2011年8月31日 星期三

Millions at risk of cholera in Ethiopia, WHO warns

Refugees and children wait to go to a refugee camp in the Ethiopian town of Dolo Ado, about 1 km north of the border with Somalia, July 9, 2011. REUTERS/Stringer

Refugees and children wait to go to a refugee camp in the Ethiopian town of Dolo Ado, about 1 km north of the border with Somalia, July 9, 2011.

Credit: Reuters/Stringer

By Stephanie Nebehay

GENEVA | Fri Jul 15, 2011 11:17am EDT

GENEVA (Reuters) - Five million people are at risk of cholera in drought-hit Ethiopia, where acute watery diarrhea has broken out in crowded, unsanitary conditions, the World Health Organization (WHO) said on Friday.

Cholera, an acute intestinal infection, causes watery diarrhea that can quickly lead to severe dehydration and death if treatment is not promptly given, according to the United Nations agency.

"Overall, 8.8 million people are at risk of malaria and 5 million of cholera (in Ethiopia)," WHO spokesman Tarik Jasarevic said in a note sent to journalists.

Ethiopian health officials have confirmed cases of acute watery diarrhea in the Somali, Afar and Oromiya regions of Ethiopia, he told Reuters. "It is not confined to the refugees."

WHO is delivering emergency health kits to Ethiopia and helping train health workers in treating malnutrition and in detecting disease outbreaks, he said.

Drought across the Horn of Africa, now affecting more than 11 million people in Ethiopia, Djibouti, Kenya and Somalia, has increased the risk of the spread of infectious diseases, especially polio, cholera and measles, the WHO says.

"So far WHO has not received any report of polio cases, it really important to help countries to keep their polio-free status," Jasarevic said.

Somalis fleeing severe drought and intensified fighting have been arriving at the rate of more than 1,700 a day in Ethiopia, where 4.5 million people now need assistance, nearly a 50 percent rise since April, he said.

MEASLES RISK

Two million children in Ethiopia are at risk of catching measles, a disease that can be deadly in children, he said.

Ethiopian officials reported 17,584 measles cases and 114 deaths during the first half of the year, UNICEF spokeswoman Marixie Mercado said. The majority of cases were in children.

Measles has also broken out in the sprawling Kenyan Dadaab camps, with 462 cases confirmed including 11 deaths, Jasarevic said.

Dadaab, an overcrowded complex of three camps, now holds some 440,000 refugees, the U.N. refugee agency said on Friday.

UNHCR plans to begin a massive airlift this weekend to bring tents and other aid supplies to the remote border region, spokesman Adrian Edwards told a news briefing.

A Boeing 747 flight carrying 100 tonnes of tents is expected to land in Nairobi on Sunday, he said. Six further flights were planned over the next two weeks.

U.N. High Commissioner for Refugees Antonio Guterres welcomed an announcement by Prime Minister Raila Odinga on Thursday that Kenya is to open an extension to the camps to ease congestion at Dadaab, where 1,300 Somali refugees arrive daily.

"It will prevent congestion increasing further in the short term. Obviously larger needs relate to the need to undertake humanitarian efforts inside Somalia itself," Edwards said.

The United Nations carried out its first airlift of emergency supplies in two years to southern Somalia -- an area controlled by al Shabaab rebels -- on Wednesday, UNICEF said.

"Ten health kits, each sufficient to treat 10,000 people over 3 months are also en route via road," Mercado said.

Obama: Americans back me on debt deal

Updated 1:02 p.m. Eastern Time

President Obama on Friday pointed to polls to argue that his proposal of a "balanced approach" on a debt deal - one that includes revenue increases as well as spending cuts - is what the American people want.

"My Republican friends have said that they're not willing to do revenues, and they have repeated that on several occasions," he told reporters at a news conference at the White House. "My hope, though, is that they're listening not just to lobbyists or special interests here in Washington, but they're also listening to the American people. Because it turns out, poll after poll, many done by your organizations, show that it's not just Democrats who think we need to take a balanced approach, it's Republicans as well."

A Gallup poll released Wednesday found that only 20 percent of Americans support a deal that only includes spending cuts, something Republicans have insisted on. Another 30 percent wanted a deal that was "mostly" spending cuts, and 32 percent wanted a deal split equally between spending cuts and tax increases. Eleven percent favored a deal that was mostly or all tax increases.

"The clear majority of Republican voters think that any deficit reduction package should have a balanced approach and should include some revenues," Mr. Obama said. "That's not just Democrats. That's the majority of Republicans." (That Gallup poll found that only one in four Republicans favor a deal that is only spending cuts.)

President Obama makes an opening statement on the ongoing budget negotiations before his press conference.

(Credit: AP Photo/Pablo Martinez Monsivais)

The president reiterated his desire to see lawmakers "do something big," saying, "We have a chance to stabilize America's finances for a decade, for 15 years or 20 years, if we're willing to seize the moment." An agreement to do so requires "shared sacrifice," he said, including cuts to defense spending, dealing with entitlement spending (including Medicare), and revenue increases.

He said he is still pushing for "a big deal" -- he has set $4 trillion as a benchmark in the past -- but also seemed to acknowledge that a smaller (if still "ambitious") deal of around $2 trillion is now more likely. He said he has told congressional leaders that "If we can't do the biggest deal possible, then let's still be ambitious, let's still try to at least get a downpayment on deficit reduction."

He said he indicated that that is something "we can actually accomplish without huge changes in revenue or significant changes in entitlements, but we could still send a signal that we are serious about this problem."

The president said he wants congressional lawmakers to come back to him within 24-36 hours with a plan, saying that "if they show me a serious plan, I'm ready to move, even it requires some tough decisions on my part."

A plan that includes spending cuts in excess of $2 trillion but is "not asking anything from the wealthiest among us or from closing corporate loopholes -- that doesn't seem like a serious plan to me," he added.

Mr. Obama's comments follow an appearance Friday morning by House Speaker John Boehner, who says Republicans are leading where the president is not. House Republicans plan a vote next week would raise the debt ceiling in conjunction with passage of a balanced budget amendment, despite the fact that such an amendment has virtually no chance of passage. (Mr. Obama said Friday that "we don't need" a balanced budget amendment.)

Obama: We don't need a balanced budget amendment

Boehner said in response to Mr. Obama's comments that "President Obama has been talking tough about cutting spending, but his deeds aren't matching his words."

"While Republicans have focused on the big problems we face, this White House has focused on protecting the status quo," he said. "The same holds true for entitlement spending, where the White House has been talking in terms of nickels and dimes at a time when trillions of dollars in serious reforms are needed to preserve the programs and put them on a sustainable path."

At a closed-door meeting Thursday, Mr. Obama told lawmakers "it's decision time" for a deal, a Democratic official familiar with the talks said. That meeting, which came after a contentious session Wednesday, was described as "very cordial" - though a breakthrough remained elusive.

Boehner: Obama has no debt plan. Republicans do
Obama presses on debt deal: "It's decision time"
Boehner says too many people trying to make deal

The Obama administration and many economists, including Federal Reserve Board Chairman Ben Bernanke, have warned of economic catastrophe if the United States does not raise the amount it is legally allowed to borrow -- now $14.3 trillion -- by August 2. Yet lawmakers remain far apart on a deal.

Republicans, who control the House of Representatives, have said they will only vote to increase the debt limit in exchange for a deficit-reduction package larger than the amount of the increase. Democrats are in favor of such a package, but there is a major point of contention between the parties: Republicans want the deal to include only spending cuts, while Democrats say it must also include revenue increases as well.

If the debt ceiling is not increased by August 2, the administration says, the United States will no longer to be able to pay its obligations, potentially resulting in default to creditors, the suspension of Social Security checks and other benefits, an increase in interest rates and a host of other extremely serious and negative economic consequences. Administration officials have suggested a deal must be in place by roughly July 22 in order to get a deal through Congress in time.

"This is not some abstract issue," Mr. Obama said Friday. "These are obligations that the United States has taken on in the past. The Congress has run up the credit card, and we now have an obligation to pay our bills. If we do not, it could have a whole set of adverse consequences. We could end up with a situation, for example, where interest rates rise for everybody all throughout the country -- effectively, a tax increase on everybody -- because suddenly, whether you're using your credit card, you're trying to get a loan for a car or a student loan, businesses that are trying to make payroll, all of them could end up being impacted as a consequence of a default."

On Wednesday, ratings agency Moody's put the United States' Aaa bond rating under review for possible downgrade as the deadline approaches, and Standard and Poor's quickly followed suit with its own warning of a possible downgrade; on Thursday, Geithner said bluntly, "we're running out of time."

There has been growing momentum around Senate Majority Leader Mitch McConnell's "back-up plan" to effectively hand responsibility for raising the debt ceiling over to Mr. Obama. That would allow Republicans not to have to vote to raise the debt ceiling, but it could also mean no spending cuts in conjunction with the debt ceiling increase. That prospect angers fiscal conservatives.

"This proposal is a dereliction of duty by Senator McConnell and everything that's wrong with Washington," Club for Growth President Chris Chocola said Friday of the plan. "It's nothing more than a legislative maneuver by so-called Republicans to avoid responsibility for America's spending problem."

Mr. Obama described the McConnell plan as "the least attractive option" Friday, saying that "if we take that approach, this issue is going to continue to plague us for months and years to come."

Asked for specifics about what he was considering as part of a debt deal, Mr. Obama said "we've said that we are willing to look at" raising the retirement age and means testing Social Security of Medicare. He said that while he sees those two programs "as the most important social safety nets that we have," by "making some modest modifications in those entitlements can save you trillions of dollars."

More coverage of the debt limit from CBS MoneyWatch.com:

Jobs: The elephant being ignored in deficit talks?
Did Republicans just force the Fed into QE3?


2011年8月30日 星期二

Elder Care - Getting to the Bottom of the Memory Problem

When you approach your medical professional regarding memory issues, what should you expect during the diagnosis period? There are several things that you should expect to be included in a good medical workup when there is memory loss.
A complete physical with medical history - Did you know that only 30% of physicians will do a complete medical workup on patients with presenting dementia symptoms after the age of 75? This is inexcusable when so many easily treatable conditions can cause memory issues.
A neurological workup- This should include brain scans such as an MRI, PET Scan, or Cat Scan. Often the physician will refer the patient to a neurologist who specializes in geriatric patients.
A complete history from the family of what is going on-Do not expect the patient to be able to give a good picture. The patient is having memory issues. They will not be able to give a good picture of the symptoms.
A thorough medication review- Medication interactions are a common cause of dementia symptoms. Once corrected, the symptoms may disappear. Even many over the counter medications may cause memory problems.
Neuropsychological Testing-This may include things such as the MMSE, the Alz Self-Test, or other screens. The value of these tests is that we get a picture of where the person is now cognitively, as well as establishing a baseline for later exams.
Follow-up- You should expect good follow-up from the physician. There will be test results to review, medications to monitor, as well as support to offer.
Referrals as needed- Your physician may refer you to a clinic in your area that specializes in dementia care and treatment. He may also refer you to a Geriatric Care Manager who will offer guidance and expertise for your area resources, along this very difficult road. This is also the time to seek an Elder Care Attorney to make sure your documents are in order. Your Geriatric Care Manager will help you find a reputable Elder Care Attorney.

Do not let your doctor ignore your symptoms. If you feel that you are not getting the care you deserve, please take the time to look for another doctor. Ask your network of friends, or look for a community expert such as a in your area. Insisting on a thorough medical workup may mean a huge difference in the rest of your life.

Health Highlights: July 13, 2011

2011年8月29日 星期一

The Elderly and Delirium

Two of the things you will notice if your elderly parent is suffering from delirium are sudden changes in behavior and their mental state. They may be hyper-alert, startle more easily or be overly sensitive to their surroundings. They can also become quite agitated or may wish to sleep for longer periods of time. They may be unable to follow a conversation or stay focused. Or their conversation may become incoherent. They may also have a decreased appetite or become incontinent. Becoming lost in places they know well is not unusual in this situation. They can experience disturbances in perception such as not understanding what is happening around them. They may not recognize familiar people. There may at times be paranoia or unrealistic fears and possibly emotional outbursts.

My mother, in her last couple of years, had several episodes of delirium and hallucinations. This is very frightening for the person experiencing them and it was also frightening for her family members, especially before we understood the reasons for them. There were several times where she saw people that were not there and carried on conversations with them. She would be adamant that the person existed and became very angry and disoriented when we tried to explain to her what was happening.

Some of the causes of delirium and/or hallucinations are:

- side effects and possible interactions of some medications;
- pain;
- infections or severe illness (with my mother it always happened when she had a bladder infection which is extremely common with elderly women);
- low oxygen levels;
- lack of sleep;
- side effects from anesthetics;
- poor nutrition and/or lack of hydration.

If this should happen to your loved one, it is important that they receive medical treatment as soon as possible. These changes in the person are sudden and are not connected with dementia.

The following are some of the things you can do if your elderly parent is suffering from delirium:

- the person by name to get their response. Remind them of the day, time and where they are;
- keep sentences short and simple;
- let them know that they are being looked after and are safe;
- if the person wears glasses, make sure they are clean and being worn. This includes their hearing aides as well. These things help them to become orientated;
- try to control excessive noise and over-stimulation. This cannot always be the case, particularly if they are in a hospital environment;
- ensure that dentures are in and that they eat regularly and drink fluids frequently;
- ensure that treatment for the cause of delirium is being treated and followed up on.

Recovery time may vary from days to several weeks or longer depending on the cause of the delirium. Comfort measures are important for the patient as well as having the support of family and friends nearby.

Sylvia Behnish writes articles relating to family issues, motivational topics, entertaining, travel and brain injuries. For more information on any of these topics, go to her sites listed below. She has recently published her first non-fiction book entitled "Rollercoaster Ride With Brain Injury (For Loved Ones)" and her first fiction novel entitled "His Sins", a three generation family saga.

"Rollercoaster Ride With Brain Injury (For Loved Ones)" and "His Sins" can be ordered by e-mail at: http://www.sbehnish.blogspot.com/

Blog: http://www.progressofabraininjury.blogspot.com/

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