Aug 29, 2008 (CIDRAP News) – Some healthcare experts have wondered if large mortality reductions among older people who receive seasonal influenza immunizations are real or if the findings are biased by a “healthy-user” effect. But now a study that more rigorously controlled for confounders suggests that the benefits are overstated.The study, by Canadian researchers who evaluated data from patients admitted to six Capital Health hospitals in Alberta, appeared in the Sep 1 issue of the American Journal of Respiratory and Critical Care Medicine.It revealed no statistical difference between in-hospital mortality rates of elderly patients receiving seasonal flu vaccination and of those not vaccinated.It is the latest among a handful of recent studies that have cast doubt on the benefits of flu vaccines for older people and may call for a reexamination of public policy on flu vaccination among the elderly. A study that appeared in the Aug 2 issue of The Lancet suggested that the vaccine’s ability to protect the group from pneumonia was less than expected.Accounting for ‘good behavior’The research group pointed out that most evidence on the benefit of influenza vaccines in older patients is based on observational studies that suggest a 50% mortality rate reduction. However, they said many experts have suspected that such a high benefit is implausible.For example, they wrote that though vaccination rates in the United States’ elderly population have risen from 15% to 65% over the over the past 20 years the increase has not been matched by decreasing hospitalization and mortality rates.”Previous studies were likely measuring a benefit not directly attributable to the vaccine itself, but something specific to the individuals who were vaccinated—a healthy-user benefit or frailty bias,” said Dean T. Eurich, PhD, the study’s first author, in a press release from the American Thoracic Society, which publishes the American Journal of Respiratory and Critical Care Medicine. Eurich is a clinical epidemiologist and assistant professor at the University of Alberta’s School of Public Health.Also, the researchers wrote that other studies have detected similar mortality reductions during the times of year when influenza viruses aren’t circulating, which cast further doubt on the size of the vaccination benefit.Sumit Majumdar, MD, MPH, principal investigator and associate professor of medicine at the University of Alberta, said in the press release, “The healthy-user effect is seen in what doctors often refer to as their “good” patients—patients who are well-informed about their health, who exercise regularly, do not smoke or have quit, drink only in moderation, watch what they eat, come in regularly for health maintenance visits and disease screenings, take their medications exactly as prescribed—and quite religiously get vaccinated each year so as to stay healthy.””Such attributes,” he said, “are almost impossible to capture in large-scale studies using administrative databases.”Majumdar and colleagues hypothesized that if a healthy-user effect was responsible for mortality benefits, then the same benefit would be seen during the “off season,” when the influenza virus wasn’t circulating.The researchers had access to a large database that allowed them a unique opportunity to explore the bias, because it included a number of potential healthy-user indicators such as smoking and functional status.Looking beyond biasesThey analyzed data from 704 patients ages 65 and over who were admitted to the hospital for community-acquired pneumonia during non-flu season intervals from 2000 through 2002. Researchers matched 352 patients who had received their flu vaccines against 352 controls who did not.Twelve percent (81) of the patients died. When the group looked at in-hospital death rates, they found that vaccinated patients were about half as likely to die as those who weren’t vaccinated (28 [8%] versus 53 [15%]), which is consistent with past observational studies. However, when they adjusted for the healthy-user effects, the benefit was much smaller, and at 19% didn’t reach statistical significance.The authors concluded that a difficult-to-detect healthy-user effect is present among vaccinated patients, and that other analyses of vaccine benefit during influenza season probably overestimate the benefit of vaccination. However, they cautioned that their findings might not be generalized to healthier, lower-risk patients in a nonhospital setting.Putting the findings to useThe findings have broad implications for public health, the authors wrote. Patients with chronic diseases, as well as their contacts, should still get their annual flu vaccines, Majumdar said in the press release. “But you also need to take care of yourself. Everyone can reduce their risk by taking simple precautions,” he said, such as hand-washing, avoiding sick people during flu season, taking antiviral medication, and seeking prompt medical care.Inflated mortality reductions noted in previous studies could hamper efforts to develop better vaccines, particularly for use in elderly populations, they wrote. Evidence-based findings, however, may help policymakers to direct their efforts more toward hand-washing and vaccinating children and healthcare workers, they added.And for researchers, the findings might serve as a useful reminder, Majumder said in the press release. “The healthy-user effect is everywhere you don’t want it to be.”Eurich DT, Marrie TJ, Johnstone J, et al. Mortality reduction with influenza vaccine in patients with pneumonia outside ‘flu’ season: pleiotropic benefits or residual confounding? Am J Respir Crit Care Med 2008 Sep 1;178(5):527-33 [Abstract]See also:Aug 29 American Thoracic Society press releaseAug 8 CIDRAP News story “Study: Flu shots may not protect elderly from pneumonia”
Apr 21, 2009 (CIDRAP News) – Two California children who had not had contact with pigs recently recovered from infections with “unique” swine influenza viruses, raising concern about possible human-to-human transmission and putting health authorities on alert, the Centers for Disease Control and Prevention (CDC) reported today.The two cases were in a 10-year-old boy in San Diego County and a 9-year-old girl in neighboring Imperial County, but they are apparently unrelated, the CDC said in an MMWR Dispatch report today.”The viruses from the two cases are closely related genetically, resistant to amantadine and rimantadine [the two older flu antivirals], and contain a unique combination of gene segments that previously has not been reported among swine or human influenza viruses in the United States or elsewhere,” the CDC report says.The lack of any known exposure to pigs in the two cases increases the chance that the children contracted their infections from other people, the CDC said. The agency advised physicians to consider animal influenza virus infections in patients who recently were in the two California counties or had contact with pigs.The CDC says it received reports of 12 human swine flu cases from December 2005 through January 2009, an increase from the previous long-term average of about one case every 1 to 2 years. The “vast majority” of such cases do not lead to human-to-human transmission, but all need to be investigated thoroughly, the agency states.Illnesses began in MarchThe 10-year-old boy fell ill with fever, cough, and vomiting on Mar 30, according to the CDC. He was taken to a clinic, where he received symptomatic treatment, and he recovered in about a week. He had not received flu vaccine this season. The boy and his family said he had had no exposure to pigs.Initial testing at the clinic indicated an influenza A virus but was negative for human subtypes H1N1, H3N2, and H5N1, the report says. A sample was sent to reference laboratories, which were unable to identify the subtype. The CDC received a sample Apr 14 and identified the virus as swine influenza A/H1N1.The boy’s mother had a nonfebrile respiratory illness in the first few days of April, and his 8-year-old brother was sick with a cough and fever on Apr 11, but no respiratory samples were taken during their illnesses.In the other case, the CDC received an influenza specimen on Apr 17 that the Naval Health Research Center in San Diego had sent as a type A virus that couldn’t be subtyped, according to the report. The CDC identified the virus as a swine influenza A/H1N1 isolate the same day.The sample came from the 9-year-old girl, who got sick with a cough and fever (104.3ºF) on Mar 28, the report says. She was treated at an outpatient clinic with antibiotics and an antihistamine, and she recovered uneventfully. The girl reported that she had visited a fair with a pig exhibit about 4 weeks before her illness but that she had not seen the pigs, and she reported no other exposure.The girl’s 13-year-old cousin, who was living with the family, had a flu-like illness 3 days before she got sick, and her 13-year-old brother had similar symptoms on Apr 1, the CDC reports. But neither was tested for flu while they were sick.So far, no epidemiologic link between the two cases has been found, nor have any other cases been identified involving the new strain, the report says. Case and contact investigations by the county and states health agencies are under way.A new combination of genesThe viruses from the two patients are similar, and the majority of their genes, including the hemagglutinin gene, are similar to those of swine flu viruses that have circulated in US pigs since about 1999, the CDC reports. But the genes for the neuraminidase (NA) and matrix (M) proteins are similar to corresponding genes of Eurasian swine flu viruses.”This particular genetic combination of swine influenza virus segments has not been recognized previously among swine or human isolates in the United States, or elsewhere based on analyses of influenza genomic sequences available on GenBank,” the report states.While there is no formal system for monitoring what viruses circulate in US swine, viruses with this combination of genes are not known to be circulating in the country, the report adds.Testing is under way to learn whether the two viruses are susceptible to the neuraminidase inhibitor drugs oseltamivir and zanamivir.The CDC advises that clinicians should consider animal as well as seasonal flu virus infections in patients who live in or who visited San Diego or Imperial County or were in contact with sick people from either county in the week before their illness onset. It also urges clinicians to take a nasopharyngeal swab in such cases and to contact their state or local health department to arrange for testing at a state public health lab.CDC. Swine influenza A (H1N1) infection in two children—Southern California, March-April 2009. MMWR Dispatch 2009 Apr 21;58 [Full text]
August 25, 2020 Gobernador Wolf: $17 millones para ayudar a las escuelas a mejorar servicios para estudiantes históricamente desatendidos Education, Español, Press Release El Gobernador Tom Wolf está dedicando aproximadamente $17 millones para ayudar a 220 agencias de educación locales (LEA, por sus siglas en inglés), incluidos los distritos escolares, a mejorar los servicios educativos para aproximadamente 180,000 estudiantes en escuelas designadas para Mejora y Apoyo Específico Adicional (ATSI, por sus siglas en inglés) en virtud de la Ley federal Cada Estudiante Triunfa (ESSA, por sus siglas en inglés).“Si bien todas las escuelas se han visto afectadas este año por la pandemia de COVID-19, las escuelas que, según la ESSA, han sido identificadas como que necesitan apoyo adicional enfrentan desafíos adicionales”, dijo el Gobernador Wolf. “Esta financiación ayudará a estas escuelas de alta necesidad a medida que implementan sistemas para ayudar a los estudiantes mientras trabajamos para controlar la propagación de este virus”.La Ley de Ayuda, Alivio y Seguridad Económica contra el Coronavirus (CARES, por sus siglas en inglés) autoriza a los gobernadores a determinar el uso educativo de los Fondos de Ayuda para la Educación de Emergencia del Gobernador (GEER, por sus siglas en ingles).ESSA requiere que los estados desarrollen planes para designar escuelas para apoyo y mejoramiento basado en el desempeño de grupos individuales de estudiantes en áreas clave, incluyendo el rendimiento y crecimiento académico; tasa de graduación y progreso de los estudiantes de inglés; y factores de éxito de los estudiantes como asistencia regular y ausentismo crónico. Los grupos de estudiantes incluyen razas, económicamente desfavorecidos, estudiantes del idioma inglés y estudiantes con discapacidades.“Reconociendo que los esfuerzos de respuesta al COVID-19, incluidos los cierres de edificios, es probable que empeoren las brechas de resultados para los estudiantes históricamente desatendidos, se alienta a las escuelas y unidades intermedias a utilizar estos fondos adicionales para acelerar los esfuerzos para involucrar a las partes interesadas locales e implementar mejoras apropiadas basadas en evidencia estrategias”, dijo el Secretario de Educación Pedro A. Rivera.Las subvenciones se calcularon en base a elementos de la fórmula federal del Título I, Parte A, incluido el número de estudiantes en desventaja económica y otros datos de inscripción escolar.Los destinatarios de la subvención recibirán una comunicación directa del Departamento de Educación (PDE, por sus siglas en inglés) con las instrucciones de solicitud de eGrant.Hasta la fecha, la Administración Wolf ha otorgado $87.5 millones en fondos GEER para ayudar a mantener seguros a los estudiantes y educadores y enfrentar los desafíos únicos de COVID-19. Además de los $17 millones para las escuelas ATSI, la Administración Wolf ha destinado $15 millones para educación especial, $28 millones para instituciones de educación superior y proveedores de educación básica para adultos, $14 millones para escuelas K-12 para apoyar la equidad en la continuidad de la educación, $10.5 millones para Centros de educación vocacional y técnica y $3 millones para programas preescolares de intervención temprana.Para obtener más información sobre las políticas y los programas educativos de Pennsylvania, consulte el sitio web del Departamento de Educación o siga al PDE en Facebook, Twitter o Pinterest.View this information in English. SHARE Email Facebook Twitter
44 Rushworth St, Bald Hills. Picture: realestate.com.au With Australia’s cricket team in turmoil, now is the time for all those future budding sporting stars to knuckle down and became the next generation of cricketing greats. Heading off to the local nets on the weekend is a great idea, but what if you had the facilities right in your own backyard? At 44 Rushworth St, Bald Hills, a three-bedroom home seeking offers of more than $439,000, has a recently constructed swimming pool, plus a cricket pitch and putt-putt golf.The home has a renovated kitchen, plus a rumpus room or teenager’s retreat. It has an open floor plan which flows out onto a covered patio. 115 Menser St, Calamvale. Picture: realestate.com.auThe house itself has a formal lounge room, large main bedroom with ensuite and built-in robes, and plantation stutters throughout.There are new carpets and Travertine marble floors.It is listed through Liz Richardson of Harcourts Beyond – Holland Park.Head north toward Hervey Bay and a five-bedroom home at 19 Island Close, Pacific Haven, is listed for $1.6 million. 115 Menser St, Calamvale. Picture: realestate.com.auIt is on a 758sq m block of land and is listed through Claudia Rocha of Ray White – Aspley Group. At 115 Menser St, Calamvale, this three-bedroom home would be a cricket lover’s dream. The semirural 10,100sq m property has plenty of room to hit a six without smashing a window.In fact it has just about enough to run your own sporting centre from home.There are two cricket nets, two tennis or basketball courts and a children’s playground as well as a swimming pool and parking for eight cars.More from newsNew apartments released at idyllic retirement community Samford Grove Presented by Parks and wildlife the new lust-haves post coronavirus19 hours ago 9 Island Close, Pacific Haven. Picture: realestate.com.auThere is also a private boat ramp, pontoon, storage shed and five rainwater tanks.It is listed through Michelle Lockwood of RE/MAX Partners Hervey Bay – Torquay. 9 Island Close, Pacific Haven. Picture: realestate.com.auThe riverfront home has multiple living and entertainment areas including a billiards room.There is a 4.5m indoor spa and an 11m swimming pool.The property also has its own beach volleyball court, cricket pitch and a fire pit for cool nights.
Sharing is caring! 30 Views no discussions HealthLifestyle Joint Cuba-Venezuela ‘Operation Miracle’ benefits more than 1.5 million people by: – October 8, 2012 Tweet Share Share Share Photo credit: avn.info.veHAVANA, Cuba (ACN) — More than 1.5 million surgeries to correct eye conditions have been performed since 2004, as part of Mission Milagro (Operation Miracle), a humanitarian and social program created by the governments of Cuba and Venezuela. Venezuelan program coordinator Manuel Pacheco told Venezuelan News Agency the program has treated 158,515 people suffering mainly from pterygium, cataracts and strabismus this year.Currently, about 5,000 patients are operated on each week in Venezuela — that’s the same amount of people who received treatment in a year there before the program started.These services have also helped more than 33,000 people from Ecuador, El Salvador, Nicaragua, Honduras, Guatemala, Costa Rica, Chile, Paraguay and Argentina.The Mission’s ophthalmologists and optometrists attend at scheduled medical appointments in each country. The program was first implemented on July 2004 to offer free service to the poor people with visual health problems.Initially, more than 200,000 patients traveled to Havana per year, where they underwent surgery, while the Venezuelan government implemented an investment plan to refurbish local hospitals. Caribbean News Now
The suspect had no legal papers for thegun, thus he would be charged with violating Republic Act 10591 or for illegalpossession of firearm. He was detained in the lockup cell of the municipalpolice station./PN The 56-year-old Loterio Castor ofBarangay Buri, Tapaz, Capiz was caught around 5:30 p.m. on April 16, a police reportshowed. ILOILO City – Police arrested a manafter an unlicensed gun was seized from him at a quarantine checkpoint in BarangayBinulosan Pequeño, Calinog, Iloilo. The Calinog police recovered fromLoterio a .45-caliber pistol loaded with three live bullets.
Curt Clawson is one of three candidates in a special election for U.S. Congress in Florida on Tuesday. (Image: Facebook)Voters in Southwest Florida have an opportunity to select a Batesville native for U.S. Representative during a special election Tuesday.Curt Clawson, a 1978 graduate of Batesville High School, won the Republican Primary in April.He is one of three candidates to replace former U.S. Rep. Trey Radel who resigned in January after pleading guilty to drug possession.Clawson is the favorite to win the congressional seat Tuesday in the heavily Republican district.He is challenged by Democrat April Freeman and Libertarian Ray Netherwood.The candidate that is voted in will head to Washington D.C. to be sworn in to congress.Clawson led the state of Indiana in scoring as a senior basketball player for the Bulldogs and went on to have a successful playing career for the Purdue Boilermakers. A former CEO and top executive in the auto industry, Clawson has ran his campaign as, “The Outsider For Congress.”
read also:Zaha hailed for saving lives during coronavirus pandemic The Ivory Coast forward had been seeking a move since January as he is in pursuit of Champions League football. The 27-year-old has reportedly appointed super-agent Pini Zahavi to broker a transfer. FacebookTwitterWhatsAppEmail分享 Newcastle United are eyeing Crystal Palace star, Wilfried Zaha, for the summer market. Should the Premier league approve the £300million buyout, Newcastle will be able to afford Zaha’s £60million price tag with the inordinate amount of wealth accessible through the Saudi Public Investment Fund, which is worth a reported £320billion, says the Daily Mail.Advertisement Loading… Promoted ContentHere Are The Best Movies Since 1982 You Should Definitely SeeBirds Enjoy Living In A Gallery Space Created For Them6 Ridiculous Health Myths That Are Actually TrueWhich Country Is The Most Romantic In The World?TV Characters Who Hated Each Other But Later Became FriendsWho’s The Best Car Manufacturer Of All Time?10 Risky Jobs Some Women DoWho Is The Most Powerful Woman On Earth?8 Superfoods For Growing Hair Back And Stimulating Its GrowthThe Highest Paid Football Players In The World7 Of The Wealthiest Universities In The WorldTop 9 Scariest Haunted Castles In Europe
Press Association That defeat prevented the Three Lions qualifying for Euro 2008 and cost McClaren his job as England boss, as well as a large chunk of his credibility. And in their first competitive meeting since that rain-soaked night, Bilic once again came out on top while McClaren’s Toon side are still winless, having not scored in the league since the opening day of the season. West Ham’s start to the campaign has been somewhat bizarre to say the least, with wins at Arsenal and Liverpool sandwiching home defeats by Leicester and Bournemouth. But they could sense Newcastle were there for the taking after just nine minutes when £10.5million summer signing Payet capped a sweeping move with a stunning opener. Mark Noble collected Diafra Sakho’s backheel in the penalty area and laid the ball back for the French midfielder to coolly sidefoot a curling effort into the top corner. Payet arrived from Marseille with a reputation for creating goals as well as scoring them, and he showed why by teeing up Manuel Lanzini for a shot which the youngster blazed over, before playing in debutant Victor Moses only for the Chelsea loanee to fire wide. By contrast, the sum total of Newcastle’s efforts in the first half was a Janmaat shot which Hammers keeper Darren Randolph comfortably kept out. And three minutes into the second half West Ham doubled their lead. Goals in each half from Dimitri Payet proved enough to fire the Hammers up to fifth in the Barclays Premier League, and leave McClaren’s Newcastle stuck in the bottom three. Bilic famously masterminded McClaren’s darkest hour in management eight years ago when his Croatia side beat England 3-2 at Wembley. Slaven Bilic gave Steve McClaren another miserable evening as West Ham finally got their home campaign up and running with a 2-0 win over Newcastle. Moses was desperately unlucky not to mark an impressive first appearance with a goal when he ran almost the length of the field following a Newcastle corner, only to crash his shot against the crossbar. The ball bounced down and out towards the lurking Payet, who thumped it into an empty net to take his tally for the season to three. Newcastle tried to find a way back into the match but the closest they came was a shot from Siem de Jong which was deflected narrowly over the top, much to McClaren’s frustration. It may not have rained at Upton Park as it did at Wembley that fateful night, but you sense the storm clouds may already be brewing at Newcastle. TWEET OF THE MATCH “Absolutely fabulous goal for West Ham. Delightful buildup play and finished exquisitely by Payet.” – Former England marksman Gary Lineker was impressed with Payet’s first goal. https://twitter.com/GaryLineker/status/643502471160201216 PLAYER RATINGS West Ham Darren Randolph: 6/10 Aaron Cresswell: 6 Winston Reid: 7 Angelo Ogbonna: 6 James Tomkins: 7 Cheikhou Kouyate: 7 Mark Noble: 7 Manuel Lanzini: 7 Dimitri Payet: 9 Victor Moses: 8 Diafra Sakho: 7 Substitutes Carl Jenkinson: 6 Pedro Obiang: 6 Andy Carroll: 6 NEWCASTLE Tim Krul: 6 Daryl Janmaat: 5 Fabricio Coloccini: 6 Chancel Mbemba: 5 Massadio Haidara: 6 Jack Colback: 5 Moussa Sissoko: 7 Georginio Wijnaldum: 6 Vernon Anita: 6 Florin Thauvin: 6 Papiss Cisse: 5 Substitutes Siem de Jong: 6 Ayoze Perez: 5 Rolando Aarons: 5 STAR PLAYER Dimitri Payet. The 10.5million summer signing from Marseille brings substance as well as style to the Hammers’ attack. He has plenty of tricks in his locker but two fine goals showed his undoubted class. MOMENT OF THE MATCH Payet’s first goal. A sweeping move down the left saw Diafra Sakho’s backheel complete a one-two with Mark Noble, who laid the ball back for Payet to sidefoot into the top corner from 20 yards. VIEW FROM THE BENCH Bilic wants his side to attack and they look like they have goals all throughout their midfield and front players. Newcastle’s problem is goalscoring, and it showed with Papiss Cisse stuck up front virtually on his own. MOAN OF THE MATCH Those hardy Newcastle fans who travelled to London for an 8pm kick-off on a Monday night deserve a break from the TV schedulers, as well as a lot more than they got from their team. WHO’S UP NEXT Man City v West Ham (Premier League, September 19) Newcastle v Watford (Premier League, September 19) West Ham manager Slaven Bilic believes his side were worthy winners at Upton Park. He told Sky Sports 1: “I think we fully deserved the three points tonight. I think that we scored a goal at the right time. “I am really proud of our performance in the second half because we were solid, good at keeping the ball and we were great at counter attacks. “This is small proof that we are on the right way and also small proof that we have really done well in the transfer window.” New Hammers captain Noble was delighted to record a long-awaited home victory. “We’ve waited a long time – obviously from the start of the season for a home win – but also from the Liverpool game due to the international break and the later Monday night kick-off but I thought we played really well tonight,” said Noble. “Dimitri showed what an asset he is to our football club. He doesn’t just create goals and score goals – he works hard, I think you’ve seen that tonight, and he plays for the team as well. That’s why the players think so much of him and you can see the fans do now as well. “We really fancied tonight after the performance against Liverpool and I think it showed in the way we started and the way we defended – (we kept) another clean sheet.” Payet was thrilled with his performance. He said: “I am very happy. It was a good match for us tonight and the three points are very, very important.” Meanwhile, Newcastle head coach Steve McClaren wants a “big reaction” from his side in their next outing. He said: “It’s a wake up call for everybody. In this Premier League you need to be at 100 per cent in every game and if you’re not, you get beaten. “Credit to West Ham, they were there. Once they got the first goal you could see they were really gunning for it and we didn’t match that, which we’ve been doing over the four games. “So yeah, a big wake up call and now we need a big reaction on Saturday.”
Comments Football beat writers Tony Olivero and Andrew John break down Syracuse’s 23-6 loss to Connecticut in the final Big East game of the season. Published on November 21, 2010 at 12:00 pm Facebook Twitter Google+