Global Health Care
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Global Health Care
Focused on national, international and global health care issues, programs and concerns -- their strategies, performance, economic potentials, and success.
Curated by Brian Altonen
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Cuba's Health Care System: a Model for the World

Cuba's Health Care System: a Model for the World | Global Health Care | Scoop.it

In praising Cuba, the World Health Organization stresses that it is possible for Third-world countries with limited resources to implement an efficient health care system and provide all segments of the population with social protection worthy of global recognition.

Brian Altonen's insight:

Here's to learning from past, present and ongoing mistakes in the US health care system. Let's hope that US companies can for once see their mistakes. There's a reason Cuban health provides a more effective preventive health care than U.S. companies, and it's not the cigars. Here's to acknowledging the faults with our health care system. Lets place the polyclinic in communities and settings where it is most need and will be most respected in the U.S., for others to see.

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Global health experts accuse WHO of 'egregious failure' on Ebola

Global health experts accuse WHO of 'egregious failure' on Ebola | Global Health Care | Scoop.it

There are many directions to point the finger for this malingering public health catastrophe.

Brian Altonen's insight:

There are other leaders that haven't served us well over time.  This article commends Harvard, slightly, but mentions that Harvard's Global Health Institute (HGHI) missed the opportunities to have a major impact.  HGHI, alongside the London School of Hygiene and Tropical Medicine agree "engendered acts of outstanding courage and solidarity" have taken place with the help of WHO, but also acknowledges that these events happened at the same time as "immense human suffering, fear and chaos".

 

This is pretty much a political move that serves the two agencies  and WHO more than it serves the people.   To point out the "good" when the horrendous "bad" is hundreds of times worse is like turning your head on a global disaster.  And it demonstrates to us that this can and very likely will happen again if the Spanish Flu re-emerged, or the polio came back to haunt a number of new countries.  

 

The news agency and news writer did not help with spreading this rumor about there possibly being a sign of hope out there concerning Ebola's history and outbreak.   It appears that no group or agency seems to have much control on the future potentials for outbreaks any more. 

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Micromanaging Health with 'Big Data'

Micromanaging Health with 'Big Data' | Global Health Care | Scoop.it

The biggest advantage to medical 'Big Data' is that it enables you to fine tune your evaluations.  By "fine tuning" I mean micromanaging your numbers.  Breaking you results down into smaller and smaller groups and subgroups, evaluating each one separately and then comparing the subgroup results to each other.  Age is one of the most important data types we deal with; routinely we evaluate age in 5 or 10 year increments, or sometimes in irregular large groups, like for HEDIS reviews about quality of care, for which the age ranges are predefined and irregular, such as asthma 10-14, 15-18, and 19-45.  With 'Big Data', all data should be analyzed in smaller age ranges, preferably one or two year ranges.  These are the results of that fine tuned approach to reviewing age distributions for diseases, diagnoses, or conditions, in which women have a higher rate of prevalence than man, and sometimes with their own unique age ranges.

Brian Altonen's insight:

Some population pyramids lack the symmetry of the traditional ink blot test, the symmetry displayed in the first figure.  Minor age range differences actually tell us a lot about where, when and how to begin our intervention programs.   You wouldn't want to design a program that treats both men and women the same way, when the effects upon the same  age range differ greatly between the two.  

 

For example, the distributions of cases and fatalities for men versus women are quite different for some of the above.  Women may in fact require a more orchestrated intervention decades after young men in some cases.  Whereas likelihood for diagnosis goes down for men after a certain age, it may still be rising and not reached its peak yet for women.

 

"Regional" (or small area for given urban settings and consumer ranges), age, gender and ethnicity differences further complicate the ways in which we can analyze our population in detail.   When you use a one year age range pyramid to depict your patients, you can come up with an exact age as to when to stop preventive care and when to start palliation or improved quality of life care for these patients.  

 

We can use this same method to compare one population defined by one occupational type, with other smaller populations engaged in other occupational lifestyles (that analysis would be company or employer defined standard industrial classification code[SIC code]-based).

 

These are all standard analytic processes for evaluating the data, and can be automated in most systems.  This means that like the automated or semiautomated HEDIS reporting systems, that most healthcare facilities and programs have developed, routines for these analyses can be developed and run on a regular basis, such as monthly or quarterly, or even live.  The current HEDIS metrics represent a very small piece of the complete assessment all large populations need to undergo in healthcare, especially within Health Insurance QOC /QI managed care settings.

 

Micromanaging your health care data is the only way to go when using you 'Big Data' to the greatest extent.  The small age peaks, differences between groups, tell us a lot about our patient population, but especially features that we never considered, like 'why are some childhood events regularly entered in our system a year or two before the other gender?'  'why does the mental health diagnosis in kids and young adults show a single peak age in girls/young men, and two spikes a couple years apart in boys/young men?'  'Why do the peaks of smoking and the cost for care administered for smoking decades different between male and female patients, for a particular program?' Late diagnoses based upon gender, peak intervention ages between ethnic groups, the age at which completion of a multi-step regimen is best performed, are all metrics that can be analyzed using this method.  

 

If you have a large enough population, there may be 101 ways to treat people with the same condition, but with different age-gender-ethnicity distributions for each intervention and treatment process.  With 'Big Data', you are able to analyze enough detail to reason out all of these processes.  

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Peru declares emergency in 14 regions on El Nino worries

Peru declares emergency in 14 regions on El Nino worries | Global Health Care | Scoop.it
Peru has declared a 60-day state of emergency in towns in 14 regions to brace for possible damage from the climate pattern El Nino in the rainy season, state media reported Sunday. Peru has forecast a "moderate to strong" El Nino in the winter season and has not ruled out an extraordinary event in the summer, which begins in December in the southern hemisphere. The phenomenon, a warming of Pacific sea-surface temperatures, has wreaked havoc on local fishing in Peru and triggered landslides in years past.
Brian Altonen's insight:

Disease ecology and recurring epidemics like Ebola, Vibrio cholera, Hanta Virus, hemorrhagic shellfish born diseases, and even Lyme Disease can be better understood once we begin to better understand the El Nino-Southern Oscillation theory, and relate it to global disease ecology.   

 

This issue and its news related links are updated:  http://www.bloomberg.com/news/videos/2015-07-07/el-ni-o-is-coming-back-here-s-what-you-need-to-know

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Brian Altonen's curator insight, July 6, 2015 8:28 PM

What has this got to do with health?  Everything!

 

Back around the turn of the 19th century (the late 1800s), cycles became a pop culture craze (like dozens of times before, and after).  During the early 1900s, professional journals came about talking about the cycling of trends in finances, crop production, political and social turmoil.  

 

The American Meteorological Association came to be, and a number of theories for cyclic weather patterns were published.  The most popular one was the Sunspots Theory, which claims that weather patterns were impacted by the changes in solar radiation related to sunspot activity due to the solar flares and "solar wind" that were produced.  Now, all of these changes in the energy patterns for the Solar System were in fact quite true.  But the association of these natural events with manmade events on the earth's surface was hard to accept.

 

So those in favor of this theory found many more ways to support it.  Some even proposed secondary cyclic patterns, which went in and out of resonance with the sunspot cycle.  This explained still more events then awaiting recognition.

 

The cycling of finances, in particular stock prices were still hard to accept this as an explanation for.  We could easily accept this argument for food industry products like corn, soy bean, grains.   Meteorologists had demonstrated some links between drought and the solar cycles.  That was enough to hush everyone who was against this theory--it had indirect implications--hard to provide either way.

 

But then out came a new rendering of this sunspot theory in the 1980s--the La Nina-El Nino cycle theory.  It provided another explanation for atmospheric changes, that couldn't always be correlated with the solar winds (which are true events, the winds are energy related).   

 

When I returned to college it was my intent to link the Asiatic Cholera outbreaks over time to this philosophy.  I spent several years researching this, even returning to some of my dendrochronology work that I did back in the 70s.  But then, I turned to the Cycles journals again, and took issue with how the natural cycles were being compared once again to finances, automobile manufacturing and sales, changes in gas and electricity stock prices.  An ecological approach to studying cholera cyclicity and peak outbreak times, based upon La Nina-El Nino theory, was in fact possible, due to the use of GIS to review these past popular culture themes.  

 

Naturally, over time, my interest in the cyclicity diminished once GIS came to be my tool at hand, instead of my handy increment borer for extracting tree rings and using the tree ring cycle data sets shipped to me from the leader in this field (evaluated on a 286 PC).

 

EMR/EHR, Big Data, the iCloud, and GIS can now be used to test these older pop culture theories.  We can prove once and for all whether or not the cost for growing coffee beans in parts of Africa will influence the country's ability to control its other social and economic problems, not to mention the events leading to the next spread of Ebola.

 

Yes, there is another cycle starting, but now we can begin to monitor it from day one.  If and when there is an outbreak, we can define how and why it had everything to do with El Nino, or nothing at all to do with the oscillation of global energy patterns.  

 

This cyclicity and global energy phenomenon was also used to explain global outbreak patterns in the mid-19th century.  The British Surgeon in Charge at the Military Hospital in Crimea, Ukraine, was removed to Jamaica in the Caribbean following the medical disaster that struck that place during the Crimean War (see http://brianaltonenmph.com/gis/historical-disease-maps/robert-lawsons-pandemic-waves-theory-and-map-ca-1864-1875/ ;).

 

In Jamaica, he came up with his theory as to how the magnetic fields generated by the earth could be the cause for the moving and cycling of yellow fever outbreaks around the world.  The earth's magnetic fields moved about, as did the yellow fever outbreaks.   As a result, his theory--Robert Lawson’s Pandemic Waves Theory--was published by esteemed medical journals. After all, he was a member of some of the Royal medical societies.  He drew up what he called "the World Isoclines Map" ca. 1860-1875, and used it to explain the outbreaks.

 

Sound familiar?  

 

We are back to square one with evaluating the impacts of climate and natural cycles on disease patterns and outbreak behaviors.  

 

With the right GIS in place, this controversial issue could have been resolved ten or fifteen years ago, all except the cycling periods of indecisiveness that politics and medicine--global health patterns--are riddled with.  Perhaps it may take a recurrence of a past disastrous outbreak, to lead to enough research, to at least resolve this issue once and for all.  And even then. we may still be left not knowing how and why Chikungunya, MERS and Ebola behave the way they do--but of course that may also be due to the lack of GIS implementation, for people health, not just ecological health.  

 

Peru by the way is a hot spot for vibrio ecology studies and a natural setting where vibrio has become naturalized.  It bears the classical and two most dangerous strains are linked to this Asiatic Cholera disease nidus, in particular the El Tor.

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The Outrageous Kindergarten Application Question One Mom Refused to Answer

The Outrageous Kindergarten Application Question One Mom Refused to Answer | Global Health Care | Scoop.it
Cara Paiuk, the mother of an incoming kindergartner in Connecticut, has persuaded officials to revise their school forms after speaking out about a question that she says got too personal. The inquiry: “Type of birth: Vaginal__ Cesarean__.”
Brian Altonen's insight:

Do schools have a right to ask a parent for personal health information (PHI) on a school application? 

 

This opens the door for other institutional queries that possible violate patient confidentiality.  

 

If this rule become accepted, then schools have to also screen their teachers and administrators for history of bipolarism, depression, mood- or schizoid affect states, compulsive fabrication, pyromancy, and other diagnoses that could potentially effect their "school performance", not to mention the students' safety.

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The world still isn't equipped to handle Ebola, Doctors Without Borders says

The world still isn't equipped to handle Ebola, Doctors Without Borders says | Global Health Care | Scoop.it

 

 

Ebola Health authorities aren't much better equipped to handle an Ebola flare-up than they were a year ago, international medical charity Doctors Without Borders claimed Saturday, Reuters reports.
"The reality today is if Ebola were to hit on scale it did in August and September, we would hardly do much better than we did the last time around," organization president Joanne Liu said.
She expressed disappointment over recent vague resolutions to combat the epidemic made by the World Health Assembly and the G7. Julie Kliegman

Brian Altonen's insight:

The graph I included her was the result of my study of internet coverage of Ebola last year.  It represents the primary content or topic of articles posted about Ebola from April to December 2014.  

 

Notice, as the months passed, the numbers of negative postings about how Ebola was being handled grew.  The articles meant to counter these the criticisms were ineffective at stopping the rise in dissatisfaction   These articles covered such topics as : i) the news of success in a particular areas,  ii) a new discovery about Ebola, its ecology, its treatment, its cases, iii) positive changes in government and health organization decisions made about how to control the crisis, iv) actions taken by pharmaceuticals to experiment with new products in the field.

 

The support for WHO and CDC continued its decent between August 1--that critical moment when an entire program should have been in place in days--to the end of September--when the failure of these agencies to control this outbreak became common conclusion.  

 

It took just 8 weeks for WHO and CDC to appear as though they had failed, even if some successes were made. 

 

The two main governmental reasons for this failure were i) the late onset of attempts to manage this outbreak, and ii) the lack of any display or public demonstration for success, even in understanding and predicting the probable disease outbreak patterns and routes of travel.  The subsequent disconnects this resulted in, between agencies and governments in the field versus in the office, made these matters worse.  

 

The main knowledge/experience based reasons for failure include: i) the lack of technology and an active highly productive GIS infrastructure,  ii) the lack of experts in the field. esp. those with prior working knowledge, experience, and success, and iii) reliance upon managers/directors and decision makers who were/are not able to develop or imagine the formulas needed to spatially map and predict our Ebola natural and human ecology (transport) patterns.  

 

Currently, spatial epidemiology remains dependent upon only a small part of the total disease ecology picture.

 

Only experienced experts should be operating the spatial analysis and related decisions making processes for a disease like Ebola, as well as MERS, SARS, or any other potentially highly fatal disease patterns, not to mention the highly disabling or debilitating diseases like Polio, Measles, West Nile, Chikungunya, Powassan, meningitis, encephalitis, etc. etc.. 

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Pentagon: Anthrax shipments broader than first thought

Pentagon: Anthrax shipments broader than first thought | Global Health Care | Scoop.it
The Pentagon said Friday that the Army's mistaken shipments of live anthrax to research laboratories were more widespread than it initially reported, prompting the Defense Department's second-ranking official to order a thorough review.
Brian Altonen's insight:
As a 30 years plus medical historian (since medical school), I have only this to say: It us looking more and more like the last time a potential public health problem of this magnitude happened, due to federally induced failures, the 1906 Food and Drugs Act had to be passed. This might sound like an exaggeration to some, but this is really just the tip of the iceberg. Much more to come.
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U.S. Removes Cuba From State-Sponsored Terrorism List - NYTimes.com

U.S. Removes Cuba From State-Sponsored Terrorism List - NYTimes.com | Global Health Care | Scoop.it
WASHINGTON — The Obama administration on Friday removed Cuba from a list of state sponsors of terrorism, a crucial step in President Obama’s push to normalize ties between Washington and Havana. . . . Cuba’s removal from the terrorism list was harshly criticized by several declared or prospective Republican presidential candidates and members of Congress, a sign that the détente may become an issue in the 2016 campaign. Critics of lifting longstanding travel, trade and financial restrictions on Cuba are increasingly finding their efforts overtaken by events. Although Mr. Obama would need Congress to lift the trade embargo and tourism ban, his move last year to relax some travel strictures and trade regulations. . . “When people get more freedom, they want even more of it,” said Senator Jeff Flake, Republican of Arizona, who has pressed for the lifting of remaining sanctions. “Time has gotten away from those who favor the old policy. It’s so yesterday.”
Brian Altonen's insight:
In healthcare, the U.S. can learn a valuable lesson or two from Cuba's Polyclinic approach to health care. In addition, the Cuban medical/pharmacy industry has patented and marketed biotech products that match those of the U.S. Our government and politicians live on old time thinking. Their primary skills appear to be not keeping up with the changes and holding grudges.
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Ebola flares up after lull in Guinea

Ebola flares up after lull in Guinea | Global Health Care | Scoop.it
Health officials are alarmed about new cases just as the crisis seemed to be getting under control
Brian Altonen's insight:

Sounds like a small 'blip' in the surveillance apparatus.  Will the Ebola flare up again due to natural cycles and ecological reasons.  Nature guides these natural cycles; the human body is more like the petri dish of nature, for natural anthroponoic and zoo-anthroponoic disease patterns, according to 1960s and 1970s Russian disease geographers Pavlovsky and Voronov.

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Onchocerciasis - YouTube

http://youtu.be/ifMmiPaji-M Onchocerciasis 7 0812 0%
Brian Altonen's insight:

Training in the management of Onchocerciasis (River Blindness) and Lymphatic Filariasis.  Cases noted in the medical records in the U.S. pertain to the history of this disease more than its migration to this country.  

 

The interesting thing about this diagnosis is its concentration in this country, in comparison with Sickle Cell carriers and disease.  The history of slavery is responsible for the southeastern clustering of sickle cell, whereas in migration since the period of slavery is responsible for the distribution pattern of Onchocerciasis.

 

 

 

 

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Chikungunya revives herbal remedies in Antigua

Chikungunya revives herbal remedies in Antigua | Global Health Care | Scoop.it

TGemma Handy reports from Antigua on how the spread of the chikungunya virus is prompting more people to turn to herbal healers.

Brian Altonen's insight:

This is the reason for the Alma-Ata Declaration of the World Health Organization (see Sept. 12, 1978 - http://www.who.int/publications/almaata_declaration_en.pdf ;  and the ethnobotany focused 1988 Declaration of Belem, http://www.ethnobiology.net/what-we-do/core-programs/global-coalition/declaration-of-belem/ ;).  

 

Other cultural philosophies and methods of health are deserve international attention and respect, since they may combat issues that regular medicine fails to address.

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Traditional Chinese medicine is getting a voice at the World Health Organization

Traditional Chinese medicine is getting a voice at the World Health Organization | Global Health Care | Scoop.it
Doubts about the effectiveness of traditional Chinese medicine remain.
Brian Altonen's insight:

One of the least known facts about traditional chinese medicine in western society is that it has several times been supported by the western medical traditions for the time.  

 

In fact, the first time we see evidence for this happening is during the 17th century, when French travelers and explorers were traveling through the orient, publishing books about their experiences in which they included the curious philosophies that Chinese doctors had, regarding pulse therapy, tongue diagnosis, moxibustion, their materia medica philosophy and their use of "accupuncture"--and how much it resembles their use of "fire", one of the four galenical elements, to define their four humours principle.  

 

Acupuncture and its various offshoots were practiced on and off as a variation on the increasingly popular form of electropathy methods of healing.  For much of the 17th and 18th century, it was the parallels that could be drawn between the ancient humoural theories, the discovery of the sympathetic nervous system, and the more recent "nervous energy" or excitement theory of the late 1700s that facilitated the addition of acupuncture into western practices by 1810-1820, in both western Europe and the U.S.  

 

During the late 1800s, early 1900s, Chinese medicine regained its popularity, due to the relatively large numbers of practitioners engaged in this healthcare tradition.  Not only were members of Asian cultures in the U.S. taking advantage of this form of health care, so too were some of the alternative healers of western allopathic medicine, ads for which appear in many US urban region newspapers.

 

The twentieth century has several periods when allopathy tries to first understand the philosophy underlying Chinese medicine, and then determine whether or not it fits into the western allopathic paradigms.  There are a number of interesting arguments posed by allopaths trying to explain the many who experienced acupuncture at work--the parasympathetic nervous system reasoning was following by the endocrine system paradigm at the turn of the century, which in turn has been followed by allopathic arguments trying to claim "natural opiates", enkephalins, neuroendocrine system, and most recently, psychoneuroimmunological reasons as to why this philosophy keeps finding new supporters.  Countering these were traditional claims regarding placebo effect, belief system related "cures", psychosomatics, and mindbody influences.  (Recall the popular point therapy faith now implemented for fibromyalgia treatment.)

 

This recent increase in interest in Chinese medicine is focused in part on the materia medica once again.  With Chinese herbal remedies, the world health belief system has transformed from its 18th century existence, relying heavily upon ginseng root and smilax root flour, to its late 20th, early 21st century period of curiosity about ginkgosides and their impacts on aging glial cells in the brain.

 

The most common feature to all of these periods of acceptance, withdrawal and change in traditional Chinese versus "traditional western" allopathic medicine is that a belief system is required and must be adhered to for the healing effect to take place.  In many cases, physicians have little to no control over what the body and its owner decide what to do, no matter what the cause might turn out to be--believe it, or not.

 

 

 

 

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Albino killers sentenced to death in Tanzania

Albino killers sentenced to death in Tanzania | Global Health Care | Scoop.it
A court in Tanzania has sentenced four people to death for the murder of an albino woman who was killed so her hacked-off limbs could be used in magic, officials said Friday. The sentencing comes after Tanzania' President Jakaya Kikwete blasted the wave of killings of albinos, whose body parts are used for witchcraft, as a "disgusting and big embarrassment for the nation". The killers who were convicted include Charles Nassoro, the husband of the murdered woman. Court officials in Mwanza, northwest Tanzania, said the victim had her legs and right hand hacked off with an axe and machete after being attacked while eating dinner in her village.
Brian Altonen's insight:

This is akin to the European use of mummy parts as recent as the nineteenth century.  The use of human parts for engaging in spiritual and/or medical practice is nothing for a race or country to brag about.  Engaging in slavery, becoming a slave, killing albino children, treating albino children worse than the millions of us treated slaves.  Where is the balance?

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Lancet: Will Ebola change the game? Ten essential reforms before the next pandemic.

Lancet: Will Ebola change the game? Ten essential reforms before the next pandemic. | Global Health Care | Scoop.it
Brian Altonen's insight:

"Earned Dogmatism" is the primary reason for the 2014 failure to accept that an outbreak was occurring soon enough, to implement programs that produce more of an impact.  This a very thorough review of the many things that need to change.  

 

But to expect  all of these changes before the next outbreak is unreal, which planners acknowledge is their primary barrier.  

 

The second barrier to change however is the lack of open-mindedness about cause-and-action effects.   The theoretical reasons for outbreaks was wrong with Ebola, and could very well be wrong for most potential outbreak theory produced for many other diseases.  Enough epidemiological transition has taken place economically, industrially, demographically, globally to make older theories way too outdated.

 

"Earned dogmatism" therefore has several parts to it. First, the "experts" of back then, are no longer the experts of today (perhaps a few have kept up with the times.)  Second, the theory the leader helped to produce is also in need of change--the herd immunity theory is a theory first--meaning its speculative and guess-worthy--and written for an older US population, one that was  homogeneous.  Today, we are a multicultural community, in need of a multifaceted, multicultural theory as to why diseases are returning.  Finally, we have experts who know medical geography only back a decade or two, without an understanding in the value of sequent occupancy theory or the reason why hexgrid mapping is more accurate than traditional grid mapping population and disease patterns.  More than likely, a lecture on hierarchical diffusion theory is not part of their repertoire.    

 

To date, there are several public health events alerting the healthcare practice to this serious lack of infrastructure that this profession now suffers.  West Nile, MERS and Chikungunya are there for starters.  Ebola was at its peak when the value of understanding the disease diffusion became clearer to spatial analysis experts.  But there is also the immunization refusal problem now troubling this country, due to the return of some older diseases like the plague, avian flu.  E. coli O157 is back in the news.   TB and STDs are now evolving into more drug-resistant forms.

 

 

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Ebola outbreak: WHO 'delayed Sierra Leone state of emergency' - BBC News

Ebola outbreak: WHO 'delayed Sierra Leone state of emergency' - BBC News | Global Health Care | Scoop.it
The World Health Organization delayed Sierra Leone from declaring a state of emergency over the Ebola outbreak, the country's president tells the BBC.
Brian Altonen's insight:

Time for WHO to recognize and accept its failures.  11,314 deaths is 10,585 too many (see http://www.who.int/csr/don/2014_07_31_ebola/en/ for the source of that number).

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"The world simply cannot afford another period of inaction until the next health crisis."

"The world simply cannot afford another period of inaction until the next health crisis." | Global Health Care | Scoop.it
The U.N. agency "does not currently possess the capacity or organizational culture to deliver a full emergency public health response", a panel of independent experts said in a report on the handling of the Ebola crisis. "This is a defining moment for the health of the global community," the report said. "(The) WHO must re-establish its pre-eminence as the guardian of global public health.
Brian Altonen's insight:
 

Hippocrates dicere (Hippocrates would say):


Vide et crede.

Vincit omnia veritas.

Et, vincit qui patitur.

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Dozens of new Ebola cases reported - Liberia is now Worried

Dozens of new Ebola cases reported  - Liberia is now Worried | Global Health Care | Scoop.it

See http://news.yahoo.com/shellshocked-liberians-brace-worst-ebola-returns-003030417.html

 

LAST YEAR's unpredicted outbreak, in case anyone forgot . . . . and the News:  "Officials say the trend of a decline in the number of Ebola cases has stalled, with dozens of new cases reported so far this month in West Africa."

Brian Altonen's insight:

It is not even a month later and the worry continues to grow.  


Keep close track of the Ebola and Chikungunya dates, as news of concerns for outbreaks continues to grow during the next 6 weeks.  


If this year is at all like last year, the MERS issue will fade away.  However, it is too early to tell if this problem in Korea might continue to escalate in the weeks ahead. 


Both time and temperature are on the side of pathogens and vectors in this case.  Time--because not enough has been spent trying to prepare for this season's outbreaks.  Temperature--because seasonal changes are typically in favor of nature as a whole, including these ecological causes for disease.  

 

 

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Brian Altonen's curator insight, June 12, 2015 8:32 AM

We spent a lot of time assuming occasional peaks, when in fact history has show that cycles in nature can reverberate, demonstrate harmonic rhythms in the same season, and may even spend a year or two building towards a crescendo.  

 

West Nile comes back, it doesn't decrease over time.  The same could be true now for Ebola, once it finds and maintains its ecological foothold.  

 

Ebola could very well demonstrate another spurt of growth this season, and along with this, demonstrate in more detail the next stage in vertebrate host-disease relationships.  Exactly how the kinds of hosts related to Ebola may cause it to find a secondary nidus, is what we may be able to learn more about this season.

 

Understanding a much truer spatio-temporal pattern for Ebola than the one we tried to convince ourselves with these past few decades, is an important outcome of this.  Should Ebola cases rise again like they did last season, they will provide us with more complete genetic findings, more detailed ecological relationships to study, a second opportunity to demonstrate these new pharmaceutical products work, and a second chance to negate our failures by not having adequate spatial surveillance staff, tools, and guidelines in place.

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Medical Pot Use Means Mom Faces Losing Son, 30 Years in Prison

Medical Pot Use Means Mom Faces Losing Son, 30 Years in Prison | Global Health Care | Scoop.it
A mom who says marijuana is the only thing that helps with her Crohn’s disease surrendered herself to Kansas authorities for arrest Monday, to face possession charges in a state where medical use of pot is illegal. Shona Banda, a cannabis advocate, made news in March when her 11-year-old son made comments about her medical pot use during an anti-drug presentation at school, leading to intervention from child services and a police search of her home that turned up over a pound of marijuana. Banda’s son was taken into state custody, where Banda’s attorney Sarah Swain says he remains now.
Brian Altonen's insight:

I see a very interesting dilemma arising in healthcare.  

 

There are two particular ways of thinking about disease that are either about to clash, or somehow develop this new hybrid of disease philosophies pertaining to mindbody related disease factors, or to use the older term psychosomatic disease, and the reasons people are either demonstrating a possible valid, positive response to the use of Cannabis for medicine.

 

In the case of epilepsy, there is no argument that cannabis works in some intractable cases.  The reason it works is not perfectly clear, but it works.  One possible reason for this may have to do with the mind-brain or thoughts and emotional processing the epileptic has to go through when trying to understand, accept and get past the mechanism and effect of a seizure on the consciousness, and the physique.

 

But there is a host of other diseases which for 50+ years have been associated with psychosomaticism in the traditional sense.  Crohn's disease is one of these.  MS may be another.  IBS still another.

 

If Cannabis works by effecting the mind and the way we think, if it works by helping us managing our distressed emotions, the limbic system you might say, then this means that a host of diseases are treatable with cannabis, if cannabis givens that person the right mindset.  In other words, like a bad LSD trip, versus the other (not that it is necessarily "good"), cannabis can hinder or help.

 

To those supporting the roles that cannabis may play in making the mindset better, healthier, and the patient in need of certain treatment, healthier than he or she was a stage or two before. . . the possible positive influence of cannabis on all of the psychosomatic diseases discussed from the 50s to 70s, this opens up a seemingly infinite number of doors for arguing the use of cannabis for treating many patients--those with "psychosomatically" induced ulcers, GERD, LBP, insomnia, tics, Tourette's, certain forms of epilepsy, etc., etc., etc.

 

To those arguing that cannabis must absolutely be used only by people with specific ailments, what type of proof are you going to need to demonstrate your claim that its demonstrated efficacy only fits for one set of symptoms, not the others.  Evidence-based medicine needs only evidence, not scientific proof based upon a specific set of theories.

 

This mother is using cannabis for Crohn's Disease, which in the past we relate causes to autoimmune aspects and history, family genetics, psychological behaviors, and some behavior and biological theories.    But emotions play an important role in how we manage this condition as well, along with mood and affect, and out overall happiness with life.  

 

To point the finger at just one thing said to cause disease would be terribly wrong--wrong because, if that is true, then we know now how to make the magical cure for it.  We don't know the magical cure--so for some, cannabis is a possible way to go, that for some to many works.

 

When diagnoses possibly have a mindbody, biofeedback and/or psychosomatic alternative to how to deal with the condition, for those people with whom such a process works, cannabis may be the way to go.  In the clinical setting, as a physician, I would therefore expect to see progress for patients using cannabis, were I to have to sign for that Rx.  There are some that cannabis doesn't fire up those "joy receptors" for.  For those people, I may not expect it to work; and if it did, there is the potential of other psychosomatic triggers being employed as well.

 

All of this stuff about mindbody, psychosomatics, etc. that I just mentioned, demonstrate what little we know about the cause for some conditions or diseases and the exact way to treat them.

 

Yet, we feel we can still take it on ourselves to say no to patients who want to use the "possible cure",.  Not our cure.  But their own.  Cannabis.  [This coming from a total non-user, very grateful mindbodyist, who believes 'you are what you believe you can be'.]

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This amazing Google Earth trick shows Russia lied about the passenger plane shot down in eastern Ukraine

This amazing Google Earth trick shows Russia lied about the passenger plane shot down in eastern Ukraine | Global Health Care | Scoop.it
The Russian Defense Ministry used misdated satellite imagery to obscure what really happened to MH17.
Brian Altonen's insight:
Since National defense PR can manipulate the imagery they show us, this also means we have to keep an open mind about the validity of internal public health images we may be provided with. I am not an conspiracist or even anti/conspiracist. But I am all into common sense and knowing whether or not I am being lied to.
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Pentagon admits live anthrax may have been shipped to Australian lab in 2008

Pentagon admits live anthrax may have been shipped to Australian lab in 2008 | Global Health Care | Scoop.it
Few details were revealed about the incident after army facility in Utah recently sent anthrax to 11 US states, as well as South Korean military base
Brian Altonen's insight:
I can hear the CDC saying ". . . but Australia is on our side, right?"
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US accidently sends live anthrax to S Korean army base

US accidently sends live anthrax to S Korean army base | Global Health Care | Scoop.it
Twenty-two personnel treated for possible exposure near Seoul, as bacteria also sent to laboratories in nine US states.
Brian Altonen's insight:
It's business as usual in the bioweapons business and biowarfare. Is it that they possibly meant to send dead anthrax instead? If so, why? What's the test they had in mind? There are not too any other terms to mix up the word 'anthrax' for on the inventory and orders list.
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From British Controversy, to growing International public health concern

From British Controversy, to growing International public health concern | Global Health Care | Scoop.it

LINK to VIDEO: Female Genital Mutilation (FGM) This is a real problem - happening right here in the UK (Third party video)

 

The figure depicts infibulation counts for up to 6 years worth of data for the U.S..  Each pair of population pyramids depicts one of the ICDs for this medical practice/process. The raw counts are the pink pyramids; the adjusted rates per 3- or 5-year age increment, rolling averages, are the brown pyramids.

 

Numbers (right side) define highest "risk" groups, with percentages of individuals <18 yo assumed to be U.S. cases, with higher percentage U.S. cases noted for youngest ages.  In other words, kids <5 yo are probably undergoing infibulation within a U.S. clinical setting, whereas 18 year olds may have undergone the process in their homeland, before removing to the U.S.  Also, a few infants may undergo this process in distant countries, esp. homeland, due to legal issues.

 

This practice is performed primarily by Muslim communities, and is illegal in many developed countries.

Brian Altonen's insight:

This is also happening in the U.S. in large numbers! In my study of this using the national EMR/EHR data focusing on ICDs, the results I obtained were quite discomforting. I found four age peaks for this repeating independently of each other for the past eight years; the first was children under 5, the second was older teenage to twenty year olds. 45 years old and 65 plus also show peaks. But the first two are of cases that probably happened in the U.S. No excuse, other than institutional blindness; turning to look in the other direction. Religious rights should never be allowed to trump the individual rights of children, in particular when immoral cultural parenting practices are involved. The resolution to this matter is plain and simple. We have a very indecisive, non-committal health care system right now. See my video on the U.S. Cases I uncovered at YouTube. http://m.youtube.com/watch?v=0A95jfeAScw

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Mapping elephantiasis in Ethiopia

Mapping elephantiasis in Ethiopia | Global Health Care | Scoop.it
Ethiopia now has a national plan for eliminating neglected tropical diseases, but success depends on disease mapping, monitoring, and making data accessible for policymakers
Brian Altonen's insight:

I have a couple of projects I posted the results for on mapping history for elephantiasis.  The figure provided ("Elephantiasis, IP") pertains to my study of the recent or modern history of importation of this disease into the United States.

 

By the mid-19th century, elephantiasis was considered a "latitudinal disease" by famous disease cartographers like Heinrich Berghaus (1847), Adolph Muhry (1856), Alexander Keith Johnston (1856),  William Aitken (1872), and Robert William Felkin (1889) (the links to the pages I developed on these scientists are below).  Its method and pattern of spread globally changed little over the next 75 years.

 

The history of mapping elephantiasis can be reviewed, starting with the links and maps below.

 

My spatial review of EMR claims noting Elephantiasis history, in video form, is at https://www.youtube.com/watch?v=Uc6zvqutU3g

 

FRIEDRICH SCHNURRER (1784-1833)

 

1827 ‘Charte Uber die geographische Ausbreitung der Krankheiten’ (1827) -- TRANSLATION & REVIEW IN PROCESS 

 

R. Brömer.  The first global map of the distribution of human diseases: Friedrich Schnurrer's 'Charte über die geographische Ausbreitung der Krankheiten' (1827).  Med Hist Suppl. 2000; (20): 176–185.  At http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2530995/?page=1

 

HEINRICH BERGHAUS (1797-1884) 

 

(1848 Map, translated, with review) -  

http://brianaltonenmph.com/gis/historical-disease-maps/heinrich-berghauss-physikalischer-atlas-1848/

 

ADOLPH MUHRY (1810-1888)

 

(1856 Map, partially translated, with discussion) - http://brianaltonenmph.com/gis/historical-disease-maps/adolph-muhrys-global-disease-map/ ;

 

ALEXANDER KEITH JOHNSTON (1844-1879)

 

(his 1856 world map) - http://brianaltonenmph.com/gis/historical-disease-maps/alexander-keith-johnstons-famous-map-a-detailed-review-1856/ ;

 

(the North America portion, reviewed in detail) - http://brianaltonenmph.com/gis/historical-disease-maps/alexander-keith-johnston-health-disease/ ;

 

(his philosophy and such) -  http://brianaltonenmph.com/gis/historical-medical-geography/1856-alexkeithjohnstonsmay5thpresentation/ ;


WILLIAM AITKEN (1825-1892)

 

(his 1872 map, compared with others) - http://brianaltonenmph.com/gis/historical-disease-maps/aitkenglobaldiseasenosogeography/

 

(more) - http://brianaltonenmph.com/gis/more-historical-disease-maps/1872-william-aitken-book/


ROBERT WILLIAM FELKINS (1853-1926)

 

(full 1889 map) -  http://brianaltonenmph.com/gis/historical-disease-maps/robert-william-felkin-1889-tropical-diseases/ ;

 

and (parts of his writings) -

http://brianaltonenmph.com/gis/more-historical-disease-maps/1889-robert-william-felkins-on-the-geographical-distribution-of-some-tropical-diseases/

 

(His work as a Google Book) -  https://books.google.com/books?id=0t1TAAAAQAAJ&pg=PA43 ;

 

 

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5 key findings from AP's story on WHO and the Ebola outbreak

5 key findings from AP's story on WHO and the Ebola outbreak | Global Health Care | Scoop.it
GENEVA (AP) — In the aftermath of the world's biggest outbreak of Ebola, the World Health Organization acknowledged it was too slow to act, blaming factors including a lack of real-time information and the unprecedented nature of the epidemic.
Brian Altonen's insight:

The Five Key Findings [Quote]:

 

1. WHO officials privately floated the idea of declaring an international health emergency in early June, more than a month before the agency maintains it got its first sign the outbreak merited one — in late July — and two months before the declaration was finally made on August 8, 2014.   

 

2. WHO blamed its slow response partly on a lack of real-time information and the surprising characteristics of the epidemic. In fact it had accurate field reports — including scientists asking for backup — and it identified the unprecedented features of the outbreak. The agency was also hobbled by a shortage of funds and a lack of clear leadership over its country and regional offices.    

 

3. Politics appear to have clouded WHO's willingness to declare an international emergency. Internal emails and documents suggest the U.N. health agency was afraid of provoking conflict with the Ebola-stricken countries and wary that a declaration could interfere with the economy and the Muslim pilgrimage to Mecca.    

 

4. An Ebola-infected WHO consultant in Sierra Leone violated WHO health protocols, creating a rift with Doctors Without Borders that was only resolved when WHO was thrown out of a shared hotel.   

 

5. Despite WHO's pledges to reform, many of the proposed changes are recycled suggestions from previous outbreaks that have never taken hold. Any meaningful reform to the organization would likely require countries to rewrite the constitution, a prospect many find unpalatable.

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At least 10 Americans being flown to U.S. after possible Ebola exposure

At least 10 Americans being flown to U.S. after possible Ebola exposure | Global Health Care | Scoop.it
(Reuters) - At least 10 Americans possibly exposed to the deadly Ebola virus were being flown to the United States from Sierra Leone for observation, the U.S. Centers for Disease Control and Prevention said on Saturday. They will be transported by non-commercial air transport and will be housed near the University of Nebraska Medical Center in Omaha, the National Institutes of Health in Maryland, or Emory University Hospital in Atlanta, the CDC said. All of the individuals who are being flown back to the United States are free of symptoms, the CDC said. It is not clear how the person became infected with Ebola, CDC said.
Brian Altonen's insight:

[Fro this article:]   

 

A CDC statement said the 10 individuals will follow the center's recommended monitoring and movement guidelines during the 21-day incubation period.  

 

If someone shows symptoms, they will be transported to an Ebola treatment center for evaluation and care, the CDC said.

On Friday, CDC sent a team to Sierra Leone to investigate how the healthcare worker became exposed, and determine who might have been in contact with the infected person.  

 

CDC spokesman Benjamin Haynes did not know where all of the patients would be sent, but he said the CDC is working out a plan with the U.S. State Department to determine who is coming back and where they will be sent.   

 

The CDC said one patient was being sent to Emory University Hospital's special isolation unit, where several Ebola patients have already been treated.  

 

Four others are being sent to Nebraska Medical Center to be near their special isolation unit in case they develop Ebola symptoms.  

 

(Reporting by Eric Beech in Washington and Julie Steenhuysen in Chicago; Editing by Marguerita Choy and Paul Simao)

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Amish country’s forgotten measles outbreak | Al Jazeera America

Amish country’s forgotten measles outbreak | Al Jazeera America | Global Health Care | Scoop.it
Knox County, Ohio, saw 377 cases last year after missionaries on a trip to the Philippines contracted the disease
Brian Altonen's insight:

Missions have always been a curse as well as a slight benefit to foreign cultures.  The major problem with missions is that they introduce new diseases to people.  STDs were popular amongst sailors who engaged in personal activities with natives in the New World--this is why Sassafras became so popular by 1600.  Measles and Small Pox made their way to the native American communes, turning the need for baptisms into a daily event.  

 

When we diverted the steer down in Mexico up into the United States via Texas, rancheros and cowboys contaminated the U.S. with tick-born "Cattle Fever", which took us 50 years to bring under control   Bovine Tuberculosis came in by ways of ships from the Netherlands into downtown Manhattan and perhaps New Jersey.

 

All of this introduction of disease to the New World reversed in the mid-1800s when we began to aggressively establish plans to convert the world to Christianity.  Mormon missions played an important role in setting up healthcare facilities during World War II.  The Amish were trying to influence Filipinos when their plan to teach and convert made it possible for missionaries to infect their own children once they returned from these religious duties.

 

Nature makes most of the decisions about where and when a disease will migrate from one part of he world to the next.  Next we have zealous human behavior and activities, serving as kindling for whatever fires are being formed in terms of public health.  

 

Man makes the decision, nature determines its fate.

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