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A peer-support program launched six years ago at Johns Hopkins Medicine to help doctors and nurses recover after traumatic patient-care events such as a patient's death probably saves the institution close to $2 million annually, according to a recent cost-benefit analysis. The findings, published online in the Journal of Patient Safety, could provide impetus for other medical centers to offer similar programs -- whose benefits go far beyond the financial, the Johns Hopkins Bloomberg School of Public Health researchers say. Clinicians who aren't able to cope with the stress or don't feel supported following these events, often suffer a decrease in their work productivity, take time off or quit their jobs, they say. "We often refer to medical providers who are part of these stressful events as 'second victims,'" says study leader William V. Padula, PhD, an assistant professor in the Department of Health Policy and Management at the Bloomberg School, using a term coined by Johns Hopkins professor Albert Wu, MD. "Although providers often aren't considered to be personally affected, the impact of these events can last through their entire career." In 2011, Johns Hopkins Medicine started the Resilience In Stressful Events (RISE) program. The program relies on a multidisciplinary network of peer counselors -- nurses, physicians, social workers, chaplains and other professionals -- who arrive or call a fellow clinician in need within 30 minutes after they request help following an emotionally difficult care-related event, such as a patient in extreme pain, dealing with an overwhelmed family, or a patient being harmed through a medical error. At large, academic medical centers such as Johns Hopkins, with a complicated and often very sick patient population, such events happen on a daily basis, Padula says. Although Padula says that he and others involved in the RISE program believe in its importance regardless of cost, the program does require Johns Hopkins to redirect some resources. For example, he says, although the peer counselors all volunteer their time, that's time taken away from other billable work, such as patient care. For Johns Hopkins to continue to invest in the program, he explains, showing a financial benefit is key. To explore whether such a benefit exists, Padula and his colleagues developed a model focused just on the nursing population to investigate the likely financial outcomes of a year with or without the RISE program in place. The model used data from a survey delivered to nurses familiar with the RISE program on their probability of quitting or taking a day off after a stressful event with or without the program in place. It also used Johns Hopkins human resources data as well as the average cost of replacing a lost nursing employee available in published literature, among other data. After inputting this information into the model, the researchers found that the annual cost of the RISE program per nurse was about $656. However, they found that the expected annual cost of not having the program in place was $23,232. Thus, the RISE program results in a net cost savings of $22,576 per nurse. Expanding that out to all users of the system -- including doctors, who have a much higher cost per billable hour and dramatically higher replacement costs -- the total savings to the entire institution in one year was expected to be about $1.81 million. The savings alone is an attractive reason to implement a program like RISE at other large, academic medical centers, Padula says. However, he says, helping clinicians get through a stressful event is the right thing to do, regardless of cost. "It's hard to put a true price on the emotional support and coping mechanisms this program provides for clinicians after tragic events," he says. Other Johns Hopkins researchers who participated in this study include Dane Moran, MPH; Albert W. Wu, MD; Cheryl Connors, MS; Meera R. Chappidi, MPH; Sushama K. Sreedhara, MBB; and Jessica J. Selter, MD. Funding for this study was provided by the Josie King Foundation and the Maryland Patient Safety Center.


News Article | May 15, 2017
Site: www.eurekalert.org

Discarded food contains a significant amount of nutrients that could be used to help many Americans meet daily requirements, according to a new study in the Journal of the Academy of Nutrition and Dietetics Philadelphia, PA, May 15, 2017 -- The extent of food waste in America is a cause for serious concern. It is estimated that around 1,217 calories per person per day are squandered. A new study in the Journal of the Academy of Nutrition and Dietetics looks beyond the caloric value of food waste and focuses on the nutritional value of the food we throw away. Investigators found that discarded food contains large amounts of key nutrients like vitamin D, fiber, and potassium that could help people get the food they need to meet their daily recommended intake. In 2014, 14% of American households suffered from food insecurity and an additional 5% experienced a shortage of resources that forced them to skip meals or reduce their food consumption. Across the population, Americans are not getting the recommended intakes of certain nutrients including dietary fiber; calcium; potassium; and vitamins A, C, D, and E. At the same time, Americans continue to waste food at an alarming rate throughout the food supply chain. It's estimated that 31-40% of the post-harvest food supply is discarded. This study was the first to demonstrate the substantial amount of nutrients, including many under-consumed nutrients, wasted due to food discarded at the retail and consumer levels of the U.S. food supply. Quantifying the loss can motivate related investments and support the case for registered dietitian nutritionist engagement with these efforts. The estimates can additionally serve as a baseline for tracking intervention impacts. Data from the National Nutrient Database for Standard Reference were used to calculate the nutritional value of retail and consumer level waste of 213 commodities in the USDA Loss-Adjusted Food Availability data series for 27 nutrients in 2012. The study, led by Roni A. Neff, PhD, Program Director at the Johns Hopkins University Center for a Livable Future (CLF), and Assistant Professor, Department of Environmental Health & Engineering, and Marie L. Spiker, MSPH, RD, CLF-Lerner Fellow and Doctoral Candidate, Department of International Health, Johns Hopkins Bloomberg School of Public Health, found that losses of under-consumed nutrients were significant. Food wasted at the retail and consumer levels of the U.S. food supply in 2012 contained 1,217 kcal, 33 g protein, 5.9 g dietary fiber, 1.7 mcg vitamin D, 286 mg calcium, and 880 mg potassium per capita per day. Using dietary fiber as an example, 5.9 g dietary fiber is 23% of the RDA for women. This is equivalent to the fiber RDA for 74 million adult women. Adult women in 2012 under-consumed dietary fiber by 8.9 g per day, and the amount of wasted fiber is equivalent to this gap for 206.6 million adult women. Data points like this highlight the need for diverse interventions including standardized date labeling (use by, sell by) and consumer education, so that people can utilize the nutrients instead of throwing them in the trash can. According to the authors, perishable foods such as fruits and vegetables are lost at particularly high rates, leading to exceptional losses of under-consumed nutrients. Changes to our food system can reduce agricultural and pre-consumer waste, and play an important role in shaping the amount of food consumers discard. Cultural shifts are also needed to change consumer and industry attitudes. Even if only the top seven most cost-effective food recovery activities were scaled up and only an additional 1.75% of food waste was recovered, this would translate into 2,000 calories per day for 3.3 million adults. "Although only a portion of discarded food can realistically be made available for human consumption, efforts to redistribute surplus foods where appropriate and prevent food waste in the first place could increase the availability of nutrients for Americans, while saving money and natural resources," concluded the authors. "The U.S. has established a target of halving food loss and waste by 2030. This research supports the case for action and for registered dietitian nutritionists to bring their expertise to the effort."


News Article | May 9, 2017
Site: www.eurekalert.org

Persecution by the Islamic State of Iraq and Syria (ISIS) against the Yazidi population of Sinjar, Iraq has been the focus of attention recently following the United Nations' recognition of these ongoing actions as genocide. The extent of the killings and kidnappings as well as the demographics of those targeted has until now remained unclear. In a new study published in PLOS Medicine, Valeria Cetorelli of the Johns Hopkins Bloomberg School of Public Health, USA, and the London School of Economics and Political Science Middle East Centre, UK and colleagues report findings from their retrospective household survey of displaced survivors in the Kurdistan Region of Iraq, providing documented insight into the extent of the attack and in particular the disproportionate burden of killings and kidnappings of children. The researchers present a compelling and disturbing account of the events that occurred over a few days in the area of Mount Sinjar in August 2014. Their survey, conducted in November and December, 2015, covered a random sample of 1,300 displaced households sheltered in camps in the Kurdistan Region of Iraq. Information about reported killings and kidnappings of household members was recorded. Using these data, the authors estimate that 9,900 Yazidis were either killed or kidnapped (95% confidence interval (CI): 7,000 - 13,900), amounting to 2.5% of the entire Yazidi population of Sinjar. Of these, an estimated 3,100 (CI: 2,100 - 4,400) were killed, with nearly half of them executed by gunshot, beheading or being burned alive, while the rest died from lack of water and food or injuries during the ISIS siege on Mount Sinjar. The authors estimated that 6,800 (CI: 4,200 - 10,800) were kidnapped, with over one third still missing at the time of the survey. In one of the most distressing aspects of the study, which distinguished between children and adults as well as males and females, the authors reveal that children were disproportionately affected: children accounted for nearly all those who died on Mount Sinjar during the ISIS siege and children were also much less likely to escape captivity following kidnapping compared to adults. Reports from escapees documented torture, sex slavery and forced religious conversion once kidnapped. The authors suggest that their analysis may have underestimated the actual toll of killings and kidnappings because of the unknown number of families who were captured in their entirety with no one surviving to report. Limitations of the study include inference from a surveyed sample of displaced households to the whole Yazidi population of Sinjar, and uncertainty of that population's exact size at the time of the attacks. This study provides systematically obtained evidence of the extent of violence against the Yazidis, most of whom remain displaced in the Kurdistan Region of Iraq. Such evidence is important to keep attention focused on the rescue, assistance and protection of this minority population. The authors note: "Combined with other existing evidence, these estimates can support a formal genocide investigation by an appointed judicial authority." This study was funded by the Emirates Foundation for Philanthropy through the LSE Middle East Centre. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that no competing interests exist. Cetorelli V, Sasson I, Shabila N, Burnham G (2017) Mortality and kidnapping estimates for the Yazidi population in the area of Mount Sinjar, Iraq, in August 2014: A retrospective household survey. PLoS Med 14(5): e1002297. https:/ Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:


News Article | May 15, 2017
Site: www.eurekalert.org

Researchers at the Johns Hopkins Bloomberg School of Public Health's Center for a Livable Future calculated the nutritional value of food wasted in the U.S. at the retail and consumer levels, shining a light on just how much protein, fiber and other important nutrients end up in the landfill in a single year. These lost nutrients are important for healthy diets, and some -- including, dietary fiber, calcium, potassium and vitamin D -- are currently consumed below recommended levels. Nutrient-dense foods like fruits, vegetables, seafood and dairy products are wasted at disproportionately high rates. Previous research estimated that as much as 40 percent of food is wasted nationally, but it wasn't clear before this study how nutritious that food was. While not all wasted food is consumable, a sizeable amount is, leaving researchers and policymakers looking for ways to minimize the amount of good food that gets tossed as millions of Americans go hungry, do not get enough nutrients or do not have access to healthy food options. The U.S. Department of Agriculture (USDA) and Environmental Protection Agency have set a goal of reducing food waste by 50 percent by 2030. The findings will appear online May 15 in the Journal of the Academy of Nutrition and Dietetics. "Huge quantities of nutritious foods end up in landfills instead of meeting Americans' dietary needs," says study lead author Marie Spiker, MSPH, RD, a CLF-Lerner Fellow at the Johns Hopkins Center for a Livable Future and a doctoral candidate in the Bloomberg School's Department of International Health. "Our findings illustrate how food waste exists alongside inadequate intake of many nutrients." For their study, the researchers calculated the nutritional value of the retail- and consumer-level food waste of 213 commodities in 2012, using data from the USDA's Loss-Adjusted Food Availability data series. The research team, looking at 27 nutrients in all, found that food wasted in the U.S. food supply that year contained 1,217 calories, 33 grams of protein, 5.9 grams of dietary fiber, 1.7 micrograms of vitamin D, 286 milligrams calcium and 880 milligrams potassium per person, per day. Nutrient loss estimates provided by this study could contribute to a baseline for measuring future progress, the authors say. The study also highlights how the amount of nutrients lost to waste compares to nutritional deficits in the typical American diet. For example, dietary fiber is important for maintaining digestive health and is found in grains, vegetables and fruits. Researchers estimate that, in 2012, food wasted each day contained upwards of 1.8 billion grams of dietary fiber, which is comparable to the full recommended intake for dietary fiber for 73.6 million adult women. American women under-consumed dietary fiber by 8.9 grams per day in 2012. The study found that the daily amount of wasted dietary fiber is equivalent to the amount needed to fill this nutritional gap for as many as 206.6 million adult women. Many factors contribute to food waste at both the retail and consumer levels, including the disposal of food due to aesthetic standards, large portion sizes, and management of perishables in fridges and pantries. There is currently great energy around efforts to address waste of food. Preventing waste at the source is considered to be the optimal approach. Strengthening food recovery efforts that bring surplus food to food banks and pantries is also an important area of effort, innovation and impact. "This study offers us new ways of appreciating the value of wasted food. While not all food that is wasted could or should be recovered, it reminds us that we are dumping a great deal of high quality, nutritious food that people could be enjoying," says Roni Neff, PhD, an assistant professor in the Bloomberg School's Department of Environmental Health and Engineering who oversaw the study and directs the CLF's Food System Sustainability & Public Health Program. "We should keep in mind that while food recovery efforts are valuable, food recovery doesn't get to the heart of either the food insecurity problem or the waste problem. We need strategies addressing these challenges at multiple levels." "Wasted Food, Wasted Nutrients: Nutrient loss from wasted food in the US and comparison to gaps in dietary intake" was written by Marie L. Spiker, Hazel A. B. Hiza, Sameer M. Siddiqi and Roni A. Neff. This research was funded by the GRACE Communications Foundation. M. L. Spiker and S. M. Siddiqi were also supported by the CLF-Lerner Fellowship.


News Article | May 15, 2017
Site: www.eurekalert.org

A new study describes an ambitious but feasible path toward what may have seemed unachievable just a decade ago: an end to the AIDS epidemic in the U.S. Using prevention surveillance data to model rates of HIV incidence, prevalence and mortality, investigators at Brigham and Women's Hospital and Johns Hopkins Bloomberg School of Public Health set targets, specifically a decrease in new infections to 21,000 by 2020 and to 12,000 by 2025, that would mark a transition toward ending the HIV/AIDS epidemic. Their findings are published in The American Journal of Preventive Medicine. "Achieving these targets will require a sustained and intensified national commitment to ending the epidemic," said Robert Bonacci, MD, MPH, of the BWH Department of Medicine and lead author of the study. "But if the U.S. does achieve a reduction to 12,000 new HIV infections by 2025, it could mark an important turning point in the U.S. HIV epidemic: a decline in the total number of people living with HIV in the U.S., and the beginning of the end of the U.S. AIDS epidemic." Using Centers for Disease Control and Prevention surveillance data for 2010 to 2013, the team modeled many key indicators including incidence and prevalence rates, transmission rates, death rates and more through 2025. Taking into account goals set forward by the U.S. National HIV/AIDS Strategy (NHAS), they estimated the potential trajectory of the epidemic if those benchmarks in care were met. The NHAS goals for 2020 included that 90 percent of people living with HIV would know their status; 90 percent would receive quality care; and 90 percent of people on antiretroviral therapy would achieve viral suppression (the "90/90/90" goals). Extending beyond 2020, they evaluated an achievement of those goals at 95 percent levels by 2025 (the "95/95/95" goals). With this framework in place, the authors evaluated whether reducing new HIV infections to 12,000 by 2025 would be achievable. Using mathematical modeling, they found that the U.S. could achieve a 46 percent reduction in HIV incidence by 2020 and a nearly 70 percent reduction in HIV incidence by 2025, provided that the U.S. implements a 90/90/90 HIV program framework by 2020 and 95/95/95 framework by 2025. In addition, the HIV transmission rate, (one measure of how fast the epidemic is spreading) would decrease from 3.53 in 2013 to 0.98 in 2025; HIV-related deaths would decrease from 16,500 in 2013 to 12,522 in 2025; and the total number of people living with HIV in the U.S. would increase from 1,104,600 in 2013 to 1,220,615 in 2025. The authors note the importance of achieving these goals across the U.S., most especially in communities that have been disproportionately affected by HIV, including gay men, young people, transgender persons, black and Hispanic Americans and those who live in southern states, and of tracking progress in real time. "Providing HIV services to our most disproportionately affected communities is fundamental to future success," said David Holtgrave, PhD, of the Johns Hopkins Bloomberg School of Public Health and senior study author. "In an era of limited funding and competing priorities, it is critically important that we intensify our national commitment to addressing the HIV epidemic over the next decade." Researchers report no external funding for this work.


News Article | May 3, 2017
Site: www.PR.com

Receive press releases from U.S. Veg Corp.: By Email U.S. Veg Corp's Vegan Fest Bringing the Farm to the City New York, NY, May 03, 2017 --( One speaker is Irina Anta. After graduating from Yale Law School, she joined the Compassion Over Killing (COK) organization as legal counsel. Her talk at the festival is titled "Introduction to Factory Farming." COK works to protect farmed animals through litigation and undercover investigation. Most recently Anta assisted with an investigation of Superior Farms, exposing abuses at the largest lamb slaughter facility in the country. A lifetime lover of animals, she became particularly passionate about farm animal issues in law school after watching documentaries about industrial agriculture. Now based in Washington DC, she is able to speak for the animals not only in English but in Russian, Spanish and Italian as well. Another festival presenter is Gene Baur, co-founder and president of Farm Sanctuary. For 30 years he has traveled extensively, campaigning to raise awareness about the abuses of industrialized factory farming and our cheap food system. Time Magazine has called him “the conscience of the food movement.” He is also a faculty member at the Johns Hopkins Bloomberg School of Public Health. Baur grew up in Hollywood, earned a bachelor’s degree in sociology, and obtained a masters degree in agricultural economics from Cornell University. Farm Sanctuary’s first rescued animal was a sick sheep who had been discarded on a pile of dead animals behind the Lancaster, Pennsylvania stockyards in 1986. The sheep, who regained her health and lived for more than 10 years, was named Hilda. Sanctuary team members raised funds for their fledgling organization by selling vegan hot dogs out of a VW van in the parking lot at Grateful Dead concerts, among other exploits. Baur played a role in passing the first U.S. laws to restrict industrial animal farming systems. In 2002, he led a campaign in Florida to pass a ballot initiative banning gestation crates for pigs. He and Farm Sanctuary were also sponsors of California’s Proposition 2 to ban veal crates, gestation crates and battery cages, which passed in 2008 with more than 63% of the vote. In 2012, Baur started competing in marathons and triathlons to demonstrate how plant-based foods can fuel top athletic performance. In July 2013, he participated in his first full Ironman Triathlon in Lake Placid, NY. Baur’s best-selling books include Living the Farm Sanctuary Life: The Ultimate Guide to Eating Mindfully, Living Longer, and Feeling Better Every Day, and Farm Sanctuary: Changing Hearts and Minds About Animals and Food. His festival talk will be based on these topics. Other speakers at the festival will include physicians, professional athletes, vegan chefs, legislators, and dietitians. There will also be special children’s activities, a ballet performance, yoga classes, film screenings, cooking demonstrations, and book signings. Additionally, the festival grounds will be packed with a variety of vegan vendors, offering cruelty-free clothing, beauty products, and food. Many of the food vendors will dish up free samples for attendees as they wind their way through the pavilion. The New York City Vegetarian Food Festival is presented by U.S. Veg Corp, a production and marketing company which also founded and produces the Arizona and California Vegetarian Food Festivals. Additionally, it produces other plant-based events throughout the year including various vegan food competitions, Vegan Drinks Brooklyn, and other smaller scale events. For more information on the upcoming New York festival or to purchase tickets, please visit http://nycvegfoodfest.com/index.php. New York, NY, May 03, 2017 --( PR.com )-- Farm animals will find a place in the heart of the city, as the seventh annual New York City Vegetarian Food Festival presents two highly respected animal advocates, May 20-21 at the Metropolitan Pavilion in Chelsea.One speaker is Irina Anta. After graduating from Yale Law School, she joined the Compassion Over Killing (COK) organization as legal counsel. Her talk at the festival is titled "Introduction to Factory Farming."COK works to protect farmed animals through litigation and undercover investigation. Most recently Anta assisted with an investigation of Superior Farms, exposing abuses at the largest lamb slaughter facility in the country.A lifetime lover of animals, she became particularly passionate about farm animal issues in law school after watching documentaries about industrial agriculture. Now based in Washington DC, she is able to speak for the animals not only in English but in Russian, Spanish and Italian as well.Another festival presenter is Gene Baur, co-founder and president of Farm Sanctuary. For 30 years he has traveled extensively, campaigning to raise awareness about the abuses of industrialized factory farming and our cheap food system. Time Magazine has called him “the conscience of the food movement.”He is also a faculty member at the Johns Hopkins Bloomberg School of Public Health. Baur grew up in Hollywood, earned a bachelor’s degree in sociology, and obtained a masters degree in agricultural economics from Cornell University.Farm Sanctuary’s first rescued animal was a sick sheep who had been discarded on a pile of dead animals behind the Lancaster, Pennsylvania stockyards in 1986. The sheep, who regained her health and lived for more than 10 years, was named Hilda. Sanctuary team members raised funds for their fledgling organization by selling vegan hot dogs out of a VW van in the parking lot at Grateful Dead concerts, among other exploits.Baur played a role in passing the first U.S. laws to restrict industrial animal farming systems. In 2002, he led a campaign in Florida to pass a ballot initiative banning gestation crates for pigs. He and Farm Sanctuary were also sponsors of California’s Proposition 2 to ban veal crates, gestation crates and battery cages, which passed in 2008 with more than 63% of the vote.In 2012, Baur started competing in marathons and triathlons to demonstrate how plant-based foods can fuel top athletic performance. In July 2013, he participated in his first full Ironman Triathlon in Lake Placid, NY.Baur’s best-selling books include Living the Farm Sanctuary Life: The Ultimate Guide to Eating Mindfully, Living Longer, and Feeling Better Every Day, and Farm Sanctuary: Changing Hearts and Minds About Animals and Food. His festival talk will be based on these topics.Other speakers at the festival will include physicians, professional athletes, vegan chefs, legislators, and dietitians. There will also be special children’s activities, a ballet performance, yoga classes, film screenings, cooking demonstrations, and book signings.Additionally, the festival grounds will be packed with a variety of vegan vendors, offering cruelty-free clothing, beauty products, and food. Many of the food vendors will dish up free samples for attendees as they wind their way through the pavilion.The New York City Vegetarian Food Festival is presented by U.S. Veg Corp, a production and marketing company which also founded and produces the Arizona and California Vegetarian Food Festivals. Additionally, it produces other plant-based events throughout the year including various vegan food competitions, Vegan Drinks Brooklyn, and other smaller scale events.For more information on the upcoming New York festival or to purchase tickets, please visit http://nycvegfoodfest.com/index.php. Click here to view the list of recent Press Releases from U.S. Veg Corp.


News Article | May 3, 2017
Site: www.eurekalert.org

Even a relatively mild Zika outbreak in the United States could cost more than $183 million in medical costs and productivity losses, suggests a computational analysis led by Johns Hopkins Bloomberg School of Public Health researchers, while a more severe one could result in $1.2 billion or more in medical costs and productivity losses. Reporting last week in PLOS Neglected Tropical Diseases, the researchers estimated the potential impact of a Zika outbreak based on a variety of epidemic sizes. They focused on five Southeastern states and Texas, the U.S. locations most populated by Aedes aegypti, the mosquito most likely to carry the disease. While many people with Zika show mild symptoms, if any, a Zika infection during pregnancy can cause birth defects such as microcephaly or other severe brain defects. In regions affected by Zika there have also been increased reports of Guillain-Barré syndrome, a rare illness of the nervous system. There is no treatment nor is there a vaccine to prevent Zika. "This is a threat that has not gone away. Zika is still spreading silently and we are just now approaching mosquito season in the United States, which has the potential of significantly increasing the spread," says study leader Bruce Y. Lee, MD, MBA, an associate professor in the Department of International Health at the Bloomberg School. "There's still a lot we don't know about the virus, but it is becoming clear that more resources will be needed to protect public health. Understanding what a Zika epidemic might look like, however, can really help us with planning and policy making as we prepare." With funding for Zika detection, prevention and control still uncertain, policymakers need estimates of Zika costs to help guide funding decisions, the researchers say. It is unclear how many people in the United States have already been infected and how many more cases will occur this summer, but the findings, they say, are further evidence that the costs of any Zika outbreak would be high. For their research, Lee and his colleagues from the Johns Hopkins Bloomberg School of Public Health, Yale and the National School of Tropical Medicine developed and ran a computational model based on different rates of spread of Zika if it were to hit Florida, Georgia, Alabama, Mississippi, Louisiana and Texas, taking into account factors including health care costs - such as visits to the doctor, laboratory tests and the lifetime cost of caring for a child born with microcephaly - as well as productivity losses. Even when assuming an attack rate - that is, the percentage of the population that eventually gets infected - of only 0.01 percent, the model estimates that Zika would cost more than $183 million and cause more than 7,000 infections, two cases of microcephaly and four cases of Guillain-Barré. An attack rate of one percent would cause more than 704,000 infections, 200 cases of microcephaly and 423 cases of Guillain-Barré. The one-percent attack rate could result in $1.2 billion in medical costs and productivity losses. A 10-percent attack rate could result in more than $10.3 billion in medical costs and productivity losses. These attack rates would still be substantially lower than those observed in French Polynesia (66 percent), Yap Island in Micronesia (73 percent) and State of Bahia in Brazil (32 percent) where the current Zika outbreak is believed to have originated. They are also lower than recent outbreaks of chikungunya, a virus spread the same way as Zika, including one in Puerto Rico (23.5 percent). After much delay last year, Congress allocated $1.1 billion for mosquito control efforts and vaccine development, as well as for emergency health care for Puerto Rico, where more than 35,000 people contracted the virus. Lee believes far more money may be necessary, given his estimates for medical care. "Without details regarding the Zika-prevention measures that would be implemented and how effective these may be, it is unclear what percentage of these costs may be averted," Lee says. "But our model shows it is very likely that preventing an epidemic - or at least finding ways to slow one down - would save money, especially since epidemics like Zika have hidden costs that aren't always considered." "The Potential Economic Burden of Zika in the Continental United States," was written by Bruce Y. Lee; Jorge A. Alfaro-Murillo; Alyssa S. Parpia; Lindsey Asti; Patrick T. Wedlock; Peter J. Hotez and Alison P. Galvani. The research was supported by the National Institutes of Health's National Institute of General Medical Studies (U01 GM087719 and U01 GM105627), Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD070725 and U01 HD086861), the Agency for Healthcare Research and Quality (R01HS023317) and the United States Agency for International Development (AID-OAA-A-15-00064).


News Article | May 2, 2017
Site: www.futurity.org

Getting half of American 8- to 11-year-olds into 25 minutes of physical activity three times a week would save $21.9 billion in medical costs and lost wages over their lifetimes, new research suggests. The relatively modest increase—from the current 32 percent to 50 percent of kids participating in exercise, active play, or sports that often—would also result in 340,000 fewer obese and overweight youth, a reduction of more than 4 percent, the study calculates. “Physical activity not only makes kids feel better and helps them develop healthy habits, it’s also good for the nation’s bottom line,” says Bruce Y. Lee, executive director of the Global Obesity Prevention Center at Johns Hopkins University. “Our findings show that encouraging exercise and investing in physical activity such as school recess and youth sports leagues when kids are young pays big dividends as they grow up.” The study, published in the journal Health Affairs, suggests an even bigger payoff if every current 8- through 11-year-old in the United States exercised 75 minutes over three sessions weekly. In that case, the researchers estimate, $62.3 billion in medical costs and lost wages over the course of their lifetimes could be avoided and 1.2 million fewer youths would be overweight or obese. And the savings would multiply if not just current 8-to-11 year olds, but every future cohort of elementary school children upped their game. Studies have shown that a high body mass index at age 18 is associated with a high BMI throughout adulthood and a higher risk for diabetes, heart disease, and other maladies linked to excess weight. The illnesses lead to high medical costs and productivity losses. In recent decades, there has been what experts describe as a growing epidemic of obesity in the United States. Lee and colleagues from the Johns Hopkins Bloomberg School of Public Health and the Pittsburgh Supercomputing Center at Carnegie Mellon University developed a computer simulation using their Virtual Population for Obesity Prevention software. They plugged in information representing current US children to show how changes in physical activity as kids could affect them—and the economy—throughout their lifetimes. The model relied on data from the 2005 and 2013 National Health and Nutrition Examination Survey and from the National Center for Health Statistics. Exercise totaling at least 25 minutes a day, three days a week, is a guideline developed for kids by the Sports and Fitness Industry Association. The researchers found that maintaining the current low 32 percent compliance would result in 8.1 million of today’s 8- to 11-year-olds being overweight or obese by 2020. That would trigger $2.8 trillion in additional medical costs and lost wages over their lifetimes. An overweight person’s lifetime medical costs average $62,331 and lost wages average $93,075. For an obese person, these amounts are even greater. “Even modest increases in physical activity could yield billions of dollars in savings,” Lee says. The costs averted are likely an underestimate, he says, as there are other benefits of physical activity that don’t affect weight, such as improving bone density, improving mood, and building muscle. Lee says that the spending averted by healthy levels of physical activity would more than make up for costs of programs designed to increase activity levels. “As the prevalence of childhood obesity grows, so will the value of increasing physical activity,” he says. “We need to be adding physical education programs and not cutting them. We need to encourage kids to be active, to reduce screen time and get them running around again. It’s important for their physical health—and the nation’s financial health.” Funding for the research came from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Agency for Healthcare Research and Quality.


The report calls on the Security Council and countries to take concrete steps toward preventing attacks and ending impunity, as recommended last year by the UN Secretary General. These steps include regular reporting by countries to the UN on actions taken to prevent attacks, investigating those that occur and holding perpetrators accountable. Where member states fail to act, the Secretary urged, the Security Council should initiate thorough investigations and establish accountability procedures. The Security Council and states have failed to take these actions. "Our findings cry out for a level of commitment and follow-through by the international community and individual governments that has been absent since the passage of Security Council Resolution 2286 a year ago," said Leonard S. Rubenstein, director of the Program on Human Rights, Health and Conflict at the Johns Hopkins Bloomberg School of Public Health and chair of the coalition. In Syria, Physicians for Human Rights (PHR) verified 108 attacks on health facilities, and the deaths of 91 health professionals in 2016. "The all-out assault on health facilities and professionals in Syria is the worst pattern of such attacks in modern history," said Susannah Sirkin, director of international policy at PHR. "2016 marked one of the worst years we've documented," she said. The UN Assistance Mission in Afghanistan reported 119 attacks on health facilities and personnel, up from 63 the year before. In Yemen, UNICEF verified 93 attacks on hospitals over a period from March 2015 to December 2016. The numbers noted in the report may greatly understate the extent and severity of attacks, the report says, because documentation of attacks remains spotty. "We know that in places like South Sudan and Iraq, many vicious attacks on health care have been inflicted by parties to the conflicts," said Laura Hoemeke, director of communications and advocacy at IntraHealth International. "These attacks cascade into lack of access to health care for suffering populations, but no one is collecting the number of attacks." The report reveals that while bombing and shelling of health facilities is the most obvious and devastating form of attack, violence against health care takes many forms. "In Afghanistan, we found patterns of intimidation and threats against health workers, and occupation of health facilities," said Christine Monaghan, a researcher at Watchlist on Children in Armed Conflict, which engaged in a field investigation in Afghanistan. "There were 13 recorded attacks on vaccinators, in which ten people were killed and 16 were abducted," she said. Continued obstruction of access to care is another key finding. In Ukraine, checkpoints, as well as the difficulty of crossing conflict lines, have impeded access to care for a third of households in conflict-affected areas, with dire implications for the 50 percent of families in the region suffering from chronic diseases. In Turkey, curfews prevented injured people from reaching care, resulting in needless civilian deaths. In the Occupied Palestinian Territory, the Palestinian Red Crescent Society reported 416 instances of violence or interference with its ambulances, injuring 162 emergency medical technicians. Accountability for these assaults is largely absent, the report said. A review by Human Rights Watch of 25 incidents of attacks on health care in ten countries between 2013 and 2016, resulting in the deaths of more than 230 people and the closure or destruction of six hospitals, found that either no proceedings for accountability were undertaken at all or the results of proceedings were inadequate. "Without accountability, these attacks won't stop, and efforts to investigate these kinds of incidents—and pursue justice where relevant—have been half-hearted or worse," said Diederik Lohman, director of health and human rights at Human Rights Watch. This fourth global report from the coalition relies on field investigations by coalition members as well as secondary data from UN agencies, non-governmental organizations and other sources. It can be accessed at: safeguardinghealth.org/report2017 The Safeguarding Health in Conflict Coalition consists of more than 30 organizations working to protect health workers and services threatened by war or civil unrest. The coalition raises awareness of global attacks on health and presses governments and United Nations agencies for greater global action to protect the security of health care. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/health-workers-and-facilities-in-23-conflict-ridden-countries-attacked-with-impunity-in-2016-300450139.html


News Article | April 17, 2017
Site: www.eurekalert.org

Cholera cases in East Africa increase by roughly 50,000 during El Niño, the cyclical weather occurrence that profoundly changes global weather patterns, new Johns Hopkins Bloomberg School of Public Health research suggests. The findings, researchers say, could help health ministries anticipate future cholera surges during El Niño years and save lives. The researchers, reporting April 10 in the Proceedings of the National Academy of Sciences, used sophisticated mapping to pinpoint the location of clusters of cholera cases before, during and after El Niño years. Cholera is an infectious and often fatal bacterial disease, typically contracted from infected water supplies and causing severe vomiting and diarrhea. Africa has the most cholera deaths in the world. "We usually know when El Niño is coming six to 12 months before it occurs," says study leader Justin Lessler, an associate professor of epidemiology at the Bloomberg School. "Knowing there is elevated cholera risk in a particular region can help reduce the number of deaths that result. If you have cholera treatment centers available, fast, supportive care can reduce the fatality rate from cholera from as high as 30 percent to next to nothing." The total number of cases of cholera across Africa as a whole were about the same in El Niño years as compared to non-El Niño years, the researchers found, but the geographic distribution of illnesses was fundamentally different. El Niño conditions in the equatorial Pacific region strongly impact weather conditions globally, including increasing rainfall in East Africa and decreasing rainfall in drier areas of northern and southern Africa. During the years classified as El Niño between 2000 and 2014, cholera incidence increased threefold in regions such as East Africa that had the strongest association between El Niño and cholera, with 177 million people living in areas that experienced an increase in cholera cases during a time of additional rainfall. At the same time, there were 30,000 fewer cases in southern Africa during El Niño where there was less rainfall than normal. Parts of central West Africa, however, saw significantly fewer cases of cholera, but with little change in rainfall patterns. While El Niño brings wetter and warmer weather to East Africa, rainfall is not the only variable that appears to impact cholera rates, Lessler says. Cholera is almost always linked to vulnerable water systems. In some areas, massive rainfall can overrun sewer systems and contaminate drinking water. In other locations, however, dry conditions can mean that clean water sources aren't available and people must consume water from sources known to be contaminated. "Countries in East Africa, including Tanzania and Kenya, have experienced several large cholera outbreaks in recent decades," says study author Sean Moore, PhD, a post-doctoral fellow in the Bloomberg School's Department of Epidemiology. "Linking these outbreaks to El Niño events and increased rainfall improves our understanding of the environmental conditions that promote cholera transmission in the region and will help predict future outbreaks." For the study, Lessler, Moore and their colleagues collected data on cholera cases in Africa from 360 separate data sets, analyzing 17,000 annual observations from 3,710 different locations between 2000 and 2014. The researchers note that there were weak El Niño years from 2004 to 2007, while 2002-2003 and 2009-2010 were classified as moderate-to-strong El Niño years. They say that 2015-2016 was also an El Niño year with the largest cholera outbreak since the 1997-1998 El Niño occurring in Tanzania. Using this knowledge of a link between cholera and El Niño could allow countries to prepare for outbreaks long before they start, Lessler says. Currently, there is an approved vaccine for cholera, but its effects are not lifelong and there are not enough doses for everyone in areas that could be impacted by El Niño. Once there is more vaccine, he says, it can be another tool for health officials to use as they try to prevent deadly cholera in their nations. As climate change continues, disease patterns will continue to change as well, Lessler says. Often, the story is that climate change will put more people at risk for more types of diseases. "But what the link between cholera and El Niño tells us is that changes may be subtler than that," he says. "There will be winners and losers. It's not a one-way street." "El Niño and the Shifting Geography of Cholera in Africa" was written by Sean Moore, Andrew Azman, Benjamin Zaitchik, Eric Mintz, Joan Brunkard, Dominique Legros, Alexandra Hill, Heather McKay, Francisco Luquero, David Olson and Justin Lessler. The research was supported by a grant from the Bill and Melinda Gates Foundation and the National Science Foundation. Cholera data was provided by the Ministries of Health of Benin, Democratic Republic of Congo, Mozambique, South Sudan and Nigeria as well as Médecins Sans Frontières and MSF/Epicentre, the World Health Organization and the United Nations Relief Agency.

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