American Lung Association Issues State Of The Air Report

The American Lung Association issued its annual report card on air pollution, ranking cities most affected by three types of pollution: short-term particle pollution, year-round particle pollution and ozone pollution. For the first time ever, a city outside California, Pittsburgh, Pennsylvania, tops one of the most polluted lists in the ninth consecutive American Lung Association State of the Air report.

Pittsburgh moved to the top of the list of cities most polluted by short-term levels of particle pollution, a deadly cocktail of ash, soot, diesel exhaust, chemicals, metals and aerosols that can spike dangerously for hours to weeks on end. The body’s natural defenses, coughing and sneezing, fail to keep these microscopic particles from burrowing deep within the lungs, triggering serious problems such as breathing, asthma and heart attacks, strokes, lung cancer and even early death. Pittsburgh also ranks second on the list of cities with the most year-round particle pollution while Los Angeles again claims the first spot this year.

Los Angeles, despite being ranked atop two of the three most-polluted lists, saw continued improvements in air quality, dropping its year-round particle pollution levels by nearly one-third during the last decade, and saw solid improvement in levels of ozone or “smog,” a gas formed most often when sunlight reacts with vapors emitted when motor vehicles, factories, power plants and other sources burn fuel. Ozone irritates the respiratory tract and causes health problems like asthma attacks, coughing, wheezing, chest pain and even premature death.

“The air quality in several cities has improved, but in others, declines in pollution have stalled. The trends tell us loud and clear that we need to do more to protect Americans from breathing air that’s simply hazardous to their health,” said Bernadette Toomey, President and Chief Executive Officer, American Lung Association. “We applaud the aggressive efforts of Los Angeles to control particle pollution. It’s proof that making a commitment to clean up pays off.”

Several cities across the country lost footing and slipped closer to the top of the list of most ozone-polluted cities, including San Diego, Atlanta, Charlotte and the Baltimore-Washington, D.C. metro area. Birmingham, Alabama, joined the list for the very first time, ranking at number 22 of most ozone-polluted cities, while the five worst cities on this list actually saw modest improvements. Fresno, California, for example, experienced a remarkable decline in the number of high ozone days since its peak in 2001-2003.

Due to the lead time for the State of the Air report, the American Lung Association used the U.S. Environmental Protection Agency’s (EPA) 1997 standard for ozone levels rather than the new tighter standard announced on March 12, 2008.

“If we were to measure the number of unhealthy days against the new ozone standard, it would show that ozone pollution is worse than the report indicates,” said Ms. Toomey. “Even with these stricter ozone standards, Americans are being denied the health protection they deserve under the Clean Air Act.”

National trends: declines in ozone and particle pollution have stalled.

New this year, the State of the Air report provides online charts showing the trends in ozone and year-round particle pollution in each of the 25 most polluted cities. The ozone charts cover data from 1996 to 2006, while the year-round particle pollution charts show trends from 2000-2006. In addition, the report incorporates the EPA analyses of ozone trend data from 1990 to 2006 and particle pollution trend data for 2000-2006. The State of the Air trend charts and the EPA analyses confirm that air pollution levels dropped in the early years of this century, but have leveled off in the last three years, particularly when controlled for weather.

Other Key Findings of State of the Air 2008:

- One in 10 people in the U.S. live in areas with unhealthful levels of all three types of pollution: ozone, short-term and year-round particle pollution.

- Two of five people in the U.S live in counties that have un?¬healthful levels of either ozone or particle pollution.

- Nearly one-third of the U.S. population lives in areas with unhealthful levels of ozone.

- Over one quarter of the people in the U.S. live in an area with unhealthful short-term levels of particle pollution.

- One in six people in the U.S. live in an area with unhealthful year-round levels of particle pollution.

The cities identified in the lists below most often include the respective metropolitan areas.

Top Ten U.S. Cities Most Polluted by Short-Term Particle Pollution: 1) Pittsburgh, Pa.; 2) Los Angeles/Long Beach/Riverside, Calif.; 3) Fresno/Madera, Calif.; 4) Bakersfield, Calif.; 5) Birmingham, Ala.; 6) Logan, Utah 7) Salt Lake City, Utah ; 8) Sacramento, Calif.; 9) Detroit, Mich.; 10) Baltimore, Md./Washington, D.C./Northern Virginia.

Top Ten U.S. Cities Most Polluted by Year-Round Particle Pollution: 1) Los Angeles/Long Beach/Riverside, Calif.; 2) Pittsburgh, Pa.; 3) Bakersfield, Calif.; 4) Birmingham, Ala.; 5) Visalia/Porterville, Calif.; 6) Atlanta, Ga.; 7) Cincinnati, Ohio; 8) Fresno/Madera, Calif. 9) Hanford/Corcoran, Calif.; 10) Detroit, Mich.

Top Ten U.S. Cities Most Polluted by Ozone: 1) Los Angeles/Long Beach/Riverside, Calif.; 2) Bakersfield, Calif.; 3) Visalia/Porterville, Calif.; 4) Houston, Texas; 5) Fresno/Madera, Calif. 6) Sacramento, Calif. 7) Dallas-Fort Worth, Texas; 8) New York, N.Y./Newark, N.J.; 9) Baltimore, Md./Washington, D.C./Northern Virginia; 10) Baton Rouge, La.

To see what grade (A to F) your community’s air quality earned, visit the American Lung Association website at lungusa. Tips are also available on how to protect yourself and your family from air pollution.

About the American Lung Association

Beginning our second century, the American Lung Association is the leading organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is “Improving life, one breath at a time.”

American Lung Association

Indoor Mold, Building Dampness Linked to Respiratory Problems

Scientific evidence links mold and other factors related to damp conditions in homes and buildings to asthma symptoms in some people with the chronic disorder, as well as to coughing, wheezing, and upper respiratory tract symptoms in otherwise healthy people, says a new report from the Institute of Medicine of the National Academies.

However, the available evidence does not support an association between either indoor dampness or mold and the wide range of other health complaints that have been ascribed to them, the report says. Given the frequent occurrence of moisture problems in buildings and their links to respiratory problems, excessive indoor dampness should be addressed through a broad range of public health initiatives and changes in how buildings are designed, constructed, and maintained, said the committee that wrote the report.

“An exhaustive review of the scientific literature made it clear to us that it can be very hard to tease apart the health effects of exposure to mold from all the other factors that may be influencing health in the typical indoor environment,” said committee chair Noreen Clark, dean, School of Public Health, University of Michigan, Ann Arbor.

“That said, we were able to find sufficient evidence that certain respiratory problems, including symptoms in asthmatics who are sensitive to mold, are associated with exposure to mold and damp conditions. Even though the available evidence does not link mold or other factors associated with building moisture to all the serious health problems that some attribute to them, excessive indoor dampness is a widespread problem that warrants action at the local, state, and national levels.”

Excessive dampness influences whether mold as well as bacteria, dust mites, and other such agents are present and thrive indoors. Moreover, wetness may cause chemicals and particles to be released from building materials. Many studies of health effects possibly related to indoor dampness do not distinguish the specific health effects of different biological or chemical agents.

Through its careful review of the available scientific studies, the committee found sufficient evidence to conclude that mold and damp conditions are associated with asthma symptoms in asthmatics who are sensitive to mold, and to coughing, wheezing, and upper respiratory tract symptoms in otherwise healthy people. However, the evidence did not meet the strict scientific standards needed to establish a clear, causal relationship. An uncommon ailment known as hypersensitivity pneumonitis also is associated with indoor mold exposure in genetically susceptible people.

Damp conditions and all they entail may be associated with the onset of asthma, as well as shortness of breath and lower respiratory illness in otherwise healthy children, although the evidence is less certain in these circumstances. Likewise, the presence of visible mold indoors may be linked to lower respiratory tract illness in children, but the evidence is not as strong in this case.

The committee found very few studies that have examined whether mold or other factors associated with indoor dampness are linked to fatigue, neuropsychiatric disorders, or other health problems that some people have attributed to fungal infestations of buildings. The little evidence that is available does not support an association, but because of the dearth of well-conducted studies and reliable data, the committee could not rule out the possibility.

Studies on animals and cell cultures in labs have found toxic effects from various microbial agents, raising concerns about whether these same agents growing in buildings can cause illness in people.

Molds that are capable of producing toxins do grow indoors, and toxic and inflammatory effects also can be caused by bacteria that flourish in damp conditions, the report noted. Little information exists on the toxic potential of chemicals or particles that may be released when building materials, furniture, and other items degrade because of wetness.

The committee recommended that current animal studies of short-term, high-level inhalation exposures to microbial toxins be supplemented with new research that evaluates the effects of long-term exposures at lower concentrations.

Moisture and mold problems stem from building designs, construction and maintenance practices, and building materials in which wetness lingers. Technical information describing how to control dampness already exists, but architects, engineers, building contractors, facility managers, and maintenance staff do not always apply this knowledge, the report says.

Training curricula on why dampness problems occur and how to prevent them should be produced and disseminated. Guidelines for preventing indoor dampness also should be developed at the national level to promote widespread adoption and to avoid the potential for conflicting advice from different quarters.

In addition, building codes and regulations should be reviewed and modified as necessary to reduce moisture problems.

Research on various means to prevent or eliminate excessive dampness — including educational initiatives and building renovations or design changes — should be undertaken to find out which are effective.

While there is universal agreement that promptly fixing leaks and cleaning up spills or standing water substantially reduces the potential for mold growth, there is little evidence that shows which forms of moisture control or prevention work best at reducing health problems associated with dampness, the report notes. In addition, materials designed to educate the public about the actual health risks associated with indoor dampness should be developed and evaluated.

The effectiveness of economic and other incentives to spur adherence to moisture prevention practices — such as bonuses for facility managers who meet defined goals for preventing or reducing problems, or fines for failure to correct problems by a specified deadline — should be evaluated, and successful strategies should be implemented.

The committee had insufficient information to recommend either an appropriate level of dampness reduction, or a safe level of exposure to organisms and chemicals linked to dampness. Better standardized methods for assessing human exposure to these agents are greatly needed, the report says. It calls for studies that compare various ways to limit moisture or eliminate mold and to evaluate whether the interventions improve occupants’ health.

The study was sponsored by the Centers for Disease Control and Prevention. The Institute of Medicine is a private, nonprofit institution that provides health policy advice under a congressional charter granted to the National Academy of Sciences. A committee roster follows.

Pre-publication copies of Damp Indoor Spaces and Health are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at nap. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).

[ This news release and report are available at national-academies ]

INSTITUTE OF MEDICINE
Board on Health Promotion and Disease Prevention

Committee on Damp Indoor Spaces and Health

Noreen M. Clark, Ph.D. (chair)
Dean
School of Public Health;
Marshall H. Becker Professor of Public Health; and
Professor of Pediatrics
University of Michigan
Ann Arbor

Harriet M. Ammann, Ph.D., D.A.B.T.
Senior Toxicologist
Air Quality Program
Washington State Department of Ecology
Olympia

Bert Brunekreff, Ph.D.
Professor of Environmental Epidemiology
Institute of Risk Assessment Sciences
University of Utrecht
Netherlands

Peyton A. Eggleston, M.D.
Professor of Pediatrics
School of Medicine, and
Professor of Environmental Health Science
Bloomberg School of Public Health
Johns Hopkins University
Baltimore

William J. Fisk, M.S., P.E.
Senior Staff Scientist and Department Head
Indoor Environment Department
Lawrence Berkeley National Laboratory
Berkeley, Calif.

Robert E. Fullilove III, Ed.D.
Associate Dean for Community and Minority Affairs, and Associate Professor of Clinical Sociomedical Sciences
Mailman School of Public Health
Columbia University
New York City

Judith Guernsey, M.Sc., Ph.D.
Associate Professor
Department of Community Health and Epidemiology
Dalhousie University
Halifax, Nova Scotia
Canada

Aino Nevalainen, Ph.D.
Head of Laboratory
Division of Environmental Health
National Public Health Institute
Kuipio, Finland

Susanna G. Von Essen, M.D.
Professor of Pulmonary and Critical Care Medicine
University of Nebraska Medical Center
Omaha

CONSULTANTS TO THE COMMITTEE

Terry Brennan, M.S.
President
Camroden Associates Inc.
Westmoreland, N.Y.

Jeroen Douwes, Ph.D.
Associate Director
Centre for Public Health Research
Massey University
Wellington, New Zealand

INSTITUTE STAFF

David A. Butler, Ph.D.
Study Director

Date: May 25, 2004
Contacts: Christine Stencel, Media Relations Officer
Megan Petty, Media Relations Assistant
Office of News and Public Information
202-334-2138; e-mail

New Task Force In Leicester To Combat Asthma

A new task force for combating asthma in Leicester is being spearheaded by a University of Leicester medical researcher.

Dr Monica Lakhanpaul, Senior Lecturer in Child Health and Consultant Community Paediatrician and her co-researchers, have won a grant from the NIHR Health Services Research programme to work with the community, families, children and professionals to develop a tailored management and intervention programme for asthma in South Asian children in Leicester.

The team will be interviewing members of the community, children with asthma and their parents to give them a voice in academic and clinical forums, so that the end product interventions are informed by the views and experiences of people who suffer with asthma and who live with asthma patients.

“This means we will be developing services with the community for the community,” said Dr Lakhanpaul. “The research will serve as a model for working collaboratively to develop community health care programmes across the UK for all communities.”

Dr Lakhanpaul said: “Asthma is one of the most common long-term childhood conditions, affecting 1 in 11 children in the UK. South Asian children with asthma suffer poorer health and outcomes than others.

“On completion, our research will provide evidence to be used when tailoring and delivering intervention programmes by providing a template for child, family, community and professional collaboration in intervention design that is intended to be transferrable to children with other chronic conditions or from other population groups.

The study will explore the perceptions and experiences of parents and children, the attitudes and experiences of the wider community in relation to child health and those of healthcare professionals involved in commissioning or delivering services for children and families.”

An important feature about the study is how it brings together researchers in the medical field with social scientists and psychologists to work together.

Dr Lakhanpaul will lead a team from the University of Leicester, De Montfort University, Leicester City Primary Care Trust and University Hospitals of Leicester NHS Trust in order to work with South Asian children, adults and healthcare professionals to understand the problem and find solutions.

Her co-researchers are:

Deborah Bird, Clinical Research Fellow on the project, University of Leicester; Lorraine Culley, Professor of Social Science and Health, De Montfort University; Jonathon Grigg, Professor, Queen Mary University London; Narynder Johal, Parent Representative ; Mark Johnson, Professor of Diversity in Health and Social Care, De Montfort University; Mel McFeeters, Consultant Nurse for Children’s Respiratory Disease, University Hospitals of Leicester NHS Trust; Noelle Robertson,Senior Lecturer in Clinical Psychology and Research Director D Clin Psy, University of Leicester and Joanne Wilson, Paediatric Advanced Nurse Practitioner, Leicester City Primary Care Trust.

Dr Lakhanpaul said: “In Leicester, a multi-cultural city with a 30% South Asian population, the rate of admission per 100,000 children was found to be 4.6 times higher in South Asian children than other children. One suggestion is that South Asian children are being under-diagnosed and under-treated at home and in the community, which may explain the increased use and need for hospital care.”

The Management and Interventions for Asthma Study (MIA) will develop suggestions for improving access to, and use of, services and ways of increasing success and confidence in self-management of asthma amongst South Asian communities.

Dr Lakhanpaul said: “MIA’s strength comes from its collaborative approach to research: it is hoped that by working with children, families and professionals, the study will be kept focussed on the issues that are important to the people affected by asthma and that the solutions are both practical and appropriate.

The lessons learnt from the study will help others to work collaboratively with communities to identify health issues which are of concern to them and to develop improved ways of tackling these.

Sources: Leicester University, AlphaGalileo Foundation.

Symbicort(R) Single Inhaler TherapyTM Better & Simpler in Asthma Control than SeretideTM

Today at the 101st International Conference of the American Thoracic Society (ATS), AstraZeneca revealed for the first
time that its novel treatment regimen, SYMBICORT(R) Single Inhaler TherapyTM (budesonide/formoterol maintenance and reliever
therapy) delivered greater improvement in key measures of asthma control and simplified management compared with SeretideTM
(fluticasone/salmeterol)1,2. Results from the COSMOS trial demonstrate that SYMBICORT Single Inhaler Therapy reduces the risk
of a severe asthma attack by 25 per cent (primary endpoint) and the total number of severe asthma attacks experienced by
patients by 22 per cent1,2.

COSMOS is the first ‘real-life’, one year, head-to-head trial of the two commonly used combination treatments, using
SYMBICORT Single Inhaler Therapy compared with a titrated dose of Seretide, as judged appropriate by the treating physician
(100/50, 250/50 and/or 500/50 BID). The study was performed open-label to allow clinicians freedom to adjust the maintenance
dose in both groups throughout the study and to examine the benefits of one inhaler versus multiple maintenance inhalers plus
separate ventoline as needed. The COSMOS trial studied 2,143 patients with moderate to severe asthma in 16 countries and
shows that patients using SYMBICORT in a Single Inhaler Therapy fashion – which is SYMBICORT as regular maintenance plus
as-needed doses at the first sign of symptoms to provide relief and added control – experienced fewer severe asthma attacks
and used less rescue medication compared to all doses of Seretide1,2. In addition, more patients at the study end were able
to use low levels of rescue therapy (i. e. less than 4 inhalations/week, which indicates good control) with SYMBICORT Single
Inhaler Therapy (76 per cent) versus Seretide (66 per cent) 1,2.

Professor Claus Vogelmeier, presenting the data at ATS commented, “Results from the COSMOS trial show for the first time that
SYMBICORT, when used as maintenance and reliever therapy, reduces the risk of developing a severe asthma exacerbation in
comparison to Seretide as maintenance plus salbutamol as reliever. SYMBICORT Single Inhaler Therapy is a unique management
approach using a simplified treatment regimen. Not only is one inhaler more convenient for patients to use and easier for
physicians to explain, but SYMBICORT can also achieve excellent asthma control, potentially impacting on future treatment
guidelines.”

A traditional fixed dosing treatment approach, as used with Seretide during this study, requires the use of separate
maintenance and reliever inhalers. In contrast, SYMBICORT Single Inhaler Therapy combines the two components of asthma
therapy in one inhaler, allowing patients the flexibility to intervene at the first signs of symptoms to prevent symptoms
from deteriorating and thereby preventing a severe asthma attack. This treatment concept is only possible with SYMBICORT as
it contains formoterol, a unique rapid and long lasting bronchodilator, which therefore can be used as maintenance and
reliever medication, and the inhaled corticosteroid budesonide to provide an additional anti-inflammatory effect.

Throughout the COSMOS study patients using SYMBICORT Single Inhaler Therapy managed their asthma using only one type of
inhaler for both maintenance and relief, while 55 per cent of the Seretide patients needed to switch their Seretide inhaler
and used a separate salbutamol inhaler as rescue, i. e. they required three different inhaler types to manage their asthma.
International asthma guidelines clearly indicate that compliance amongst patients is negatively affected by complex treatment
regimens resulting in poor asthma control. SYMBICORT Single Inhaler Therapy(R) not only offers a treatment option that is more
effective that Seretide but also simpler for the patients to use.

Additional benefits observed in the COSMOS trial for patients treated within the SYMBICORT Single Inhaler Therapy group,
versus the Seretide group, were1,2:

– The full effect on the exacerbation burden was exemplified by a 34 per cent reduction in oral steroid days and a 37 per
cent reduction in hospital days with Symbicort Single Inhaler Therapy

– Significantly less need for rescue medication throughout the year (38 per cent) with Symbicort Single Inhaler Therapy

– Significantly higher maximum lung function (FEV1) following bronchodilation at the clinic with Symbicort Single Inhaler
Therapy

– More patients on study completion were able to manage their asthma on a reduced dose of regular combination treatment (31
per cent vs. 14 per cent) with Symbicort Single Inhaler Therapy compared to initial maintenance dose

COSMOS is part of the wider, ongoing SYMBICORT Single Inhaler Therapy clinical trials programme3,4,5, which has already
exhibited superiority for this treatment regimen versus a fixed dose regimen of SYMBICORT. The programme now includes over
13,000 patients with mild to severe asthma and the results of all studies consistently indicate that SYMBICORT Single Inhaler
Therapy prevents patients from developing potentially life-threatening asthma attacks significantly better than fixed dosing.
SYMBICORT Single Inhaler Therapy is currently approved in two markets but outside the current licence for SYMBICORT in
Europe. The regulatory file for Europe will be re-submitted before end of 2005.

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of
prescription pharmaceuticals and the supply of healthcare services. It is one of the world’s leading pharmaceutical companies
with healthcare sales of over $21.4 billion and leading positions in sales of gastrointestinal, cardiovascular, respiratory,
oncology and neuroscience products. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the
FTSE4Good Index.

For more information, please visit astrazenecapressoffice

References

1 Vogelmeier C, D’Urzo A, Jaspal M, Merino JM, Johansson G, Boutet S. Symbicort for Both Maintenance and Relief Reduces
Exacerbations Compared with a Titration of Seretide (Advair) in Patients with Asthma: A Real-life Study. Abstract presented
at the ATS Congress 2005.

2 D’Urzo A, Vogelmeier C, Jaspal M, Merino JM, Boutet S. Symbicort (Budesonide/Formoterol) for Both Maintenance and Relief
Reduces the Exacerbation Burden Compared with a Titration of Seretide (Salmeterol/Fluticasone) in Patients with Asthma: A
Real-life Study. Abstract presented at the ATS Congress 2005.

3 KF Rabe, E Pizzichini, B Stollberg et al. Single Inhaler Therapy With Budesonide/Formoterol Provides Superior Asthma
Control Compared With Fixed Dosing With Budesonide Plus Terbutaline As Needed. Abstract presented at the 60th International
Meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI), San Francisco, USA, March, 2004

4 Scicchitano R, Aalbers R, Ukena D, Manjra A, Fouquert L, Centanni S, Boulet L-P, Naya IP, Hultquist C. Efficacy and safety
of budesonide/formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma. Current
Medical Research and Opinion 2004;20(9):1403-18.

5 O’Byrne P et al. Budesonide/Formoterol Combination Therapy as Both Maintenance and Reliever Medication in Asthma. American
Journal of Respiratory and Critical Care Medicine 2005; 171(2): 129-136

Ethics In Disaster Planning – Deciding What Is Fair

Most of us don’t want to think about the terrible choices a disaster or pandemic will force upon all of us. The questions such scenarios present are enormous in scope. How to answer those questions is the focus of the new issue of Practical Bioethics, the quarterly publication of the Center for Practical Bioethics.

“Preparedness for catastrophic events forces us to consider our unexamined priorities and values,” says Michael Brannigan, the Center’s vice president for clinical and organizational ethics. “With diminishing resources and escalating needs and costs, how do we fairly resolve the intractable conflict between self-interest and the good of the group?”

Brannigan says planning for a disaster or pandemic forces us to consider how to allocate scarce medical resources. The issues to be resolved are enormous:

How do we fairly ration scarce medical treatment such as vaccines and disposable ventilators?

– Who is treated after frontline workers and first responders? Those with high risk conditions or those who are healthier with normal life spans yet to live?

– What is the scope of healthcare workers’ duties to patients? How do we resolve duties to patients and duties to family?

– What is the institutions’ duty to safeguard and support staff who face disproportionate risks during disasters?

Articles in this edition of Practical Bioethics address how to set priorities, how hospitals are planning for the unthinkable, the importance of community input into disaster planning to ensure a moral framework for such planning, and factoring inequalities into pandemic flu planning.

Brannigan notes the Center is working with the Mid America Regional Council (MARC) to examine ethical issues in disaster planning and mass-casualty events. An Ethics in Disaster Planning Task Force has been formed comprised of members from hospital ethics committees, MARC hospital representatives and staff from both organizations.

“Our first charge as a task force is to establish a protocol for the fair allocation of ventilators, certainly a scarce resource even in the absence of a major crisis,” Brannigan says. “Only through such collaborative efforts can evenhanded rationing begin to make sense.”

Link: Making Hard Choices, Practical Bioethics, Volume 2, Number 4; Volume 3, Nos. 1,2 May 2007

Founded in 1984, the Center for Practical Bioethics raises and responds to ethical issues in health and healthcare. As an independent organization nationally recognized for its work in practical bioethics, the Center is more than a think tank. The Center puts theory into action to help people and organizations find real-world solutions to complex issues in health and healthcare.

Center for Practical Bioethics
1111 Main Suite 500
Kansas City, MO 64105
USA
practicalbioethics

Pancreatic Cancer Action Network Urges Congress For More Funding To Research This Deadly Disease

Today the Pancreatic
Cancer Action Network (PanCAN) and 165 advocates from all over the U.S. are
in Washington, DC to call on members of Congress to support federal cancer
research funding. To meet this urgent need, PanCAN will call on Congress to
support a minimum 6.7 percent increase for the National Institutes of
Health (NIH) and the National Cancer Institute (NCI). In 2006, an estimated
$66.7 million dollars of the NCI’s cancer research investment was spent on
pancreatic cancer research. This was just one percent of the NCI’s $4.8
billion dollar cancer research budget for 2006.

More than 37,000 Americans will be diagnosed this year with pancreatic
cancer, and 75 percent will die within the first twelve months from
diagnosis. Pancreatic cancer is the fourth leading cause of cancer death in
the U.S, yet one of the most underfunded for research.

“The need for more research is tremendous and our voices must be
heard,” says PanCAN President & CEO Julie Fleshman. “No effective early
detection methods currently exist and there are minimal treatment options
available. And very little research is being done due to limited research
funding.”

The country’s investment in cancer research over the last 20 years has
led to a slight drop in 2006 in overall deaths due to cancer. This fact
illustrates that our investment in cancer research is moving science
forward in the most common cancers, such as breast, colon and prostate.
However, the lack of progress in pancreatic cancer proves that we must
continue to make federal funding of cancer research a priority.

While in Washington, PanCAN advocates will also ask members of the U.S.
House of Representatives to support awareness efforts by co-sponsoring
legislation proclaiming November as “Pancreatic Cancer Awareness Month,” a
key component in raising awareness among policy makers about the high
mortality rate and lack of screening or treatment options for this
devastating disease.

“I’m able to be here because I’m a pancreatic cancer survivor, which
right now, is a very small group of people. I want to make a difference and
help others have the chance to survive. It’s important our legislative
decision- makers know that this disease exists and is fatal unless they
help fund research to develop pre-screening methods, diagnostic tools and
the development of effective treatments,” said Chris Calaprice, a
three-and-a half-year pancreatic cancer survivor from Santa Clarita, Calif.

About PanCan

The Pancreatic Cancer Action Network, Inc. (PanCAN), established in
1999, is the first national patient advocacy organization for the
pancreatic cancer community. PanCAN works to focus national attention on
the need to find a cure for pancreatic cancer. We provide public and
professional education embracing the urgent need for more research,
effective treatments, prevention programs and early detection methods.
PanCAN also funds research grants for pancreatic cancer, as well as
providing patient services. Volunteers across the country help us to
accomplish our goals.

Pancreatic Cancer Action Network, Inc.
pancan

Asthma Sufferer Wins Fight Over Council’s Toxic Cleaning Scheme, UK

A hospital worker has received compensation after a council exposed him to a toxic cleaning substance for more than a year, which seriously aggravated his asthma.

Julian Corlett, who works as an operational practitioner at Scunthorpe General Hospital and is secretary of UNISON’s Scunthorpe health branch, was forced to take time off work because the council refused to clear up the Freshclean cleaning powder dumped in his flat’s stairwell.

The powder had been left on the communal stairwell from August 2006 and is a known irritant for those who suffer breathing difficulties.

The product advises that protective clothing, a dust mask or respirator should be used to avoid dust inhalation.

Julian previously had mild asthma, which meant he did not need to use an inhaler, but within 12 months of being exposed to the cleaner, he had used four inhalers.

UNISON’s lawyers, Thompsons Solicitors, settled the claim for ??1,800. North Lincolnshire Council did not admit liability.

Julian Corlett said:

“The council had no grasp of the severity of the problem.

The powder was thick, like snow, and every time I came home I could not stop it coming into the house.

“I had chronic breathing difficulties and was unable to sleep, which had a huge effect on my work performance and relationships.

“It took such a long time to resolve, because the council did not take my complaints seriously, which made me feel depressed.

“If I hadn’t received help from UNISON and Thompsons I would still be living in a nightmare.”

John Cafferty, Head of Health for UNISON’s Yorkshire and Humberside region, said:

“We are pleased that Mr Corlett has received compensation for the effect of the toxic cleaning substance.

“But this cannot make up for such a long period of health problems, which have had a knock on effect on his work, relationships and mental health.

“It is disgraceful that Julian Corlett’s health complaint was not taken seriously and he would have been left to suffer in silence without UNISON’s help.

“Organisation’s must take note of health and safety problems and act on concerns and complaints, if the Council had acted when initially asked this could so easily have been avoided.”

Gillian Sayers, of Thompsons Solicitors, said:

“This case shows the important role trade union legal services have to play when members are injured in incidents which occur outside the work place.

“Asthma can be a debilitating condition. Julian was in control of his asthma before his contact with this product and, as a result of his exposure, was forced to take medication.

“Steps should have been taken to make sure it was kept out of harm’s way.”

Source
UNISON

Innovative Brain Scanning For Alzheimer’s Screening Unveiled

Researchers at the University
of Kentucky Sanders-Brown Center on Aging are launching an Alzheimer’s
screening clinical trial with Neuronetrix’s innovative brain scanning
system, called COGNISION(TM). The study will involve brainwave assessments
using a technology called event-related potentials (ERP’s). The study is
expected to validate the performance of the COGNISION(TM) system and to
demonstrate the system’s applicability in a primary care setting. Up to 100
Alzheimer sufferers and controls will participate over the next 6-12
months.

During the study patients will wear a sophisticated electronic headset
which will record brain activity in response to an auditory stimulus. The
process is similar to hearing screening tests performed on newborn infants
throughout the country. The data is then uploaded to an online database
where a powerful pattern recognition engine will correlate the ERP tests
with known brainwave patterns.

The COGNISION(TM) test is expected to be the first approved Alzheimer’s
disease screening test which directly evaluates a patient’s cognitive
performance. “We are not looking at a surrogate biomarker which may or may
not correlate with Alzheimer’s. Instead, we are directly measuring the
cognitive deficits caused by the disease,” says K.C. Fadem, co-founder of
Neuronetrix.

It is generally believed that the drugs used to treat Alzheimer’s, such
as market leader Aricept(R) from Pfizer, are most effective early in the
disease process. Because of this, a national focus has been placed on the
importance of Alzheimer’s screening to determine optimum treatment paths in
the early stage of the disease. At least one organization of medical
experts, the AD Screening Discussion Group, has advocated that Alzheimer’s
disease screenings become a routine part of the application for Medicare.

Alzheimer’s disease affects about 5 million Americans with 500,000 new
cases reported each year. This number is expected to grow to 16 million by
2050. The CDC recently reported that Alzheimer’s disease moved up to 7th
place from 8th place among the leading causes of death in 2004, passing
influenza and pneumonia.

The Sanders-Brown Center at the University of Kentucky is one of only
32 Alzheimer’s Centers of Excellence in the country. Neuronetrix is
planning a follow on study to evaluate the COGNISION(TM) System on a
commercial scale that will be performed at other Alzheimer’s Centers of
Excellence including the University of Pennsylvania and Indiana University.

For more information, go to neuronetrix

Neuronetrix, Inc.
neuronetrix

Potential Rapid Deployment Of Emergency Communication Infrastructure: Virginia Tech

Technologies used today by companies, such as Direct TV, Iridium Satellite, Bluetooth, and Globalstar, are based on satellite communications efforts started at Virginia Tech four decades ago in its Bradley Department of Electrical and Computer Engineering (ECE).

Beginning with their first NASA-funded project in 1971 and continuing through the 1990s, ECE Professors Charles Bostian and Warren Stutzman led Virginia Tech’s satellite communications efforts, building ground stations for global satellite communications and characterizing the propagation environment. “The work they started as members of Virginia Tech’s Satellite Communications Group has impacted standards and real systems used by industry and government,” said Jeff Reed, current director of WirelessVT.

A defining moment for Virginia Tech’s wireless researchers came when they started receiving major funding in 1993 from the Defense Advanced Projects Research Project Agency (DARPA). The first $1.7 million DARPA contract asked Virginia Tech to develop a revolutionary approach to wireless communications.

The Virginia Tech communications engineers combined new technologies in computer chips, antennas, and digital signal processing in a novel way, eventually allowing wireless devices to be extremely miniature, but able to adapt to interference in the radio channel. They accomplished their goals and increased the number of radio devices that could share a single radio frequency, thereby increasing the capacity of wireless users in a specific region of space.

“Companies spun out of this research,” Reed said, including the first wireless communications company in Blacksburg, TSR Technologies, which later was sold to Grayson Electronics. In 1998, a second spin-off, Wireless Valley Communications Inc., was founded and later sold to Motorola for some $30 million. “People made their careers from the enabling technologies that we developed,” Reed said.

In the 1990s, the wireless researchers at Virginia Tech began filing for patent after patent. Within a few years, some of the technologies they had developed included SIRCOM, an indoor channel modeling program; CELLSCOPE, a technology that identifies a person using a cellular phone; SMT, a site modeling tool for indoor communications that led to Wireless Valley Communications; Stallion, a high-performance computing device for handsets; and Interactive Video, a wireless mechanism for users to order products they see advertised on TV. All were available for licensing through Virginia Tech Intellectual Properties Inc.

In one of the first highly publicized uses of CELLSCOPE, the FBI employed it in 1995 to track down Kevin Mitnick, the nation’s most-wanted computer hacker, in Raleigh, N.C. The SMT software was licensed in its introductory year to leading communications companies, including Motorola, Ericsson, Hewlett Packard, Tellans, and Mobile System International.

Some of the other wireless projects the different groups were working on then are commonplace today, such as the creation of Bluetooth technologies that enable the wireless office emerging in the 21st century; software radio for wireless communication interoperability and smart antenna technologies to eliminate co-channel interference; and advanced wireless modems to support remote computing and high-data-rate wireless access to the Internet. They also were instrumental in improving cellular communications to prevent co-channel interference, and in allowing radio waves to penetrate into buildings. In the area of intelligent transportation systems, they were working on Global Positioning Systems more than a decade before they became popular Christmas presents for directionally challenged drivers.

MPRG founder Ted Rapapport authored the first textbook on modern wireless communications, called Wireless Communications: Principles and Practice in 1996. An instant classic in academia, some 30 universities from around the world adopted its use within the first 12 months, and thousands of engineers were trained using the knowledge coming from the Virginia Tech research laboratories.

As the wireless faculty moved into the 21st century, Virginia Tech became the leading research institution in the field of cognitive radios, called a new frontier for the world of wireless communications. Cognitive radios are intelligent radios that can determine the best way to operate in any given situation. “The new cognitive radios are similar to living creatures in that they are aware of their surroundings and understand their own and other users’ capabilities and the governing regulatory constraints” and address the incompatible communications problems between emergency services, said Bostian, also an Alumni Distinguished Professor. They also hold promise for rapid deployment of emergency communication infrastructure in the event of a disaster.

Virginia Tech has led the charge in this new research field of cognitive radios, developing prototype radios and intellectual property in this area. “We are very optimistic that this technology will begin to show up in products within the next five years and be very common within 10 years,” Reed said.

Source: Lynn Nystrom

Virginia Tech

More Non-Physician Clinicians Will Boost African Healthcare Workforce

The use of more non-physician clinicians in sub-Saharan Africa could be a cost-effective way
to boost the healthcare workforce in the region, and help deliver specific projects such as
the planned expansion of HIV/AIDS prevention and treatment programmes. The findings
are reported in a Public Health study published early Online and in an upcoming edition of
The Lancet.

Professor Fitzhugh Mullan and Dr Seble Frehywot, George Washington University School
of Public Health and Health Services, Washington, DC, USA, and colleagues did an analysis
of numbers of “non-physician clinicians” (NPCs), and their various roles, in 47 sub-Saharan
African countries.

The authors say: “Many nations have a history of health-care provision by staff who are not
trained as physicians but who are capable of many of the diagnostic and clinical functions
of medical doctors.” They add that this would include clinical officers, health officers, nurse
practitioners, and physician assistants.

They add: “The growing HIV/AIDS epidemic and the health targets established by the
Millennium Development Goals have brought global attention to the shortage of health
workers in Sub-Saharan Africa, and the necessary challenge of scaling-up the health
workforce.”

The researchers found that roles of NPCs varied widely between countries, and in nine
countries numbers of NPCs equalled or exceeded numbers of fully trained physicians. All
NPCs did basic diagnosis and medical treatment, and some were trained in certain specialty
activities, such as caesarean section, opthamology, and anaesthesia.

Many NPCs were recruited from rural and poor areas, and worked in those same regions, and
many of them have a pivotal role in the implementation and maintenance of antiretroviral
treatment campaigns.

The authors conclude: “Low training costs, reduced training duration, and success in
rural placements suggest that NPCs could have substantial roles in the scale-up of health
workforces in sub-Saharan African countries, including for the planned expansion of
HIV/AIDS prevention and treatment programmes.”

In an accompanying Comment, Dr Piya Hanvoravongchai, Department of Preventive and
Social Medicine, Chulalongkorn University, Bangkok, Thailand, says: “The crisis in the health
workforce in Africa needs urgent, systematic and collaborative action, and scaling up NPCs to
address health-workforce shortages is a promising solution that many countries are currently
pursuing.

“It is important that this rush towards actions is accompanied by active pursuit of evidence
and knowledge about the management of health workforces and systems.”

lancet