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Taiwanese minister: China is playing politics with health

Taiwan’s health minister on Monday accused China of playing politics with health after Taiwan was blocked from taking part in the annual meeting of the governing body of the World Health Organization for the first time since 2008.

Health and Welfare Minister Chen Shih-chung lashed out at China’s actions, which Beijing said was taken because Taiwan’s year-old government has reneged on the “One China” principle.

“Are we here to discuss politics, or are we here to discuss health?” Chen told supporters and journalists. “I think that all discussion should be based on the right to health, instead of anything political.”

The World Health Assembly accepted the exclusion of Taiwan without a vote at the beginning of its annual session in Geneva Monday. Taiwan isn’t a U.N. member state, but had been granted assembly “observer status” every year since 2009 under an arrangement on the “One China” principle.

On Sunday, Chen’s Chinese counterpart, Li Bin, blamed the governing party of Taiwanese President Tsai Ing-wen for the exclusion of Taiwan this year, insisting its refusal to accept the principle of a single China has torpedoed its hopes to attend.

Chen struck back at that claim.

“Since President Tsai took office, we have not done anything to proactively change the status quo,” he said, expressing “disappointment” about Li’s comments. He added he would not rule out a meeting with Li in Geneva, but that nothing was yet planned.

Chen said Taiwan has “many things to share” in the health arena.

“We have a full-coverage national health care insurance policy, high-quality medical care, powerful epidemic control, and many other successful initiatives,” Chen said. “It is not only that Taiwan needs the WHO, the WHO also needs Taiwan.”

The World Health Assembly, now in its 70th edition, brings together health ministers and other top health officials from its 194 member states. The highlight of this year is expected to be the election Tuesday of a successor for Director-General Dr. Margaret Chan, a native of Hong Kong who has led the agency for a decade.

A statement Monday from the office of U.S. Health and Human Services Secretary Tom Price said he had met with health officials from Taiwan “to discuss mutual efforts in support of global health security” — one of many bilateral meetings he has planned in Geneva.

Before taking office in January, President-elect Donald Trump — now Price’s boss — astonished many by talking directly with President Tsai by phone, the highest level U.S.-Taiwan conversation since Washington switched diplomatic recognition to Beijing in 1979. Trump further stirred the pot by questioning the need to uphold the longtime U.S. “One China” policy.

Trump has since moved to reassure Beijing that he will adhere to that policy.

China has used its clout as one of five veto-wielding members of the U.N. Security Council to exclude Taiwan from the United Nations and other world bodies that require sovereign status for membership.

Article source: http://abcnews.go.com/Health/wireStory/taiwanese-minister-china-playing-politics-health-47558870

Cash-strapped World Health Organization slammed for high travel costs

L

ONDON — Dr. Margaret Chan, director-general of the World Health Organization, traveled to Guinea earlier this month to join the country’s president in celebrating the world’s first Ebola vaccine.

After praising health workers in West Africa for their triumph over the lethal virus, Chan spent the night in the presidential suite at the beach-side Palm Camayenne hotel. The suite, equipped with marble bathrooms and a dining room that seats eight, has an advertised price of 900 euros ($1,008) per night.

Some say such luxurious accommodations send the wrong message to the rest of WHO’s 7,000 staffers — and may hurt the cash-strapped health agency’s fundraising efforts to fight diseases worldwide.

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According to internal documents obtained by the Associated Press, the UN health agency routinely has spent about $200 million a year on travel expenses, more than what it doles out to fight some of the biggest problems in public health, including AIDS, tuberculosis and malaria combined.

Last year, WHO spent about $71 million on AIDS and hepatitis. It devoted $61 million to malaria. To slow the spread of tuberculosis, WHO invested $59 million. Still, some health programs do get exceptional funding — the agency spends about $450 million trying to wipe out polio every year.

WHO declined to say if it paid for Chan’s stay at the Palm Camayenne in Conakry, but noted that host countries sometimes pick up her hotel tabs.

At a time when the health agency is pleading for more money to fund its responses to health crises worldwide, it has struggled to get its travel costs under control. Senior officials have complained internally that UN staffers break new rules aimed at curbing its expansive travel costs, booking perks like business class airplane tickets and rooms in five-star hotels with few consequences.

“We don’t trust people to do the right thing when it comes to travel,” Nick Jeffreys, WHO’s director of finance, said during a September 2015 in-house seminar on accountability — a video of which was obtained by the AP.

Despite WHO’s numerous travel regulations, Jeffreys said the agency couldn’t be sure its staffers always booked the cheapest fares or that their travel was even warranted.

Ian Smith, executive director of Chan’s office, said the chair of WHO’s audit committee said the agency often did little to stop misbehavior.

“We, as an organization, sometimes function as if rules are there to be broken and that exceptions are the rule rather than the norm,” Smith said.

Earlier that year, a memorandum was sent to Chan and other top leaders with the subject line “ACTIONS TO CONTAIN TRAVEL COSTS” in capital letters. The memo reported that compliance with rules requiring travel to be booked in advance was “very low.” The document also pointed out that WHO was under pressure from its member countries to save money.

Travel would always be necessary, the memo said, but “as an organization we must demonstrate that we are serious about managing this appropriately.”

In a statement to the AP, the UN health agency said “the nature of WHO’s work often requires WHO staff to travel” and that costs were reduced 14 percent last year compared to the previous year — although the 2015 total was exceptionally high due to the 2014 Ebola outbreak in West Africa.

But staffers still are openly ignoring the rules.

An internal analysis in March, obtained by the AP, found that only two of seven departments at WHO’s Geneva headquarters met their budget targets and concluded that the compliance rate for booking travel in advance was only between 28 and 59 percent.

Since 2013, WHO has paid $803 million for travel. WHO’s approximately $2 billion annual budget is drawn from the taxpayer-funded contributions of its 194 member countries; the United States is the largest contributor.

After he was elected, President Donald Trump tweeted: “The UN has such great potential,” but had become “just a club for people to get together, talk, and have a good time. So sad!”

WHO said Sunday that nearly 60 percent of its travel costs were spent on sending outside experts to affected countries and for national representatives to attend WHO meetings.

During the Ebola disaster in West Africa, WHO’s travel costs spiked to $234 million. Although experts say on-the-ground help was critical, some question whether the agency couldn’t have shaved its costs so more funds went to West Africa. The three countries that bore the brunt of the outbreak couldn’t even afford basics such as protective boots, gloves and soap for endangered medical workers.


Dr. Bruce Aylward, who directed WHO’s outbreak response, racked up nearly $400,000 in travel expenses during the Ebola crisis, sometimes flying by helicopter to visit clinics instead of traveling by jeep over muddy roads, according to trip reports he filed.

Chan spent more than $370,000 in travel that year, as documented in a confidential 25-page analysis of WHO expenses that identified the agency’s top 50 spenders. Aylward and Chan were first and second. WHO declined requests for an interview with Chan; Aylward did not respond to a request for comment.

Three sources who asked not to be identified for fear of losing their jobs told the AP that Chan often flew in first class.

WHO said its travel policy, until February, permitted its chief “to fly first class.” It said Chan now flies business class, at her request.

Devi Sridhar, a global health professor at the University of Edinburgh, described WHO’s travel costs as “extremely high” but said the problems at WHO probably stretched across the whole United Nations.

“People know these UN jobs can be cushy and come with perks, that you get to travel business class and stay at nice hotels,” she said, adding that the lack of scrutiny of UN finances was a problem.

Other international aid agencies, including Doctors Without Borders, explicitly forbid their staff from traveling in business class. Even the charity’s president must fly in economy class. With a staff of about 37,000 aid workers versus WHO’s 7,000 staffers, Doctors Without Borders spends about $43 million on travel a year.

The US Centers for Disease Control and Prevention would not provide its travel costs, but said staffers are not allowed to fly business class unless they have a medical condition. The UN children’s agency UNICEF, which has about 13,000 staffers, said it spent $140 million on global travel in 2016.

“When you spend the kind of money WHO is spending on travel, you have to be able to justify it,” said Dr. Ashish Jha, director of the Global Health Institute at Harvard University. “I can’t think of any justification for ever flying first class.”

Jha warned that WHO’s travel spending could have significant consequences for fundraising. Several weeks ago, WHO asked for about $100 million to save people in Somalia from an ongoing drought. In April, it requested $126 million to stop the humanitarian catastrophe in Yemen.

“If WHO is not being as lean as possible, it’s going to be hard to remain credible when they make their next funding appeal,” Jha said.

— Maria Cheng

Article source: https://www.statnews.com/2017/05/21/who-spends-on-travel/

As GOP Tarries On Health Bill, Funding For Children’s Health Languishes

The federal CHIP program funds health care for almost 9 million children.

Terry Vine/Blend Images/Getty Images


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Terry Vine/Blend Images/Getty Images

The federal CHIP program funds health care for almost 9 million children.

Terry Vine/Blend Images/Getty Images

Back in January, Republicans boasted they would deliver a “repeal and replace” bill for the Affordable Care Act to President Donald Trump’s desk by the end of the month.

In the interim, that bravado has faded as their efforts stalled and they found out how complicated undoing a major law can be. With summer just around the corner, and most of official Washington swept up in scandals surrounding Trump, the health overhaul delays are starting to back up the rest of the 2018 agenda.

One of the immediate casualties is the renewal of the Children’s Health Insurance Program. CHIP covers just under 9 million children in low- and moderate-income families, at a cost of about $15 billion a year.

Funding for CHIP does not technically end until Sept. 30, but it is already too late for states to plan their budgets effectively. They needed to know about future funding while their legislatures were still in session, but, according to the National Conference of State Legislatures, the local lawmakers have already adjourned for the year in more than half of the states.

“If [Congress] had wanted to do what states needed with respect to CHIP, it would be done already,” says Joan Alker of the Georgetown Center for Children and Families.

“Certainty and predictability [are] important,” agrees Matt Salo, executive director of the National Association of Medicaid Directors. “If we don’t know that the money is going to be there, we have to start planning to dismantle things early, and that has a real human toll.”

In a March letter urging prompt action, the Medicaid directors noted that while the end of September might seem far off, “as the program nears the end of its congressional funding, states will be required to notify current CHIP beneficiaries of the termination of their coverage. This process may be required to begin as early as July in some states.”

CHIP has long been a bipartisan program. One of its original sponsors is Sen. Orrin Hatch, R-Utah, who chairs the Finance Committee that oversees it. It was created in 1997, and last reauthorized in 2015, for two years. But a Finance hearing that was intended to launch the effort to renew the program was abruptly canceled this month, amid suggestions that Republicans might want to hold the program’s renewal hostage to force Democrats and moderate Republicans to make concessions on the bill to replace the Affordable Care Act.

“It’s a very difficult time with respect to children’s coverage,” says Alker. Not only is the future of CHIP in doubt, but also the House-passed health bill would make major cuts to the Medicaid program, and many states have chosen to roll CHIP into the Medicaid program.”

“We’ve just achieved a historic level in coverage of kids,” she says, referring to a new report finding that more than 93 percent of eligible U.S. children now have health insurance under CHIP. “Now all three legs of that coverage stool — CHIP, Medicaid and ACA — are up for grabs.”

But it’s not just CHIP at risk due to the congested congressional calendar. Congress also can’t do the tax bill Republicans badly want until lawmakers wrap up the health bill.

5 Things To Watch As GOP Health Bill Moves To The Senate

That is because Republicans want to use the same budget procedure, called reconciliation, for both bills. That procedure forbids a filibuster in the Senate and allows passage with a simple majority.

There’s a catch, though. The health bill’s reconciliation instructions were part of the fiscal 2017 budget resolution, which Congress passed in January. Lawmakers would need to adopt a fiscal 2018 budget resolution in order to use the same fast-track procedures for their tax changes.

And they cannot do both at the same time. “Once Congress adopts a new budget resolution for fiscal year 2018,” says Ed Lorenzen, a budget-process expert at the Committee for a Responsible Federal Budget, that new resolution “supplants the fiscal year 2017 resolution and the reconciliation instructions in the fiscal year 2017 budget are moot.”

Fact-Checking Republicans' Defense Of The GOP Health Bill

That would mean that if Congress wanted to continue with the health bill, it would need 60 votes in the Senate, not a simple majority.

There is, however, a loophole of sorts. Congress “can start the next budget resolution before they finish health care,” said Lorenzen. “They just can’t finish the new budget resolution until they finish health care.”

So the House and Senate could each pass its own separate budget blueprint, and even meet to come to a consensus on its final product. But they cannot take the last step of the process — with each approving a conference report or identical resolutions — until the health bill is done or given up for dead. They could also start work on a tax plan, although, again, they could not take the bill to the floor of the Senate until they finish health care and the new budget resolution.

At least that’s what most budget experts and lawmakers assume. “There’s no precedent to go on,” said Lorenzen, because no budget reconciliation bill has taken Congress this far into a fiscal year. “So nobody really knows.”

Kaiser Health News is an editorially independent part of the Kaiser Family Foundation.

Article source: http://www.npr.org/sections/health-shots/2017/05/22/529144353/as-gop-tarries-on-health-bill-funding-for-childrens-health-languishes

A glass of red wine is NOT good for the heart

  • Previous studies imply moderate drinkers have less heart disease than abstainers
  • Yet, these teetotallers frequently used to drink and cut back or quit for their health
  • Nondrinkers are therefore often less healthy, regardless of their alcohol intake
  • Healthy older people are more inclined to drink than people with worse health
  • This gives the false illusion that moderate drinking promotes boost wellbeing 

Alexandra Thompson Health Reporter For Mailonline

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An occasional glass of wine does not benefit your heart, according to a review of 45 studies.

Previous studies have suggested moderate drinkers have lower heart disease rates than teetotallers, leading to the widespread myth that the occasional indulgence boosts our heart health.

Yet, alcohol abstainers in these past studies may have been former drinkers who quit or cut down due to an existing health concern, and are therefore less healthy than moderate drinkers irrespective of their alcohol consumption, the review found.

Healthy older people may also be more inclined to enjoy an occasional alcoholic drink than those with existing health problems, the research adds.

This gives the false illusion of an association between moderate drinking and better health, the researchers said.

Lead author Dr Tim Stockwell, director of the Center for Addictions Research at the University of Victoria in British Columbia, Canada, said: ‘The notion that one or two drinks a day is doing us good may just be wishful thinking.’

An occasional glass of wine does not benefit your heart health, according a 45 study review

An occasional glass of wine does not benefit your heart health, according a 45 study review

EATING CHEESE DOES NOT RAISE YOUR HEART ATTACK RISK 

Eating dairy does not raise the risk of suffering a heart attack or stroke, a team of international experts have found.

Even full-fat cheese, milk and yoghurt do not increase the danger, a meta-analysis of 29 studies revealed.

The research team, including the University of Reading, concluded that dairy has only a neutral impact on human health.

Ian Givens, professor of food chain nutrition at Reading University, said: ‘There’s quite a widespread but mistaken belief among the public that dairy products in general can be bad for you, but that’s a misconception.

‘While it is a widely held belief, our research shows that that’s wrong.’ 

Dr Givens added that public health warnings have seen people shun full-fat versions of cheese, milk or yoghurt, in the mistaken belief that they could harm their health.

Young people, especially young women, risk damage to their bones and osteoporosis by drinking too little milk, which can deprive them of calcium, he said. 

Researchers followed more than 9,100 adults from the UK aged between 23 and 55.

They found that moderate drinkers – defined as those who had up to two alcoholic beverages a day – had a lower risk of heart disease than nondrinkers.

Yet, this was not the case when the researchers analysed the drinking habits of younger people – aged 55 or less – and then followed them to an older age when they are more at-risk of heart disease.

The researchers argue that while past studies suggest nondrinkers are less healthy than those who drink moderately, this is likely due to our health influencing our drinking habits, resulting in people with poor health choosing to abstain.

Dr Stockwell, said: ‘We know that people generally cut down on drinking as they age, especially if they have health problems.

‘People who continue to be moderate drinkers later in life are healthier.

‘They’re not sick, or taking medications that can interact with alcohol.

‘We can’t “prove” it one way or the other. But we can say there are grounds for a healthy skepticism around the idea that moderate drinking is good for you.’

The researchers also revealed that people’s drinking habits change over time, with few people typically being lifelong alcohol abstainers.

Their results also showed than nondrinkers of any age tend to be in poorer physical and mental health compared to those who drink moderately and do not smoke. They are also typically less educated, which is an important factor in lifetime health, the researchers said.  

The review is published in the Journal of Studies on Alcohol and Drugs.  

These findings contradict a recent study by the University of Cambridge that found men and women who drink moderately – no more than 14 units a week – are at less risk of heart problems than teetotallers.

Yet, adults who exceed this limit – defined as heavy drinkers – greatly increase their risk of common heart complications, they found.  


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Article source: http://www.dailymail.co.uk/health/article-4529928/A-glass-red-wine-NOT-good-heart.html

AP Exclusive: Health agency spends more on travel than AIDS

Dr. Margaret Chan, director-general of the World Health Organization, traveled to Guinea earlier this month to join the country’s president in celebrating the world’s first Ebola vaccine.

After praising health workers in West Africa for their triumph over the lethal virus, Chan spent the night in the top-tier presidential suite at the beach-side Palm Camayenne hotel. The suite, equipped with marble bathrooms and a dining room that seats eight, has an advertised price of 900 euros ($1,008) per night.

Some say such luxurious accommodations send the wrong message to the rest of WHO’s 7,000 staffers.

According to internal documents obtained by The Associated Press, the United Nations health agency routinely has spent about $200 million a year on travel expenses, more than what it doles out to fight some of the biggest problems in public health, including AIDS, tuberculosis and malaria combined.

Last year, WHO spent about $71 million on AIDS and hepatitis. It devoted $61 million to malaria. To slow the spread of tuberculosis, WHO invested $59 million. Still, some health programs do get exceptional funding — the agency spends about $450 million trying to wipe out polio every year.

WHO declined to say if it paid for Chan’s stay at the Palm Camayenne in Conakry, but noted that host countries sometimes pick up the tab for her hotels.

At a time when the cash-strapped health agency is pleading for more money to fund its responses to health crises worldwide, it has struggled to get its travel costs under control. Senior officials have complained internally that U.N. staffers break new rules that were introduced to try to curb its expansive travel spending, booking perks like business class airplane tickets and rooms in five-star hotels with few consequences.

“We don’t trust people to do the right thing when it comes to travel,” Nick Jeffreys, WHO’s director of finance, said during a September 2015 in-house seminar on accountability — a video of which was obtained by the AP.

Despite WHO’s numerous travel regulations, Jeffreys said staffers “can sometimes manipulate a little bit their travel.” The agency couldn’t be sure people on its payroll always booked the cheapest fares or that their travel was even warranted, he said.

“People don’t always know what the right thing to do is,” Jeffreys said.

Ian Smith, executive director of Chan’s office, said the chair of WHO’s audit committee said the agency often did little to stop misbehavior.

“We, as an organization, sometimes function as if rules are there to be broken and that exceptions are the rule rather than the norm,” Smith said.

Earlier that year, a memorandum was sent to Chan and other top leaders with the subject line “ACTIONS TO CONTAIN TRAVEL COSTS” written in capital letters. The memo reported that compliance with rules requiring travel to be booked in advance was “very low.” The document also pointed out that WHO was under pressure from its member countries to save money.

Travel would always be necessary, the memo said, but “as an organization we must demonstrate that we are serious about managing this appropriately.”

In a statement to the AP, the U.N. health agency said “the nature of WHO’s work often requires WHO staff to travel” and that costs were reduced 14 percent last year compared to the previous year — although that year’s total was exceptionally high due to the 2014 Ebola outbreak in West Africa.

But staffers still are openly ignoring the rules.

An internal analysis in March, obtained by the AP, found that only two of seven departments at WHO’s Geneva headquarters met their budget targets and concluded that the compliance rate for booking travel in advance was between 28 and 59 percent.

Since 2013, WHO has paid out $803 million for travel. WHO’s approximately $2 billion annual budget is drawn from the taxpayer-funded contributions of its 194 member countries; the United States is the largest contributor.

After he was elected, U.S. President Donald Trump tweeted : “The UN has such great potential,” but had become “just a club for people to get together, talk, and have a good time. So sad!”

Some health experts said while WHO’s travel costs look out of place when compared to some of its disease budgets, that doesn’t necessarily mean the agency’s travel expenses are inflated.

Michael Osterholm, an infectious diseases expert at the University of Minnesota, has frequently been flown to WHO meetings — in economy seating — at the agency’s expense.

“This may just speak to how misplaced international priorities are, that WHO is getting so little for these disease programs,” Osterholm said.

WHO said that nearly 60 percent of its travel costs were spent on sending outside experts to countries and for representatives from member countries to attend their meetings, according to a press statement issued Sunday.

During the Ebola disaster in West Africa, WHO’s travel costs spiked to $234 million. Although experts say on-the-ground help was critical, some question whether the agency couldn’t have shaved its costs so more funds went to West Africa . The three countries that bore the brunt of the outbreak couldn’t even afford basics such as protective boots, gloves and soap for endangered medical workers or body bags for the thousands who died.

Dr. Bruce Aylward, who directed WHO’s outbreak response, racked up nearly $400,000 in travel expenses during the Ebola crisis, sometimes flying by helicopter to visit clinics instead of traveling by jeep over muddy roads, according to internal trip reports he filed.

Chan spent more than $370,000 in travel that year, as documented in a confidential 25-page analysis of WHO expenses that identified the agency’s top 50 spenders. Aylward and Chan were first and second on that list. WHO declined requests for an interview with Chan; Aylward did not immediately respond to a request for comment.

Three sources who asked not to be identified for fear of losing their jobs told the AP that Chan often flew in first class.

WHO said its travel policy, until February, “included the possibility for the (director-general) to fly first class.” It said Chan flew business class and asked for the policy to be changed to eliminate the first-class option.

“There’s a huge inequality between the people at the top who are getting helicopters and business class, and everyone else who just has to make do,” Sophie Harman, an expert in global health politics at Queen Mary University in London, said.

Other international aid agencies, including Doctors Without Borders, explicitly forbid their staff from traveling in business class. Even the charity’s president must fly in economy class, a spokeswoman said. With a staff of about 37,000 aid workers versus WHO’s 7,000 staffers, Doctors Without Borders spends about $43 million on travel a year.

The U.S. Centers for Disease Control and Prevention would not provide its travel costs, but said staffers are not allowed to fly business class unless they have a medical condition that warrants it. The U.N. children’s agency UNICEF, which has about 13,000 staffers, said it spent $140 million on global travel in 2016.

“When you spend the kind of money WHO is spending on travel, you have to be able to justify it,” Dr. Ashish Jha, director of the Global Health Institute at Harvard University, said. “I can’t think of any justification for ever flying first class.”

Jha warned that WHO’s travel spending could have significant consequences for fundraising. Several weeks ago, WHO asked for about $100 million to save people in Somalia from an ongoing drought. In April, it requested $126 million to stop the humanitarian catastrophe in Yemen .

“If WHO is not being as lean as possible, it’s going to be hard to remain credible when they make their next funding appeal,” Jha said.

———

Follow Maria Cheng on Twitter @mylcheng.

———

Have a public health tip? Send it securely to Cheng at: www.ap.org/tips

Article source: http://abcnews.go.com/Health/wireStory/ap-exclusive-health-agency-spends-travel-aids-47555348

Tips For Staying Healthy When Traveling Abroad

Heading someplace where you could get traveler’s diarrhea? Try packing some prophylactic pills containing bismuth subsalicylate, such as Pepto Bismol.

Meredith Rizzo/NPR


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Meredith Rizzo/NPR

Heading someplace where you could get traveler’s diarrhea? Try packing some prophylactic pills containing bismuth subsalicylate, such as Pepto Bismol.

Meredith Rizzo/NPR

When planning a summer trip abroad, it’s easy to think, “Oh, I’ll just hop over to a travel clinic, and they’ll tell me everything I need to know — and do — to keep from getting sick.”

But that’s not always the case.

A study published last week in the Annals of Internal Medicine found that travel clinics missed giving the measles vaccine to about half of eligible travelers.

For nearly a third of the missed cases, doctors or nurses simply didn’t offer the vaccine, even though measles is a problem in many parts of the world, including Western Europe and Mexico.

“That’s very unfortunate,” says Capt. Gary Burnett, who leads the Traveler’s Health branch at the Centers for Disease Control and Prevention. “A traveler can be very easily exposed to measles around the world. That risk is very real.”

With international travel, Burnette says it’s best to figure out what you need before you go to the clinic, and then discuss the items with your doctor.

So, to kick off the summer travel season, we’re offering two tips that are often overlooked by clinicians.

1. Pack the pink pills

Let’s start with what you’re most likely to suffer from while traveling: food poisoning. About a quarter of travelers will get gastrointestinal problems within the first two weeks of an international trip, studies have found.

The major advice clinics give is, “Watch what you eat.” The CDC even has an app to help you decide whether or not to put that raw cheese or carnitas into your mouth.

The app is appropriately name “Can I Eat This?”

That strategy won’t hurt, but also might not help. Science just doesn’t back it up, says Daniel Leung, an infectious disease doctor at the University of Utah.

“There have been only a few studies on the topic, and they’ve shown that dietary discretion does not seem to change the risk of getting traveler’s diarrhea,” Leung says. “Even people who are eating street food or aren’t being very careful may not be at higher risk.”

But science does support another strategy; a prophylaxis that clinicians often overlook. We even missed it when we reported on this topic back in 2015.

Can You Protect Your Tummy From Traveler's Diarrhea?

It’s cheap, safe and … it’s a beautiful pink color.

Yep, I’m talking about Pepto Bismol, or any generic alternative with the same active ingredient, bismuth subsalicylate.

Back in 1987, a study found that two tablets of Pepto Bismol tablets, taken four times a day, cut the risk of traveler’s diarrhea by more than 60 percent. The pills dropped the risk from 40 percent to only 14 percent.

The study wasn’t super big, just 182 students traveling to Guadalajara, Mexico, but it was a randomized, placebo-controlled study, which is the gold standard design for medical trials. And it showed a dose-dependent effect. A lower dose of one tablet, four times a day reduced the risk by 40 percent rather than 60 percent.

“The findings showed fairly clearly that Pepto Bismol is effective at preventing diarrhea,” Leung says.

So why don’t we hear more often about this strategy?

“For one thing, the study is old,” Leung says. “A second might be because drug companies don’t widely market Pepto Bismol.”

And some travelers might find it tough to take pills four times a day, he says.

But even less frequent doses might be helpful, Leung says. Bismuth subsalicylate is known to have antimicrobial properties, and it may actually form a protective layer on top of the intestinal wall.

If you do get sick, Leung says, the pink pills may come in handy again. Bismuth subsalicylate can shorten the duration of a bout of diarrhea, and is a good alternative to antibiotics, Leung says.

2. Remember the routine vaccines

There’s a good chance you might need a vaccine, says Burnette, even if you’re just headed for a quick trip to Europe or the U.K.

That’s because the CDC recommends that all international travelers be up to date on “routine vaccines,” no matter the destination.

“You know, we try to stress this, with both travelers and clinicians, because some clinicians won’t check to see if you’ve completed routine vaccinations, such as the measles,” Burnette says.

Routine immunizations are the ones we get as children. The list is long. It includes about a dozen vaccines, everything from the pneumonia and whooping cough vaccines to those for Hepatitis A and B.

When you add onto this list any shots recommended for your specific destination, the list of possible vaccines can get complicated.

Plus, the CDC’s recommendations often get updated. Just a few weeks ago, the agency officially started recommending the cholera vaccine for travelers headed to places with ongoing outbreaks. And last month, they warned of a potential yellow vaccine shortage.

To make sure your clinician gets the list right for your specific trip, Burnette recommends using the CDC’s new travel app, called Trav Well.

Users type their destination and time of travel into the app, and it tells them what they need to do to prepare.

“It will suggest the vaccines and medications you probably need, and it will ask you to take those recommendations to your doctor about four to six weeks before you travel,” Burnette says. “I think it’s very helpful and can certainly make the whole process of preparing for trip a lot easier.”

Article source: http://www.npr.org/sections/health-shots/2017/05/22/528802722/tips-for-staying-healthy-when-traveling-abroad

Global health spending good for US security and economy, National Academies say


The United States needs to stay engaged in global health efforts, a new report argues. Here, a U.S. Army contingent participates in a humanitarian aid mission in East Africa.

If a serious infectious disease blossomed across the globe today, the U.S. death toll could be double that of all the casualties suffered in wars since the American Revolution. Those 2 million potential American lives lost to a global pandemic is just one sobering statistic cited in a new report released today by the U.S. National Academies of Sciences, Engineering, and Medicine that urges sustained U.S. spending on global health initiatives. It also calls on the federal government to develop a new “International Response Framework” to guide the nation’s preparation and reaction to intercontinental epidemics and global pandemics.

“While global crises have largely been avoided to date, the lack of a strategic [U.S.] approach to these threats could have grave consequences,” the report warns. “If the system for responding to such threats remains reactionary, the world will not always be so lucky.”

The next epidemic—whether from nature or bioterrorism—is a question of “when,” not “if,” according to the authors of the report, titled Global Health and the Future Role of the United States. They say the 313-page tome is intended to send a strong message that investing in public health beyond U.S. borders is more than a philanthropy project; it’s also a matter of economic stability and national security here at home.

“I have long argued that it is not just being altruistic to address these issues on a global basis, because sooner or later [they] will impact us,” says Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis and a member of the panel that wrote the report. (Osterholm has also recently written that President Donald Trump’s proposed budget cuts to the National Institutes of Health miss the mark on “the greatest national security threat of all: our fight against infectious disease.”)

The report’s authors make 14 recommendations for intervening in global health across four broad areas: prepping for global disease outbreaks; sustaining funds for responding to AIDS, tuberculosis, and malaria; improving women’s and children’s health; and reducing incidence of cardiovascular disease and cancers in low- and middle-income countries. It also calls for “the creation of an International Response Framework to guide the U.S. response to an international health emergency.”

Osterholm tells ScienceInsider that the structure of such a framework was left intentionally open-ended, to give officials leeway to think about how to avoid duplication of effort and wasted resources. Federal law already enables U.S. agencies to respond to domestic disease outbreaks, Osterholm notes, but “it is more complicated when you get into other countries.”

For example, at the height of national concern several years ago about the Ebola virus outbreak in West Africa, former President Barack Obama named a temporary “Ebola czar” to oversee the U.S. response. But report author Michael Merson, director of the Duke Global Health Institute in Durham, North Carolina, says the United States needs to “have a more stable system or framework in place so we would not have to do things on an ad hoc basis in the future.”

The report also argues that steady federal spending on disease preparedness—rather than the reactive and often delayed infusions of funds prompted by the recent Ebola and Zika virus outbreaks—would save money and increase effectiveness over the long haul. The report notes that even a “moderate influenza pandemic” that reduces global economic output by 2% could cost the world economy between $570 billion to $2 trillion.

Good health can also equal greater political stability, the authors argue. “When one thinks of global health, one often thinks of disease, humanitarian needs, and the moral imperative,” Merson says. “But now there is evidence that countries with good health are more secure and have less terrorism. So we tried to explain the benefits of global health from various perspectives: It is an economic issue, it is good for markets, it is important for diplomacy.”

The report comes as the Trump administration has proposed deep cuts in public health and foreign aid programs in the 2018 fiscal year that begins 1 October. Key members of Congress have been cool to those proposals, but final spending levels are not expected to be set until late this year at the earliest.

Article source: http://www.sciencemag.org/news/2017/05/global-health-spending-good-us-security-and-economy-national-academies-say

Good physical health critical to economic well-being

‘At least I have my health” is a phrase we use to signify that, of all the items we possess, good health is the most important to our personal well-being. But we often don’t consider the important role good health plays in our economic well-being too.

The social determinants of health and economic well-being will be a key topic in my May 22 commencement speech to graduates of the Jefferson College of Health Professionals and College of Pharmacy. I am sure these grads look forward to taking their places in our healthcare system. But, I wonder, do they appreciate their importance in our economic future? Indeed, helping households and communities achieve good physical health is critical to promoting economic growth.

To be clear, I am not talking about increasing access to health-care providers and insurance. I leave that to the politicians. I am talking about a holistic approach to good health in all of our communities.

Where you live goes a long way in determining how you feel. Being able to see a doctor or dentist or go to an emergency room is important, but so is having a home free from lead or asthma irritants. Most of us know we can probably eat better or should drop a few pounds, but a healthy diet is a challenge when you live in a “food desert,” with little access to fresh produce and unprocessed foods.

It is no surprise that poorer households have worse health outcomes. Financial instability raises physical stress levels. Poor adults are twice as likely as affluent adults to have diabetes and they experience coronary heart disease at a rate that is nearly 50 percent higher than that of the most affluent adults.

In recent research, economists Anne Case and Angus Deaton traced the rising mortality rates among middle-aged, non-Hispanic whites to increases in deaths from drug overdoses (including opioids), suicide, and alcohol-related diseases. They labeled these fatalities “deaths of despair,” because stagnant wages and fewer work opportunities have created a culture of hopelessness for those who are less educated and less skilled in our economy.

We as a nation must address this link between social determinants and physical health.

When Dr. Tom Friedan, former director of the U.S. Centers for Disease Control and Prevention, created “the health impact pyramid,” he found socioeconomic factors were the base of the pyramid – the area where money spent has the largest impact on health. So, investing in better housing, education, and job training in our poorer communities offers a “bigger bang for the buck” than money spent on expensive items such as clinical interventions. It may be a key way to slow the growth in health-care spending, which now accounts for almost 18 percent of our economic output.

The Federal Reserve is working to understand the interconnectedness of social factors, physical health, and economic well-being. Here at the Philadelphia Fed, our new initiative, the Economic Growth and Mobility Project, is championing research and best practices that move individuals, families, and communities out of poverty and into prosperity. Key to this effort is understanding how poverty is diminished – or worsened – by the health circumstances in our communities in Pennsylvania, New Jersey, and Delaware.

Elsewhere in the system, the San Francisco Fed is leading a venture with the Robert Wood Johnson Foundation to address ways to build and sustain healthy communities. Additionally, regional Fed banks bring together participants in community development, public health, and health care to share research and best practices. Just last year, in partnership with the University of Pennsylvania’s School of Public Health, the Philadelphia Fed hosted a forum on the topic “financial health is public health.” Finally, we are exploring how banks can leverage their Community Reinvestment Act commitments to support healthy outcomes such as financing a new water treatment plant or rehabbing housing to remove lead paint or mold.

The 2017 graduates at Jefferson may not realize it, but when they work in health care they will not just be providing help. They will also be creating a more optimistic future, not just for their patients, but for all of us. That’s because healthier people are more likely to be in the labor force and earning a paycheck. Businesses gain from fewer sick days and improved productivity. Less government money is spent on social programs and more funds come in as tax revenues, providing money for infrastructure and debt repayments.

If the physical well-being of our most vulnerable neighbors can be improved, we will all benefit.

Patrick T. Harker is president of the Federal Reserve Bank of Philadelphia. pharker@phil.frb.org




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Article source: http://www.philly.com/philly/opinion/20170522_Good_physical_health_critical_to_economic_well-being.html

A men’s guide to good health through the decades

There are a variety of health concerns that Men’s Health Network and other medical organizations recommend. Here’s a look at some decade-by-decade suggestions.

It may be a generalization, but men aren’t known to be proactive about their health care. “Men can be a hard group to get to the doctor’s office,” said Ana Fadich, vice president of Men’s Health Network, a national nonprofit. Often, they are driven to be good providers and work hard for their families, but don’t always take care of themselves. “That’s our goal, to raise awareness about this issue and hopefully help them live longer, healthier lives.”

One of the organization’s efforts was the establishment of a National Men’s Health Week in 1994 to offer a concentrated effort to tell men and boys about the benefits of regular health screenings and disease prevention initiatives in the week leading to Father’s Day. Its success has led to similar events around the world, and the move to make June Men’s Health Month.

“It’s really about education, education at every level,” said Dr. James Joachim, of Wilmington’s Coastal Primary Care. He’s an internist, a general practitioner with a subspecialty in medical nutrition, and has been a long-time adviser for MHN. “What’s helpful is that it not only focuses on medical tests and exams that are helpful for preventative care and screening, but also lifestyle changes, fitness, and efforts to improve overall well-being. It’s so easy for men to neglect these things or put them off.” That can be especially true for young men, but even those in their 20s should start getting regular physical exams and establishing a rapport with a doctor.

Starting a conversation about health isn’t always easy though, said Karina McLamb, a physician’s assistant at Coastal Primary Care. “I tell my husband and my friends to start taking notes. Write down a few things that are bothering you before your appointment. It can help start the dialogue.” Another helpful technique is to note and share your family medical history before an appointment, which can let the staff know about which tests and screenings are most important. And if men are less likely to see to their medical care, it might help if it were part of a larger conversation. “I suggest that men talk to others, talk to their friends and encourage them to go,” McLamb said. Men’s Health Month is also taking the dialogue to social media for the same reason. “We encourage people to wear blue,” Fadich said, as part of their ‘Wear Blue For Men’s Health’ campaign. Tag pictures of yourself and other men in your life to promote their health and well-being.

What’s up at check-ups

There are a wide variety of health concerns that Men’s Health Network and other medical organizations recommend. Here’s a look at some decade-by-decade suggestions. Keep in mind that these are just guidelines. Those with a family history of colon cancer, for example, might need to begin screenings earlier. And smokers could have other health concerns.

20s

Physical exam: The Men’s Health Network recommends that men in their 20s and 30s get a physical exam to check for basic health status, weight and body mass index, as well as get a blood test and urinalysis every three years. They can help you avoid problems like high cholesterol and blood pressure in the future.

Vaccines and immunizations: These can be important at this age, McLamb said. Get a tetanus-diphtheria vaccination every 10 years. Also ask about hepatitis vaccines and screening for sexually transmitted diseases.

Blood pressure: This is something the MHN recommends checking every year, even in your 20s. Consider getting tested at a drugstore or using a home kit.

Self-exams: Although guidelines for these vary, monthly self-exams can be helpful for checking for changes in your skin or mouth. Young men are especially affected by testicular cancer. You can check for lumps each month that can be an early sign of the disease.

30s

Physical exam: Continue with regular check-ups, even if you feel healthy, to look for signs of any potential problems. These should come with blood tests and urinalysis, and cholesterol screenings for men 35 and older.

EKG: Doctors recommend that men get a baseline electrocardiogram, which checks the electrical activity of the heart, at age 30.

Other checks: If men haven’t already started having regular visits to the dentist, they should start. Also continue with STD screenings and immunization boosters. Yearly rectal exams can screen for hemorrhoids and cancers.

40s

More screenings: Continue with regular physical exams. You might also need to more closely monitor high blood pressure and cholesterol. Doctors usually require more regular EKGs now. Patients who are overweight, or have other risk factors, should start to be screened regularly for diabetes. Others might need a chest X-ray.

Colon health: Regular rectal exams and hemoccult screenings could be helpful at this age to check for early stages of some cancers.

Ask your doctor: Some men in their 40s might want to ask their doctor about starting tests for PSA, or prostate specific antigen, and testosterone levels.

Eye exam: Get a regular vision check every few years beginning now, and until the mid-50s. This should be done more often for those with diabetes.

50s

Physical exams: Doctors usually recommend that men begin getting yearly exams now, if they aren’t already, to check for the aforementioned health concerns.

Colorectal screenings: Doctors suggest that men (and women) start getting checked for deadly colon cancer at age 50, or earlier in some cases.

Prostate health: This is still a subject for debate among doctors but many recommend yearly PSA tests, which can detect prostate cancer in its early stages, beginning at age 50.

Eye exam: These should be done more frequently starting at age 55.

60s+

More frequently: Depending on your overall health, your doctor may recommend more frequency for any of the above tests. For example, expect regular screenings for colorectal cancer until age 75.

Bone health: Some men may want to talk with their doctor about checking their bone mineral density now.

Skin tests: Depending on your risk factors, and the results of previous monthly skin checks, you might already be meeting with a dermatologist yearly for a regular skin exam. If not, these could start now.

More vaccines: Men should also check with their doctors about getting the vaccines for shingles and pneumonia.

 

Article source: http://www.starnewsonline.com/special/20170521/mens-guide-to-good-health-through-decades

Healthy Living: Giant Cell Myocarditis – Northern Michigan’s News …

We’re used to hearing about wolves and bears in the U.P, but not tigers, African lions and camels.  

Article source: http://www.9and10news.com/story/35452376/healthy-living-giant-cell-myocarditis