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  • Kebijakan Kesehatan Indonesia

    First Ever Tuberculosis Booster Vaccine Shows Promising Results

    Canadian researchers have developed a new tuberculosis vaccine that could boost or perhaps replace the only existing way to immunize against the infection.

    The researchers say the new vaccine is an important breakthrough because the current tuberculosis vaccine is not effective enough to curb the TB epidemic in some parts of the world.

    "We are the first to have developed such a vaccine for tuberculosis," said Dr. Fiona Smaill, professor and chair of the Department of Pathology and Molecular Medicine at McMaster University.

    "Tuberculosis is a serious public health threat," she said. "One-third of world's population is infected with the organism that causes tuberculosis, and it remains the top infectious killer of people, only secondary to HIV, yet the current vaccine used to prevent it is ineffective."

    The control of TB has met with further challenge from the high incidence of multi-drug resistant tuberculosis, she added.

    Smaill led the phase-one clinical study alongside Zhou Xing, professor of pathology and molecular medicine at the McMaster Immunology Research Centre. The findings were published Wednesday in the journal Science Translational Medicine.

    The McMaster vaccine, which was developed in Xing's laboratory, is based on a genetically modified cold virus, and was designed to act as a booster to Bacille Calmette Guerin (BCG), the only TB vaccine available today.

    BCG was developed in the 1920s, and is currently part of the World Health Organization's immunization program in Asia, Africa, Eastern Europe and South America, as well as Nunavut, the only Canadian jurisdiction where the BCG vaccine is routinely given because of the high rate of tuberculosis in the territory. It is typically given during the first year of life.

    The new vaccine would serve as a "booster" that would reactivate immune elements that over time diminish following BCG vaccination.

    The McMaster researchers have worked for more than a decade to develop their vaccine. The first human clinical trial began in 2009 with 24 healthy human volunteers, including 12 who were previously BCG-immunized.

    "The primary goal was to look at the safety of a single dose vaccine injection...as well as its potency to engage the immune system," said Xing.

    By 2012, the researchers established that the vaccine was safe, and had observed a robust immune response in most trial participants.

    Xing said additional clinical trials are needed to measure the vaccine's true potential.

    Smaill emphasized the significance of completing the phase-one clinical trial, and its potential impact.

    "As a doctor who looks after patients who have tuberculosis, including those who are HIV infected, I realize how important it is going to be to control this infection with a good vaccine," she said. "We are probably one of a few groups in the world who are actually doing bench-to-human tuberculosis vaccine work, and we are excited to be part of this and thrilled that it started at McMaster."

    The World Health Organization reports 8.7 million people were sickened with TB in 2011, and 1.4 million people died.

    source: www.redorbit.com/news

     

    Study: World not prepared to support growing elderly population

    The world is aging so fast that most countries are not prepared to support their swelling numbers of elderly people, according to a global study being issued Tuesday by the United Nations and an elder rights group.

    The report ranks the social and economic well-being of elders in 91 countries, with Sweden coming out on top and Afghanistan at the bottom.

    Canada is at fifth place.

    "In 2011, an estimated five million Canadians were 65 years of age or older, a number that is expected to double in the next 25 years," the report said.

    The study reflects what advocates for the old have been warning, with increasing urgency, for years: Countries are simply not working quickly enough to cope with a population greying faster than ever before. By the year 2050, for the first time in history, seniors older than 60 will outnumber children younger than 15.

    Truong Tien Thao, who runs a small tea shop on the sidewalk near his home in Hanoi, Vietnam, is 65 and acutely aware that he, like millions of others, is plunging into old age without a safety net. He wishes he could retire, but he and his 61-year-old wife depend on the US$50 a month they earn from the shop. And so every day, Thao rises early to open the stall at 6 a.m. and works until 2 p.m., when his wife takes over until closing.

    "People at my age should have a rest, but I still have to work to make our ends meet," he says, while waiting for customers at the shop, which sells green tea, cigarettes and chewing gum. "My wife and I have no pension, no health insurance. I'm scared of thinking of being sick — I don't know how I can pay for the medical care."

    Thao's story reflects a key point in the report, which was released early to The Associated Press: Aging is an issue across the world. Perhaps surprisingly, the report shows that the fastest aging countries are developing ones, such as Jordan, Laos, Mongolia, Nicaragua and Vietnam, where the number of older people will more than triple by 2050. All ranked in the bottom half of the index.

    The Global AgeWatch Index (www.globalagewatch.org) was created by elder advocacy group HelpAge International and the UN Population Fund in part to address a lack of international data on the extent and impact of global aging. The index, released on the UN's International Day of Older Persons, compiles data from the UN, World Health Organization, World Bank and other global agencies, and analyzes income, health, education, employment and age-friendly environment in each country.

    The index was welcomed by elder rights advocates, who have long complained that a lack of data has thwarted their attempts to raise the issue on government agendas.

    "Unless you measure something, it doesn't really exist in the minds of decision-makers," said John Beard, Director of Ageing and Life Course for the World Health Organization. "One of the challenges for population aging is that we don't even collect the data, let alone start to analyze it. ... For example, we've been talking about how people are living longer, but I can't tell you people are living longer and sicker, or longer in good health."

    The report fits into an increasingly complex picture of aging and what it means to the world. On the one hand, the fact that people are living longer is a testament to advances in health care and nutrition, and advocates emphasize that the elderly should be seen not as a burden but as a resource. On the other, many countries still lack a basic social protection floor that provides income, health care and housing for their senior citizens.

    Afghanistan, for example, offers no pension to those not in the government. Life expectancy is 59 years for men and 61 for women, compared to a global average of 68 for men and 72 for women, according to UN data.

    That leaves Abdul Wasay struggling to survive. At 75, the former cook and blacksmith spends most of his day trying to sell toothbrushes and toothpaste on a busy street corner in Kabul's main market. The job nets him just $6 a day — barely enough to support his wife. He can only afford to buy meat twice a month; the family relies mainly on potatoes and curried vegetables.

    "It's difficult because my knees are weak and I can't really stand for a long time," he says. "But what can I do? It's even harder in winter, but I can't afford treatment."

    Although government hospitals are free, Wasay complains that they provide little treatment and hardly any medicine. He wants to stop working in three years, but is not sure his children can support him. He says many older people cannot find work because they are not strong enough to do day labour, and some resort to begging.

    "You have to keep working no matter how old you are — no one is rich enough to stop," he says. "Life is very difficult."

    Many governments have resisted tackling the issue partly because it is viewed as hugely complicated, negative and costly — which is not necessarily true, says Silvia Stefanoni, chief executive of HelpAge International. Japan and Germany, she says, have among the highest proportions of elders in the world, but also boast steady economies.

    "There's no evidence that an aging population is a population that is economically damaged," she says.

    Prosperity in itself does not guarantee protection for the old. The world's rising economic powers — the so-called BRICS countries of Brazil, Russia, India, China and South Africa — rank lower in the index than some poorer countries such as Uruguay and Panama.

    However, the report found, wealthy countries are in general better prepared for aging than poorer ones. Sweden, where the pension system is now 100 years old, makes the top of the list because of its social support, education and health coverage, followed by Norway, Germany, the Netherlands and Canada. The United States comes in eighth.

    Sweden's health system earns praise from Marianne Blomberg, an 80-year-old Stockholm resident.

    "The health-care system, for me, has worked extraordinarily well," she says. "I suffer from atrial fibrillation and from the minute I call emergency until I am discharged, it is absolutely amazing. I can't complain about anything — even the food is good."

    Still, even in an elder-friendly country like Sweden, aging is not without its challenges. The Swedish government has suggested people continue working beyond 65, a prospect Blomberg cautiously welcomes but warns should not be a requirement. Blomberg also criticized the country's finance minister, Anders Borg, for cutting taxes sharply for working Swedes but only marginally for retirees.

    "I go to lectures and museums and the theatre and those kinds of things, but I probably have to stop that soon because it gets terribly expensive," she says. "If you want to be active like me, it is hard. But to sit home and stare at the walls doesn't cost anything."

    source: www.ottawacitizen.com

     

    Indonesia introduces pentavalent vaccine for children

    Indonesia recently announced an ambitious plan to vaccinate children against five major diseases throughout the country's 6,000 inhabited islands by the end of 2014, thanks to the help of the GAVI Alliance.

    GAVI will support Indonesia's plan to buy the pentavalent vaccine from Bio Farma, a national vaccine supplier based in Bandung, Indonesia. The vaccine protects against diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type B.

    Representatives from the GAVI Alliance, UNICEF and the World Health Organization joined the Indonesian Ministry of Health in a ceremony to commemorate the start of the campaign in August.

    With strong political will, Indonesia is making strides towards improving its routine immunization program and making it sustainable in the long term," Helen Evans, the deputy CEO of the GAVI Alliance, said. "The Minister (of Health Nafsiah Mboi) has rightly set an ambitious target for children in all parts of Indonesia to have access to the five-in-one pentavalent vaccine by the end of next year."

    Distribution trucks are already transporting vaccine stocks from Bio Farma's plant to regional cold storage rooms so that the vaccines can be delivered to many of Indonesia's remote areas.

    "UNICEF is pleased to continue its support to the government of Indonesia for the introduction of new vaccines," Angela Kearney, UNICEF's country representative, said. "Despite immunization programs being in place for several decades, children in Indonesia continue to suffer and die from vaccine preventable diseases. Let us use the opportunity of the introduction of pentavalent vaccine to reach the poorest and hardest to reach children and protect them from preventable deaths and suffering."

    The introduction of the pentavalent vaccine may help to contribute to the achievement of Millennium Development Goal IV, which seeks to reduce the global under-five mortality rate by two-thirds by 2015.

    "We applaud the collaborative and sustainable approach taken by Indonesia to develop and introduce pentavalent vaccine," Khanchit Limpakarnjanarat, WHO's country representative, said. "It is one of many powerful and safe vaccines commercially available to countries that can reduce childhood deaths and disability. We hope this is the beginning of a new era in public health in Indonesia where highly cost-effective vaccines play an expanded role in reaching the country's millennium development goals."

    Since 2002, GAVI has provided $57 million to support immunization in Indonesia.

    source: vaccinenewsdaily.com

     

    Today is World Rabies Day

    World Rabies Day is an international campaign coordinated by the Global Alliance for Rabies Control, a non-profit organization with headquarters in the United States and the United Kingdom. It is a United Nations Observance and has been endorsed by international human and veterinary health organizations such as the World Health Organization, the Pan American Health Organization, the World Organization for Animal Health (OIE), the US Centers for Disease Control and Prevention, and the World Veterinary Association.

    World Rabies Day takes place each year on September 28, the anniversary of the death of Louis Pasteur who, with the collaboration of his colleagues, developed the first efficacious rabies vaccine. World Rabies Day aims to raise awareness about the impact of rabies on humans and animals, provide information and advice on how to prevent the disease, and how individuals and organizations can help eliminate the main global sources.

    Rabies is still a significant health problem in many countries of the world. Over 99% of all human deaths that are caused by infected dogs usually occur in Africa and Asia, especially in regions with large numbers of unvaccinated community and domestic dogs. With the exception of Antarctica, people and animals on every continent are at risk of contracting rabies.

    source: www.panorama.am

     

    World Heart Day: focus on women and children

    Dubai: The simple logic behind healthy children lead to healthy adults and later to healthy families and communities is the message driving World Heart Day activities around the world on Sunday.

    In the UAE, an array of free screening camps is being held.

    The Day, observed annually on September 29 and held in conjunction with World Heart Federation (WHF) and World Health Organisation (WHO), focuses on the prevention and control of cardiovascular disease (CVD).

    The reasoning behind targeting children say the WHF and WHO is many serious diseases in adulthood have roots in adolescence, leading to illness or premature death later in life. Good habits instilled in childhood continue into adulthood. As a result, children are less likely to develop heart diseases and diabetes as adults.

    The observance also aims to bust the myth that heart disease and stroke only affect older, male, rich populations. In fact, heart disease is the number one killer of women, causing 1 in 3 female deaths, and children are vulnerable too.

    According to more figures by the WHF and WHO, cardiovascular diseases, including heart disease and stroke, take lives prematurely, causing 17.3 million deaths each year.

    By 2030, 23 million people are expected to die from CVDs annually.

    The four-fold message for the day is to get active, eat a heart-healthy diet, say 'no' to tobacco, and know your numbers (like weight, glucose level, cholesterol and blood pressure).

    Speaking to Gulf News, Dr Obaid Al Jassim, Consultant Cardiac Surgeon at Dubai Hospital and the Head of the hospital's Cardiothoracic Surgery Department said women and children are also at risk of heart disease and should take preventive action.

    Endorsing the heart-healthy behaviour promoted by the World Heart Day, he said women and children should avoid CVD risk factors.

    Specific to children, Dr Al Jassim explained the risk for CVDs can happen in the womb and increase as the child grows due to unhealthy habits like poor diet and exercise.

    "Children should be encouraged to engage in physical activity and eat a healthy, balanced diet. Further they shouldn't be exposed to tobacco smoke," said Dr Al Jassim.

    Women in particular should take care of their health so they can better care for their family and children, said Dr Nooshin Bazargani, consultant cardiologist with the Dubai Health Authority (DHA).

    "It is important that women and children stay active. Obesity, diabetes coupled with a lack of physical activity increases the chances of developing heart disease. About 30 minutes of moderate exercise five times a week is recommended. A diet rich in fruit and vegetables can help prevent heart disease. Further tobacco either first-hand smoke or second-hand should be avoided so as to reduce the risk of heart disease," Dr Bazargani said.

    Physical activity is not about exercise – any kind moderate activity brisk walking can significantly benefit your heart, she said. "Childhood obesity is becoming more and more prevalent in boys and girls. This is due to unhealthy lifestyle which includes lack of physical activity."

    source: gulfnews.com

     

    WHO raises concern about possible spread of MERS among hajj pilgrims

    The World Health Organization's emergency committee on the Middle East Respiratory Syndrome coronavirus, or MERS-CoV, met Wednesday.

    After hearing updates on the spread of the virus -- which as of Sept. 20 had killed 58 of the 130 people confirmed to have contracted it, most in Saudi Arabia -- the committee decided against calling the outbreak a "Public Health Emergency of International Concern": a situation that requires a certain level of immediate, coordinated international action.

    At the same time, the group urged countries to strengthen MERS-CoV surveillance and improve their ability to diagnose the illness as pilgrims return to their homes from the hajj pilgrimage later this fall. The hajj typically brings around 3 million travelers each year to Mecca, in Saudi Arabia.

    "Levels of surveillance are suboptimal in a number of countries that may be particularly at risk," said Dr. Keiji Fukuda, WHO assistant director-general for health security and environment, during a call with reporters at the close of the session.

    MERS first came to the attention of public health officials in 2012. The virus seems to pose the greatest threat to people with preexisting medical conditions, some of whom have developed severe respiratory and kidney problems after infection. Over the summer months, Fukuda said, the numbers of reported cases of MERS have been elevated but steady. He said it was hard to tell if those increases reflected greater numbers of infections or improvements in countries' efforts to detect and report illnesses.

    Although recent research is improving infectious disease specialists' knowledge about the virus, public health officials still do not fully understand how people contract the virus, what animals pass it along and whether it propagates differently at different times of the year, Fukuda said.

    "We're still early in our understanding of how to put this together," he added.

    The hajj poses a particular worry for public health workers because Saudi Arabia has had more cases of the disease than any other nation -- 108, including 47 fatalities.

    The WHO committee called on countries that will send pilgrims to Saudi Arabia in coming months to step up surveillance efforts as their citizens return home from the Middle East. But for some countries -- particularly those in developing regions such as sub-Saharan Africa -- it won't be easy, Fukuda said. Tracking cases and patterns of infection takes lab testing facilities and communications systems, basic capacities that are "limited" in the developing world, he said. (The WHO offers this advice for hajj travelers; the U.S. Centers for Disease Control has these recommendations.)

    Fukuda did not comment at length on efforts by Saudi Arabian officials to combat the virus, except to note that the kingdom had "made extensive efforts to investigate these cases and get a better handle on things." Over the last year, Saudi Arabia has come under fire from some for its MERS response.

    Fukuda said that the emergency committee would convene again sometime in late November, after the pilgrimage season had concluded.

    source: www.latimes.com

     

    GMOs: tolerable or pressing health risk?

    A ballot proposal to require labels on food products containing genetically modified ingredients would seem to be all about public health and science. But voters won't hear proponents saying much about that in the political campaign that is just heating up over Initiative 522, the food-labeling measure on Washington's statewide Nov. 5 ballot.

    The reason: the science around genetically engineered foods is complex, with little clear scientific evidence that genetically engineered crops cause harm, yet too little research to guarantee safety.

    The text of the initiative makes reference to the potential for "adverse health ... consequences," but the campaign supporting I-522 is steering away from talking about the science.

    Yes on I-522 leaders argue the real issue is consumers want the kind of labeling their measure will deliver. They say it's just like other labeling for farm-raised fish, the origin of meat products or the use of food coloring.

    "Our campaign is not saying there is a specific health concern or not. We say this provides information so that you as a shopper can do more research ... or you can make a grocery shopping decision for yourself," Yes on I-522 spokeswoman Elizabeth Larter said.

    Early polling shows I-522 is winning. But the No on 522 campaign is making headway. Its well-funded campaign already has collected $11.1 million — or more than twice what proponents' various political committees have raised

    No on 522 says the lack of scientific proof helps make its case that labeling is misleading and not worth the cost to farmers and consumers.

    "They may not be arguing (health issues), but it's all in the initiative," No on 522 spokeswoman Dana Bieber says of her rivals. "They delivered their (voter) signatures in an ambulance. ... They can't have it both ways."

    No on 522 is endorsed by most of the state's major agriculture groups, but the money is coming from six out-of-state donors, including Monsanto, the agricultural seed and fertilizer giant that has donated $4.8 million, DuPont Pioneer with $3.2 million and the Grocery Manufacturers Association with $2.2 million.

    Larter's group, which is backed by organic food and consumer groups, says this is the same food industry that warned in the past against other labeling, and those cost warnings proved false.

    But a recent editorial in Scientific American Magazine backed up the No on 522 argument, casting doubt on any human health threats and criticizing labeling campaigns nationally.

    "Instead of providing people with useful information, mandatory GMO (genetically modified organism) labels would only intensify the misconception that so-called Frankenfoods endanger people's health," the editorial declared. "The American Association for the Advancement of Science, the World Health Organization and the exceptionally vigilant European Union agree that GMOs are just as safe as other foods."

    Food labeling advocates point out 64 countries have labeling laws. In the United States, voters narrowly rejected a ballot measure in California, but advocates passed bills in Connecticut and Maine that eventually might require labels on foods made from GMOs.

    Two scientists at the University of Washington say the scientific proof of harm is not yet there.

    Professor Toby Bradshaw, who chairs the biology department at UW and taught a graduate class last spring that examined I-522, is a strong critic of the labeling proposal.

    "The science that exists on this suggests that the foods in the human food supply that are genetically engineered are perfectly safe for humans," Bradshaw said. "There is no evidence of harm."

    Bradshaw said that as a scientist he normally favors more information. But he thinks the kind of information to be included on the labels misses the mark – because they won't tell what genetically modified ingredients might be present. The labeling proposal also has exemptions – such as for alcohol and food sold in restaurants, which I-522 backers say they adopted because they are similar to exemptions already in law for other food labeling.

    Professor Michael Rosenfeld, a pathologist in the UW's School of Public Health who has taught on the science behind GMOs, said that while there is no clear evidence of health risks, genetically engineered foods are not in the clear.

    The credible reports of problems have been around the introductions of allergens, "but this is very rare and impacted very few people. So I think the jury's out. The question is who is going to fund hard-core research on this," he said.

    Professor Chuck Benbrook, an agricultural economist at Washington State University, said that after doing 25 years' work to develop, test and regulate genetically-engineered crops, he agrees there is no clear proof of health threats. But he said the vast majority of research has focused on the nutrient composition of crops and not the impacts on humans.

    "There has, in fact, not been detailed food safety research on any of today's major GE commodities," Benbrook said, specifically noting there are few studies in long term laboratory tests that look at "changes in reproductive development, immune system health, the rate of cancer, various blood problems, etc."

    He thinks there is "a solid case to make for labeling emerging GE foods that will be consumed in fresh or close to fresh form." But he also said more research by government scientists who are independent from commercial interests and financing is needed.

    I-522 was filed as an initiative to the Legislature last year, but lawmakers declined to act on it, so it is going to the ballot.

    Despite inaction, lawmakers did ask the Washington State Academy of Sciences to produce a report on the impacts of the measure – including potential costs if the measure is passed into law.

    The report is about two weeks away from being finished, according to Robert C. Bates, executive director for the academy. The academy has six experts looking at the Legislature's questions and has vetted the panelists to guard against conflicts of interest. The team is looking at definitions of GMOs, nutritional and food safety issues, policy and trade implications, costs to farmers and consumers, and questions about regulating the labeling in Washington.

    source: www.theolympian.com

     

    Health Ministry in Gaza faces a real disaster

    Health Ministry in Gaza faces a real disaster amid tightened Siege

    Palestinian Minister of Health Dr Mofeed Mokhalalati urges the international community to exert pressure on the Israeli Occupation so that it lifts the illegal siege imposed on Gaza Strip, and permits the access of medicines, medical supplies, and basic construction materials .

    He said in a press conference held yesterday, "Health sector bases in Gaza face a real disaster, everyone in the world has to shoulder their responsibility in the face of medical needs for Palestinian patients amid the closure of the Rafah Border Crossing."

    Mokhalalati pointed out that 145 types of medicine have run out and the lack of medicines imported by Rafah Border Crossing decreased the balance to 30% of that required.

    1000 patients cannot receive treatment in specialized Egyptian hospitals, in addition to 300 referred officially by the health ministry, the minister added.

    He said the ongoing closure of Rafah Terminal also deprives hundreds of patients from surgical services offered by specialized delegations coming from various countries around the world, as they cannot enter Gaza to perform their surgeries.

    Mokhalalati warns that the quantity of fuel necessary for generators and ambulances is not enough, explaining that health centers need 360 liters per a month, thus currently their electricity supply is disconnected for12 hours daily.

    He appealed to Gaza's brothers and sisters in Egypt to open the Rafah Border Crossing in both directions to alleviate the suffering of Palestinian people, in particular humanitarian cases .

    Mokhalalati asked international organizations to support the steadfastness of Palestinian people and ensure continuous medical services.

    He urged human rights organizations including the International Committee of Red Cross, the United Nations Organisation for the Co-ordination of Humanitarian Affairs, and the World Health Organization to support right to health of Palestsinian patients, and their freedom of movement across Gaza crossings, demanding they also support Gaza's hospitals and health centers with medicines, medical consumables, and fuel necessary to run generators in 13 hospitals and 56 primary care centers, in addition to ambulances.

    source: www.scoop.co.nz