In late October, we presented the case of a patient with stable coronary artery disease in Clinical Decisions,1 an interactive feature designed to assess how readers would manage a clinical problem for which there may be more than one appropriate treatment. Our patient was a 65-year-old man with hypertension, obesity, and type 2 diabetes who presented with a 2-week history of exertional angina. He underwent an exercise-tolerance test on a treadmill, along with myocardial perfusion imaging, which showed a fixed anterior defect and a reversible anterolateral defect, both of moderate size. His subsequent cardiac catheterization revealed an occluded first diagonal branch, a long lesion with 70% stenosis in the midportion of the left anterior descending coronary artery, a calcified lesion with 80% stenosis in the proximal left circumflex coronary artery, and 50% stenosis of the posterior descending coronary artery. These findings were accompanied by anterior-wall hypokinesis and an ejection fraction of 45% by left ventriculography.
........
This is clearly a controversial area; more data on symptomatic but stable coronary artery disease are needed to direct clinical decisions. As we await such data, it appears that current approaches will continue to vary on the basis of an integration of physicians' experience and knowledge with patients' preferences. Given a clinical problem without a clear solution, many respondents appropriately noted the importance of discussing with the patient all treatment options and their possible outcomes.
Comments from this interactive feature will remain available at www.nejm.org, along with data on the voting results. We thank you for your input, and we look forward to hearing from you again soon about another challenging case.
Wednesday, November 28, 2007
Tuesday, November 27, 2007
BR no Grupo de IDH alto
Brasília, 27/11/2007
Brasil entra no grupo de países de alto IDH
Índice de Desenvolvimento Humano (IDH) do Brasil aumentou em relação ao ano passado e permitiu que o país entrasse pela primeira vez no grupo dos países de Alto Desenvolvimento Humano.
Em termos absolutos, o país ultrapassou a barreira de 0,800 (linha de corte) no índice — que varia de 0 a 1 —, considerada o marco de alto desenvolvimento humano. Em termos relativos, o Brasil caiu uma posição no ranking de 177 países e territórios: de 69º, em 2006, para 70º este ano.
O IDH, calculado anualmente pelo Programa das Nações Unidas para o Desenvolvimento (PNUD) foi divulgado nesta terça-feira e faz parte do Relatório de Desenvolvimento Humano 2007/2008 – Combater as Mudanças do Clima: Solidariedade Humana em um mundo dividido.
Neste ano, Albânia e Arábia Saudita ultrapassaram o Brasil, subindo respectivamente cinco e 15 posições no ranking. A ilha caribenha de Dominica, que estava acima do Brasil em 2006, ocupando o 68° lugar no ranking, caiu duas posições. No caso da Arábia Saudita,a revisão na forma de cálculo na taxa de matrícula foi o grande impulsionador da melhora do país. Como já aconteceu no ano passado, o estudo usou indicadores que foram revisados e aperfeiçoados.
Parte destas variações resultou de atualizações feitas para a expectativa de vida em 62 países (revisão do impacto da incidência, transmissão e sobrevida dos infectados com HIV/AIDS). Esta revisão beneficiou o Brasil e a Albânia. A expectativa de vida no Brasil aumentou de 70,8 anos para 71,7. Na Albânia, o aumento foi de 73,9 anos para 76,2 anos, em média, graças a esta revisão. /.../
Leia o relatório
Prefácio e ÍndiceSumário executivoCapítulo 1Capítulo 2Capítulo 3Capítulo 4Anexo estatístico (em inglês)Notas e bibliografia
Leia também
Divisão entre ricos e pobres aumenta ainda mais com mudança do clima, diz relatórioMudança climática pode gerar regresso inédito no desenvolvimento humano
Aquecimento ampliará desigualdade na ALRDH defende fim da taxação sobre o etanol brasileiroRanking do IDH
Mudança climática pode gerar regresso inédito no desenvolvimento humano
Aquecimento ampliará desigualdade na ALRDH defende fim da taxação sobre o etanol brasileiro
Ranking do IDH
Brasil entra no grupo de países de alto IDH
Índice de Desenvolvimento Humano (IDH) do Brasil aumentou em relação ao ano passado e permitiu que o país entrasse pela primeira vez no grupo dos países de Alto Desenvolvimento Humano.
Em termos absolutos, o país ultrapassou a barreira de 0,800 (linha de corte) no índice — que varia de 0 a 1 —, considerada o marco de alto desenvolvimento humano. Em termos relativos, o Brasil caiu uma posição no ranking de 177 países e territórios: de 69º, em 2006, para 70º este ano.
O IDH, calculado anualmente pelo Programa das Nações Unidas para o Desenvolvimento (PNUD) foi divulgado nesta terça-feira e faz parte do Relatório de Desenvolvimento Humano 2007/2008 – Combater as Mudanças do Clima: Solidariedade Humana em um mundo dividido.
Neste ano, Albânia e Arábia Saudita ultrapassaram o Brasil, subindo respectivamente cinco e 15 posições no ranking. A ilha caribenha de Dominica, que estava acima do Brasil em 2006, ocupando o 68° lugar no ranking, caiu duas posições. No caso da Arábia Saudita,a revisão na forma de cálculo na taxa de matrícula foi o grande impulsionador da melhora do país. Como já aconteceu no ano passado, o estudo usou indicadores que foram revisados e aperfeiçoados.
Parte destas variações resultou de atualizações feitas para a expectativa de vida em 62 países (revisão do impacto da incidência, transmissão e sobrevida dos infectados com HIV/AIDS). Esta revisão beneficiou o Brasil e a Albânia. A expectativa de vida no Brasil aumentou de 70,8 anos para 71,7. Na Albânia, o aumento foi de 73,9 anos para 76,2 anos, em média, graças a esta revisão. /.../
Leia o relatório
Prefácio e ÍndiceSumário executivoCapítulo 1Capítulo 2Capítulo 3Capítulo 4Anexo estatístico (em inglês)Notas e bibliografia
Leia também
Divisão entre ricos e pobres aumenta ainda mais com mudança do clima, diz relatórioMudança climática pode gerar regresso inédito no desenvolvimento humano
Aquecimento ampliará desigualdade na ALRDH defende fim da taxação sobre o etanol brasileiroRanking do IDH
Mudança climática pode gerar regresso inédito no desenvolvimento humano
Aquecimento ampliará desigualdade na ALRDH defende fim da taxação sobre o etanol brasileiro
Ranking do IDH
Sunday, November 25, 2007
Anuario estadístico de América Latina y el Caribe, 2006
Anuario estadístico de América Latina y el Caribe, 2006
El Anuario cuenta con cuatro capítulos. En el primer capítulo se presentan los indicadores demográficos y sociales, que reflejan el esfuerzo especial realizado para incluir la dimensión de género en la información estadística. En el segundo capítulo se reúnen las estadísticas económicas básicas, de comercio y balanza de pagos, y las cuentas nacionales. En virtud del creciente interés de la comunidad regional e internacional en el desarrollo sostenible, en el tercer capítulo se recopila la información disponible sobre el medio ambiente y los recursos naturales.
La abundancia de datos -a menudo diferentes y a veces contradictorios- a los que los investigadores pueden acceder hoy en día mediante Internet obliga a prestar una especial atención a las fichas técnicas en las que se documenta el origen de los datos, su definición y cobertura. Esta información se presenta en el cuarto capítulo, sobre metodología y metadatos. Por medio de este capítulo se complementa la información más específica que figura en las notas al pie de los cuadros del Anuario./.../
El Anuario cuenta con cuatro capítulos. En el primer capítulo se presentan los indicadores demográficos y sociales, que reflejan el esfuerzo especial realizado para incluir la dimensión de género en la información estadística. En el segundo capítulo se reúnen las estadísticas económicas básicas, de comercio y balanza de pagos, y las cuentas nacionales. En virtud del creciente interés de la comunidad regional e internacional en el desarrollo sostenible, en el tercer capítulo se recopila la información disponible sobre el medio ambiente y los recursos naturales.
La abundancia de datos -a menudo diferentes y a veces contradictorios- a los que los investigadores pueden acceder hoy en día mediante Internet obliga a prestar una especial atención a las fichas técnicas en las que se documenta el origen de los datos, su definición y cobertura. Esta información se presenta en el cuarto capítulo, sobre metodología y metadatos. Por medio de este capítulo se complementa la información más específica que figura en las notas al pie de los cuadros del Anuario./.../
New Universal Definition of Myocardial Infarction
De: Mario Maranhao [mailto:mariomaranhao@uol.com.br]
Enviada em: sábado, 24 de novembro de 2007 10:55
Assunto: MM wants you to take a look at this link:
http://www.world-heart-federation.org/press/press-releases/news-details/article/new-escaccahawhf-universal-definition-of-myocardial-infarction-released/
Enviada em: sábado, 24 de novembro de 2007 10:55
Assunto: MM wants you to take a look at this link:
http://www.world-heart-federation.org/press/press-releases/news-details/article/new-escaccahawhf-universal-definition-of-myocardial-infarction-released/
Saturday, November 24, 2007
Agita Mundo
Agita Mundo
The 10th International Agita Mundo Course on Physical Activity and Public Health and II CARMEN School Course was held from November 13th to 16th in the Antigua City, Guatemala. The Opening Cerimony was attended by representatives of the Ministry of Health, the Presidency of the Republic, Maggie Fischer and Angel Rocca from PAHO . The Course has many national and international speakers some of them with great transcendence in the Agita Mundo and RAFA/PANA Network: Michael Pratt, Greg Heath, Branka Legetic, Manuel Ramirez, Victor Matsudo and Sandra Matsudo.
The local coordination of the 10th Agita Mundo International Course was made by Lorena Lopez, Judith Cruz from the Ministry of Health, Sandra Sanchez and Walter Soto. The course had around 65 participants from 6 countries: Guatemala, Costa Rica, Honduras, Mexico, El Salvador and Colombia. The tenth edition was celebrated and a special tribute was provide from CDC to CELAFISCS for being part of the idealiz ation and organiz ation of most of the ten editions. It´s amazing to see that we have more than 500 new agitators from Americas, Africa and Asia/.../
The 10th International Agita Mundo Course on Physical Activity and Public Health and II CARMEN School Course was held from November 13th to 16th in the Antigua City, Guatemala. The Opening Cerimony was attended by representatives of the Ministry of Health, the Presidency of the Republic, Maggie Fischer and Angel Rocca from PAHO . The Course has many national and international speakers some of them with great transcendence in the Agita Mundo and RAFA/PANA Network: Michael Pratt, Greg Heath, Branka Legetic, Manuel Ramirez, Victor Matsudo and Sandra Matsudo.
The local coordination of the 10th Agita Mundo International Course was made by Lorena Lopez, Judith Cruz from the Ministry of Health, Sandra Sanchez and Walter Soto. The course had around 65 participants from 6 countries: Guatemala, Costa Rica, Honduras, Mexico, El Salvador and Colombia. The tenth edition was celebrated and a special tribute was provide from CDC to CELAFISCS for being part of the idealiz ation and organiz ation of most of the ten editions. It´s amazing to see that we have more than 500 new agitators from Americas, Africa and Asia/.../
Friday, November 23, 2007
2371 – AMICOR10 – 23 nov. 2007
Thursday, November 22, 2007
Lebanon Indpendence Day November 22.
Hoje é o dia da Independência do Líbano de onde veio meu avô paterno ha 120 anos.
Dom Edgard Madi e a Diocese Maronita do Brasil estão ajudando os descendentes interessados em obter a cidadania Libanesa através do projeto Eu sou Libanês.
http://www.soulibanes.com.br/index.htm
NEJM -- Statistics in Medicine -- Reporting of Subgroup Analyses in Clinical Trials
Wednesday, November 21, 2007
Conferência Mundial sobre o Desenvolvimento de Cidades
Tuesday, November 20, 2007
Monday, November 19, 2007
Guidelines for Monitoring, Reporting, and Conducting Research on Medical Emergency Team
Introduction - Nuffield Council on Bioethics
Nuffield Council on Bioethics - Nuffield Council on Bioethics:
Thursday, November 15, 2007
Tuesday, November 13, 2007
Monday, November 12, 2007
Mortalidade Precoce por Doenças Cardiovasculares e as Desigualdades Sociais em Porto Alegre, Brasil.
Autoria: Sérgio Luiz Bassanesi, Maria Inês Reinert Azambuja e Aloyzio Cechella Achutti.
Thursday, November 22, 2007
Lebanon Indpendence Day November 22.
Hoje é o dia da Independência do Líbano de onde veio meu avô paterno ha 120 anos.
Dom Edgard Madi e a Diocese Maronita do Brasil estão ajudando os decendentes interessados em obter a cidadania Libanesa através do projeto Eu sou Libanês.
NEJM -- Statistics in Medicine -- Reporting of Subgroup Analyses in Clinical Trials
NEJM -- Statistics in Medicine -- Reporting of Subgroup Analyses in Clinical Trials: "Medical research relies on clinical trials to assess therapeutic benefits. Because of the effort and cost involved in these studies, investigators frequently use analyses of subgroups of study participants to extract as much information as possible. Such analyses, which assess the heterogeneity of treatment effects in subgroups of patients, may provide useful information for the care of patients and for future research. However, subgroup analyses also introduce analytic challenges and can lead to overstated and misleading results.1,2,3,4,5,6,7 This report outlines the challenges associated with conducting and reporting subgroup analyses, and it sets forth guidelines for their use in the Journal. Although this report focuses on the reporting of clinical trials, many of the issues discussed also apply to observational studies. "/.../
Wednesday, November 21, 2007
Chagas Disease - CDC DPD
Chagas Disease - CDC DPD: "Chagas Disease (Trypanosoma cruzi Infection) Girl and poorly built hut Triatomine bugs, the vector for Chagas, can hide in the cracks of poorly built dwellings. (CDC Photo) Chagas disease is named after the Brazilian physician Carlos Chagas, who discovered the disease in 1909. It is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors that are found only in the Americas (mainly, in rural areas of Latin America where poverty is widespread). Chagas disease (T. cruzi infection) is also referred to as American trypanosomiasis."
Conferência Mundial sobre o Desenvolvimento de Cidades
Nome Oficial da Conferência: Conferência Mundial sobre o Desenvolvimento de Cidades: Inovação democrática e transformação social para cidades inclusivas no século 21
Promoção: Prefeitura de Porto Alegre (Rio Grande do Sul, Brasil), Ministério das Cidades, Prefeitura de Roma, Itália, Governo do Estado do Rio Grande do Sul e Confederação Nacional de Municípios (CNM).
Apoio: UNESCO, UN-HABITAT, Banco Interamericano de Desenvolvimento (BID) e Banco Mundial (BIRD).
Parceria: CGLU – Cidades e Governos Locais Unidos, Federação Latino Americana de Cidades, Municípios e Associações (FLACMA), OIDP – Observatório Internacional de Democracia Participativa, CISDP – Comissão de Inclusão Social e Democracia Participativa do Fórum de Autoridades Locais, CIGU – Centro Internacional de Gestão Urbana, Aliança de Cidades/Cities Alliance, Associação Internacional de Prefeitos Francófonos (AIMF), Federação das Associações de Municípios do Rio Grande do Sul (FAMURS), EXPO BRASIL Desenvolvimento Local, RED DETE-ALC, Observatório das Metrópoles, Oficina Municipal, Instituto Brasileiro de Gestão Municipal, ¿Bogotá Cómo Vamos? e dezenas de instituições nacionais e internacionais.
Realização: Cidade de Porto Alegre, Rio Grande do Sul, Brasil, de 13 a 16 de fevereiro de 2008.
Objetivo principal: Captar a diversidade de iniciativas de inovação e transformação social que vêm surgindo nos últimos anos, criando um ambiente de reflexão coletiva, de discussão e apresentação de experiências, que permita uma abordagem da temática do desenvolvimento de cidades de modo mais orgânico ou sistêmico, focalizando, para tanto, quatro grandes temas centrais: 1) Direito à Cidade (Políticas Locais sobre Direitos e Responsabilidades dos Cidadãos); 2) Governança e Democracia em Cidades (Experiências Inovadoras de Gestão e Participação Democrática); 3) Desenvolvimento Local em Cidades; e 4) Sustentabilidade e Cidade-Rede.
Destaque: Como ponto alto da Conferência, ocorrerá uma ampla discussão sobre os critérios para inventariar boas práticas de governança e indução do desenvolvimento local em cidades inclusivas. A própria realização da Conferência já será uma oportunidade para mapear experiências inovadoras de gestão e participação democráticas em cidades, as quais serão convidadas a apresentar e debater suas iniciativas em múltiplos painéis e oficinas ao longo do encontro.
Público-Alvo: Gestores públicos (prefeitos, vereadores e operadores de políticas públicas), acadêmicos e especialistas, lideranças comunitárias e, enfim, a todos os promotores governamentais, empresariais e sociais de experiências de participação democrática focalizadas em territorialidades urbanas e voltadas para a indução do desenvolvimento local em cidades.
Formato: 400 horas de atividades, distribuídas nos 4 dias do evento, em seis tipos de atividades: Mesas de Abertura, Conferências Magnas, Oficinas, Painéis, Comunicações e Minicursos.
Promoção: Prefeitura de Porto Alegre (Rio Grande do Sul, Brasil), Ministério das Cidades, Prefeitura de Roma, Itália, Governo do Estado do Rio Grande do Sul e Confederação Nacional de Municípios (CNM).
Apoio: UNESCO, UN-HABITAT, Banco Interamericano de Desenvolvimento (BID) e Banco Mundial (BIRD).
Parceria: CGLU – Cidades e Governos Locais Unidos, Federação Latino Americana de Cidades, Municípios e Associações (FLACMA), OIDP – Observatório Internacional de Democracia Participativa, CISDP – Comissão de Inclusão Social e Democracia Participativa do Fórum de Autoridades Locais, CIGU – Centro Internacional de Gestão Urbana, Aliança de Cidades/Cities Alliance, Associação Internacional de Prefeitos Francófonos (AIMF), Federação das Associações de Municípios do Rio Grande do Sul (FAMURS), EXPO BRASIL Desenvolvimento Local, RED DETE-ALC, Observatório das Metrópoles, Oficina Municipal, Instituto Brasileiro de Gestão Municipal, ¿Bogotá Cómo Vamos? e dezenas de instituições nacionais e internacionais.
Realização: Cidade de Porto Alegre, Rio Grande do Sul, Brasil, de 13 a 16 de fevereiro de 2008.
Objetivo principal: Captar a diversidade de iniciativas de inovação e transformação social que vêm surgindo nos últimos anos, criando um ambiente de reflexão coletiva, de discussão e apresentação de experiências, que permita uma abordagem da temática do desenvolvimento de cidades de modo mais orgânico ou sistêmico, focalizando, para tanto, quatro grandes temas centrais: 1) Direito à Cidade (Políticas Locais sobre Direitos e Responsabilidades dos Cidadãos); 2) Governança e Democracia em Cidades (Experiências Inovadoras de Gestão e Participação Democrática); 3) Desenvolvimento Local em Cidades; e 4) Sustentabilidade e Cidade-Rede.
Destaque: Como ponto alto da Conferência, ocorrerá uma ampla discussão sobre os critérios para inventariar boas práticas de governança e indução do desenvolvimento local em cidades inclusivas. A própria realização da Conferência já será uma oportunidade para mapear experiências inovadoras de gestão e participação democráticas em cidades, as quais serão convidadas a apresentar e debater suas iniciativas em múltiplos painéis e oficinas ao longo do encontro.
Público-Alvo: Gestores públicos (prefeitos, vereadores e operadores de políticas públicas), acadêmicos e especialistas, lideranças comunitárias e, enfim, a todos os promotores governamentais, empresariais e sociais de experiências de participação democrática focalizadas em territorialidades urbanas e voltadas para a indução do desenvolvimento local em cidades.
Formato: 400 horas de atividades, distribuídas nos 4 dias do evento, em seis tipos de atividades: Mesas de Abertura, Conferências Magnas, Oficinas, Painéis, Comunicações e Minicursos.
Tuesday, November 20, 2007
Contagem da População do IBGE
O Brasil tem atualmente 183,9 milhões de habitantes, segundo o relatório final da Contagem da População do IBGE, feita em 5.435 municípios com até 170 mil habitantes e entregue hoje (14/11) ao Tribunal de Contas da União, que a utilizará para o cálculo das quotas referentes ao Fundo de Participação dos Municípios (FPM). Nos últimos sete anos, o Brasil ganhou mais 14 milhões de habitantes, o que corresponde a um estado do porte da Bahia. Na Contagem, foram visitados 30 milhões de domicílios em todo o país.
Entre as Grandes Regiões, todas apresentaram crescimento populacional em relação ao Censo 2000, mas não houve alterações no ranking dos mais populosos: o Sudeste ainda lidera, com 77,8 milhões, seguido do Nordeste (58,5 milhões); Sul (26,7 milhões), Norte (14,5 milhões); e Centro-Oeste (13,2 milhões). Há sete anos, mantida a ordem de regiões acima, os números eram de, respectivamente: 72,4 milhões (Sudeste); 47,7 milhões (Nordeste); 25 milhões (Sul); 12,9 milhões (Norte); e 11,6 milhões (Centro-Oeste). /.../
Entre as Grandes Regiões, todas apresentaram crescimento populacional em relação ao Censo 2000, mas não houve alterações no ranking dos mais populosos: o Sudeste ainda lidera, com 77,8 milhões, seguido do Nordeste (58,5 milhões); Sul (26,7 milhões), Norte (14,5 milhões); e Centro-Oeste (13,2 milhões). Há sete anos, mantida a ordem de regiões acima, os números eram de, respectivamente: 72,4 milhões (Sudeste); 47,7 milhões (Nordeste); 25 milhões (Sul); 12,9 milhões (Norte); e 11,6 milhões (Centro-Oeste). /.../
Monday, November 19, 2007
Guidelines for Monitoring, Reporting, and Conducting Research on Medical Emergency Team
The majority of patients hospitalized with a cardiac arrest or requiring emergency transfer to the intensive care unit have abnormal physiological values recorded in the hours preceding the event.1–11 Many studies document that physiological measurements often are not made or recorded during this critical time of clinical deterioration.12–16 Such physiological abnormalities can be associated with adverse outcome.17–20 Measurements of abnormal physiology, including temperature, pulse rate, blood pressure, respiratory rate, hemoglobin, oxygen saturation by pulse oximetry, and deterioration of mental status, are therefore important to any system designed for early detection of physiological instability. At a minimum, these measurements must be obtained accurately and recorded with appropriate frequency. A system that both recognizes significantly abnormal values and triggers an immediate and appropriate treatment response is required. /...
Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
New guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) were published in November 2005.1,2 Publication followed a systematic evaluation of scientific evidence that culminated in the 2005 International Consensus Conference on ECC and CPR Science With Treatment Recommendations hosted by the American Heart Association (AHA) in January 2005.3,4 The new treatment recommendations from this meeting incorporated scientific advances made after publication of the 2000 guidelines and were published with the expectation that their worldwide implementation would help improve rates of survival from cardiac arrest and other life-threatening cardiopulmonary emergencies.
A new cycle of evidence evaluation has begun and is expected to be completed in 2010 with the publication of new and revised treatment recommendations. These recommendations will once again reflect the scientific knowledge gained during the intervening period. As the cycle begins, a unique opportunity exists to identify areas in greatest need of clinical research, with the expectation that key questions asked today may be answered in time for the 2010 guidelines. To this end, valuable information was obtained during the evidence evaluation process that led to the 2005 guidelines. Experts appointed to review specific resuscitation topics were asked not only to summarize the existing science but also to identify knowledge gaps. As a result, experts identified knowledge gaps in 276 preassigned topics. We have compiled and organized these knowledge gaps and, through a process of consultation and consensus, identified areas of priority for clinical research.
Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
New guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) were published in November 2005.1,2 Publication followed a systematic evaluation of scientific evidence that culminated in the 2005 International Consensus Conference on ECC and CPR Science With Treatment Recommendations hosted by the American Heart Association (AHA) in January 2005.3,4 The new treatment recommendations from this meeting incorporated scientific advances made after publication of the 2000 guidelines and were published with the expectation that their worldwide implementation would help improve rates of survival from cardiac arrest and other life-threatening cardiopulmonary emergencies.
A new cycle of evidence evaluation has begun and is expected to be completed in 2010 with the publication of new and revised treatment recommendations. These recommendations will once again reflect the scientific knowledge gained during the intervening period. As the cycle begins, a unique opportunity exists to identify areas in greatest need of clinical research, with the expectation that key questions asked today may be answered in time for the 2010 guidelines. To this end, valuable information was obtained during the evidence evaluation process that led to the 2005 guidelines. Experts appointed to review specific resuscitation topics were asked not only to summarize the existing science but also to identify knowledge gaps. As a result, experts identified knowledge gaps in 276 preassigned topics. We have compiled and organized these knowledge gaps and, through a process of consultation and consensus, identified areas of priority for clinical research.
Socioeconomic Position, Race/Ethnicity, and Inflammation in the Multi-Ethnic Study of Atherosclerosis
Socioeconomic Position, Race/Ethnicity, and Inflammation in the Multi-Ethnic Study of AtherosclerosisNalini Ranjit, PhD; Ana V. Diez-Roux, MD, PhD; Steven Shea, MD, MS; Mary Cushman, MD, MSc; Hanyu Ni, PhD, MPH; Teresa Seeman, PhD
From the Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor (N.R., A.V.D.-R.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); Department of Medicine, University of Vermont, Burlington (M.C.); Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (H.N.); and Division of Geriatrics, School of Medicine, University of California at Los Angeles (T.S.).
Correspondence to Nalini Ranjit, 1214 S University, University of Michigan, Ann Arbor, MI 48104. E-mail nranjit@umich.edu
'//-->
Received March 29, 2007; accepted August 17, 2007.
Background— Low socioeconomic position is known to be associated with cardiovascular events and atherosclerosis. Reasons for these associations remain a topic of research. Inflammation could be an important mediating mechanism linking socioeconomic position to cardiovascular risk.
Methods and Results— This cross-sectional study used data from the baseline examination of the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 men and women 45 to 84 years of age. Race- and ethnicity-stratified regression analyses were used to estimate associations of household income and education with C-reactive protein and interleukin-6 before and after adjustment for infection and medication use, psychosocial factors, behaviors, adiposity, and diabetes mellitus. Low income was associated with higher concentrations of interleukin-6 in all race/ethnic groups. Percent differences associated with 1-SD–lower income were 9% (95% confidence interval [CI], 7 to 11), 6% (95% CI, 1 to 10), 8% (95% CI, 4 to 11), and 8% (95% CI, 3 to 13) for whites, Chinese, blacks, and Hispanics. Low levels of education were associated with higher levels of interleukin-6 only among whites and blacks (percent difference in interleukin-6 associated with 1-SD–lower education: 9% [95% CI, 6 to 12] among Whites, and 7% [95% CI, 3 to 10] among blacks). Similar patterns were observed for C-reactive protein. Adiposity was the single most important factor explaining socioeconomic position associations, especially among blacks and whites. A smaller effect was seen for psychosocial factors and behaviors in all race groups.
Conclusions— Both household income and education are associated with inflammation, but associations vary across race/ethnic groups. Associations likely result from socioeconomic position patterning of adiposity and other factors.
From the Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor (N.R., A.V.D.-R.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); Department of Medicine, University of Vermont, Burlington (M.C.); Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (H.N.); and Division of Geriatrics, School of Medicine, University of California at Los Angeles (T.S.).
Correspondence to Nalini Ranjit, 1214 S University, University of Michigan, Ann Arbor, MI 48104. E-mail nranjit@umich.edu
'//-->
Received March 29, 2007; accepted August 17, 2007.
Background— Low socioeconomic position is known to be associated with cardiovascular events and atherosclerosis. Reasons for these associations remain a topic of research. Inflammation could be an important mediating mechanism linking socioeconomic position to cardiovascular risk.
Methods and Results— This cross-sectional study used data from the baseline examination of the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 men and women 45 to 84 years of age. Race- and ethnicity-stratified regression analyses were used to estimate associations of household income and education with C-reactive protein and interleukin-6 before and after adjustment for infection and medication use, psychosocial factors, behaviors, adiposity, and diabetes mellitus. Low income was associated with higher concentrations of interleukin-6 in all race/ethnic groups. Percent differences associated with 1-SD–lower income were 9% (95% confidence interval [CI], 7 to 11), 6% (95% CI, 1 to 10), 8% (95% CI, 4 to 11), and 8% (95% CI, 3 to 13) for whites, Chinese, blacks, and Hispanics. Low levels of education were associated with higher levels of interleukin-6 only among whites and blacks (percent difference in interleukin-6 associated with 1-SD–lower education: 9% [95% CI, 6 to 12] among Whites, and 7% [95% CI, 3 to 10] among blacks). Similar patterns were observed for C-reactive protein. Adiposity was the single most important factor explaining socioeconomic position associations, especially among blacks and whites. A smaller effect was seen for psychosocial factors and behaviors in all race groups.
Conclusions— Both household income and education are associated with inflammation, but associations vary across race/ethnic groups. Associations likely result from socioeconomic position patterning of adiposity and other factors.
Public health: ethical issues
Introduction - Nuffield Council on Bioethics: "Public health: ethical issues Introduction How and when should the government intervene in our lives to help us be healthy? Some people object to the ‘nanny state’ and want to be left to make their own lifestyle choices. Others think that the government should do more to tackle problems such as childhood obesity and the binge drinking culture. And what are the responsibilities of the food and drinks industry? In July 2004, the Council held a Workshop, involving a range of experts, to examine the range of ethical issues raised in the context of public health. As a result of the discussions that took place, the Council formed a Working Party in February 2006 to examine the issues further. Following a public consultation and meetings with a variety of stakeholders, a report with recommendations for policy makers was published on 13th November 2007. Download report Last Updated Fri, 16 November 2007"
Nuffield Council on Bioethics
Nuffield Council on Bioethics - Nuffield Council on Bioethics: "Nuffield Council on Bioethics The Nuffield Council on Bioethics examines ethical issues raised by new developments in biology and medicine. Established by the Nuffield Foundation in 1991, the Council is an independent body, funded jointly by the Foundation, the Medical Research Council and the Wellcome Trust. The Council has achieved an international reputation for addressing public concerns, and providing independent advice to assist policy makers and stimulate debate in bioethics. "/.../
Thursday, November 15, 2007
The high cost of smoking
The high cost of smoking
The costs add up: Cigarettes, dry cleaning, insurance -- you can even lose your job. A 40-year-old who quits and puts the savings into a 401(k) could save almost $250,000 by age 70.
By Hilary Smith
If the threat of cancer can't persuade you to quit smoking, maybe the prospect of poverty will.
The financial consequences of lighting up stretch far beyond the cost of a pack of cigarettes. Smokers pay more for insurance. They lose money on the resale value of their cars and homes. They spend extra on dry cleaning and teeth cleaning. Long term, they earn less and receive less in pension and Social Security benefits.
Indeed, being a smoker can not only mean you don't get hired -- you can get fired, too. After announcing it would no longer employ smokers, Weyco, a medical-benefits administrator in Michigan, fired four employees who refused to submit to a breath test. It began testing the spouses of its employees, too, levying an $80-per-month surcharge on those who don't test clean.
Overall, 5% of employers prefer to hire nonsmokers, according to the most recent survey by the Society for Human Resource Management, and 1% do not hire smokers. A few examples:
Kalamazoo Valley Community College in Michigan stopped hiring smokers for full-time positions at both its Michigan campuses.
Alaska Airlines, based in Washington state, requires a nicotine test before hiring people.
The Tacoma-Pierce County (Wash.) Health Department has applicants sign an "affidavit of nontobacco use."
Union Pacific won't hire smokers.
That same poll found that 5% of companies charge smokers more for health-care premiums. The costs don't stop with your paycheck. Figures from the Campaign for Tobacco-Free Kids assert that smokers cost the economy $97.6 billion a year in lost productivity.
That's based on the number of working years lost because of premature death. (The Bureau of National Affairs says 95% of companies banning smoking report no financial savings, and the U.S. Chamber of Commerce finds no connection between smoking and absenteeism.)
An additional $96.7 billion is spent on public and private health care combined, according to the Campaign for Tobacco-Free Kids, and each American household spends $630 a year in federal and state taxes due to smoking.
Personal financial impactThe cost of a pack of cigarettes averages $4.49, including taxes. Using this number, a pack-a-day smoker burns through about $31.43 per week, or $1,635 per year. That's a fat house payment or a nice vacation with the family. A 40-year-old who quits smoking and puts the savings into a 401(k) earning 9% a year would have nearly $250,000 by age 70.
But only you know exactly how much you pay and how often. Plug your yearly tally into our Savings Calculator and see what it'll cost you over the coming decades.
The one place many smokers feel free and comfortable to light up is in their car. Without consistent and thorough cleanings, however, a car that is smoked in will soon start to resemble an ashtray on wheels. The interior inevitably smells like smoke, and stray ashes and butts can burn holes in the upholstery and floor mats.
None of these things has much financial impact until you try to sell the car. Figure a minimum of $150 for a good cleaning with an extractor.
Time to quit?Learn the first steps toward losing the urge to light up.On a trade-in, dealers can easily knock off more than $1,000 on higher-end vehicles like vans, SUVs and expensive sport-types. Terry Cooper, a car dealer with seven new- and used-car stores, says he took a 1999 Porsche 911 Cabriolet in on trade for $37,000. That sounds OK, but the owner could have fetched $40,000 for it had he not "smoked out" the car's interior.
The criteria that apply to cars apply to homes as well, only on a bigger scale.
Smokers' houses often require all new paint and/or wall treatments, as well as professional drapery and carpet cleaning. According to Contractors.com, priming and painting an average-size living room, dining room and two bedrooms would cost around $2,100. The Carpet Buying Handbook puts the average cleaning cost per square foot at 28 cents, and the average home has 1,000 square feet of carpet. That's $280. Add $55 to clean a typical sofa and $25 for a chair, says Diversified Carpet in San Diego.
Walt Molony with the National Association of Realtors says that "certainly the smell of cigarettes can be a turnoff to potential buyers," but he notes that it is less of a problem in tight housing markets.
Insurers weigh in, and they're not happy We pulled some online quotes on 20-year term life insurance (a $500,000 policy) for a healthy 44-year-old male through BudgetLife.com. The range for a nonsmoker was $570 to $1,035 in premiums per year; for someone smoking a pack a day, the prices skyrocketed to as much as $4,250 per year.
The difference in health insurance isn't as dramatic. According to eHealthInsurance.com, the monthly premium for a policy from Regence Blue Shield with a $1,500 deductible for a 44-year-old male nonsmoker is $239. The same policy for a smoker is $276 per month. He will pay $444 more per year.
A few state governments also charge their employees extra for health insurance if they smoke, and others are gradually joining the trend. West Virginia, Georgia, Kentucky and Alabama charge state employees who smoke a surcharge; in Georgia, for example, that surcharge is an additional $40 per month.
According to the ACLU, a majority of states do not have a state law preventing employers from discriminating against potential and current employees based on nonwork-related activities. Thirty-one states do have laws that protect smokers, including Colorado and North Dakota, which ban discrimination based on any form of legal, off-duty behavior.
When shopping for homeowners insurance, nonsmokers can generally expect to receive a minimum 10% discount, according to Ray Neumiller, an agent with Farmer's Insurance in Seattle.
The insurer's point of view: Smokers burn down houses.
The most common homeowners insurance policies range from approximately $450 to $1,350 per year, depending on the home's location. With the discount, a nonsmoker would realize savings of at least $45, but most likely more. Few people set out to cut their life short, but smokers greatly increase their chances of dying sooner than nonsmokers. In his book "The Price of Smoking," Frank Sloan, the director of the Center for Health Policy, Law and Management at Duke University in Durham, N.C., details the financial impact of a shorter life span on retirement benefits.
"Smokers, due to higher mortality rates, obtained lower lifetime benefits compared to never smokers, even after accounting for their smoking-related lower lifetime contributions," the research says.
Sloan and his colleagues found that the effects of smoking on lifetime Social Security benefits were $1,519 for 24-year-old female smokers and $6,549 for 24-year-old male smokers. This is money paid into Social Security but never collected, because the beneficiary died prematurely of a smoking-related illness.
"You could be paying into Social Security year after year, and if you die at 66 because you're a smoker, it's money down the drain," says Sloan.
Time to quit?Learn the first steps toward losing the urge to light up.
Keeping up appearances Numerous studies find that smokers earn anywhere from 4% to 11% less than nonsmokers. It's not just a loss of productivity to smoke breaks and poorer health that takes a financial toll, researchers theorize; smokers are perceived to be less attractive and successful as well.
Bad breath, yellow teeth and smelly clothes are just a few of the personal side effects of smoking, and all cost money to correct.
An extra pack of mints or gum a week adds up to about $50 per year. Need your teeth whitened once a year? Brite Smile, which has offices across the country, sells its service for $400 to $600. Most professional-grade teeth whitening products retail for a minimum of $200.
Dry-cleaning bills are likely to be higher also. Clean that suit one extra time a month at a cost of $12, and there goes an additional $144.
The costs add up: Cigarettes, dry cleaning, insurance -- you can even lose your job. A 40-year-old who quits and puts the savings into a 401(k) could save almost $250,000 by age 70.
By Hilary Smith
If the threat of cancer can't persuade you to quit smoking, maybe the prospect of poverty will.
The financial consequences of lighting up stretch far beyond the cost of a pack of cigarettes. Smokers pay more for insurance. They lose money on the resale value of their cars and homes. They spend extra on dry cleaning and teeth cleaning. Long term, they earn less and receive less in pension and Social Security benefits.
Indeed, being a smoker can not only mean you don't get hired -- you can get fired, too. After announcing it would no longer employ smokers, Weyco, a medical-benefits administrator in Michigan, fired four employees who refused to submit to a breath test. It began testing the spouses of its employees, too, levying an $80-per-month surcharge on those who don't test clean.
Overall, 5% of employers prefer to hire nonsmokers, according to the most recent survey by the Society for Human Resource Management, and 1% do not hire smokers. A few examples:
Kalamazoo Valley Community College in Michigan stopped hiring smokers for full-time positions at both its Michigan campuses.
Alaska Airlines, based in Washington state, requires a nicotine test before hiring people.
The Tacoma-Pierce County (Wash.) Health Department has applicants sign an "affidavit of nontobacco use."
Union Pacific won't hire smokers.
That same poll found that 5% of companies charge smokers more for health-care premiums. The costs don't stop with your paycheck. Figures from the Campaign for Tobacco-Free Kids assert that smokers cost the economy $97.6 billion a year in lost productivity.
That's based on the number of working years lost because of premature death. (The Bureau of National Affairs says 95% of companies banning smoking report no financial savings, and the U.S. Chamber of Commerce finds no connection between smoking and absenteeism.)
An additional $96.7 billion is spent on public and private health care combined, according to the Campaign for Tobacco-Free Kids, and each American household spends $630 a year in federal and state taxes due to smoking.
Personal financial impactThe cost of a pack of cigarettes averages $4.49, including taxes. Using this number, a pack-a-day smoker burns through about $31.43 per week, or $1,635 per year. That's a fat house payment or a nice vacation with the family. A 40-year-old who quits smoking and puts the savings into a 401(k) earning 9% a year would have nearly $250,000 by age 70.
But only you know exactly how much you pay and how often. Plug your yearly tally into our Savings Calculator and see what it'll cost you over the coming decades.
The one place many smokers feel free and comfortable to light up is in their car. Without consistent and thorough cleanings, however, a car that is smoked in will soon start to resemble an ashtray on wheels. The interior inevitably smells like smoke, and stray ashes and butts can burn holes in the upholstery and floor mats.
None of these things has much financial impact until you try to sell the car. Figure a minimum of $150 for a good cleaning with an extractor.
Time to quit?Learn the first steps toward losing the urge to light up.On a trade-in, dealers can easily knock off more than $1,000 on higher-end vehicles like vans, SUVs and expensive sport-types. Terry Cooper, a car dealer with seven new- and used-car stores, says he took a 1999 Porsche 911 Cabriolet in on trade for $37,000. That sounds OK, but the owner could have fetched $40,000 for it had he not "smoked out" the car's interior.
The criteria that apply to cars apply to homes as well, only on a bigger scale.
Smokers' houses often require all new paint and/or wall treatments, as well as professional drapery and carpet cleaning. According to Contractors.com, priming and painting an average-size living room, dining room and two bedrooms would cost around $2,100. The Carpet Buying Handbook puts the average cleaning cost per square foot at 28 cents, and the average home has 1,000 square feet of carpet. That's $280. Add $55 to clean a typical sofa and $25 for a chair, says Diversified Carpet in San Diego.
Walt Molony with the National Association of Realtors says that "certainly the smell of cigarettes can be a turnoff to potential buyers," but he notes that it is less of a problem in tight housing markets.
Insurers weigh in, and they're not happy We pulled some online quotes on 20-year term life insurance (a $500,000 policy) for a healthy 44-year-old male through BudgetLife.com. The range for a nonsmoker was $570 to $1,035 in premiums per year; for someone smoking a pack a day, the prices skyrocketed to as much as $4,250 per year.
The difference in health insurance isn't as dramatic. According to eHealthInsurance.com, the monthly premium for a policy from Regence Blue Shield with a $1,500 deductible for a 44-year-old male nonsmoker is $239. The same policy for a smoker is $276 per month. He will pay $444 more per year.
A few state governments also charge their employees extra for health insurance if they smoke, and others are gradually joining the trend. West Virginia, Georgia, Kentucky and Alabama charge state employees who smoke a surcharge; in Georgia, for example, that surcharge is an additional $40 per month.
According to the ACLU, a majority of states do not have a state law preventing employers from discriminating against potential and current employees based on nonwork-related activities. Thirty-one states do have laws that protect smokers, including Colorado and North Dakota, which ban discrimination based on any form of legal, off-duty behavior.
When shopping for homeowners insurance, nonsmokers can generally expect to receive a minimum 10% discount, according to Ray Neumiller, an agent with Farmer's Insurance in Seattle.
The insurer's point of view: Smokers burn down houses.
The most common homeowners insurance policies range from approximately $450 to $1,350 per year, depending on the home's location. With the discount, a nonsmoker would realize savings of at least $45, but most likely more. Few people set out to cut their life short, but smokers greatly increase their chances of dying sooner than nonsmokers. In his book "The Price of Smoking," Frank Sloan, the director of the Center for Health Policy, Law and Management at Duke University in Durham, N.C., details the financial impact of a shorter life span on retirement benefits.
"Smokers, due to higher mortality rates, obtained lower lifetime benefits compared to never smokers, even after accounting for their smoking-related lower lifetime contributions," the research says.
Sloan and his colleagues found that the effects of smoking on lifetime Social Security benefits were $1,519 for 24-year-old female smokers and $6,549 for 24-year-old male smokers. This is money paid into Social Security but never collected, because the beneficiary died prematurely of a smoking-related illness.
"You could be paying into Social Security year after year, and if you die at 66 because you're a smoker, it's money down the drain," says Sloan.
Time to quit?Learn the first steps toward losing the urge to light up.
Keeping up appearances Numerous studies find that smokers earn anywhere from 4% to 11% less than nonsmokers. It's not just a loss of productivity to smoke breaks and poorer health that takes a financial toll, researchers theorize; smokers are perceived to be less attractive and successful as well.
Bad breath, yellow teeth and smelly clothes are just a few of the personal side effects of smoking, and all cost money to correct.
An extra pack of mints or gum a week adds up to about $50 per year. Need your teeth whitened once a year? Brite Smile, which has offices across the country, sells its service for $400 to $600. Most professional-grade teeth whitening products retail for a minimum of $200.
Dry-cleaning bills are likely to be higher also. Clean that suit one extra time a month at a cost of $12, and there goes an additional $144.
Tuesday, November 13, 2007
Café e Saúde
Depois de ser lançado nos Estados Unidos, será apresentado no Brasil, maior produtor e segundo país que mais consome a bebida, o livro “Café: a bebida revolucionária para o prazer e a saúde”, do médico e estudioso dos efeitos do café na saúde, Darcy Lima, com co-autoria de Roseane Santos. A obra desvenda o paradoxo do café em um estudo fascinante que informa, especialmente aos amantes da bebida, os efeitos positivos do café no corpo humano. O lançamento faz parte da programação do 15° Encafé (maior evento do setor industrial de café - ABIC), que será realizado de 14 a 18 de novembro, em Porto de Galinhas, Pernambuco, com o tema "Sustentabilidade e Consumo Consciente"./.../
World Diabetes Day
NEW YORK, NY (Nov. 5 2007) - Diabetes currently affects 246 million people globally, including nearly 21 million children and adults in the United States. For all of them and the many millions more at risk, November 14, 2007 is a highly significant date as it marks the first United Nations-observed World Diabetes Day.
The International Diabetes Federation (IDF), who leads the campaign, will be joined by the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation (JDRF), and many other organizations to mark the day in celebrations throughout the United States.
World Diabetes Day is the primary global awareness campaign of the diabetes world. It was introduced by IDF and the World Health Organization in response to concern over increasing numbers of people with diabetes around the world. The date marks the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in 1921. With the passage of the United Nations' World Diabetes Day Resolution in December 2006, November 14 has now become a United Nations-observed day.
Thousands of New Yorkers will join the millions of people worldwide who will use the day to raise awareness of diabetes and its serious complications. IDF has planned a host of activities throughout the city. These include the formation of a human blue circle on the grounds of the United Nations - the blue circle is the global symbol for diabetes; a 246-step march from the UN down 1st Avenue in honor of people with diabetes worldwide; and a diabetes education rally that will include musical performances and celebrity appearances. As the sun sets on World Diabetes Day, over 120 iconic sites and buildings around the world will light up in blue to mark the day. Monuments in the US include the Empire State Building in New York, Sears Tower in Chicago, Prudential Tower in Boston, Los Angeles Airport (LAX) in Los Angeles, the Soldiers' and Sailors' Monument in Indianapolis, the Four Freedoms Monument in Evansville, San Francisco City Hall and Coit Tower in San Francisco, Qwest Stadium in Seattle and the Naismith Memorial Basketball Hall of Fame in Springfield.
Professor Martin Silink, President of the International Diabetes Federation explained the significance of the lightings: "These landmarks are lighting up as beacons of hope for the 246 million people living with diabetes worldwide. The illumination of so many landmarks is a prominent statement to governments everywhere: the global diabetes epidemic can no longer be ignored."
American Idol finalist and recording artist Elliott Yamin, who has type 1 diabetes, will perform "Promise to Remember Me," a song written for JDRF by Grammy-award winning composer Alan Silvestri and lyricist Steven Schwartz. He will be joined in song at the U.N.'s Rose Garden opening ceremony by children with diabetes. Restaurateur and television host B. Smith will emcee the Diabetes Education Rally and lead hundreds of World Diabetes Day supporters. This inspirational and educational event follows the 246-step march from the U.N. building to Guastavino's restaurant under the 59th Street Bridge, with each step representing one million people with diabetes.
Dr. Francine Kaufman, who leads the campaign to raise awareness of diabetes in children, the theme of this year's World Diabetes Day hopes that increased awareness of diabetes can lead to improved care: "The United Nations now recognizes diabetes as a serious disease that poses severe risks for families, countries and the entire world. Governments everywhere have now acknowledged the negative effect on economies and development. We now need individuals to appreciate the risks of diabetes and understand what can be done to control the disease and prevent or delay its life-threatening complications."
New York's Mayor Michael Bloomberg and Governor Eliot Spitzer, Chicago's Mayor Richard Daley, Los Angeles' Mayor Antonio R. Villaraigosa, and the Mayor of St. Louis, Francis Slay among others, have all officially proclaimed November 14 as World Diabetes Day in their respective cities. City and town officials throughout the country have responded to the need to recognize the day and the significance of diabetes for so many Americans.
This first U.N.-observed day is a result of the landmark resolution recognizing that diabetes presents as great a threat to global health as HIV/AIDS, tuberculosis and malaria.
For more details on World Diabetes Day and events around the U.S., please visit www.worlddiabetesday.org
The International Diabetes Federation (IDF), who leads the campaign, will be joined by the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation (JDRF), and many other organizations to mark the day in celebrations throughout the United States.
World Diabetes Day is the primary global awareness campaign of the diabetes world. It was introduced by IDF and the World Health Organization in response to concern over increasing numbers of people with diabetes around the world. The date marks the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in 1921. With the passage of the United Nations' World Diabetes Day Resolution in December 2006, November 14 has now become a United Nations-observed day.
Thousands of New Yorkers will join the millions of people worldwide who will use the day to raise awareness of diabetes and its serious complications. IDF has planned a host of activities throughout the city. These include the formation of a human blue circle on the grounds of the United Nations - the blue circle is the global symbol for diabetes; a 246-step march from the UN down 1st Avenue in honor of people with diabetes worldwide; and a diabetes education rally that will include musical performances and celebrity appearances. As the sun sets on World Diabetes Day, over 120 iconic sites and buildings around the world will light up in blue to mark the day. Monuments in the US include the Empire State Building in New York, Sears Tower in Chicago, Prudential Tower in Boston, Los Angeles Airport (LAX) in Los Angeles, the Soldiers' and Sailors' Monument in Indianapolis, the Four Freedoms Monument in Evansville, San Francisco City Hall and Coit Tower in San Francisco, Qwest Stadium in Seattle and the Naismith Memorial Basketball Hall of Fame in Springfield.
Professor Martin Silink, President of the International Diabetes Federation explained the significance of the lightings: "These landmarks are lighting up as beacons of hope for the 246 million people living with diabetes worldwide. The illumination of so many landmarks is a prominent statement to governments everywhere: the global diabetes epidemic can no longer be ignored."
American Idol finalist and recording artist Elliott Yamin, who has type 1 diabetes, will perform "Promise to Remember Me," a song written for JDRF by Grammy-award winning composer Alan Silvestri and lyricist Steven Schwartz. He will be joined in song at the U.N.'s Rose Garden opening ceremony by children with diabetes. Restaurateur and television host B. Smith will emcee the Diabetes Education Rally and lead hundreds of World Diabetes Day supporters. This inspirational and educational event follows the 246-step march from the U.N. building to Guastavino's restaurant under the 59th Street Bridge, with each step representing one million people with diabetes.
Dr. Francine Kaufman, who leads the campaign to raise awareness of diabetes in children, the theme of this year's World Diabetes Day hopes that increased awareness of diabetes can lead to improved care: "The United Nations now recognizes diabetes as a serious disease that poses severe risks for families, countries and the entire world. Governments everywhere have now acknowledged the negative effect on economies and development. We now need individuals to appreciate the risks of diabetes and understand what can be done to control the disease and prevent or delay its life-threatening complications."
New York's Mayor Michael Bloomberg and Governor Eliot Spitzer, Chicago's Mayor Richard Daley, Los Angeles' Mayor Antonio R. Villaraigosa, and the Mayor of St. Louis, Francis Slay among others, have all officially proclaimed November 14 as World Diabetes Day in their respective cities. City and town officials throughout the country have responded to the need to recognize the day and the significance of diabetes for so many Americans.
This first U.N.-observed day is a result of the landmark resolution recognizing that diabetes presents as great a threat to global health as HIV/AIDS, tuberculosis and malaria.
For more details on World Diabetes Day and events around the U.S., please visit www.worlddiabetesday.org
Monday, November 12, 2007
Mortalidade Precoce por Doenças Cardiovasculares e as Desigualdades Sociais em Porto Alegre, Brasil.
Hoje foi enviado para publicação nos Arquivos Brasileiros de Cardiologia o Artigo premiado como o melhor Tema Livre Oral nas áreas de Epidemiologia e Clínica, durante o último 62o. Congresso da SBC, realizado em São Paulo, intitulado " Mortalidade Precoce por Doenças Cardiovasculares e as Desigualdades Sociais em Porto Alegre, Brasil.
Autoria: Sérgio Luiz Bassanesi, Maria Inês Reinert Azambuja e Aloyzio Cechella Achutti.
Esta é uma das ilustrações relacionadas com o texto.
2370 - AMICOR10 - 12/11/2007
enMonday, November 12, 2007
Health in the Americas: Brazil
Capítulo sobre Condições de Saúde no BR 2007. Há um capítulo para cada país da América e outro temático para o conjunto
Labels: Brazil;
posted by Aloyzio Achutti at 12:33 AM 0 comments
Wednesday, November 07, 2007
Our Greatest Challenge? Global Inequalities in CV Care
Low and middle income countries suffer more than 80% of the global burden of cardiovascular disease, but more than 80% of global expenditure on cardiovascular health care occurs in high income countries, according to Stephen MacMahon from The George Institute for International Health in Sydney, Australia.
Sessions Science OnDemand®.
Labels: inequality
posted by Aloyzio Achutti at 10:17 AM 0 comments
Tuesday, November 06, 2007
Why has healthcare reform failed?
To make it work, lawmakers need to understand the barriers that have blocked reform.By Henry Aaron November 6, 2007Every 15 years or so, proposals to reform the entire U.S. healthcare system seize national attention. It suggests that even if it succeeds, healthcare reform will not come from a single bill that transforms a $2.5-trillion industry but from repeated legislation of modest scope enacted over many years.
Labels: Health system
posted by Aloyzio Achutti at 5:00 PM 0 comments
Shaping the world to illustrate inequalities in health
Shaping the world to illustrate inequalities in healthDanny Dorling a, Anna Barford aVisualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers realize. Labels: inequality
posted by Aloyzio Achutti at 12:09 PM 0 comments
AHA President: Disparities in health care
Labels: inequality
posted by Aloyzio Achutti at 9:12 AM 0 comments
Conner Lecturer: Social inequality
Conner Lecturer: Social inequalityboosts heart diseasePoverty is widely recognized as a risk factor for poor health and lower life expectancy, but lack of income is not the main determinant of health.
Labels: inequality
posted by Aloyzio Achutti at 9:09 AM 0 comments
Saturday, November 03, 2007
The social determinants of health:Developing an evidence base for political action
Political briefing• The health of individuals and of populations is determined to a significant degree by social factors.• The social determinants of health produce widespread inequities in health within and between societies.
************************
The authors would like to thank Somsak Chunharas, John Lynch, Carlos Silva,Cesar G Victora and Michael C Wolfson for their peer reviews of this report.
posted by Aloyzio Achutti at 10:05 PM 0 comments
Health in the Americas: Brazil
Capítulo sobre Condições de Saúde no BR 2007. Há um capítulo para cada país da América e outro temático para o conjunto
Labels: Brazil;
posted by Aloyzio Achutti at 12:33 AM 0 comments
Wednesday, November 07, 2007
Our Greatest Challenge? Global Inequalities in CV Care
Low and middle income countries suffer more than 80% of the global burden of cardiovascular disease, but more than 80% of global expenditure on cardiovascular health care occurs in high income countries, according to Stephen MacMahon from The George Institute for International Health in Sydney, Australia.
Sessions Science OnDemand®.
Labels: inequality
posted by Aloyzio Achutti at 10:17 AM 0 comments
Tuesday, November 06, 2007
Why has healthcare reform failed?
To make it work, lawmakers need to understand the barriers that have blocked reform.By Henry Aaron November 6, 2007Every 15 years or so, proposals to reform the entire U.S. healthcare system seize national attention. It suggests that even if it succeeds, healthcare reform will not come from a single bill that transforms a $2.5-trillion industry but from repeated legislation of modest scope enacted over many years.
Labels: Health system
posted by Aloyzio Achutti at 5:00 PM 0 comments
Shaping the world to illustrate inequalities in health
Shaping the world to illustrate inequalities in healthDanny Dorling a, Anna Barford aVisualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers realize. Labels: inequality
posted by Aloyzio Achutti at 12:09 PM 0 comments
AHA President: Disparities in health care
Labels: inequality
posted by Aloyzio Achutti at 9:12 AM 0 comments
Conner Lecturer: Social inequality
Conner Lecturer: Social inequalityboosts heart diseasePoverty is widely recognized as a risk factor for poor health and lower life expectancy, but lack of income is not the main determinant of health.
Labels: inequality
posted by Aloyzio Achutti at 9:09 AM 0 comments
Saturday, November 03, 2007
The social determinants of health:Developing an evidence base for political action
Political briefing• The health of individuals and of populations is determined to a significant degree by social factors.• The social determinants of health produce widespread inequities in health within and between societies.
************************
The authors would like to thank Somsak Chunharas, John Lynch, Carlos Silva,Cesar G Victora and Michael C Wolfson for their peer reviews of this report.
posted by Aloyzio Achutti at 10:05 PM 0 comments
Health in the Americas: Brazil
Capítulo sobre Condições de Saúde no BR 2007. Há um capítulo para cada país da América e outro temático para o conjunto
Wednesday, November 07, 2007
Our Greatest Challenge? Global Inequalities in CV Care
Our Greatest Challenge? Global Inequalities in Cardiovascular Care
Low and middle income countries suffer more than 80% of the global burden of cardiovascular disease, but more than 80% of global expenditure on cardiovascular health care occurs in high income countries, according to Stephen MacMahon from The George Institute for International Health in Sydney, Australia. In low and middle income countries, more than half of all cardiovascular disease affects people in middle age - during their most economically productive years - and as a result cardiovascular disease is now an important cause of poverty in many regions. Most individuals in those countries who are at high risk of a fatal or disabling cardiovascular event receive no treatment whatsoever. Even aspirin is not routinely provided to patients who have suffered a myocardial infarction. To address these disparities, Dr. MacMahon called for a broad approach to the WHO, the World Bank, governments and pharma to promote an increase in healthcare workers and capacity, preventive programs of guidelines and education, and availability of reasonably priced generic medications.See the live presentation, or review the full transcript, at AHA Sessions Science OnDemand®.
Low and middle income countries suffer more than 80% of the global burden of cardiovascular disease, but more than 80% of global expenditure on cardiovascular health care occurs in high income countries, according to Stephen MacMahon from The George Institute for International Health in Sydney, Australia. In low and middle income countries, more than half of all cardiovascular disease affects people in middle age - during their most economically productive years - and as a result cardiovascular disease is now an important cause of poverty in many regions. Most individuals in those countries who are at high risk of a fatal or disabling cardiovascular event receive no treatment whatsoever. Even aspirin is not routinely provided to patients who have suffered a myocardial infarction. To address these disparities, Dr. MacMahon called for a broad approach to the WHO, the World Bank, governments and pharma to promote an increase in healthcare workers and capacity, preventive programs of guidelines and education, and availability of reasonably priced generic medications.See the live presentation, or review the full transcript, at AHA Sessions Science OnDemand®.
Tuesday, November 06, 2007
Why has healthcare reform failed?
Why has healthcare reform failed?
To make it work, lawmakers need to understand the barriers that have blocked reform.
By Henry Aaron November 6, 2007
Every 15 years or so, proposals to reform the entire U.S. healthcare system seize national attention. The cycle has endured since President Franklin D. Roosevelt considered proposing universal health coverage as part of the Social Security Act. Presidents Truman, Carter, Ford, George H.W. Bush and Clinton all produced proposals for universal coverage. Though different in detail, they shared one key characteristic -- failure. Each time, supporters of reform believed, popular clamor would drive elected officials to end the national embarrassment of millions of uninsured and rein in health expenditures that were needlessly high and bought less than they should. Each time, reformers were right in their indictment and wrong in their political judgments.Now, once again, advocates of health-system reform believe that the time for action has arrived. The U.S. spends twice as much per capita on healthcare as the average of the 10 other richest countries in the world. More than one person in six under age 65 is uninsured. And business and labor leaders alike are convinced that employer-financed healthcare is undermining U.S. competitiveness. But the case has seemed strong before when reform efforts failed. If there's any chance of success this time, we need to understand the barriers that prevented reform in the past:* Elites remain deeply divided on what to do. Solid and stubborn minorities favor enrolling everyone in a nationally administered system financed largely by taxes, shoring up the current employment-based system for workers and their families or extending tax incentives to encourage individuals to buy insurance themselves. Supporters of each approach prefer the status quo to the alternatives, so doing nothing wins.* Eighty-five percent of Americans are insured and fear change. Repeated surveys document that most are pleased with their doctors and satisfied with their last contact with a hospital. Yes, healthcare costs them more than they would like, and insurance red tape is a huge pain. But they regard any plan that threatens their current arrangements with suspicion, particularly if it is imposed by a Congress they distrust.* Large-scale health reform is large-scale income redistribution, and the politics of redistribution is the politics of trench warfare. Unless healthcare spending is greatly increased -- something no one wants -- boosting spending on some groups means cutting spending on others. Increasing one kind of care means cutting another. Those who stand to lose services can be counted on to invoke high-flown reasons why reform is retrograde. To be sure, advocates of each approach to reform claim that increases in efficiency will result if their ideas are adopted. But these claims are hard to document, and they would take years to realize.* Healthcare reform involves huge financial stakes. When Clinton proposed his reform, the U.S. healthcare system spent as much as the gross domestic product of France. Now it spends as much as the combined GDPs of France and Spain. The potential losers from any reform -- insurers, hospitals, doctors -- can and will marshal enormous resources to block action. * The U.S. political system is exquisitely structured to frustrate action on large and controversial matters on which there is not overwhelming agreement. Party discipline is an oxymoron. Congressional committee chairmen can and do block action that the majority of their party embraces. The political composition of the two houses of Congress requires that to get majorities, both large and small states, despite their often conflicting interests, must make common cause. Senate rules require super-majority support for any controversial action. And all elected officials persistently obey the political corollary of the Hippocratic oath: Do not be seen to do obvious harm.* Healthcare varies greatly across the United States, making consensus hard to come by. In Texas, 24% of the population is uninsured; in three Midwestern states and Hawaii, fewer than 10% are uninsured. Massachusetts spends 70% more per person on healthcare than Utah does. Health maintenance organizations enroll more than a third of the population in three states, including the nation's largest, while three other states have only a single HMO and one has none. None of this means that sweeping transformation is impossible. Seismic political events do sometimes occur. But it does mean that faith that this is the moment feels a bit like Charlie Brown's innocent faith that, this time, Lucy will not yank the football away. It suggests that even if it succeeds, healthcare reform will not come from a single bill that transforms a $2.5-trillion industry but from repeated legislation of modest scope enacted over many years. The next president can articulate a vision, but like Moses, he or she is unlikely to see the promised land.On a more positive note, the many barriers to national reform may in fact spur state reforms already in the planning stages. Congressional proposals to relax regulations and provide modest financial support have been introduced and enjoy bipartisan backing. The appeal of this approach is growing because even politicians unwilling or unable to agree on sweeping national reform increasingly understand that the nation cannot afford to once again walk away from the healthcare mess with nothing to show for the effort.Henry Aaron is a senior fellow at the Brookings Institution in Washington.
To make it work, lawmakers need to understand the barriers that have blocked reform.
By Henry Aaron November 6, 2007
Every 15 years or so, proposals to reform the entire U.S. healthcare system seize national attention. The cycle has endured since President Franklin D. Roosevelt considered proposing universal health coverage as part of the Social Security Act. Presidents Truman, Carter, Ford, George H.W. Bush and Clinton all produced proposals for universal coverage. Though different in detail, they shared one key characteristic -- failure. Each time, supporters of reform believed, popular clamor would drive elected officials to end the national embarrassment of millions of uninsured and rein in health expenditures that were needlessly high and bought less than they should. Each time, reformers were right in their indictment and wrong in their political judgments.Now, once again, advocates of health-system reform believe that the time for action has arrived. The U.S. spends twice as much per capita on healthcare as the average of the 10 other richest countries in the world. More than one person in six under age 65 is uninsured. And business and labor leaders alike are convinced that employer-financed healthcare is undermining U.S. competitiveness. But the case has seemed strong before when reform efforts failed. If there's any chance of success this time, we need to understand the barriers that prevented reform in the past:* Elites remain deeply divided on what to do. Solid and stubborn minorities favor enrolling everyone in a nationally administered system financed largely by taxes, shoring up the current employment-based system for workers and their families or extending tax incentives to encourage individuals to buy insurance themselves. Supporters of each approach prefer the status quo to the alternatives, so doing nothing wins.* Eighty-five percent of Americans are insured and fear change. Repeated surveys document that most are pleased with their doctors and satisfied with their last contact with a hospital. Yes, healthcare costs them more than they would like, and insurance red tape is a huge pain. But they regard any plan that threatens their current arrangements with suspicion, particularly if it is imposed by a Congress they distrust.* Large-scale health reform is large-scale income redistribution, and the politics of redistribution is the politics of trench warfare. Unless healthcare spending is greatly increased -- something no one wants -- boosting spending on some groups means cutting spending on others. Increasing one kind of care means cutting another. Those who stand to lose services can be counted on to invoke high-flown reasons why reform is retrograde. To be sure, advocates of each approach to reform claim that increases in efficiency will result if their ideas are adopted. But these claims are hard to document, and they would take years to realize.* Healthcare reform involves huge financial stakes. When Clinton proposed his reform, the U.S. healthcare system spent as much as the gross domestic product of France. Now it spends as much as the combined GDPs of France and Spain. The potential losers from any reform -- insurers, hospitals, doctors -- can and will marshal enormous resources to block action. * The U.S. political system is exquisitely structured to frustrate action on large and controversial matters on which there is not overwhelming agreement. Party discipline is an oxymoron. Congressional committee chairmen can and do block action that the majority of their party embraces. The political composition of the two houses of Congress requires that to get majorities, both large and small states, despite their often conflicting interests, must make common cause. Senate rules require super-majority support for any controversial action. And all elected officials persistently obey the political corollary of the Hippocratic oath: Do not be seen to do obvious harm.* Healthcare varies greatly across the United States, making consensus hard to come by. In Texas, 24% of the population is uninsured; in three Midwestern states and Hawaii, fewer than 10% are uninsured. Massachusetts spends 70% more per person on healthcare than Utah does. Health maintenance organizations enroll more than a third of the population in three states, including the nation's largest, while three other states have only a single HMO and one has none. None of this means that sweeping transformation is impossible. Seismic political events do sometimes occur. But it does mean that faith that this is the moment feels a bit like Charlie Brown's innocent faith that, this time, Lucy will not yank the football away. It suggests that even if it succeeds, healthcare reform will not come from a single bill that transforms a $2.5-trillion industry but from repeated legislation of modest scope enacted over many years. The next president can articulate a vision, but like Moses, he or she is unlikely to see the promised land.On a more positive note, the many barriers to national reform may in fact spur state reforms already in the planning stages. Congressional proposals to relax regulations and provide modest financial support have been introduced and enjoy bipartisan backing. The appeal of this approach is growing because even politicians unwilling or unable to agree on sweeping national reform increasingly understand that the nation cannot afford to once again walk away from the healthcare mess with nothing to show for the effort.Henry Aaron is a senior fellow at the Brookings Institution in Washington.
Shaping the world to illustrate inequalities in health
Shaping the world to illustrate inequalities in health
Danny Dorling a, Anna Barford a
Visualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers realize. For instance, a country with a very small land area receives less attention, whereas a large, sparsely populated area on a map is more obvious. Furthermore, unlike our visual ability to compare the lengths of bars in a chart, we do not have a natural aptitude for translating different colours or shades to the magnitudes they represent. Here we introduce another approach to mapping the world that can be useful for illustrating inequalities in health./.../
Danny Dorling a, Anna Barford a
Visualizing inequalities in health at the world scale is not easily achieved from tables of mortality rates. Maps that show rates using a colour scale often are less informative than many map-readers realize. For instance, a country with a very small land area receives less attention, whereas a large, sparsely populated area on a map is more obvious. Furthermore, unlike our visual ability to compare the lengths of bars in a chart, we do not have a natural aptitude for translating different colours or shades to the magnitudes they represent. Here we introduce another approach to mapping the world that can be useful for illustrating inequalities in health./.../
AHA President: Disparities in health care
AHA President: Disparities in health caremust be eliminatedGreat strides have been made in treating cardiovascular disease in recent years, but those advances have not reached some Americans because of disparities in health care that must be addressed, according to AHA President Daniel Jones, M.D., FAHA.“While in the United States the medical care glass is indeed half full, I’d like us to spend a few moments to focus on the half that is empty,” Dr. Jones said in his President’s Address Sunday. “To make this metaphor more apt, the glass is clearly full for some of us — most of us in this room — but it is nearly empty for many of our neighbors.”Dr. Jones outlined four areas where the American Heart Association should lead the effort to build healthier lives for everyone. Those areas are making the reduction of health disparities a priority, expanding research, increasing the AHA’s efforts in advocacy and increasing efforts in the prevention of disease.To highlight the differences in health care, he traced the histories of two patients — an elderly white male living near a large city and a black female living in the rural south. The man benefited from medical advances for almost 30 years after he was diagnosed with hypertension at age 45. The woman was diagnosed with hypertension and diabetes at 24 and suffered a stroke at 38, which caused her to move to a nursing home and her family to declare bankruptcy because of the medical debt.“We must find ways to address the serious disparity in cardiovascular disease outcomes across geography, race, gender and economics,” Dr. Jones said. “Should we consider the problem of health disparities a social issue outside our area of interest? No, we should not.”Dr. Jones called for all government agencies and voluntary health organizations to make reducing disparities a priority.“The American Heart Association’s recently adopted strategic driving force calls for measuring our progress toward eliminating health disparities in cardiovascular disease,” he said. “This will help us keep eliminating health disparities a priority.”Expanding research will help increase the understanding of the causes of disparities and ways to eliminate them.“This will require continued investment in basic science, and translational, clinical, population, and quality and outcomes research,” Dr. Jones said.In advocacy, the AHA must be a leader in calling for more cardiovascular disease research that focuses on disparities.“It is clear that in the U.S., we cannot achieve good health for all until the issue of access to health care is addressed,” he said.Prevention is also important in reducing disparities, particularly primordial prevention in early life.“We must prevent obesity from an early age, as present science suggests prevention is our only real hope in managing the obesity epidemic,” Dr. Jones said. Some studies have shown that programs can reduce disparities in diseases like hypertension, he added.Although disparities are a problem, recognizing the problem has created an opportunity, Dr. Jones said.“I ask you to rise to this medical and moral challenge, seize the opportunity before us and commit to eliminating health disparities in cardiovascular diseases,” he said.
Conner Lecturer: Social inequality
Conner Lecturer: Social inequalityboosts heart diseasePoverty is widely recognized as a risk factor for poor health and lower life expectancy, but lack of income is not the main determinant of health. Where you stand in the social pecking order is critically important. Social inequality is the leading risk factor for higher incidences of cardiovascular disease and increased mortality.“The issue of inequality is key to all of our activities,” said Professor Sir Michael Marmot, M.D., Ph.D., director of the International Institute for Society and Health, London, and head of the World Health Organization Commission on Social Determinants of Health.Cardiovascular disease has already emerged as the No. 1 cause of mortality in all but the poorest countries, Dr. Marmot said during the Lewis A. Conner Memorial Lecture on Sunday afternoon. That puts reducing cardiovascular risk at the top of the disease prevention list, and the No. 1 risk for CVD is social inequality.Psychosocial factors, such as empowerment, can affect health. The life expectancy for Oscar winners, for example, is four years longer than Oscar nominees who have not won.“Winning an Oscar is like reducing your risk of dying from heart attack from population normal to zero,” Dr. Marmot said. “That is a tremendous improvement.”Population studies around the world show that social inequality affects control over one’s own life and work, he explained. In the United States, United Kingdom, Sweden, South Korea and other countries, the key factors are education and social status in the workplace. Better-educated individuals and those with more authority at work have lower rates of cardiovascular disease and longer life expectancy.Education and status even trump access to health care, he noted. In the United States, for example, education and workplace status are positively associated with longer life expectancy, even in populations with similar access to health insurance and medical care.“Health equity, putting inequality right, is a matter of social justice,” he said. “The medical profession should take the lead.”
Saturday, November 03, 2007
The social determinants of health:Developing an evidence base for political action
Political briefing
• The health of individuals and of populations is determined to a significant degree by social factors.
• The social determinants of health produce widespread inequities in health within and between societies.
• The poor and the disadvantaged experience worse health than the rich and powerful, have less access to services and die younger in all societies.
• The social determinants of health and illness and health inequities can be described and measured although this is a complex process.
• The measurement of the social determinants provides evidence which is the basis for political action which may change the action of the determinants of health.
• Evidence is not the only basis for political action, although evidence constituted of experience or media reports might be.
• Evidence is generated and used in a continuous cycle involving evidence production, guidance and policy development, implementation, and then learning from the implementation to inform the evidence base.
• Evidence on the effects of policies and programmes on inequities can be measured and monitored and can provide an evidence base on the effects of interventions.
• Evidence about the social determinants of health is insufficient to bring about change on its own; political will combined with the evidence offers the most powerful response to the negative effects of the social determinants./.../
************************
The authors would like to thank Somsak Chunharas, John Lynch, Carlos Silva,
Cesar G Victora and Michael C Wolfson for their peer reviews of this report.
• The health of individuals and of populations is determined to a significant degree by social factors.
• The social determinants of health produce widespread inequities in health within and between societies.
• The poor and the disadvantaged experience worse health than the rich and powerful, have less access to services and die younger in all societies.
• The social determinants of health and illness and health inequities can be described and measured although this is a complex process.
• The measurement of the social determinants provides evidence which is the basis for political action which may change the action of the determinants of health.
• Evidence is not the only basis for political action, although evidence constituted of experience or media reports might be.
• Evidence is generated and used in a continuous cycle involving evidence production, guidance and policy development, implementation, and then learning from the implementation to inform the evidence base.
• Evidence on the effects of policies and programmes on inequities can be measured and monitored and can provide an evidence base on the effects of interventions.
• Evidence about the social determinants of health is insufficient to bring about change on its own; political will combined with the evidence offers the most powerful response to the negative effects of the social determinants./.../
************************
The authors would like to thank Somsak Chunharas, John Lynch, Carlos Silva,
Cesar G Victora and Michael C Wolfson for their peer reviews of this report.
2369 – AMICOR10 – 03/11/2007
Saturday, November 03, 2007
Cardiosource coverage of the 2007 AHA Scientific Sessions begins Sunday, November 4
New Expert Opinion and Case Study posted.
Cardiosource coverage of the 2007 AHA Scientific Sessions begins Sunday, November 4—don't miss it!
Attention all ACC members: Don't miss out on your FREE subscriptions to the new JACC Journals! Due to postalregulations, ACC members must sign up for their free subscriptions.
posted by Aloyzio Achutti at 9:38 AM
0 comments
Saturday, November 03, 2007
"TVtuga, onde poderá encontrar diversos canais de televisão que são transmitidos pela Internet, gratuitamente. "
posted by Aloyzio Achutti at 9:33 AM
0 comments
Thursday, November 01, 2007
Excess Body Fat Associated with Increased Risk for Six Cancers
By Peggy Peck, Executive Editor, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco October 31, 2007
Add Your Knowledge™
Additional Other Cancers Coverage
Walter C. Willett, M.D.Harvard Medical School
WASHINGTON, Oct. 31 -- Obesity is on course to overtake tobacco as the leading risk factor for cancer in America, according to a report issued today.
posted by Aloyzio Achutti at 9:41 AM
0 comments
Wednesday, October 31, 2007
PLoS Journals : Poverty Collection: "Poverty Collection The Council of Science Editors has organized a Global Theme Issue on Poverty and Human Development on October 22, 2007. More than 200 science and health journals, including three PLoS journals, are participating by publishing new articles. We have also collected together related articles with a poverty theme from the archive of all the PLoS journals. Global Theme Issue Related PLoS Articles "
posted by Aloyzio Achutti at 8:31 AM
0 comments
Tuesday, October 30, 2007
(Na série especial de ZH "Mentes Iluminadas" está um AMICOR:)
posted by Aloyzio Achutti at 7:40 AM
0 comments
Monday, October 29, 2007
Social Determinants of the Premature Cardiovascular Mortality
De: Ruggiero, Mrs. Ana Lucia (WDC) [mailto:ruglucia@paho.org]
Enviada em: segunda-feira, 29 de outubro de 2007 18:38
Presentacion: Factores Sociales Determinantes de la Muerte Prematura debida a Enfermedades cardiovasculares
Porto Alegre – Brazil
Prof. Sergio Luiz Bassanesi
Departamento de Medicina Social
Facultad de Medicina Universidad Federal de Rio Grande do Sul - Brazil
Monday 29 October 2007 in Room C
PAHO/WHO - Health Surveillance and Disease Management Area, HDM
Recording link to Elluminate web conference session:
https://sas.elluminate.com/p.jnlp?psid=2007-10-29.1009.M.1BC839C524B0BA4B8BF53A3EC0770F.vcr
Link to: PPT presentation:
http://portal.paho.org/sites/IKM/WorkSpaces/ikmbrownbag/Documents/Cardiovascular%20Diseases%20OPAS.ppt
Labels: Cardiovascular Diseases, epidemiology, inequality
posted by Aloyzio Achutti at 9:21 PM
0 comments
Saturday, October 27, 2007
Genome-wide association with select biomarker traits in the Framingham Heart Study
Emelia J Benjamin1,
Abstract
Background
Systemic biomarkers provide insights into disease pathogenesis, diagnosis, and risk stratification. Many systemic biomarker concentrations are heritable phenotypes. Genome-wide association studies (GWAS) provide mechanisms to investigate the genetic contributions to biomarker variability unconstrained by current knowledge of physiological relations.
posted by Aloyzio Achutti at 9:12 AM
0 comments
De: Reginaldo Albuquerque [mailto:reginaldo.albuquerque@gmail.com]
Enviada em: sexta-feira, 26 de outubro de 2007 21:
Caro amigo:
.... o ebookeletronico que lançamos no site da SBD. Chama-se "Diabetes na Prática Clínica" e endereço é: http://www.diabetesebook.org.br/
O leitor pode baixar e montar o seu banco de dados das imagens para futuras aulas. Estamos com 30 mil páginas lidas desde o lançamento em 15/10. Veja que não se trata de PDFs. Foi necessário desenvolvermos uma ferramenta que permite aos leitores fazerem comentários e aos autores realizarem as atualizações.
.............
Labels: Diabetes
Cardiosource coverage of the 2007 AHA Scientific Sessions begins Sunday, November 4
New Expert Opinion and Case Study posted.
Cardiosource coverage of the 2007 AHA Scientific Sessions begins Sunday, November 4—don't miss it!
Attention all ACC members: Don't miss out on your FREE subscriptions to the new JACC Journals! Due to postalregulations, ACC members must sign up for their free subscriptions.
Cardiosource coverage of the 2007 AHA Scientific Sessions begins Sunday, November 4—don't miss it!
Attention all ACC members: Don't miss out on your FREE subscriptions to the new JACC Journals! Due to postalregulations, ACC members must sign up for their free subscriptions.
TELEVISÃO ONLINE
" TVtuga, onde poderá encontrar diversos canais de televisão que são transmitidos pela Internet, gratuitamente. "
Thursday, November 01, 2007
Excess Body Fat Associated with Increased Risk for Six Cancers
By Peggy Peck, Executive Editor, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco October 31, 2007
Add Your Knowledge™
Additional Other Cancers Coverage
Walter C. Willett, M.D.Harvard Medical School
WASHINGTON, Oct. 31 -- Obesity is on course to overtake tobacco as the leading risk factor for cancer in America, according to a report issued today.
Add Your Knowledge™
Additional Other Cancers Coverage
Walter C. Willett, M.D.Harvard Medical School
WASHINGTON, Oct. 31 -- Obesity is on course to overtake tobacco as the leading risk factor for cancer in America, according to a report issued today.
Action Points
Explain to interested patients that the report issued today was
based on an analysis of data from more than 7,000 diet and nutrition studies,
but the report itself has not been peer-reviewed or published by a journal.
Explain to interested patients that excess weight has been associated with
increased risk of heart disease and diabetes and this report adds more evidence
of the benefit of maintaining normal weight throughout life.Moreover, the risk for cancer increases even with modest weight gain, said Walter C. Willett, M.D., Ph.D., of the Harvard School of Public Health. He said excess body fat increased the risk for cancers of the colon, kidney, and pancreas, adenocarcinoma of the esophagus and endometrium, and breast cancer in postmenopausal women.
That was the major finding from a mega-analysis of more than 7,000 published studies conducted by a 21-member board assembled by the American Institute for Cancer Research and the World Cancer Research Fund International.
The results of the analysis, Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, were released at a press conference here.
Dr. Willett pointed out that obesity is now the second leading cause of cancer, just behind tobacco, because "obesity increases the risk of so many cancers and because two-thirds of Americans are overweight."
He and his colleagues predicted that over the next decade "obesity will become the number one risk factor for cancer" as obesity increases and the number of smokers decreases.
Dr. Willett said the finding was a call to action for clinicians, who he said should begin counseling patients about the danger of excess weight with "the first few pounds gained or first few extra inches of abdominal girth."
He faulted clinicians for failing to mention weight until patients need to lose 30 pounds or more, which he said was the wrong approach.
In addition to excess weight, Dr. Willett and colleagues said that 18 ounces of red meat per week was a safe amount but for every 1.7 additional ounces consumed per week the risk of cancer increased by 15%.
For processed meats, the panelists said it was not able to identify a safe level. "Every 1.7 ounces of processed meats consumed per day increased the risk of colorectal cancer by 21%," they said.
Dr. Willett said that alcohol was also linked to a variety of cancers and in some cases -- older women for example -- the risk of breast cancer begins to increase at levels as low as a single glass of wine per day.
How clinicians should balance the risk of breast cancer against the reported cardiovascular benefit of a daily glass of red wine is problematic, Dr. Willett admitted. But he said that folic acid consumption appeared to counterbalance the increased risk associated with alcohol.
His advice to patients who want the heart protective benefit of red wine is to take a multivitamin daily. "I believe that will offset the increased risk."
On the basis of the analysis, the panelists issued these 10 recommendations for cancer prevention:
- Be lean as possible within the normal range of body weight.
Be physically active as part of everyday life.
Limit consumption of energy-dense foods. Avoid sugary drinks.
Eat mostly foods of plant origin.
Limit alcoholic drinks.
Limit consumption of salt. Avoid moldy cereals (grains) or pulses (legumes).
Aim to meet nutritional needs through diet alone.
Women of childbearing age should plan to breastfeed and children should be breastfed.
Cancer survivors should follow the recommendations for cancer prevention.AICR supports research and educational programs focused on diet and cancer. It is a member of the World Cancer Research Fund International, which along with AICR funded the analysis.
Additional Other Cancers CoverageAdditional source: American Institute for Cancer Research and World Cancer Research Fund InternationalSource reference: World Cancer Research Fund, American Institute for Cancer Research, "Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective" 2007.
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