Cuba gives doctors big pay raise—to $64 a month

Cuba's doctors got a big pay raise Friday —to 64 dollars a month, the official Communist Party newspaper Granma said.

22 mar 2014--The hike in pay from $25 a month was to reward health professionals for being the country's top source of hard currency export earnings.

President Raul Castro last month rejected pay increases for other state workers, but said they were justified for doctors, dentists and nurses "because at the moment the country's main income is due to the work of thousands of doctors overseas."

Some 50,000 Cuban doctors and health specialists work in 66 countries.

They bring in $8.2 billion a year into state coffers. The value of Cuban exports, by comparison, totals only $5 billion a year.

Cuban doctors earn far more serving overseas than they do at home, but the lion's share of their salaries goes to the government.

In Brazil last month, a Cuban doctor asked for asylum after learning that she would receive only $1,000 dollars of her $4,000 salary—with the balance going to Cuban authorities.

Take home pay for the more than 11,000 Cuban doctors in Brazil was raised to the equivalent of $1,245 after the incident.

Granma said the pay hike announced Friday would "contribute to the stability and quality of medical services to the public, while also meeting international commitments."

© 2014 AFP

One million people commit suicide each year: WHO

One million people die by their own hand each year, accounting for more deaths than wars and murders put together, the World Health Organisation said Friday, calling for urgent action to address the problem.

22 mar 2014--"Data from the WHO indicate that approximately one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds," the organisation said in a report launched ahead of the World Suicide Prevention Day on Monday.

And while the number of deaths by suicide is staggering, the number of attempts each year is 20 times higher, the WHO said, pointing out that five percent of people in the world try to kill themselves at least once during their lifetime.

And the problem is getting worse, the organisation said, insisting that "given the magnitude of the public health problem of suicidal behaviours", urgent action was needed.

"As suicide is largely preventable, it is imperative that governments, through their health, social and other relevant sectors, invest human and financial resources in suicide prevention," the report said.

According to Dr. Shekhar Saxena, who headed the team behind the report, suicide rates have risen sharply in some parts of the world in recent years, with some countries seeing their rates jump by as much as 60 percent.

"Although suicide continues to remain a serious problem in high income countries, it is the low and middle income countries that bear the larger part of the global suicide burden," the report said, adding: "It is also these countries that are relatively less equipped to prevent suicide".

The highest documented suicide rates can be found in Eastern European countries like Lithuania and Russia, while they are lowest in Latin America, WHO said.

The United States, Western European countries and Asia fell in the middle of the range, the report showed, but stressed that statistics are not available for many countries in Africa and South-East Asia.

Globally, suicide is meanwhile the second cause of death worldwide among 15-19 year-olds, with at least 100,000 adolescents killing themselves each year, according to the study.

Among adults, the suicide rate is highest among those aged 75 and older, the WHO said, pointing out that "elderly people are likely to have higher suicide intent and use more lethal methods than younger people, and they are less likely to survive the physical consequences of an attempt".

The report also showed that men were three times more likely to commit suicide, but that three times as many women as men attempted to kill themselves.

"The disparity in suicide rates has been partly explained by the use of more lethal means and the experience of more aggression and higher intent to die, when suicidal, in men than women," it explained.

Evidence supports existence of mid-life crises

21 mar 2014—Social economists from the University of Melbourne have confirmed the age-old suspicion of a dip in human happiness during middle age.

Past evidence for "mid-life crises" have come from cross sectional data. That is, by comparing surveys of different people's happiness at different ages.

But now, for the first time, researchers have tracked the happiness levels of thousands of people across three countries over multiple decades.

"We have identified a clear 'U-shape' in human wellbeing," said researcher Dr Terence Cheng, from the University of Melbourne's Institute of Applied Economic and Social Research.

"The jury's now in. People really do experience mid-life crises."

The study—Longitudinal Evidence for a Midlife Nadir in Human Well-being—was completed in partnership with the University of Warwick and the London School of Economics, and published as a working paper by the German based Institute for the Study of Labor.

It used nationally representative survey data from Australia, Britain and Germany.

"What is interesting is the consistency of the results in all of the three countries we examined. Human happiness hits the lowest point around the ages of 40 to 42", Dr Cheng said.

"Indeed all the more intriguing is that the U-shape pattern has been recently observed in research on great apes. Perhaps we are more similar than we think?"

Dr Cheng said tracking changes in happiness over time makes the study more accurate.

"We looked at the well-being of 'Mr Jones' at age 35, 45, 55, and so on. This is important as the U-shape finding therefore does not arise from variations across different people, but rather within individuals," Dr Cheng adds.

More information: The study, "Longitudinal Evidence for a Midlife Nadir in Human Well-being," is available online: ftp.iza.org/dp7942.pdf

Provided by University of Melbourne

High-protein diets: Bad for the middle-aged, good for the elderly

Consuming high levels of protein - particularly animal protein - is a bad strategy if you're at midlife and aiming to live into old age, new research finds. But a study out Tuesday reveals that in older age, fortifying one's diet with more protein-rich foods appears to be a formula for extending life.

20 mar 2014--An article published in the journal Cell Metabolism says that, over an 18-year study period, middle-aged Americans who had the highest consumption of protein were more than four times as likely to die of cancer or diabetes, and twice as likely to die of any cause, than those whose diets were lowest in protein.

But a high-protein diet had the opposite effect on Americans 66 and older, a group of American and Italian researchers found. Those whose diets were highest in protein were 60 percent less likely to die of cancer and 28 percent less likely to die of any cause than were those whose protein intake was lowest.

"Your stage in life matters," said biogerontologist Valter Longo, director of the University of Southern California's Longevity Institute and lead author of the paper, which explores the role of dietary protein from the cellular level to the population level. "Some have said for years that proteins are bad. That's half right and half wrong."

Tapping a national database of 6,381 Americans' health and nutrition behaviors, Longo's team found that in people between the ages of 50 and 65, following a diet in which protein accounted for 20 percent or more of daily calories consumed increased the risk of death during the 18-year study period to levels comparable to the effect of smoking cigarettes.

Whether the remainder of those younger individuals' diet was dominated by fat or carbohydrates made no difference to the outcome. But the source of the protein mattered a great deal: for those whose sources of protein were heavily plant-based - nuts and legumes - the increased risk of dying of cancer declined and the increased risk of all-cause mortality disappeared altogether.

Among the study's older subjects, by contrast, the source of proteins was less important. What was important, said Longo, appeared to be that those entering a period of growing frailty reduced their loss of weight and muscle mass with a higher intake of a nutrient that helps sustain and build both.

The article by the U.S.-Italian team is the culmination of two decades of study that has coaxed the researchers to look for clues well outside the lab: Longo and his team have studied the dietary habits of a little town in Italy with a high concentration of centenarians, and have traveled to Ecuador to gather information on an exceptionally long-lived family congenitally deficient in a growth hormone linked to cancer.

The findings of Longo's team are in line with mounting research on the hazards of heavy consumption of red meats and the protective effects of plant-based nutrients. But unlike many large-population studies that have found links between poor health outcomes and animal protein consumption, the current study identified the potentially pivotal role that a hormone called insulin-like growth factor-1, or IGF-1, plays in driving age-related diseases such as cancer.

In a subset of the study's human subjects who submitted their blood for analysis, as well as in laboratory mice, Longo's team found that heavy protein consumption in middle age drove up levels of IGF-1. In the group's rodent experiments, higher IGF-1 levels - whether induced by high protein consumption or genetic engineering - promoted rapid cancerous growth when the researchers implanted 20,000 cancer cells under the animals' skin: 100 percent of these mice developed tumors.

Among mice that were fed a low-protein diet through middle age - and which therefore had lower IGF-1 levels - tumor formation was 10 percent to 30 percent lower.

At the same time, the researchers uncovered evidence that older mice were less able to absorb or process proteins. When they were fed high-protein diets, the older mice tended to maintain or increase their weight - a factor that appeared to keep them from becoming frail. By contrast, older mice fed a low-protein diet lost weight; that, says Longo, appeared to make them more vulnerable to diseases of aging.

IGF-1, produced largely in the liver, is essential to normal human growth and to the process of cell replacement after injury . But it is also implicated in a wide range of disorders associated with overgrowth and cell proliferation, including heart enlargement, the runaway cell growth common to all cancers, and obesity.

But while IGF-1's role in promoting tumor growth has long been recognized, its link to a high-protein diet appears to be a new.

"People will say, 'Here we go again: First you attack the fats, then you attack the carbohydrates, now it's the protein,' " Longo said. But over 20 years of research linking heavy protein consumption to diseases of aging, and eventually to higher IGF-1 levels, he said, "we never changed our mind": Americans' protein-packed diets "are hurting them in a major way."

Aging population leading to more arrhythmia diagnoses

Craig Wilkins was feeling tired, breathless and in need of a vacation. Although he attributed his tiredness to too many long and hectic hours at the office, the 56-year-old decided to see his family doctor in Cary, N.C., before leaving for a family trip.

09 mar 2014--Craig was otherwise healthy and had no history of heart disease, but his doctor discovered he had atrial fibrillation, a condition that can cause the heart to race, sometimes beating hundreds of times in one minute. These episodes, called tachycardias, were making Craig feel fatigued.

An estimated 12 million people will have atrial fibrillation by 2050, according to the Centers for Disease Control and Prevention. Atrial fibrillation is a type of arrhythmia that causes the heart to beat irregularly. It can be genetic or caused by scar tissue on the heart, diabetes, high blood pressure or stress. An aging population, an increased survival rate following heart attacks and rising rates of heart disease mean more Americans will be entering their 60s and 70s with arrhythmias, which are a leading cause of stroke and cardiac events, and can dramatically alter a person's quality of life.

For some, atrial fibrillation is annoying but not life threatening. For Craig, the condition had gone undetected for so long that he had developed congestive heart failure. "I was shocked when the doctor told me how serious it was," says Craig.

Initially, Craig was given a course of blood thinners to prevent clots that could be lethal, followed by a cardioversion, an electrical shock to the heart, to reset the heart beat back to normal. Though this worked initially, his heart eventually returned to the abnormal heartbeat. After several attempts at cardioversion, Craig's doctor tried anti arrhythmia medication.

"They put me in the hospital and used a powerful anti arrhythmia drug," says Craig, who stayed in the hospital for three days as doctors watched his heart.Two days after he was released, he returned to work and passed out at his desk.

An estimated 12 million people will have atrial fibrillation by 2050, according to the Centers for Disease Control and Prevention. Atrial fibrillation is a type of arrhythmia that causes the heart to beat irregularly. It can be genetic or caused by scar tissue on the heart, diabetes, high blood pressure or stress. An aging population, an increased survival rate following heart attacks and rising rates of heart disease mean more Americans will be entering their 60s and 70s with arrhythmias, which are a leading cause of stroke and cardiac events, and can dramatically alter a person's quality of life.

Andy Kiser, MD (left), with Paul Mounsey, MD Courtesy Donn Young

For some, atrial fibrillation is annoying but not life threatening. For Craig, the condition had gone undetected for so long that he had developed congestive heart failure. "I was shocked when the doctor told me how serious it was," says Craig.

Initially, Craig was given a course of blood thinners to prevent clots that could be lethal, followed by a cardioversion, an electrical shock to the heart, to reset the heart beat back to normal. Though this worked initially, his heart eventually returned to the abnormal heartbeat. After several attempts at cardioversion, Craig's doctor tried anti arrhythmia medication.

"They put me in the hospital and used a powerful anti arrhythmia drug," says Craig, who stayed in the hospital for three days as doctors watched his heart.Two days after he was released, he returned to work and passed out at his desk.

Dr. Mounsey performed a cardiac ablation on Craig's heart. In an ablation, doctors thread catheters through the arteries to the heart and use radiofrequency to destroy the damaged heart tissue causing the atrial fibrillation. Ablations are often successful, but in Craig's case, a flutter continued even after the procedure. A second ablation was performed, but the location of where the flutter was originating meant ablation could not correct it.

Dr. Mounsey then collaborated with Dr. Kiser to perform the Convergent Procedure.

Traditionally, surgeons, like Dr. Kiser, have created scar pat- terns to disrupt the circuitry that causes atrial fibrillation arrhythmia, while electrophysiologists, like Dr. Mounsey, have performed ablations. With the Convergent Procedure, Drs. Mounsey and Kiser work side by side using miniature cameras, small catheters and electrodes to map out an individualized pattern that will work to reestablish normal rhythms in each patient.

Drs. Mounsey and Kiser have been performing the procedure since 2011, and they recently completed their 100th surgery. They have an 80 percent success rate, which is extremely high for complex arrhythmias.

Five years after Craig's initial atrial fibrillation diagnosis and a year and a half after having the Convergent Procedure, he says his health is excellent. "I can't believe how bad I used to feel," says Craig. "I have energy and a desire to do things now."

Craig felt so good, he left his IT job behind and made a career change, opening The Meat House, a neighborhood butcher and grocery franchise in Raleigh and Cary.

Craig's case is a good example of the patients who will benefit most from the UNC Heart & Vascular Network. Patients who live in the Raleigh area and their primary care physicians will have access to a group of cardiologists and services in their local communities, and for the most complex cases, they will have access to the leading research, technology and specialty care available at UNC Health Care.

With the creation of this new network, Drs. Kiser and Mounsey will work alongside Sidharth Shah, MD, a cardiac electrophysiologist in Raleigh. Dr. Shah performs cardiac ablations and works with cardiac devices, such as pacemakers and cardio defibrillators, and his work is closely associated with research opportunities and clinical trials.

"In the past we had to send our patients who were in the UNC or Rex system to other centers," says Dr. Shah. "Now, we can keep them close to home."

Provided by University of North Carolina at Chapel Hill School of Medicine

How the internet is transforming our experience of being ill

The last decade has seen a remarkable shift in how people use the internet in relation to their health and it is now talked of as a routine feature of being ill.

06 mar 2014--Professor Sue Ziebland, Director of the Health Experiences Research Group, based in the Nuffield Department of Primary Health Care at the University of Oxford, will share these findings with health practitioners and researchers at the South West Society for Academic Primary Care (SW SAPC) meeting hosted by the Centre for Academic Primary Care at the University of Bristol, today [Thursday 6 March].

This study examined interviews with patients conducted between 2001 and 2013 and explored how people talked about the internet, capturing changing attitudes towards the use of the internet for health across the last decade.

In the early 2000's people who sought health information online saw themselves as particularly engaged, expert and activated patients. By 2013 the web had become an almost routine part of many people's experience of health and illness. The internet has transformed how people make sense of and respond to symptoms, decide whether to consult, make treatment choices, cope with their illness and connect to others.

The study found that people want more than just information online, they also seek reflections, insights and practical advice from other patients. Every year millions of people use sites such as Oxford's http://www.healthtalkonline.org to learn about their health issues from other patients. Film, animations, sound, pictures and personal experiences online make health information more digestible for people from all backgrounds. By helping people to learn about their condition, prepare for consultations and demonstrate to doctors their interest and involvement, the web may even help to undermine some health inequalities.

Increasingly doctors are aware of this and recommend useful sites to their patients yet, even in 2013, patients were reluctant to talk to their doctors about what they find online, fearing that such revelations might damage their relationship with their doctor.

Professor Sue Ziebland said "GPs and nurses who recognise that people are using the internet when they are ill can support and discuss the information with their patients; those who do not recognise this shift can unwittingly undermine and patronise their patients."

Provided by University of Bristol

Developing an intelligent avatar to help UK's aging population

The University is taking a leading role in a ground-breaking project to support the UK's aging population through the use of responsive and interactive avatars.

03 mar 2014---Kent's Centre for Child Protection is heading a consortium of partners developing a project, known as Responsive InTeractive Advocate (RITA), which has won a share of £2.4m in funding from the UK's innovation agency, the Technology Strategy Board (TSB).

The RITA project is one of six born of a national Technology Strategy Board initiative aimed at developing new cost-effective ways of helping elderly people to continue to live comfortably and independently in their own homes if they want to.

Kent is working with the University of Portsmouth's School of Creative Technologies and two companies - Affective State and We Are Snook - in the consortium, with each partner responsible for a different element of the project.

Dr Jane Reeves, Co-Director of the Centre for Child Protection, said: 'There is a major debate about how we provide care for vulnerable people across all age-groups and this project is seeking to meet one of our biggest challenges, which is ensuring older adults can remain independent for as long as possible.

'Although this project is at an early stage, with a number of technical, moral and ethical issues to be addressed, the development of RITA in the form of a humanised avatar could revolutionise how an individual's personal, social emotional and intellectual needs are met in the future.

'RITA would exist as a digital champion, an advocate in the form of an avatar, providing a friendly interface between the individual, family, friends, professions and services.'

The avatar might appear as a figure on a television screen or a tablet computer or could even be a holographic display. It could monitor heart rate and blood pressure, remind people to take medication and would know if they had fallen over or were in pain and alert the doctor or the emergency services. It would be able to analyse their speech, movement and facial expression to detect their mood and respond accordingly. The system would not require computer literacy and would be no more challenging to operate than switching on a television.

Kent's Centre for Child Protection has an international reputation as a centre of excellence and innovation in training, research and practice for the full range of professionals involved in child protection. It sees this project as an opportunity to become involved in developing an innovation for the future that could provide significant benefit across the life course.

Dr Reeves added: 'Of course, these developments have enormous ethical and legal implications but we will explore these fully as the project develops.'

The University of Portsmouth will focus on developing the interactive avatar, while Winchester-based company Affective State will work on sensing and forecasting emotional well-being and Glasgow-based We Are Snook focus on the user experience design.

The funding competition, called the Long Term Care Revolution, is funded through the Small Business Research Initiative scheme, which connects public sector challenges with innovative ideas from industry. The RITA project has been awarded £500K.

Iain Gray, Chief Executive of the Technology Strategy Board said: 'This is an expanding market and we need to radically rethink our approach to long-term care provision, providing options that will enable people to live with more dignity and autonomy.

'We focus innovation activity on areas where we think it can make the biggest difference. Late life care is often regarded as an economic liability but it can actually be an engine for economic growth.'

Provided by University of Kent

Personalized medicine has finally arrived—or has it?

As the price for decoding a person's DNA keeps dropping, expectations for personalized medicine based on specific genetic profiling rise. But translating an individual's genetic data into finely tailored medical treatments still faces major challenges, explains a new article in Chemical & Engineering News (C&EN), the weekly magazine of the American Chemical Society.

01 mar 2014--Rick Mullin, senior editor at C&EN, notes that advances in DNA sequencing have allowed researchers to design some therapies, particularly in the cancer realm, for patients with certain genetic traits. As the technology for reading people's genes improves and drops even further in cost, more progress is on the horizon. The U.S. Food and Drug Administration, the government body responsible for approving pharmaceuticals for commercialization, supports these efforts. With the stars seemingly aligned, some industry experts have declared that the age of personalized medicine has arrived. So why do others claim that victory is still a long way off?

The article points out that when pharmaceutical labs launched their search for new drugs based on genomics more than 15 years ago, the focus was almost exclusively on DNA sequences. But now researchers have realized that for personalized medicine to truly take hold, they need to also pay attention to individuals' health histories, their environments and how their genes actually translate into physical traits. This requires a shift in thinking, plus closer ties between the research and clinical sides, and ultimately, insurers. But perhaps the tallest barrier is cultural—an attitude among some in the health care industry to simply continue business as usual.

Provided by American Chemical Society