Category Archives: Health

WHO lists drug-resitant bacteria fight priorities


Following up on our earlier post about the soaring rates of antibiotic-resistant bacteria in children comes word from the World Health Organization of a new catalog on the rising number of drug-repellent microbes, setting priorities for development of new medical treatments:

WHO today published its first ever list of antibiotic-resistant “priority pathogens” – a catalogue of 12 families of bacteria that pose the greatest threat to human health.

The list was drawn up in a bid to guide and promote research and development (R&D) of new antibiotics, as part of WHO’s efforts to address growing global resistance to antimicrobial medicines.

The list highlights in particular the threat of gram-negative bacteria that are resistant to multiple antibiotics. These bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well.

“This list is a new tool to ensure R&D responds to urgent public health needs,” says Dr Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation. “Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”

The WHO list is divided into three categories according to the urgency of need for new antibiotics: critical, high and medium priority.

The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia.

These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria.

The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhoea and food poisoning caused by salmonella.

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Child antibiotic-resistant infections soar 700%


The Enterobacteriaceae are members a family of bacteria that don’t thrive in the open air, proliferating instead in water, soil, and the digestive tracts of larger animals. Like, say, us.

While many Enterobacteriaceae are helpful in digesting what we eat, others are much more nasty, including Salmonella, Escherichia coli, and Yersinia pestis [cause of the bubonic plague].

For most of the seven decades we’ve spent on planet Earth, a dose of penicillin or some of the other antibiotics developed since would provide a reliable cure,

But no longer, because overuse of antibiotics both in human medicine and in industrial animal agriculture and the failure of patients to take full courses of prescribed and unprescribed medications have given rise to bacteria capable of withstanding all those medications.

In just eight years, starting in 2007, the rate of antibiotic-resistant Enterobacteriaceae in U.S. children has soared a shocking 700 percent.

From Case Western University:

The adage that kids are growing up too fast these days has yet another locus of applicability.

In a new, first-of-its-kind study, researchers from Case Western Reserve University School of Medicine have found a 700-percent surge in infections caused by bacteria from the Enterobacteriaceae family resistant to multiple kinds of antibiotics among children in the US. These antibiotic resistant infections are in turn linked to longer hospital stays and potentially greater risk of death.

The research, published [an astounding $251 to read — esnl] in the March issue of the Journal of the Pediatric Infectious Diseases Society, is the first known effort to comprehensively examine the problem of multi-drug resistant infections among patients under 18 admitted to US children’s hospitals with Enterobacteriaceae infections. Earlier studies focused mainly on adults, while some looked at young people in more limited geographical areas, such as individual hospitals or cities, or used more limited surveillance data.

“There is a clear and alarming upswing throughout this country of antibiotic resistant Enterobacteriaceae infections in kids and teens,” said lead author Sharon B. Meropol, MD, PhD, a pediatrician and epidemiologist at Case Western Reserve University School of Medicine and Rainbow Babies and Children’s Hospital in Cleveland. “This makes it harder to effectively treat our patients’ infections. The problem is compounded because there are fewer antibiotics approved for young people than adults to begin with. Health care providers have to make sure we only prescribe antibiotics when they’re really needed. It’s also essential to stop using antibiotics in healthy agricultural animals.”

In the retrospective study, Meropol and co-authors Allison A. Haupt, MSPH, and Sara M. Debanne, PhD, both from Case Western Reserve University School of Medicine, analyzed medical data from nearly 94,000 patients under the age of 18 years diagnosed with Enterobacteriaceae-associated infections at 48 children’s hospitals throughout the US. The average age was 4.1 years. Enterobacteriaceae are a family of bacteria; some types are harmless, but they also include such pathogens as Salmonella and Escherichia coli; Enterobacteriaceae are responsible for a rising proportion of serious bacterial infections in children.

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John Oliver tackles the GOP war on Obamacare


In the latest episode of his HBO series, John Oliver casts a suspicious eye at the Republican rhetoric surrounding their attack of the Affordable Care Act.

It’d be hilarious were the Republicans not seemingly bent on killing off the poor.

Obamacare: Last Week Tonight with John Oliver

Program notes:

Congressional Republicans could soon vote to repeal Obamacare. John Oliver explores why their replacement plans are similar to a thong.

Why Donald Trump could win his war on the EPA


Founded in 1970, the Environmental Protection Agency is the one positive legacy left by Richard M. Nixon, one of America’s worst Republican Presidents, the only one forced to resign in disgrace because of his criminal conduct.

The agency, charged with protecting folks from the worst environmental ravages wrought by corporations and developers, the EPA has played a major role in cleaning up the nation’s worst environmental disasters and preventing others.

But with prominent members of the Trump administration opposed to the agency’s vary existence, California legislators announced new measures this week designed to replace threatened federal regulations with new state counterparts.

From the Sacramento Bee:

Fearing a federal rollback of longstanding protections for air quality, clean water, endangered species and workers’ rights, California Democrats are pursuing legislation that would cement those environmental and labor regulations in state law.

The trio of bills announced Thursday also seek to use state authority to block private development of federal lands in California and extend some safeguards to federal whistleblowers.

“Californians can’t afford to go back to the days of unregulated pollution,” Senate President Pro Tem Kevin de León said at a press conference. “So we’re not going to let this administration or any other undermine our progress.”

>snip<

De León and other state senators who joined him Thursday pointed to a litany of developments over recent months that compelled them to act: Trump calling climate change a hoax; proposals to eliminate the U.S. Environmental Protection Agency; the confirmation of Scott Pruitt, who as attorney general of Oklahoma repeatedly sued the EPA, to lead the agency.

But nationally the threat remains

And it’s very real, with the Trumpies presented with uniquely circumstances boding ill for our world and our descendants.

University of Florida Professor Emeritus of Political Science Walter A. Rosenbaum is uniquely suited to address the threat, being both an internationally recognized academic environmentalist and a former Special Assistant to the EPA’s Assistant Administrator for Policy Planning.

What follows is his analysis, Why Trump’s EPA is far more vulnerable to attack than Reagan’s or Bush’s, an essay written for The Conversation, an open-source academic journal written in conversational English:

For people concerned with environmental protection, including many EPA employees, there is broad agreement: The U.S. Environmental Protection Agency is in deep trouble.

The Trump administration has begun the third, most formidable White House-led attempt in EPA’s brief history to diminish the agency’s regulatory capacity.

Scott Pruitt, Trump’s newly appointed EPA administrator, is a harsh critic and self-described “leading advocate against EPA’s activist agenda.” Pruitt’s intention to reduce EPA’s budget, workforce and authority is powerfully fortified by President Donald Trump’s own determination to repeal major EPA regulations like the Obama’s Clean Power Plan and Climate Action Plan.

Previous presidents have tried to scale back the work of the EPA, but as a former EPA staff member and researcher in environmental policy and politics, I believe the current administration is likely to seriously degrade EPA’s authority and enforcement capacity.

The vanished majorities

This latest assault on EPA is more menacing than previous ones in part because of today’s Republican-led Congress. The Democratic congressional majorities forestalled most past White House efforts to impair the agency’s rulemaking and protected EPA from prolonged damage to its enforcement capability.

Presidents Ronald Reagan (1981-1988) and George H. W. Bush (1989-1993) both sought to cut back EPA’s regulatory activism. Reagan was fixated on governmental deregulation and EPA was a favorite target. His powerful assault on EPA’s authority began with the appointment of Anne Gorsuch, an outspoken EPA critic, as EPA administrator. Gorsuch populated the agency’s leadership positions with like-minded reformers and supervised progressive reductions in EPA’s budget, especially for EPA’s critically important enforcement division, and hobbled the agency’s rule-making – a key step in the regulatory process – while reducing scientific support services.

Bush’s forays against EPA authority were milder, consisting primarily of progressive budget cuts, impaired rule-making and disengagement from international environmental activism.

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Ending gay marriage could increase teen suicides


As triumphant Republican lawmakers, now controlling the national legislature and the legislatures of 32 states, we can expect action of promises to end same-sex marriage,

But, if successful, will those efforts lead to a spike in teen suicides?

That’s to conclusion of a new scientific study released today.

From the Johns Hopkins Bloomberg School of Public Health:

The implementation of state laws legalizing same-sex marriage was associated with a significant reduction in the rate of suicide attempts among high school students—and an even greater reduction among gay, lesbian and bisexual adolescents, new Johns Hopkins Bloomberg School of Public Health research suggests.

The researchers, whose work was published today in JAMA Pediatrics [open access], estimate that state-level same-sex marriage policies were associated with more than 134,000 fewer adolescent suicide attempts per year. The study compared states that passed laws allowing same-sex marriage through January 2015 to states that did not enact state-level legalization. A Supreme Court decision made same-sex marriage federal law in June 2015.

The findings show the effect that social policies can have on behavior, the researchers say.

“These are high school students, so they aren’t getting married any time soon, for the most part,” says study leader Julia Raifman, a post-doctoral fellow in the Department of Epidemiology at the Bloomberg School. “Still, permitting same-sex marriage reduces structural stigma associated with sexual orientation. There may be something about having equal rights—even if they have no immediate plans to take advantage of them—that makes students feel less stigmatized and more hopeful for the future.”

Suicide is the second-most common cause of death among people ages 15 to 24 in the United States, trailing only unintentional injury. U.S. suicide rates have been rising, and data indicate that rates of suicide attempts requiring medical attention among adolescents increased 47 percent between 2009 and 2015.

Gay, lesbian, and bisexual high school students are at particular risk. In the new study, 29 percent of gay, lesbian, and bisexual high school students reported attempting suicide in the previous year as compared to 6 percent of heterosexual teens.

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Chart of the day: What makes us feel stressed


From Stress in America™: Coping with Change [open access]:

blog-stress

Another new report offers some meaningful insight into the reasons the White House is now occupied by the Orange Abomination.

Each of us suffers from stress to one degree or another, be it from our health, our family life, our friends, or any one the myriad factors at play in our lives.

But some stresses are more general, emotional themes at work in communities states, and nations.

And those external stresses and the anxieties we feel because of them, the ones held in common by so many,  offer a fertile medium for ideological contagion by folks skilled at manipulating fears and capitalizing on the mass anxieties they mobilize.

A new study from the American Psychological Association looks at the fears held in common, and the stressors they reveal are precoisely the fears Donald Trump aroused, mobilized, and exploited in his drive to win the Oval Office:

Two-thirds of Americans say they are stressed about the future of our nation, including a majority of both Democrats and Republicans, according to the American Psychological Association’s (APA) report Stress in America™: Coping with Change. [open access].

More than half of Americans (57 percent) say the current political climate is a very or somewhat significant source of stress, and nearly half (49 percent) say the same about the outcome of the election, according to an APA poll conducted in January.

While Democrats were more likely than Republicans (72 percent vs. 26 percent) to report the outcome of the 2016 presidential election as a significant source of stress, a majority of Republicans (59 percent) said the future of the nation was a significant source of stress for them, compared with 76 percent of Democrats.

“The stress we’re seeing around political issues is deeply concerning, because it’s hard for Americans to get away from it,” said Katherine C. Nordal, PhD, APA’s executive director for professional practice . “We’re surrounded by conversations, news and social media that constantly remind us of the issues that are stressing us the most.”

Nordal also noted that while APA is seeing continued stress around politics, the survey also showed an increased number of people reporting that acts of terrorism, police violence toward minorities and personal safety are adding to their stress levels.

These results come on the heels of APA survey results released last fall that found 52 percent of Americans reported that the presidential election was a significant source of stress. That survey was conducted online in August 2016 among 3,511 adults 18+ living in the U.S. by Harris Poll on behalf of the APA. To better understand these political stressors and assess potential long-term effects, APA commissioned an additional survey, conducted online by Harris Poll in early January 2017, among 1,019 adults ages 18+ who reside in the U.S. , asking adults once again to rate the sources of their stress, including the political climate, the future of our nation and the outcome of the 2016 U.S. presidential election.

Between August 2016 and January 2017, the overall average reported stress level of Americans rose from 4.8 to 5.1, on a scale where 1 means little or no stress and 10 means a great deal of stress, according to the APA survey. This represents the first significant increase in the 10 years since the Stress in America survey began. At the same time, more Americans said that they experienced physical and emotional symptoms of stress in the prior month, health symptoms that the APA warns could have long-term consequences.

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Poor teens go hungry as younger sibs are fed


From Johns Hopkins University, an alarming finger about hunger and poverty in the United States:

In very poor families, teenagers are going hungry twice as often as their younger siblings, a new Johns Hopkins University study finds.

Parents first forgo food themselves, skipping meals to feed their children. But if there still isn’t enough for everyone, the study found parents will feed younger children before teenagers, regularly leaving the older kids—teen boys in particular—without enough to eat.

“If you’re really poor, you try to sacrifice yourself first, but when you’re forced to make some choices, these parents are deciding to let the teens not have enough—if they have to give up on something, they’re giving up on teenagers,” said JHU economist Robert Moffitt, the lead author. “It’s hard to imagine parents having to do that.”

The study, which is the first to demonstrate how children’s food deprivation can differ by age and gender, even within the same household, is published as a working paper for the National Bureau of Economic Research [$5 to read].

Moffitt and co-author David C. Ribar of the Melbourne Institute of Applied Economic and Social Research analyzed a survey of about 1,500 extremely disadvantaged families in Boston, Chicago, and San Antonio. The survey asked parents, along with one of their children, about missing meals, checking in with them several times over six years, from 1999 to 2005.

The families had incomes well below the federal poverty line, making an average of about $1,558 a month, or $18,696 a year. Most were headed by single parents, unemployed, on welfare, and not college-educated. Most were minorities and raising children in rental homes.

Questions for the parents included:

  • At any time in the past 12 months, did you or other adults in your household cut the size of your meals or skip meals because there wasn’t enough money for food?
  • At any time in the past 12 months, did you or any other adults in your household not eat for a whole day because there wasn’t enough money for food?
  • In the past 12 months, were you ever hungry but didn’t eat because you couldn’t afford food?
  • Sometimes people lose weight because they don’t have enough to eat. In the past 12 months, did you lose weight because there wasn’t enough food?

In these disadvantaged families, researchers found 12 percent of the adults suffered from extreme food hardship, answering “yes” to several of these questions. At the same time, about 4 percent of the children went hungry.

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