'Urgent action' needed on child TB

1 October 2013 Last updated at 11:00 ET

Child with scar on arm from BCG vaccination

Global health agencies have launched an action plan to reduce child deaths from tuberculosis (TB).

A report led by the World Health Organization says 74,000 lives could be saved each year through better diagnosis and treatment.

Funds of $120m (￡74m) a year could have a major impact on children's lives, including among those infected with both TB and HIV, say experts.

The action plan was unveiled in Washington on Tuesday.

Stakeholders include the WHO, Unicef, the Stop TB Partnership and a number of global TB agencies.

The Roadmap for Childhood TB: Toward Zero Deaths builds on the latest knowledge of the disease and highlights actions to prevent child deaths.

Each day almost 200 children under the age of 15 die from tuberculosis, while more than half a million fall ill every year, it says.

"Any child who dies from TB is one child too many," said Dr Mario Raviglione, Global Tuberculosis Programme director at WHO.

"TB is preventable and treatable, and this roadmap focuses on immediate actions governments and partners can take to stop children dying."

The report says there is an urgent need to focus on children. Diagnostic tests and child-friendly drug formulations are lacking, and there is a need for better screening and awareness, it says.

"To get to zero TB deaths, we must focus on the most vulnerable groups and children are the most vulnerable of all," said Dr Lucica Ditiu, executive secretary of the Stop TB Partnership.

"The steps outlined in this roadmap are simple and low-cost. We owe it to the children of the world to put this plan into action."

Contagious infection

Tuberculosis is a contagious infection that mainly affects the lungs, but may spread to other parts of the body.

If not treated, it can damage the lungs to such an extent that a person cannot breathe properly.

Sometimes, people do not experience any symptoms for many months or even years after being infected.

TB can be treated with antibiotics but is sometimes fatal.

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Clinician observations of preschoolers' behavior help to predict ADHD at school age

Oct. 1, 2013 — Don't rely on one source of information about your preschoolers' inattention or hyperactivity. Rather, consider how your child behaves at home as well as information from his or her teacher and a clinician. This advice comes from Sarah O'Neill, of The City College of New York, based on research she conducted at Queens College (CUNY), in an article published in Springer's Journal of Abnormal Child Psychology. The study examines how well parent, teacher, and clinician ratings of preschoolers' behavior are able to predict severity and diagnosis of attention deficit hyperactivity disorder (ADHD) at age six.

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, ADHD is one of the most frequently diagnosed childhood psychiatric disorders. Although many studies focusing on school-aged children have shown that parents and teachers -- rather than clinician observations alone -- are more likely to assess ADHD accurately, scant evidence exists to support similar conclusions with preschoolers.

To fill this gap in the research, O'Neill and colleagues followed a group of 104 hyperactive and/or inattentive three- and four-year-olds for a period of two years. Both parents and teachers rated the preschoolers' behavior. In addition, clinicians, who were blind to parent and teacher reports, completed ratings of preschoolers' behavior during a psychological testing session. By the time the children reached age six, more than half (53.8 percent) had been diagnosed with ADHD. The likelihood of such a diagnosis increased when all three informants had rated the child as high on symptoms at age three or four. Furthermore, after analyzing the reports separately, the research team found that parents' reports were critical, particularly when combined with either teacher or clinician reports.

Teacher reports alone were not as useful, and the research team ascribed the relative inability of educators' reports to predict a child's ADHD status over time to possible situational variables. Preschoolers may initially have difficulty adjusting to the structured classroom setting, but this disruptive behavior is time-limited to the transition to school. Teachers' perceptions of "difficult" behavior may also be affected by factors such as classroom setting and size as well as their expectations of children's behavior.

As a result of the study findings, O'Neill and her team emphasize the importance of using information from multiple informants who have seen the child in different settings. Parent reports of preschoolers' behavior appear to be crucial, but these alone are not sufficient. Augmenting the parent report with that of the teacher and/or clinician is necessary. Also important are clinician observations of preschoolers during psychological testing, which are predictive of an ADHD diagnosis and its severity over time. Being able to identify children at risk for poorer outcomes may help educators and clinicians to plan appropriate interventions.

"Consider a preschool child's behavior in different contexts," O'Neill emphasized. "Although parents' reports of preschoolers' inattention, hyperactivity, or impulsivity are very important, ideally we would not rely solely on them. At least for young children, the clinician's behavioral observations appear to hold prognostic utility."

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Obamacare launch hits early hitch as web traffic snarls up sites

By David Morgan and Caroline Humer

(Reuters) - The U.S. government launched the centerpiece of President Barack Obama's landmark healthcare reform on Tuesday, opening online insurance marketplaces across the country for millions of uninsured Americans, but technical glitches prevented early access for many.

The first day of the six-month open enrollment period on the state marketplaces, or exchanges, went ahead despite a partial federal government shutdown precipitated by Republican opposition to the healthcare law that deadlocked a spending bill in Congress.

According to early checks, the rollout of the most ambitious U.S. social program in five decades had a rocky start. A federally-run exchange for consumers in 36 states began posting error messages for at least 25 of them soon after the system opened for enrollment at 8 a.m. EDT, citing online traffic as a reason for the difficulties.

An Obama administration official said experts were aware of the issue and were working on it. The Department of Health and Human Services directed consumers to call centers and local community organizers to seek information.

The administration had predicted hitches early on because of the challenge of building a massive technology infrastructure in a short time. The problems could last weeks. Even before Tuesday's launch, officials last week announced delays for exchanges geared toward Spanish speakers and small businesses.

The snags are expected to contribute to a slow start to enrollment and will be a focus of the political debate over whether the 2010 Affordable Care Act, commonly known as Obamacare, will succeed.

Frustrated customers are likely to fuel opposition to the healthcare law from Republicans in the U.S. House of Representatives, who have voted more than 40 times to repeal or delay it.

"It's very significant for the political campaign but not for the enrollment campaign," said Jon Kingsdale, the former head of the Massachusetts state health exchange, which opened in 2006 and became the model for Obamacare.

"I don't know if it's two weeks or five weeks, but I don't think we're talking just days," Kingsdale said. He said if the problems persist until November, "that is really a big problem."

The exchanges, shopping places for people to find out whether they qualify for federal subsidies, will accept applications for the new plans until March 31. They are expected to sign up as many as 7 million people in their first year.

Republicans have fought for years to delay or stop Obamacare, blaming its requirements for pushing up the cost of health insurance for business and individuals. On Monday night, that battle triggered a shutdown of several federal government agencies after Republicans insisted that a routine funding measure include a delay in the law. The Democratic-controlled Senate rejected it.

"What I want is to keep the government running and at the same time to deal with the harms, the millions of Americans who are ... at risk of losing their healthcare, are facing skyrocketing insurance premiums," Texas Senator Ted Cruz, who has been leading the charge among Republicans in Congress to defund the law, said in an interview with CNN.

SUBSIDIZED INSURANCE

The websites will give many Americans their first glimpse of new subsidized health plans that are being offered to millions of the uninsured, in the most ambitious U.S. social program since Medicare was introduced in the 1960s.

Exchanges run by 14 states and the District of Columbia presented a mixed picture early on Tuesday. Some, like Massachusetts and New York, were able to accept consumer log-ins. New York said its site received 2 million hits in the first two hours.

The state-run exchange in Maryland delayed its opening by four hours and Minnesota said it would wait until the afternoon to check its connection with federal databases.

California and Washington state exchange officials said they were ready to open later in the morning as planned.

Obama was scheduled to promote his signature domestic policy achievement on Tuesday, including a meeting in the Oval Office with a group of Americans who stand to benefit from the program.

Vice President Joe Biden and first lady Michelle Obama will also promote the law in the media.

The marketplaces require health plans to provide a broad range of essential benefits that were not necessarily part of individual policies in the past, including mental health services, birth control and preventive care. The coverage is linked to other insurance market reforms and new consumer safeguards, including a ban on discrimination based on gender and health history.

The Affordable Care Act also mandates that Americans obtain insurance or pay a fine. Provisions that have taken effect since the law was passed three years ago have already prompted changes in the way insurance companies and hospitals do business, as they prepare for an influx of new insured members.

Shares in health insurers like UnitedHealth Group and Aetna Inc, as well as for hospital operator HCA Holdings Inc, outpaced rises on the broader U.S. stock market on Tuesday.

"For years, the financial, physical or mental health of millions of Americans suffered because they couldn't afford the care they or their family needed," Health and Human Services Secretary Kathleen Sebelius said in a statement on Tuesday. "But thanks to the health care law, all of that is changing. Today's launch begins a new day when health care coverage will be more accessible and affordable than ever before."

(Additional reporting by Lewis Krauskopf, Sharon Begley and Curits Skinner in New York; Editing by Michele Gershberg and Grant McCool)

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Insurance markets open to surge of new customers

CHICAGO (AP) — The online insurance marketplaces that are at the heart of President Barack Obama's health care overhaul struggled to handle the volume of new consumers Tuesday, the first day of a six-month open-enrollment period.

Federal officials said they were working to address the website problems as quickly as possible. People contacting the federal call center also reported long wait times.

"We have built a dynamic system and are prepared to make adjustments as needed and improve the consumer experience," Health and Human Services spokeswoman Joanne Peters said.

State-operated sites also experienced glitches. Rhode Island's site opened as scheduled, but was quickly overwhelmed by visitors and went down. Sites for Maryland and Minnesota were not expected to open until at least midday.

Exchange officials in Colorado said their website would not be fully functional for the first month, although consumers will be able to get help applying for government subsidies during that time.

In Portsmouth, N.H., Deborah Lielasus tried to sign up for coverage but got only as far as creating an account before the website stopped working. She said she expected glitches.

Lielasus, a 54-year-old self-employed grant writer, currently spends about $8,500 a year in premiums and more than $10,000 for out-of-pocket expenses because she has a health condition and her only option was a state high-risk insurance pool. She said she expects those costs to decrease significantly when she's able to sign up for insurance on the marketplace.

As excited as she was to sign up, she said, her anticipation was tempered by dismay over the government shutdown that was led by congressional Republicans who want to block the health insurance reforms.

"I'm really happy that this is happening, that this is being launched ... I feel like it's a child caught in the middle of a really bad divorce," Lielasus said.

Despite the first-day hitches, insurers and advocates pushed the message to consumers about the new health insurance options.

Employees of Independence Blue Cross converged on four of Philadelphia's main train transit hubs Tuesday to distribute information and answer questions about the new exchanges.

At Suburban Station downtown, the company gave out more than 7,000 calendars marked with important insurance-related dates — starting with Oct. 1, the first day consumers can buy policies.

Ralph Kellum took a calendar even though he's already covered through his employer, the local transit agency. He said he knew a lot of people who would be interested in getting insurance.

"A lot of people ... (who) have the pre-existing problems, couldn't get insurance, now they can," Kellum said. "Well, supposedly they can."

The nationwide rollout comes after months of buildup in which the marketplaces have been both praised and vilified.

The shutdown will have no immediate effect on the insurance marketplaces that are the backbone of the law, because they operate with money that isn't subject to the annual budget wrangling in Washington.

The marketplaces represent a turning point in the nation's approach to health care, the biggest expansion in coverage in nearly 50 years.

The Obama administration hopes to sign up 7 million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.

But if people become frustrated with the glitches in the computer-based enrollment process and turn away from the program, the prospects for Obama's signature domestic policy achievement could dim.

"The promise of the law is that no one will go bankrupt because of medical bills," said Neera Tanden, president of the Center for American Progress, which helped work for passage of the law. "It won't happen in the first day or the first year. But when the law is fully operational, it will provide an economic benefit to roughly 30 million Americans."

Tanden cautioned against rushing to judge the marketplace's success on its first-day performance. Numerous observers had predicted bugs and setbacks. Trained outreach workers in many states are having trouble getting the certification they need to start helping people to enroll.

Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15, which is the deadline for coverage to start Jan. 1. Customers have until the end of March to sign up in order to avoid tax penalties.

Looming as one of the biggest challenges to the law's success is the ability of insurers to persuade young and healthy people to buy insurance to balance the costs of covering the older and the sick.

"You've got to launch this thing right the first time," said Robert Laszewski, a consultant who worked 20 years in the insurance industry. "If you don't, financially you will never recover."

Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, ranging from mental health treatment to maternity services.

Another obstacle: Nearly three-fourths of people under 65 who lack insurance are unaware that the marketplaces open Tuesday, according to a Kaiser Family Foundation survey released over the weekend.

Spending money to raise that awareness with ad campaigns has varied vastly, with some Republican-led states doing little or nothing to promote the insurance exchanges. Missouri Lt. Gov. Peter Kinder, a Republican, even recently urged residents not to sign up for coverage.

In Florida, Republican Gov. Rick Scott and key lawmakers have pushed back against implementing parts of the law. The Florida Department of Health recently ordered county health departments to prohibit so-called navigators from signing people up for health insurance at those facilities.

But other states are doing more, such as Kentucky, the only Southern state running its own marketplace. Kentucky Gov. Steve Beshear, a Democrat, was an early supporter of the health law.

The state kicked off an $11 million advertising campaign in June, with ads on TV, radio, Internet and newspapers. It will expand Tuesday and continue through the first three months of next year.

"Frankly, we can't implement the Affordable Care Act fast enough," Beshear said.

___

Associated Press writers Kelli Kennedy in Miami; David Lieb in Jefferson City, Mo.; Kristen Wyatt in Denver; Kathy Matheson in Philadelphia; Erika Niedowski in Providence; Holly Ramer in Portsmouth, N.H.; and Roger Alford in Frankfort, Ky., contributed to this report.

___

AP Medical Writer Carla K. Johnson can be reached at http://www.twitter.com/CarlaKJohnson

___

Online:

https://www.healthcare.gov

Copyright c 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Global war on drugs failing - report

30 September 2013 Last updated at 19:45 ET

The average street price of cocaine in Europe fell by 51% between 1990 and 2010

Illegal drugs are now cheaper and purer globally than at any time over the last 20 years, a report has warned.

The International Centre for Science in Drug Policy said its report suggested the war on drugs had failed.

The report, published in the British Medical Journal Open, looked at data from seven international government-funded drug surveillance systems.

Its researchers said it was time to consider drug use a public health issue rather than a criminal justice issue.

The seven drug surveillance systems the study looked at had at least 10 years of information on the price and purity of cannabis, cocaine and opiates, including heroin.

The report said street prices of drugs had fallen in real terms between 1990 and 2010, while their purity and potency had increased.

In Europe, for example, the average price of opiates and cocaine, adjusted for inflation and purity, decreased by 74% and 51% respectively between 1990 and 2010, the Vancouver-based centre said.

The report also found there had been a substantial increase in most parts of the world in the amount of cocaine, heroin and cannabis seized by law enforcement agencies since 1990.

Most national drug control strategies have focused on law enforcement to curb supply despite calls to explore other approaches, such as decriminalisation and strict legal regulation, it said.

It concluded: "These findings suggest that expanding efforts at controlling the global illegal drug market through law enforcement are failing."

'More addiction treatment'

Co-author Dr Evan Wood, scientific chairman of the centre, said: "We should look to implement policies that place community health and safety at the forefront of our efforts, and consider drug use a public health issue rather than a criminal justice issue.

"With the recognition that efforts to reduce drug supply are unlikely to be successful, there is a clear need to scale up addiction treatment and other strategies that can effectively reduce drug-related harm."

The study comes two days after a senior UK police officer said class A drugs should be decriminalised.

On Sunday, Chief Constable Mike Barton, of Durham Police, said drug addicts should be "treated and cared for, not criminalised".

The chief constable, who is the intelligence lead for the Association of Chief Police Officers, told the Observer he believed decriminalisation would take away the income of dealers, destroy their power, and that a "controlled environment" would be a more successful way of tackling the issue.

He said prohibition had put billions of pounds into the hands of criminals and called for an open debate on the problems caused by drugs.

Mr Barton is among a small number of top police officers in the UK who have called for a major review of drugs policy.

The Home Office said drugs were illegal because they were dangerous.

It said the UK's approach on drugs was clear: "We must help individuals who are dependent by treatment, while ensuring law enforcement protects society by stopping the supply and tackling the organised crime that is associated with the drugs trade."

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Merck to slash annual costs by $2.5 billion, cut 8,500 jobs

By Ransdell Pierson

(Reuters) - Merck & Co, taking a cue from rival drugmakers that have slashed research spending to bolster earnings, on Tuesday said it plans to cut annual operating costs by $2.5 billion and eliminate 8,500 jobs.

Merck, whose shares rose 2.2 percent, said it aims to narrow its focus to products with the best chance of winning regulatory approval and achieving substantial sales.

It will jettison research products with less likelihood of success. It plans to pull the plug on some drugs already in late-stage trials, and will license some products to other companies.

The job cuts, representing more than 10 percent of the company's global workforce of 81,000 employees, would be in addition to previously announced cuts of 7,500 positions.

About 40 percent of the cost-cutting, or $1 billion, will be realized by the end of 2014 and will come equally from marketing and administrative areas and from research and development, Merck said. The rest of the cuts will be completed by the end of 2015, it said.

"We're not doing indiscriminate cuts in research and development, we're doing surgery around where we should invest," Merck Chief Executive Kenneth Frazier said in an interview.

Frazier said the company is now evaluating which drugs or disease areas to discard and which to keep, but few decisions have yet been made.

"And by attacking our cost bases, we will free up resources for mergers and acquisitions and business development," Frazier said, noting the company's strong interest in buying new drugs or licensing them from other drugmakers.

The company said it would take restructuring charges of $900 million to $1 billion this year, mostly in the third quarter.

Many Merck products have failed to win regulatory approval in recent years, and the company has suffered delays in getting products to market. Moreover, Wall Street is concerned about sharply slowing sales growth for the diabetes drug Januvia, Merck's biggest growth engine over the past three years. Rival drugs and newer classes of diabetes treatments have hurt Januvia sales.

Alex Arfaei, an analyst with BMO Capital Markets, said the cost-cutting will be helpful in the short term, especially next year, when he expects Merck revenues to be flat due to increased pressure on Januvia.

But he said he was concerned that Merck was putting too much faith in a handful of experimental drugs, including a new type of cancer drug called a PD-1 inhibitor that works by boosting the immune system, a new type of treatment for Alzheimer's disease called a BACE inhibitor, and improved versions of its Gardasil vaccine to prevent cervical cancer and its treatment for hepatitis C.

"Overall, today's announcement makes us more cautious about the potential of Merck's pipeline" of experimental drugs, Arfaei said.

Merck in April replaced its long-time research chief, Peter Kim, with Roger Perlmutter, a former Amgen Inc research head who is expected to better acquaint Merck with biotech drugs - injectable drugs made in living cells that have become standard treatments for a wide array of diseases, including cancer and rheumatoid arthritis.

Merck has focused mainly on development of conventional drugs, or pills, although it is a also leader in vaccines.

The company had several triumphs under Kim, including development of Januvia, its Gardasil vaccine to prevent cervical cancer, its Zostavax shingles vaccine, and its Isentress treatment for HIV.

But more recently, it has been hurt by failed trials of cholesterol treatment Tredaptive and migraine drug telcagepant, and a regulatory delay for a new type of osteoporosis medicine called odanacatib.

Perlmutter's work is cut out for him because new medicines are badly needed at Merck. Sales of the asthma drug Singulair - which reached $6 billion a year at one point - are plunging due to generic competition, and other Merck medicines will also face cheaper generics soon.

Moreover, cost savings from Merck's 2009 purchase of rival Schering Plough have mostly dried up and are no longer able to boost company earnings.

Merck said it still expects full-year 2013 earnings of $3.45 to $3.55 per share, excluding special items. It earned $3.82 per share last year.

Pfizer Inc became an industry trendsetter in aggressive cost-cutting in early 2011 when it announced plans to chop annual research spending by as much as $3 billion. It went on to close numerous research sites and has halted or curtailed spending for research on drugs for allergy, urology, internal medicine and other therapeutic areas requiring large sales forces.

Wall Street has cheered Pfizer's moves, especially since the company has launched many new medicines since the changes, including cancer drugs. Moreover, it has divested its animal health and infant formula businesses, and plans to return much of the proceeds to investors through share buybacks.

Merck dug in its heels after Pfizer's dramatic streamlining, saying it planned to hold steady with its research spending in order to advance its promising medicines through clinical trials.

The company on Tuesday also said it plans by 2015 to move its global headquarters from Whitehouse Station, New Jersey, to existing facilities in Kenilworth, New Jersey. It previously planned to move its headquarters to Summit, New Jersey.

Merck said it decided it could achieve more cost savings by closing its Summit site and its main Whitehouse Station facility.

Merck shares have risen 17.3 percent this year, in line with advances seen for the ARCA Pharmaceutical Index of large U.S. and European drugmakers.

(Reporting by Ransdell Pierson; Editing by John Wallace)

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'Obamacare' launches amid shutdown

1 October 2013 Last updated at 10:47 ET

The Obamacare website - HealthCare.gov - launched on 1 October

A central provision of President Barack Obama's healthcare reform law has taken effect, having survived Republicans' years-long effort to undermine it.

Markets run by federal and state governments opened for the millions of Americans seeking insurance plans.

As many as seven million Americans who do not already have health insurance are eligible to purchase coverage in the coming months.

Republican opposition to the law led to the government shutdown on Tuesday.

While Mr Obama and his supporters in the Democratic Party portray the law as a historic effort to extend healthcare coverage to the millions of Americans who lack it, the law's opponents say it amounts to an unprecedented intrusion into Americans' private lives.

The opening of the private health insurance marketplaces, or exchanges, was the culmination of more than three years of political combat in Washington over the Patient Protection and Affordable Care Act, signed into law by President Barack Obama in 2010 and known to both sides as Obamacare.

'Shutdown triggered'

Republicans in Washington and in state capitals across the country have vehemently fought the law since its passage, with the US House of Representatives taking dozens of symbolic votes to repeal it or eliminate its funding.

A legal challenge led by Republican opponents of the law ended when the Supreme Court in June 2012 validated the law's keystone provision - a requirement that Americans not receiving health coverage from their employers or the government purchase individual plans or pay a fine.

That requirement, known as the individual mandate, takes effect in January.

The healthcare law was also a central issue in the 2012 presidential election. Republican candidate Mitt Romney vowed to press for its repeal. Mr Obama handily won re-election.

On Tuesday, the US government shut non-essential services, keeping more than 700,000 workers at home, when the Democrats who control the Senate refused to agree to Republican demands to repeal the health law or delay the individual mandate.

Both Mr Obama and congressional Democrats have said they will not negotiate on Obamacare, with Mr Obama on Monday evening accusing the Republicans of attempting to refight the last election.

In spite of the political turmoil in Washington, on Tuesday Americans were able to enrol in insurance plans offered by private companies and ranging in price and level of coverage through exchanges in every state.

Even supporters of the law anticipated that technical glitches and consumer confusion would slow adoption.

Sixteen states and Washington DC have opted to operate their own exchanges, while the exchanges in 34 states will be fully or partially run by the federal government.

'Major concession'

Exchanges will also inform customers of tax subsidies available to ease the cost of the insurance. An estimated six million US citizens are expected to qualify.

Customers enrolling under Obamacare will not be covered by the insurance until 1 January however.

That corresponds with the start of the individual mandate, as well as consumer protections including a rule barring insurers from denying coverage to people with pre-existing health conditions.

Several Obamacare provisions had taken effect prior to Tuesday, including prescription drug discounts for pensioners, a rule allowing children to remain on their parents' insurance plans up to age 26, a rule barring insurers from denying coverage to children with pre-existing health conditions, and a ban on lifetime limits on health coverage.

Another major provision known as the employer mandate - which requires employers with at least 50 full-time workers to provide insurance or incur a $2,000 (￡1,320) per employee penalty - has been delayed until 2015.

That delay, announced by the Obama administration in July, has been seen as a concession to retailers and other businesses - and an acknowledgement that the health law was not fully ready for implementation.

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Despite growth reports, Africa mired in poverty

Oct. 1, 2013 — Despite continued reports of economic growth in Africa, much of the continent remains wracked by poverty, with roughly one in five citizens saying they frequently lack food, clean water and medical care, according to the largest survey of African citizens.

This suggests the growth is not trickling down to the poorest citizens or that actual growth rates are inflated, said Carolyn Logan, assistant professor of political science at Michigan State University and deputy director of the survey, called the Afrobarometer.

"The survey results show there is a disconnect between reported growth and the persistence -- in both frequency and severity -- of poverty among ordinary citizens," Logan said. "It's evident that African governments need to focus as much attention on poverty reduction efforts as they are on growing their economies."

The fifth round of the Afrobarometer, which comes out every several years, was released today in Johannesburg. Thirty-four countries were surveyed -- up from 20 countries during the last round of surveys in 2008-9 -- making it the most comprehensive look at life in Africa since the Afrobarometer was started in 1999.

The release of today's findings on poverty and economic conditions is the first of seven release events in African cities up through Dec. 12. Future topics include democracy, corruption and Internet usage.

According to the current findings, 17 percent of Africans say they frequently go without food, 22 percent lack clean water on a regular basis, and 20 percent often go without medical care. About 50 percent do without these necessities at least occasionally. The problem is particularly striking in West Africa and East Africa, and less so in the northern and southern regions of the continent.

In addition, 53 percent of Africans rated their national economy negatively. And 38 percent said their national economy has gotten worse in the past year.

Moreover, Africans give their governments failing marks for economic management. Fifty-six percent say they are doing a bad job of managing the economy and even higher numbers rate them poorly for improving the living standards of the poor (69 percent), creating jobs (71 percent) and narrowing income gaps (76 percent).

The findings come despite the fact that Africa's gross domestic product grew by an average of 4.8 percent between 2002 and 2011, making Africa a new darling of portfolio investors and prompting The Economist magazine to tag Africa as "The Hopeful Continent."

The Afrobarometer is an independent, nonpartisan research project co-founded by Michael Bratton, University Distinguished Professor at MSU. Bratton currently serves as senior adviser on the project.

Core partners of the survey include the Center for Democratic Development in Ghana; the Institute for Justice and Reconciliation in South Africa; the Institute for Empirical Research in Political Economy in the Republic of Benin; and the Institute for Development Studies at the University of Nairobi in Kenya.

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Cancer biggest killer of Hispanic Texans

Sep. 30, 2013 — More Hispanic Texans die from cancer than any other cause, according to a new report by the Comparative Effectiveness Research on Cancer in Texas research group.

The report documents cancer as the leading cause of death among Hispanic Texans under the age of 76. Only three percent of Hispanic Texans are older than 75.

Texas's Hispanic population has more than doubled since 1990. Texans of Hispanic ethnicity now comprise 38 percent of the state's population.

The findings are published in a September 2013 special issue of the Texas Public Health Journal, available online at http://txcercit.org/.

Based on data from the Texas Cancer Registry, Medicare claims records and state vital statistics, researchers compared rates and trends for cancer in Hispanics to those for non-Hispanic whites in Texas. Key findings include:

• Hispanic Texans are less likely to be screened for breast or colon cancer.
• Hispanics have lower rates of new cancer diagnoses for breast, colon and lung cancer.
• Of the cancers diagnosed in Hispanics, fewer were in the earliest, most treatable stages -- those typically detected through screening. Breast cancer at the most advanced stage was diagnosed at a 12 percent higher rate.
• Cancers more common among Hispanics were stomach and liver cancer in men and stomach, liver and cervical cancer in women. Such cancers can arise from untreated infections.
• Overall mortality from all cancer was lower among Hispanics with the exception of stomach and liver cancer.
• Survival after a diagnosis of cancer is superior for Hispanics compared to non-Hispanic whites.

These findings were based on 10 years of data about the diagnoses of new cancer cases and 21 years of data about cancer deaths.

The CERCIT researchers noted one puzzling contradiction. Even though cancers tend to be more advanced when diagnosed in Hispanics, death rates were lower than in the white population. This phenomenon, known as the Hispanic Paradox, has been noted before by other researchers looking at disease and survival rates across the spectrum. Hispanic Americans tend to survive illness and live longer than white Americans with the same diseases even though the Hispanics have less education, income and access to health care.

Foreign-born Hispanics had lower mortality rates than those born in the United States, according to analyses of regional differences within the state.

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Mid-life stress 'precedes dementia'

30 September 2013 Last updated at 20:02 ET

The study only looked at women, not men

Mid-life stress may increase a woman's risk of developing dementia, according to researchers.

In a study of 800 Swedish women, those who had to cope with events such as divorce or bereavement were more likely to get Alzheimer's decades later.

The more stressful events there were, the higher the dementia risk became, BMJ Open reports.

The study authors say stress hormones may be to blame, triggering harmful alterations in the brain.

Stress hormones can cause a number of changes in the body and affect things such as blood pressure and blood sugar control.

And they can remain at high levels many years after experiencing a traumatic event, Dr Lena Johansson and colleagues explain.

But they say more work is needed to confirm their findings and ascertain whether the same stress and dementia link might also occur in men.

Stress link

In the study, the women underwent a battery of tests and examinations when they were in either their late 30s, mid-40s or 50s, and then again at regular intervals over the next four decades.

At the start of the study, one in four women said they had experienced at least one stressful event, such as widowhood or unemployment.

A similar proportion had experienced at least two stressful events, while one in five had experienced at least three. The remaining women had either experienced more than this or none.

During follow-up, 425 of the women died and 153 developed dementia.

When the researchers looked back at the women's history of mid-life stress, they found the link between stress and dementia risk.

Dr Johansson says future studies should look at whether stress management and behavioural therapy might help offset dementia.

Dr Simon Ridley, of Alzheimer's Research UK, said that from this study, it was hard to know whether stress contributed directly to the development of dementia, whether it was purely an indicator of another underlying risk factor in this population of women, or whether the link was due to an entirely different factor.

"We know that the risk factors for dementia are complex and our age, genetics and environment may all play a role. Current evidence suggests the best ways to reduce the risk of dementia are to eat a balanced diet, take regular exercise, not smoke, and keep blood pressure and cholesterol in check.

"If you are feeling stressed or concerned about your health in general, we would recommend you talk this through with your GP."

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First-ever targeted roadmap outlines steps to end childhood TB deaths

1 October 2013 | Washington - The deaths of more than 74 000 children from tuberculosis (TB) could be prevented each year through measures outlined in the first ever action plan developed specifically on TB and children.

The "Roadmap for childhood TB: towards zero deaths", launched today by global TB leaders ¹ in Washington D.C., estimates that US$ 120 million per year could have a major impact on saving tens of thousands of children’s lives from TB, including among children infected with both TB and HIV.

Every day, more than 200 children under the age of 15 die needlessly from TB – a disease that is preventable and curable. WHO estimates that as many as 1 in 10 TB cases globally (6 to 10% of all TB cases) are among this age group, but that the number could be even higher because many children are simply undiagnosed. The new roadmap builds on the latest knowledge of the disease and identifies clear actions to prevent these child deaths.

“Any child who dies from TB is one child too many,” says Dr Mario Raviglione, Director, Global Tuberculosis Programme at WHO. “TB is preventable and treatable, and this roadmap focuses on immediate actions governments and partners can take to stop children dying.”

The launch of the first roadmap on TB and children follows increasing awareness on the urgent need to address the issue. Under the child survival movement’s banner of A Promise Renewed, more than 175 countries signed a pledge in June 2012, vowing to redouble efforts to stop children from dying of preventable diseases, including tuberculosis.

A small price tag to halt a global disease

The US$ 120 million a year in new funding for addressing TB in children from governments and donors includes US$ 40 million for HIV antiretroviral therapy and preventive therapy (to prevent active TB disease) for children co-infected with TB and HIV.

The funds will also go towards improving detection, developing better medicines for children and integrating TB treatment into existing maternal and child health programmes. Getting more paediatric health professionals to actively screen for TB with better tools, i.e. drugs, diagnostics and vaccines, will help capture the full scope of the epidemic and reach more children with life-saving treatment sooner.

“Far too many children with tuberculosis are not getting the treatment they need,” says Nicholas Alipui, Director of Programmes for UNICEF. “Most of these children live in the poorest, most vulnerable households. It is wrong that any children should die for want of a simple, affordable cure, especially where there are community-based options to deliver life-saving interventions.”

Ten actions to save young lives

The "Roadmap for childhood TB: towards zero deaths" recommends ten actions at national and global levels:

• include the needs of children and adolescents in research, policy development and clinical practices;
• collect and report better data, including preventive measures;
• develop training and reference materials on childhood TB for health workers;
• foster local expertise and leadership among child health workers at all levels of health systems;
• use critical intervention strategies, such as intensive case finding, contact tracing and preventive therapy; implement policies enabling early diagnosis; and ensure there is an uninterrupted supply of high-quality anti-TB medicines for children;
• engage key stakeholders and establish effective communication and collaboration between the health sector and other sectors that address the social determinants of health and access to care;
• develop integrated family- and community-centred strategies to provide comprehensive and effective services at the community level;
• address research gaps in the following areas: epidemiology, fundamental research, the development of new tools (such as diagnostics, medicines and vaccines); and address gaps in operational research and research looking at health systems and services;
• close all funding gaps for childhood TB;
• form coalitions and partnerships to study and evaluate the best strategies for preventing and managing childhood TB, and for improving tools used for diagnosis and treatment.

“If a small child can summon the bravery to complete a six-month TB treatment, the global community must be similarly brave in its ambitions to defeat the epidemic,” says Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership. “To get to zero TB deaths, we must focus on the most vulnerable groups and children are the most vulnerable of all. The steps outlined in this roadmap are simple and low-cost. We owe it to the children of the world to put this plan into action.”

Bringing childhood TB into the mainstream

As more attention has focused on the need to address child TB, experts have sought to broaden the net and involve organizations and agencies beyond the national TB programmes that have contact with children. As much as possible, the roadmap recommends that TB services for children be mainstreamed into existing children’s health services, and more responsibility and accountability be given to primary care providers.

“By scaling up existing tools and investing in improved approaches for the future, we can turn the tide on this hidden epidemic. But we must put these tools in the hands of front-line health care workers and use every opportunity to identify children at risk for TB,” says Dr Tom Kenyon, Director of the Center for Global Health at the U.S. Centers for Disease Control and Prevention. “We must ensure systems are in place to serve children through existing health, community, and child-centred services.”

Moving to this type of family-centred or community-centred approach, however, will require effective collaboration and joint planning among TB control programmes, maternal and child health services, and HIV services.

“If we can shift TB diagnosis and treatment out of specialised programmes and into other existing maternal and child health activities, we automatically gain reach and scale,” says Jose Luis Castro, Interim Executive Director of the International Union Against Tuberculosis and Lung Disease. “Combining that scale with investment in tools and medicine would save tens of thousands of lives.”

“By integrating critical child TB interventions into community health services, we will contribute to the global goal of ending preventable child deaths,” says Katie Taylor, Deputy Assistant Administrator, Bureau for Global Health, USAID. “The next step will require investment and engagement at all levels, including families, frontline health workers, and community leaders. The Roadmap equips all involved with the tools needed to fight childhood TB. As a result, children will receive the quality and comprehensive care they deserve close to home.”

"Current diagnostics, toxic drugs and inadequate drug formulations are insufficient to respond to the needs of children with TB,” says Colleen Daniels, Director TB/HIV at Treatment Action Group (TAG). “New tools will be a crucial part of addressing TB in children and current investments are minimal at best. Much more investment and commitment to childhood TB is urgently needed now".

---

¹ World Health Organization (WHO), Stop TB Partnership, the International Union Against Tuberculosis and Lung Disease (The Union), UNICEF, U.S. Centers for Disease Control and Prevention (CDC), United States Agency for International Development (USAID) and Treatment Action Group (TAG).

About the Global TB Programme, WHO

The Global TB Programme at WHO guides global action for a world free of TB by advancing universal access to TB prevention, care and control; framing the response to threats through norms, standards and strategy; technically supporting Member States; monitoring the burden and response; and promoting innovation. WHO is the directing and coordinating authority for health within the United Nations system.

About the Stop TB Partnership

The Stop TB Partnership is leading the way to a world without tuberculosis, a disease that is curable but still kills three people every minute. Its partners are a collective force that is transforming the fight against TB in more than 100 countries. They include international and technical organizations, government programmes, research and funding agencies, foundations, NGOs, civil society and community groups and the private sector.

About the International Union Against Tuberculosis and Lung Disease

The mission of the International Union Against Tuberculosis and Lung Disease (The Union) is to bring innovation, expertise, solutions and support to address health challenges in low- and middle-income populations. With nearly 15 000 members and subscribers from 150 countries, The Union has its headquarters in Paris and offices in the Africa, Asia Pacific, Europe, Latin America, North America and South-East Asia regions. Its scientific departments focus on tuberculosis and HIV, lung health and non-communications diseases, tobacco control and research.

About UNICEF and A Promise Renewed

UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is hosting the secretariat of A Promise Renewed, a global movement that seeks through action and advocacy to accelerate reductions in preventable maternal, newborn and child deaths. The movement emerged from the Child Survival Call to Action, a high-level forum convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF, to examine ways to spur progress on child survival and advance the goals of Every Woman Every Child, a strategy launched by United Nations Secretary-General Ban Ki-moon to mobilize and intensify global action to improve the health of women and children everywhere. Over 175 governments have signed a pledge vowing to redouble efforts to stop women and children from dying of preventable causes. Hundreds of civil society organizations, including Save the Children, have signed their own pledges of support for this global effort.

About U.S. Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

About the United States Agency for International Development

The American people, through the US Agency for International Development (USAID), have provided economic and social development, as well as humanitarian assistance, worldwide for more than 50 years. USAID’s programs in global health represent the commitment and determination of the US government to partner with countries to prevent suffering, save lives, and create a brighter future for families throughout the world. USAID’s Bureau for Global Health is contributing to President Obama’s goal of eliminating extreme poverty by working to end preventable child deaths and realize an AIDS-free generation.

About the Treatment Action Group

Treatment Action Group (TAG) is an independent AIDS research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS. TAG works to ensure that all people with HIV receive lifesaving treatment, care, and information. We are science-based treatment activists working to expand and accelerate vital research and effective community engagement with research and policy institutions. TAG catalyzes open collective action by all affected communities, scientists, and policy makers to end AIDS.

For more information please contact:

Glenn Thomas
Communications Officer
WHO
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

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Scientists who share data publicly receive more citations

Oct. 1, 2013 — A new study finds that papers with data shared in public gene expression archives received increased numbers of citations for at least five years. The large size of the study allowed the researchers to exclude confounding factors that have plagued prior studies of the effect and to spot a trend of increasing dataset reuse over time. The findings will be important in persuading scientists that they can benefit directly from publicly sharing their data.

The study, which adds to growing evidence for an open data citation benefit across different scientific fields, is entitled "Data reuse and the open citation advantage." It was conducted by Dr. Heather Piwowar of Duke University and Dr. Todd Vision of the University of North Carolina at Chapel Hill, and published today in PeerJ, a peer reviewed open access journal in which all articles are freely available to everyone.

The study examined citations to over ten thousand articles that generated new gene expression data, a quarter of which had data publicly archived in the GEO and ArrayExpress repositories. Papers with publicly available data received about 9% more citations overall, with the difference increasing over time. The researchers concluded that much of this citation difference was due to actual data reuse.

"Professional advancement in science is still highly dependent on how well your paper gets cited, even in a field like genomics where the data underlying that paper may have far more scientific impact over the long term." said Dr. Vision, a biologist affiliated with the National Evolutionary Synthesis Center and the Dryad Digital Repository. "Until the happy day when hiring and promotion committees catch up with how to value data sharing for its own sake, it is comforting to know that scientists can still receive credit for data sharing in a currency that counts."

The researchers also mined the full text of articles for references to dataset identifiers in order to study trends in data reuse directly. They took the unusual step of discussing the obstacles they encountered in the paper. Dr. Piwowar, at the time of the study a postdoc with the DataONE project, said "We need more open and cohesive infrastructure to support collecting evidence about the process and products of science. This evidence is needed to inform important policy decisions. For example, data archiving requirements, infrastructure, and education should be informed by evidence about how data is and is not reused."

The mined references revealed that scientists generally stopped publishing papers using their own datasets within two years, while other scientists continued to reuse their data for at least six years. It also showed that data reuse is on the rise. "Not only were the number of reuse papers higher," says Dr. Piwowar, "but analyses from 2002 to 2004 were reusing only one or two datasets, while a quarter of the studies by 2010 were using three or more."

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TSX gains as investors shrug off U.S. shutdown

TORONTO (Reuters) - Canada's main stock index was marginally higher on Tuesday as the market largely shrugged off a partial shutdown of the U.S. government, though many of the index's biggest mining stocks fell.

Investors are getting wise to Washington politics and do not expect the shutdown, which could put up to 1 million workers on unpaid leave, to last too long, said Keith Richards, portfolio manager and technical analyst at ValueTrend Wealth Management in Barrie, Ontario.

If the shutdown were prolonged, it might encourage the U.S. Federal Reserve to maintain its stimulus program for a longer period, which would also boost stocks, he said.

"If there is a longer shutdown it would slow the economy and therefore reduce the (Fed) taper talk that's been the prevalent fear out there," Richards said, adding that a looming fight over raising Washington's borrowing authority was much more dangerous. "We still have the debt ceiling nonsense coming up. That's a bigger issue than a government shutdown."

The Toronto Stock Exchange's S&P/TSX composite index <.GSPTSE> was up 36.20 points, or 0.28 percent, at 12,824.59 at midmorning. It had opened in the red after hitting a two-week low on Monday.

"I'm personally not getting too excited over any little rally we get today. It's too early to get too bullish on this market," Richards said.

Valeant Pharmaceuticals International Inc had the single biggest positive impact on the index, up 3.1 percent at

C$110.70.

The index's heavyweight energy sector was up despite a drop in oil prices. In the group, Suncor Energy added 1.2 percent to C$37.28. The financial sector was also higher, with Royal Bank of Canada up 0.6 percent at C$66.41.

Mining companies were the main drag, with Barrick Gold down 3 percent at C$18.60, and Goldcorp Inc off 2.4 percent at C$26.17. The price of gold fell below $1,300 per ounce to its lowest since early August on Tuesday as some investors saw the U.S. standoff as likely temporary and drove safe-haven bullion lower.

($1=$1.03 Canadian)

(Reporting by Alastair Sharp; Editing by James Dalgleish and Peter Galloway)

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Sweden is 'best place to be old'

1 October 2013 Last updated at 06:42 ET

The report said Sweden was the best country at supporting and helping its elderly population

Sweden is the best place in the world to be old and Afghanistan the worst, according to a UN-backed global study.

The Global AgeWatch Index examined the quality of life of the elderly in 91 countries.

It warns that many countries do not have adequate support in place for their ageing populations.

By 2050, older people will outnumber children under 15 for the first time, with most of the elderly in developing countries, it said.

The Global AgeWatch Index was complied by the UN Population Fund and advocacy group HelpAge International, and released to mark the UN's Day of Older Persons.

Researchers used 13 different indicators - including income and employment, health provision, education, and environment - in what they said was the first study of kind to be conducted on a global scale.

Obstacles to well-being

The study's authors say countries across the world face an ongoing challenge from the rapidly ageing global population.

"The continual exclusion of ageing from national and global agendas is one of the biggest obstacles to meeting the needs of the world's ageing population," says Silvia Stefanoni, the interim chief executive of HelpAge International.

"By giving us a better understanding of the quality of life of women and men as they age, this new index can help us focus our attention on where things are going well and where we have to make improvements."

While Sweden came top, and Afghanistan was placed last, the top 20 was dominated by countries from Western Europe and North America, along with Japan, Australia and Chile.

But some large fast-developing countries fared worse than others, with Russia (78), India (73) and Turkey (70) receiving a low rank, while Brazil (31) and China (35) were considered more favourably by the researchers.

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The Pill's link to depression still unclear

By Anne Harding

NEW YORK (Reuters Health) - Young women using hormone-based contraceptives, including the Pill, were no more likely to be depressed than other women in a new U.S. study.

In fact, the women in their 20s and 30s on hormonal contraceptives had fewer symptoms of depression than their peers using other types of contraception or no contraception at all, researchers found.

"This counters somewhat some of the prevailing wisdom that hormone contraceptive use in general is associated with adverse mental health outcomes in women," lead author of the study Dr. Katherine Keyes of the Mailman School of Public Health at Columbia University in New York told Reuters Health.

"When you look at it on a national scale, certainly there's no evidence that at a population level hormonal contraceptive use is associated with an increased risk of mood problems," Keyes added.

Still, Keyes and her colleagues caution, it's also true that depressed women are less likely to use hormone-based contraceptives.

Scientists have suspected that estrogen and progesterone levels play a role in mood disturbances, but studies looking at the effects of hormonal contraception on mood have had mixed results, Keyes and her team note in their report, published .in the American Journal of Epidemiology.

To investigate, they looked at data on 6,654 sexually active women between 25 and 34 years old who participated in four surveys between1994 and 2008.

Contraceptive methods used by women in the group included hormone-based pills, patches, vaginal rings or implants. Non-hormonal methods included IUDs and barriers like diaphragms and condoms.

The women who used hormonal contraceptives were younger, less likely to have children, less likely to smoke, and more likely to have graduated from college, to engage in individual sports like running and in healthy behaviors like getting regular dental and medical checkups.

After adjusting for those differences, the researchers found that women using hormonal contraceptives were less likely to report symptoms of depression in the week preceding the survey.

They were also 32 percent less likely than the other women to have high levels of depressive symptoms and 63 percent less likely to report having attempted suicide in the past year.

Hormonal contraception could improve women's mood by helping to even out menstrual cycle mood swings, Keyes told Reuters Health. "We're definitely following this up and hoping to get at the mechanism," she said.

About 30 percent of women do experience emotional and sexual side effects while using hormonal contraception, Dr. Ellen Wiebe, the medical director of the Willow Women's Clinic in Vancouver, British Columbia, told Reuters Health.

A major problem with the new study, said Wiebe, who wrote an accompanying commentary, is that the hormonal contraceptive users really are a different group from non-users. The "non-users" group also likely includes many women who quit taking hormonal contraception due to mood and sexual side effects.

In their paper, Keyes and her team point out that women with a history of depression are less likely to start taking hormonal contraception, and less likely to stay on it, which could help explain why the risk of depressive symptoms was lower in women who were taking hormonal birth control.

Wiebe also questioned the way depressive symptoms and sexual problems were identified. "A screen for clinical depression does not capture the actual problems that we see with the mood side effects with hormonal contraception, and the same thing with the sexual side effects," she said.

Sexual side effects include having fewer sexual thoughts and lower arousability, Wiebe said, while mood problems typically include irritability.

Given how widely hormonal contraceptives are used in the U.S. and worldwide, "systematic investigation" of the role of outside hormones in mood is warranted, Keyes and her team write. So is study of how mood issues predict who will stick with prescribed hormonal contraception, they conclude.

Decisions on what type of contraception to use and how birth control choices might affect mental health are critical issues for young women, yet there has been very little research into "this intersection of family planning and psychiatric disorders," Keyes said.

SOURCE: http://bit.ly/1dMBOHk American Journal of Epidemiology, online September 15, 2013.

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New weapon for Penn Medicine thyroid cancer two survey results reveal.

Over the years faced to bleak prospects and a viable treatment options no patients with advanced thyroid cancer. But now the recent discovery of thyroid tumor in buildings, genetics, cell signaling pathways are using kinase inhibitors for r & d and exciting new weapons, disease that targets tumor cell division and blood vessels. University of Pennsylvania (Abramson Cancer Center to house) led by a researcher from Perelman, two recent clinical trials shows great promise of these new approaches. Work is displayed at the Amsterdam European Cancer Conference.

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AstraZeneca CEO gets two cheers after first year in job

By Ben Hirschler

LONDON (Reuters) - Fixing ailing drugmaker AstraZeneca remains a work in progress for Chief Executive Pascal Soriot, with sales and profits still heading firmly downhill after his first year in the job.

Yet confidence is slowly building that he may have the right long-term prescription for the British group, helped by some lessons learnt at his past employer Roche.

Soriot has shunned a big acquisition as a way to plug the deep revenue gap left by multiple patent expiries, opting instead for a string of smaller deals, a reboot of the drug pipeline and a shake-out of top management.

His goal of "achieving scientific leadership" may fall short on the kind of hard financial targets that some investors would like, but it has resonated with many younger researchers who felt the group was drifting, following past R&D setbacks. It has already accelerated work on several promising cancer drugs.

"When I talk to people in the industry about AstraZeneca, it is a place where people now want to go and work - and that hasn't been true for about 10 or 15 years," said Dan Mahony, a fund manager at Polar Capital, who has raised his stake in the company in the past year.

Reversing AstraZeneca's poor record in drug research is Soriot's top priority, so staff morale matters. Rival executives say he is borrowing some ideas from Switzerland's Roche.

Roche - particularly its Genentech biotech unit, which Soriot used to head - is renowned for its R&D successes, something Soriot hopes to replicate with a $500 million move of AstraZeneca operations to Cambridge, a British science hub.

"I see him implementing some of the same strategies that have been adopted by Roche, in terms of focusing on highly innovative products and taking risks," said one senior Roche insider.

"You have to have patience when your company is going through these kinds of adjustments."

Soriot told Reuters in June that turning around the company would take three to four years.

Industry analysts predict sales and earnings will continue to fall to 2017 or beyond, since a big hit is still to come when top-selling cholesterol fighter Crestor loses patent cover in 2016.

AstraZeneca's problems are not unique, but its patent expiries are bigger and longer-lasting than at rivals such as British peer GlaxoSmithKline. Its pure focus on prescription drugs also means it lacks the buffer of consumer-focused sales seen at the likes of GSK and Switzerland's Novartis.

SELECTED BETS

Things could be different with a large acquisition that might bring in new revenue overnight - a strategy adopted by some other drugmakers, such as Pfizer, faced with similar sales cliffs. Soriot, however, says such a deal is unlikely, though he hasn't ruled it out altogether.

Since taking over on October 1, 2012, the one-time French veterinary surgeon has spent a modest $2 billion on buying companies like heart drug firm Omthera, respiratory medicine specialist Pearl and Amplimmune in oncology.

That is far below the $20 billion analysts believe he could afford, and the cautious approach is cheered by shareholders who worry about the risk of wasting cash on over-priced deals.

"He is focusing on the appropriate areas like bolt-on rather than major acquisitions, restructuring management and shifting R&D to Cambridge," one of AstraZeneca's 30 largest shareholders said, speaking on condition of anonymity.

Proving the value of this strategy will take time, however.

"The M&A has looked okay, but it is still too early to say if it is really going to shore up the pipeline," a second leading investor said.

In the meantime, Soriot also has his work cut out trying to bolster AstraZeneca's existing drugs business, where he has raised investment in new heart drug Brilinta, in the hope of a pick-up in sales towards the end of this year.

Investors, though, are not banking on a quick turnaround for either Brilinta or the company's important diabetes business.

Emerging markets, another key growth driver, are also a challenge as economies slow and China becomes a far more difficult market following an anti-corruption drive that has disrupted drug sales.

China is an especially important market for AstraZeneca, representing some 7 percent of the group's total revenue.

Given its well-known problems, investor expectations for AstraZeneca are the lowest among all major drugmakers, with the shares trading at just 10 times this year's expected earnings, against more than 16 times for Roche.

But they do offer a chunky 5.5 percent dividend yield as a consolation for those investors who are betting such "broken" drug stocks have a way of mending themselves, as Bernstein analyst Tim Anderson says has often been the case in history.

"I'm patient," said Polar Capital's Mahony. "It might take three years, but I'll get paid the best part of 6 percent in a dividend while I'm waiting."

(Additional reporting by Sinead Cruise; Editing by Will Waterman)

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FDA clears UCB's Cimzia for psoriatic arthritis treatment

BRUSSELS (Reuters) - U.S. regulators have cleared UCB's Cimzia for the treatments of adult patients with active psoriatic arthritis, the Belgian group said on Monday.

Psoriatic arthritis is an inflammatory disease that affects joints and tendons, and usually occurs in combination with psoriasis.

In the United States, Cimzia is already approved for the treatment of moderate to severe rheumatoid arthritis and for reducing the signs and symptoms of Crohn's disease, UCB said.

(Reporting by Robert-Jan Bartunek)

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London 2012 athletes 'had bad teeth'

28 September 2013 Last updated at 19:01 ET

Dentists have found "striking" levels of bad teeth in athletes competing at the London 2012 Olympic Games.

A fifth of athletes surveyed said their oral health actually damaged their training and performance.

The study, published in the British Journal of Sports Medicine, suggested cavities, tooth erosion and gum disease were common.

Researchers said athletes, as a group, had worse dental health than other people of a similar age.

The beaming smiles of gold-medal winners Usain Bolt, Jessica Ennis-Hill and Mo Farah are some of the defining memories of London 2012.

But a team at University College London says many competitors had dental problems.

"Our data and other studies suggest that, for a similar age profile, the oral health of athletes is poor. It's quite striking," said lead researcher Prof Ian Needleman.

He said eating large amounts of carbohydrates regularly, including sugary energy drinks, was damaging teeth.

He added that the stress on the immune system from intense training may leave athletes at risk of oral disease and that a fixation on training, preparation and other aspects of health may leave little time or awareness of oral health.

The study looked at those visiting the dental clinic at the Games, which offered free check-ups and mouth guards.

Competitors using the clinic may have been more likely to have dental problems than other athletes, but the research group say their findings are consistent with previous studies.

Of the 302 athletes examined, from 25 sports, 55% had evidence of cavities, 45% had tooth erosion and 76% had gum disease.

One in three said their oral health affected their quality of life and one in five said it affected training or athletic performance.

Teeth to training

Oral health is already a suspect in other seemingly unrelated conditions such as heart disease. People who do not brush twice a day are at higher risk of a heart attack and inflammation is common to both.

The researchers suggest inflammation elsewhere in the body may also affect recovery time and susceptibility to injury.

They added that tooth pain and the resulting impact on diet and sleep may also damage performance.

Prof Needleman, who is also director of the International Centre for Evidence-Based Oral Health, told the BBC: "We know the differences at the high end of elite sport are small, it would not be surprising if oral health was having an impact on those differences.

"Many sports medics have anecdotes about athletes missing medals at major competitions as a result of oral health problems."

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Young mum 'child death risk' link

29 September 2013 Last updated at 19:07 ET

The number of children dying in the UK is decreasing

Children born to mothers under 30 are more likely to die than those born to older mums, a report on child deaths in the UK suggests.

While overall child mortality fell by 50% in the past 20 years, young maternal age was found to be a risk factor for death in early childhood.

Support should be extended to mothers of all ages, not just first-time teenage mums, the report said.

The research was led by the Institute of Child Health at UCL.

It looked at why children die in the UK using death registration data from January 1980 to December 2010.

It focused on child injuries, birthweight and maternal age to assess the risk factors for child deaths.

The research found that in England, Scotland and Wales, the difference in mortality between children of mothers under 30 and those born to mothers aged 30 to 34 accounted for 11% of all deaths up to nine years old.

This is equivalent to an average of 397 deaths in the UK each year, the report said.

Deaths in children born to mothers under 20 accounted for just 3.8% of all child deaths up to nine years old.

The study compared children with similar birthweight in each age category.

'Alcohol use, smoking and deprivation'

It reported that the biggest difference in deaths was in infants aged from one month to one year.

Among this age group, 22% of deaths in the UK were due to "unexplained causes", the report said, "which are strongly associated with maternal alcohol use, smoking and deprivation".

The report added that the current policy, which focuses support on teenage first-time mothers, was not wide-ranging enough because mothers aged under 30 account for 52% of all births in the UK.

Ruth Gilbert, lead researcher and professor of clinical epidemiology at UCL Institute of Child Health, said the findings were important.

"Young maternal age at birth is becoming a marker of social disadvantage as women who have been through higher education and those with career prospects are more likely to postpone pregnancy until their 30s.

"Universal policies are needed to address the disparities."

Jill Rutter, head of policy and research at the Family and Childcare Trust, said the government needed to do more.

"Disadvantage and maternal age are factors often associated with child deaths. The government has recognised the vulnerability of the children of teenage mothers and given these families extra help with parenting.

"In England the Family Nurse Partnership is an intensive, structured, home-visiting programme, which is offered to first-time parents under the age of 20.

"A specially trained nurse visits regularly from early pregnancy until the child is two years old. This project has excellent results, but is not available to older mothers.

"We would like the Family Nurse Partnership to be extended to take older mothers who need help."

Toll from injuries

The study, commissioned by the Healthcare Quality Improvement Partnership and published by the Royal College of Paediatrics and Child Health, had other key findings.

First, injuries continue to be the biggest cause of death in childhood, but they are declining,

Between 1980 and 2010, injuries accounted for 31% of deaths in one to four-year-olds and 48% of deaths in those aged 15 to 18.

England had consistently lower rates of deaths from injury than the other UK countries, particularly among older boys.

But there was no decline in deaths due to intentional injury or self-harm over 30 years, the report found.

Dr Hilary Cass, president of the royal college, said this was worrying.

"Injuries remain the biggest cause of child deaths but are declining, so we need to continue to build upon public policy interventions such as traffic calming.

"The lack of decline in intentional injuries calls for a concerted focus on reducing violence and self-harm in older children."

Disabilities and serious diseases

The study also found that up to 70% of children who die in the UK have chronic conditions such as cancer, cystic fibrosis or epilepsy.

This was not necessarily the cause of their death but likely to be an underlying factor in it.

Prof Gilbert said that although the overall number of children dying is falling, the picture was complicated by the increasing number of children now surviving with disabilities and serious diseases, and this meant that proactive care was vital.

"For some children with serious chronic conditions who are expected to die, this means high-quality end-of-life care for the child and to support their families.

"For others, their death may have been premature or completely preventable. Most children with chronic conditions are managed at home by parents with support from primary and community care services as well as hospitals. We need to focus on the quality of long-term care at home for these children as well as in hospital."

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For yogi Hilaria Baldwin, pregnancy was an easy stretch

By Dorene Internicola

NEW YORK (Reuters) - Yoga teacher and fitness expert Hilaria Baldwin practices what she preaches and credits her easy pregnancy and labor to exercising - every day and sometimes during the night.

During her pregnancy, the wife of Emmy award-winning actor Alec Baldwin and new mother to 5-week-old Carmen Gabriela, said she gave up spinning classes for a less vigorous fitness regimen that included jogging.

But yoga, the 3,000-year-old practice that marries movement to breath, was the 29-year-old's primary thing.

"When I had aches and pains in the middle of the night, I'd just get out of bed and stretch," said Baldwin, who teaches at Yoga Vida in New York and will release a fitness DVD, "@Home with Hilaria Baldwin: Fit Mommy-to-Be Prenatal Yoga," on Tuesday.

"A lot of people are so afraid to exercise they do damage by becoming sedentary," she added.

In the absence of complications, The American College of Obstetricians and Gynecologists recommends 30 minutes of moderate exercise on most, if not all, days for pregnant women.

Dr. Raul Artal, an expert on exercise and pregnancy who helped develop the ACOG guidelines, said women who are physically active have easier labor and recovery than sedentary women.

"There are also positive effects on mood that may prevent depression," said Artal, a professor and chairman of the department of Obstetrics, Gynecology & Women's Health at Saint Louis University School of Medicine.

Artal said women should not hesitate to do yoga, as long as any movement is moderate and hydration is encouraged.

"Pregnancy is one of the main contributors to obesity," he noted. "Obese women have a higher incidence of infants with birth defects."

Exercise physiologist and yoga instructor Jessica Matthews, of the American Council on Exercise, said experienced yogis don't have to abandon their practice during pregnancy.

But there are necessary tweaks and modifications.

"In the first trimester most standing poses (and) balancing postures are still accessible," said Matthews. "As the belly starts to grow, some balancing may require the support of a wall."

As pregnancy progresses, she urges women to use pillows and other props, and added that during the second trimester the body really starts to change and aches, pains and discomfort sets in.

"In the third trimester yoga's greatest benefit is not so much asana (postures) but focus on relaxation and breath work that can help with the whole delivery process," she said.

Matthews has seen the egos of even the most daring, arm-balance and inversion-loving yogis recede during pregnancy.

"They really do already have the instinct to protect their child. Ego starts to take a back seat," she explained. "And often those who came with a more physical focus find that after pregnancy they connect to yoga in a different way."

Baldwin plans to pass on her yoga expertise to her daughter, who already has two baby yoga mats.

"She's going to totally do yoga," she said, "I have high hopes for her."

Baldwin's 55-year-old husband, who appears in her DVD, practices with her.

"We do yoga together. I think we should do more," she said. "She is (Carmen) going to tell her father to get off his butt."

(Editing by Patricia Reaney and Doina Chiacu)

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Combining Chinese, Western medicine could lead to new cancer treatments

Sep. 28, 2013 — Combining traditional forms of Chinese and Western medicine could offer new hope for developing new treatments for liver, lung, colorectal cancers and osteosarcoma of the bones.

Experts from Cardiff University's School of Medicine have joined forces with Peking University in China to test the health benefits of a traditional Chinese medicine.

The team also set-out to examine how by combining it with more traditional methods like Chemotherapy could improve patient outcomes and potentially lead to the development of new cancer treatments and therapies.

"Traditional Chinese medicine where compounds are extracted from natural products or herbs has been practised for centuries in China, Korea, Japan and other countries in Asia," according to Professor Wen Jiang from Cardiff University's School of Medicine, who is the director of the Cardiff University-Peking University Joint Cancer Institute at Cardiff and led the research as part of a collaboration between Cardiff University and Peking University.

"Although a few successes, most of the traditional remedies are short of scientific explanation which has inevitably led to scepticism -- especially amongst traditionalists in the West.

"As a result, we set out to test the success of a Chinese medicine and then consider how combining it alongside traditional methods like Chemotherapy could result in positive outcome for patients," he adds.

Yangzheng Xiaoji is a traditional Chinese formula consisting of 14 herbs. The formula has been shown to be beneficial to cancer patients -- however, until now how it works has remained unknown.

Since 2012 the Team have investigated how the formula works, discovering that it works by blocking a pathway which stops the spread of cancer cells in the body.

"The formula has been shown to be beneficial to patients with certain solid tumours, when used alone and in conventional therapies, such as Chemotherapy.

"It suggests that combining the formula with conventional as well as new therapies could hold the key to developing new treatments for cancer patients.

"We are already looking to clinical trials in treatment of lung and other cancer types."

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FDA approved anti fatal form of the antidepressant battle study found lung

Anti use of antidepressant drugs small class Stanford University School of medicine, Stanford University Cancer Institute (home) of according to new research from researchers during the fight against a particularly deadly form of lung cancer, potentially effective displays. Medicines for human use by the United States food and Drug Administration already approved, so researchers can launch clinical trials to test their theories in patients soon has been.

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Tiny sensor used in smart phones could create urban seismic network

Sep. 29, 2013 — A tiny chip used in smart phones to adjust the orientation of the screen could serve to create a real-time urban seismic network, easily increasing the amount of strong motion data collected during a large earthquake, according to a new study published in the October issue of the Bulletin of the Seismological Society of America (BSSA).

Micro-Electro-Mechanical System (MEMS) accelerometers measure the rate of acceleration of ground motion and vibration of cars, buildings and installations. In the 1990s MEMS accelerometers revolutionized the automotive airbag industry and are found in many devices used daily, including smart phones, video games and laptops.

Antonino D'Alessandro and Giuseppe D'Anna, both seismologists at Istituto Nazionale di Geosifica e Vulcanologia in Italy, tested whether inexpensive MEMS accelerometers could reliably and accurately detect ground motion caused by earthquakes. They tested the LIS331DLH MEMS accelerometer installed in the iPhone mobile phone, comparing it to the earthquake sensor EpiSensor ES-T force balance accelerometer produced by Kinemetrics Inc.

The tests suggest that the MEMS accelerometers can detect moderate to strong earthquakes (greater than magnitude 5) when located near the epicenter. The device produces sufficient noise to prevent it from accurately detecting lesser quakes -- a limitation to its use in monitoring strong motion.

D'Alessandro and D'Anna note that the technology is rapidly evolving, and there will soon be MEMS sensors that are sensitive to quakes less than magnitude 5. The real advantage, say the authors, is the widespread use of mobile phones and laptops that include MEMS technology, making it possible to dramatically increase coverage when strong earthquakes occur.

The current state of the MEMS sensors, suggest the authors, could be used for the creation of an urban seismic network that could transmit in real-time ground motion data to a central location for assessment. The rich volume of data could help first responders identify areas of greatest potential damage, allowing them to allocate resources more effectively.

The article, "Suitability of low-cost three-axis MEMS accelerometers in strong-motion seismology: tests on the LIS331DLH (iPhone) accelerometer," is published in October issue of BSSA.

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UK A&Es seeing 'drunk children'

30 September 2013 Last updated at 00:00 ET

Public Health England says one in four underage drinkers consumes more than 15 units a week

Nearly 300 children aged 11 or under were admitted to A&E units across the UK last year after drinking too much, a BBC Radio 5 live investigation shows.

Revealing UK-wide data for the first time, it said a total of 6,500 under-18s were admitted with alcohol-related illnesses in 2012-13.

The data came from 125 of the 189 UK NHS organisations following Freedom of Information requests.

More girls than boys are now being admitted, a reversal of the past trend.

Over the last five years A&E departments across the UK have dealt with nearly 48,000 incidents where under-18s have been admitted for drink or drug related illnesses.

'Hiding away'

Ayrshire and Arran Health Board dealt with the highest number of cases last year - with 483 alcohol-related admissions.

Morten Draegebo, an A&E consultant at Cross House Hospital in Kilmarnock, said children were exposing themselves to significant danger.

He said: "There is a problem with their ability to defend themselves. The typical patient may be found in a field.

"They often need to hide away from any sort of adults in the area so they're picked up by the ambulance service.

"They have difficulty locating where they are because the description comes through from a distressed half-drunk teenager potentially saying that they're under a tree somewhere in a large park.

"Eventually they're found but even in summer-time in Scotland they're vaguely hypothermic.

"They have vomited. The vomit may go down the wrong way into the lungs. They are unable to defend themselves even from assault."

Dr Draegbo added: "We have had many cases where teenage, young teenage females have come in saying that they may have been sexually assaulted and they're that intoxicated and are distressed and say, 'I may have been', but they don't even know if they have been or not.

"On a humane level that is very distressing. I'm a parent, I would hate for that to happen to my daughter."

Heavy burden

There has been a long-term fall in the number of children admitted to A&E after drinking too much - with 2,000 fewer under-18s admitted to A&E last year than in 2009.

Charities and public health bodies agree fewer children are drinking across the UK, but say the amount being consumed has stayed the same - suggesting those who do drink are drinking more.

Public Health England says one in four underage drinkers consumes more than 15 units a week - the equivalent of seven pints of lager.

The official advice from the chief medical officers across the UK is that no children should be given alcohol until they are 16, and alcohol should only be given to older teenagers under supervision of a carer or parent, and never on more than one day a week.

A Department of Health England spokesman said: "We know that fewer young people are drinking and being admitted to hospital as a result.

"But with more than one million alcohol-related hospital admissions overall in the last year we know too many people are drinking too much and that alcohol places a heavy burden on the NHS, costing around ￡3.5bn every year. "

Hear more on the Victoria Derbyshire programme at 10:00 BST on Monday 30 September on BBC Radio 5 Live.

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