The rest of the world may be exhaling at the apparent easing of a potential swine flu pandemic, but some global experts are tempering their optimism with concerns about what one calls "the fall question."
That's the uncertainty over whether the current outbreak is only a preview of what's to come, an echo of previous epidemics — including the 1918 flu — that saw mild first cases of infection in the spring followed by more severe second and third bouts in the fall and winter that brought widespread infection, illness and death.
"Right now, you have to wait and watch," said Ann Marie Kimball, professor of epidemiology and an expert in emerging infectious disease at the University of Washington in Seattle.
But Kimball and others, including Dr. Margaret Chan, the World Health Organization’s director-general, warn that it's possible the swine flu could re-emerge in a stronger form next fall.
"We hope the virus fizzles out, because if it doesn't we are heading for a big outbreak," Chan told Britain's Financial Times on Monday. "I'm not predicting the pandemic will blow up, but if I miss it and we don't prepare, I fail. I'd rather over-prepare than not prepare."
More than 20 countries have reported cases of swine flu, with most of the more than 1,600 confirmed cases in Mexico, the United States and Canada. Health officials in the U.S. and abroad say that the death toll, which now stands at 30, is not as bad as they originally feared.
Flu season is ending in the northern hemisphere, where most of the current infections of the H1N1 swine flu virus have been reported. The coming summer with warm temperatures and higher humidity means that the flu will be less transmissible there, although it raises worries for the spread of virus during the approaching winter in the southernhemisphere. So far, countries there have escaped the outbreak.
But the big fear is that the current swine flu virus could die down now in the north, but mutate during the ensuing months to become more transmissible and more virulent, fueling a serious outbreak when flu season resumes in that hemisphere, Kimball said.
“You have to remember that you are dealing with a flu virus,” she said. “They do reassort, shift and drift.”
1918: Second wave most deadly
The echoes of the 1918 flu are unavoidable. Historical accounts long have suggested that the first pandemic wave appeared in the U.S. in the spring of 1918, causing illness, but no appreciable deaths above normal.
Dr. Jeffery K. Taubenberger, an influenza investigator in the Laboratory of Infectious Diseases at the National Institutes of Health, said cases may well have turned up in the spring, but evidence suggests they certainly did by the summer of that year, causing out-of-season infections and deaths among young, healthy people.
Those early cases were followed by far more fatal second and third waves in the fall and winter of 1918 and 1919 in the United States.
"When it got cool enough to spread well, the virus exploded," Taubenberger said.
The thought was that the virus initially was strong enough to cause serious illness in some places, but not fit enough to launch a pandemic. Quickly, however, it progressed from causing uncomplicated influenza infections to fatal pneumonia, eventually leading to an estimated 650,000 deaths in the U.S. and between 25 million and 100 million around the world.
That model has led some scientists and ordinary people to question whether coming down with a mild case of swine flu now might actually protect against more serious illness in the future.
So far, government health officials say they still can’t tell whether infection now would confer immunity, said Dr. Anne Schuchat, a deputy director with the federal Centers for Disease Control and Protection. And Taubenberger said flu viruses mutate so quickly, there's no guarantee that this virus will be the same in six months.
Other flu experts said they would recommend avoiding exposure because the virus is still capable of causing severe disease, as seen in the cases in Mexico. And few would be willing to take chances with their own families, said Dr. Anne Moscona, a professor of pediatrics, microbiology and immunology at Weill Cornell Medical Center/New York Presbyterian Hospital.
“I think that it’s just too unpredictable to know how this virus is going to be in any one individual,” said Moscona, whose own children are 8 and 14. “I would by far prefer to avoid it.”
Avoiding the swine flu outbreak, even as it wanes in this country, depends on the habits that health officials have been emphasizing: good hand hygiene, avoiding close contact with sick people, staying home at the first sign of illness.
It does not depend on stockpiling antiviral medications, such as Tamiflu and Relenza. In Miami, CVS pharmacist Lauren B. Strzelecki saw a several months’ supply of Tamiflu disappear overnight from her as patients with valid prescriptions but no symptoms of illness loaded up on the drugs.
“They said, ‘I just walked in and said I was really nervous about swine flu,’” Strzelecki said.
Drug-resistant antivirals a worry
Increased use of antiviral medications raises concerns about growing drug resistance, said Moscana and Dr. David M. Weinstock, a flu expert and an assistant professor at the Department of Medicine at Harvard Medical School.
Before this new strain of swine flu emerged, the dominant strain of H1N1 influenza was almost entirely resistant to oseltamivir, or Tamiflu. So far, the new strain is susceptible to Tamiflu and to zanamivir, or Relenza.
“What we’ve learned about influenza is every time we feel confident with the way it evolves, it throws us a curveball,” Weinstock said.
Although the new flu is not likely to become resistant overnight, ill-advised use could speed up the process, allowing flu viruses to develop immunity to the only drugs that remain.
“The worst case scenario is that if people decided they want to take their Tamiflu, they’d take one pill a week for the next four months, then get the flu,” he said.
That could accelerate the person’s own resistance to the drug, as well as the wider resistance in the larger community.
Worries about a second wave of flu, early immunity and growing drug resistance all could be eased by the development of a safe, effective, widely available vaccine to protect against the new H1N1 swine virus.
Federal officials have started growing enough “seed stock” of the novel virus to provide material to vaccine manufacturers, according to press briefings. So far, it appears that the process is going as it should.
“I’m very hopeful that we’ll have a vaccine by the fall,” Weinstock said.
Thursday, May 7, 2009
Swine flu fears subside, but second wave looms
Swine flu outbreak costs Mexico $2.2 billion
MEXICO CITY - Mexico's finance secretary says the swine flu outbreak has cost the Mexican economy at least $2.2 billion.
Agustin Carstens said Tuesday the government will implement a $1.3 billion stimulus package, aimed primarily at small businesses and the tourism industry, the sectors hardest hit by the epidemic.
The government will temporarily cut health insurance payments for small businesses and reduce taxes for airlines and cruise ships.
Tourism, the country's third largest source of foreign income, has taken a serious blow with hotel occupancy at half its normal rate.
Many airlines have canceled flights because of the outbreak.
Carstens spoke to reporters on Tuesday.
In Europe, social safety net softens the slump
EPPELHEIM, Germany — With its tidy villages, orderly cities and atmospheric scenery, there are few outward signs that the German state of Baden-Wuerttemberg, home to historic Heidelberg and the famed Black Forest, is a victim of the current economic crisis.
But with the auto industry here hit especially hard — this is the home of Mercedes-Benz — things are tougher than they have been in decades. Unemployment is up 70 percent in the past year (albeit to a relatively low 5 percent total) and many employees have been forced to cut down their hours.
Misery below the surface, perhaps? Not at the bustling Fuerstenberger home just outside Heidelberg, where little has changed for the family's four children despite neither parent currently working.
“If we were in Detroit, we could worry every minute,” said Sarah Fuerstenberger, 37. “But here, we’re safe because of the system."
While economic forecasts are just as dire on this continent as in the United States, Germany’s citizens — and, indeed, most across western Europe — can count on a broad government safety net that includes generous unemployment checks, universal healthcare and inexpensive university education to tide them over.
“The German government is really good about taking care of people; we know we won’t be starving one way or another," she added.
With "Jobs Bloodbaths" in the headlines, tax money being used to bail out private banks and iconic car companies such as Britain’s Mini, France’s Renault and Italy’s Fiat laying off thousands, news here is similar to that across the Atlantic. Unemployment is also the same — around 8.5 percent across Western Europe and the United States.
However, Europe fiercely resisted President Obama's calls for it to increase its stimulus programs last month at the Group of 20 industrial and developing nations summit in London. That’s because leaders here argue that their existing social welfare initiatives are already keeping people afloat as well as stimulating demand.
Of course, these ongoing European programs come with a cost — higher taxes, which critics say can sap economic vitality.
GE plans $6 billion health care initiative
WASHINGTON - General Electric Co. said Thursday that it will invest $6 billion over the next six years in an attempt to lower the cost of health care and improve the quality of medical care in underserved regions of the United States and abroad.
The broad program sets goals of reducing health care costs by 15 percent through $3 billion of spending on new, lower cost medical technology. The initiative also plans to broaden the use of tools such as electronic medical records and other medical information technology, with the hope of providing more advanced care to 100 million additional people each year.
That will include $2 billion of financing for rural health care systems in the United States to adopt medical IT systems. It will also expand clinics in Cambodia and provide additional funding for maternal health care programs in Bangladesh.
“Health care needs new solutions,” said GE CEO Jeffrey Immelt. “We must combine technology with innovations and smarter processes that help doctors and hospitals deliver better health care to more people at a lower cost.”
The company, which has struggled over the past year due to the recession and problems at its GE Capital financing arm, has said that health care and energy are two likely growth areas over the next several years.
GE plans to use its NBC television networks as a way to increase consumer knowledge about health, and will launch a daily program devoted to health in June on MSNBC.
The Fairfield, Conn.-based GE is one of the world’s largest industrial companies, making products like jet engines, household appliances and light bulbs. It also has a large health care division, which produces diagnostic equipment for hospitals and medical information technology systems.
GE has dubbed the program “healthymagination,” saying it is on par with its “ecomagination” initiative that focuses on cleaner energy projects like wind turbines and more efficient electric grids.
As part of “healthymagination,” GE plans to appoint a health care advisory board that includes former Sens. Tom Daschle and Bill Frist.
Stocks slip as investors take profits
NEW YORK - Investors heard some more good news about the economy Thursday but locked in profits anyway following huge gains earlier in the week.
Upbeat reports on the job market and retail sales initially sent stocks higher but the gains eroded by mid-morning as traders asked “What’s next?” and trimmed their holdings following the 4.8 percent gain so far this week in the Standard & Poor’s 500 index.
“This is a market that is starting to bake in a lot of positive surprises,” said Craig Peckham, a market strategist at Jefferies & Co.
The selling comes ahead of the formal release of results from the government’s “stress tests” of bank balance sheets after the closing bell. News reports have already given investors a decent idea of what to expect so analysts aren’t predicting big surprises.
A massive two-month rally has left the S&P 500 index in the black for the year and up more than 30 percent from 12-year lows reached in early March. Analysts said it wasn’t surprising that the market would take a break after such big gains.
Technology shares posted the biggest losses Thursday after security software maker Symantec Corp. posted weaker-than-expected results. Retailers were mixed even after many of them, including Wal-Mart Stores Inc., reported better-than-expected April sales.
“The fact that we’re seeing the retailers sell off on these positive surprises suggests the bar has been raised on what companies need to do to take stocks higher,” Peckham said.
In early afternoon trading, the Dow Jones industrial average fell 82.20, or 1 percent, to 8,430.08 a day after the blue chips jumped 102 points to close above the 8,500 level for the first time in four months. The index is down only 3 percent for the year.
The Standard & Poor’s 500 index fell 8.37, or 0.9 percent, to 911.16, and the Nasdaq composite index fell 34.55, or 2 percent, to 1,724.55.
Federal Reserve Chairman Ben Bernanke, addressing a Fed conference, said a broader approach is needed for strengthening oversight of the banking system and said information gleaned from big bank “stress tests” should pave the way for improvements on that front.
In economic news, new applications for unemployment benefits fell last week to the lowest level in 14 weeks. The Labor Department’s tally of new jobless claims fell to 601,000 from 631,000 the previous week, well below the 635,000 economists had been expecting. A four-week moving average of initial jobless claims that smooths out fluctuations fell from a high in early April.
The employment reading follows a better-than-expected private snapshot of the labor market on Wednesday and comes a day ahead of the government’s April employment report. It is often regarded as the most important economic news each month because a drop in unemployment could bolster everything from banks to retailers if consumers can continue to make mortgage payments and go shopping.
There were also reports showing that productivity rebounded slightly in the first quarter while wage pressures eased.
Wal-Mart said sales of Easter merchandise and more shoppers in its stores helped its sales jump 5 percent, much more than the 2.9 percent rise analysts had forecast. Wal-Mart rose 89 cents to $50.40.
The well-being of retailers is key to the economy because consumer spending accounts for more than two-thirds of economic activity.
Symantec reported a loss for its fiscal 2009 fourth quarter, hurt by a hefty goodwill impairment charge and lower-than-expected revenue. The stock fell $2.59, or 14.7 percent, to $15.
Financial stocks were mixed ahead of the government report cards on banks. The tests, designed to determine which banks would need a stronger capital base if the economy weakens, are at the crux of the Obama administration’s plan to fortify the financial system. The market rallied this week ahead of the results, despite some initial concerns that the tests would show more pain in the industry.
Citigroup Inc. rose 8 cents, or 2.1 percent, to $3.94, while Bank of America Corp. rose $1.19, or 9.4 percent, to $13.88. Both banks are among those told by regulators they will need to raise more money. Regions Financial Corp. will also need to raise more money, according to people briefed on the results, as will Wells Fargo & Co. Regions Financial rose 3 cents to $5.86, while Wells Fargo fell $1.64, or 6.1 percent, to $25.20.
Bond prices dropped as demand for government debt waned. The yield on the benchmark 10-year Treasury note jumped to 3.28 percent from 3.16 percent late Wednesday.
Influenza Outbreak Changes the Friendly Skies
If you’ve been second guessing your vacation plans because of the H1N1 influenza outbreak, you’re not alone. According to a recent TripAdvisor.com poll of 2,857 users of the site, one-fourth of respondents said they were changing their plans because of the virus. Experts say it’s too early to access the fallout from the outbreak, which has spread to 12 countries, but one area is already feeling the crunch—the airline industry.
Instead of gearing up for the summer travel season, many airlines are being forced to reduce their flights to Mexico, the epicenter of the outbreak, and nearly every U.S. airline with routes to Mexico have extended the period that customers can change their travel plans without a penalty. “It (the outbreak) couldn’t come at a worse time for the travel industry,” said Matthew Jacob, an analyst with Majestic Research LLC. “It had seemed like things were starting to recover. This will probably set that back a little.”
Continental, with the most Mexico flights at 450 a week, announced that beginning May 4, it will be reducing the number of flights and switching to smaller planes on some routes. Weekly flights to Cancun will drop from 98 to 46, then to 40 the following week, according to spokeswoman Julie King. Weekly flights to Mexico City will be cut from 116 to 78, and to 60 the subsequent week. “We were already experiencing soft market conditions due to the economy,” said Continental chief executive Larry Kellner, “and now our Mexico routes in particular have extra weakness.” The airline is allowing passengers to postpone trips to Mexico without penalty for all flights departing the U.S. through May 15.
United Airlines says they will continue to serve all four of its destinations but will reduce its weekly round-trip flights between the U.S. and Mexico from 61 to 24 in May and from 90 to 52 in June. Its nonstop flights from Denver to Mexico are being canceled in May, but will resume to two per week for Cancun, Puerto Vallarta and Los Cabos in June. John Tague, United’s chief operating officer, said the airline is “adjusting our schedule to match customer interest.” The carrier says they will monitor demand and make further adjustments as needed. United is issuing waivers for tickets purchased by April 26th for travel to, from, or through Mexico through May 31.
Delta, the world’s biggest airline, plans to cut some of its 350 weekly flights to Mexico, spokeswoman Betsy Talton said in a statement, but that the company still plans to provide service to all of its 11 Mexico destinations. For flights leaving through May 16, Delta will allow you to exchange your tickets to Mexico for another destination altogether without a change fee.
US Airways says it will reduce flights by 38 percent in two phases between May 10 and July 1 and then re-evaluate to see if further cuts are needed in July and August. US is providing a one-time option to re-schedule or re-route for those who are ticketed and traveling to, from or through Mexico City and will waive the standard change fee, advance reservation and ticketing requirements. AirTran Holdings said it has reduced its total flights to Mexico from 16 to 14. They will waive change fees for passengers who want to alter their travel scheduled to or from Cancun through May 31.
On the other hand, American Airlines, the second-largest U.S. carrier flying to Mexico, hasn’t trimmed Mexico flights. Tim Smith, a spokesman for the airlines, said the airline is “monitoring and evaluating demand” on a regular basis. American “does not plan to make any changes unless given a directive from the CDC,” the Association of Professional Flight Attendants told its members in a message. “At this time, all flights are scheduled to depart regardless of flight loads.” But the airline is taking precautions, such as issuing medical kits consisting of masks, gloves and medical equipment to cabin crews and allowing flight attendants to wear both gloves and a mask while working flights in and out of Mexico. For those who still feel skittish about travel to Mexico, American has activated its “storm policy,” which allows passengers to change routes or dates without charge and is also offering refunds for all tickets to Mexico for flights through May 31.
Some global airlines have also reduced links to Mexico. Canada’s largest carriers, Air Canada and WestJet Airlines have suspended all flights to Mexico, as did Cuba, Ecuador and Argentina. Germany’s Deutsche Lufthansa announced plans to cut flights and drop routes and says the planes that do fly to Mexico will have a doctor on board. “The doctor is there to answer passenger questions and to identify suspicions of flu during flight and to act to handle the situation before landing,” said Thomas Jachnow, a Lufthansa spokesman in Frankfurt.
Alaska Airways said it will remove blankets and pillows from all its planes and British Airways is handing out face masks to passengers so they can comply with a request by Mexican authorities that passengers cover their faces as they go through Mexican airports.
Brian Hoyt, a spokesperson for Orbitz, a travel booking and comparison site, said overall “people are still flying.” He said their site is suggesting alternative destinations with similar climates, such as Las Vegas or the Caribbean. “Travelers should take precautions, but they should let science, meaning the Centers for Disease Control and the World Health Organization, dictate their decisions,” said Hoyt. “Right now the only place they’re saying to be careful is in Mexico.”
However, that recommendation could change at any time, so if you are planning to travel, be sure to check with your airline for their current policies or access Orbitz’s list of airlines and their status.
Drug Use for Mental Illness on the Rise
Although mental illness has not always been treated as a medical condition, increasing knowledge and greater conceptual sophistication have brought with them significant change. Both the acknowledgment of mental illness by medical science and its quest for successful treatment of these disorders have marked milestones in the journey toward improving these aspects of the human condition. However, there remains a great deal of research to be done regarding the causes and treatment of mental illness.
Mental health disorders affect an estimated 22 percent of American adults each year due to very complex causes that often involve a combination of genetics, biology, and uncontrolled life experiences. Studies have shown that mental disorders are linked to physical changes in the brain and that some mental illnesses run in families, indicating a genetic association. Millions of Americans suffer from various forms of mental health issues ranging from social anxiety and obsessive-compulsive disorder to drug and alcohol addiction to personality disorders. However, successful treatment options including medications and psychotherapy as well as other treatments are available.
Since 1996, the number of Americans who use prescription drugs for the treatment of mental illness has been on the rise. In fact, among seniors 65 and older, the use of psychotropic drugs such as antidepressants, antipsychotics and Alzheimer's medicines doubled between 1996 and 2006. In addition, the 10-year period revealed an increase of 73 percent among adults and 50 percent among children in drug use for the treatment of mental illness. This accounts for one in 10 adults and one in 20 children having reported prescription mental health drug use in 2006.
According to health policy researchers Sherry Glied of Columbia University and Richard Frank of Harvard Medical School, the drug usage increase may be due in part to the expansion of insurance coverage for these drugs as well as a broader familiarity with them among primary care physicians. Their report appears in the journal Health Affairs and is titled "Better But Not Best: Recent Trends In The Well-Being Of The Mentally Ill." Glied said, “What we generally find is there has been an increase in access to care for all populations.” She went on to explain, “Mental health has become much more a part of mainstream medical care.”
The researchers gathered their data from several large U.S. public health surveys that included the National Center for Health Statistics, the Agency for Healthcare Research and Quality, the Substance Abuse and Mental Health Services Administration and the Social Security Administration.
Glied voiced concern regarding the little progress that has been made in the access to care for people suffering from more serious mental illnesses. The study found that treatment for older adults having mental limitations and requiring assistance with dressing, eating, or bathing dropped over the 10-year period between 1996 and 2006. Frank agreed by saying, “seniors are most concerning to us.” These patients have been the most under-treated and although many are now getting psychiatric medication, access to specialists is declining among the seriously impaired. In addition, with approximately 7 percent of Americans suffering from serious mental illness ending up in jail or prison each year, the researchers noted, “New policies are desperately needed to reduce the flow of people whose primary problem is a mental disorder into the criminal justice system.”
With the 2008 federal parity law came the requirement employers to provide equivalent insurance coverage for both physical and mental illness in an effort to improve access to care. However, concerns remain that the ongoing recession will leave a growing number of Americans uninsured and this could leading to less mental health coverage for many in the near future.
Researchers Put Another Piece of the Autism Puzzle in Place
What has more than 65 years of research uncovered about autism? Not its cause, not a cure, not a means to prevent it, not a fully effective treatment. Researchers have identified a number of genes associated with the disorder and some studies suggest that people with autism have abnormal levels of serotonin and other neurotransmitters in the brain. Other studies of people with autism have found irregularities in several regions of the brain. But intriguing new research by scientists at the University of North Carolina actually pinpoints the time when these brain anomalies occur, findings that experts say are critical in developing new ways to treat and diagnose autism earlier.
For the study, Dr. Matthew W. Mosconi and his colleagues at UNC took magnetic resonance imaging (MRI) scans of 50 children with autism and 33 controls—22 typically developing children and 11 who were developmentally delayed—between 18 and 35 months and again between 42 and 59 months. Participants also underwent tests that looked for certain behavioral features of autism. The researchers found that at both time points, the amygdala region of the brain, which is associated with controlling emotions, regulating attention and reading social cues from eye contact, in the children with autism was larger than the toddlers in the control group. “The amygdala plays a critical role in early-stage processing of facial expression and in alerting cortical areas to the emotional significance of an event,” the authors wrote. “Amygdala disturbances early in development, therefore, disrupt the appropriate assignment of emotional significance to faces and social interaction.”
The researchers said after observing the children that the enlarged amygdala appeared consistent with something called joint attention, or the ability of a young child to follow another person’s gaze and to share attention with others; behaviors thought to predict later social and language function. “We would basically try to get the child to look one way, we’d turn and point to a clock and see whether or not the child would notice it,” explained Dr. Joseph Piven, director of UNC’s Neurodevelopmental Disorders Research Center and one of the study’s authors. “The two-year-olds without autism would see your face, see where you are looking and join you but the children with autism, with large amygdalas, would not.”
“We believe that children with autism have normal-sized brains at birth but at some point, in the latter part of the first year of life, it (the amygdala) begins to grow in kids with autism,” said Piven. “Once we understand the neurological circuits, we may be able to detect if a child has problems in those circuits as early as 6 months of age. We need to let the pattern of early brain development guide us to predict who is at higher risk and who would benefit from early intervention.”
The team continues to follow study participants to determine whether amygdala growth rates continue at the same rate, speed up or slow down in children with autism after age four. “Studying this relationship as these children develop will shed important light on the neurobiological basis of autism,” Piven said. UNC researchers are also recruiting 500 infants who are also sibling of children with autism for a follow-up to their initial findings. “By tracking the behaviors and brain volume growth from birth in high-risk babies, we can pinpoint when the brain first begins to grow larger than normal and provide therapy or medications to limit the growth or symptoms a lot earlier than we are doing now,” said Piven.
“What they’re doing at UNC is really starting to define in the brain what’s going on with someone who has autism,” said Scott Badesch, chief executive of the Autism Society of North Carolina. “That gives us an ability as providers to address those needs.” Badesch said recent scientific findings, including an announcement last week about a new genetic clue for up to 15 percent of cases, are offering hope to families struggling with the disorder. “We’re beginning to find things, and the next question is what, if anything, we can do regarding treatment or a cure.”
Gender Parity Issue to be Corrected by Health Insurance Industry
Discrimination on the basis of gender is nothing new. Women have been fighting for equal rights, equal pay, and equal treatment by employers and society alike since the dawn of time. But many people do not realize that insurance companies have been charging women higher coverage rates than men, and some members of the United States Senate have chosen to address the issue through the initial stages of drafting legislation to stop it.
On Tuesday, May 5, the Senate Finance Committee met to discuss health care reform, specifically a closer federal regulation of the industry as a whole. Though a number of topics were brought to the floor, including single-payer health insurance plans and public versus private health care companies, it was a focus on gender parity and the need for action that seemed to resonate with most members of the committee.
President of America’s Health Insurance Plans Karen Ignagni was present to testify at the hearing and discussed the need for an end to gender discrimination regarding health insurance policy rates. Since many lawmakers already agree that bias on the basis of health history is unethical and discriminatory, it is more than fair that insurance companies give gender the same fairness. Though Ignagni’s overall point was to address the push for a massive overhaul of the insurance industry that could allow a federally sponsored plan to compete with private insurers, the gender parity issue was of specific importance.
Insurance companies are open to equaling the rates of men and women who apply for health care coverage, though the concession is in exchange for nixing the idea of a government-sponsored insurance company.
Senator John Kerry (D-MA) was particularly keen on sponsoring legislation that would address gender discrimination in the insurance market. “The disparity between women and men in the individual marketplace is just plain wrong,” he said, “and it has to change.”
He attended the committee meeting armed with research to show that women are often charged with higher premiums based purely on gender. In fact, this disparity currently affects the premiums paid by 5.7 million women in the United States, many of whom are self-employed and purchase individual coverage. It has previously been noted in studies that in California, women pay up to 39 percent more than men for individual policies. In addition, it was pointed out during the hearing that costs for women often increase during childbearing years, and some policies refuse to cover maternity care at all.
Employer-based plans are currently prohibited from charging women higher rates than men or eliminating maternity care from plans. In addition, ten states already ban the discriminatory practice -- Maine, Massachusetts, Minnesota, Montana, New Hampshire, New Jersey, New York, North Dakota, Oregon, and Washington. But many agree that a federal law to eliminate the discrimination across the board is needed.
The bill is currently being drafted, and lawmakers hope to introduce it to the Senate by the summer of 2009.
New Testosterone Injections Work as Male Contraceptive
Pregnancy is a big step in life for any couple. Until now, there have only been a few ways to prevent pregnancy and most of them are centered around the female. Now, there is a new monthly injection of testosterone that works as a contraceptive in men, allowing the responsibility of birth control to be shared among the sexes.
For years, scientists have been looking for a contraceptive to be the male equivalent to the Pill. The trials that were conducted in the 1990s found that weekly injections of testosterone reduced the sperm counts for 98 percent of the men, and the effects disappeared when the injections were stopped. However, the researchers thought that the weekly injections would be considered too unpopular and troublesome with men to be a very useful method of contraception.
Since then, researchers have been experimenting with injections that are oil-based. They combined the testosterone with tea seed oil which means that once it was injected, it was absorbed very slowly by the body. This also means that the effect of a single injection could last for much longer.
A new, large-scale study has looked at how well the monthly injections of testosterone has worked as a contraceptive and how safe they really are. The recent study looked at approximately 1,045 Chinese men that were between the ages of 20 and 45, had fathered at least one child in the two years prior to the study, and were in a stable relationship.
For six months, the men that participated in the study took monthly injections of testosterone in their buttocks. After that time, most of the men had very low sperm counts. However, the testosterone injections failed to lower the sperm count in about 5 percent of the men.
If the injections were successful, the men continued to take them for two years. However, many of the participants dropped out over time, so only 733 actually completed the trial. Also during the trial, the sperm count rose again for just over 1 percent of the men, and there were nine pregnancies during the two years. Overall, after the first year of the study, there was 1 pregnancy for every 100 men that participated. At the end of the second year, the pregnancy rate was fractionally higher at 1.1 per 100 men.
Condoms, when they are used perfectly, have about a 2 in 100 pregnancy rate a year. With the female contraceptive pill, the pregnancy rate is approximately 0.3 in 100. It is very important to remember that most of the contraceptives are a lot less effective in the real world than these ‘"perfect use" figures suggest, because people can forget to take a pill or the condom can fail to work properly.
An important question is whether the men’s sperm count rose again after the testosterone injections were stopped. For most of the men it took approximately 200 days for their sperm count to return to normal, however, 17 of the men still had not recovered their fertility after one year. Most of the men who participated had a normal sperm count after an extra three months, but two of the men were still not producing sperm after this time period.
The side of effects of the injections included tenderness at the injection site, a rash or acne, and some men experienced changes in their sex drive. These changes varied from man to man, but the most common side effect was a sex drive that was higher.
The next question is, what does this mean for me? The injection is currently being tested in Phase III trials, which are considered the largest scale human trials that are carried out before a new drug is released to the market. If a new medication is safe and effective in Phase III trials, its manufacturer can then apply to the appropriate regulatory agency for a license to manufacture and sell the product. There is no definite timescale, but it is usually a few years from the successful completion Phase III trials to the launch of the new product.
Job Vacancy : AGI Program Manager
Winrock International
Closing date: 15 May 2009
Location: Sudan (the) - Wau, Western Bahr El Ghazal, Southern Sudan
Winrock International is seeking a Program Manager for an upcoming project based in Wau, Western Bahr El Ghazal, Southern Sudan. The position will start o/a July 2009 and be for a three year term.
Reports to: GEE Chief of Party
Program Title: Southern Sudan Adolescent Girls Initiative
Program Summary: The Southern Sudan Adolescent Girls Initiative will provide job skills and training for adolescent girls and young women leading to increased opportunities and access to demand-driven wage employment and/or entrepreneurship activities that meet market demands of Southernern Sudan.
Position Summary: The AIG Program Manager will provide overall management of the program activities, including maintaining donor relationships, overseeing program development and implementation, managing consultants and staff, supervising project spending, and providing oversight to data collection and monitoring and evaluation.
Qualifications:
Education:
* Bachelors Degree from an accredited institution, (Masters preferred), in education, training, business, or another appropriate field
Work Experience:
* Successful experience as a Program Manager of a similar program
* Prior experience managing funding equal to or exceeding USD 500,000
* Prior experience with programs targeting women or girls empowerment
* Demonstrable experience in implementing vocational education training programs for marginalized populations, especially young women
Skills:
* Excellent oral and written English skills, Arabic a plus
* Computer literacy in Microsoft Office applications
* Skills in financial management and program monitoring and evaluation
* Expertise in at least two of the following: small business development, entrepreneurship training , vocational training (especially agriculture-based), income-generation/micro-credit
Other:
* Experience working in Southern Sudan, experience in Wau a plus
* Willingness to live and work in Wau, Western Bahr El Ghazal
How to apply
Interested candidates should submit a cover letter and resume via email only to Necia Stanford nstanford@winrock.org with Subject Line of "AGI Program Manager Sudan", no later than Friday, May 15, 2009. Only candidates selected for an interview will be contacted.
Reference Code: RW_7RRRNY-86
Job Vacancy : Coordonnateur (trice) Médical(e)
Médecins du Monde Canada
Médecins du Monde est une organisation non gouvernementale de coopération et de solidarité internationales qui a pour vocation, par l'engagement volontaire et bénévole de professionnels de la santé, d'aider et de soigner les populations les plus vulnérables dans des situations de crise, de guerre, de catastrophe naturelle et d'exclusion dans le monde
Closing date: 24 May 2009
Location: Haiti - POrt-au-Prince
Le candidat au poste sera responsable de coordonner, superviser et offrir un appui technique en s’assurant l’atteinte des résultats attendus pour les projets. Il (elle) coordonnera également de futurs projets médicaux qui pourraient être réalisés.
Ses tâches seront :
* coordonner la planification des objectifs des différents objectifs des projets;
* contrôler la qualité des prestations des services médicaux offerts;
* présenter périodiquement les résultats des projets;
* superviser la production des rapports d’activités mensuelles prévues et réalisées ainsi que les rapports narratifs intérimaires et finales;
* assurer le suivi budgétaire des activités médicales;
* participer au développement de nouveaux projets sur demande et en collaboration avec le coordonnateur général;
* superviser la planification des besoins en ressources humaines, matérielles et financières nécessaires à la réalisation des projets;
* établir et maintenir des relations avec les autorités locales médicales, les partenaires, ainsi que la gestion du personnel médical
Profil:
* Expérience humanitaire indispensable (au moins une expérience à un poste similaire) en VIH/SIDA et en santé communautaire
* Capacité de gestion, leadership, diplomatie, connaissance informatique.
* Capable de travailler dans un milieu à sécurité limitée
* Capacité à travailler dans un milieu instable, et à s’adapter aux pratiques locales.
* Expérience de préparation et de planification de projets souhaitée
* Formation : médecine, sciences infirmières
* Langues : Français, créole un atout
How to apply
Si vous êtes disponibles et intéressées, merci d’envoyer lettre de motivation et CV à :
Médecins du Monde
338 rue Sherbrooke Est
Montréal, H2X 1E6
Québec, Canada
Fax : 514-281-3011
recrutement@medecinsdumonde.ac
Reference Code: RW_7RRS8X-40
Job Vacancy : Senior Agricultural Production Advisor
For over 45 years and in 145 countries, ACDI/VOCA has empowered people in developing and transitional nations to succeed in the global economy. Based in Washington, D.C., ACDI/VOCA is a nonprofit international development organization that delivers technical and management assistance in agribusiness, financial services, enterprise development, community development and food security in order to promote broad-based economic growth and a vibrant civil society. ACDI/VOCA currently has approximately 76 projects in 41 countries and revenues of $100 million.
Closing date: 04 Jun 2009
Location: Afghanistan
We are currently seeking a Senior Agricultural Production Advisor for a multiyear, USAID-funded program in Afghanistan. The Senior Agricultural Production Advisor is responsible for managing the agricultural and productivity activities for the program in the region, overseeing ACDI/VOCA local agricultural-production staff and coordinating inputs with all IDEA-NEW partners. He/she must coordinate technical activities with the Regional Director and other IDEA-NEW Senior Management Committee members. The Senior Agricultural Production Advisor, in tandem with the Regional Director, must interface with regional and local government officials regarding agricultural project ideas and implementation. The position is based in Mazar-e-Sharif with substantial attention to three satellite offices. Please note this is an unaccompanied post (no spouse or family at post).
Responsibilities:
* Reach out to the community to make inroads and develop possible activities
* Manage long-term local technical staff based out of the Mazar-e-Sharif office and satellite offices in coordination with their day-to-day supervisor and oversee all short-term advisors in coordination with their technical counterpart
* Identify implementation issues and work with relevant project stakeholders to solve them
* Participate in the creation and implementation of programmatic work plans in accordance with USAID’s overall objectives
* Provide overall direction and guidance pertaining to agricultural and productivity interventions
* Facilitate technical assistance and training in areas such as fruits and nuts, vegetables, grains, livestock and poultry, productive infrastructure, and organizational strengthening
* Ensure community participation and link with local government
* Incorporate gender considerations into programming as appropriate
* Develop strategic methodologies and interventions for agricultural development relevant to IDEA-NEW
Qualifications:
* Relevant advanced degree from an accredited university
* Minimum 8-10 years of progressive experience in managing a large and complex agricultural production or related project.
* Relevant experience in Afghanistan or similar conflict setting
* Experience planning and managing programs for local government and agricultural organizations; experience assessing needs and gaps, determining appropriate interventions, and monitoring and evaluation effectiveness
* Experience managing a team in multiple locations and ensuring consistent programming
* Experience managing grants programs for USAID in similar environment
How to apply
For quick consideration, Click here to apply: http://www.cytiva.com/av/apply.asp?av?av1072?chayes?29
No phone calls please. Only finalists contacted. Women and minorities encouraged to apply.
Reference Code: RW_7RRSC5-72
Job Vacancy : International Business & Technical Consultants, Inc. (IBTCI)
International Business & Technical Consultants, Inc. (IBTCI)
international development consulting firm
Closing date: 22 May 2009
Location: South Africa - Southern Africa
International Business & Technical Consultants, Inc. (IBTCI), a US-based international management consulting firm, is seeking a Team Leader for a capacity building project in Southern Africa targeted to procurement curriculum development and training.
Qualifications:
* Demonstrated 10+ years of professional experience, 5+ years of international project management experience as team leader or chief of party in developing countries;
* 10+ years in conducting training courses, needs assessment, and curriculum development
* Proven experience in managing projects in Sub-Saharan Africa
* Graduate degree in business management, business administration, economics, and/or international development
* High level of computer skills, including Microsoft Project
* Fluent in English
How to apply
To Apply: Please send a full Curriculum Vitae (CV) and a cover letter addressing each of the above qualifications to lcosgrove@ibtci.com. Please indicate Team Leader in the subject line. No phone calls will be accepted.
Reference Code: RW_7RRT4B-21
Job Vacancy : Procurement Agent Manager
International Business & Technical Consultants, Inc. (IBTCI)
international development consulting firm
Closing date: 05 Jun 2009
Location: Senegal - Dakar
International Business & Technical Consultants Inc (IBTCI), an international development consulting firm, is seeking:
Procurement Agent Manager / Team Leader for an MCC project in Senegal that will, at a minimum, possess the following qualifications, skills and professional experience:
* Education or training in procurement, logistics, business, law, economics, finance, public administration, or related field.
* More than 10 years as a professional procurement and logistics qualifications or specialized training.
* More than 3 years as a Team Leader /COP/DCOP for World Bank or MCC projects.
* Extensive knowledge of international best practices in procurement procedures, project administration, contract procedures and project follow-up.
* Proven leadership qualities and experience as project manager/procurement agent.
* Excellent communication and interpersonal skills and experience in working with high level government officials and business executives.
* Bilingual: fluency in written and spoken French and English.
* Working experience in similar countries; experience of working in Senegal or West Africa would be an advantage.
* Computer literate in Microsoft Word and Microsoft Project.
Procurement specialists with an education or training in relevant subjects and at least 8 years experience working as procurement professionals, preferably in the areas of agriculture, education and tourism. Specialists shall be computer literate and must be bilingual, able to communicate effectively in both French and English. Experience working in similar developing countries would be an advantage.
How to apply
To Apply: Please send a full Curriculum Vitae (CV) and a cover letter addressing each of the above qualifications to lcosgrove@ibtci.com. Please indicate Procurement-Senegal in the subject line. No phone calls will be accepted.
Reference Code: RW_7RRT8E-28
NewsGator's Enterprise Collaboration SW Adds Brainstorming
NewsGator's enterprise social-networking product, Social Sites, now has a component for employees to submit, discuss and evaluate ideas for business projects.
In its version 2.7, announced Thursday, Social Sites has a new tab in its interface labeled "Ideas," which provides functionality for what NewsGator calls "innovation management."
There are stand-alone applications for automating these idea-generation tasks, but NewsGator believes the functionality is important enough that it should be a standard component of Social Sites.
"Companies have to innovate their way to a better position in this economy," said Brian Kellner, NewsGator's vice president of products.
Social Sites as a whole is designed as an enterprise social-networking complement to Microsoft's Office SharePoint Server 2007.
The product's idea management component lets users draft ideas not only in written form, but also with embedded images, tables, links and other elements.
Once the employee submits the idea, colleagues to whom this person is linked via contacts list or workgroup membership are notified and can append comments to the document and vote it up or down.
However, the feature isn't meant to manage the entire evolution of an idea into a finalized project. "We focus on the front-end of the process: capturing ideas easily. We stop at the point where the idea is considered worthwhile and moves into a stage involving funding, proof-of-concepts and so on," Kellner said.
Once supervisors promote ideas into a more formal initiative beyond the brainstorming and evaluation process, the discussion can be moved into a community or wiki page in Social Sites for further collaboration or into a separate, third-party project management application.
Ideas get aggregated in a central repository where the list of submissions can be sorted and filtered based on different parameters, such as date created, number of votes and number of comments. Ideas also get logged into the individual profiles of the employees who submitted them.
Other enhancements in Social Sites 2.7 include an option for employees to get a daily e-mail digest with activity notifications from colleagues and workgroups to which they belong. Version 2.7 also lets employees who create community sections for collaboration within Social Sites to add blogs, wikis and announcement modules to them.
Facebook's Censorship of E-Mail Puts it in Free Speech Hot Seat
Facebook is actively filtering out Pirate Bay content from its Web site banning a Pirate Bay link-posting application that allows you to easily share torrent files from the Pirate Bay's site with Facebook members. Facebook is also censoring e-mail that contain Pirate Bay URLs from its e-mail system preventing users from cutting and pasting a Pirate Bay Web address in a Facebook e-mail message and sending it. While Facebook's evasive action may seem to be an effort to maintain its "family friendly" visage, there are now questions as to whether the social networking site is violating free speech.
In order to determine what constitutes "blocked content," Facebook must first read the e-mail message being sent. This may be an abuse of the federal wiretapping law. It's apparent from our tests that any URL originating from Pirate Bay's Web site is automatically filtered out of the system; if no other text is added to the outgoing message, the message arrives blank. Identifying what the contents of an e-mail is or "Sniffing" e-mails, as Wired calls it, is not an unknown practice -- Google does it to deliver ads -- but censoring e-mails based on content inches closer to an abuse of administrative power.
There certainly are ways around privately maintained e-mail systems such as Facebook's, ISP, and other bittorrent blockades. The Pirate Bay has a few tricks up its sleeve. For instance, if you find the "Download this Torrent" URL on Pirate Bay pages it uses the subdomain "http://torrents.thepiratebay.org/..." which is not blocked by Facebook - yet. Users may also check out Tiny URL to fool the filter.
Facebook is also behaving ignorantly. Bittorrents from other file-sharing sites are not blocked. Using Facebook to sent torrents found on the sites Mininova and Isohunt works fine. In fact, Isohunt has the same "Share on Facebook" feature that Pirate Bay has, isoHunt's works.
Facebook spoke to Wired and stated its right to censor e-mail based on links that may contain "spammy, illegal, threatening or harassing content." But Facebook is taking it too far. Bittorrents links themselves are not spammy, illegal, threatening or harassing. They are simply portals to a site where a user takes a personal risk downloading what may be copyrighted material or not. Facebook is creating its own set of rules here, and in the meantime, may be ignoring federally-established laws.
Australian Rockers 26 Take Apple's Logic Onstage
Many professional musicians, producers, and engineers use Apple's Logic digital audio workstation software to record and mix music, but one group of musicians is taking that practice a step further. Australian band 26 takes Logic on the road with them, allowing them to perfectly duplicate the sound of their recorded music onstage.
"For me you can't beat Logic," Nick O'Donnell, the band's lead vocalist and guitar player, told Macworld. "I have been a user since Logic 4 and it was the only Mac-based program that really incorporated the recording side with the MIDI sampling side of things. It is the best thing for integrating the two elements."
As an audience, we have become accustomed not to hear all of the same sounds from a live performance that we do from a band's recordings. Typically, there are percussion, strings, extra guitars, and other instruments on the album that most bands just can't recreate in a live setting. But that's not the case for 26.
O'Donnell said that it is Logic's ability to recreate the same sounds live as they have on their CDs that make for such a great show. The band's keyboard player, Drew Fellows, has a MIDI controller onstage to trigger the sounds during the live performances.
"We use Logic and the laptop live for our keyboard sounds, backing sounds like strings and percussion, changing my guitar effects, and to supply a click track," said O'Donnell. "We also have a MIDI track that wirelessly sends patch changes to our lighting and visual guy's PowerBook to trigger our visuals and some lighting cues. It all sounds pretty crazy but it makes the show really run smoothly and look really pro on our mini budget."
The band is using an old PowerBook and a Power Mac G5 tower for their recordings and live performances. In fact, they do much of the songwriting on the PowerBook, although they are purchasing some new gear soon, including a MacBook Pro.
O'Donnell said there are a lot of benefits to using Logic in a live performance, beyond having the ability to play back so many instruments in their songs.
"I think other than having to lug a grand piano, Fender Rhodes, a full Hammond Organ, an orchestra, and a choir with you everywhere you go, it is the best option," said O'Donnell. "I used to have to take so much gear out on the road and now I don't even have to take a guitar amp, if I don't want to. And, I think the sound quality is great."
After recording a session in the studio, O'Donnell and Fellows will often take their projects home to work on them. They will record vocal tracks or polish up some of the guitars and not have to be in the studio to it.
This brings up another small problem--with only the two of them, sometimes there is nobody left to push the buttons in Logic, but they figured a way around that using the iPhone. O'Donnell said they use the iPhone to change the keyboard sounds wirelessly, adjust the mix, and arm and record tracks.
The band is currently looking into using Apple's MainStage, which was designed specifically for live performances. They are testing the capabilities of the application to make sure it matches with everything they currently do with Logic.
The band makes use of a lot of other Apple technologies as well.
"Our lives revolve around Logic and Adobe's design suite, but we also use iLife a lot as well," said Fellows. "We have used iMovie to create the occasional video, GarageBand to create podcasts, and iDVD to create promo DVDs. I even prefer to use TextEdit over Microsoft Word."
Kindle DX: First Impressions of the Large Doc Reader
NEW YORK CITY -- At today's launch event here, Amazon unveiled the details of its Kindle DX. The rumors about the device proved true: It has a larger screen than the Kindle 2, and is aimed squarely at maximizing the newspaper and textbook market. However, that's not the only angle that Amazon head Jeff Bezos took today. By focusing on professional documents, too, Bezos positions Kindle DX as a business productivity tool, too.
The shift to a larger-screen Kindle makes sense. (See related: First Official Images of Kindle DX)
"The reason we still print so much is that traditional computer displays are a worse display device than paper. Kindle's paper-like display solves that problem. But most of the documents we print and read are 8.5-by-11-inch," Bezos notes. "The information on those documents is structured to be read [in that form]."
The larger Kindle DX, with its 9.7-inch E Ink display, has an integrated native PDF reader, something that has been missing from previous versions of the Kindle. And with that PDF reader, Amazon is suddenly able to target the professional market, too. Consider for a moment how prevalent PDF documents are in the business world: Financial documents, reports, marketing flyers, even PowerPoint presentations are published as PDFs. While one can view PDFs on a laptop, imagine reading documents in a more relaxed and flexible manner than a laptop can provide.
Of course, Kindle DX also opens wide educational opportunities for textbooks -- and, indeed, any highly-formatted book (such as a cookbook or a book with illustrations). And newspaper and magazine publishers have an opportunity to deliver more targeted and custom content that specifically takes advantage of this platform (instead of solely porting their existing print products to digital).
At $489, Kindle DX straddles a precarious position. It is an expensive proposition that will make consumers think hard about buying one (especially when highly functional mini-notebooks can be had for far less). But it is also a highly targeted device that can benefit from this broadening of its scope. The more multipurpose Kindle can become without detracting or minimizing its primary mission as an electronic reader, the better-positioned Kindle will be going forward.
Microsoft tweaks antipiracy tech for Windows 7
With Windows 7, Microsoft is making some subtle changes to the ways it tries to thwart piracy.
As has been the case for some time, Microsoft's strategy hinges on requiring a user to electronically verify their copy of the software, a process known as activation, and then the software also periodically validates that a copy of Windows is genuine.
In Windows Vista, if a user does not activate their software immediately, they get a warning that they still need to do so. The dialog box offers two options, to activate immediately or to do so later. However, the activate later box cannot be checked for 15 seconds.
Microsoft decided this was a bit too annoying. With Windows 7, users can click activate later immediately, but then get a dialog box touting the benefits of activation.
It's the latest effort by Microsoft to scale back the intrusiveness of its technology while still aiming to deter piracy. With the first service pack to Vista, Microsoft made the software significantly more usable to those whose versions of Windows are determined not to be genuine. Before that, Vista systems entered a nearly unusable "reduced functionality mode" once they were deemed to be non-genuine.
"We think we've gotten it to a pretty good place where it strikes an effective balance," said Alex Kochis, director of product management for Microsoft's Genuine Windows unit. "We're committed to the program for the long term because it works."
Microsoft said in December 2007 that it was seeing Windows Vista pirated at only half the rate of Windows XP. Kochis said that general trend has continued.
With Windows 7, Microsoft is also changing the name of its antipiracy technology, from Windows Genuine Advantage to Windows Activation Technologies. The Windows Genuine name took some beatings in the Windows XP time frame, so probably a good move from a PR standpoint.
The software maker is also adding technology designed to make it easier for businesses to activate multiple machines as well as manage activation for virtual machines.