News Article | January 6, 2016
A decades-long push to make Guinea-worm disease the first parasitic infection to be wiped out is close to victory. But a mysterious epidemic of the parasite in dogs threatens to foil the eradication effort. “If we’re going to be aggressive and achieve this, we have to eliminate the infection in dogs,” says David Molyneux, a parasitologist at Liverpool School of Tropical Medicine, UK. The Carter Center in Atlanta, Georgia, is leading the global campaign to eradicate Guinea worm. Next week, it will announce that case numbers for the excruciatingly painful infection are at a record low, with approximately 25 cases reported in 2015 in just 4 countries: Chad, Ethiopia, Mali and South Sudan. But infections in dogs are soaring in Chad, where officials will meet at the end of January to grapple with the canine epidemic. The central African nation recorded more than 450 cases of Guinea worm in domestic dogs last year — an all-time high (see ‘Canine comeback’). Researchers and officials strongly suspect that dogs are spreading the infection to humans; now the race is on to understand how this might happen, as well as how dogs acquire the infection in the first place. The World Health Organization is unlikely to declare Guinea worm eradicated until the parasite has stopped spreading in dogs, says Molyneux, who is part of the commission that will make that decision. In 1986, when the Carter Centre joined the Guinea-worm eradication campaign, there were an estimated 3.5 million infections annually, mostly due to poor sanitation and lack of access to clean water. When people drink unfiltered water, they can swallow microscopic freshwater crustaceans called copepods, which Guinea-worm larvae infect. The copepods die, releasing the larvae, which mature and mate in the human intestine. Male worms die after mating, but adult females — approximately 80 centimetres in length — survive and slowly migrate out of the gut. About a year after infection, they burrow through their host’s skin, usually around the legs and feet, sometimes taking weeks to fully escape. To cope with the searing pain, many people bathe in rivers and lakes, contaminating the water with the next generation of larvae. Although rarely fatal, Guinea worm can debilitate people for months and keep children out of school. There is no vaccine against the parasite and no effective treatment, so eradication efforts have focused on providing clean water and changing people’s behaviour, says Donald Hopkins, a special adviser at the Carter Center who is leading its Guinea-worm eradication efforts. People in areas in which the parasite was once rife have learnt to filter their water using cloths and to avoid re-contaminating water supplies. Even the most out-of-the-way villages now quickly contain cases and report them to health officials. Chad was on the cusp of being declared free of Guinea worm in the late 2000s: no case had been recorded in the previous decade. But starting in April 2010, increased surveillance turned up a handful of human infections, and around 60 cases have been recorded since then. The cases are unusually sporadic and isolated from one another, says Mark Eberhard, a parasitologist who consults on Guinea-worm eradication for the Carter Center. More typically, cases occur in clusters and recur in the same village year after year. “There was no increase or explosion of cases as one would expect,” he says. Shortly after these observations, officials began to hear rumours of Guinea-worm-infected dogs in Chad. Researchers have known for decades that dogs, leopards and other mammals occasionally acquire Guinea-worm-like infections, but they assumed that these cases stemmed from distinct species of Dracunculus, the nematode worm that causes the disease, or were rare examples of infections that had somehow spilt over from an outbreak in humans. But in Chad, researchers now think that dogs are spreading the worms to humans — not the other way around. Between January and October 2015, officials recorded 459 canine infections from 150 villages in the central African nation — an unprecedented volume. And genome sequencing has confirmed that dogs in Chad are infected by the same nematode worms (Dracunculus medinensis) that plague humans (M. L. Eberhard et al. Am. J. Trop. Med. Hyg. 90, 61–70; 2014). To better understand the situation, a team led by James Cotton and Caroline Durrant, genome scientists at the Wellcome Trust Sanger Institute in Hinxton, UK, is now sequencing the genomes of more Guinea worms collected from dogs and humans in Chad to confirm that dogs are indeed transmitting the disease to people. And Eberhard, who is convinced that this is the case, is trying to determine how dogs become infected in the first place. They are unlikely to contract the worms from drinking water, he says, because dogs tend to scare away copepods when they lap. Most of Chad’s cases have occurred among fishing communities along the Chari River, and Eberhard suspects that dogs are eating the entrails of gutted, copepod-eating fish. Dogs then pass the worms to humans by reintroducing the larvae into water. Researchers, including Eberhard, are testing aspects of this hypothesis in ferrets, a common animal model in disease research, but eradication officials in Chad are not waiting for the results before taking action. Since February 2015, they have offered the equivalent of US$20 to people who report Guinea-worm cases in dogs and tie up the animals to prevent them from contaminating water sources. They are also encouraging villagers to bury fish entrails to keep dogs from eating them. And a trial is ongoing to test whether a drug used to treat heartworm — a roundworm parasite common in dogs — has any effect on Guinea worm. Because of Guinea worm’s one-year incubation time, it should be clear before the end of 2016 whether these interventions have worked. Older residents from villages along the Chari River say that their fishing practices have not changed, according to Hopkins, and they cannot recall dogs becoming infected with Guinea worm in the past. But Molyneux says that the dearth of humans transmitting the disease could explain the parasite’s jump to dogs. “If you were Guinea worm and there were only 100 of you left in the world,” he says, “what would you do? You’d get the hell out of the host that’s being targeted and move to something else.”
News Article | February 4, 2016
The image of a serpent twisting around a staff is probably medicine’s most enduring icon; we wear it on medical alert bracelets, hang it in doctors’ surgeries, and print it on healthcare documents. But the story behind the so-called fiery serpent is, at least according to former US President Jimmy Carter, almost over. Since 1986, incidences of Guinea worm disease have reduced from 3.5 million to just 22. Read that again—just twenty-two. It’s a drop so enormous that medical experts believe Guinea worm disease is on the brink of becoming the second ever human disease to be completely eradicated through human endeavour, the first being smallpox in 1980. This week, The UK’s Department for International Development announced a £4.5 million partnership ($6.6 million) to support the Carter Center’s Guinea Worm Eradication Programme. Following the announcement, Carter took to the stage in the gloriously camp, gilt-edged Queen’s Robing Room at the House of Lords on Wednesday evening to speak about his 30 years spent battling the disease. For centuries, the only treatment for Guinea worm has been to wait for the parasite, which breeds unseen in stagnant water, to burrow out of human skin, then wrap it around a stick and slowly wind it out of the body like a blistering cotton reel over 20 days. This is one theory of where we get the snake around a staff symbol from—a worm and a stick. The process of extracting Guinea worm is not only as unpleasant as it sounds (the worms grow up to a metre long and can break out anywhere on the body, sometimes with as many as 81 emerging from a single person, according to one representative of the Carter Center) but the lesions can often lead to secondary bacterial infections. In short, getting Guinea worms out of your body is every David Kronenberg nightmare made flesh. The eradication of Guinea worm disease is, in his own words, former President Jimmy Carter’s “most satisfying achievement.” In 1988, just a few years after leaving the White House, Carter travelled to Ghana where he saw a woman holding what he thought was a baby in her arms. As he moved closer, he realised that what this woman was holding was in fact her right breast; a Guinea worm was emerging from her body through her nipple, creating a searing blister and untold tissue damage. As there is no known cure for Guinea worm disease, the focus had to instead be on prevention; educating what Carter described in his lecture last night as “the poorest of all people, but who are as intelligent, ambitious and as hard-working as we are.” The science behind the programme is so simple that it can be communicated in a cartoon. A special water filtration system—which looks like little more than a large fine-weave hair net fitted over a bucket—cleans water of the copepods or “water fleas” that carry the Guinea worm larvae. In Nigeria, which had 656,000 cases back in 1988 at the beginning of the programme and now has none, 6 million square metres of a special fibre were created to filter people’s drinking water without rotting in the damp, tropical conditions. In countries like South Sudan, where people frequently move around to access water, the Carter Center gives out special straws, worn around your neck like a pendant, to filter water as you drink it. Back in 1986, there was no YouTube, no television, and little radio to be found in the countries worst affected by Guinea worm disease. So the medical experts involved in the programme turned to cartoons—posters and picture books showing how Guinea worm disease is contracted and how to filter your drinking water. These pictures have now become so widespread that they can even be found printed on the cloth that people use to sew t-shirts, dresses and shirts—literally a walking advertisement for the public health programme. Children in South Sudan with special filtering straws. Image: The Carter Center/J. Albertson According to a 2015 CDC report, stopping the transmission of Dracunculiasis (Guinea worm disease) is a four-pronged attack: educating residents in communities where the disease is endemic to avoid immersing affected body parts in sources of drinking water; filtering potentially contaminated drinking water through a cloth filter or pipe filter; treating potentially contaminated surface water with the insecticide temephos to kill the copepods; and providing safe drinking water from bore-hole or protected hand-dug wells. It is vitally important that once an adult worm has been extracted from the body it does not re-enter the water, otherwise it can release hundreds of thousands of immature larvae back into the drinking supply, starting up the whole terrifying, debilitating cycle once more. So far, the campaign to eradicate the world from Guinea worm disease has cost £225 million. This, as President Carter pointed out to the assembled academics, journalists and medical professionals last night, is less that the price of a single C17 military transport aircraft; and America has already bought 119 of those. Preventative medicine is often the cheapest, most effective and most efficient way to eradicate disease. Funding has been provided by the Bill & Melinda Gates Foundation, the British Government, OPEC Fund for International Development, the President of the United Arab Emirates, the Children's Investment Fund Foundation and many, many more. “Guinea worm is a truly horrendous disease, causing unimaginable pain and suffering,” said UK International Development Minister Nick Hurd in yesterday’s announcement. “The fact that we are now so close to eradicating it is one of the great public health success stories of modern times.” Jimmy Carter tries to comfort a girl in Ghana as a Carter Center assistant dresses her wound. Image: The Carter Center/L. Gubb This may be true, but keeping communities clear of the disease is an ongoing process. Guinea worm larvae operate on a one-year breeding cycle. Stop people drinking infected water for a year and you can eradicate the disease completely—without a host, the larvae will die. So the £4.5 million worth of funding promised by the UK’s Department for International Development will pay for health volunteers, water filters and larvicide in the few remaining endemic villages in South Sudan, Ethiopia, Chad and Mali. It will also, vitally, “support surveillance campaigns in 6,000 villages across these four remaining endemic countries as well as education campaigns to ensure the disease doesn’t resurface.” Former President Jimmy Carter told the attendees at the House of Lords last night that it is his ambition to live longer than the last Guinea worm—something that seems possible if his treatment for cancer continues to work. Standing under painted murals titled “mercy,” “generosity,” “courtesy,” “religion,” and “hospitality,” the former-President said, simply, that failure to eradicate the disease would be one thing, but that the “biggest failure is not to try.” And so, at 91, he is still trying.
Eberhard M.L.,Centers for Disease Control and Prevention |
Ruiz-Tiben E.,Carter Center
American Journal of Tropical Medicine and Hygiene | Year: 2014
Two large, living worms were collected as they emerged from the lower limb of each of two persons in South Sudan. The worms were observed by staff of the South Sudan Guinea Worm Eradication Program during surveillance activities in communities at-risk for cases of Guinea worm disease (dracunculiasis). The worms measured 7 and 8 cm in length and were identified as fourth-stage larvae of Eustrongylides. This is the first report of such worms emerging from the skin; all five previous reports of human infection involved surgical removal of worms from the peritoneal cavity. Copyright © 2014 by The American Society of Tropical Medicine and Hygiene.
News Article | February 17, 2017
There’s no time to waste: the climate crisis threatens public health with more fatal heat waves, disease outbreaks, and massive food shortages. All these could result in premature deaths. This is the general warning from experts attending the Climate & Health Meeting at the Carter Center in Atlanta, which replaced the climate change conference previously set — and postponed in January — by the Centers for Disease Control and Prevention (CDC). Former vice-president Al Gore and other health and climate groups committed to hold the meeting to replace the long-planned CDC climate change summit, which was abruptly postponed ahead of Trump’s inauguration. Trump has earlier expressed doubts about an actual climate crisis, although he finds “some connectivity” between climate change and human action. The office of the incoming president, however, has not been reported to explicitly request the move. “The extreme weather events calculated by the insurance industry have obviously been increasing,” said Gore in a keynote speech during the meeting, as reported by CNN. He likened climate-related news on TV to “a nature hike through the Book of Revelation.” A staggering 97 percent of climate scientists agreed that climate change is actually happening, with human activity largely responsible for it. The World Health Organization (WHO) estimated that the phenomenon will cause around 250,000 extra deaths annually from 2030 to 2050, due to heat stress, spread of infectious disease, and malnutrition — numbers that some scientists even deemed an underestimate. The projected data could be “a drop in the bucket” when it comes to actual future impacts, warned professor and meeting participant Dr. Jonathan Patz. According to Gore, heat stress emerges as the factor behind most U.S. climate-related deaths, with mortality climbing at an average of 4 percent during heat waves. It outperformed tornadoes, floods, and lightning in weather-linked fatalities in the last three decades. 2016 was the hottest year on record since documentation began in the 1880s, the third year in a row to set a new record for average global temperatures. In 2003, nearly 17,000 in the United Kingdom and France, along with over 70,000 in Europe, died in a heat wave, while merciless back-to-back heat waves struck India and claimed at least 2,500 lives. Flooding remains another urgent concern, surfacing as the reason behind most weather-related deaths in 2015. Along with heat stress, humans can expect the spread of infectious conditions as a threat to health and life. High temperatures are key in the spread of those diseases. The climate crisis could promote human infection through the pathogen, host, or newer conditions for transmission, warned a study last year, which reviewed climate change and health research published from 1990 to 2015. Warmer temperatures, for instance, could be conducive to mosquitoes and therefore diseases they carry, including the Zika virus that recently posed a global health emergency. Crops also suffer from climate effects, with more extreme weather situations — from flooding to off-the-charts temperature records — preventing them from growing, reducing yields, and causing higher carbon dioxide levels to affect food. Zinc, iron, and other essential nutrients could be significantly reduced in crops due to higher CO2, warned Gore. Unlike the planned CDC summit, the recently held meeting is only a one-day affair and did not involve government circles. The federal agency said it might hold the event later this year. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | February 15, 2017
When a long-planned 2017 climate change summit, slated to be held at the U.S. Centers for Disease Control and Prevention, was abruptly canceled without explanation about a week before Pres. Donald Trump’s inauguration, it was not because of a specific directive from his administration. But individuals involved with the conference say political worries influenced the decision. The CDC had not responded to an e-mailed request for comment by the time of publication on Friday, and it was impossible to confirm any official reason for the altered plans. Some scheduled participants and a former CDC official, however, linked the agency’s move to concerns about attitudes within the Trump administration. Comments from Trump and some of his cabinet nominees about human-caused climate change (Trump has called it a hoax) had underscored their skepticism, and conference planners preemptively nixed the conference to prevent political backlash, says physician Georges Benjamin, executive director of the American Public Health Association and a scheduled opening speaker at the event. The decision “was informed by the political environment,” Benjamin says. “Obviously it was informed by the fact that there were a lot of mixed messages about support for climate change [science], and during the campaign there was a lot said on that,” he adds. “It was canceled because of political nervousness about the new administration's attitudes toward climate change work," says Howard Frumkin, former director of the CDC’s National Center for Environmental Health and currently an environmental health professor at the University of Washington's School of Public Health. In an e-mail to speakers, the CDC summit planners simply wrote, “Unfortunately, we are unable to hold the Summit in February 2017 as scheduled. We are currently exploring options so that the summit may take place later in the year. We will provide additional details in early 2017,” according to a copy of the e-mail seen by Scientific American. The conference is now back on—but not at the CDC. Former Vice Pres. Al Gore will instead host the event on February 16 at the nonprofit Carter Center in Atlanta. It remains unclear, however, whether any governmental scientists will attend or speak, Benjamin says. The new conference will be abridged to a one-day summit instead of the original three-day program, and will be sponsored by nongovernmental groups including the Harvard Global Health Institute and the Turner Foundation, along with Gore’s education and advocacy group, the Climate Reality Project. “I think it’s deeply problematic that the meeting was canceled in the first place,” says Ed Maibach, director of the Center for Climate Change Communication at George Mason University, who had also been scheduled to speak at the CDC conference. “I hope that our nation’s public health agencies—and by that I mean CDC, National Institutes of Health and the Environmental Protection Agency—will be allowed to participate in the replacement meeting, but I don’t know if that’s the case. I’m glad that there is an alternative to the original meeting, but I’m a little concerned that it will be perceived as a political event—not a public health and science event—based on the change in sponsorship.”
News Article | January 30, 2017
The U.S. Centers for Disease Control and Prevention (CDC) has abruptly canceled the climate change summit it has been planning for months. But no need to fret, as former vice president Al Gore has stepped in to host his own conference in Atlanta next month. Last Thursday, Gore announced holding the Climate & Health Meeting in the state on Feb. 16 along with Howard Frumkin, former National Center for Environmental Health director, as well as health and climate groups such as the American Public Health Association, Harvard Global Health Institute, The Climate Reality Project, and the University of Washington Center for Health and the Global Environment. “[Al] called me and we talked about it and we said, ‘There’s still a void and still a need,’” recalled APHA’s executive director Georges Benjamin in a Washington Post report. “We said, Let’s make this thing happen.” The news came days after the CDC canceled its summit in the lead-up to the recent change in administrations in the White House. The decision was not explained in emails given to participants as well as invited speakers, the agency saying, when sought for comment, that the event might be held later this year. In a statement announcing the meeting, Gore said the conference will go forward anyway. “Today we face a challenging political climate, but climate shouldn’t be a political issue,” Gore asserted, citing the urgent need for health professionals for “the very best science” to protect the public. He also mentioned current warming and how it worsens the spread of public health threats such as the Zika virus. The one-day Feb. 16 meeting will not involve government circles, and will be conducted at the nonprofit Carter Center rather than at CDC. Organizers are eyeing as many as 200 participants from around the United States. It also remains unclear whether previously involved CDC employees will attend. Studies continue to warn the major public health risks of climate change around the world, with experts implicating warming in millions of deaths from heat, disease outbreak, longer allergy seasons, and more extreme weather events. Research published in the journal Lancet in 2016 argued that failing to address climate change could “undermine the last half century of gains” made in global health and development. But Frumkin is no longer surprised by how political climate change could get. He pointed out the external political pressure faced by the CDC, and sometimes its self-censorship and decision to shy away from specific issues. “Climate change has been that issue historically,” the expert told E&E News. The Huffington Post cited federal agency sources saying that the Trump administration’s efforts to limit access to climate change information from government have already begun. EPA sources, for instance, said they have been told to stop disseminating press releases and social media announcements, with the possibility of their climate change webpage coming down. The new summit vows to “preserve the focus of the CDC conference” and offer a platform for professionals and the community to discuss and provide solutions to climate change-related health problems. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | February 22, 2017
Two drugs used to treat asthma and allergies may offer a way to prevent a form of pneumonia that can kill up to 40 percent of people who contract it, researchers at the University of Virginia School of Medicine have found. Influenza pneumonia results when a flu infection spreads to alveolar air sacs deep within the lungs. Normally, a flu infection does not progress that far into the lower respiratory tract, but when it does, the results can be deadly. "If infection is severe enough, and the immune response is potent enough, you get injury to these cells and are no longer able to get sufficient oxygen exchange," explained UVA researcher Thomas J. Braciale, MD, PhD. "As a result of the infection of the cells, you can develop lethal pneumonia and die." But early administration of the two asthma drugs, Accolate and Singulair, could prevent the infection of the alveolar cells deep in the lower respiratory tract, Braciale's research suggests. "The excitement of this is the possibility of someone coming to see the physician with influenza that looks a little more severe than usual and treating them with the drugs Singulair or Accolate and preventing them from getting severe pneumonia," he said. "The fatality rate from influenza pneumonia can be pretty high, even with all modern techniques to support these patients. Up to 40 percent. So it's a very serious problem when it occurs." Unlike bacterial pneumonia, influenza pneumonia is caused by a virus. That makes it very difficult to treat - and makes the possibility of prevention all the more tantalizing. "When we look at pandemic strains of influenza that have high mortality rates, one of the best adaptations of those pandemic viruses is their ability to infect these alveolar epithelial cells," explained researcher Amber Cardani, PhD. "It's one of the hallmarks for certain strains that cause the lethality in these pandemics." Once influenza spreads deep into the lungs, the body's own immune response can prove harmful, resulting in severe damage to the alveolar air sacs. "It's an important observation the field is coming to," Cardani said. "We really need to limit the infection of these lower respiratory airways." The researchers determined that the alveolar epithelial cells are typically protected from influenza infection by immune cells called alveolar macrophages. In some instances, however, the flu virus can prevent the macrophages from carrying out their protective function, allowing the epithelial cells to become vulnerable to infection. "It's not as though they lack alveolar macrophages, it's just that their alveolar macrophages don't work right when they get exposed to the flu," Braciale said. "And those are the types of patients, who potentially would eventually go to the intensive care unit, that we think could be treated early in infection with Accolate or Singulair to prevent infection of these epithelial cells and prevent lethal infection." For their next steps, the researchers are consulting with colleagues to determine if patients being treated with Accolate and Singulair are less likely to develop influenza pneumonia during flu outbreaks. "This was a totally unexpected observation," Braciale said. "When I told multiple colleagues who are infectious disease or pulmonary physicians, they were absolutely flabbergasted." The findings have been published by the scientific journal PLOS Pathogens. It was written by Cardani, Adam Boulton, Taeg S. Kim and Braciale. Braciale and Cardani are both part of UVA's Department of Microbiology, Immunology and Cancer Biology and UVA's Beirne B. Carter Center for Immunology Research. Braciale's primary appointment is with the Department of Pathology. The work was supported by the National Institutes of Health, grant R01AI015608-35, and the NIH's National Institute of General Medical Sciences, grants T32 GM007055 and T32 GM007055.
News Article | December 4, 2016
Im Oktober war Michael Sitowitz, der Leiter des Rechnungswesens des Parrish Medical Centers, mit dem früheren Präsidenten und der First Lady auf einem Angelausflug in den North Georgia Mountains. Begleitet wurden sie von vier weiteren Persönlichkeiten, die sich national und international um die Foundation und deren Ausbau verdient gemacht haben: Dr. Yisrael Safeek von der SafeCare Group; Dr. Robert Kamei und Dr. Michelle Thai, den Co-Vorsitzenden des Regionalnetzwerkes der Foundation in Asien und Dr. Javier Davila, Vorsitzender des Regionalnetzwerkes in Mexiko. Das Parrish Medical Center wird seine Selbstverpflichtung auf dem 5. Weltjahresgipfel für Patientensicherheit, Wissenschaft und Technologie bekannt geben, der vom 3. bis 4. Februar 2017 im Laguna Cliffs Marriott Resort and Spa im kalifornischen Dana Point stattfindet. „Beim Parrish Medical Center als verantwortungsbewusstem medizinischen Dienstleister an der Ostküste Floridas stehen Patientenversorgung und Sicherheit seit jeher an erster Stelle“, sagte Edwin Loftin, Vice President Akutversorgung/Pflegedirektor beim Parrish Medical Center. „Teil einer solch lebenswichtigen Bewegung zu sein, betrachten wir als Ehre. Die APSS machen es medizinischen Fachkräften in sämtlichen Umfeldern leicht, evidenzbasierte, kostensparende Abläufe einzuhalten, durch die tausenden Familien der tragische, aber vermeidbare Verlust eines Angehörigen erspart werden kann.“ „Dass Parrish eine Selbstverpflichtung für jede unserer APSS aufstellt, ist beeindruckend. Sie sind das herausragende Beispiel einer Organisation, bei der Patientensicherheit an erster Stelle steht“, sagte der Gründer der Patient Safety Movement Foundation Joe Kiani. „Wir sind stolz darauf, dass 1624 Krankenhäuser eine formelle Selbstverpflichtung eingegangen sind, um die Zahl vermeidbarer Todesfälle bis zum Jahr 2020 auf null zu reduzieren. Ich fordere in diesem Sinne alle Krankenhäuser auf, im kommenden Jahr alle zwölf APSS zu übernehmen. Dies ist unbedingt nötig, wenn wir unserer Ziel von null vermeidbaren Todesfällen bis zum Jahr 2020 erreichen wollen. Im Gegensatz zu den über 200.000 Familien, die im vergangenen Jahr einen Angehörigen aufgrund eines Behandlungsfehlers verloren haben, stehen dieses Selbstverpflichtungen dafür, dass Familien Müttern, Vätern, Kindern oder sonstige Angehörige das am Leben bleiben ermöglichen.“ „Wir sind sehr dankbar, dass der frühere Präsident Jimmy Carter und die First Lady uns wieder diese einmalige Möglichkeit zur Feier die Gewinner und die Leben, die sie bewahren werden, gegeben haben“, fuhr Joe Kiani fort. „Durch ihre Führung hat das Carter Center dazu beigetragen, die Lebensqualität von Menschen in über 80 Ländern zu verbessern. Als sie begannen, waren pro Jahr geschätzt 3.5 Millionen Menschen in 21 Ländern Afrikas und Asiens von der Guinea-Wurm-Erkrankung betroffen. Heute ist diese Zahl auf 22 Fälle zurückgegangen. Wir hatten einige Gespräche geführt, wie wir unsere Bemühungen, die Zahl der vermeidbaren Todesfälle von 3 Millionen in den entwickelten Ländern und der 17.000.000 vermeidbaren Todesfälle in den Entwicklungsländern zu reduzieren, vorantreiben können.“ Über 200.000 Menschen sterben jedes Jahr in Krankenhäusern in den USA an Ursachen, die vermeidbar gewesen wären. Die Patient Safety Movement Foundation wurde mit Unterstützung der Masimo Foundation for Ethics, Innovation and Competition in Healthcare gegründet, um die Anzahl von vermeidbaren Todesfällen bis 2020 auf 0 zu reduzieren (0X2020). Eine Verbesserung der Patientensicherheit erfordert gemeinschaftliche Bemühungen aller Interessenvertreter, unter anderem von Patienten, Gesundheitsdienstleistern, medizintechnischen Unternehmen, Regierungsbehörden, Arbeitgebern und privaten Kostenträgern. Die Patient Safety Movement Foundation arbeitet mit allen Interessenvertretern (Stakeholdern) zusammen, um Probleme und Lösungen in Bezug auf Patientensicherheit anzusprechen. Die Stiftung kommt auch bei Konferenzen zu Patientensicherheit, Wissenschaft und Technologie zusammen. Die erste Jahreskonferenz fand im Januar 2013 statt. Die besten Köpfe des Landes trafen sich zu anregenden Gesprächen und für neue Ideen zur Herausforderung des Status quo. Die Stiftung arbeitet darauf hin, bis 2020 null vermeidbare Todesfälle zu erreichen, indem sie spezifische hochwirksame Rezepturen zur Bewältigung der Herausforderungen der Patientensicherheit präsentiert. Darüber hinaus fordert sie Medizintechnologieunternehmen dazu auf, Daten darüber auszutauschen, für wen ihre Produkte gekauft werden und bittet Krankenhäuser, sich für die Implementierung durchsetzbarer Patientensicherheitslösungen einzusetzen. Besuchen Sie www.patientsafetymovement.org.
News Article | December 5, 2015
When Venezuelans go to the polls this Sunday to elect all 167 members of the National Assembly, they will be deciding whether to continue the 17-year legislative majority of President Nicolas Maduro's socialist party. Partido Socialista Unido de Venezuela, or PSUV (United Socialist Party of Venezuela), created by the late president Hugo Chavez in 2006 to absorb various similarly-minded parties under one umbrella, has been accused of intimidating its opponents and exploiting government propaganda. President Maduro has declared the government will do "whatever it takes" to win this election. Enter augmented reality. Hack De Patria (HDP), a project developed by a Venezuelan experimental activist group and Berlin-based media artists Refrakt, attempts to reveal the "truth" in the campaign ads for Maduro’s Chavismo government and its allies. Point the phone's camera at a particular campaign logo, and the app reveals more sinister meanings: one logo suddenly reads "Obey" and another "Fraud." The idea is to provoke citizens to think more about the political imagery that surrounds them, said Gina Monc, a founder of Dismantling the Simulation, the group behind the app. “We are trying to bring attention to something that is probably more obvious to you—or anyone not being affected by the government hegemonic model—something that's even been taken for granted,” she said. “And it is the fact that there are more ways to see things—that you are being indoctrinated, and resistance is not only possible, it is your right.” During this election cycle, PSUV has been accused of intimidating opponents, including through violence. Opposition politician Luis Diaz was killed in a drive-by shooting at a November 5th election rally. Meanwhile, the National Election Board—which PSUV essentially controls—have allowed one opposition group, MIN Unity, to remain on the ballot even though its party logo and slogan are nearly identical to the opposition coalition, Democratic Unity (also known as MUD Unity). Critics have also accused Venezuelan president Maduro and PSUV of trying to confuse voters at the ballot box: MIN Unity’s candidate, a 28-year old parking attendant with no political experience, shares the same name as Democratic Unity’s candidate, Ismael Garcia. Election-monitoring organizations like the Organization of American States and the Carter Center have been barred from observing Sunday's vote, and the OAS has expressed concerns that the playing field between the opposition and the government has been unequal during the campaign. Still, if the elections proceed without interference, there are strong indications that mounting frustration with the Maduro government could lead to victory for the opposition parties. The app's first intervention centers on the image of Hugo Chavez’s eyes, a symbol used by the Maduro government after his death in 2013. The image can be found across the country on giant billboards, the facade of public building facades, graffiti murals, t-shirts, hats, jewelry and even school books. When a mobile device equipped with HDP is pointed at any surface with the logo featuring Chavez’s eyes, the word “Obedéceme,” or "Obey," appears on the screen. The second augmented reality intervention uses the controversial MIN Unity party logo. The party’s slogan is, “We are the opposition.” But, again, the party is suspected of being Chavistas (its most recognizable candidate is William Ojeda, a Socialist Party legislator). When a device running HDP is pointed at the MIN Unity logo, the word “Unidad” is changed to “Fraude,” or “fraud.” “The pieces work in many different ways, from interaction in space and morphing images, to editing the original image itself,” Dismantling the Simulation’s Helena Acosta told Motherboard. Hack de Patria—named after the paternalistic approach of Chavez propaganda—was built on top of the augmented reality app Refrakt, created by the artists Carla Streckwall and Alexander Govoni. The idea grew out of a chance meeting between Acosta, Streckwall and Govoni at the B3 Biennale of Moving Image held in Frankfurt. Acosta was giving a talk on art and activism, which led the three artists to talk about “hacking” political propaganda in Venezuela along with Dismantling the Simulation’s other founding members Monc, Violette Bule, and Miyö Van Stenis. (Refrakt debuted in a “guerilla exhibition” titled “Objects in Mirror Are Closer Than They Appear,” currently on display at Berlin’s Gemäldegalerie.) Five Economies That Could Use Bitcoin Acosta cited groups Voina and Pussy Riot, the Facebook group We Are All Khalid Said, and Paul Virilio as influences on projects like HDP. They are also interested in embracing the internet itself for their visual art activism. Dismantling the Simulation came into being as a Facebook group days after an array of human rights violations occurred at the student protests against Maduro in February of 2014. Acosta, Bule, Monc and Van Stenis “appropriated” the social media platform and attempted to deconstruct the overwhelming reality in the country by “assuming a critical posture towards institutionalized media content,” modeling its non-hierarchical structure after the rhizome. Not surprisingly, in creating HDP the groups were also influenced by the subliminal message-destroying glasses worn in John Carpenter's 1988 science-fiction satire They Live. The glasses allowed John Nada, the main character, to see the truth behind seemingly innocuous advertising, revealing an alien conspiracy to control the masses through capitalism. “John Nada and his adventures discovering the messages behind commercial propaganda on the streets were definitely an inspiration in finding a way to communicate the message in a simple but strong way,” Acosta said. “At some point, after more than a decade of living in this politically policed environment in Venezuela, you end up wishing there was such a device that could ‘clean’ the totality of our political reality.” “Unfortunately, we can’t," she added, "but we hope that more people gain awareness of our predicament.” On television, opposition candidates for the National Assembly are rarely mentioned—unless they are being denounced—while the regime’s candidates are widely lauded, according to a recent study by Javier Corrales and Franz Von Bergen. The few media companies that are still independent are severely constricted in terms of what they can broadcast or publish. One revealing indicator, writes Moses Naim at The Atlantic, "is the fact that there has been no mention on national television of the arrest in Haiti of two of the first lady’s nephews, who are accused of trafficking 800 kilos of cocaine and are currently being processed in a Manhattan court. (High-ranking Venezuelan officials have increasingly been seeking asylum in the United States and making serious allegations about the criminal behavior of their former bosses and colleagues in government.)" How Tomorrow's Battles Will Be Fought in Augmented Reality Acosta said that even after the election the group intends to keep distributing the app via their social networks. “This is something that is still legal since the National Electoral Council (CNE) doesn't regulate the internet—yet,” Monc said. “The Chavez's portion of the the app has a more atemporal character, since we know that the government will keep pushing its agenda even after the elections. In fact, Maduro has promised to radicalize the revolution ‘by any means’ independently of losing or winning the elections.” As HDP proves, the use of augmented reality for political and electoral ends is still in its infancy, but has some interesting potential to convey messages and influence voters. Apart from HDP, augmented reality has been used in Lee Leffingwell’s campaign for mayor of Austin and in Pilnu Bildi, or “The Whole Picture,” an app developed by Latvian magazine ir and startup Overly, which allows anyone to hack political ads with more information on politicians. The iOS app, ir said, reached the third spot on Latvian App Store charts. The simplicity of HDP, Acosta hoped, will eventually extend far outside the borders of Venezuela, to allow artists to respond to political advertising globally. For this to happen, activists and political operators will have to make the augmented reality experience easy to use, even for non-tech savvy folks—and not dorky. Let the political augmented reality games begin.
Downes E.,Emory University |
Downes E.,Carter Center
Nursing Outlook | Year: 2015
To effectively address the Ebola outbreak in West Africa, it must be viewed in terms of the connections between health, politics, security, the environment, and poverty. For the people in the countries involved and those responding, it is more than the viral illness. Although the medical management of the disease is far from simple, it is really only the proximal event of much greater social upheaval in the region, creating what is known as a complex humanitarian emergency (CHE). This article describes a course to introduce nursing students to CHEs and the role of nurses in the field of global response. CHEs are becoming more frequent with high death and disease rates. Nurses must become familiar with their complexity and multifaceted response. Although the planning for the course predated the current epidemic, the Ebola outbreak in West Africa served as an excellent exemplar for the health sector response in CHEs. © 2015 Elsevier Inc.