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Showing posts with label Still. Show all posts
Showing posts with label Still. Show all posts

Saturday, January 18, 2014

Is Europe equipped with enough medical oncologists? Horizon still unknown

Jan. 17, 2014 — The European Society for Medical Oncology (ESMO) has welcomed a recent survey that shows the number of medical oncologists in Western Europe appears to be keeping pace with the rising toll of cancer.

But the society has also warned that a worrying lack of information about the situation in Eastern Europe must be urgently addressed.

Published in the Annals of Oncology this week, the survey provides the first detailed information on the current number of medical oncologists in 12 European Union countries, mostly in Western Europe, and their predicted availability by 2020.

Around the world countries are struggling to ensure their medical oncology systems can deal with the increase in cancer cases, says ESMO Press Officer Solange Peters, a lung cancer expert from the university of Lausanne, Switzerland. Until now, nobody could say what the situation was in Europe.

The survey, led by Evandro de Azambuja from Jules Bordet Institute, Brussels, shows that Austria, Belgium, Bulgaria, Finland, France, Germany, Hungary, Italy, The Netherlands, Portugal, Sweden and the UK will probably have enough medical oncologists over the next eight years since data collection to meet the needs of an increasing cancer patient population.

The study provides the current ratio of cancer cases to medical oncologists for each country, and shows the annual increase in the total number of medical oncologists.

However, despite repeated attempts, researchers were not able to gather adequate information from the 15 other EU Member States, making it impossible to paint a full picture of the situation in Europe.

"ESMO is willing to help countries work together to make this kind of data available for all of Europe," Peters says. "We need a complete picture and the current one is insufficient to draw firm conclusions."

"It is vital that we collect this data and we continuously monitor it, to optimise the medical oncology system in every European country," says the ESMO spokesperson.

"In the long term, we hope that it might be possible to build a Europe-wide system that will ensure we have a full picture of the needs across Europe, also beyond 2020, to guarantee optimal care to cancer patients" she says.


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Wednesday, November 13, 2013

Pneumonia still responsible for one fifth of child deaths

Pneumonia remains the single biggest killer of children under 5 globally, claiming the lives of more than 1 million girls and boys every year. But pneumonia deaths are preventable.

As countries mark World Pneumonia Day on 12 November, WHO, UNICEF and the GAVI Alliance are highlighting essential actions that can help end child deaths from this disease.

“Every 30 seconds, a child younger than 5 dies of pneumonia. This is a great shame as we know what it takes to prevent children from dying of this illness,” says Dr Mickey Chopra, Chief of Health, UNICEF. “Tackling pneumonia doesn’t necessarily need complicated solutions.”

Many factors contribute to pneumonia, and no single intervention can effectively prevent, treat and control it. 5 simple but effective interventions, if implemented properly, will help reduce the burden of the disease that is responsible for almost one-fifth of all child deaths around the world.

These are:

  • exclusive breastfeeding for 6 months and continued breastfeeding complemented by nutritious solid foods up to age 2;
  • vaccination against whooping cough (pertussis), measles, Haemophilus influenzae type b (Hib) and pneumococcus;
  • safe drinking water, sanitation and handwashing facilities;
  • improved cooking stoves to reduce indoor air pollution; and
  • treatment, including amoxicillin dispersible tablets and oxygen.

The theme of World Pneumonia Day 2013 is “Innovate to End Child Pneumonia”. Recognizing that child mortality cannot be addressed in a vacuum, but only through integrated efforts, in April 2013, WHO and UNICEF released an Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD).

The GAPPD presents an innovative framework bringing together prevention, protection and control of both pneumonia and diarrhoea – two of the world’s leading killers of children under 5 - to make more efficient and effective use of scarce health resources.

To mark 5th World Pneumonia Day, Mauritania and Papua New Guinea are today introducing the pneumococcal vaccine, which protects against one of the leading causes of pneumonia. With support from the GAVI Alliance, more than 50 countries will introduce this vaccine by 2015.

“The GAVI Alliance is helping to accelerate the fight against pneumonia by increasing access to pneumococcal vaccines, thanks to GAVI’s innovative Advance Market Commitment (AMC), but also to the 5-in-1 pentavalent vaccine which protects against Haemophilus influenzae type b, another major cause of pneumonia,” says Dr Seth Berkley, CEO of the GAVI Alliance.

Since the launch of the GAPPD 7 months ago, several countries have taken this forward. For example, Bangladesh and Zambia are translating the GAPPD into local implementation plans in some districts. Programme managers responsible for immunisation, child health, nutrition and water and sanitation have joined forces to accelerate progress and eliminate preventable deaths from pneumonia and diarrhoea.

In addition, in October 2013, WHO published new technical advice for countries:

  • Based on a review of the latest evidence, guidelines on the treatment of pneumonia were updated, recommending simpler antibiotic regimens.
  • A handbook to guide district and health facility staff on how to introduce the pneumococcal vaccine emphasizes using new vaccine introductions to scale up access to other essential interventions to protect, prevent and treat pneumonia, in line with the GAPPD.

“To achieve the vision and goals of the integrated plan – to end preventable deaths from pneumonia and diarrhoea in the next generation – the children of the world need to see political will, coordinated efforts, and increased resources at the global and national levels to fight these stubborn killers,” says Dr Elizabeth Mason, Director of WHO’s Department of Maternal, Newborn, Child and Adolescent Health.

For more information please contact:

Tarik Jasarevic
Communications Officer
Mobile: +41 79 367 6214
E-mail: jasarevict@who.int

Tamara Kummer
UNICEF New York
Mobile: +1 (617) 331 4305
E-mail: tkummer@unicef.org

Frederique Tissandier
GAVI Alliance
Mobile: +41 79 300 8253
E-mail: ftissandier@gavialliance.org


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Tuesday, October 1, 2013

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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Sunday, September 15, 2013

U.S., Russia agree on Syria weapons, Obama says force still option

By Warren Strobel and Mariam Karouny

GENEVA/BEIRUT (Reuters) - Russia and the United States put aside bitter differences over Syria to strike a deal on Saturday that by removing President Bashar al-Assad's chemical arsenal may avert U.S. military action against him.

After three days of talks in Geneva, U.S. Secretary of State John Kerry and Russian Foreign Minister Sergei Lavrov demanded Assad account for his secret stockpile within a week and let international inspectors eliminate all the weapons by the middle of next year - an "ambitious" target, Kerry said.

The accord leaves major questions unanswered, including how feasible such a major disarmament can be in the midst of civil war and at what point Washington might yet make good on a continued threat to attack if it thinks Assad is reneging.

Under the Geneva pact, the United States and Russia will back a U.N. enforcement mechanism. But its terms are not yet set. Russia is unlikely to support the military option that President Barack Obama said he was still ready to use.

"If diplomacy fails, the United States remains prepared to act," Obama said. "The international community expects the Assad regime to live up to its public commitments."

To that end, the Pentagon said U.S. military forces were still positioned to strike, if ordered.

But for Assad's opponents, who two weeks ago thought U.S. missile strikes were imminent in response to a gas attack on rebel territory, the deal was a blow to hopes of swinging the war their way. Kerry and Lavrov said it could herald broader peace talks, as warplanes hit rebel positions again near Damascus.

The accord, however, was as much about U.S.-Russian ties as it was about Syria. The conflict has chilled relations to levels recalling the Cold War.

In reaching a bilateral deal after what one U.S. official described as three days of "hard-fought" debate, Moscow and Washington can each count benefits.

For Russian President Vladimir Putin, it brings management of the Syrian crisis back to the United Nations. For Obama, it solves the dilemma created by Congress' reluctance to back military strikes that he was preparing without a U.N. mandate.

Lavrov told a joint news conference in Geneva, "It shows that when there is a will ... Russia and the United States can get results on the most important problems."

"The successful realization of this agreement will have meaning not only from the point of view of the common goal of eliminating all arsenals of chemical weapons, but also to avoid the military scenario that would be catastrophic for this region and international relations on the whole."

Kerry acknowledged that further success was far from guaranteed: "The implementation of this framework, which will require the vigilance and the investment of the international community, and full accountability of the Assad regime, presents a hard road ahead," he said.

Despite a measure of camaraderie on display in banter between the two men during the presentation of the two-page framework agreement, they remained openly at odds over the U.S. willingness to use force in Syria without U.N. backing.

REBELS DISMISSIVE

In Istanbul, the head of the Syrian rebel Supreme Military Council, General Selim Idris, called it a blow to opposition hopes of overthrowing Assad and accused the Syrian president of circumventing any disarmament by already sending chemical weapons to allies in Lebanon and Iraq in recent days.

Qassim Saadeddine, a rebel commander in northern Syria, told Reuters: "Let the Kerry-Lavrov plan go to hell. We reject it and we will not protect the inspectors."

Idris said, however, his forces would help the inspectors. A U.S. official said Washington believed all Syria's chemical weapons remained in areas under government control.

Assad, backed by Iran, crushed demonstrations demanding democracy in 2011 and, while losing territory, has withstood a full-blown uprising supported by Arab states and the West.

Prodded by Russia, he has now agreed to abide by a global chemical weapons ban and submit to controls by the U.N.-backed Organisation for the Prohibition of Chemical Weapons, or OPCW.

That will deprive him of arms he denies having used and spares him, at least for now, what were likely to be heavy U.S. and French missile strikes and bombing raids.

The United Nations said on Saturday it had received all documents necessary for Syria to join the chemical weapons convention. Syria would come under the treaty starting on October 14, it said.

Assad's opponents criticize the United States and its allies for the focus on chemical weapons, which account for a very small number of the more than 100,000 dead in the war, and of abandoning them to face a deadly, Russian-armed enemy.

On Saturday, as government jets struck rebel-held suburbs of the capital and troops fought rebels on the ground, one opposition activist in Damascus voiced anger and resignation

"The most important point is the act of killing, no matter what is the weapon," said Tariq al-Dimashqi. "The killing will continue. No change will happen. That is it."

Syrian state media broadcast the Geneva news conference live, indicating that Damascus was satisfied with the deal.

DEAL OFFERS WAY OUT

Having taken the surprise decision two weeks ago to seek congressional approval for strikes to punish Assad for using poison gas, Obama faced a dilemma when lawmakers appeared likely to deny him authorization.

They cited unease about inadvertently helping Islamist militants among the rebels and a wariness of new entanglements in the Middle East after wars in Iraq and Afghanistan.

The weapons deal proposed by Putin, a former KGB agent intent on restoring some of the influence Moscow lost with the Soviet collapse two decades ago, offered Obama a way out.

But Obama has been bombarded with criticism for his handling of Syria and a muddled message, moving the United States toward, and then back from the brink of striking Syria over an August 21 poison gas attack that Washington blames on Assad.

Republican Senators John McCain and Lindsey Graham, who advocate deeper U.S. involvement in Syria's civil war, blasted the deal, saying it would effectively allow Assad months to "delay and deceive."

"It requires a willful suspension of disbelief to see this agreement as anything other than the start of a diplomatic blind alley, and the Obama administration is being led into it by Bashar Assad and Vladimir Putin," they said.

Carl Levin, a Democrat aligned with Obama and head of the Senate Armed Services Committee, hailed the agreement and noted it did not restrict the United States from supporting the moderate Syrian opposition or acting unilaterally, if needed.

Under the terms of the U.S.-Russian agreement, the U.N. Security Council - on which Russia has a veto - will oversee the process. Syria must let the OPCW complete an initial inspection of its chemical weapons sites by November.

Kerry said Assad must produce a "comprehensive listing" of its chemical weapons within a week. The goal is to complete destruction of Syria's arsenal in the first half of 2014.

The agreement states that a Security Council resolution should allow for regular assessments of Syria's behavior and "in the event of non-compliance ... the UN Security Council should impose measures under Chapter VII of the UN Charter".

Chapter VII can include force but can be limited to other kinds of sanction. When Kerry said the council "must" impose measures under Chapter VII, Lavrov interrupted to point out that the agreed text says only it "should" impose penalties.

"There's no diminution of options," Kerry said, noting Obama's right under U.S. law to order military action, with or without support from Congress or any international body.

The Pentagon said it had made no change to the forces it had lined up. A spokesman said, "The credible threat of military force has been key to driving diplomatic progress."

Lavrov said of the agreement, "There is nothing said about the use of force and not about any automatic sanctions."

Putin has supported Assad's contention that the sarin gas attack on August 21, which Washington says killed over 1,400 civilians, was the work of rebels trying to provoke Western intervention.

Lavrov said, however, that Russia would support U.N. punishment for anyone whose guilt was clearly proven.

A new round of argument about responsibility for the August 21 deaths is likely in coming days, once U.N. inspectors deliver their report on the incident to the world body.

PEACE NEGOTIATIONS?

In two weeks, when the U.N. General Assembly convenes in New York, Lavrov and Kerry have said they will meet the U.N. Syria envoy to see if they can push forward a plan for an international peace conference to negotiate an end to the war.

An effort last year for a political solution, dubbed the "Geneva Plan" and calling for a transitional government, went nowhere as Assad refused to cede power and the opposition insisted he could not be a part of any new political order.

Kerry said Saturday's chemical weapons deal could be "the first concrete step" toward a final settlement. Lavrov said he hoped all parties to the conflict could attend a conference in October, without setting pre-conditions for their attendance.

There is little sign of softening among Syrians, however, or among rival backers in the Middle East, where the conflict is part of a broader regional confrontation with sectarian elements between Shi'ite Iran and Sunni Muslim Arab leaders.

The opposition Syrian National Coalition in Istanbul elected a moderate Islamist, former political prisoner Ahmad Tumeh, as its provisional prime minister on Saturday. Members said they hoped Tumeh could help make the often fractious opposition's case in negotiations to achieve their demands.

Senior Kerry aides involved in the talks said that the United States and Russia agreed that Syria has 1,000 tonnes of chemical agents, including nerve gas sarin and mustard gas - one of the world's largest stockpiles of such material.

But the officials said there was no agreement on how many sites must be inspected. Washington thinks it is at least 45.

One U.S. official called the task "daunting to say the least". Another noted there were "targets ... not a deadline".

The weapons are likely to be removed through a combination of destroying them in Syria and shipping some for destruction elsewhere, U.S. officials said. Russia is one possible site for destruction, but no final decisions have been made.

The Hague-based OPCW has never moved weapons across borders before, because of the risk, and never worked in a war zone.

(Additional reporting by Stephanie Nebehay and Tom Miles in Geneva, Oliver Holmes in Beirut and Steve Holland and Phil Stewart in Washington; Writing by Alastair Macdonald and Phil Stewart; Editing by Mike Collett-White and Peter Cooney)


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