View Full Version : Odds & Ends on Health and Wellness

Jun 13, 2007, 06:12 AM
This is one chain email I found useful and worth passing on. I found this to be very useful advice awhile back when it emerged during 9/11 and the London bombings. I find it quite useful still today.


We all carry our mobile phones with hundreds of names/ numbers stored in its memory but yet nobody, other than ourselves, know which of these numbers belong to our near and dear ones? In case we are involved in an accident or had a heart attack and the people attending us get hold of our mobile phone but don't know which number to call to inform our family members. Yes, there are many numbers stored but which one is the contact person in case of an emergency?

For this reason, we must have one or more telephone numbers stored under the name ICE (In case of Emergency) in our mobile phones. Recently, the concept of "ICE" is catching up quickly. It is simple, an important method of contact during emergency situations. As cell phones are carried by majority of the population, just store the number of a contact person or person who should be contacted at during emergency as ICE" (meaning In Case of Emergency). The idea was thought up by a paramedic
>who found that when they went to the scenes of accidents, there were always >mobile phones with patients, but they didn't know which number to call. He therefore thought that it would be a good idea if there was a nationally recognized name for this purpose. Following a disaster in London , the East Anglican Ambulance Service has launched a national "In case of Emergency
(ICE)" campaign. In an emergency situation, Emergency Service personnel and hospital staff would then be able to quickly contact your next of kin, by simply dialing the number stored as "ICE".

Please forward this. It won't take too many "forwards" before every body will know about this. It really could save your life, or put a loved one's mind at rest. For more than one contact name simply enter ICE1, ICE2 and ICE3 etc. A great idea that will make a difference! Let's spread the concept of ICE by storing an ICE number in our mobile phones today! Please forward to all your nearest and dearest.

Jul 28, 2007, 02:33 AM
Questions to ask your doctor before your tests (http://cosmos.bcst.yahoo.com/up/player/popup/?rn=49750&cl=3482252&ch=49799&src=news).

Jul 30, 2007, 04:32 AM
Nigerian Guardian-- Natural Health section (http://www.guardiannewsngr.com/natural_health/article06)
Retrieved on Sunday July 29th, 2007
Lactose intolerance may not require dairy exclusion
IF your child is lactose-intolerant, you probably shy away from giving him or her milk or other dairy products. But that may not be the best tactic to take, experts say.

In fact, the American Academy of Pediatricians -- America's largest organization of pediatricians -- is urging the moms and the dads of lactose-intolerant kids to at least give dairy a chance.

The AAP issued new guidelines several months ago that advise parents to not give up on giving their lactose-intolerant children dairy products. The reason: The calcium in these foods is important for bone mineral health, and dairy products also contain other nutrients important for growth in children and teens.

Lactose intolerance is often mild enough so that kids can tolerate at least some milk and milk products, experts added.

"Lactose intolerance is relatively common," noted Dr. Melvin Heyman, a professor of pediatrics at the University of California, San Francisco, and a member of the committee that wrote the AAP guidelines.

While he was not familiar with any study citing the exact prevalence, he estimated that 20 per cent or 30 per cent of U.S. children have "some degree of lactose intolerance."

However, "there is a lot of confusion," Heyman said. Parents often confuse milk protein intolerance and lactose intolerance, he said. "Some people do get allergic to the protein in milk," he added. That condition can be serious but probably affects only three to five per cent of children in the U.S., he said.

An intolerance for lactose, the sugar found in milk, is much more common. Even with this sensitivity, Heyman said, the new thinking is that children may still tolerate some dairy.

To be sure calcium intake is sufficient, Heyman sometimes tells parents to focus more on yogurt and cheese than on milk, especially if milk gives their child the classic intolerance symptom of abdominal pain. "There is less lactose in yogurt and cheese compared to milk," he explained.

Or, your child may be able to drink a little milk without the reaction of stomach pain, he said.

Parents can also educate themselves about lactose intolerance, added Dr. Frank Greer, a professor of pediatrics at the University of Wisconsin, Madison, and chairman of the Academy's Committee on Nutrition.

"If you child is going to have a lactose-intolerance problem, it's usually identified as a problem in the first five years," Greer said. Certain ethnic and racial groups are more likely to suffer from the condition, including blacks, Hispanics and some Asians, he added.

Even if there is a problem, Greer said, "the position now is that your child, even if lactose intolerant, can really tolerate small amounts of lactose, especially in dairy products other than milk, such as yogurt and cheese. Even with milk, you can sort of build up a tolerance."

Moderation may be key, Heyman said. Your child may be able to have one glass of milk, but probably not two or three in a day.

If you suspect your child has lactose intolerance, Heyman said, your pediatrician will probably suggest taking him or her off all dairy for two weeks. "If the symptoms go away, we can be pretty sure it's lactose intolerance," he said.

If it's still not clear, there is a simple in-office test your doctor can do, Heyman noted.

When choosing dairy products for your child, look at the label to be sure you are getting a healthy dose of calcium. "Ideal would be the same amount as in milk, 250 or 300 milligrams (per serving)," he said.

Jul 30, 2007, 04:48 AM
Thisday (http://www.thisdayonline.com/nview.php?id=44944)

Stem Cell Transplant Takes off in Enugu
From Emmanuel Ugwu in Enugu, 04.08.2006

Nigeria is poised to lead the rest of Africa in benefiting from Stem Cell xenotransplantation, regarded as the medicine of the 21st Century following the establishment of Stem Cell xenotransplantation project in Enugu as a pioneer outlet for the rest of Africa.

Chairman/chief executive officer of the Stem Cell Transplantation Project for Africa, Dr Perry Iloegbunam, made this known at a medical/scientific conference held at the Annunciation Specialist Hospital Enugu, where medical practitioners and scientists gathered to brainstorm on the novel curative medicine for various types of diseases.

Stem Cell Transplantation (SCT) is a surgical procedure involving the replacement of a damaged human cell with a replica manufactured through a biotechnological process.
Dr Iloegbunam said that he got interested in the field of stem cell xenotransplantation in may 2002 when he embarked on a search for readily available cure for such life-threatening diseases like HIV/AIDS, Diabetes mellitus, which are ravaging most parts of developing world and which have also snuffed lives out of our beloved ones.

“My search got me into contact with the Bio-Cellular Research Organisation of the USA, the leading institution and authority in stem cell xenotransplantation in the world,” he said, adding that his sustained interest and commitment in this life-saving project has finally been rewarded with the decision of Prof E. Michael Molnar, the founder of BCRO.

Dr Iloegbunam said that a strategic time-phased development plan has drawn for the project, which would entail the setting up a storage facility for transplant, constitution of a technical committee comprising mainly of medical personnel, setting up a closed colony farm and a manufacturing plant.

He disclosed that arrangements have been concluded for the commencement of the Down syndrome project in Nigeria with the first batch of children with disease to start receiving treatment every four months starting from August 2006.

The chief executive of SCTPA said that while the stem cell xenotransplantation was being pioneered in Nigeria for the benefit of the whole of Africa.
He said: “We are already establishing cooperation with private and public hospitals in major cities of African countries, so that treatment could be carried out in such cities. The complicated part of Stem cell transplantation is taken care of in the manufacturing laboratory while the treatment itself is very simple

for the patient. It requires just an ordinary clinic or hospital as well as hospital physician willing to learn something new.” In his presentation Prof Molnar, the world’s renowned expert in stem cell transplantation, said that BCRO has been able to prepare stem cell transplants of every known kind of cell and make such transplants available for the patient treatment without immunosuppression.

According to him, xenotransplantation was suitable for the treatment of a variety of diseases such as diabetes mellitus, hormone deficiency diseases, early menopause, aging diseases, and degenerative diseases of liver, intestines, heart and other organs.

He noted that xenotransplantation has been in practice for over 70 years, adding that his organisation has carried out over 5, 000 cell transplants without using immunosuppressant.
Earlier chairman of the occasion, Dr B. C Ezeokpo, expressed his excitement over the project, saying, “If we cannot send all patients abroad for stem cell harvest, then stem cell harvest technology has come to Nigeria.”

But the endocrinologist from Federal Medical Centre Abakaliki warned against any abuse of the medical curative practice, adding that a number of question need to be answered including the ideal source of stem cell for each disease condition and the minimal cell count for treatment.

Dr Alex Akpa, who represented the national Biotechnology Development Agency (NBDA), assured of the support of the agency for the project and also to play its regulatory role to ensure that everything was done in good clinical, laboratory, manufacturing and ethical practices.

He reminded the medical practitioners and scientist that Nigeria was “totally against” embryonic stem cell and cloning of human beings and as such they should stay off those areas

Jul 30, 2007, 05:00 AM
Some reports from the states on health care issues

Thisday (http://www.thisdayonline.com/nview.php?id=21659)
Govt Reads Riot Act to Private Hospitals
From Tunde Sanni in Ilorin, 07.04.2005


Kwara State Commissioner for Health, Dr Bola Olaosebikan, has warned operators of private clinics to improve the standard of their operation or be sanctioned.

Olaosebikan, at the opening of the Annual General Meeting and Scientific Conference of the Nigeria Medical Association (NMA) Kwara State branch, said the ministry would begin inspection of private hospitals from this month, adding that anyone who did not meet its standard would be penalised.

He sought the cooperation of doctors in the state in the implementation of the newly introduced National Health Insurance Scheme (NHIS).

According to him, â??we want the NMA to take the National Health Insurance Scheme seriously by helping us translate the scheme to the people.â??
He said the people would benefit immensely from the scheme if they are properly briefed by doctors.

He restated governmentâ??s determination to improve the health sector and added that government had inaugurated a 19-member committee to tackle the deadly HIV/AIDS disease.

He added that government had set aside N250 million for the renovation of 36 hospitals across the state. Olaosebikan commended the NMA for maintaining industrial harmony and assured that government would continue to maintain an open door policy with all industrial unions.

â??We want you to sustain this understanding. We donâ??t want you to go on strike, we promise to continue to operate an open door policy,â?? he added.

The commissioner called on the private sector to partner with government in ensuring success of the Primary Health Care (PHC) programme, saying government was determined to revive the PHC in order to improve health care delivery.

In his address, state Chairman of NMA, Dr. Isâ??haq Funsho Abdul, said the AGM, with the theme â??Diabetes Mellitus and Hypertension, an unholy alliance: Management Challengesâ?? was aimed to raise the awareness of the public to the diseases.

He described hypertension and diabetes as diseases that affected mostly members of the higher social class.

Thisday (http://www.thisdayonline.com/nview.php?id=44944)
Stem Cell Transplant Takes off in Enugu
From Emmanuel Ugwu in Enugu, 04.08.2006

Nigeria is poised to lead the rest of Africa in benefiting from Stem Cell xenotransplantation, regarded as the medicine of the 21st Century following the establishment of Stem Cell xenotransplantation project in Enugu as a pioneer outlet for the rest of Africa.

Chairman/chief executive officer of the Stem Cell Transplantation Project for Africa, Dr Perry Iloegbunam, made this known at a medical/scientific conference held at the Annunciation Specialist Hospital Enugu, where medical practitioners and scientists gathered to brainstorm on the novel curative medicine for various types of diseases. Stem Cell Transplantation (SCT) is a surgical procedure involving the replacement of a damaged human cell with a replica manufactured through a biotechnological process.

Dr Iloegbunam said that he got interested in the field of stem cell xenotransplantation in may 2002 when he embarked on a search for readily available cure for such life-threatening diseases like HIV/AIDS, Diabetes mellitus, which are ravaging most parts of developing world and which have also snuffed lives out of our beloved ones.

“My search got me into contact with the Bio-Cellular Research Organisation of the USA, the leading institution and authority in stem cell xenotransplantation in the world,” he said, adding that his sustained interest and commitment in this life-saving project has finally been rewarded with the decision of Prof E. Michael Molnar, the founder of BCRO.
Dr Iloegbunam said that a strategic time-phased development plan has drawn for the project, which would entail the setting up a storage facility for transplant, constitution of a technical committee comprising mainly of medical personnel, setting up a closed colony farm and a manufacturing plant.

He disclosed that arrangements have been concluded for the commencement of the Down syndrome project in Nigeria with the first batch of children with disease to start receiving treatment every four months starting from August 2006.
The chief executive of SCTPA said that while the stem cell xenotransplantation was being pioneered in Nigeria for the benefit of the whole of Africa.

He said: “We are already establishing cooperation with private and public hospitals in major cities of
African countries, so that treatment could be carried out in such cities. The complicated part of Stem cell transplantation is taken care of in the manufacturing laboratory while the treatment itself is very simple for the patient. It requires just an ordinary clinic or hospital as well as hospital physician willing to learn something new.” In his presentation Prof Molnar, the world’s renowned expert in stem cell transplantation, said that BCRO has been able to prepare stem cell transplants of every known kind of cell and make such transplants available for the patient treatment without immunosuppression.

According to him, xenotransplantation was suitable for the treatment of a variety of diseases such as diabetes mellitus, hormone deficiency diseases, early menopause, aging diseases, and degenerative diseases of liver, intestines, heart and other organs.

He noted that xenotransplantation has been in practice for over 70 years, adding that his organisation has carried out over 5, 000 cell transplants without using immunosuppressant.

Earlier chairman of the occasion, Dr B. C Ezeokpo, expressed his excitement over the project, saying, “If we cannot send all patients abroad for stem cell harvest, then stem cell harvest technology has come to Nigeria.”
But the endocrinologist from Federal Medical Centre Abakaliki warned against any abuse of the medical curative practice, adding that a number of question need to be answered including the ideal source of stem cell for each disease condition and the minimal cell count for treatment.

Dr Alex Akpa, who represented the national Biotechnology Development Agency (NBDA), assured of the support of the agency for the project and also to play its regulatory role to ensure that everything was done in good clinical, laboratory, manufacturing and ethical practices.

He reminded the medical practitioners and scientist that Nigeria was “totally against” embryonic stem cell and cloning of human beings and as such they should stay off those areas

Aug 2, 2007, 01:13 AM
Thisday (http://www.thisdayonline.com/nview.php?id=84928)
Malaria Gulps N132bn Annually, Says FG

From Onwuka Nzeshi in Abuja, 07.31.2007

The Federal Government yesterday said an estimated N132billion is lost annually in Nigeria, due to malaria scourge and the huge cost of treatment, prevention and loss of man hours.

It said malaria has been responsible for 60 per cent of outpatient visits to health facilities, 30 per cent of childhood death, 25 per cent of death in children under one year and 11 per cent of maternal mortality, making it even more of a killer disease that the much dreaded Human Immuno-deficiency Virus (HIV).

Minister for Health, Professor Adenike Grange, who disclosed this in Abuja at the opening of a workshop on Federal Health Expenditure Analysis and the Medium Term Sector Strategy, pledged that the sector, under her tenure, will mobilise all available resou-rces to ensure that infant and maternal mortality as a result of malaria and other disease conditions were reduced to the barest minimum.

According to her, a Nigerian child falls prey to malaria at least four times in a year, while 70 per cent of pregnant women suffer from malaria and its accompanying complications such as maternal anaemia, low birth weight, still births and abortions.

Grange said given increasing challenges in the health sector and the limited resources available to meet the challenges, there was an urgent need to institutionalise a sustainable system of public expenditure management in the sector.

She acknowledged the variou reform efforts by her predecessors and assured that her regime will build on the foundation already laid .Part the reform process, she said, was the introduction of the Medium Term Sector Strategy (MTSS) approach designed to strenghten the systems of budget preparation and controls as well as instil fiscal discipline in the face of severe resource constraint.The Medium Term Sector Strategy was derived from the national Economic Empowerment and Development Strategy (NEEDS) and the Millennium Development Goals(MDGs) and is expected to set out fully costed initiatives and expenditure plans of the Federal Ministry of Health over the medium term period of 2008-2010.

The MTSS complements the already developed five-year strategic plan of tertiary health institutions drawn by the past administration as part of the reform agenda to make managers of these institutions project into the future in the interest of the health of the people.Professor Grange urged participants to deliberate on ways ofimproving the system of tracking and reporting health expenditure foreffective performance-based budgeting in the public health sector.Minister of State for Health, Archuitect Gabriel Aduku had in an earlier presentation decried the situation in the past where budgeting, within the Federal Civil Service and Federal Minstry of Health in particular, had been undertaken using systems that did not allow for proper expenditure management. Aduku observed that the MTSS and the Federal Health expenditure Analysis System were two complementary financial management tools that will help make the best use of available but scarce resources at the disposal of the sector.

Aug 4, 2007, 02:48 AM
Conversations on health care and allied matters on NVS









http://www.nigeriavillagesquare.com/board/main-square/37533-obasanjo-legacy-lest-we-forget-3.html (Comments on health sector)








Aug 5, 2007, 05:28 AM
Nigerian Guardian (http://www.guardiannewsngr.com/news/article06)

NDLEA Burns Tons Of Hard Drugs In Kano
The National Drug Law Enforcement Agency (NDLEA), at the weekend in Kano destroyed over 4, 806, 280 kilogrammes of hard drugs, worth hundreds of millions of naira.

Chairman and chief executive of the NDLEA, Alhaji Ahmadu Giade; Kano State Deputy Governor, Abdullahi Tijjani Gwarzo, traditional rulers from Kano and Jigawa states and heads of security outfits jointly set fire to the hard drugs.

The NDLEA Chief expressed satisfaction over the destruction of the drugs, noting that the presence of an International Airport as well as the strategic position of the city, has made it a high risk zone in illicit traffic in narcotic drugs and psychotropic substances in the northern part of the country.

Cannabis, also known as Indian Hemp, dominates the seizures with 4,572,912 kilogrammes, followed by psychotropic substances (with 209.797 kilogrammes), cocaine (23,515 kilogrammes) and heroine, 0.0564 grammes.

Reiterating NDLEA resolve to tackle the menace of the trade and consumption of illicit drugs, Giade enjoined the citizenry not to allow selfish interest to override that of the nation.

Giade disclosed that since the start of this year, 51,546.961 kilogrammes, equivalent to over 51 metric tones of drugs, worth over a trillion naira, had been seized and destroyed in the state.

NDLEA's Kano State commander, Walter Nicholas lamented the devastating effects of drugs on users, adding that drug abuse accounts for more than 60 percent of crimes committed across the country.

Dozens of students from tertiary institutions and medicine dealers from Kano and Jigawa states also witnessed the destruction of the illicit drugs.

Aug 5, 2007, 05:38 AM
Thisday Online (http://www.thisdayonline.com/nview.php?id=85362)

A – Z of Foods that Heal Your Heart

Wellness & Wellbeing With DR. BISOLA AKINDEKO, 08.05.2007

Sure, an egg is loaded with cholesterol. But don’t let that stop you from enjoying this nutrient powerhouse. Mounting research shows eating three or four eggs weekly or even as many as one or two daily is okay for your heart. In fact, contrary to popular belief, scientific studies failed to link egg consumption with heart disease or hypertension in the first place. The egg scare got its start when researchers first connected high blood cholesterol levels to heart-disease risk. Unfortunately, eggs became guilty by association.
We need to remember that for most of us, dietary cholesterol from eggs and other foods does not have an impact on our blood cholesterol levels. About three-fourths of the population is able to gear down their production of cholesterol to compensate for what is coming in the body from foods.

Bumping eggs out of your diet in hopes of lowering heart-disease risk may actually be a bad idea. Eggs are packed with good nutrition. One large egg has only 75 calories and five grams of fat with about half of this from heart-healthy monounsaturated fats. Eggs also contain nature’s best protein source along with other nutrients including folate, riboflavin, vitamins A and B12; and they are one of the few dietary sources of vitamin D. Since eggs are so nutrient dense, they become a must for people eating very little, such as the elderly and those cutting back on calories for weight loss.

Some specialty brands of eggs are now available that come pumped up with even more good nutrition especially for your heart. For example, a Texas-based egg producer, Pilgrim Pride, now sells eggs that deliver about 60 percent of vitamin E needs, good for protecting LDLs from damaging artery walls. These eggs also provide 100 milligrams of omega-3 fats, typically not found in eggs, which also help protect against heart disease (These eggs are not yet available in Nigeria). As an added bonus, research shows that these omega-3 boosted eggs will actually lower blood fat levels. Feeding the hens a special diet that includes flax seed which is rich in omega-3 fats gives these specialty eggs their nutritional boost. These super eggs taste, good, and look like ordinary ones (might be some good advice for our government and all poultry farmers).

Good Eggs
Let me convince you that if you were eating eggs on a regular basis you are not the “bad egg” you once thought. In one study, men were fed either three, seven, or 14 eggs per week for five months. Following this egg treatment, blood cholesterol levels were measured along with other risk factors for heart disease. Despite heavy egg consumption amounting to an extra 220 to 440 milligrams of cholesterol daily, none of the men showed an increase in blood cholesterol levels.

Along the same lines, here’s a true story I want to share with you. An 88-year-old man was reported to eat an average of 15 to 25 eggs daily (and that’s no yolk!). He practiced his egg-eating routine for 15 years and suffered no ill effects. His blood cholesterol levels were healthy. While I’m not suggesting you gobble down 15 eggs a day, you certainly can include eggs in your weekly or even daily menu.

Egg Alternatives
For those individuals who have dangerously high blood cholesterol levels and cutting back on dietary cholesterol is a must, consider egg substitutes. Provided you like your eggs scrambled, these products are a fabulous trade-off for the real thing (see “Egg Stats” chart for comparison). Egg substitutes are fat and cholesterol free, a great source of protein (made mostly from egg whites) along with folate, riboflavin, and vitamins A and B 12 Use egg substitutes the same way you would regular eggs in omelets, casseroles, baked goods, French toast, desserts, and anything else you can think of.
An advantage of egg substitutes over the real thing is that they are pasteurized, meaning heat treated, so there is no risk of food poisoning from salmonella bacteria found in raw eggs. For any recipe that calls for uncooked eggs, you can safely use egg substitutes. Also, egg substitutes can be frozen (find some brands in the frozen foods section of your supermarket).

Fabulous Vanilla French Toast
4 hearty slices of whole-grain sourdough bread
•cup egg substitute or 2 whole eggs + 2 egg whites
3 tbsp. milk
•tsp. vanilla
•tsp. cinnamon
Dash allspice
Combine all the ingredients (except the bread) in a bowl. Whisk the mixture until light and fluffy (about 2 minutes). Dip one slice of bread at a time on both sides making sure to cover all edges. Place in a heated nonstick skillet and brown on both sides. If using whole eggs, cook thoroughly. Top with fresh sliced strawberries and a dollop of vanilla nonfat yogurt. Makes four servings.
Nutrition Facts
Fabulous Vanilla French Toast*
Serving Size 1 slice
Amount per Serving
Calories 211 34 Calories from fat
% Daily Value
Total Fat 4g 6%
Saturated Fat 1g 4%
Cholesterol 0mg 0%
Sodium 324mg 13%
Total Carbohydrate 32g 11%
Dietary Fiber 5g 20%
Protein 12g
Vitamin A 13% Vitamin C 71%
Calcium 16% Iron 16%
•(with strawberries and yogurt topping)
Ingredient can be found in most Nigerian supermarket

With its satin smooth purple finish, I often display eggplant on my kitchen counter, besides eating it for a heathy heart. It is actually that beautiful purple colour that gives eggplant its heart saving qualities. The phytochemical nasunin, which is a type of purple pigment found in other vegetables and fruits like red cabbage and grapes, has been shown to help lower blood cholesterol levels. Besides nasunin, eggplant is also a great source of potassium to help fight high blood pressure. And as an extra bonus, a half-cup cooked serving also supplies about seven percent of folate and fiber needs all in just 13 calories.
Researchers from Yamagata University in Japan studied the effect of dosing laboratory animals with eggplant’s nasunin while the animals ate a diet loaded with cholesterol. The scientists wanted to know if nasunin was effective in lowering the animals’ blood cholesterol levels. They were also checking on whether nasunin could block the absorption of cholesterol into the body.
After a few weeks on the high-cholesterol diet with nasunin, the animals’ blood cholesterol levels dropped compared to a group that did not get the nasunin. There’s more good news: HDL levels went up in the group getting the nasunin. More HDLs can mean lower risk for heart disease since these cholesterol carriers help rid the body of unwanted cholesterol. Also, the researchers found that the nasunin was blocking absorption of cholesterol from the diet because more cholesterol was appearing in the animals’ waste.
So help yourself to some eggplant. But one word of caution: Eggplant’s unusual cell structure makes it a great “sponge,” especially for oil. This means if you cook eggplant in a pan with some oil, the eggplant soaks the oil up just like a sponge. The best way to cook eggplant is in bite-size pieces or sliced in an oven casserole. You can also microwave eggplant until tender and top it with a small amount of shaved Parmesan cheese. Eggplant is quite popular in our culture, sometimes made into a source to be eaten with yam.

Aug 6, 2007, 04:06 AM
New York Times (http://www.nytimes.com/2007/08/05/magazine/05autism-t.html?em&ex=1186459200&en=53744c93562d4a80&ei=5087%0A)

August 5, 2007
What Autistic Girls Are Made Of
Caitlyn & Marguerite sat knee to knee in a sunny room at the Hawks Camp in Park City, Utah. On one wall was a white board with these questions: What’s your favorite vacation and why? What’s your favorite thing about yourself? If you could have any superpower, what would it be?

Caitlyn, who is 13, and Marguerite, who is 16 (I’ve used only their first names to protect their privacy), held yellow sheets of paper on which they had written their answers. It was the third day of the weeklong camp, late for icebreakers. But the Hawks are kids with autistic disorders accompanied by a normal or high I.Q. And so the main goal of the camp, run on a 26-acre ranch by a Utah nonprofit organization called the National Ability Center, is to nudge them toward the sort of back and forth — “What’s your favorite video game?” — that comes easily to most kids.

Along with Caitlyn and Marguerite, there were nine boys in the camp between the ages of 10 and 18. They also sat across from one another in pairs, with the exception of one 18-year-old who was arguing with a counselor. “All I require is a purple marker,” the boy said over and over again, refusing to write with the black marker he had been given. A few feet away, an 11-year-old was yipping and grunting while his partner read his answers in a monotone, eyes trained on his yellow paper. Another counselor hurried over to them.

Marguerite was also reading her answers without eye contact or inflection. “My favorite vacations were to India and Thailand my favorite thing about myself is that I’m nice to people if I could choose any superpower I’d be invisible,” she said in an unbroken stream. She looked up from her paper and past Caitlyn, smoothing her turquoise halter top over the waist of a pair of baggy cotton pants. Caitlyn was also staring into the middle distance. She has gold-streaked hair, which was bunched on top, and wore a black T-shirt with a sunburst on the front and canvas sneakers with skulls on the tops. The girls didn’t look uncomfortable, just unplugged.

A counselor noticed their marooned silence and prodded Caitlyn to take her turn. At first, she ran quickly through her answers, too. But Caitlyn loves fantasy — she is an avid writer of “fan fiction,” spinning new story lines for familiar characters from “Pokémon” and “Harry Potter” — and the superpower question grabbed her. She looked at Marguerite. “If I could have any power, I’d want to be able to transform into an animal like a tiger,” she said, smiling and putting her hands in front of her face, fingers tensed as if they were claws. Marguerite smiled and tentatively mirrored the claw gesture. Caitlyn smiled back. “I like tigers,” she said, her eyes bright behind her glasses. “Do you?”

It was a small, casual encounter and also an exceedingly rare one — a taste of teenage patter shared by two autistic girls.

Autism is often thought of as a boys’ affliction. Boys are three or four times as likely as girls to have classic autism (autism with mental retardation, which is now often referred to as cognitive impairment). The sex ratio is even more imbalanced for diagnoses that include normal intelligence along with the features of autism — social and communication impairments and restricted interests; this is called Asperger’s syndrome (when there is no speech delay) or high-functioning autism or, more generally, being “on the autistic spectrum.” Among kids in this category, referral rates are in the range of 10 boys for every girl.

According to the Centers for Disease Control, there are about 560,000 people under the age of 21 with autism in the United States. (Adults aren’t included because there is no good data on their numbers.) If 1 in 4 are female, the girls number about 140,000. The C.D.C. estimates that about 42 percent of them are of normal intelligence, putting their total at roughly 58,000 (with the caveat that these numbers are, at best, estimates).

Because there are so many fewer females with autism, they are “research orphans,” as Ami Klin, a psychology and psychiatry professor who directs Yale’s autism program, puts it. Scientists have tended to cull girls from studies because it is difficult to find sufficiently large numbers of them. Some of the drugs, for example, commonly used to treat symptoms of autism like anxiety and hyperactivity have rarely been tested on autistic girls.

The scant data make it impossible to draw firm conclusions about why their numbers are small and how autistic girls and boys with normal intelligence may differ. But a few researchers are trying to establish whether and how the disorder may vary by sex. This research and the observations of some clinicians who work with autistic girls suggest that because of biology and experience, and the interaction between the two, autism may express itself differently in girls. And that may have implications for their well-being.

The typical image of the autistic child is a boy who is lost in his own world and indifferent to other people. It is hard to generalize about autistic kids, boys or girls, but some clinicians who work with high-functioning autistic children say they often see girls who care a great deal about what their peers think. These girls want to connect with people outside their families, says Janet Lainhart, a professor of psychiatry and pediatrics at the University of Utah who treats Caitlyn and Marguerite. But often they can’t. Lainhart says that this thwarted desire may trigger severe anxiety and depression.

Other specialists are not sure that girls struggle more in these ways. “This is a profile of both boys and girls,” Klin says of the wish to connect that some people with autism have. But he agrees with Lainhart that it is easier for Asperger’s boys to find other boys — either on or off the autistic spectrum — who want to spend hours on their Game Boys or in a realm of Internet fantasy. Klin and Lainhart also say they think that the world is a more forgiving place for boys with the quirks of Asperger’s because, like it or not, awkwardness is a more acceptable male trait.

This gender dynamic doesn’t necessarily affect girls with Asperger’s when they are very young; if anything, they often fare better than boys at an early age because they tend to be less disruptive. In 1993, Catherine Lord, a veteran autism researcher, published a study of 21 boys and 21 girls. She found that when the children were between the ages of 3 and 5, parents more frequently described the girls as imitating typical kids and seeking out social contacts. Yet by age 10, none of the girls had reciprocal friendships while some of the boys did. “The girls often have the potential to really develop relationships,’ says Lord, a psychology and psychiatry professor and director of the Autism and Communication Disorders Center at the University of Michigan. “But by middle school, a subset of them is literally dumbstruck by anxiety. They do things like bursting into tears or lashing out in school, which make them very conspicuous. Their behavior really doesn’t jibe with what’s expected of girls. And that makes their lives very hard.”

No doubt part of the problem for autistic girls is the rising level of social interaction that comes in middle school. Girls’ networks become intricate and demanding, and friendships often hinge on attention to feelings and lots of rapid and nuanced communication — in person, by cellphone or Instant Messenger. No matter how much they want to connect, autistic girls are not good at empathy and conversation, and they find themselves locked out, seemingly even more than boys do. At the University of Texas Medical School, Katherine Loveland, a psychiatry professor, recently compared 700 autistic boys and 300 autistic girls and found that while the boys’ “abnormal communications” decreased as I.Q. scores rose, the girls’ did not. “Girls will have more trouble with social networks if they’re having greater difficulty with communication and language,” she says.

And so girls with autism and normal intelligence may end up at a particular disadvantage. In a new study published in May, a group of German researchers compared 23 high-functioning autistic girls with 23 high-functioning boys between the ages of 5 and 20, matching them for age, I.Q. and autism diagnosis. Parents reported more problems for girls involving peer relations, maturity, social independence and attention.

The difficulty may continue into adulthood. While some men with Asperger’s marry and have families, women almost never do, psychiatrists observe. A 2004 study by two prominent British researchers, Michael Rutter and Patricia Howlin, followed 68 high-functioning autistics over more than two decades. The group included only seven women, too small a sample to reach solid conclusions about gender differences, Rutter and Howlin caution. But 15 men — 22 percent of the sample — rated “good” or “very good” for educational attainment, employment, relationships and independent living, while no women did. Two women rated “fair,” compared with 11 men, and the other five women were counted as “poor” or “very poor.” None had gone to college. None reported having friends or living on their own. Only one had a job. Undermined by anxiety and depression, women with autism appear to be more often confined to the small world of their families.

When Caitlyn started kindergarten and didn’t play normally with other kids, her mother, Juli, thought it was because she hadn’t gone to preschool. The first warning of real trouble came from the first-grade gym teacher, who told Juli that Caitlyn exposed herself to the class. Caitlyn is overweight, and she has always been private about her body. Juli couldn’t imagine her daughter taking off her clothes in public, and when she asked what had happened, Caitlyn said another girl had pulled down her pants. “Caitlyn stood there mortified,” Juli says. “But she couldn’t express that to the teacher.”

Caitlyn lives with her mother, her older sister, the girls’ great-grandparents and a pair of poodles in Farmington, outside of Salt Lake City. (Her father died before she was 2.) Until second grade, Caitlyn had a neighborhood friend with whom she went to school. Other than that, she was often alone in class. Her teachers were frequently frustrated with her inability to work and play in groups. But she connected with a few adults — in fifth grade, one class aide took her horseback riding, and the school librarian gave Caitlyn her own copy of “Spindle’s End,” a retelling of “Sleeping Beauty,” “because she said I helped her so much,” Caitlyn remembers.

Contrary to the Asperger’s stereotype, Caitlyn struggles in math but tests in the highly gifted range in reading and writing. This is another sex difference that Lord sees among her patients. “I don’t have any real data, but a lot of high-functioning girls are real readers — not great on subtleties, but they like fantasies and the ‘Baby-Sitters’ series,” she says. “The boys are much less so.”

In elementary school, Caitlyn went to special-education classes for math and social skills. At 11, as other girls began to slip out of reach, Asperger’s was diagnosed. The shift a year later to junior high for seventh grade was a jolt. By the second week of school, a few boys were mocking Caitlyn’s weight and calling her weird while other kids laughed. “No one would sit by me at lunch,” Caitlyn says. Girls told her that they didn’t want her to be in their reading group. Caitlyn did her homework, but she was too anxious to walk to the front of the room to turn it in. At home, her neighborhood friend no longer came out to play.

In the winter, Caitlyn switched from a special-education math class into a mainstream one, and the kids in her new class made her miserable. For days she refused to go to school. She told Lainhart: “No one likes me at lunch. I’m very sad.” (With Juli’s and Caitlyn’s permission, I read Lainhart’s notes on Caitlyn’s treatment.) After a huge outburst of anger at home, Caitlyn told her mother that she wanted to die. At her next appointment with Lainhart, she said: “I listen to people’s conversations during free time in science. They talk about live games, R-rated movies, outfits. I feel left out.” Caitlyn told Lainhart about two dreams. In one, her school had a bridge running through it, and she kept falling off. In the second, she was in the lunchroom throwing a party; no one came. Lainhart says that while boys are aware of rejection and bullying, in her experience they are not hurt by it to the extent that some girls are. “I have rarely had a male patient with autism become suicidal or express such intense emotional pain,” she says.

Caitlyn has never hit another child. But at school, her retorts to her peers — “I yelled at a . . . little bimbo. They yelled at me,” she told Lainhart during one appointment — pushed them further away. With Lainhart’s help, Juli persuaded the school to let her daughter eat lunch in a classroom rather than in the cafeteria. Still, Caitlyn’s grades dropped from A’s and B’s to D’s and F’s. Her anxiety level spiked, and her sadness bloomed into depression.

Lainhart has seen the same blend of anxiety and depression in other female patients. Like Caitlyn, Marguerite’s serious problems date from middle school. In sixth grade, she moved to Salt Lake City and away from a couple of strong friendships, and she couldn’t replace them. “She found it increasingly difficult to do the things necessary to maintain friendships with ‘normal’ kids,” her father says. Last fall, at 15, she withdrew further. An olive-skinned girl with thick brown hair — she was adopted from Guatemala as a baby — Marguerite has always liked to go shopping and wear pretty things (not a typical trait for a girl with autism, though not unique either). But she stopped dressing herself, washing her hair and going to school. For months, Marguerite spiraled into one of the worst bouts of depression Lainhart has ever seen.

Since 1990, when she was recruited to work with autistic children by Susan Folstein, a prominent Johns Hopkins researcher, Lainhart has been interested in the relationship between autism and depression. In a 1994 paper, Lainhart and Folstein pointed out that despite the 4-to-1 male-female ratio for autism, females made up half the autistic patients with mood disorders described in the medical literature. The case reports may not represent the population as a whole; still, the overrepresentation is suggestive. Lainhart is currently looking at the relationship between autism and depression in boys and girls and the potential link to depression in their parents and siblings. “We know that anxiety and depression are co-morbid,” meaning that they occur together, Lainhart says. “And we know that depression is worse for women in the general population. But what’s the link to autism? And is it worse for girls?”

Social anxiety affects Lainhart’s female patients into adulthood. Liz Lee, who is 43, is studying for her master’s degree in electrical engineering, yet she cannot cope with going to lunch with the other graduate students at the lab where she works. Ash Baxter, who is 22, spends hours making art, sewing dolls with wild yarn hair and macramé-edged suits; she created an extraordinary blue-and-gold octopus mask out of a three-foot gourd she found in the garage. She is talented and would like to attend art school, but Baxter can’t master her anxiety well enough to learn to drive or live in a dorm, so college art classes remain out of reach. Another patient, Charlotte (she asked that I not use her last name) is 23 and goes to a social-skills class that Lainhart runs for her patients in their late teens and early 20s. Because of the dearth of females, the class is mostly male, and Charlotte often leaves in the middle saying she’s “stressed out.” “She can only take so much,” her mother told me. Lainhart says, “You see these incredible areas of anxiety in Liz and Charlotte and Marguerite that don’t seem to have a parallel in the boys and men.”

There is preliminary evidence that girls and women also vary from the male Asperger’s profile in terms of their interests, as Catherine Lord suggests. David Skuse, a psychiatry professor at the Institute of Child Health at University College London, has analyzed data from 1,000 children, 700 of them on the autistic spectrum. “Girls with autism are rarely fascinated with numbers and rarely have stores of arcane knowledge, and this is reflected in the interests of females in the general population,” Skuse explains. “The girls are strikingly different from the boys in this respect.”

With her high aptitude for reading and writing and her difficulties with math, Caitlyn fits Skuse’s model. Even as she was failing school last year, she kept up her fan fiction, posting stories she had written on the Web site Gaia Online. On the 40-mile drive home from camp, she told me about her plan to write an original eight-book fantasy series about a werewolf, to be called “Midnight Wind.”

One of the best-known theorists on sex difference and autism, Simon Baron-Cohen, comes at these questions from another angle. A psychology professor and director of the Autism Research Centre at Cambridge University, Baron-Cohen has characterized autism as a condition of the “extreme male brain.” His research shows that in the general population men are more likely than women to score low on a test of empathy and high on a test of recognizing rules and patterns, or “systemizing.” High systemizing together with low empathy correlates with social and communication deficits and, at the extreme end of the scale, with autism. Baron-Cohen is currently studying whether elevated levels of fetal testosterone — a prime driver of masculinity — are linked to autistic traits.

Baron-Cohen says that he believes that autistic girls are strong systemizers. That quality may manifest itself in letters rather than numbers. But in his view, the thought processes for Asperger’s girls mirror those of boys. He explains, “These females often feel more compatibility with typical males simply because typical males may be more willing to adhere to the linear, step-by-step form of thinking and conversation — more like debating or playing chess or doing logic.”

To Lainhart, Baron-Cohen’s extreme-male-brain theory is an apt description for a subset of her female patients, for example Liz Lee, who in pursuing electrical engineering is training for a classic Asperger’s profession. Lee is socially aloof: she usually sits on the floor with her back to Lainhart during their sessions, twirling the propeller of a toy helicopter. Eye contact makes Lee angry, and she says she would like to live alone in the desert.

But based on their clinical experience, Lainhart and also Skuse see autism as a heterogeneous disorder. Its profile may change and expand as more is understood about girls, whose autism, they worry, often goes undiagnosed. That is partly, Skuse posits, because girls’ general aptitude for communication and their social competence helps some Asperger’s girls “pass” — they pick up on their difference and carefully mask it by mimicking other girls’ speech and manner and dress. In a sense, their femaleness allows some girls to seem less autistic. It is as if they start off with a social advantage — Skuse sees this as a 20-point bonus on a scale of 100 — that helps counter the disorder. This idea isn’t necessarily at odds with the findings that show girls to be more seriously affected by autism, Skuse says, because the girls who succeed in masking their deficit wouldn’t be included in studies. And so they are missing from the picture. “There is no doubt in my mind that the way we have defined autism currently biases our assessments strongly in the direction of identifying a male stereotype,” he says. The C.D.C. agrees and says that as a result the estimate for the number of girls with autism and normal intelligence may be low.

Why would autism express itself differently depending on sex? The short answer is that no one knows. Genetic researchers, however, have just begun to hint at possibilities. In the last two years, new data-pooling efforts have yielded two major genetic-linkage studies — attempts to link autism to specific chromosomes — that suggest that some of the genes underlying autism may be different in males and females. By isolating sex as a variable, scientists are seeing potential genetic hot spots for autism. “By comparing males and females, we will have a much better chance of discovering the causes of autism,” says Geraldine Dawson, a psychology professor and director of the University of Washington Autism Center, who was a co-author of one of the studies.

Studies that use the latest brain-scanning tools — magnetic resonance imaging and diffusion tensor imaging — generally focus on boys. But a single study of M.R.I.’s of both boys and girls found differences in their brain anatomy. Published in April in The Journal of the American Academy of Child and Adolescent Psychiatry, the study compared nine girls and 27 boys who were matched for age, I.Q. and severity of autism. Other research has established some correlation between abnormally large brain size and autism; the April paper reported that the brain volume of the autistic girls deviated from the norm more than the volume of the autistic boys. Lainhart, who is a member of the University of Utah’s Brain Institute, has measured head circumference as a proxy for brain volume. (The two are linked.) In a 1997 paper, she reported that the mean head circumference of eight autistic girls at birth was significantly greater than the norm, whereas the mean head size of 37 autistic boys was not.

These are small and preliminary studies, but their findings may relate to a puzzle of autism: while overall, there are more mentally retarded autistic boys than girls, a greater proportion of autistic girls are retarded — 58 percent compared with 42 percent for boys, according to the C.D.C. As for Asperger’s girls, Lainhart, who continues to conduct brain research, says she hopes eventually to shed light on the deficits of girls like Caitlyn and Marguerite and suggest new treatments for them. “In children with dyslexia, scientists identified where the basic cognitive deficits were,” she says. “Then they intervened to go after those deficits, and they saw the brain change in those areas.”

In the meantime, girls with autism and normal I.Q.’s pose a particular challenge for schools. Though mainstreaming has its benefits, autistic kids risk becoming outcasts in a regular classroom. Yet if girls go to a special-education program or a separate school, they are often swimming in a sea of boys. Lord pointed to this as a factor in girls’ lack of friendships in her 1993 study. When the girls in her sample were shifted to specialized programs, “their opportunities to meet girls and women with some common interests were even more limited than those of the boys and men,” she wrote.

The Harbour School in Baltimore has tried to address this predicament. The school has 120 students, all with learning disabilities, speech impairments, attention-deficit disorders and autistic-spectrum disorders. Only 19 of them are girls, which leaves one or two in each class from first to 12th grade. (More boys than girls are also diagnosed with the hyperactive form of A.D.D. and some learning disabilities.) Along with the playful Baltimore street scenes that decorate the walls of the hallways at Harbour, the predominance of gangly male bodies and loud voices was the first thing I noticed on a recent visit. The school felt like a haven — for boys.

And so I wondered whether the girls would feel overwhelmed, as Charlotte often is at her mostly male social-skills class. In the school auditorium at about 9 a.m., there were 13 sixth graders — 12 boys and a single girl, Krissy, whose clinical designation is pervasive developmental disorder on the autistic spectrum. She was sitting on the floor playing Connect Four with one of the boys. She won her game, smiled without looking at her opponent, then got up and walked across the room to another of her classmates.

“Hi, Michael,” she said. He didn’t look up. Krissy sat down next to him and watched him play on his Game Boy. They talked quietly about his progress; she knew the game. A few minutes later, she found her Connect Four partner again, and they decided to play Operation. They talked about the rules, but when Krissy tripped the buzzer, he let her finish taking out the body parts she was maneuvering. Krissy declared victory and moved on again, this time to lie on the floor next to a boy who was building with metal rods and blue glass balls.

“Do you need help?” she asked him.

“No,” he answered.

“Can I at least play with you?” Krissy persisted. The boy grunted. Without talking more, they each built a structure.

Krissy has been at Harbour since first grade, and the small size of her class means that she knows the boys well. Her teachers say she is at ease with them because she shares their Game Boy enthusiasm and watches the same movies. But sometimes Krissy’s interests seem entirely girlish. She was excited about straightening her hair and then styling it into corkscrew curls for her interview with me and showed off pictures she had drawn of princesses, covered with hearts.

Harbour makes a concerted effort to give its girls the chance to develop relationships with one another. The girls’ lunch periods coincide to give them time together. A social worker, Kelli Remmel, runs a regular “girls club” for a group of about half a dozen. “There are some things the girls don’t want to discuss in front of their male peers,” she says. “It’s a chance for them to talk about boys, how to handle hormonal changes, other girls, their bodies, dating.”

Krissy seems to be getting the social opportunities and support that Lord and Lainhart want for the girls they treat. Salt Lake City has good schools for kids with Asperger’s, Lainhart says, but the catch is money. School districts in Maryland, Washington and Virginia pay Harbour’s tuition for more than 95 percent of the students. But districts in many parts of the country — including Utah — don’t pay for private-school placements for kids with Asperger’s. Caitlyn doesn’t go to a school like Harbour because her family can’t afford it; her experience, not Krissy’s, is typical.

Lord and Lainhart try to help by setting up social-skills groups for their patients. But families must pay for the classes out of pocket because medical insurers generally don’t pay for treatment and services that focus on autism — a terrible problem for her patients, Lainhart says. So the groups tend to meet only a couple of times a month for a few hours. Charlotte doesn’t know the boys in her group the way Krissy knows her classmates. At the University of Michigan, Lord runs co-ed groups for younger children and then tries to put together groups of older girls that mix autistic and nonautistic kids. As the girls get older, it is harder to find normally developing girls who want to participate. Twenty years ago, as a clinical psychologist in Canada, Lord started a group of four Asperger’s girls who stayed in touch into adulthood. They called themselves the highest-functioning autistic women in Canada, she remembers, and treasured their solidarity. “It’s striking how much girls with autism can care about each other and other people and develop friendships that are really a source of joy for them,” Lord says. “But when I think of the teenage girls I know, many of them have no shot at forming those relationships.”

At the Hawks Camp in Utah, Caitlyn and Marguerite didn’t become friends. A week earlier, Marguerite and Lainhart had made a list of conversation starters, but Marguerite didn’t really use them. Caitlyn didn’t try to talk to her much, either. The camp lasted only a week; for these girls, not long enough for bonding. Still, Caitlyn said it was the best week of her year. One day after lunch, the Hawks campers drove in two minivans to a nearby lakefront to go tubing and Jet Skiing. Caitlyn changed into her bathing suit, then wrapped herself in a towel despite the strong hot sun. “Do I look O.K.?” she asked a counselor. “It’s just that there are so many people.”

But the other kids were paying Caitlyn no mind. This wasn’t a group that Caitlyn had to fear. She balled her hands into fists, visibly holding her anxiety at bay. “Sometimes I feel like I’m weird and ugly,” she said, “but I’m not going to today. I’m confident!” She strode out to Jet Ski and later returned with a description that she planned to use in a future story: “It was like riding a dragon through the storm.”

Back at camp, the Hawks poured onto the playground. During the school year, Caitlyn had been excused from gym class because she was so nervous about changing her clothes and running around in front of her classmates. As she sat on a swing and watched kids play tag, a counselor named Claire came over. As she and Caitlyn talked, Caitlyn did all the tiny things that people do to engage one another, smiling, laughing, gesturing, looking Claire in the eye. Claire urged her to join the game and called out, “Caitlyn’s playing!” Caitlyn protested. But Claire persisted, and finally Caitlyn yelled, “O.K., where’s the base?” A teenage boy pointed to the monkey bars, and Caitlyn ran for it. Her glasses slipped off her nose, and her shorts slipped a bit, too. She hiked them up and kept running, surrounded by other kids. Sweating and laughing, she yelled, “Safe!”

Emily Bazelon is an editor of the online publication Slate. Her last article for the magazine was about the grass-roots pro-life movement.

Aug 7, 2007, 04:15 PM
Nigerian Guardian (http://www.guardiannewsngr.com/science/article03)

Pharmacists express concern over health insurance scheme
By Ben Ukwuoma
Sunday, August 05, 2007

WITH just two million Nigerians accessing the National Health Insurance Scheme (NHIS) with over N35 billion disbursed in the last two years, pharmacists in Lagos State have warned of the imminent collapse of the scheme if the operational guidelines are not reviewed.

Although the Scheme desires a target universal coverage by the year 2015 but the pharmacists claimed that only about 8 percent of the formal sector had accessed the scheme (less than 2 million Nigerians) after almost one and a half years of its take off despite the fact that 27 HMOs and over 5000 providers have been accredited.
"It has been in without any impact in the life of overwhelming majority of Nigerians," they stated.

The pharmacists who articulated their views under the aegis of Lagos state branch of the Pharmaceutical Society of Nigeria stressed that the continuous implementation of Global capitation mode of payment despite overwhelming disapproval of all the stakeholders is threatening the sustainability of the Scheme.

Chairman of the association, Mr. Tony Oyawole said, "this aspect of a primary care provider controlled free-for-service payment mechanism for secondary providers is presently a serious bone of contention that has threatened the sustainability of the Scheme in Nigeria," .

Currently, Nigeria 's nascent social health insurance combines capitation and fee-for-service payments to primary care providers but fee-for-service for specialist secondary providers. It is assumed that this Scheme will offer equitable and physical accessibility to the enrollee.

But Oyawole said the Scheme is yet to ensure delivery of efficiency, quality assurance, effectiveness, sustainability and harmony amongst providers.

"We therefore call on the Federal Government, through the instrument of the Governing Council of the National Health Insurance Scheme to redress the classification of primary providers, if the Scheme will not become another white elephant projects. This is more so against the background that over N35 billion (Thirty-five billion naira) has been disbursed in the National Health Insurance Scheme without any impact in the life of overwhelming majority of Nigerians," he said .

"The need for a review is supported by the fact that the adopted global capital mode of payment was never subjected to any debate at any Stakeholders forum known to Pharmacy Society of Nigeria (PSN). We are at a loss why the payment mechanism prescribed by the enabling law and in the working guidelines that was extensively reviewed and rehearsed by Stakeholders was never tried instead, in its place, a Global Capitation mode of payment was smuggled into the Scheme," he added.

"The guidelines prescribed a review of prices in the Scheme but after almost two years, nothing has happened,".

He explained that the smuggling in of global capitation mode of payment succeeded in marginalizing other healthcare providers other than primary providers (gate keeper). Pharmacists and other Healthcare providers protested the global capitation mode of payment before the dissolution of the Governing Council last year.

"In response, a 27-man Committee was put in place by Government to review the payment mechanism of the Scheme. The Committee was inaugurated on 3rd July 2006 and given 90 days to submit its report. The Committee reached a consensus to jettison the global capitation mode of payment and in its place allow the HMOs to pay all providers including the Pharmacists as entrenched in the Act and operational guidelines,".

"The implications of the above is that apart from pharmacists and their practice been sidelined, the much desired professionalism or separation of roles of healthcare providers has become an illusion (prescriber is also the dispenser). Yes, it might be argued that drugs from the industry are dispensed in these non registered NHIS Pharmacy Facilities but the quality of such drugs cannot be guaranteed since no pharmacist is in charge of the procurement and dispensing of the National Drug Policy amongst others,".

Pharmacists are also worried that HMOs that are supposed to maintain quality assurance "have abandoned their basic duties even when they are regularly paid for services not rendered,".

"We observe a very dangerous trend where some HMOs run their own group of clinics and hospitals, operate their own laboratories and indeed dispense drugs from non-approved in-house pharmacies and using non-pharmacists to dispense drugs. This is n aberration where registered HMOs also serve as providers under the Scheme. The implication is that the Scheme cannot guarantee drugs dispensed from such facilities using non-pharmacists with grave implications for the enrollees. In this circumstance, can the HMOs be fair to all in the discharge of their functions under this Scheme especially as the enabling laws leave the HMOs with the burden of monitoring and evaluation?"

"In our estimation, most of the hiccups that the Scheme has witnessed in the past one year are traceable to the gaps created by the Global Capitation mode of payment scheme and the near absence of quality assurance protocols to monitor the Scheme,".

The nations pharmacists regretted that despite the assurances from the management of the NHIS that the Global Capitation regulated the risk level and served to further strengthen the checks and balances in the system, the observations in the past one year have revealed that it has encouraged primary providers not to use good quality drugs in the management of patients, allowed primary providers to run and operate unapproved pharmacies by (Pharmacists Council of Nigeria - PCN and National Health Insurance Scheme - NHIS) in contravention of the NHIS operational guidelines.

The mode of payment they argued has permited primary providers to source and dispense the drugs themselves using unqualified manpower to offer pharmaceutical services thus giving room to the possible use of fake and counterfeit drugs.

"It has created disharmony amongst healthcare providers and delays in payment where necessary.

Made primary providers to act as HMO to the secondary provider thus eroding one of the functions o HMOs. our findings are that emerging tendencies in Global Capitation will further encourage fraud and weaken the checks and balances necessary to sustain the Scheme.

"The golden rule in modern healthcare at the primary level is that the prescriber does not benefit financial and economically from the process of dispensing that the dispenser should not benefit financially from the process of prescribing. This allows the prescriber to choose the best for his patients at all times.


Aug 7, 2007, 04:26 PM
Nigerian Guardian

Sunday, August 05, 2007
Circumcision doesn't reduce sensation, says study
UNCIRCUMCISED men receive no more sexual sensation than circumcised men, according to a new study that contradicts the widely held belief.

Researchers from McGill University in Montreal found that circumcised men felt the same amount of sensitivity to touch and pain in various states of sexual arousal as those with foreskins.

"This study suggests that preconceptions of penile sensory differences between circumcised and uncircumcised men may be unfounded," the study's principal author Kimberley Payne said in a release.

The study, published in The Journal of Sexual Medicine, looked at a group of 40 men, half of them circumcised. Using sensory testing, the men were monitored at two points on the penis and the forearm while viewing erotic films. Thermal imaging was used to measure sexual arousal.

The effect of circumcision on sexual sensitivity has long been debated and the team hopes its finding will prompt further research on the topic.

The practice of circumcision in Canada has been declining over the years and in 2005 only 9.2 percent of male infants were circumcised.

Aug 7, 2007, 04:28 PM
Retrieved from Guardian Sunday Aug. 7th, 2007

Study dismisses reported emissions risks from cell phone towers
ONE of the largest studies into the short-term health effects of mobile phone technology has found that reported symptoms such as anxiety, tension and tiredness are not caused by the typical emissions from phone masts (cell phone towers).

A team of independent scientists at the University of Essex tested 44 people who had previously reported symptoms or sensitivity to mobile phone technology, and 114 people who had not reported any health effects (controls), at a specially-designed laboratory.
The study was funded by the Mobile Telecommunications and Health Research (MTHR) programme (http://www.mthr.org.uk). The results are published online Monday by the journal Environmental Health Perspectives (http://www.ehponline.org).

The three-year study found that physiological measures such as heart rate, blood pressure and skin conductance were not affected by whether the mast was switched on or off, and did not detect any significant effects in either sensitive or control participants between GSM (conventional) exposure and no exposure.

When both sensitive and control participants were exposed to a 3G (UMTS) signal, neither the physiological measures nor the number of reported symptoms increased. However, the sensitive group did report increased levels of arousal when exposed to 3G, but further analysis suggested that this was related to the fact that a higher proportion of sensitive people received the UMTS signal during their first 50-minute testing session. All other measures did not differ between the 3G and the sham conditions.

All participants were tested in several different sessions. In open provocation tests, when both participant and experimenter knew whether the signal was on or off, sensitive individuals reported lower levels of well being and more symptoms when the signal was on. This confirmed that the laboratory conditions did not prevent them from experiencing typical symptoms in response to mobile phone masts.

However, when tests were carried out under double-blind conditions, where neither experimenter nor participant knew whether the signal was on or off, the number of symptoms reported was not related to whether the mast was on or off. Two of the 44 sensitive individuals correctly judged whether the mast was on or off in all six tests, compared with five out of 114 control participants. This proportion is what is expected by chance and was not increased in the sensitive group.

The study found that, compared with controls, sensitive individuals reported more symptoms and greater severity of symptoms, as well as higher skin conductance (which is a good measure of physiological response to environmental stressors), regardless of whether the signal was on or off. Hence, the range of symptoms and physiological response does not appear to be related to the presence of either GSM or 3G signals.
Principal investigator Professor Elaine Fox explained: "It is clear that sensitive individuals are suffering real symptoms and often have a poor quality of life. It is now important to determine what other factors could be causing these symptoms, so appropriate research studies and treatment strategies can be developed."

The results are consistent with the only other published large-scale study of the effects of short-term exposure to mobile phone masts with sensitive individuals (published in Environmental Health Perspectives by Regel et al, 2006).

Dr James Rubin, of the Mobile Phones Research Unit at Kings College London, who has reviewed 31 blind and double-blind studies carried out under controlled laboratory conditions, said: 'The Essex study is one of the largest and most detailed of these experiments and its findings, that mobile phone signals are not responsible for the symptoms that some people describe, are in line with those from most other previous experiments. This should be reassuring news for anyone who is concerned about the possible short-term health effects of masts.'

The multi-disciplinary scientific research team at Essex included cognitive psychologists, electronic and biomedical engineers and a medical doctor. Testing took place in the Electromagnetics and Health Laboratory at the University's Colchester campus. The exposure system was provided by Red-M, and the accuracy of both the exposure system and the testing environment was confirmed by the National Physical Laboratory.
The Essex research team is now undertaking an MTHR-funded study into the short-term health effects of exposure to TETRA mobile radio masts, which are used for the emergency services' communications systems.


Aug 7, 2007, 04:39 PM
Guardian Health article. Retrieved Sunday. Aug 5th, 2007

Cashew extracts show promise in preventing infections, sudden death
Can stem bark extract of cashew provide 100 per cent protection against sudden death? CHUKWUMA MUANYA writes on this latest addition to the health benefits of cashew.
HIGH dose of cashew stem bark extract has been shown to produce a 100 protection against death from sepsis. Sepsis is a systemic response to infection, which causes organ failure and death in severe cases.

Researchers have also demonstrated how a combination of the nutshell oil of cashew has shown potent anti-fungal activities.
Cashew is scientifically known as Anacardium occidentale and belongs to the plant family Anacardiaceae. The French calls it acajou and the Portugues cajueiro. In Nigeria, the Hausa's call the tree and fruit, fisa, the nuts jambe; it is kanju in Kanuri and kaju or kantonoyo in Yoruba.

However, probably because the colonial masters introduced cashew into the country, it's known in other Nigerian languages as pronounced- the Igbo's call it kachu.
Nigerian researchers in a study titled "Effects of Anacardium occidentale stem bark extract on in vivo inflammatory models" evaluated the methanol extract of Anacardium occidentale stem bark for activities against the lipopolysaccharide (LPS)-induced septic shock, as well as LPS-induced microvascular permeability in mice.

The researchers include Olumayokun A. Olajide, Mutallib A. Aderogba, Aduragbenro D.A. Adedapo and Janet M. Makinde, from the Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Oyo State and the Department of Chemistry, Faculty of Science, Obafemi Awolowo University, Ile-Ife, Osun State.

Septic shock is an often fatal condition that results from severe infections, most often caused by Gram-negative bacteria including Escherichia coli, Pseudomonas aeruginosa and Klebsiella and Bacteroides species. Gram-positive bacterial infections can also lead to septic shock particularly those caused by Staphylococcus aureus and the Pneumococci.

The bacterial infections can be acquired via the usual routes-ingestion of contaminated food or water-but can also result as a consequence of surgical procedures including catherisation and implantation of prosthetic devices. In addition, patients with depressed immune function-for example, cancer chemotherapy patients-are also susceptible to overwhelming bacterial infections, which a patient with a normal immune system could handle easily.

The sequence of events that evolves into septic shock is initiated by the release of large quantities of a bacterial endotoxin into the blood stream in the case of Gram-negative organisms or of the release of a comparable product-cell wall substances-in the case of Gram-positive bacteria, yeast and fungal infections. The bacterial endotoxin is a component of the bacterial cell wall. The active part of the endotoxin is an LPS.
The study indicates that pre-treatment with Anacardium occidentale extract (25-200 mg/kg) caused a dose-dependent and significant reduction in the elevated levels of alanine and aspartate aminotransferases in the sera of d-galactosamine-primed mice injected with LPS. Alanine is a non-essential amino acid and is used by the body to build protein. D-Galactosamine is an amino sugar with unique hepatotoxic (liver toxic) properties in animals.

The highest dose of the extract studied (200 mg/kg) produced a 100 per cent protection against death from sepsis. Pentoxifylline (100 mg/kg) - A drug used to prevent blood clotting and as an investigational treatment that may help reduce weight loss in cancer patients- and L-NAME (5 mg/kg)-patients randomised to supportive care alone- offered 100 per cent protection against LPS-induced septic shock and produced marked reduction in elevated levels of transferases- are enzymes that transfer a group (example a methyl or glycosyl group) from one compound (which is generally regarded as the donor) to another compound (generally regarded as the acceptor).
Pentoxifylline, L-NAME and the extract also produced a dose-related inhibition of LPS-induced microvascular permability in mice.

In another study published in the Journal of Ethnopharmacology, "Antifungal Compounds from Anarcadium occidentale", by Consolacion Y. Ragasaa, Dodee Borjaa, Raquelle Bassiga and John A. Rideoutb of the Chemistry Department, De La Salle University, Manila, Philippines and School of Chemical and Biomedical Sciences Central Queensland University, Rockhampton, Queensland, Australia the nutshell oil of Anacardium occidentale, commonly known as kasoy afforded mixtures of anacardic acids and cardols in varying degrees of unsaturation.

Their structures were elucidated by extensive 1D and 2D NMR- Nuclear magnetic resonance spectroscopy most commonly known as NMR spectroscopy is the name given to the technique which exploits the magnetic properties of certain nuclei- and high resolution mass spectrometry. The anacardic acids were identified as 1a (50 per cent), 1b (17 per cent) and 1c (33 per cent), while the cardols were identified as 2a (80 per cent) and 2b (20 per cent).

Small amounts of mono-, di- and triunsaturated seventeen-carbon side-chain analogues of sample 1, and bilobol, the monounsaturated analogue of sample 2, were also observed by mass spectrometry.

The mixture of 1a, 1b, and 1c indicated slight activity against Escherichia coli and Pseudomonas aeruginosa and moderate activity against Staphylococcus aureus, Bacillus subtilis, Candida albicans, T. mentagrophytes and Aspergillus niger. The mixture of 2a, and 2b indicated slight activity against P. aeruginosa and C. albicans, moderate activity against B. subtilis and T. mentagrophytes, and high activity against A. niger.
Previous studies indicate that eating cashew fruit, nuts and extract of the leaves and bark may be the key to beating high blood pressure, thrush, tooth and gum disease, diabetes, diarrhoea, dysentery and haemorrhoids.

A study published last year indicates that eating a diet rich in cashew nuts improves the sensitivity of a key reflex for maintaining healthy blood pressure known as the baroreflex. It has also been shown that gram positive bacteria, which cause tooth decay, acne, tuberculosis, and leprosy are killed by chemicals in cashew nuts, cashew apples, and cashew shell oil.

Indeed, cashew's antimicrobial properties were first documented in a 1982 in vitro study. In 1999, another study was published indicating it has good in vitro antibacterial activity against E. coli and Pseudomonas.

Until now, cashew leaf tea is employed in Nigeria as a common diarrhoea remedy, a bark tea is used as an antiseptic vaginal douche and the seeds are used for skin infections. "The natural Nigerian remedy for diarrhoea and dysentery is half cup of a standard decoction of leaves and twigs, taken two or three times daily," said Dr. Osmond Onyeka of the National Association of Physicians of Natural Medicine (NAPNM).

He said that the fruit was taken for syphilis and as a diuretic, stimulant, and aphrodisiac. "A leaf tea is prepared as a mouthwash and gargle for mouth ulcers, tonsillitis, and throat problems and is used for washing wounds," Onyeka added.

The homeopath further stated that an infusion and/or maceration of the bark is used to treat diabetes, weakness, muscular debility, urinary disorders and asthma. He continued: "The leaves and/or the bark is also used for eczema, psoriasis, scrofula, dyspepsia, genital problems and venereal diseases, as well as for impotence, bronchitis, cough, intestinal colic, leishmaniasis and syphilis-related skin disorders. Cashew is also used for diabetes, coughs, bronchitis, tonsillitis, intestinal colic, and diarrhoea, and as a general tonic."
The bark according to an encyclopaedia, Useful Plants of Tropical West Africa by H. M Burkil has astringent properties. "It contains nine to 21 per cent tannin and is used in tanning. Bark and leave infusions are used to relieve toothache and sore gums and are taken internally for dysenteric conditions. The bark is used in Lagos for a disease known in Yoruba as efu, symptomised by white tender tongue, chiefly in children ('thrush'), and for another disease known as kolobo or ishanu (Ijebu), a more serious condition of black tongue."

According to Burkhil, the bark-infusion is taken for urethral discharge and with Manilkara obovata (Sapotaceae) a decoction is used to treat women's stomach pains. Oral administration of a tincture or extract of bark, according to Burkhil lowers blood-sugar level within 15 minutes of ingestion and continues for some hours.

Extracts have been shown ineffective in antibiotic tests and insecticidally. "The young leaves can be eaten. Mature leaves are rich in tannin (23 per cent) and are used for their astringent properties as in the bark. The young leaves are used for dysentry, diarrhoea and haemorrhoids among other diseases. The sap may be expressed and taken for diarrhoea. A trace of alkaloid has been reported present in the leaves."

The Encyclopaedia suggests that before becoming ripe the fruit is highly astringent. It reads: "When ripe, a slight astringent remains, but it is edible, and the juice is pleasantly thirst quenching. It is rich in sugars and vitamins, especially Vitamin C. The fruit can be made into jam and preserves. It is sold in markets for food and medicine, sun-dried or reduced to a syrup endowed with the attributes of a general panacea, an aphrodisiac, stimulant, strengthener and elixir of longevity."

Phytochemical analysis indicates that in addition to being delicious, cashew fruit is a rich source of vitamins, minerals and other essential nutrients. It has been shown to have up to five times more Vitamin C than oranges and contains a high amount of mineral salts.

Volatile compounds present in the fruit include esters, terpenes and carboxylic acids.
The bark and leaves of cashew are a rich source of tannins, a group of plant chemicals with documented biological activity. These tannins, in a 1985 rat study, demonstrated anti-inflammatory and astringent effects, which may be why cashew is effective in treating diarrhoea. Anacardic acids are found in cashew with their highest concentration in the nutshells. Several clinical studies have shown that these chemicals curb the darkening effect of ageing by inhibiting tyrosinase activity and that they are toxic to certain cancer cells.

A 2001 study reported that a bark extract exhibited in vitro antimicrobial activity against 13 of 15 micro-organisms tested. In 1999, researchers reported that cashew fruit exhibited antibacterial activity against the Gram-negative bacterium Helicobacter pylori, which is now considered to cause acute gastritis and stomach ulcers. Its effectiveness against leishmanial ulcers also was documented in two clinical studies.

Finally, two studies (one in mice and the other in rats) in 1989 and 1998 document the protective quality of a leaf extract against lab-induced diabetes, although the extract did not act as hypoglycaemic as some others, it did stabilise blood glucose levels near pre-test levels.


Aug 8, 2007, 06:19 AM
Nigerian Guardian

Govt seeks partnership to battle malaria

From Collins Olayinka and Funmi Awoyale, Abuja
THE Minister of Health, Prof. Adenike Grange, has identified malaria as the leading cause of infant mortality, claiming the lives of about 300,000 Nigerian children yearly.
Grange, who painted this grim picture in Abuja yesterday at the National Malaria Control Programme review meeting, also hinged a reversal of the development on the availability of effective and affordable vaccine in the country.

The meeting was to identify the existing challenges and ensure that the Roll Back Malaria (RBM) and malaria-related Millennium Development Goals (MDGs) are achieved by 2010 and 2015 respectively.

She said: "I believe that you are all aware that malaria is still the leading cause of morbidity and mortality in children in Nigeria. It is responsible for the deaths of 300,000 children annually as it causes 30 per cent (three in 10 of the deaths) in under-five and 25 per cent (one in four) of the deaths of infants.

"In addition, malaria is a primary cause of miscarriage, stillbirth and low birth weight and is responsible for 11 per cent of all maternal mortality and as you well know, malaria contributes to poverty and under-development", she added.

Grange, who was represented by the Minister of State for Health, Yakubu Aduku, said Roll Back Malaria, as a social movement involving government at all levels, non-governmental organisations, private sector and everybody, was initiated to checkmate the ravaging effects of malaria.

As an indication of Federal Government's commitment to reducing the burden of malaria and through the support of development partners and other stakeholders, Grange said the government is providing free malaria commodities.

According to her, the commodities include: "pre-packed Artemisinin-based combination therapies (ACTs), Insecticide Treated Nets (ITNs), Sufadoxine-Pyrimethamine (SP), among others, to all the 36 states and the Federal Capital Territory".

To consolidate on the achievements so far, Grange canvassed a Roll Back Malaria Partnership and all stakeholders in the country to review the activities so as to fashion out the way forward for sustained RBM implementation and scaling up in the country to meet the RBM and Millennium Development Goals (MDGs) in 2010 and 2015 respectively.
She urged partners and stakeholders to speed up the process of ensuring community ownership of the programme so as to ensure "sustainability and equitable distribution of Roll Back Malaria commodities".

Earlier, the Head, Department of Public Health, Dr. Ngozi Njepuome, in her welcome address, insisted that malaria could be eliminated from Nigeria if all hands were on deck to combat the menace.

She said: "If we can all agree and work together, we can eradicate malaria. If other advanced countries have done it, then Nigeria can also do it. If we are able to eradicate malaria, then joint border activities can be embarked upon to prevent re-infestation in the country".


Aug 9, 2007, 10:02 PM
New York Times reports (http://www.nytimes.com/2007/08/08/dining/08raw.html?em&ex=1186804800&en=0d797ce6edce7564&ei=5087%0A)

Should This Milk Be Legal?
August 8, 2007
THERE was the name of a Web site scrawled on cardboard and quickly torn to bits by an anonymous farmer in the Greenmarket at Union Square. Then came the paperwork, legal enough presumably, to protect the source of the illicit substance. Finally, Yaron Milgrom-Elcott received the monthly drop site: an address near Chelsea, open for two hours, show up or lose the white stuff.

Mr. Milgrom-Elcott never missed a drop. Each month, he joined mothers with newborns and Wall Street titans in search of a box of unpasteurized, unhomogenized, raw milk. He is also part of a movement of perhaps hundreds of thousands across the country who will risk illness or even death to drink their milk the way Americans did for centuries: straight from the cow.

Twenty years ago, the Food and Drug Administration banned interstate sales of unpasteurized milk. This spring the agency warned consumers again that they were risking their health drinking raw milk.

Still, individual states determine how raw milk is bought and sold within their borders. While its sale for human consumption is illegal in 15 states, New York is one of 26 where it can be bought with restrictions. The chief one is that raw milk can only be sold on the premises of one of 19 dairy farms approved by the state. Clandestine milk clubs, like the one Mr. Milgrom-Elcott joined, are one way of circumventing the law, and there are others.
Raw milk drinkers may praise its richer flavor or claim it is more nutritious than pasteurized milk. No matter why they drink it, the demand for it is booming.

In 2000, the Organic Pastures Dairy Company in the San Joaquin Valley near Fresno became California’s first raw milk dairy with certified organic pasture land. This year its co-founder, Mark McAfee, expects it to gross $6 million — up from $4.9 last year.

His raw milk is sold in 300 stores in California, where it is legal. He also has an $80,000 a month mail order business, shipping creams and cheese as well as milk to all 50 states. He believes he reaches 35,000 customers a week for his raw milk products. Because the laws allow interstate shipping of raw milk that is not meant for human consumption, Organic Pastures milk is labeled as pet food.

“I like to go into the warehouse and see the addresses — it goes all over creation,” he said. “We don’t have the same customers day in and day out. We’re the entry point. We hear back that shipping is too expensive but that they found a local provider, either a farm or on the black market. They have got to have it.”

Mr. McAfee said he knows firsthand of more than six dairies in Pennsylvania, some of them Amish, that supply the black market in New York and Boston. “They’re sending in 200 cases of milk every month,” he said.

Some drink it for the same reason raw milk cheeses are popular: the taste. “I first discovered it two summers ago in France,” said Mr. Milgrom-Elcott, who is pursuing a doctorate in medieval Jewish mysticism at New York University. “There is a richness and density unlike processed milk, plus there’s this complexity of flavor.”

Others believe that it is good for them. Pasteurization — a process of heating and quickly cooling milk to kill pathogens such as E. coli, salmonella and listeria — also destroys beneficial bacteria, proteins and enzymes, they say. Advocates attribute stronger immune and better digestive systems to raw milk. Many have incorporated it into their diet as part of a broader philosophy to treat their bodies and the planet properly.

Nina Planck, the author of “Real Food: What to Eat and Why,” defied the F.D.A.’s warning and drank raw milk while she was pregnant. She not only continues to drink it while nursing her 9-month-old son, Julian, but also allows him the occasional sip. She has an arrangement with a couple of farmers to deliver it to New York City.

“We drink raw milk because we trust the traditional food chain more than the industrial one,” said Ms. Planck, who knows a number of farmers from her days as director of the New York City Greenmarkets and through her boyfriend, Rob Kaufelt, the owner of Murray’s Cheese in Greenwich Village.

“We’re willing to spend more money the higher up the food chain we go,” she said. “We’re not alone, either. You cannot categorize the people who are drinking raw milk. They are people from the blue states and red states, farmers and yuppies and Birkenstock wearers.”

Food scientists can hardly believe that so many consumers have turned their back on one of the most successful public health endeavors of the 20th century. In 1938, for example, milk caused 25 percent of all outbreaks of food- and water-related sickness.

With the advent of universal pasteurization, that number fell to 1 percent by 1993, according to the Center for Science in the Public Interest, a nutrition advocacy group in Washington.

David Barbano, director of the Northeast Dairy Foods Research Center, operated by Cornell and the University of Vermont and supported by the dairy industry, grew up drinking raw milk on a family farm. He does not remember ever getting sick, but says science has never found any evidence that it was more beneficial than pasteurized milk. In fact, he said, raw milk has very little vitamin D, which is added to most pasteurized milk.

“There is always going to be a percentage of raw milk that carries disease-causing bacteria,” said Dr. Barbano, who is a professor of food science at Cornell. “As long as I have pasteurized milk available for me, and I guess more importantly for my daughter, the risk is not worth any benefit anyone has been able to prove.”

Sally Fallon, president of the Westin A. Price Foundation, another nutrition advocacy group, argues that the risk to raw milk drinkers is insignificant, and the demand for product is growing steadily. In 1998, when the Washington-based foundation created the Web site realmilk.com, it barely had half a page of sources where raw milk could be purchased legally. Now, the list has grown to more than two dozen pages, and Ms. Fallon puts the number of raw milk drinkers at half a million.

“We are trying to be pragmatic and create demand,” said Ms. Fallon of the 10,000-member, 400-chapter foundation, which has mounted legal challenges to raw milk regulations in several states. “Even though it is illegal in some places, it is very available through cow sharing or cow herding programs.”

In Virginia, for example, Chip and Susan Planck — Nina’s parents — pay $40 a year plus $25 monthly to own a share in one cow, the only legal way to get raw milk in that state. In return, they get a gallon of raw milk a week. It is technically not a sale but compensation for the cow’s room and board.

Last year the Hawthorne Valley Farm in Ghent, N.Y., offered a buyers’ club program to its raw milk customers in the hopes of giving a bigger boost to a steadily growing market. It was designed to encourage those customers in New York and beyond to order in bulk but send only one representative a week to pick up the order.

When the New York State Department Public Interestand Markets caught wind of it, however, it asked Hawthorne to end the program and the farm complied. Still, Abe Madey, the farm’s dairy manager and cheesemaker, says business is steady. About 100 regular customers, many of whom drive two hours from New York City, purchase up to 7,500 gallons annually of raw milk worth about $45,000 to the farm, he said.

The milk club that Mr. Milgrom-Elcott belongs to, and others like it, is far more problematic, according to Jessica A. Chittenden, a spokeswoman for the Agriculture and Markets department. She says the 41 milk inspectors charged with the monthly testing of New York’s 5,000 dairy farms had not yet turned their attention to the clandestine dropoffs.

“It is under review,” said Ms. Chittenden, adding that the department cited five of the raw milk permit holders for violations in the past year. “Our utmost concern is for public health. We are trying to insure that the safest products are out there.”
For a few months anyhow, Mr. Milgrom-Elcott can shed his identity of a potential law-breaker. His wife, Miriam Sheinbein, just finished her third year at the Albert Einstein College of Medicine and is currently serving a brief rotation in San Francisco. In California, raw milk is legal and widely available. While Ms. Sheinbein, who is 19 weeks pregnant, has decided to forego the delicacy until the baby is born, Mr. Milgrom-Elcott is delighted to take his habit above-ground. “It’s hard to live without,” he said.

But then again, Mr. Milgrom-Elcott’s secret life in New York was not without its thrills.
“We also bought crème fraîche from the milk club,” he said. “It was nearly as ethereal as our fromager’s in Aix-en-Provence.”

Aug 9, 2007, 10:05 PM
New York Times reports (http://www.nytimes.com/2007/08/08/health/08cancer.html?th&emc=th)

August 8, 2007
Court Rejects the Right to Use Drugs Being Tested

A federal appeals court ruled yesterday that patients with terminal illnesses do not have a constitutional right to use medicines that have not yet won regulatory approval.

The 8-to-2 decision by the Court of Appeals for the District of Columbia Circuit came in a closely watched and emotional case that pitted desperate patients willing to try unproven, even risky, therapies against those arguing that drugs should be proved safe and effective before they are made available.

The decision preserves the current regulatory system. If it had gone the other way “it would have undermined the entire drug approval process,” said William B. Schultz, a former deputy commissioner of the Food and Drug Administration, who wrote an amicus brief arguing against the early access to drugs.

The case was filed against the Food and Drug Administration in 2003 by the Abigail Alliance for Better Access to Developmental Drugs, a group founded by a man whose daughter Abigail died from cancer after a long battle to receive treatment with experimental drugs that were eventually approved.

The group, joined by the Washington Legal Foundation, argued that forcing patients to wait years for a drug to go through the process of clinical trials deprived dying patients of their right to self-defense and violated the Fifth Amendment clause stating that people cannot be deprived of life, liberty or property without due process of law.

A district court ruled against the Abigail Alliance. That decision was reversed by an appeals court panel, but the full appeals court yesterday upheld the original district court decision.

Judge Thomas B. Griffith, writing for the majority, said a right to experimental drugs was not deeply rooted in the nation’s history and tradition. Judge Griffith said the right of self-defense “cannot justify creating a constitutional right to assume any level of risk without regard to the scientific and medical judgment expressed through the clinical testing process.”

In a dissent, Judge Judith W. Rogers wrote that it was “startling” that the “right to try to save one’s life is left out in the cold,” not protected by the due process clause of the Constitution, “despite its textual anchor in the right to life.”

Frank Burroughs, the founder of the Abigail Alliance, said his group was “dumbfounded that most of the justices tragically missed the merits of the case.” Mr. Burroughs vowed to appeal to the Supreme Court.

While critics often accuse the F.D.A. of letting unsafe drugs on the market, this case points to pressure on the agency from the opposite direction — patients who say it is too stringent in approving drugs for serious diseases. Many prostate cancer patients and advocacy groups, for instance, have recently criticized the agency for not approving a drug called Provenge.

The agency sometimes does lower the bar for approval of medicines for life-threatening diseases. And the companies developing such drugs can make them available before approval under some circumstances.

But Mr. Burroughs said such programs were inadequate. His organization advocates that drugs be made available to terminally ill patients as early as the conclusion of the first of three phases of clinical trials.

Some drug companies, doctors and other patient groups oppose that idea. Mr. Schultz, for instance, filed his brief supporting the current system on behalf of the National Organization for Rare Disorders, a patient advocacy group.

He and others say that if drugs were made available after only preliminary testing, drug companies would have little incentive to conduct full clinical trials to determine if a drug really works. That would allow companies to “profit from offering empty hope,” said Robert Erwin of the Marti Nelson Cancer Foundation, a patient advocacy group.

Aug 22, 2007, 03:35 PM
Thisday Online (http://www.thisdayonline.com/nview.php?id=85362)

your write up is a God sent. You know what? I have drastically reduced abi denied my family of egg especially my husband because of the tot of helping to ward off cholesterol.
I am so grateful to you for bringing this information to the forum.
I still have one hurdle --- which one is healthier and safer-------half boiled or hard boiled??:)

Oct 17, 2007, 04:24 PM
Source (http://news.yahoo.com/s/ap/20071017/ap_on_he_me/staph_infections)

Staph fatalities may exceed AIDS deaths

By LINDSEY TANNER, AP Medical Writer2 hours, 23 minutes ago

More than 90,000 Americans get potentially deadly infections each year from a drug-resistant staph "superbug," the government reported in its first overall estimate of invasive disease caused by the germ.

Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. Tuesdays report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.

The overall incidence rate was about 32 invasive infections per 100,000 people. That's an "astounding" figure, said an editorial in Wednesday's Journal of the American Medical Association, which published the study.

Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections — those that enter the bloodstream or destroy flesh and can turn deadly.

Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system — people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.

In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods.

The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.

An invasive form of the disease is being blamed for the death Monday of a 17-year-old Virginia high school senior. Doctors said the germ had spread to his kidneys, liver, lungs and muscles around his heart.

The researchers' estimates are extrapolated from 2005 surveillance data from nine mostly urban regions considered representative of the country. There were 5,287 invasive infections reported that year in people living in those regions, which would translate to an estimated 94,360 cases nationally, the researchers said.

Most cases were life-threatening bloodstream infections. However, about 10 percent involved so-called flesh-eating disease, according to the study led by researchers at the federal Centers for Disease Control and Prevention.

There were 988 reported deaths among infected people in the study, for a rate of 6.3 per 100,000. That would translate to 18,650 deaths annually, although the researchers don't know if MRSA was the cause in all cases.

If these deaths all were related to staph infections, the total would exceed other better-known causes of death including AIDS — which killed an estimated 17,011 Americans in 2005 — said Dr. Elizabeth Bancroft of the Los Angeles County Health Department, the editorial author.

The results underscore the need for better prevention measures. That includes curbing the overuse of antibiotics and improving hand-washing and other hygiene procedures among hospital workers, said the CDC's Dr. Scott Fridkin, a study co-author.

Some hospitals have drastically cut infections by first isolating new patients until they are screened for MRSA.

The bacteria don't respond to penicillin-related antibiotics once commonly used to treat them, partly because of overuse. They can be treated with other drugs but health officials worry that their overuse could cause the germ to become resistant to those, too.

A survey earlier this year suggested that MRSA infections, including noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital and nursing home patients — or as many as 5 percent. These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University, said the JAMA study emphasizes the broad scope of the drug-resistant staph "epidemic," and highlights the need for a vaccine, which he called "the holy grail of staphylococcal research."

The regions studied were: the Atlanta metropolitan area; Baltimore, Connecticut; Davidson County, Tenn.; the Denver metropolitan area; Monroe County, NY; the Portland, Ore. metropolitan area; Ramsey County, Minn.; and the San Francisco metropolitan area.


On the Net:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov

Copyright © 2007 The Associated Press. All rights reserved. T