in development work, including the conservation of biodiversity, must be welcomed and strengthened. Important strategies for improving governance include

* integrating ecosystem management for human well-being into development planning and implementation,

* decentralizing natural resource management,

* mainstreaming the multilateral environmental agreements in development planning and implementation, and

* promoting equity, especially gender equity, in natural resource management.

Increasing Investment in Ecosystem Services for People

A corollary to strategies to improve governance of biodiversity in development is the need to ensure adequate resources (both human and financial) to implement actions. All countries should seek to increase the efficiency of current expenditures for supporting ecosystem services across all sectors (including agriculture, fisheries, forestry, economic development, and environment ministries). In some cases, decreasing expenditures for subsidies that are detrimental to the provision of ecosystem services may be the most efficient way forward. At the same time, increased amounts of development funding can be directed at activities that incorporate the conservation and sustainable use of biodiversity, and incentives for biodiversity conservation at the community level can be improved. Capacity building and technology transfer programs must also take biodiversity into consideration. Finally, the need for private investment is paramount and will require enabling conditions, including reform of natural resource tenure and raising awareness among investors, insurers, and entrepreneurs to stimulate more investment in biodiversity-friendly enterprise. In particular, mainstreaming biodiversity issues in business planning and operations and exploring and supporting payments for ecosystem services schemes will be key to securing new finances.

Adopting Landscape-Scale Approaches and Technology

Landscape-scale management acts on a scale broad enough to recognize the role of all critical influencing factors and stakeholders that shape land-use decisions. Good landscape management will fulfill societal needs by equitably balancing tradeoffs between the productive, social, and environmental requirements of current land use. To function properly, it requires supportive policies, incentives, and organizational arrangements that are capable of operating at that scale. It means conserving and restoring ecosystems so that they can fulfill their potential to support livelihoods while also taking into consideration the concerns of people depending on those ecosystems. It also means incorporating the understanding of how a management action in one part of the landscape may affect another and allowing flexibility and adaptation in management responses for changing situations.

Other approaches and technologies that are proving useful include management of environmental flows-the minimum flow of water (by volume and season) necessary to maintain aquatic biota and ecosystem processes36-and decision support tools such as CRiSTAL, a community- based risk-screening tool for climate change adaptation, which is freely available on the Internet.37

In addition, ecological restoration techniques should adapt to include consideration of people’s needs. For example, lessons from experiences such as post-tsunami recovery in Indian Ocean countries suggests that the ultimate goal should not necessarily be to achieve the state of the ecosystem prior to the tsunami but to ensure that restoration is done in a way that ensures all those affected will have the means to reestablish their livelihoods. In areas affected by the tsunami, coastal zone restoration should support a reduction in peoples’ vulnerability to future natural disasters through promotion of land-use practices that do not replicate the previous ad hoc and fragmented approach.38

In terms of technology, the rapid advance of access to the Internet and computer hardware and software is important, but the principle of open access to information and presentation of that information in a user-friendly and relevant manner to those engaged in conservation and development is paramount.

Building on the three key challenges of improving governance, increasing investment and adopting relevant technology and knowledge, and employing the key strategies of partnerships and knowledge mobilization, a suite of more specific approaches is suggested as fundamental to success. Integrated interventions, not isolated strategies, will be needed to achieve the MDGs, as the Millennium Ecosystem Assessment has noted. Finally, for many of these actions, an influx of money is not the only answer. The political will for change in human behavior is a necessary foundation for achieving success.

Workers prepare mangrove saplings for planting near Banda Aceh, Indonesia, as part of a coastal protection reforestation project in the wake of the 2004 Indian Ocean tsunami. 2007 IUCN RED LIST OF THREATENED SPECIES

As of 2007, there are 41,415 species on the IUCN Red List, and 16,306 of them are threatened with extinction-up from 16,118 in 2006.

The total number of extinct species has reached 785, and a further 65 are only found in captivity or in cultivation.

One in four mammals, one in eight birds, one-third of all amphibians, and 70 percent of the world’s assessed plants on the 2007 IUCN Red List are in jeopardy.

Source: The IUCN Species Survival Commission, 2007 IUCN Red List of Threatened Species, http://www.iucnredlist.org.

Drought and salinization have hit farmers hard in Australia’s Murray-Darling basin; conserving water and reestablishing native vegetation may help solve both problems.

A girl carries beans back to her village in southern Malawi. About half of the students in her region stopped going to school after drought and floods resulted in food shortages.

IMPROVING GOVERNANCE OF NATURAL RESOURCES

Improving governance of natural resources often results in direct benefits to local livelihoods and well-being. Consider the following examples:

* Post-tsunami recovery plans in six Indian Ocean countries have included consideration of ecosystems as critical infrastructure for the future, with particular attention being given to the role of mangroves in coastal protection.1

* In the Shinyanga region of northwestern Tanzania, where high population density combined with expansive agro-pastoralist land use has exacerbated serious problems of land clearing for cultivation, devolution processes supported 500 villages in declaring new forest reserves, thereby conserving resources necessary for their livelihoods, including enhanced incomes from locally managed woodlands.2

* In Gambia, control of cereal production by women added 322 more calories per adult, equivalent to household energy consumption per day. In Kenya and Malawi, moderate to severe levels of malnutrition were much lower among children in female-headed households than in male-headed households.3

1. L. Emerton, Counting Coastal Ecosystems as an Economic Part of Development Infrastructure (Colombo, Sri Lanka: IUCN Ecosystems and Livelihoods Group Asia, 2006).

2. G. C. Monela, S. A. O. Chamshamma, R. Mwaipopo, and D. M. Gamassa, A Study on the Social, Economic and Environmental Impacts of Forest Landscape Restoration in Shinyanga Region, Tanzania, First Draft (Dar es Salaam, Tanzania, and Nairobi, Kenya: Tanzania Ministry of Natural Resources and Tourism and IUCN Eastern Africa Regional Office, 2004), 224.

3. N. Kabeer, Gender Mainstreaming in Poverty Eradication and the Millennium Development Goals: A Handbook for Policy-Makers and Other Stakeholders (London: Commonwealth Secretariat, 2003).

INCREASING ATTENTION TO AND INVESTMENT IN ECOSYSTEM SERVICES FOR PEOPLE

As the following examples show, focusing attention to and investment in ecosystem services provides many longterm benefits on local, regional, and global levels.

* Global carbon markets were valued at US$10 billion in 2006 and represent an important opportunity for investment in conservation.1

* In Australia’s Murray-Darling Basin, often considered the country’s breadbasket, a payment scheme is used to finance restoration of natural vegetation as a strategy for controlling dryland salinization.2

* In Costa Rica, different ways to finance voluntary approaches to optimizing land use for watershed protection and water flows have been implemented, including paying upstream farmers for conserving forests that help deliver clean water downstream.3

1. World Bank, World Development Indicators (Washington DC: World Bank, 2006).

2. D. Perrot-MaItre and P. Davis, Case Studies of Markets and Innovative Financial Mechanisms for Water Services (Washington, DC: Forest Trends and The Katoomba Group, 2001), http://www.forest- trends.org/documents/publications/casesWSofF.pdf.

3. S. Pagiola, “Paying for Water Services in Central America: Learning from Costa Rica,” in S. Pagiola, J. Bishop, and N. Landell- Mills, eds., Selling Forest Environmental Services: Market-based Mechanisms for Conservation (London: Earthscan, 2002).

NOTES

1. G. C. Daily, ed., Nature’s Services: Societal Dependence on Natural Ecosystems (Washington DC: Island Press, 1997); and Millennium Ecosystem Assessment (MA), Ecosystems and Human Well- Being: Synthesis (Washington, DC: Island Press, 2005), http:// www.millenniumassessment.org/documents/document.356.aspx.pdf.

2. MA, ibid.

3. MA, note 1 above.

4. MA, note 1 above.

5. K. McCann, “The Diversity-Stability Debate,” Nature 405, no. 6783 (11 May 2000): 228-33.

6 S. Yooseph et al., “The Sorcerer II Global Ocean Sampling Expedition: Expanding the Universe of Protein Families,” PLoS Biology 5, no. 3 (2007): e16 doi:10.1371/journal.pbio.0050016, http:/ /dx.doi.org/10.1371/journal.pbio.0050016.

7. R. N. Young, “Importance of Biodiversity to the Modern Pharmaceutical Industry,” plenary lecture presented at the 2nd International Conference on Biodiversity, Belo Horizonte, Brazil, July 1999, http://www.iupac.org/publications/pac/1999/71_09_pdf/ 7109young_1655.pdf.

8. R. Wynberg and S. Laird, “Bioprospecting: Tracking the Policy Debate,” Environment 49, no. 10 (2007): 20-32.

9. L. F. Keller and D. M. Waller, “Inbreeding Effects in Wild Populations,” Trends in Ecology and Evolution 17, no. 5 (2002): 230.

10. S. Butchart et al., “Using Red List Indices to Measure Progress towards the 2010 Target and Beyond,” Philosophical Transactions of the Royal Society B 360, no. 1454 (2005): 255-68.

11. J. E. M. Baillie, C. Hilton-Taylor, and S. N. Stuart, eds., 2004 IUCN Red List of Threatened Species. A Global Species Assessment (Gland, Switzerland, and Cambridge, UK: IUCN, 2004), xxiv and 191.

12. Ibid.

13. R. A. Myers and B. Worm, “Rapid Worldwide Depletion of Predatory Fish Communities,” Nature 423, no. 6937 (2003): 280-83.

14. World Resources Institute, Pilot Analysis of Global Ecosystems, http://www.wri.org/project/globalecosystems-analysis.

15. B. Groombridge and M. D. Jenkins, Global Biodiversity: Earth’s Living Resources in the 21st Century (Cambridge, UK: World Conservation Press, 2000).

16. MA, note 1 above.

17. United Nations Environment Programme (UNEP), Global Environment Outlook 4 (Nairobi: UNEP, 2007), http://www.unep.org/ geo.

18. Ibid.

19. UNEP, Global International Waters Assessment: Challenges to International Waters: Regional Assessments in a Global Perspective (Nairobi: UNEP, 2006), http://www.giwa.net/publications/finalreport/ executive_summary.pdf

20. Food and Agricultural Organization of the United Nations (FAO), The State of Food Insecurity 2004 (Rome: FAO, 2004), http:// www.fao.org/newsroom/en/focus/2004/51786/article_51791en.html.

21. International Food Policy Research Institute, “Global Study Reveals New Warning Signals:?Degraded Agricultural Lands Threaten World’s Food Production Capacity,” press release, 21 May 2000, http:/ /www.ifpri.org/pressrel/2000/052500.htm.

22. UNDP, Human Development Report 2006: Beyond Scarcity: Power, Poverty, and the Global Water Crisis (New York: UNDP, 2006), http:// hdr.undp.org/en/reports/global/hdr2006/.

23. United Nations, World Population Prospects: The 2004 Revision (New York: UN Department of Economic and Social Affairs, 2005), http://www.un.org/esa/population/publications/WPP2004/wpp2004.htm.

24. FAO, note 20 above.

25. P. Brevoort, “The Booming US Botanical Market: A New Overview,” HerbalGram 44 (Fall 1998), 33-46.

26. UNDP, note 22 above.

27. World Bank, 2000/2001 World Development Report (Washington, DC: World Bank 2001).

28. International Fund for Agricultural Development (IFAD), Enabling the Rural Poor to Overcome Their Poverty: Strategic Framework for IFAD 2002-2006 (Rome: IFAD, 2002).

29. R. J. Fisher, S. Maginnis, W.J. Jackson, E. Barrow, and S. Jeanrenaud, Poverty and Conservation: Landscapes, People and Power (Gland, Switzerland, and Cambridge, U.K.: IUCN, 2005), xvi and 148.

30. Organisation for Economic Co-operation and Development (OECD), “Official Development Assistance Increases Further – But 2006 Targets Still a Challenge,” press release 11 April 2005, http:/ /www.oecd.org/document/3/ 0,2340,en_2649_201185_34700611_1_1_1_1,00.html.

31. UNEP, Options for Mobilizing Financial Resources for the Implementation of the Programme of Work by Developing Countries and Countries with Economies in Transition, UNEP/CBD/WG-PA/1/3 (Nairobi: UNEP, 2005).

32. Ibid.

33. A. K. James, J. Gaston, and A. Balmford. “Can We Afford to Conserve Biodiversity?” BioScience 51, no. 1 (2001): 43-52.

34. W. Krug, “Private Supply of Protected Land in Southern Africa: A Review of Markets, Approaches, Barriers and Issues,” workshop paper presented at the World Bank / OECD International Workshop on Market Creation for Biodiversity Products and Services, Paris, 25 and 26 January 2001.

35. A. Molnar, S. J. Scherr, and A. Khare, Who Conserves the World’s Forests? Community-Driven Strategies to Protect Forests & Respect Rights (Washington, DC: Forest Trends, 2004).

36. M. Dyson, G. Bergkamp, and J. Scanlon, eds., Flow-The Essentials of Environmental Flows (Gland, Switzerland, and Cambridge, U.K.: IUCN, 2003), xiv and 118.

37. IUCN, International Institute for Sustainable Development, Stockholm Environment Institute, and Intercooperation, Summary of CRiSTAL: Communitybased Risk Screening Tool-Adaptation & Livelihoods) http://www.iisd.org/pdf/2007/brochure_cristal.pdf.

38. IUCN, Recovery from the Indian Ocean Tsunami-Guidance for Ecosystem Rehabilitation Incorporating Livelihoods Concerns, IUCN information paper, February 2005, http://www.iucn.org/en/news/ archive/2001_2005/press/tsunami-guidance-info.pdf.

Susan A. Mainka is a senior coordinator in the Global Programme Team at IUCN, with particular responsibility for supporting policy coordination as well as linkages with the regional programs in Asia, Oceania, and eastern and southern Africa. A veterinarian with 20 years experience in wildlife conservation, she has worked in particular on giant panda conservation and captive wildlife management. She is the author of more than 50 publications. Her fields of interest are species conservation and sustainable use issues, particularly as related to traditional medicine. Jeffrey A. McNeely is chief scientist at IUCN, where he has worked since 1980. He is author or editor of more than three dozen books, the latest of which is Farming with Nature: The Science and Practice of Ecoagriculture (Island Press, 2007, with Sara Scherr). He serves on the editorial board of ten international journals. He worked in Asia (Thailand, Nepal, and Indonesia) from 1968 to 1980 on various issues related to conservation and development. He currently serves on the Governing Board of the Society for Conservation Biology and is Chairman of the Board of Trustees of Ecoagriculture Partners (a nongovernmental organization that promotes enhancing agricultural productivity and biodiversity conservation at landscape levels).

William J. Jackson is the deputy director general of IUCN. He has extensive field experience in ecosystem conservation and management at the global level and in Asia, Australia, and Africa. He has worked with many governments and IUCN partner organizations in devising forest conservation programs and policies and in evaluating conservation and rural development projects. He also has experience in advising international agencies such as the World Bank on the development and implementation of participatory processes for policy reviews. He has published a number of articles and books on community forestry, forest conservation, and monitoring and evaluation of projects.

The authors gratefully acknowledge the contributions from numerous colleagues, including Lorena Aguilar, Joshua Bishop, David Brackett, Carolina Caceres, Andrew Deutz, Stewart Maginnis, Brett Orlando, Mohammed Rafiq, Simon Rietbergen, Frederik Schutyser, and David Sheppard.

SUSAN A. MAINKA (“Depending on Nature: Ecosystem Services for Human Livelihoods,” page 42) is a senior coordinator in the Global Programme Team at IUCN-The World Conservation Union. JEFFREY A. MCNEELY is chief scientist at IUCN. WILLIAM J. JACKSON is the deputy director general of IUCN.

Copyright Heldref Publications Mar/Apr 2008

(c) 2008 Environment. Provided by ProQuest Information and Learning. All rights Reserved.

Alzheimer’s Risk Skyrockets if Both Parents Have the Disease

Researchers at the University of Washington in Seattle reported Monday that a person’s risk of Alzheimer’s disease jumps dramatically if both parents have the disease.

The researchers performed a study with 111 families in which both parents had been diagnosed with Alzheimer’s disease, and then assessed the risk among the offspring of developing the disease.

In total, the parents had 297 children, of whom 98 were at least 70 years old.  The research found that of these 98 children, 41, about 42 percent, had developed Alzheimer’s disease.

“That’s greater than you would expect in the general population in that age group,” Dr. Thomas Bird, one of the researchers, said in a Reuters telephone interview.

During the study, approximately two-thirds of the adult children had not yet reached age 70. As a whole, the researchers found that 23 percent of all the adult offspring, regardless of age, had been diagnosed with Alzheimer’s disease at an average at age 66.

Bird said that equates to roughly a one in 10 chance of developing the disease.

“I think it confirms that there’s a strong genetic component in the disease and that’s not a surprise,” said Bird.

Bird said only one gene, known as ApoE, is generally acknowledged among experts as a risk factor for the disease, although there are likely many more.

The ApoE gene plays a role in producing a chemical in the body that helps carry cholesterol in the bloodstream, and appears to effect the age of onset of Alzheimer’s.

The study has been ongoing for the past two decades, with plans to continue for at least another decade. The researchers are not examining Alzheimer’s risk children who have only one parent with the disease.

“The numbers will be interesting to follow as they get older and older,” Bird said.

In confirming the presence of Alzheimer’s disease in both parents, researchers reviewed medical records, analyzed brain autopsies of those who had died, and when possible met with those still living with the disease.

Alzheimer’s disease is the most common form of dementia among the elderly. It results in the degeneration of healthy brain tissue, causing an inevitable decline of memory and mental abilities. The average length of time from diagnosis to death is about eight years.

Scientists do not fully understand the underlying cause of the disease, although genetics is believed to play an important role. There is no known cure. 

The risk of developing Alzheimer’s disease increases after age 65, with the number of people developing the disease doubling every five years thereafter.

The study was published in the journal Archives of Neurology.  A summary can be viewed at http://archneur.ama-assn.org/cgi/content/abstract/65/3/373.

On the Net:

University of Washington

Burn Center Opens in Rankin County

BRANDON, Miss. – A new burn center has opened in Rankin County after Mississippi went nearly two years without any such treatment facility in the state.

Rankin Medical Center’s outpatient burn center opened Friday and took on 14 patients from three states. Brandon is an eastern suburb of Jackson.

Hospital officials say the privately funded facility will reduce the need for patients to travel outside the state to facilities such as the Regional Medical Center at Memphis and Doctors Hospital in Augusta, Ga.

The Mississippi Firefighters Memorial Burn Center in Greenville, which was at the time the state’s only burn unit, shut down in 2005 over a lack of funding. The facility, which was part of the private Delta Regional Medical Center, closed after lawmakers declined to offer millions in aid to the ailing unit.

While the state still has no inpatient burn unit, advocates say the facility in Rankin County will help. Doctors from the Augusta, Ga.-based Joseph M. Still Burn Center will visit the Rankin facility two days each month to provide outpatient care to patients from Mississippi, Louisiana and Alabama.

Originally published by Associated Press .

(c) 2008 Commercial Appeal, The. Provided by ProQuest Information and Learning. All rights Reserved.

Cell Regeneration Slows to a Crawl As We Age

You’re feeling pretty good about yourself. You exercise. You watch what you eat. Your parents lived into their 80s, and your children insist you’re going to beat that and live to be 100.

Now consider:

With each passing day, your heart muscle thickens and your arteries stiffen. Your breathing capacity declines and your brain gradually loses its ability to remember, say, where you put your car keys.

What’s more, each of the more than 10 trillion cells in your body sustains damage 50,000 to 100,000 times every day from aggressive compounds, many of which your body produces in the normal course of living. Keeping in mind that survival depends on your body’s ability to repair and regenerate cells, that disconcerting fact is enough to make you say to heck with it and reach for the brownies.

Welcome to the world of aging, where the unavoidable processes within our body combine with our sometimes-detrimental lifestyles to lead us ever closer to life’s inevitable conclusion — death.

“It’s many, many different interactions between the environment and our gene pool that cause us to age,” says Dr. Jeffrey Ross, chairman of the pathology department at Albany Medical Center Hospital. “But one thing that’s absolutely a guarantee: To date, every human being that has been born has aged. It’s ubiquitous, not preventable currently, and has been demonstrated on everyone who has walked the planet.”

The good news

Fortunately, the news isn’t all grim. Humans are living longer than ever. Life expectancy in the United States has risen in the past century from 47 to 78. That promises to keep rising with continued advances in research, medical care and public awareness of healthy lifestyles.

Someone alive today will become the first human to live to be 150, says Steven Austad, one of the country’s foremost experts on aging and author of “Why We Age: What Science Is Discovering About the Body’s Journey Through Life.”

But first, that person, and the rest of us, must survive the constant assaults on our cells and the gradual deterioration of our body’s mechanisms for keeping us vital.

Aging involves every molecule, cell and organ in the body, and it’s not completely understood. But basically, the experts say, like the aging of a house or car, it’s a maintenance problem.

“What happens is, everything falls apart,” says Austad, professor of cellular and structural biology at the University of Texas Health Science Center. “If you think of us as something capable of repair when damage occurs inside our bodies, then what aging is, is the gradual failure of repair.”

Free radicals

One of the most vivid examples is how our bodies constantly battle a greedy molecule known as the oxygen free radical. Free radicals are a byproduct of burning oxygen in our cells. We ensure their production by eating food and breathing air. Pollution, radiation and cigarette smoke also produce free radicals.

When the body breaks down an oxygen atom during its production of energy, the reaction strips away an electron. Electrons are electrically charged particles that spin around atoms and molecules, usually in pairs.

Free radicals lack one electron, and that’s where the trouble starts. (Under certain conditions, however, free radicals do good things, such as help the body fight infection.) But now, unstable without its mate, it “steals” electrons from other molecules, in the process damaging DNA, the protein inside cells, and even the membrane-enclosing cells.

That damage accumulates in cells and tissues, triggering many of the changes that occur as we age, according to the National Institutes of Health. Free radicals have been implicated in nearly every major disease and malady.

“Everything in your cell is basically damaged by these oxygen radicals,” Austad says. “All that damage is repaired to a certain extent, just like when you get cut, it’s repaired to a certain extent. But it’s not repaired perfectly; you get a little scar.”

Breaking down

The unrepaired damage not only mounts, but the body’s ability to counteract free radicals also diminishes with age. Meanwhile, cells wear out and die. Other cells lose their ability to divide.

“You’ve got slightly different problems depending on whether you’re talking about the brain, the heart, the kidneys, the skin, the immune system,” Austad says. “The thing that unifies them all is that the cells are not working as well as you get older as they were when they were younger.”

This breakdown in cellular function compounds the maintenance problem and lessens the body’s ability to fight disease, leading to aging and, eventually, death. Although scientists have slowed the aging process in laboratory animals by altering genes associated with growth hormones and other procedures, they have yet to find ways to do it with humans.

“There’s nothing that we can really put our finger on right now to say ‘This is how to slow aging in people,’ Austad says. “But progress is moving along so many different directions now. It’s just a matter of time until we figure out what works for humans.”

Three part series begins today

We are living longer than ever before. And scientists are studying ways to keep us alive, healthy and active even longer. Starting today, we are launching a three-part series taking a look at human longevity.

Today we peek into the complicated process of aging, the science of how and why we age.

Tuesday we examine the major advances in medicine and changes in lifestyle that are allowing us to live longer.

And Wednesday we look for what you need to know to live to be 100, including tips from those who’ve made it.

Individuals age at extremely different rates. In fact even within one person, organs and organ systems show different rates of decline. However, some generalities can be made, based on data from the Baltimore Longitudinal Study of Aging.

HEART thickens with age. Maximal oxygen consumption during exercise declines in men by about 10 percent with each decade of adult life and in women by about 7.5 percent. This decline occurs because the heart’s maximum pumping rate and the body’s ability to extract oxygen from blood both diminish with age.

ARTERIES tend to stiffen with age. The older heart, in turn, needs to supply more force to propel the blood forward through the less-elastic arteries.

LUNGS maximum breathing capacity may decline by about 40 percent between the ages of 20 and 70.

BRAIN loses some of the structures (axons) that connect nerve cells (neurons) to each other as we age, although the actual number of neurons seems to be less affected. The ability of individual neurons to function may diminish with age.

KIDNEYS gradually become less efficient at extracting wastes from the blood (and bladder capacity declines).

BODY FAT gradually increases in adulthood until individuals reach middle age. Then it usually stabilizes until late life, when body weight tends to decline. As weight falls, older individuals tend to lose both muscle and body fat. With age, fat is redistributed in the body, shifting from just beneath the skin to deeper organs.

MUSCLE mass declines without exercise, an estimated 22 percent for women and 23 percent for men between the ages of 30 and 70.

BONE MINERAL is lost and replaced throughout life; loss begins to outstrip replacement around age 35. This loss accelerates in women at menopause. Regular weight-bearing exercise — walking, running, strength training — can slow bone loss.

EYES can have difficulty focusing close up, beginning in the 40s; the ability to distinguish fine details may begin to decline in the 70s. From 50 on, there is increased susceptibility to glare, greater difficulty in seeing at low levels of illumination, and more difficulty in detecting moving objects.

HEARING becomes more difficult in higher frequencies with age. Even older individuals who have good hearing thresholds may experience difficulty in understanding speech, especially in situations where there is background noise. Hearingdeclines more quickly in men than in women.

Source: http://www.nia.nih.gov

Dorothea Dix A Crusader for Humane Treatment of the Mentally Ill

By MEG HASKELL; OF THE NEWS STAFF

It’s easy to drive right past the woodsy little roadside park in Hampden that marks the birthplace of Dorothea Dix. And perhaps that’s the way she’d want it. By all accounts, Dix was averse to publicity and during her lifetime turned down several opportunities to have her name attached to hospitals and other institutions.

But more than 120 years after her death in 1887, the name of Dorothea Dix is still associated with one of the most important social reform movements ever undertaken: the humane and therapeutic treatment of people with mental illness.

“She was absolutely seminal in promoting the humane treatment of the mentally ill,” said Carol Carothers, director of the Maine chapter of the National Alliance on Mental Illness. Carothers said Dix’s humanitarian influence still can be felt in the public debate over providing appropriate care to people with mental illness, both in residential facilities and in the communities where they live.

Dorothea Dix was born on April 4, 1802. Her father was an itinerant preacher and the family was poor. When she was 10 years old, she moved with her family to Worcester, Mass., to be near her paternal grandfather, a wealthy Boston physician named Elijah Dix. The elder Dix owned large tracts of Maine timberland, and in time the towns of Dixmont and Dixfield were established and still bear the family name.

Young Dolly, as she was called, eventually went to live with her grandparents in Boston and at the age of 14 opened her own school for girls. When her grandparents died, she inherited the family home and continued to work as an educator.

Her own formal education was not extensive, but Dix read widely, attended public lectures and performances, and developed close relationships with many knowledgeable and influential people of her time.

Although her religious training was grounded in the Methodist and Congregational churches, she was drawn to the Transcendentalist thinkers and eventually became a close friend of the renowned Unitarian minister William Ellery Channing and his family.

In 1836, Dix suffered a severe illness related to a chronic respiratory weakness and was unable to work for several years. She traveled to England and stayed in Liverpool with the family of William Rathbone, a Quaker philanthropist and a friend of Channing’s. While she was there, Dix was asked to teach a Sunday school class for women incarcerated at the East Cambridge Jail. The experience changed her life.

The jail was filthy and unheated, she wrote later. Men, women and children were locked up together. Most shocking, though, was the presence of mentally ill and mentally retarded people enduring the same deplorable conditions as hardened criminals.

Dix immediately petitioned local officials and succeeded in improving conditions somewhat at the jail, and she resolved to investigate the treatment of people with mental illness in her own country.

Upon her return to Massachusetts in 1842, Dix undertook the inspection of jails and poorhouses throughout the state. She took careful notes on each facility and the conditions of the inmates. She found people with mental illness kept in chains, unclean, poorly fed and exposed to the cold. Armed with a report of her findings, she persuaded the Massachusetts Legislature to fund a major expansion and improvements at the state mental hospital in Worcester.

Hundreds of people with mental illness were transferred from the cruel environment of the prisons to the more humane and therapeutic hospital setting. Dix advocated for secure surroundings and medical treatment, as well as access to books, music, recreation and meaningful work.

Dix expanded her efforts to a nationwide crusade. In state after state, she exposed the inhumane treatment of the mentally ill and inspired the establishment of more than 30 hospitals dedicated to their care.

During the Civil War, Dix was appointed the superintendent of Union Army nurses. Though her headstrong, outspoken character did not endear her to the nurses or doctors with whom she worked, she established a reputation for tending to wounded soldiers from both sides. After the war, she helped trace missing soldiers and assisted families in reuniting with their loved ones.

As the 19th century neared its close, waves of European immigrants arrived in the United States, straining social programs and budgets. The hospitals Dix had helped establish grew overcrowded and underfunded. Conditions for the mentally ill patients within their walls worsened, and in some cases came to resemble the deplorable environment of the prisons they had replaced.

Discouraged by these changes, Dix retired at the age of 79. She was reluctant to speak about her work and quashed several attempts to have hospitals or other facilities named in her honor. In the early 1880s she entered the Trenton Insane Asylum in New Jersey. She died there on July 17, 1887, and is buried in Mount Auburn Cemetery in Cambridge, Mass.

Late in the 20th century, the large residential hospitals Dix had helped build began releasing their patients, on the premise that adequate care could be provided by community clinics and patients could live more independently. The community model is now widely considered to be in crisis, with many mentally ill people not getting the care they need. Homelessness, poverty and criminal behaviors are, unfortunately, not uncommon.

Carothers of NAMI Maine said Dix would be dismayed to see people with mental illness living on the street or shut up in prisons and jails instead of getting the care they need.

“Conditions are going back to the way they were when she first became involved,” Carothers said.

In 1899, the small park in Hampden was established on the site of Dorothea Dix’s first home. Hundreds of area residents attended the dedication. Honorary trustees of the park included Clara Barton, mother of the Red Cross; author Sarah Orne Jewett; Gettysburg hero Gen. Joshua Chamberlain; Col. Augustus Hamlin, Vice President Hannibal Hamlin’s nephew; Julia Ward Howe, writer of “The Battle Hymn of the Republic”; and Susan B. Anthony, legendary leader of women’s suffrage.

In September 2005, the former Bangor Mental Health Institute was renamed the Dorothea Dix Psychiatric Center.

[email protected]

990-8291

From the collection of the Maine Historical Society. This image and thousands of others spanning Maine history are on Maine Memory Network, www.mainememory.net, Maine’s digital museum developed by the Maine Historical Society.

(c) 2008 Bangor Daily News. Provided by ProQuest Information and Learning. All rights Reserved.

PEST Analysis of the Canadian Food Processing Industry – The Largest Food Processing Industry

Research and Markets (http://www.researchandmarkets.com/reports/c85340) has announced the addition of “Food Processing in Canada – PEST Framework Analysis” to their offering.

The largest food processing industry, measured by shipments and value added, in Canada was meat processing. The sugar and confectionery industry was the smallest in terms of shipments and sea food product processing was the smallest in terms of valued added.

Meat processing leads the food industry in exports and accounted for one third of the value of total food exports, as the result of the identification of a single cow with bovine spongiform encephalopathy (BSE). A further 20% of total food exports are accounted for by the seafood product industry, followed by grain and oilseed milling (10%), fruit and vegetable processing (9%).

Aruvian Research analyzes Food Processing in Canada in a PEST Framework Analysis. A PEST analysis is concerned with the environmental influences on a business. The acronym stands for the Political, Economic, Social and Technological issues that could affect the strategic development of a business. Identifying PEST influences is a useful way of summarizing the external environment in which a business operates.

Key Topics

Executive Summary

Introduction to the Industry

– Industry Definition

– Industry Profile

– Future Outlook

PEST Framework Analysis

– Political Aspects

– Economic Aspects

– Social Aspects

– Technological Aspects

Glossary of Terms

For more information visit http://www.researchandmarkets.com/reports/c85340

Blood Test a Very Early Indicator of Type 2 Diabetes

It may soon be possible to take a simple blood test and predict whether or not someone has low levels of a particular molecule, predisposing them to the development of Type 2 diabetes. If the test is positive, it may then be possible to use preventative treatment, slowing down, or even halting that development.

Such is the hope of scientists and clinicians at Sydney’s Garvan Institute of Medical Research who have shown conclusively that people who produce low levels of the molecule PYY have a higher risk of developing Type 2 diabetes and obesity.

The findings were published online on 4 March in the prestigious International Journal of Obesity.

It is already known that the hormone PYY, which is released from the gut after a meal, creates a feeling of satiety. When PYY is in oversupply, it prevents diet-induced obesity in mice.

Professor Herbert Herzog, Director of Garvan’s Neuroscience Program, and an expert on appetite, says that the new findings are important in that they show a metabolic defect before the presence of any disease or manifestation of weight gain. “We can now see that low PYY levels after eating are a very early predictor of the development of obesity and Type 2 diabetes,” he said.

Professor Lesley Campbell, Director of Diabetes Services at St. Vincent’s Hospital and a senior member of Garvan’s Diabetes and Obesity Clinical Studies group, has been researching genetic factors in the development of Type 2 diabetes for over 10 years. Specifically, her research looks at people before they get the disease, the contributing factors, and the effects of the diabetes.

Professor Campbell has already published findings that insulin resistant people, with a family history of Type 2 diabetes, have low levels of PYY. “In earlier studies we hinted at the fact that before any of the abnormalities of diabetes are present, people already have an abnormality of satiety, marked by the lack of the secretion of this PYY hormone,” she said.

“We now have published that, even earlier in the development of diabetes, people who are not yet insulin resistant show a low secretion of PYY. They have a blunted post-meal secretion of this hormone, making them less likely to feel satiety, and more likely to gain weight.”

Professor Campbell’s research involved elaborate testing of two groups of people, eight in each group, over a period of two years. One group had relatives with Type 2 diabetes, the other group had no family history of the disease. The groups were matched for gender, for age and for adiposity.

“It was most important to match the groups for their fatness,” said Professor Campbell. “The only difference was their relatives. You assume that they are carrying the genetic burden of diabetes, which we already know to be a reality.”

“Low levels of PYY at this very early pre-diabetes stage could be used as a marker, or predictor, that Type 2 diabetes is very likely to develop.”

“As a clinician, I am hopeful that it will be possible to screen extensively in the future, and therefore stem the spread of this debilitating disease.”

On the Net:

Research Australia

Garvan Institute of Medical Research

International Journal of Obesity

Peptide YY – Wikipedia

America’s Drinking Water Full of Drugs

A five-month Associated Press (AP) investigation found that drinking water supplies for at least 41 million Americans are contaminated with a variety of pharmaceuticals, including sex hormones, antibiotics, mood stabilizers, anti-convulsants and even some over-the-counter medicines such as acetaminophen and ibuprofen.

The report said that concentrations of these pharmaceuticals, measured in parts per billion or trillion, are far below the levels of a medical dose. But the presence of prescription and over-the-counter drugs in our drinking water is alarming to some scientists who worry about the long-term ramifications to public health.

For their part, the utility companies are insisting their water supplies are safe.

During their investigation, the AP discovered that drugs have been detected in drinking water supplies of 24 major metropolitan areas. The investigative team said the water providers rarely disclose results of pharmaceutical screenings unless pressed. For example, the head of a group representing major California suppliers said the public “doesn’t know how to interpret the information” and might be unduly alarmed, the team reported.

The pharmaceuticals find their way into the water supply through a series of events, beginning with people who take these medications. While their bodies absorb some of the medication, the rest passes through and is flushed down the toilet. Although the wastewater is treated before it is discharged into reservoirs, rivers or lakes, and some of the water is cleansed again at drinking water treatment plants, most treatments do not remove the entire drug residue.

Scientists do not yet fully understand the precise risks from decades of persistent exposure to random combinations of low levels of these pharmaceuticals, recent studies have found alarming effects on both humans and wildlife.

“We recognize it is a growing concern and we’re taking it very seriously,” said Benjamin H. Grumbles, assistant administrator for water at the U.S. Environmental Protection Agency (EPA), according to the AP report of the inquiry.

Members of the AP National Investigative Team surveyed the country’s 50 largest cities along with 12 other major water providers, and also examined smaller community water providers within all 50 states. They reviewed hundreds of scientific reports, analyzed federal drinking water databases, visited environmental study sites and treatment plants and interviewed more than 230 officials, academics and scientists.

The following are some of the results reported by the AP after their analysis:

  • In Philadelphia, officials discovered 56 pharmaceuticals or byproducts in treated drinking water, including medicines for pain, infection, high cholesterol, asthma, epilepsy, mental illness and heart problems. 63 pharmaceuticals or byproducts were found in the city’s watersheds.
  • In Southern California, anti-epileptic and anti-anxiety medications were detected in a portion of the treated drinking water for 18.5 million people.
  • Researchers at the U.S. Geological Survey (USGS) analyzed a Passaic Valley Water Commission drinking water treatment plant serving 850,000 people in Northern New Jersey, and discovered a metabolized angina medicine and the mood-stabilizing carbamazepine in the drinking water.
  • A sex hormone was detected in San Francisco’s drinking water.
  • Washington, D.C.’s drinking water tested positive for six pharmaceuticals.
  • In Tucson, AZ, water was found to have three medications, including an antibiotic.

Since the federal government doesn’t require any testing and has not set safety limits for concentrations of drugs in water, the situation is likely worse than suggested by the positive test results in the major population centers.

In fact, of the 62 major water providers contacted, only 28 were even tested. Included in the 34 that were not tested are Houston, Chicago, Miami, Baltimore, Phoenix, Boston and New York City’s Department of Environmental Protection, which delivers water to 9 million people.

Some providers only test for one or two pharmaceuticals, leaving open the possibility that others are present but go undetected.

The AP’s investigation found that watersheds, the natural sources of most of the nation’s water supply, are also contaminated. Tests of watersheds in 35 of the 62 major providers surveyed detected pharmaceuticals in 28. Yet officials in six of those 28 metropolitan areas, which include Fairfax, Va., Montgomery County, MD., Omaha, NE., Oklahoma City; Santa Clara, CA., and New York City, said they did not go on to test their drinking water.

The New York state health department and the USGS tested the source of the city’s water upstate, and found trace concentrations of heart medicine, infection fighters, estrogen, anti-convulsants, a mood stabilizer and a tranquilizer.

The AP report said city water officials declined repeated requests for an interview. However, in a statement officials insisted that “New York City’s drinking water continues to meet all federal and state regulations regarding drinking water quality in the watershed and the distribution system”, regulations that do not address trace pharmaceuticals.

In several cases, officials at municipal or regional water providers told the AP that pharmaceuticals had not been detected, but the AP obtained the results of tests conducted by independent researchers that showed differently. For instance, officials with the New Orleans water department said their water had not been tested for pharmaceuticals, but a Tulane University researcher and his students had published a study showing the pain reliever naproxen, the sex hormone estrone and the anti-cholesterol drug byproduct clofibric acid were present in treated drinking water.

Of the 28 major metropolitan areas where tests were performed on drinking water supplies, only Austin, TX, Virginia Beach, VA, and Albuquerque, NM, reported negative results. Officials in Dallas are awaiting test results, but Arlington, Texas, acknowledged that traces of a pharmaceutical were detected in its drinking water. They cited post-9/11 security concerns in refusing to identify the drug.

During their investigation, the AP also contacted 52 small water providers, one in each state and two each in Missouri and Texas, which serve communities with approximately 25,000 people. All but one said their drinking water had not been screened for pharmaceuticals. Providers in Emporia, KS., declined to answer AP’s questions, citing post-9/11 security concerns.

Experts say consumers in rural area who draw water from their own wells cannot necessarily be sure their water is free from contamination.

The Stroud Water Research Center in Avondale, PA., measured water samples from New York City’s watershed upstate for caffeine, a common test that could also suggest the presence of other pharmaceuticals. Though less caffeine was detected there than at suburban sites, researcher Anthony Aufdenkampe was surprised by the relatively high levels the tests revealed.

He believes it could be escaping from failed septic tanks, maybe with other drugs. “Septic systems are essentially small treatment plants that are essentially unmanaged and therefore tend to fail,” Aufdenkampe said.

Even those who drink bottled water or utilize home filtration systems are not necessarily guaranteed their water is free from pharmaceutical contaminants.

The AP report quoted the industry’s main trade group as saying that some bottled water manufacturers simply repackage tap water and do not test or treat for pharmaceuticals. The same holds true for makers of home filtration systems.

Outside the United States, studies have detected more than 100 unique pharmaceuticals in lakes, rivers, reservoirs and streams throughout Asia, Australia, Canada and Europe, and even in Swiss lakes and the North Sea.

In Canada, a study by a national research institute found 9 pharmaceuticals in water samples from 20 different water treatment plants. In December, after detecting prescription drugs in drinking water at seven sites, Japanese health authorities called for human health impact studies.

In the United States, pharmaceuticals have also been found to permeate aquifers deep underground, the source of 40 percent of the nation’s water supply. Federal researchers drew water from aquifers near contaminant sources such as landfills and animal feed lots in 24 states and found minute levels of hormones, antibiotics and other drugs.

The AP suggested that the problem might be due to Americans taking drugs, and flushing them unmetabolized or unused, in growing amounts. According to IMS Health and The Nielsen Co., the number of U.S. prescriptions rose 12 percent to a record 3.7 billion over the past five years, while nonprescription drug purchases held steady around 3.3 billion.

“People think that if they take a medication, their body absorbs it and it disappears, but of course that’s not the case,” said EPA scientist Christian Daughton, one of the first to draw attention to the issue of pharmaceuticals in water in the United States, according to the Associated Press report.

Some drugs are even resistant to modern drinking water and wastewater treatment processes, including the popular cholesterol fighters, tranquilizers and anti-epileptic medications. Additionally, the EPA says there are no sewage treatment systems specifically engineered to remove pharmaceuticals.

However, one technology, reverse osmosis, effectively removes all pharmaceutical contaminants. But is extremely costly for large-scale use and leaves several gallons of polluted water for every one that is made drinkable.

Further complicating the issue, there’s evidence that adding chlorine, a common process in conventional drinking water treatment plants, makes some drugs even more toxic.

The Associated Press report said animals are also contributing to the problem. For instance, cattle are given ear implants that slowly release the anabolic steroid trenbolone that causes them to bulk up. However, not all the trenbolone circulating in a steer is metabolized, and a German study found that 10 percent of the steroid passed right through the animals.

Another study found samples of water downstream of a Nebraska feedlot contained steroid levels four times as high as the water taken upstream. The research also showed that the male fathead minnows living in the downstream area had small heads and low testosterone levels.

Other veterinary drugs also contribute to the problem. For example, pets are now routinely diagnosed and treated for conditions such as arthritis, cancer, heart disease, diabetes, allergies, dementia, and even obesity. Often, these pets receive the same drugs as humans for these illnesses. And as with humans, the amount of pharmaceuticals given to pets is also on the rise. An analysis of data from the Animal Health Institute found the inflation-adjusted value of veterinary drugs had risen 8 percent, to $5.2 billion, over the past five years.

The AP investigative team sought the pharmaceutical industry’s perspective about the contaminated water, and received a mixed response.

“Based on what we now know, I would say we find there’s little or no risk from pharmaceuticals in the environment to human health,” said microbiologist Thomas White, a consultant for the Pharmaceutical Research and Manufacturers of America, according to AP’s report.

But at a conference last summer, Mary Buzby, director of environmental technology for drug maker Merck & Co., said, “There’s no doubt about it, pharmaceuticals are being detected in the environment and there is genuine concern that these compounds, in the small concentrations that they’re at, could be causing impacts to human health or to aquatic organisms.”

Studies support the concern. Recent laboratory research has shown that small amounts of pharmaceuticals affect human embryonic kidney cells, human blood cells and human breast cancer cells. The research found the kidney cells grew too slowly, the cancer cells proliferated too quickly, and the blood cells showed inflammatory biological activity.

In addition to the impact on humans, the AP report outlined some of the effects the contaminated water is having on wildlife. Pharmaceuticals present in waterways are damaging wildlife worldwide. For instance, male fish are being feminized, creating egg yolk proteins, a process usually restricted to females. Furthermore, studies show pharmaceuticals are affecting sentinel species at the foundation of the pyramid of life, such as earth worms in the wild and zooplankton in the laboratory, although scientists stress the research is extremely limited with many unknowns. However, they add that the documented health problems in wildlife are troubling.

“It brings a question to people’s minds that if the fish were affected … might there be a potential problem for humans?” EPA research biologist Vickie Wilson told the AP. “It could be that the fish are just exquisitely sensitive because of their physiology or something. We haven’t gotten far enough along.”

Shane Snyder, a research and development project manager at the Southern Nevada Water Authority, said greater emphasis should be placed on studying the effects of the contaminated water.

“I think it’s a shame that so much money is going into monitoring to figure out if these things are out there, and so little is being spent on human health,” he said. “They need to just accept that these things are everywhere – every chemical and pharmaceutical could be there. It’s time for the EPA to step up to the plate and make a statement about the need to study effects, both human and environmental.”

For now, the EPA seems focused on detection. Grumbles acknowledged that just late last year the agency developed three new methods to “detect and quantify pharmaceuticals” in wastewater.

“We realize that we have a limited amount of data on the concentrations,” he said. “We’re going to be able to learn a lot more.”

Grumbles said the EPA had analyzed 287 pharmaceuticals for possible inclusion on a draft list of candidates for regulation under the Safe Drinking Water Act. However, he said only nitroglycerin, used to treat heart problems, was on the list. It is primarily being considered due to the drug’s widespread use in making explosives.

Much remains to be learned as experts study the effects of the contaminated water. Many independent scientists do not believe trace concentrations of pharmaceuticals will ultimately prove to be harmful, however this confidence is based largely on studies that poison lab animals with much higher amounts. Meanwhile, the scientific community is increasingly concerned that certain drugs, or combinations of drugs, could harm humans over long periods of time because water is consumed consistently and in sizeable amounts every day.

Whereas the human body may be capable of shrugging off a one-time large dose, it may react negatively from smaller amounts delivered continuously over decades. Pregnant women, the severely ill and the elderly could perhaps be even more sensitive to the effects.

Many concerns about chronic low-level exposure are centered around certain drugs, for instance chemotherapy agents that can act as a poison, hormones that can hamper reproduction or development, depression and epilepsy medications that can damage the brain or alter behavior, antibiotics that can cause germs to mutate into more dangerous drug-resistant forms, and pain relievers and blood-pressure diuretics.

For decades nonprofit watchdog groups and federal environmental officials have focused on regulated contaminants such as pesticides, lead, and PCBs, which are known to be present in water and pose a clear health risk to humans and animals. However, some experts say medications may pose a unique danger because they were actually designed to act on the human body, unlike most pollutants.

“These are chemicals that are designed to have very specific effects at very low concentrations. That’s what pharmaceuticals do. So when they get out to the environment, it should not be a shock to people that they have effects,” says John Sumpter, a zoologist at Brunel University in London, who has studied trace hormones, heart medicine and other drugs.

While some drugs have passed safety tests for human exposure, the timeframe is usually over a matter of months, not over decades or entire lifetimes. And pharmaceuticals can create side effects and interact with other drugs at normal medical doses, a reason why these drugs are prescribed only to those who need them.

“We know we are being exposed to other people’s drugs through our drinking water, and that can’t be good,” says Dr. David Carpenter, director of the Institute for Health and the Environment of the State University of New York at Albany.

On the Net:

U.S. Environmental Protection Agency (EPA)

USGS Water Resources of the United States

Stroud Water Research Center

“The fate of trenbolone acetate and melengestrol acetate after application as growth promoters in cattle: environmental studies”

Pharmaceutical Research and Manufacturers of America

HumanaOne Introduces New, Flexible Individual Health Insurance Plans in Nine States

Humana (NYSE: HUM) today announced the introduction of a new portfolio of individual health insurance plans under its HumanaOne® brand in nine states — Alabama, Arkansas, Iowa, Indiana, Mississippi, Nebraska, Oklahoma, South Carolina and Utah. In 2007, Humana introduced the individual health insurance coverage options in 15 other states (listed below), where they have been popular with consumers.

The variety of plans makes it easy for individuals and families to select a plan according to their own personal preferences, lifestyles and budgets. HumanaOne plans are designed specifically for self-employed entrepreneurs, small-business employees, part-time workers, students and early retirees. Humana markets HumanaOne plans through insurance agents and brokers, as well as directly to consumers. Health insurance quote applications for the plans are available online or by phone.

HumanaOne’s new personal health insurance plan portfolio includes a broad spectrum of benefits — with three in-network coinsurance levels and 17 annual deductible choices — organized into three, distinct packages, for:

People who are security-minded and want benefits like those provided by big employers

People who want flexibility to fit their financial plan, including HSA-qualified offerings

People who want a low-cost plan with a safety net “just in case”

The plans can be further customized with optional benefits such as dental insurance, life insurance, and supplemental accident coverage.

“With the U.S. market for individual health insurance at 18 million and growing, we recognize that individual health insurance plans cannot be ‘one size fits all,'” said Jerry Ganoni, president of HumanaOne, Humana Small Business and HumanaDental. “That’s why we created three separate families of plans, each tailored for a particular kind of consumer, but at the same time highly customizable. This represents the most significant product expansion for HumanaOne since its inception in 2002.”

In 2007, Humana launched the new products in 15 other states — Arizona, Colorado, Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Michigan, Missouri, North Carolina, Ohio, Tennessee, Texas and Wisconsin. Soon, the company plans to introduce the new product portfolio in the remaining two states where HumanaOne currently operates. At present, HumanaOne serves more than 250,000 health plan members in 26 states.

The new plans from HumanaOne are designed to appeal to a variety of consumers — from those who desire the security, coverage and service commonly found in health plans from large employers, to those wanting a simple safety net in the event of a major health problem.

The new portfolio of HumanaOne plans offers deductibles ranging from $1,000 to $7,500 for single coverage, and from $2,000 to $15,000 for family coverage. Premiums start as low as $30 per month for single coverage and increase according to the plan, its features and level of benefits.

“This new portfolio of products positions HumanaOne to serve a much larger portion of the individual health insurance market, which we believe will continue to grow at a rate of five to eight percent annually over the next five years,” said Steve DeRaleau, chief operating officer of HumanaOne. “As more people leave group health plans, retire early, become self-employed or work part-time, they will increasingly look to individual health plans, and HumanaOne will be there to serve them with a plan ideally suited to their distinct needs.”

Humana guarantees monthly premium rates on its HumanaOne plans for one full year after purchase, as long as the member remains in the same area and keeps the same benefits. Thanks to Humana’s large network of doctors and hospitals, HumanaOne policyholders who move to a different state can simply take their plan with them, and in most cases, those who work or travel away from home can receive in-network benefits by seeing any of the more than 400,000 Humana-contracted doctors, hospitals and other health care providers across the country.

HumanaOne members have 24-hour access to online tools and resources, enabling them to check claims status, medical expenses, compare hospital, doctor and prescription costs and more. HumanaOne accepts applications by phone or via its Website at http://www.humana-one.com/.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health and supplemental benefits companies, with approximately 11.5 million medical members. Humana is a full-service benefits solutions company, offering a wide array of health and supplementary benefit plans for employer groups, government programs and individuals.

Over its 47-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at Humana.com, including copies of:

Annual reports to stockholders

Securities and Exchange Commission filings

Most recent investor conference presentations

Quarterly earnings news releases

Replays of most recent earnings release conference calls

Calendar of events (includes upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors)

Corporate Governance Information

SCE Begins Construction of Tehachapi Transmission Project

Southern California Edison has begun construction of the Tehachapi Renewable Transmission Project in the US state of California. The project will include a series of new and upgraded high-voltage transmission lines capable of delivering 4,500MW of electricity from wind farms and other generating companies in the northern Los Angeles and eastern Kern counties.

The first three segments will include the Windhub and Highwind substations, located near Mojave and Monolith; a 25.6-mile, 500kV transmission line connecting Southern California Edison’s (SCE) existing Antelope substation with the new Windhub substation and a 9.6-mile, 220kV transmission line connecting the Windhub substation and the Highwind substation.

As part of the project, a 21-mile, 500kV transmission line connecting SCE’s Antelope and Vincent substations and a 26.7-mile, 500kV transmission line connecting the Antelope and Pardee substations will also be built. The new lines are expected to be operational in early 2009.

SCE noted that the Tehachapi project is the first major transmission project in California being built specifically to access multiple renewable generators in a remote renewable energy-rich resource area.

When complete, the project will be part of a $1.8 billion program to provide the high-voltage transmission infrastructure necessary to interconnect and deliver the renewable wind resources being developed in the Tehachapi wind resource area to California’s electricity customers.

IMAX Signs Exclusive Thirty-Five Theatre Deal for South and Central America

TORONTO, March 10 /PRNewswire-FirstCall/ — March 10, 2008 – IMAX Corporation (NASDAQ: IMAX; TSX: IMX) today announced an agreement with Giencourt Investments S.A., a member of the RACIMEC International Group (RACIMEC) to purchase and install 35 IMAX(R) Digital projection systems in Central and South America and the Caribbean over the next six years. The agreement marks the largest international theatre deal, and second largest overall theatre deal, in IMAX’s history, following on the heels of AMC’s 100-theatre North America deal announced in December.

Under the terms of the agreement, RACIMEC will provide an initial down payment and a firm commitment to install a minimum of 35 IMAX theatres with fixed payment dates and opening dates. RACIMEC plans to contribute the IMAX theatre systems to its partners – developers, exhibitors and other entertainment operators – for negotiated economic terms and work with them to identify the best locations based on market demographics and cultural trends, ultimately building a substantial network of IMAX(R) theatres throughout the region.

“This important partnership with RACIMEC will result in a robust network of IMAX theatres in South and Central America,” said IMAX Co-CEOs and Co-Chairmen Richard L. Gelfond and Bradley J. Wechsler. “RACIMEC is a well-respected business innovator, and we are thrilled to expand our relationship with them at this level. As the industry moves toward digital and developers as well as exhibitors seek new ways to attract moviegoers, we are confident that RACIMEC’s experience and expertise are an ideal match for increasing IMAX’s presence in this critical market.”

“Based on the growing network of successful IMAX theatres and the introduction of IMAX’s digital projection system, we believe this is a perfect time to aggressively develop the South and Central American and Caribbean markets, said Miguel Sfeir, President of RACIMEC International Group. “We want to capitalize on the momentum IMAX has with its pending digital projection system and its robust array of Hollywood content to bring the ultimate movie-going experience to consumers in this part of the world.”

In 2005, RACIMEC signed a deal to install three IMAX theatre systems into new entertainment retail developments in Chile and Venezuela. Two IMAX theatres are being built and developed in Santiago, Chile, in addition to one in Caracas, Venezuela, and all are expected to open by mid-2009.

The highly anticipated IMAX Digital projection system will further enhance The IMAX Experience(R) and help to drive profitability for studios, exhibitors and IMAX theatres by virtually eliminating the need for film prints, increasing program flexibility and ultimately increasing the number of movies shown on IMAX screens.

IMAX has already secured important parts of its film slate for 2008, 2009 and 2010 through agreements with major Hollywood studios including: The Spiderwick Chronicles (in theatres now), Shine A Light (April 4, 2008), Speed Racer (May 9, 2008), Kung Fu Panda (June 6, 2008), The Dark Knight (July 19, 2008), Under the Sea 3D (February 2009), Monsters vs. Aliens 3D (March 2009), Hubble 3D (working title, February 2010), How to Train Your Dragon 3D (March 2010), and Shrek Goes Forth 3D (May 2010).

   About RACIMEC International Group   ---------------------------------  

Founded in Rio de Janeiro, Brazil, in August 1966, as one of the most prominent entertainment and public gaming companies in the world, developing gaming applications such as Lotto and Soccer Lottery, for various Latin American countries including Brazil, Chile, Argentina, Venezuela, Colombia and Paraguay. The RACIMEC International Group has reached outstanding success in various countries with its starring game KINO, a pre-printed ticket game with a real time live TV show, crossing over the 4 billion dollar barrier during the last decade. RACIMEC has been identified by the Lottery market as the creator of new standards in Game operation and safety in the different countries where it operates.

About IMAX Corporation

IMAX Corporation is one of the world’s leading digital entertainment and technology companies. The worldwide IMAX network is among the most important and successful theatrical distribution platforms for major event Hollywood films around the globe, with IMAX theatres delivering the world’s best cinematic presentations using proprietary IMAX, IMAX(R) 3D, and IMAX DMR technology. IMAX DMR is the Company’s groundbreaking digital remastering technology that allows it to digitally transform virtually any conventional motion picture into the unparalleled image and sound quality of The IMAX Experience. IMAX’s renowned projectors and new digital systems display crystal-clear images on the world’s biggest screens. The IMAX brand is recognized throughout the world for extraordinary and immersive entertainment experiences for consumers. As of September 30, 2007, there were 296 IMAX theatres operating in 40 countries.

IMAX(R), IMAX(R) 3D, IMAX DMR(R), IMAX MPX(R), and The IMAX Experience(R) are trademarks of IMAX Corporation. More information on the Company can be found at http://www.imax.com/.

This press release contains forward looking statements that are based on management’s assumptions and existing information and involve certain risks and uncertainties which could cause actual results to differ materially from future results expressed or implied by such forward looking statements. Important factors that could affect these statements include ongoing discussions with the SEC and OSC relating to their ongoing inquiries and the Company’s financial reporting and accounting, the timing of theatre system deliveries, the mix of theatre systems shipped, the timing of the recognition of revenues and expenses on film production and distribution agreements, the performance of films, the viability of new businesses and products, risks arising from potential material weaknesses in internal control over financial reporting and fluctuations in foreign currency and in the large format and general commercial exhibition market. These factors and other risks and uncertainties are discussed in the Company’s Annual Report on Form 10-K/A for the year ended December 31, 2006, as well as the Company’s Quarterly Reports on Form 10-Q/A and Form 10-Q.

IMAX Corporation

CONTACT: Media: IMAX Corporation, New York, Sarah Gormley, (212)821-0155, [email protected]; Entertainment Media: Newman & Company, LosAngeles, Al Newman, (310) 278-1560, [email protected]; Investors: IntegratedCorporate Relations, Amanda Mullin, (203) 682-8243; Business Media: Sloane &Company, New York, Whit Clay, (212) 446-1864, [email protected]

Health Promotion Activities in China From the Ottawa Charter to the Bangkok Charter: Revolution to Evolution

By Lee, Albert Fu, Hua; Chenyi, Ji

Abstract: China has the world’s largest population. In the past, the public health system in mainland China has been strongly influenced by the former Soviet Union. Hong Kong and Macao, the Special Administrative Regions (SAR), have been under colonial administration adopting a laisser-faire approach to health policy. Over the most recent decades, mainland China and the two SARs have adopted the Ottawa Charter principles and re-orientated the healthcare systems towards greater community participation, built a healthy environment in different settings and developed capacity in health promotion. Positive results have resulted from efforts to move towards a bottom-up approach to health promotion, using the overarching framework of Healthy Settings. Adequate resources will be needed to build up the infrastructure for sustainable development of health promotion initiatives. This report is selective, rather than comprehensive and will highlight specific health promotion activities in different parts of China, reflecting how the approach to health promotion has evolved since Ottawa. An analysis will be made of the potentials of these initiatives to take forward the spirit of the Ottawa Charter in paving the way for the Bangkok Charter. (Promotion & Education, 2007, XIV (4): pp 219-223)

Key Words: healthy settings, capacity building, Bangkok Charter, bottom-up approach

KEY POINTS

* China has the world’s largest population.

* Over the last two decades, mainland China, Hong Kong and Macao have adopted the Ottawa Charter principles.

* Health promotion efforts have been directed towards greater community participation, building healthy environments in different settings and developing workforce capacity.

* Adequate resources will be needed to sustain the infrastructure for health promotion.

China has an overall population exceeding 1.3 billion, containing 56 ethnic groups. There are a total of four municipalities, 22 provinces, five autonomous regions and two special administrative regions, Hong Kong and Macau. Whilst Taiwan is also part of the sacred territory of China, Taiwan will not be dealt with in this report The whole nation will be divided into mainland China, the Hong Kong Special Administrative Region (Hong Kong SAR) and Macao Special Administrative Region (Macao SAR), as the two Special Administrative Regions have separate system of governance under the concept of One Country, Two Systems.

Mainland China

In 2005, the China Human Development Report pointed to radical health improvements generated by economic and social progress. GDP per annum growth since the late 1970s has helped to lift several hundred million people out of absolute poverty and in the past three decades, the life expectancy of the Chinese population increased by nearly eight years. However, China is facing ongoing and emerging challenges related to its continued rapid expansion, income inequality, economically lagging western and northeast regions, unsustainable resource exploitation, and issues related to growing regional and global economic integration. People in the geographically disadvantaged regions migrate to the urban areas, resulting in the rise of urban poverty and growing social discontent. To close the gap and to catch up with mainland China’s wealthier eastern provinces, the government has initiated a number of social welfare projects. Environmental initiatives are also in place to deal with serious degradation as a result of earlier growth at all cost policies.

Demographics in mainland China are changing due to an ageing population, which alongside a decrease in infectious disease rates, are changing morbidity and mortality patterns. Cardiovascular diseases, cancer and chronic respiratory diseases are ranked as the top three of the mortalities and accounted for over 70 percent of total mortality. The prevalence of related risk factors: smoking, physical inactivity, hypertension, hyperlipidemia, and obesity are rising. In 2002 the smoking rate was 66 percent in males; the prevalence of physical activity (more than three times per week) was less than one third; the prevalence of hypertension was 18.8 percent; the prevalence of hyperlipidemia was 18.6 percent; the prevalence of overweight and obesity were 22.8 percent and 7.1 percent respectively.

Hong Kong SAR

Hong Kong has a population about 6.88 million and became a Special Administrative Region (SAR) of the People’s Republic of China on July 1,1997, after a century and a half of British administration. Under Hong Kong’s constitutional document, the Basic Law, the SAR enjoys a high degree of autonomy with a Government known for its efficiency, transparency and fairness. Hong Kong’s health indices compare favourably with developed countries. Health problems are mostly associated with lifestyles-related chronic degenerative diseases such as cancers, heart diseases and cerebrovascular diseases accounting for over 60 percent of all deaths.

Macao SAR

The Government of the People’s Republic of China resumed exercising sovereignty over Macao on 20th December, 1999 after four hundred years of Portuguese administration.

Macao’s population is around 435,000, comprising 51.7 percent female; 15.6 percent of residents are under 15 years of age; 76.1 percent are aged between 15 and 64 and 8.3 percent aged 65 years and over. According to the Statistics and Census Service, in 2005 the general mortality rate was 3.4 per 1,000 residents, while the mortality rate for infants under one year old was 3.3 per 1,000 live births. The average life expectancy was 79.3 years.

Health promotion policy

Mainland China: In the early 1950s, the main policy driver was health propaganda emphasizing prevention of communicable diseases and basic hygiene. During the 1960s, the health propaganda activities declined because of the Cultural Revolution. In the 1970s, health policy momentum emphasised health education, networking, training of professionals and development of settings and population approach to promote health. From late 1980s onwards, the policy directive moved away from the health propaganda approach to an education for health approach. In 1984 the Chinese Health Education Association was established and by 1986, there were Institutes of Health Education at different levels in 26 provinces and over 150 cities.

From mid 1980s to early 1990s, health education was put on the health agenda for health departments at national, provincial, cities and counties levels, with guidelines issued. Appropriate infrastructure was established at different levels to ensure better co-ordination and provide adequate support and resources.

From the 1990s, the hygienic city program, embracing health education and health promotion, has become an integral part of city development. Healthy Cities followed in 1996. The State Council also approved the School Health Act in 1990, containing statutory requirement and guidelines for teaching health education in primary and secondary schools. In 1998 a random survey of schools from 32 cities revealed that over 90 percent of schools fulfilled the requirements of school health education and nearly 90 percent of students had acquired basic health knowledge.

Hong Kong SAR: Statutory measures are established to safeguard and protect the health of the population in terms of infectious disease control, occupational safety and health, smoke free environment, food and industrial safety. The government has created statutory bodies such as Occupation Safety and Safe Council, AIDs Foundation, Action Committee Against Narcotics (ACAN), Council on Smoking and Health (COSH) to help oversee different aspects of population heath. The Centre for Health Protection within the Department of Health was launched in 2004 to strengthen health protection and disease prevention. More recently the Department of Health has established a Steering Committee on Healthy Eating with involvement of academic institutions, professional bodies, non- government organizations, School Councils and Parents’Associations to promote healthy eating amongst school children.

Macao SAR: With rapid globalization and urbanization, policies and strategies are being developed that embrace intersectoral collaboration to safeguard population health. Macao Healthy City has formulated interventions targeting multiple health risk behaviours in different key settings such as schools and workplace, with Health Promoting Schools seen as a key component of the Healthy Cities project.

Health promotion services

Mainland China: The publication of health education periodicals and films resumed in 1970 following the Cultural Revolution. Training of health promotion professionals developed rapidly in many cities and provinces. From late 1970s, health education was introduced in primary and secondary schools in different provinces. The topics ranged from prevention of communicable diseases to healthy lifestyle, including healthy eating. During the 1980s, the academic discipline of health education was introduced at universities. Academic exchange had taken place nationally and internationally including attending and hosting international conferences.

From the 1990s onwards, health education materials had become more scientific and marketable. Health education and health promotion activities emphasized inter-personal communication, peer education, and self-directed learning. The advancement of the theory of health promotion, community diagnosis, mobilisation of community resources, and policies on promoting health has facilitated the development of methods of health promotion. Websites by government or Institute of Health Education have now been established (see, for example www.health-education.gov.cn, www.cnhei.com, www.che.medchina.net).

Hong Kong SAR: There have been many types of services operated at both governmental and non-governmental level for health promotion. Over the last few years, the concept of Health Promoting School (HPS) has been implemented to improve the health literacy of students. The emphasis of public health action has shifted from addressing the devastating effects of the living and working conditions imposed on the population to modification of health risk behaviours by individuals. Schools are regarded as essential in helping students to achieve health literacy.

The Centre for Health Education and Health Promotion of the Chinese University of Hong Kong (CUHK) first launched the HPS Programme in 1998 to provide a good example of close partnerships between health and education sectors, and promotes multi- disciplinary approach and active learning towards health promotion (Lee at al, 2003a). The Centre has trained up large numbers of teachers to adopt a holistic approach to health and supported the integration of school programmes with community resources. The Healthy Schools Award Scheme (HKHSA) has built on HPS (Lee, 2002) and is modelled on the WHO Western Pacific Regional Office HPS framework covering six key areas (health policy, physical and social environments, community relationships, personal health skills and health services). During the SARS (Severe Acute Respiratory Syndrome) crisis, the HKHSA scheme was able to empower schools to step up public health measures against SARS (Lee et al., 2003b).

Macao SAR: To realise the objective of Health for All advocated by the World Health Organization, the Health Bureau has established Health Centres throughout the territory as the operational units for providing comprehensive primary healthcare. Training has been provided for health and education professionals to implement HPS and offer different types of health promotion activities.

Health promotion funding and availability of resources

Mainland China: Since the establishment of People’s Republic of China in 1949, attempts had been made to redistribute healthcare resources to avoid an elite urban physician-orientated medical establishment by placing more emphasis on rural areas (Henderson & Cohen, 1982). With the introduction of advanced medical technology, the financial burden on health was escalating, so means to decrease healthcare costs included avoiding hospitalization whenever possible and controlling the drug cost This has lead to the development of community health services with strong focus on primary care. In 1997, the State Council launched healthcare reform with an integrated approach adopted to manage and prevent non-communicable diseases. It is aiming to develop a strong team of well trained high quality primary care physicians in delivering community health services through curative, preventive and rehabilitative services. In 2001, out of the total of 36 provinces, autonomous regions, municipalities, 15 put the task of health education under primary healthcare and maternal and child health centres. In 13 provinces, autonomous regions and municipalities, health education was put under Centre for Disease Control.

Since 1998, the Community Health Services have developed rapidly. Under the leadership of local government and health education agencies, the community doctors and nurses have been trained to become community health educators. There are also new health insurance policies for people living in rural areas (Liu, 2004).

In order to strengthen health promotion, many provinces and cities had started developing school health education; community based health education for chronic illnesses, promotion of elderly health, and prevention of non-communicable diseases, and are moving away from information giving to a population health approach. During the period 1997 to 2,000 a technical assistance project was implemented in seven cities and one province in China to build capacity for community based health promotion particularly, focussing on the development and management of community health programmes and comprehensive health promotion strategies (Tang et al., 2005). At the same time there was a shift from risk factor orientation to a setting approach and a move away from expert lead approach to a more participatory and problem based approach.

Hong Kong SAR: A Working Party on Primary Healthcare in 1990 recommended a District Health System, a shift to community based healthcare with more emphasis on preventative medicine and the establishment of Primary Healthcare Authority. However, the Hospital Authority was established in 1991 integrating all the hospital services, so the progress of primary healthcare has not been accorded high priority. Healthcare Promotion Fund has been established to fund proposal for pilot health promotion projects, but does not fund research or the furtherance of pilot projects. The AIDS Trust Fund is available for health promotion related to HIV/ AIDs prevention and ACAN provides funding for drug education programmes. There are statutory bodies providing funding for health promotion programmes usually focusing on specific health issues. CUHK, for example, obtained funding from Quality Education Fund (QEF) for various HPS programmes. There is a strong need to have a foundation that would provide health promotion funds for large scale health promotion projects.

Macao SAR: The government maintains its commitment to improving medical and healthcare quality and safeguarding the health of the public (http://www.gov.mo/ egi/Portal/index.jsp accessed August 2007). Medical and health services providers are classified as Governmental or Non-governmental. The former includes Government Health Centres providing primary healthcare and a hospital providing specialists medical services. The latter includes medical entities subsidised by the Government and other institutions. Most medical services provided by the Government are free.

Community participation in health

Mainland China: A number of initiatives have encouraged community participation. In 1986, the Ministry of Health together with Broadcasting Authority started First Special Award for films and television programmes related to health, to encourage participation from different sectors. There was an early adoption of WHO participatory approaches, with Healthy Schools introduced 1995, two Healthy Workplace demonstrations sites developed in Shanghai (WHO, 1999) and Healthy Cities piloted in six cities in 1997. The Alliance for Healthy Cities (AFHC) was established in 2003. Since 2002, China has launched the Health Partnership in Community programme. The programme aimed at grouping all professionals around the country together to serve the community, promote science, health, healthy lifestyle and comprehensive prevention for NCD. Using community health services centres as a focal point for networking, the health education professionals provide health promotion services to the community through large scale cross counties health forums. At the same time, in order to enhance the community awareness of the importance of health, innovative and creative ideas are used to introduce concepts so community populations have the opportunity to share the health education resources.

Hong Kong SAR: Healthy Cities, initiated in 1998, from a collaboration of NGOs, the District Council, other stakeholders including academic institutions, has initiated projects in different settings to promote better health and meet the needs of local people. There is strong support from the lay population and there has been a rapid expansion of the Alliance for Healthy.

As a continuing effort in the fight against SARS; the Operation UNITE proposed to draft the Hygiene Charter which aimed at encouraging individuals, as well as business and industry sectors, to pledge their commitment to improve hygiene practices for the good of all. The Charter puts forward suggestions and guidelines on hygiene practices for individuals, management, businesses and organizations from over 10 different sectors. The key goal is to unite the community and create a new culture of hygiene in Hong Kong. CUHK was invited to develop the Charter (Lee & Chan, 2005). The Charter has laid down the guidelines on hygiene practice, and a series of workshops for the different sectors, school teaching kits that include videos and community education programs are used to empower the population to adopt good hygienic practice.

Macao SAR: The implementation of HPS aims to stimulate the schools to mobilise community resources available to promote school health. It aims to move away from passive role of schools in participation in health promotion to active role in setting their own priorities and choosing those programmes meeting their own needs.

Research and information

The overall strategy in health promotion is to achieve mass shifts in risk factors prevalence and change in policy and organizational practice, rather than just simply focus on improving personal health literacy and behaviour modification among defined individuals. Evidence of success would be best built on data deriving from several different sources; making use of qualitative and quantitative information. CUHK has developed a set of indicators and frameworks to evaluate the effectiveness of HPS. These encompass a wide spectrum of outcome measurements based on both health and educational frameworks covering appropriate short, medium, and long term indicators with broad perspective (Lee et al., 2004a; Lee et al., 2005a). It would help to identify methods by which schools can develop as health promoting institutions, and the factors that influence this process and assess what can be achieved by schools with the use of additional resources. Youth Risk Behavioural Surveillance (YRBS) has been carried out in mainland China, Hong Kong SAR and Macao SAR periodically based on the tool used by CDC, USA (Kolbe et al., 1993). In Hong Kong, the YRBS in 1999, 2001and 2003 revealed that substantial high proportion of our young people did not have a healthy eating habit, or exercise regularly and are also emotionally disturbed (Lee et al., 2005b). The 2001 survey found correlation of youth health compromising behaviors with emotional disturbance and life satisfaction. Macao YRBS in 2003 also revealed similar pattern of youth risk behaviours as in Hong Kong. Currently a study is underway to compare the results of YRBS in 2003 amongst Hong Kong, Macao, Taipei, selected cities in mainland China and the USA. The findings would add new knowledge of changing pattern of youth risk behaviours with changing socioeconomic circumstances.

Community diagnosis has been conducted on several districts in Hong Kong to create their city health profiles before they launched the Healthy Cities movement (Lee et al., 2003b; Lee et al., 2004b). One evaluation several years after implementation of Healthy Cities shows positive results (Lam & Mok, 2006).

Evaluation of the HPS and the Healthy School Award illustrated early intervention for lifestyle changes to be effective (Lee et al., 2006). There was significant improvement in students’satisfaction with life, student health, in school culture and organisation for those schools participated in the award scheme (Lee et al., 2005c).

Health promotion programme exemplars

Health promoting schools in Hong Kong SAR

Improvement in dietary and exercise habit, mental wellness has resulted from HPS (Centre for Health Education and Health Promotion, 2006). In one school a decreased consumption of high fat snacks, sugary drinks, chocolate and candies were observed and an increase in supply and three-fold increase in consumption of vegetables at lunchtime was recorded. Bullying has decreased as has reporting of suicidal thoughts, plan or action. School health policies, curriculum, linkage with parents and community has been strengthened. Parents are provided with more opportunities to participate, support and cooperate with school to ensure the balanced development of their children. Both school social and physical environments have also been improved. The school collaborated with another gold award winning secondary school and built a healthy school network to share good practice of developing and implementing the concept of health promoting schools with other schools and kindergartens in the District. The network is now supporting 20 primary schools and pre-schools to develop as a health promoting school.

Healthy workplace project in China

The Shanghai Health Education Institute, Ministry of Health and WHO launched a model healthy workplace project in four enterprises between 1993 and 1995 (WHO, 1999). The project aims to implement a comprehensive approach with objectives to create healthy work environments, encourage healthy lifestyles and reduce the incidence of occupational diseases and industrial accidents.

Three surveys were conducted during the study period. The first survey established baseline data and guide the development of an action plan, the second to measure mid-term progress and the last to evaluate project outcomes. Using data collected from the baseline survey and focus group discussions, the factories developed multifaceted work plans focused on promoting healthy lifestyles, controlling common diseases, reducing occupational health risks, improving the general work environment and strengthening basic and occupational healthcare services. Among the outcomes were reduced smoking rates and increase in physical exercise among males, decreased noise and dust levels, development of health-promoting policies, reduced salt content in canteen food, improved health services, cleaner environment, decreased prevalence of target diseases and integration of health promotion and protection into ongoing management practices.

Healthy City programmes in mainland China

SuZhou city, winner of AFHC, has a very good infrastructure, adequate resources, has launched initiatives to involve community members and has established programmes to assist disadvantaged groups. Seminars have been held on wide range of topics to empower the citizens to lead to healthy life and policies and community actions have been developed to sustain the effect. A comprehensive set of indicators has been developed to measure the health of the population.

Healthy City Programme in Hong Kong SAR

A non-government organization, Haven of Hope Christian Service (HOHCS), initiated in 1997 the development of Tseng Kwan 0 New Town into the first Healthy City in Hong Kong. The stakeholders range from the district council, government departments, corporations, non- government organizations, schools, housing estates, commercial enterprises, community bodies to local people. Intervention included:

1. Promotion of physical activity for all, which encourages local people to walk more in daily life; multi-faceted approach encompassing interventions in the behavioral, educational and environmental aspects and through peer support by forming different physical activity groups. Collaboration with general practitioners has been effective in encouraging their patients to start physical activity for health reasons during consultations

2. Healthy Schools where interdisciplinary team of social workers, dietician and nurses collaborate with schools to provide tailored programs and activities to promote health of their students, teachers and parents

3. Sai Kung Elderly Service Coordinating Committee, as a district- wide platform organised various programs to promote physical activity, emotional health, flu prevention, fall prevention, home safety and drug safety

4. Healthy and Safe Estates where the Hello, My Neighbours! And Health Everywhere, Blessings Every Year campaigns were launched to promote neighbourhood relationship

5. TKO is My Home Community Health and Inclusion Project

Evaluation results show great success in terms of raising knowledge, understanding and commitment to health improvement.

Conclusions

The rapid economic development in mainland China and the fast pace of urbanization and industrialization has lead to a widening in health inequities and the country is also facing double challenges of NCD and emerging new infectious diseases such as HIV/AIDS, Avian Flu and SARS. Healthcare reforms have reoriented the health services towards primary healthcare with greater emphasis on health promotion and disease prevention. Policy and infrastructure need to be further reformed to involve multisectoral cooperation including NGOs and private health enterprise. Hong Kong and Macao face the impact of globalization and urbanization and need to safeguard the health of populations by monitoring and surveillance of health problems, intervening at early stage. Both SARs should build on their success in Healthy Settings to involve more stakeholders for continuous improvement and further refine the measuring tools so the success of healthy settings approaches can be evaluated.

Acknowledgements

The authors would like to express sincere thanks to Dr. Stella T. M. Chan of Macao SAR CDC for information on health promoting schools and healthy cities in Macao.

La Chine est le pays le plus peuple du monde. Par le passe, le systeme de sante publique en Chine continentale a ete fortement influence par l’ex-Union sovietique. Hong Kong et Macao, les Regions administratives speciales (RAS), quant a elles sous autorite coloniale, avaient adopte une approche de ‘laisser-faire’pour leurs politiques de sante. Au cours des deux dernieres decennies, cependant, la Chine continentale et les deux RAS ont adopte les principes de la Charte d’Ottawa, et ont reoriente leurs systemes de soins de sante vers une plus grande participation communautaire. Des environnements favorables a la sante ont ete crees dans divers lieux de vie, de meme que l’on a developpe les capacites de la promotion de la sante. Des efforts pour aller vers une approche consultative qui tienne compte des lieux de Vie favorables a la Sante, ont eu des effets positifs. Des ressources appropriees seront necessaires a la construction des infrastructures permettant un developpement durable des initiatives de promotion de la sante. Le present rapport est davantage selectif que global et met en evidence des activites promotrices de sante specifiques dans differentes parties de la Chine, refletant ainsi la maniere dont l’approche de la promotion de la sante y a evolue depuis Ottawa. Une analyse du potentiel de ces initiatives sera realisee afin de maintenir l’esprit de la Charte d’Ottawa tout en ouvrant la voie a celle de Bangkok. (Promotion & Education, 2007, XIV (4): pp 219-223).

China posee la poblacion mas numerosa del mundo. En el pasado, el sistema publico de salud de Ia China continental recibio mucha influencia de la antigua Union Sovietica. Hong Kong, Macao y las Regiones Administrativas Especiales (SAR, en sus siglas en ingles) vivieron bajo la administracion colonial que adopto un enfoque de mera tolerancia de las politicas sanitarias. En las ultimas decadas, la China continental y las SAR han aprobado los principios de la Carta de Ottawa y han reorientado los sistemas de atencion de salud hacia una mayor participacion de la comunidad, la creacion de un medio ambiente propicio para la salud en todos los entornos de vida y la capacitacion en el ambito de la promocion de la salud. Se han obtenido resultados positivos partiendo de iniciativas que incorporan enfoques mas participativos de la promocion de la salud, empleando para ello el marco de los Entornos Saludables. Si se pretende levantar una infraestructura capaz de desarrollar de manera sostenible las iniciativas de promocion de la salud se necesitaran recursos en cantidad suficiente. El informe es selectivo, mas que integral, y subraya actividades concretas de promocion de la salud realizadas en diferentes partes de la China, que reflejan la evolucion del enfoque de la promocion de la salud desde la Carta de Ottawa. Se realizara un analisis del potencial de dichas iniciativas para llevar adelante el espiritu de Ottawa como una manera de abrir camino a la Carta de Bangkok. (Promotion & Education, 2007, XIV (4): pp 219-223). References

Centre for Health Education and Health Promotion of Chinese University of Hong Kong (2006). Role of Schools in Promoting physical Activity and Healthy Diets: Case study in Hong Kong. Workshop on Implementation of the Global Strategy on Diet, Physical Activity and Health in Asian Countries 10 October-13 October 2006

Henderson, G. E., Cohen, M. S. (1982) Healthcare in the People’s Republic of China: A View from Inside the System. American Journal of Public Health 72(11): 1238-1245.

Kolbe, L J., Kann, L1 Collins, J. L . (1993) Overview of the Youth Risk Behavior Surveillance System. Public Health Rep, 108(suppl 1):2-10.

Lam, C. C, Mok, E. (2006) Sai Kung Healthy City project: Pioneer of Healthy City in Hong Kong. In Lee, A., Improving Health and Building Human Capital through an effective primary care system and Healthy Setting approach. Thematic Paper for the Knowledge Network on Urban Settings, WHO Commission on the Social Determinants of Health

Lee, A. (2002) Helping Schools to Promote Healthy Educational Environments as New Initiatives for School Based Management: The Hong Kong Healthy Schools Award Scheme. Promotion and Education Suppl 1 -.29-32.

Lee, A., Chan, K. M. (2005) Hygiene Charter: Laying down the spirit of Healthy City. Gallery Paper. Journal of Epidemiology and Community 59:30.

Lee, A., Chen, C. I., Wong, P. K, et al (2003c) Tai Po Safe and Healthy City: Community Diagnosis. Tai Po Safe and Healthy City Steering Committee.

Lee, A., Cheng, F., Fung, Y, St Leger, L. (2006) Can Health Promoting Schools contribute to the better health and well being of young people: Hong Kong experience? Journal of Epidemiology and Community, 60:530-536.

Lee, A., Cheng, R, St Leger, L (2005a) Evaluating Health Promoting Schools in Hong Kong: The Development of a Framework. Health Promotional International 2005; 20(2): 177-186.

Lee, A., Cheng, R, Yuen, H., Ho, M., Healthy Schools Support Group (2003b) How would schools step up public health measure to control spread of SARS? Journal of Epidemiology and Community Health 57:945-949.

Lee, A., Chow, C. B., et al (2004b) Kwai Tsing Safe and Healthy City: Community Diagnosis. Centre for Health Education and Health Promotion, The Chinese University of Hong Kong and Kwai Tsing District Council.

Lee, A., Ho, M., Leung, T. C. Y., Cheng, F. F. K., Tsang, K. K, Suen, Y. P., Yuen, S. K, Hong Kong Healthy Schools Project Team (2004a) Development of indicators and guidelines for the Hong Kong Healthy Schools Award Scheme. Journal of Primary Care and Health Promotion, 1(1): 4-9. ISBN 1811-931X

Lee, A., Lee, N., Tsang, C. K. K, Wong., Cheng, K. F. F, Wong, S.Y.S., Wong, C. S. (2005b) Youth Risk Behaviour Survey, Hong Kong (2003/04) Journal of Primary Care and Health Promotion Special issue; 1-47.

Lee, A., Lee, S. H., Tsang, K. K., To, C. Y. (2003a) A comprehensive Healthy Schools Programme to promote school health: The Hong Kong experience in joining the efforts of Health and Education sectors. Journal of Epidemiology and Community Health, 57:174-177

Lee, A., St Leger, L, Moon, A. S. (2005c) Evaluating Health Promotion in Schools meeting the needs for education and health professionals: A case study of developing appropriate indictors and data collection methods in Hong Kong. Promotion and Education, XII (3-4): 123-130. Special issue reporting successful school health programme globally.

Liu, Y. (2004) China’s public health-care system: facing the challenges: Policy and Practice. Bulletin of the World Health Organisation 82(7): 532-538.

Liu, K. (2002) Review of health education in China in the past fifty years. Promotion and Education. Suppl. 1:48.

Tang, K. C, Nutbeam, Kong, L Z., Wang, R. T, Yan, J. (2005) Building capacity for health promotion- a case study from China. Health Promotion International, 20(3): 285-295.

WHO (1999) Healthy Settings: Regional Guidelines for the Development of Healthy Workplaces. WHO Regional Office for the Western Pacific, 1999.

Albert Lee1, Hua Fu2 and Ji Chenyi3

1. Professor and Director of Centre for Health Education and Health Promotion, the Chinese University of Hong Kong; Regional Leader (NWP) of IUHPE Global Programme for Health Promotion Effectiveness. Correspondence to: Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, N.T., Hong Kong ([email protected])

2. Professor, Deputy Dean, School of Public Health, Fudan University, Shanghai, People’s Republic of China.

3. Professor, Director, Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, People’s Republic of China.

Copyright International Union for Health Promotion and Education 2007

(c) 2007 Promotion & Education. Provided by ProQuest Information and Learning. All rights Reserved.

Whole Health Management Opens Second On-Site Wellness Center for Sprint Employees and Dependents

Whole Health Management, a leading operator of on-site and near-site health clinics for large corporations, and Sprint, opened a 4,500 square-foot health and wellness center and pharmacy on Feb. 15 to serve Sprint employees working at the company’s Reston, Va. offices. The on-site clinic offers quality health services to more than 4,000 Sprint employees and their spouses, as well as minor dependents 14 and older.

The clinic is open to employees Monday through Friday, and is one of two on-site health care clinics operated by Whole Health at Sprint facilities; the other health and wellness center is located at Sprint’s main campus in Overland Park, Kan.

“We are excited to partner with Whole Health to open a second on-site health and wellness center for our Reston employees,” said Stacey Nelson, health care delivery manager for Sprint. “Our existing Whole Health clinic has provided our employees with superior health care services, improving access to care and enhancing employee engagement in important health-care decisions. They have been able to do this while helping to increase productivity and reduce health-care costs. Sprint’s decision to open a new health center and pharmacy supports our efforts to attract and retain the best employees and to keep our employees healthy and productive.”

Medical Services

Whole Health staffs and operates the center’s health and wellness center which provides a broad range of services, including: minor illness treatment, health promotion initiatives, physical examinations, allergy shots, immunizations, health risk and disease management, and nutritional counseling. Facility staff includes a full-time, board-certified physician, a full-time nurse practitioner, two full-time registered nurses, a full-time x-ray technologist, a full-time physical therapist, and two full-time medical assistants.

“Sprint’s dedication to providing proactive health services to its employees at the work site is commendable. We’re excited to grow our partnership with the company to include its Reston offices,” said Jim Hummer, founder and CEO of Whole Health. “We are working with Sprint to customize our services to meet the individual needs of their employees, and are confident that our model of personalized, integrated, proactive care will build a healthier workforce while reducing health-care costs.”

Whole Health specializes in on-site and near-site health clinics that offer comprehensive care. The company is responsible for urgent care and preventative health services at the new Reston, Va., location. The on-site pharmacy provides prescription drugs, over-the-counter medications, and other pharmacy items, in addition to allowing employees access to the pharmacist for counseling and education.

About Sprint Nextel

Sprint Nextel offers a comprehensive range of wireless and wireline communications services bringing the freedom of mobility to consumers, businesses and government users. Sprint Nextel is widely recognized for developing, engineering and deploying innovative technologies, including two robust wireless networks serving approximately 54 million customers at the end of 2007; industry-leading mobile data services; instant national and international push-to-talk capabilities; and a global Tier 1 Internet backbone. For more information, visit www.sprint.com.

About Whole Health Management

Whole Health Management is a leading operator of on-site and near-site employer sponsored clinics, health and wellness centers, and pharmacies in the United States. Since 1981, Whole Health has provided comprehensive and integrated occupational health, preventive care, urgent and primary care, physical therapy, fitness programs, health risk and disease management, health coaching and behavioral health counseling to corporate employees and their families. Whole Health clinics deliver significant savings to corporations through lower health care costs, increased productivity, reduced employee sick time, and decreased pharmacy costs. Whole Health serves more than 300,000 employees, and in many cases, spouses and dependents, at 69 sites, including many large corporations and Fortune 500 companies. For more information about Whole Health, visit www.wholehealthnet.com.

Hospitals are Spending Big to Upgrade for the Obese

About 15 years ago, a hospital asked Paul Fox, whose Jenkintown company sells medical furniture and equipment, if he could supply a chair for a 500-pound patient.

He was stunned.

“I had never sold a chair for somebody who weighed 500 pounds,” he said.

It is a measure of how much Americans have grown that such requests are no longer unusual.

“We could sell 10 to 15 pieces a month today,” Fox said.

The obesity epidemic means that more patients are maxing out equipment meant to safely hold people who weigh no more than, say, 250 to 350 pounds. As a result, hospitals are now peppering their waiting areas with tastefully understated “love seats” that can be used by the supersized, or two or three people of normal weight. They are buying overhead lifts that help nurses move patients who weigh up to 1,000 pounds and switching to stretchers safe for 750 pounds.

Hospitals are investing in MRI machines big enough to hold 550-pound patients. They are buying portable machines to extricate obese patients from their cars at the emergency department entrance. They are widening doors and switching from wall-mounted toilets, which support a mere 325 pounds, to sturdier floor-mounted models. They are buying longer needles and catheters and bigger patient gowns. They are renting or buying “big-boy” beds, commodes and walkers designed for the morbidly obese. Two Main Line Health hospitals have purchased extra-large hyperbaric chambers to aid wound healing for patients up to 550 pounds.

“Demand’s been huge, I can tell you that, no pun intended,” said Lauren Green-Caldwell, a spokeswoman for Hill-Rom, which makes medical equipment. The company’s largest bed can support half a ton.

Stryker, another medical supply maker, estimates the U.S. bariatric market — products made for the obese — at $100 million a year, with 20 percent annual growth.

The larger patients are also driving changes in medical technology, particularly imaging equipment such as CT scanners and ultrasound, X-ray and MRI machines. In standard machines, several inches of fat can get in the way of a good picture or make it impossible. “We probably don’t make anything that wouldn’t be affected in one way or another by this epidemic,” said Corey Miller, a GE Healthcare spokesman.

The extra steel reinforcement and design changes do not come cheap. Bariatric furniture costs 20 to 50 percent more than standard products, Green-Caldwell said. For example, a basic hospital bed might cost $6,000 to $8,000, but the extra-large model costs $10,000 to $12,000.

Hospitals say insurance companies do not pay more for care given to extra-big patients.

Fifteen million Americans are morbidly obese, or at least 100 pounds overweight, according to the American Society for Metabolic & Bariatric Surgery. A Rand Corp. study published last year found that the fastest growing group of the overweight is the fattest — what it called the “super obese.”

Scientists use the Body Mass Index, a measure of the relationship between height and weight, to classify obesity. With some exceptions — such as professional athletes — you’re obese at a BMI of 30, morbidly obese at 40 and super obese at 50. For someone who stands 5-foot-9, that translates, respectively, to 203, 270 and 338 pounds. While the proportion of people who are super obese is still under 1 percent, it increased 75 percent between 2000 and 2005, according to the study.

Obese people tend to have more than their share of health problems, making them prime candidates for a hospital stay. And they are more likely to have complications when they are in the hospital. “From the beginning to the end, they’re more likely to have a problem,” said Fernando Bonanni, director of Abington Memorial Hospital’s surgical weight-loss center.

“There’s lots of patients that are between 250 and 400, more than you might think,” said Richard Webster, vice president for musculoskeletal services at Thomas Jefferson University Hospital, which does not have a bariatric surgery program. “Your size and your health are directly related, which is why we see so many large patients.”

When Bonanni came to Abington, he set about raising everyone’s consciousness about comfortable equipment and humane treatment for his patients. Rudeness to obese people, he said, “is absolutely the only form of prejudice left in our society that’s acceptable.”

Hospitals quickly learn that it’s not enough to set up special rooms for patients recovering from bariatric surgery. Severely obese patients need treatment for all kinds of reasons. Christiana Hospital, for example, cared for a 600-pound pregnant woman last summer.

Temple University Hospital is making changes that help its biggest patients whenever it renovates. “We just realized that bariatrics was not confined to four rooms on the ninth floor,” said Terry McGoldrick, the hospital’s chief nursing officer.

Hospitals everywhere are finding the changes expensive. Abington Memorial shared some prices: Stretchers that can hold 700 pounds cost $3,147, compared to $2,400 for the standard version. Wheelchairs with a 700-pound weight limit cost $1,300, more than five times the price of the standard size.

Outfitting a room with an overhead lift costs about $12,000, said Jan Nash, chief nursing officer for Paoli Memorial Hospital.

Jefferson Hospital now routinely buys beds that can support 500 pounds and stretchers strong enough for 700. The hospital says it still expects to spend more than $250,000 renting bariatric equipment this year. The extra-large furniture cannot fit in the city hospital’s private rooms, so another cost is that morbidly obese patients often must be by themselves in rooms meant to hold two patients.

Harvard University radiologist Raul Uppot studied how patients’ expanding waistlines are affecting medical imaging and found a growing number of fuzzy pictures. Some patients can’t fit in the machines at all. Those who can are more likely than thin people to have “inconclusive” films. With CT scans and X-rays, doctors can improve the picture, but at a price: exposing patients to higher levels of radiation.

Patients too big for a hospital’s imaging machines may face exploratory surgery or other less efficient diagnosis methods, Uppot said.

GE Healthcare recently started making a CT machine with an 80-centimeter opening. Siemens last year introduced an MRI machine with a 70-centimeter opening and an extra-powerful magnet meant for examining obese patients.

The Hospital of the University of Pennsylvania has an earlier incarnation of the large-bore MRI, which is 10 centimeters bigger than the standard model. Evan Siegelman, chief of body MRI at the hospital, said his department, which takes referrals from two sister hospitals, scans a patient every two days who could not fit in any other MRI. Siegelman hopes to have one of the more powerful open-bore machines when Penn’s Perelman Center for Advanced Medicine opens next year.

Even getting patients to the hospital requires special equipment.

In the past, it could take six ambulance crews to get super-obese patients out of their houses, said Karen Kroon, general manager for American Medical Response, a Philadelphia ambulance company. And then they might have had to ride on the ambulance floor because stretchers were not strong enough.

In 2005, her company bought a stretcher that can support 1,000 pounds. It comes with a ramp and motorized winch. The company uses the equipment “fairly regularly,” Kroon said.

The Philadelphia Fire Department has spent more than $200,000 over the last three years on patient carrying devices that can hold up to 1,600 pounds, stair chairs for people up to 500 pounds and stretchers that hold 650 pounds. Every ladder company has the jumbo equipment, said Daniel Williams, executive chief.

The special needs don’t stop with a patient’s last breath.

Hospitals are also buying lifts for their morgues.

——

Body-Mass Index

The index measures the relationship of height and weight. People with a BMI over 30 are considered obese.

Normal weight: 18.5

Overweight: 25

Obese: 30

Morbidly obese: 40

Super obese: 50

To use the National Institutes of Health BMI calculator, go to:

http://go.philly.com/BMI

Cell Phone Companies Fight Backup Power Rule

When Hurricane Katrina assaulted the Gulf Coast in 2005, wind and flooding knocked out hundreds of cell towers and cell sites, silencing wireless communication exactly when emergency crews and victims needed it.

To avoid similar debacles in the future, the Federal Communications Commission wants most cell transmitter sites in the U.S. to have at least eight hours of backup power in the event main power fails, one of several moves regulators say will make the nation’s communication system stronger and more reliable.

Two and a half years after Katrina and eight months after the FCC’s regulations were first released, the two sides are still wrestling with the issue.

A federal appeals court in Washington, D.C., put those regulations on hold last week while it considers an appeal by some in the wireless industry.

Several cell phone companies, while agreeing their networks need to become more resilient, have opposed the FCC’s backup power regulations, claiming they were illegally drafted and would present a huge economic and bureaucratic burden.

There are almost 210,000 cell towers and roof-mounted cell sites across the country, and carriers have said many would require some modification. At least one industry estimate puts the per-site price tag at up to $15,000.

In a request for the FCC to delay implementing the change, Sprint Nextel Corp. (S) wrote that the rules would lead to “staggering and irreparable harm” for the company. The cost couldn’t be recouped through legal action or passed on to consumers, it said.

Jackie McCarthy, director of governmental affairs for PCIA – The Wireless Infrastructure Association, said the government should allow the industry to decide how best to keep its networks running, pointing out that all the backup power in the world won’t help a cell tower destroyed by wind or wildfires.

“Our members’ position is that the ‘one size fits all’ approach to requiring eight hours of backup power at all cell sites really doesn’t accomplish the commission’s stated purpose of providing reliable wireless coverage,” McCarthy said.

The wireless carriers also are claiming the FCC failed to follow federal guidelines for creating new mandates and went far beyond its authority when it created the eight-hour requirement last summer.

FCC officials have so far stood their ground.

“We find that the benefits of ensuring sufficient emergency backup power, especially in times of crisis involving possible loss of life or injury, outweighs the fact that carriers may have to spend resources, perhaps even significant resources, to comply with the rule,” the agency said in a regulatory filing.

“The need for backup power in the event of emergencies has been made abundantly clear by recent events, and the cost of failing to have such power may be measured in lives lost,” it said.

A panel of experts appointed by the FCC following Katrina was critical of how communications networks performed during and after the storm. The group noted that service restoration was “a long and slow process.”

Panel members recommended the FCC work with telecommunications companies to make their networks more robust. Regulators then created the eight-hour mandate, exempting carriers with fewer than 500,000 subscribers.

Wireless companies quickly complained about the regulations, calling them arbitrary and saying they would rob them of the flexibility to target backup power upgrades at the most important or most vulnerable cell sites in their networks.

They also said local zoning rules, existing leases and structural limitations could make it impossible to add batteries or backup generators to cell sites.

Miles Schreiner, director of national operations planning for T-Mobile, said it can take 1,500 pounds or more of batteries to provide eight hours of backup energy in areas with a lot of cell phone traffic.

“In urban areas, most of the sites are on rooftops and those sites weren’t built to hold that much weight,” Schreiner said.

In regulatory filings, the FCC has said the wireless carriers chose to put their equipment in areas that can’t be readily expanded. However, the agency agreed in October that it would exempt cell sites from the rules but only if the wireless carrier provided paperwork proving the exemption was necessary.

It would give companies six months from when the rules went into effect to submit those reports and then another six months to either bring the sites into compliance or explain how they would provide backup service to those areas through other means, such as portable cellular transmitters.

CTIA-The Wireless Association and several carriers asked the U.S. Court of Appeals in Washington, D.C., to intervene, saying the exemptions would still leave wireless companies scrambling to inspect and compile reports on thousands of towers.

On Feb. 28, the court granted Sprint Nextel’s request to stay the regulations while the case moves forward. Oral arguments are scheduled for May.

An FCC spokesman said the agency was disappointed with court’s decision.

Not all carriers have joined the fight. Verizon Wireless is not a party to the appeal and has a history of installing backup generators and batteries to its cell sites. Most famously, during a 2003 blackout that kept much of the Northeast in the dark for hours, Verizon customers could still communicate.

AT&T, the nation’s largest wireless carrier, would not comment on the FCC regulations.

McCarthy, whose organization represents both the wireless carriers and companies that lease space on their own cell towers, said her members worry that they will face a high hurdle to get exemptions.

“I don’t think it’s hyperbole or exaggeration to say if it gets to that point with specific sites it could lead to sites being decommissioned,” she said. “If the ultimate endgame is a site being turned off because of noncompliance, the area immediately around that site is going to have an immediate negative impact. It’s going to hurt public safety from day one.”

Sea Slug’s Skin May Help Parkinson’s Patients

Scientists have developed a new material based on the skin of a breed of sea slugs which they hope will one day be used to help patients with Parkinson’s disease.

The development of the stimuli-responsive polymer nanocomposites was influenced by the sea cucumber’s ability to rapidly and reversibly alter the stiffness of their skin.

These “self-assessing polymers” use integrated sensors, which visually indicate stimuli such as mechanical deformation, according to the team.

“The water acts as a chemical switch,” Dr Christoph Weder, a professor at Case Western Reserve University and a member of the team, said.

The importance of water acting as the chemical switch is that the brain is made up of about 75% water.

When water is added, the rigid material switches to a rubber-like state in seconds, and it can change back just as quickly, they said.

The team said they hope the new developments will lead to assistance in patients suffering from Parkinson’s disease, stroke or spinal cord injuries.By remaining stiff, the material will be able to be implanted easier, after contacting water, it would become flexible again.

“If you look at the tissue of the brain, it is much, much softer than the typical electrode you would implant,” Weder said.

“I think there is a range of applications in the biomedical implant area, such as stents that one could envision to be realized with these materials.”

The new material is formed of a rubber-like polymer and tiny cellulose fibers that add stiffness. They form hydrogen bonds that make the whole material hard wherever they intersect.

“These nanofibers are glued to each other wherever they intersect. If you add water, the water will unglue those intersections,” said Weder. He said the water acts as a hydrogen de-bonding agent.

While boasting the material’s versatility, Weder even hinted at its potential non-medical applications.

“Think of an electrically switchable bulletproof vest that would be comfortable to wear, but that you could switch on to become bulletproof,” he said. “It could be really broadly important.”

On the Net:

Case Western Reserve University

Stimuli-Responsive Polymers

”Biochemistry of Drug Metabolism: Principles, Redox Reactions, Hydrolyses” Now Available

Research and Markets (http://www.researchandmarkets.com/reports/c84902) has announced the addition of The Biochemistry of Drug Metabolism: Principles, Redox Reactions, Hydrolyses to their offering.

The first of the two volumes is divided into three parts. Part One begins by introducing xenobiotics in the broad context of physiological metabolism, and continues with an overview of the processes of drug disposition and metabolism. It then goes on to summarize the macroscopic and microscopic locations of drug metabolism in animals and humans. This is followed by an introduction to the all-important issue of the consequences of drug and xenobiotic metabolism, providing an initial overview of pharmacokinetic, pharmacological and toxicological consequences. The last chapter examines drug metabolism in the context of drug research, with a focus on medicinal chemistry.

The second part is a major component of the book, corresponding to the role of oxidoreductases as major agents of metabolism. Cytochromes P450 receive particular attention, namely their multiplicity, structure, catalytic mechanisms, and the various reactions they catalyze, while other oxidoreductases are also presented, such as flavin monooxygenases, monoamine oxidases and other amine oxidases, aldehyde oxidase and xanthine dehydrogenase, peroxidases, and dehydrogenases-reductases. Each drug-metabolizing enzyme or enzyme family begins with an Enzyme Identity Card summarizing its nomenclature and biochemical essentials.

Part Three begins with a survey of the classification, properties and catalytic mechanism of the innumerable hydrolases known or suspected to play a role in xenobiotic metabolism. The focus then shifts to a systematic presentation of the various substrate classes, namely carboxylic esters, amides and peptides, lactams and lactones, esters of inorganic acids, alkene and arene epoxides, and some miscellaneous hydrolyzable moieties.

With a foreword by Prof Leslie Z. Benet, the world’s best and best-known biopharmaceutical scientist.

Topics Covered:

-Drugs and Xenobiotics

-What Are Drug Disposition and Metabolism?

-Where Does Drug Metabolism Occur?

-Consequences of Drug Metabolism – An Overview

-Drug Metabolism and Drug Discovery

-Redox Reactions and Their Enzymes

-Cytochromes P450 (CYPs) and Flavin-Containing Monooxygenases (FMOs)

-CYP-Catalyzed sp3-C-Oxidations

-CYP-Catalyzed sp2-C- and sp-C-Oxidations

-Oxidations of N- and S-Atoms Catalyzed by CYPs and/or FMOs

-Other Reactions Catalyzed by CYPs

-Other Oxidoreductases and Their Reactions

-Reactions of Hydrolysis and Their Enzymes

-A Survey of Hydrolases

-The Hydrolysis of Carboxylic Esters

-Synthetic Reactions of Esterases

-The Hydrolysis of Amides and Peptides

-Hydrolytic Ring Opening

-The Hydrolysis of Esters of Inorganic Acids

-The Hydration of Epoxides

-Miscellaneous Reactions

For more information visit http://www.researchandmarkets.com/reports/c84902.

Research Shows Cigarettes Won’t Make You Happy

If you are planning to ignore the messages of national No Smoking Day on 12th March by claiming that smoking is one of the few pleasures left to you, then recent research from the Peninsula Medical School in the South West of England may make you think again.

Extensive research carried out by Dr Iain Lang at the Peninsula Medical School looked at the relationship between smoking and psychological wellbeing. Dr Lang and colleagues used a measure of quality of life called the CASP-19 and found that smokers experienced lower average levels of pleasure and life satisfaction compared with non-smokers. The difference was even more pronounced in smokers from lower socio-economic groups.

In short ““ smoking doesn’t make you happy.

Dr. Lang and his team carried out a study involving 9176 individuals aged 50 or over, who took part in ELSA, the English Longitudinal Study of Ageing. The studies for the research categorised people as never-smokers, ex-smokers and current smokers, and used household wealth as an indicator for socio-economic position.

Said Dr. Lang: “We found no evidence to support the claim that smoking is associated with pleasure, either in people from lower socio-economic groups or in the general population.”

He added: “People may feel like they’re getting pleasure when they smoke a cigarette but in fact smokers are likely to be less happy overall ““ the pleasure they feel from having a smoke comes only because they’re addicted. These results show smoking doesn’t make you happy ““ in fact, it is associated with poorer overall quality of life. Anyone thinking of giving up smoking should understand that quitting will be better for them in terms of their well-being ““ as well as their physical health ““ in the long-run.”

On the Net:

The Peninsula College of Medicine and Dentistry

No Smoking Day Website

Blood Thinning Heparin Recalled Due to Contamination

The Food and Drug Administration announced on Wednesday that it is investigating the blood thinning drug heparin for what appears to be a fake ingredient.

The drug’s distributor, Baxter International, voluntarily recalled nine lots of heparin sodium injection multi-dose vials on January 17, 2008 “as a precautionary measure due to a higher than usual number of reports of adverse patient reactions involving the product and suspended production,” according to a press release.

“The safety and quality of our products is always our highest priority, and we will continue to collaborate with the FDA as we work to determine the cause of the increased rate of adverse reactions and resolve this issue,” said Peter J. Arduini, president of Baxter’s Medication Delivery business.

After 19 deaths related with allergic-type reactions to the drug, the FDA ordered Baxter to recall its remaining heparin products.

“We still don’t know whether this inadvertently got into the supply or whether it was actually added,” said FDA drug chief Dr. Janet Woodcock. “We can’t tell you where the contamination originated.”

The FDA claimed that contaminant was a heparin-like compound that accounted for between 5 percent and 20 percent of some of the samples tested.

Woodcock said that these batches weren’t noticed by Baxter because the contaminant appeared so chemically close to real heparin.

Taken from pig intestines, Heparin is used in patients undergoing dialysis and heart surgery. FDA officials are experiencing difficulties locating the root cause of the contaminated compound which is derived from a group of chemicals also located in pig intestines.

Baxter claimed that the majority of heparin products come from China.

If the contaminated ingredients from China are discovered to be intentional, it would be reminiscent of last year’s scandal when a Chinese company was charged with adding the toxic chemical melamine to an ingredient used in U.S. pet food, killing thousands of dogs and cats, according to Associated Press.

Baxter said it found the contaminant in samples of the ingredient from the China plant, Changzhou SPL, and in samples processed at the Wisconsin factory that came from Chinese-made crude heparin.

“It is premature to conclude that the heparin active pharmaceutical ingredient sourced from China and provided by SPL to Baxter is responsible for these adverse events,” the Wisconsin-based SPL said in a statement.

The Changzhou factory’s first FDA inspection last week produced quality-control issues. The FDA is currently faced with 785 reports of side effects from heparin products.

On the Net:

Food and Drug Administration

Baxter International

Associated Press

Delta Dental Foundation Awards Over $73,000 in Grants to Improve Oral Health in Michigan, Ohio and Indiana

The Delta Dental Foundation (DDF), the philanthropic arm of Delta Dental of Michigan, Ohio and Indiana, recently announced the recipients of its second annual Community Mini-Grant Program designed to support programs that address the oral health needs of residents in Michigan, Ohio and Indiana. The announcement was made by Nancy E. Hostetler, senior vice president of the DDF.

Nearly 70 grant applications were received for the program, and 16 were made. Grants were awarded in increments up to $5,000.

“The need for community-based dental care is demonstrated by the significant number of applications we receive for the Community Mini-Grant Program,” said Hostetler. “Through these grants, we hope to increase access to dental treatment and oral health education for those in the communities we serve.”

The 2007 grantees are:

Michigan

Center for Family Health, Oral Health DVD for Medical Professionals, Jackson, Mich. A grant of $5,000 will help to produce an educational DVD that will demonstrate the basic steps to screen infants and young children for dental disease.

Michigan Oral Health Coalition, Cavity Free Kids program, Lansing, Mich. A grant of $5,000 to purchase curriculum developed by Delta Dental of Washington’s Foundation for its Cavity Free Kids program.

Sweet Dreamzz, Inc., Sleep Kits, Detroit. A grant of $5,000 to provide toothbrushes and toothpaste for “sleep kits” distributed to children in need throughout the city.

Henry Ford Health System, School-Based and Community Health Program, Detroit. A grant of nearly $5,000 will support the Dental Sealant and Referral Program for children in Detroit. The program provides dental sealants and oral health education to prevent childhood tooth decay.

Macomb District Dental Hygienists Association, Heartfelt Project, Sterling Heights, Mich. A grant of $1,500 will help provide dental treatment and education to uninsured children in Macomb County.

Cherry Street Health Services, Athletic Mouth Guard program, Grand Rapids, Mich. A grant of $3,264 to provide custom-fitted mouth guards for student athletes in three Grand Rapids high schools.

Ohio

Ohio University, ComCorps Program, Athens County, Ohio. A grant of $4,559 to assist with oral health education and a fluoridation program for more than 1,500 underserved children in the county.

Ross County Community Action Head Start, Chillicothe, Ohio. A grant of $5,000 will support the Head Start’s Dental Prevention and Education Program. The program is designed to improve the oral health of 300 low-income children ages three to five.

Medina County Oral Health Coalition, Medina, Ohio. A grant of $4,974 to support the funding of a dental clinic inside the Medina County Health Department, which will provide free or affordable oral health services and supplies to underserved children in the county.

Cincinnati Center for Children’s Dentistry, Cincinnati, Ohio. A grant of $5,000 to fund the center’s charitable program, Dental Care: Providing Access to Underserved Children. The center is an entity of the Cincinnati Dental Society whose members provide free service for the program.

Ashland County Oral Health Services, Inc., Ashland, Ohio. A grant of $5,000 will support the county’s School Sealant Program, which provides oral health education and sealants to second graders in local schools and serves low-income children who wouldn’t regularly have access to oral health care.

Columbus Children’s Hospital, Columbus, Ohio. A grant of $4,861 to the hospital’s Oral Health for Immigrants’ Offspring — Linking Immigrants to Needed Care program to improve oral health of Somali children through education, community outreach and provision of needed dental services.

Indiana

Neighborhood Health Clinics, Inc., Fort Wayne, Ind. A grant of $5,000 to the clinic’s Dental Sealant Program, which provides dental screenings, dental education and sealants to underserved second, third, sixth and seventh graders.

Parents as Teachers (PAT) of Hammond/Lake County, Inc., Hammond, Ind. A grant of $4,168 to the local PAT program, which provides free education and support to parents with children prenatal to kindergarten. The funds will purchase supplies for the Dental Health Month programs.

Hilltop Community Health Center, Valparaiso, Ind. A grant of $5,000 will go toward the center’s Seal Deal Program, which aims to improve oral hygiene and prevention among the Spanish-speaking population in the area. The program provides education materials, as well as fluoride treatments and sealants.

Indiana University School of Dentistry, Indianapolis, Ind. A grant of $5,000 will go toward a joint program with the Indiana Dental Association and the University’s Give Kids a Smile Day. The event helps children from low-income families get the dental care they need.

The 2008 Delta Dental Foundation Community Mini-Grant Program call for entries will be announced later this year.

The Delta Dental Foundation is a nonprofit, charitable organization established in 1980 by Delta Dental of Michigan, which also operates Delta Dental of Ohio and Delta Dental of Indiana. The Foundation’s goals are to support education and research for the advancement of dental science and to promote the oral health of the public through education and service activities, particularly for those with special needs.

Genzyme Launches Renvela(R) in the U.S. For Dialysis Patients

CAMBRIDGE, Mass., March 6 /PRNewswire-FirstCall/ — Genzyme Corp. today announced the U.S. launch of the phosphate binder Renvela(R) (sevelamer carbonate) for dialysis patients, as well as significant progress in its international efforts to secure additional approvals for the product.

Genzyme has submitted a marketing authorization application to the European Medicines Agency seeking approval of Renvela for the control of serum phosphorus in chronic kidney disease patients regardless of whether they are on dialysis. This application, which includes both tablet and powder formulations, must be validated before it will be accepted for review.

Genzyme anticipates that the application will be validated by the end of this month, and the review period is expected to take approximately 15 months. The first E.U. launch of Renvela is anticipated in the third quarter of 2009. Genzyme also applied for approval of Renvela tablets for dialysis patients in the key South American market of Brazil late last year, and will continue to pursue additional approvals internationally.

In the United States, Genzyme is engaged in active discussions with the Food and Drug Administration to expand Renvela’s labeling to include chronic kidney disease patients with hyperphosphatemia who are not on dialysis. At the FDA’s request, the three companies that currently market phosphate binders for dialysis patients are working collaboratively to provide information that will assist the agency in defining the appropriate earlier stage chronic kidney disease patient population.

Genzyme had previously anticipated filing a supplemental New Drug Application for Renvela’s use in non-dialysis patients during the first half of 2008. Given the current discussions with the FDA, it will not be necessary for the company to file an sNDA for this indication. However, Genzyme anticipates the Renvela label expansion will take place within a similar timeframe had it gone a more traditional route. During the second quarter, Genzyme also plans to file for U.S. approval of the powder formulation of the product, which may make it easier for patients to comply with their prescribed treatment program.

“We are very pleased with the progress we’ve made to date on our comprehensive global plan for Renvela,” stated John P. Butler, president, Genzyme Renal. “The U.S. launch in dialysis, the E.U. and Brazil filings, and the positive nature of our current conversations with the FDA represent significant steps forward as we work to make this important product available to all patients who can benefit from it.”

Renvela is a next-generation version of Renagel(R) (sevelamer hydrochloride), the most-prescribed phosphate binder in the United States. It is a calcium-free, metal-free, non-absorbed phosphate binder and is available in the U.S. as 800mg tablets. Renvela offers all of the advantages of Renagel with the benefit of a carbonate buffer. In a clinical study comparing Renvela to Renagel, both drugs controlled serum phosphorus equally to within KDOQI recommended ranges. Patients on Renvela, however, were more likely to maintain bicarbonate levels within the recommended KDOQI ranges, and had a lower incidence of gastrointestinal adverse events.

About Renagel and Renvela

Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate) both control serum phosphorus in patients with chronic kidney disease (CKD) on dialysis. Controlling serum phosphorus is an important element in the care of dialysis patients. Elevated serum phosphorus levels are common in dialysis patients and associated with increased risk of cardiovascular morbidity and mortality. Sevelamer provides the added benefit of significant LDL cholesterol reduction.

Sevelamer is the only phosphate binder available that does not contain either calcium or a metal. It has an established safety profile, is not systemically absorbed and provides phosphorus control without the concerns of calcium or metal accumulation. The National Kidney Foundation’s 2003 Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines for Bone Metabolism and Disease in CKD recommend sevelamer as a first-line treatment option to control phosphorus. Sevelamer hydrochloride is currently used by more than 350,000 patients worldwide.

Product Information

Renvela (sevelamer carbonate) and Renagel (sevelamer hydrochloride) are indicated for the control of serum phosphorus in patients with chronic kidney disease (CKD) on dialysis. Sevelamer is contraindicated in patients with hypophosphatemia or bowel obstruction. Caution should be exercised in patients with dysphagia, swallowing disorders, severe gastrointestinal (GI) motility disorders including severe constipation or major GI tract surgery. Common adverse events reported with sevelamer include vomiting, nausea, diarrhea, dyspepsia, abdominal pain, and constipation. Other events reported include pruritus, rash, fecal impaction, and intestinal obstruction. Drug- drug interactions may occur with some medications and should be taken into consideration when instructing patients how to take sevelamer. Patients should be informed to take sevelamer with meals and to adhere to their prescribed diets. For more information on Renvela or Renagel, please see Full Prescribing Information, call Genzyme Medical Information at 1-800-847-0069 or visit http://www.renagel.com/ or http://www.renvela.com/

About Genzyme

One of the world’s leading biotechnology companies, Genzyme is dedicated to making a major positive impact on the lives of people with serious diseases. Since 1981, the company has grown from a small start-up to a diversified enterprise with more than 10,000 employees in locations spanning the globe and 2007 revenues of $3.8 billion. In 2007, Genzyme was chosen to receive the National Medal of Technology, the highest honor awarded by the President of the United States for technological innovation.

With many established products and services helping patients in nearly 90 countries, Genzyme is a leader in the effort to develop and apply the most advanced technologies in the life sciences. The company’s products and services are focused on rare inherited disorders, kidney disease, orthopaedics, cancer, transplant, and diagnostic testing. Genzyme’s commitment to innovation continues today with a substantial development program focused on these fields, as well as immune disease, infectious disease, and other areas of unmet medical need.

This press release contains forward-looking statements including, without limitation, statements about the potential approval and launch of Renvela(R) in the E.U. and internationally and plans for, and the potential approval of, new indications and formulations of Renvela(R) in the U.S. These statements are subject to risks and uncertainties that could cause actual results to differ materially from those projected in these forward-looking statements. These risks and uncertainties include, among others: the timing of discussions with regulatory authorities regarding the approval of Renvela(R); the timing and content of submissions to and decisions made by regulatory authorities relating to Renvela(R); further analysis of clinical trial data; the results of other studies and whether such results are consistent with this data; the actual efficacy and safety of the powder formulation of Renvela(R); the outcome of discussions with the FDA regarding the approval of Renvela(R) for use in non-dialysis chronic kidney disease patients and the timing of such discussions; the availability and extent of third-party reimbursement for Renvela(R); and the risks and uncertainties described in reports filed by Genzyme with the Securities and Exchange Commission under the Securities Exchange Act of 1934, as amended, including without limitation the information under the heading “Risk Factors” in the Management’s Discussion and Analysis of Financial Condition and Results of Operations section in Genzyme’s Annual Report on Form 10-K for the year ended December 31, 2007. Genzyme cautions investors not to place substantial reliance on the forward-looking statements contained in this press release. These statements speak only as of the date of this press release, and Genzyme undertakes no obligation to update or revise these statements.

Genzyme’s press releases and other company information are available at http://www.genzyme.com/ and by calling Genzyme’s investor information line at 1-800-905-4369 within the United States or 1-678-999-4572 outside the United States.

Genzyme(R), Renagel(R) and Renvela(R) are registered trademarks of Genzyme Corporation. All rights reserved.

   Media Contact:                   Investor Contact:   Erin Emlock                      Patrick Flanigan   (617) 768-6923                   (617) 768-6563  

Genzyme Corporation

CONTACT: Media Contact, Erin Emlock, +1-617-768-6923, or InvestorContact, Patrick Flanigan, +1-617-768-6563, both of Genzyme Corporation

Web site: http://www.genzyme.com/http://www.renvela.com/http://www.renagel.com/

Company News On-Call: http://www.prnewswire.com/comp/113803.html

The Dallas Morning News Robert Miller Column: UT Southwestern Medical Center Receives Big Gifts

By Robert Miller, The Dallas Morning News

Mar. 6–Texas oilman Vernon Faulconer and his wife, Amy, have given $1 million to support gynecologic oncology programs and establish a distinguished chair at UT Southwestern Medical Center.

The gift, made through the Southwestern Medical Foundation, will create the Amy and Vernon E. Faulconer Distinguished Chair in Medical Science.

Dr. John Schorge, associate professor of obstetrics and gynecology, has been named the first person to hold the chair.

“We think very highly of UT Southwestern and of Dr. Schorge, so this gift simply has been our way of thanking the medical center for all it does for Texas and the rest of the world,” Mr. Faulconer said.

“Obviously, gynecologic oncology research is an area of great importance affecting the lives of millions of women and families everywhere. We’re pleased to be able to contribute whatever we can to the cause and are truly excited about the kinds of research and clinical programs that might be helped through this gift.”

Mr. Faulconer is chief executive of Vernon E. Faulconer Inc., an independent oil and gas production company in Tyler that he also founded. He is a native of El Dorado, Kan.

In 2003, Mr. Faulconer was awarded an honorary doctor of laws degree from Iowa’s Grinnell College, his alma mater.

The Faulconers are major supporters of the arts in Dallas. In 1990, the couple established the Faulconer Academic Incentive Award for minority students to attend a Texas college of their choice. More than 350 black students have benefited from the awards.

“Amy and Vern Faulconer’s generous support of UT Southwestern will help ensure that our programs in gynecologic cancer will remain second to none,” said Dr. Kern Wildenthal, UT Southwestern president.

Geriatric program gift

Dallas oilman John R. Murrell and his wife, Kelley, have given $100,000 to support geriatric research, education and clinical care at UT Southwestern.

In the 1990s, Mr. Murrell’s mother was a patient of renowned geriatrician Dr. Craig Rubin. Dr. Rubin is director of the Mildred Wyatt and Ivor P. Wold Center for Geriatrics Care.

“Dr. Rubin is a fine gentleman and a thorough and compassionate doctor,” Mr. Murrell said. “I greatly admire the work he’s doing in the often unsung field of geriatrics and have found his compassion for the elderly quite refreshing. Kelley and I are big fans of UT Southwestern and of the high-caliber research being done there.”

A Dallas native, Mr. Murrell graduated from St. Mark’s School of Texas in 1973 and earned a bachelor’s degree in economics from Southern Methodist University in 1977.

Mr. Murrell is president of Three M Oil Co. and of the Murrell Foundation, which his family established in 1990. He is on the board of visitors of UT Southwestern Health System and is a member of the Council on Foundations in Washington, D.C., and the Conference of Southwest Foundations in Dallas.

Mrs. Murrell, a former commercial real estate and banking attorney, earned a law degree from the University of Memphis in 1984 after graduating from Rhodes College in 1977.

“Friends like John and Kelley Murrell are essential to our ability to build and maintain great medical research, teaching and patient care programs,” Dr. Wildenthal said.

—–

To see more of The Dallas Morning News, or to subscribe to the newspaper, go to http://www.dallasnews.com.

Copyright (c) 2008, The Dallas Morning News

Distributed by McClatchy-Tribune Information Services.

For reprints, email [email protected], call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

Community & Mission Hospital of Huntington Park Shutting Down Mission Campus, Terminating Workers

HUNTINGTON PARK, Calif., March 5 /PRNewswire-USNewswire/ — Hundreds of patients who rely on Community and Mission Hospital of Huntington Park’s Mission campus for medical services will be forced to go elsewhere as the facility shuts its doors.

The hospital will shut down the Pediatric and Obstetrical Departments at Mission. No new patients will be admitted and about 100 workers will be transferred or terminated. Mission shut down its urgent care operations last year.

The Huntington Park hospitals provide healthcare services to thousands in one of L.A.’s most densely populated area. The closing of the Mission campus and the termination of employees will be a serious blow not only to the community, which will lose access to these vital services, but to devoted caregivers who will lose their jobs.

“We will do what we do best, put patients first,” said Lisette Perez, admitting representative. “But I’m worried about them. When will enough be enough with this employer?”

With the loss of many emergency rooms and hospitals in Los Angeles in the past few years, this area can ill afford more patient care cuts.

“Additional closures of services will simply devastate our community,” said Gilbert Zamora, ultrasound technician. “I am very concerned about the crisis that awaits our patients and the healthcare workers who work here.”

Healthcare workers, elected officials and community leaders will hold a press conference denouncing the closure of the campus.

   What:  Press Conference    Where:  In front of Mission Hospital of Huntington Park    3111 E Florence Ave, Huntington Park, Calif. 90255    When:  10 a.m., Thursday, March 6, 2008    Who:  Healthcare workers, elected officials, community leaders   

The 150,000-member SEIU United Healthcare Workers-West is the largest hospital and healthcare union in the western United States and represents every type of healthcare worker, including nurses, professional, technical and service classifications. Our mission is to achieve high-quality healthcare for all.

   Contact:  Tadzio Garcia    213-300-8974    [email protected]  

SEIU United Healthcare Workers-West

CONTACT: Tadzio Garcia of SEIU United Healthcare Workers-West,+1-213-300-8974, [email protected]

Web Site: http://www.seiu-uhw.org/

Some Branches on Animal Tree of Life Rearranged

A study led by Brown University biologist Casey Dunn uses new genomics tools to answer old questions about animal evolution. The study is the most comprehensive animal phylogenomic research project to date, involving 40 million base pairs of new DNA data taken from 29 animal species.

The study, which appears in Nature, settles some long-standing debates about the relationships between major groups of animals and offers up a few surprises.

The big shocker: Comb jellyfish ““ common and extremely fragile jellies with well-developed tissues ““ appear to have diverged from other animals even before the lowly sponge, which has no tissue to speak of. This finding calls into question the very root of the animal tree of life, which traditionally placed sponges at the base.

“This finding suggests either that comb jellies evolved their complexity independently from other animals, or that sponges have become greatly simplified through the course of evolution. If corroborated by other types of evidence, this would significantly change the way we think about the earliest multicellular animals,” said Dunn, assistant professor of ecology and evolutionary biology at Brown. “Coming up with these surprises, and trying to better understand the relationships between living things, made this project so fascinating.”

Charles Darwin introduced the idea of a “tree of life” in his seminal book Origin of Species. A sketch of the tree was the book’s only illustration. Nearly 150 years after its publication, many relationships between animal groups are still unclear. While enormous strides have been made in genomics, offering up a species’ entire genome for comparison, there are millions of animal species on the planet. There simply isn’t the time to sequence all these genomes.

To get a better grasp of the tree of life ““ without sequencing the entire genomes of scores of species ““ Dunn and his team collected data, called expressed sequence tags, from the active genes of 29 poorly understood animals that perch on far-flung branches of the tree of life, including comb jellies, centipedes and mollusks. The scientists analyzed this data in combination with existing genomic data from 48 other animals, such as humans and fruit flies, looking for the most common genes being activated, or expressed.

The aim of this new approach is to analyze a large number of genes from a large number of animals ““ an improvement over comparative genomics methods which allow for a limited analysis of genes or animals. The new process is not only more comprehensive, it is also more computationally intensive. Dunn’s project demanded the power of more than 120 processors housed in computer clusters located in laboratories around the globe.

Dunn and his team:

— unambiguously confirmed certain animal relationships, including the existence of a group that includes invertebrates that shed their skin, such as arthropods and nematodes;
— convincingly resolved conflicting evidence surrounding other relationships, such as the close relationship of millipedes and centipedes to spiders rather than insects;
— established new animal relationships, such as the close ties between nemerteans, or ribbon worms, and brachiopods, or two-shelled invertebrates.

“What is exciting is that this new information changes our basic understanding about the natural world ““ information found in basic biology books and natural history posters,” Dunn said. “While the picture of the tree of life is far from complete after this study, it is clearer. And these new results show that these new genomic approaches will be able to resolve at least some problems that have been previously intractable.”

On the Net:

Brown University

Back to Basics: Aspirin After Knee Surgery

Taking aspirin to prevent blood clots after knee surgery may be a safe and effective alternative to currently recommended treatments that are often costlier and riskier, according to preliminary results from a study presented today at the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The study found that patients taking aspirin had less risk of developing blood clots than patients taking other blood-thinning drugs. They also faced a similar risk compared to patients receiving injectable drugs.

“Given the modern, less invasive techniques that orthopaedic surgeons are using now for total knee replacement, aspirin should be reconsidered a viable alternative to recommended therapies,” said Kevin J. Bozic, MD, MBA. Dr. Bozic is lead author on the study and associate professor in residence at the University of California, San Francisco Department of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies. Currently, clinical practice guidelines for preventing blood clots (venous thromboembolism) after total knee replacement do not recommend aspirin use.

This study suggests otherwise. Dr. Bozic and his team compared data from more than 93,840 patients who underwent knee replacement surgeries at some 300 hospitals between October 2003 and September 2005. Researchers compared the risk of:

 --  blood clots --  mortality --  surgical-site bleeding --  infection in patients receiving aspirin versus guideline-approved     therapies      

The study found that aspirin patients had:

 --  fewer risk factors for blood clots prior to surgery --  lower odds for blood clots compared to patients on warfarin --  similar odds compared to patients receiving injectable therapies to     prevent clots --  no difference in bleeding risks or mortality      

“Not only have surgical techniques changed, but patients undergoing knee surgery today are more likely to be younger and healthier than when the current treatment guidelines were developed,” said Dr. Bozic. “Aspirin is a simple, inexpensive and commonly used drug with few side effects, so it’s a very attractive alternative.”

The study concludes that more research needs to be conducted to help physicians determine which patient characteristics and treatment factors are best suited for aspirin use to prevent blood clots in knee replacement patients.

Most patients who undergo total knee replacement are between the ages of 60 and 80, but orthopaedic surgeons evaluate patients on an individual basis. Recommendations for surgery are based on a patient’s pain and disability, not age. Total knee replacements have been performed successfully at all ages, from the teenager with juvenile arthritis to the elderly patient with degenerative arthritis. This study shows significance as more than 533,000 knee replacements were performed in 2005.

Disclosure: Dr. Bozic and his co-authors received research grants from the Orthopaedic Research and Education Foundation and California Healthcare Foundation, and the Patient Safety Research and Training Grant from the Agency for Healthcare Research and Quality.

Abstract 073

More information about joint replacement and blood clots

About AAOS

To view this release online, go to: http://www.pwrnewmedia.com/2008/aaos030508/index.html

 For more information, contact: Lauren Pearson C: (224) 374-8610 O: (847) 384-4031 Email Contact  Catherine Dolf C: (847) 894-9112 O: (847) 384-4034 Email Contact

SOURCE: AAOS

Global Warming Means Fewer Flowers in the Rockies

Spring in the Rockies begins when the snowpack melts. But with the advent of global climate change, the snow is gone sooner. Research conducted on the region’s wildflowers shows some plants are blooming less because of it.

David Inouye (University of Maryland) used data gathered in the Rockies from 1973 to the present to uncover the problem. Writing in the journal Ecology, he demonstrates that three flowers found in the Rockies are far more susceptible to late frost damage when the snow melts more quickly.

Inouye looked at three blossoms that are common to the famous mountain range. Larkspur (Delphinium barbeyi), holds its intense blue star-shaped, hooded blooms on thin-stemmed plants that can be anywhere from 3-6 feet tall. Aspen fleabane (Erigeron speciosus) is one of the most common asters to the region, and its small, purple daisy-like flowers have yellow centers. And aspen sunflowers (Helianthella quinquenervis) are well known for their startlingly bright yellow flowers which are often found in open, grassy areas.

Winter snow can be as deep as eight feet in the area where all three of these flowers grow, at 9,500 feet altitude, but the snow has been melting increasing early over the past decade because of a combination of lower snowfall and warmer springs. For the wildflower, earlier snowmelt results in an earlier growing season.

Once the snow is gone in the spring, the flowers begin to form buds and prepare to flower. But masses of cold air can still move through the region at night, causing frost as late as the month of June. The numbers indicate that frost events have increased in the past decade. From 1992 to 1998, on average 36.1 percent of the aspen sunflower buds were frosted. But for 1999-2000 the mean is 73.9 percent, and in only one year since 1998 have plants escaped all frost damage.

When those frost events occur, the long-lived plants do not die but are unable to produce flowers for that entire year. Without flowers, they cannot set seed and reproduce.

Inouye says the change happening here may be undetected by humans casually observing the area because these are all long-lived perennial plants. An individual sunflower, for instance, can live to be 50 or 75 years old.

“But we find that these perennials are not producing enough seeds to make the next generation of plants,” he says, and without new plants the transformations within plant and animal communities of this ecosystem could be quite intense.

Many insects such as the fruit flies known as tephritid flies, which eat the flowers’ seeds, seem to be plant specific, he points out, and so they may disappear, too if there are no flowers to produce seeds. Parasitoid wasps that feed on those flies will then feel the loss, as well. Grasshoppers also feast upon the flower petals. And, these plants are eaten by many kinds of large herbivores, including deer, elk, cows and sheep.

“What will replace these colorful flowers? We don’t know,” says Inouye. “But we know that many animals depend upon them, and so the outcome could be quite dramatic.”

Inouye and his colleagues say that there is much work to be done on the topic of phenology, which is the study of periodic plant and animal life cycle events. These events are heavily influenced by environmental changes, especially seasonal variations in temperature and precipitation driven by weather and climate. There is even an important role to be played by citizen scientists, who can gather information for the National Phenology Network’s new endeavor called Project Budburst.

“In the future, we anticipate climate change will affect plants and animals in many ways, but information is needed on how those changes will play out for specific plants,” says Inouye. Some, he says, may bloom sooner and others may not bloom at all. Some may become more prolific and others may die out completely. Citizen scientists who volunteer to help record phenological events can make an important contribution to such studies.

On the Net:

Ecological Society of America

Aging Baby Boomers Could Overwhelm U.S. Health Care System By 2017

NEW YORK, March 5 /PRNewswire/ — The approaching onslaught of over 70 million aging baby boomers could overwhelm the U.S. health care system and engulf the nation’s tenuous economy, according to a new study, “Will the Boom Bust Health Care?,” by management consulting firm Tefen USA.

A recent report from the Centers for Medicare and Medicaid Services (CMS) predicts that unless decisive action is taken, total U.S. health care spending will double to just over $4.3 trillion by 2017 – or nearly 20 percent of the nation’s gross domestic product. Tefen USA estimates that this figure could be considerably higher, based on its assessment of data that people over the age of 65 experience nearly three times as many hospital days per thousand as the general population, and that sixty-two percent of 50-64 year-olds report having at least one of six chronic health conditions: arthritis, high cholesterol, cancer, diabetes, heart disease and hypertension.

Declining Hospital Capacity

Compounding the problem, according to Tefen, is a sharp decline in hospital capacity. The number of community hospitals decreased from 5,384 to 4,915 between 1990 and 2000. During the same time period, the number of beds per 1,000 of population decreased from 4.2 to 3.0. This reduction in capacity, Tefen points out, has been accompanied by a sharp increase in hospital staffing. Between 1995 and 2000, full-time equivalent personnel increased from about 3,420,000 to about 3,911,400. At the same time, hospitals have spent almost $100 billion in facility and infrastructure improvements.

“There is an immense, growing disconnect within the U.S. health care sector,” said Barry Calogero, president, Tefen USA, and author of the study. “Capacity is shrinking, costs are skyrocketing, and the patient population is about to explode. Our nation must bring these disparate factors into alignment in order to preserve the foundation of U.S. health care while adapting to the economic, medical and political conditions of today and tomorrow.

Severe Consequences Projected

As baby boomer-induced health care costs grow, these severe consequences are likely to occur, according to the Tefen study:

   -- The problem of uninsured Americans will escalate, as employers seek to      reduce the burden of retiree health care coverage, trim their      contributions to health care premiums and, in some instances, eliminate      the health care benefit entirely.   -- Health care quality will suffer, with wide variation in treatments and      big differences in death rates and surgical complications.   -- Federal spending on Medicare and Medicaid will skyrocket, forcing      politicians to raise taxes or severely curtail a wide range of other      government programs.   -- State budgets will suffer under the crush of soaring Medicaid costs,      compromising support for education and other local initiatives.   -- The nation as a whole will have fewer and fewer dollars to spend on      education, environmental protection, scientific research and national      security.    

“Despite what many people think, the solution is not a single-payer system,” said Calogero. “While socialized medicine provides some advantages from an access standpoint, it does not address the underlying cost and quality issues that threaten the functional integrity of health care in the U.S. The real solution to America’s health care challenges requires three components: implementing tort reforms, mandating the use of best practices and driving systemic process improvement.” The Tefen study provides insights and details on each of these three solution elements.

Implement Tort Reforms

The study’s author suggests that the threat of lawsuits causes providers to hide problems and engage in unnecessary procedures to avoid potential negative occurrences. “If caregivers document mistakes, they are immediately exposed to litigation,” observes Calogero. “Consequently, obfuscation and secrecy become the standard practice when confronted with errors. Quality issues are concealed and knowledge is suppressed, leading to the high likelihood that mistakes will be replicated.”

The solution, according to Tefen, is a system of health courts similar in practice to the arbitration system utilized to address other complex issues requiring dispute resolution, such as workers’ compensation, tax and patent disputes and vaccine liability, where claims against institutions are adjudicated. Health courts would administer peer reviews and independent analysis of procedural errors – differentiating between human error and negligence – and determining damages proportionate to the mistakes.

Mandate the Use of Best Practices

The current system of medical reimbursement actually rewards providers for delivering more care – not necessarily better care, according to Tefen. “With fairly uniform medical pricing across the industry set by the government and private insurers, providers can optimize revenues only by increasing the number of procedures,” explains Calogero. “This perverse system creates immense variability in how care is delivered. It gives hospitals and doctors little incentive to consistently provide treatments that medical research has shown produce the best results.”

The solution, according to Tefen, is a mandated system that holds providers accountable for delivering health care using the best known practices and protocols. Such a system would reduce variability and administer compensation directly tied to improving practice patterns and medical outcomes.

Drive Systemic Process Improvement

When compared to other industries, health care is the single largest sub- optimized sector of the U.S. economy, states the author. Rampant opportunities exist to transform inefficient, serial processes into efficient, parallel ones that eliminate unnecessary activities in the care giving process. As an example, Calogero cites a study at a major academic medical center which found that only 25 percent of nurses’ time was spent actually providing care in a patient’s room. The rest was consumed with administrative chores.

The solution, according to Tefen, is to change inefficient paradigms. “By removing redundant duties, implementing new, time-efficient systems and eliminating supply management tasks, we have demonstrated the ability to more than double the time nurses spend with patients, with attendant improvements in quality of care.”

The entire Tefen study, “Will the Boom Bust Health Care?” is now available at http://www.tefen.com/.

About Tefen USA

Tefen USA is a subsidiary of Tefen, a global management consulting firm founded in 1982. The company focuses on driving performance excellence to achieve improvements in cost, quality, and service delivery. Tefen USA supports a variety of industries and has worked with many Fortune 500 organizations. Tefen partners with clients to build quantified cases for change, setting themselves apart by working with clients from strategy through implementation to achieve sustainable results.

Tefen USA

CONTACT: Yvonne Liu, Tefen USA, +1-646-652-8275, [email protected]; or TheaLinscott, CooperKatz & Company for Tefen USA, +1-212-455-8045,[email protected]

Web site: http://www.tefen.com/

Some Claim Obesity Epidemic is Exaggerated

Although a majority of public health experts would be quick to preach against the dangers of obesity, there are some who continue to voice their opinion that the so-called obesity epidemic is a miscalculated term.

“The obesity epidemic has absolutely been exaggerated,” said Dr. Vincent Marks, emeritus professor of clinical biochemistry at the University of Surrey.

Experts like Dr. Marks claim that they have yet to see conclusive evidence which could allow them to blame obesity for health risks such as heart disease or cancer.

Experts on the other side of the issue would be likely to label these notions as heresies.

Dr. James Hill, director of the Center for Human Nutrition at the University of Colorado, said that there is a strong correlation between obesity and diabetes which can lead to kidney and heart disease among other health problems.

“The evidence linking obesity to diabetes and cardiovascular disease is very strong,” Hill, said. “Type two diabetes rarely happens in people who aren’t obese.”

However, Eric Oliver, author of Fat Politics and a political science professor at the University of Chicago, said that there is “no good causal connection,” that links being fat to dangerous health problems.

The skeptical experts also have doubts about the projected rate of obesity such as the British government’s estimation that nearly half of Britain will be obese by 2050. They claim there’s simply not enough evidence to support such a claim.

To them, the issue is that too many people are considered fat.

The World Health Organization labels anyone with a body mass index above 25 as overweight, and anyone with a BMI above 30 is obese. Experts on both sides have criticized their grading scale for being too low.

“Being moderately plump is not a health disadvantage,” Marks said. “Some overweight people may not look svelte, but they may be perfectly healthy.”

Marks refers to studies such as one published by Katherine Flegal of the United States’ Centers for Disease Control and Prevention in which she noted that people who had extra weight tended to live longer than their skinnier counterparts.

In other related research, Flegal and colleagues found there to be almost no link between death rates and weight.

“I think some experts found it disturbing that we actually said that overweight people have a lower death risk,” Flegal said.

“The relationship between weight and disease and survival is very complex and we don’t have a good handle on why some of these things are related and others are not.”

Many obesity skeptics question the motives of researchers who campaign against obesity claiming that they are simply chasing the millions of dollars in the weight loss industry.

“There’s not a lot of money in trying to debunk obesity, but a huge amount in making sure it stays a big problem,” said Patrick Basham, a professor of health care policy at Johns Hopkins University.

On the Net:

University of Surrey

Johns Hopkins University

Aerospace Industry Faces Coming Worker Shortage

As the large baby boom generation retires over the next decade, the aerospace and defense industries will be particularly hard hit, and industry officials worry there are not enough qualified young Americans to take the place of these retiring Cold War scientists and engineers.

As of last year, nearly 60 percent of U.S. aerospace workers were 45 or older, according to an Associated Press report. The problem could carry national security implications, and significantly reduce the number of commercial product developments that begin with military technology.   

Although there are two-and-a-half times the number of engineering, math and computer science graduates as there were 40 years ago, there is also more competition for these graduates. Defense companies must now compete with leading technology companies such as Google, Microsoft and Verizon.

“It’s about choices,” said Rich Hartnett, director of global staffing at Boeing Co., in an Associated Press interview. “There are so many more options today with a proliferation in the kinds of degrees and career paths that people can follow.”

But despite the industry’s efforts to emphasize the appeal and growing importance of careers involved in national defense, Aerospace Industries Association Chief Executive Marion Blakey is concerned the U.S. could be facing a “wake-up call,” similar to the 1957 Soviet launch of Sputnik, the world’s first satellite. 

Blakey said China’s recent success in shooting down one of its own satellites last year, combined with the upcoming retirement of the U.S. space shuttle fleet, demonstrate that the U.S. can no longer afford to take its technological and military superiority for granted. 

Blakey formerly served as head of the Federal Aviation Administration.

In addition to fierce competition for a limited number of technical experts from all corners of corporate America, contractors working on classified government projects are further held back due to restrictions on hiring foreigners or off-shoring work to other countries.

“The ability to attract and retain individuals with technical skills is a lifeblood issue for us,” said Ian Ziskin, corporate vice president and chief human resources and administrative officer for Los Angeles-based Northrop Grumman Corp. Ziskin told AP that he estimates roughly half of Northrop Grumman’s 122,000 workers will be eligible to retire in the next five to 10 years.  Similar trends exist at Lockheed Martin Corp., of Bethesda, Md., which could lose up to half of its 140,000 workers to retirement over the next decade.

At Boeing, roughly 15 percent of the company’s engineers are 55 or older and currently eligible for retirement.

The Soviet Union’s launch of Sputnik in 1957 set off panic that the U.S. was falling behind in the space race. It quickly expanded the ranks of aerospace and defense workers as a wave of Americans began careers in the aerospace industry to help the U.S. regain military superiority. However, industry executives now worry there won’t be enough new defense sector workers to replace those employees as they retire.

U.S. universities awarded 196,797 undergraduate and graduate degrees in engineering, math and computer science in 2005, according to the Commission on Professionals in Science and Technology. That’s a significant increase from the 77,790 degrees awarded in 1966, however there is also a corresponding rise in competition for those graduates.

Defense companies today are competing with companies such as Google Inc., Microsoft and Verizon, along with Wal-Mart and the Navy, for computer science majors, said to Kimberly Ware, associate director for employer relations at Virginia Tech.  And they are competing with General Electric Co., Westinghouse Electric Corp. and top automakers for electrical and mechanical engineering graduates, she said.

Boeing must contend with telecom industry leaders such as Verizon Communications Inc. and Sprint Nextel Corp. as it grows its satellite business. It even competes with video game developers for 3D graphic designers and software programmers.

At the same time, since young people today have never known a time when the U.S. was not a leader in space exploration or the world’s sole superpower, the defense sector does not exert the same patriotic draw as it once did.
 
The defense and aerospace industries confront another challenge as well, in that unlike technology companies, defense companies generally have to hire American citizens since they need employees who can obtain security clearance.  This eliminates foreign graduates of American universities and foreign employees in the U.S. on H-1B visas.

“The talent is going to have to be homegrown,” said Blakey.

Defense contractors face similar limitations since they cannot outsource to countries with more technical workers, such as India or China.

In an effort to solve the problem, defense companies are initiating programs to reach out to American students as early as possible. For example, Lockheed Martin is sending employees into elementary schools to tutor students in math and science, as well as recruiting high school students to shadow Lockheed workers on the job.  Lockheed’s engineers provide coaching for robotics teams, conduct rocket propulsion experiments for students and participate in various mentoring programs.

At Northrop Grumman, a program has been established called Weightless Flights of Discovery that allows middle school teachers to experience temporary weightlessness on “zero-gravity” airplane flights that imitate astronaut training for space travel.

Defense contractors are also using other methods to attract new workers, such as flexible schedules, tuition reimbursement programs and plenty of opportunities for advancement. The most important aspect of the recruitment efforts is the defense industry’s appeal of offering “challenging work on programs of national importance,” said Linda Olin-Weiss, director of staffing services at Lockheed Martin.

The implications of falling behind extend beyond national security since military technology often has civilian uses, too.  For instance, GPS satellites and the Internet both originated from military or defense applications.

Industry officials hope the U.S. space program’s plan to return to the moon and implement a manned mission to Mars could lure a new generation of Americans into the aerospace and defense industry, said Blakey.

“The question is: how do you encourage young kids to think of themselves as potential scientists and engineers,” Blakey said. “We hope that a return to the moon and Mars will help inspire them.”

On the Net:

Aerospace Industries Association

Federal Aviation Administration