Month: December 2017

A survey by the U.N. refugee agency reveals heightened worries by the Rohingya refugee population in Cox’s Bazar, Bangladesh over their health and safety.

It has been nearly four months since the mass exodus of Rohingya refugees began from Myanmar into Cox’s Bazar, Bangladesh. More than 645,000 Rohingya who escaped violence and persecution in Myanmar are living in squalid, overcrowded settlements.  

A survey by the U.N. refugee agency and 13 other organizations finds the refugees have developed strong support networks to help them cope with their difficulties.

UNHCR spokesman Andrej Mahecic says the refugees have many worries. They express concern about their safety, considering their weak shelter accommodations and poor lighting at night.

“Access to sanitation is still insufficient, leading sometimes to long queues for latrines,” said Mahecic. “Women and girls are anxious about the shortage of private bathing spaces, forcing some to wash outside their shelters in early morning hours.”

The survey finds some children have to walk long distances to fetch water and firewood, a situation that can put them at risk. Mahecic says both parents and children want access to education and more safe places for children to play. He says health services also are a major concern.

“Increased mental health support for those who have witnessed the killings or suffered torture or rape remains crucially needed,” said Mahecic. “Refugees cite continued feelings of depression and rejection, especially among the elderly and disabled. Many young people are worried about their uncertain future.” 

Mahecic says the UNHCR will use the survey findings to improve its protection and assistance programs for the Rohingya in the coming year. He says the agency already has begun providing alternatives to firewood to address child labor and environmental concerns.

He says efforts also are under way to improve the hygiene and sanitary conditions for women and girls and to provide more child-friendly spaces where boys and girls can play in safety. Children account for more than half of the refugee population.

Health officials say the refugees are extremely vulnerable to diseases as they have low vaccination coverage and are living in congested, unsanitary settlements that are breeding grounds for infectious diseases.

 
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The World Meteorological Organization reports 2017 is on track to be among the three hottest years on record, just behind the two preceding years.

While 2017 may only emerge as the third warmest year on record, scientists predict it will beat out the competition for warmest year without a warming El Nino. These record setting years concern those who see this as a sure sign that climate change is happening at a quickened pace.

The WMO says the overall long-term warming trend since the late 1970s is worrying and cannot be ignored. The United Nations agency says rising temperatures are ushering in more extreme weather with huge socioeconomic impact.

WMO spokeswoman Claire Nullis says the warming conditions prevailing over both the Arctic and the Antarctic are very alarming. She says the Arctic is warming at about twice the rate of the global temperature increase.

“We are very, very concerned about the rate of warming in the Arctic,” she said. “There was an Arctic Report Card released last week. It said while 2017 saw fewer records shattered than in 2016, the Arctic shows no sign of returning to the reliably frozen region it was decades ago.”

​The Arctic Report Card is a peer-reviewed report that brings together the work of 85 scientists from 12 nations.

WMO notes warmer than average temperatures dominated across much of the world’s land and ocean surfaces during November. It says the most notable temperature rises were across the Northern Hemisphere.

For example, it reports temperatures in northern Canada and northwestern Alaska were two degrees centigrade above the average, indicating a very pronounced warming at the Arctic.

 
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The Environmental Protection Agency says an internal task force appointed to revamp how the nation’s most polluted sites are cleaned up generated no record of its deliberations.

EPA Administrator Scott Pruitt in May announced the creation of a Superfund Task Force that he said would reprioritize and streamline procedures for remediating more than 1,300 sites. Pruitt, the former attorney general of Oklahoma, appointed a political supporter from his home state with no experience in pollution cleanups to lead the group.

The task force in June issued a nearly three-dozen page report containing 42 detailed recommendations, all of which Pruitt immediately adopted. The advocacy group Public Employees for Environmental Responsibility, known as PEER, quickly filed a Freedom of Information Act request seeking a long list of documents related to the development of Pruitt’s plan.

After EPA didn’t immediately release any records, PEER sued.

Now, nearly six months after the task force released its report, a lawyer for EPA has written PEER to say that the task force had no agenda for its meetings, kept no minutes and used no reference materials.

Further, there was no written criteria for selecting the 107 EPA employees the agency says served on the task force or background materials distributed to them during the deliberative process for creating the recommendations.

According to EPA, the task force also created no work product other than its final report.

“Pruitt’s plan for cleaning up toxic sites was apparently immaculately conceived, without the usual trappings of human parentage,” said Jeff Ruch, the executive direction of PEER. “It stretches credulity that 107 EPA staff members with no agenda or reference materials somehow wrote an intricate plan in 30 days.”

The task force was led by Albert “Kell” Kelly, whom Pruitt hired at EPA as a senior adviser. Kelly was previously the chairman of Tulsa-based SpiritBank, where he worked as an executive for 34 years.

The Associated Press reported in August that Kelly was barred by the Federal Deposit Insurance Corporation from working for any U.S. financial institution after officials determined he violated laws or regulations, leading to a financial loss for his bank. The FDIC’s order didn’t detail what Kelly is alleged to have done. Without admitting wrongdoing, he agreed to pay a $125,000 penalty.
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In the universe, particularly in our galaxy, there are a great number of multiple-stellar systems where two or more stars rotate around each other. In many of these systems, the stars collide – a phenomenon that has been familiar to astronomers for a long time. But scientists say a collision that happened almost two thousand years ago will soon be able to be seen with the naked eye. VOA’s Aram Vanetsyan has more.
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A new study has dashed hopes that people may be able to protect themselves from dementia through medicine, diet or exercise.

“To put it simply, all evidence indicates that there is no magic bullet,” Dr. Eric Larson wrote in the Annals of Internal Medicine.

The study outlined in the medical journal looked at four types of intervention to try to prevent dementia — prescription drugs, exercise, cognitive training, and nonprescription vitamins and supplements.

Researchers found none worked.

The Lancet, a British medical journal, ​reported earlier this year that about one-third of dementia cases could be linked to such conditions as cigarette smoking, high blood pressure, obesity, a lack of exercise and depression.

While Larson said there was no simple answer to the prevention of dementia, he highly recommended a commonsense, healthful lifestyle that may help delay the disease. It would involve exercising regularly, refraining from smoking, eating a healthful diet and taking part in activities that stimulate the brain.
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Like a friendly Pied Piper, the violinist keeps up a toe-tapping beat as dancers weave through busy hospital hallways and into the chemotherapy unit, patients looking up in surprised delight. Upstairs, a cellist plays an Irish folk tune for a patient in intensive care.

Music increasingly is becoming a part of patient care, although it’s still pretty unusual to see roving performers captivating entire wards, as they did at MedStar Georgetown University Hospital one recent fall morning.

“It takes them away for just a few minutes to some other place where they don’t have to think about what’s going on,” said cellist Martha Vance after playing for a patient isolated to avoid spreading infection.

The challenge: harnessing music to do more than comfort the sick. Now, moving beyond programs like Georgetown’s, the National Institutes of Health is bringing together musicians, music therapists and neuroscientists to tap into the brain’s circuitry and figure out how.

“The brain is able to compensate for other deficits sometimes by using music to communicate,” said NIH Director Dr. Francis Collins, a geneticist who also plays a mean guitar.

To turn that ability into a successful therapy, “it would be a really good thing to know which parts of the brain are still intact to be called into action — to know the circuits well enough to know the backup plan,” Collins added.

Scientists aren’t starting from scratch. Learning to play an instrument, for example, sharpens how the brain processes sound and can improve children’s reading and other school skills. Stroke survivors who can’t speak sometimes can sing, and music therapy can help them retrain brain pathways to communicate. Similarly, Parkinson’s patients sometimes walk better to the right beat.

Scientific explanation

But what’s missing is rigorous science to better understand how either listening to or creating music might improve health in a range of other ways — research into how the brain processes music that NIH is beginning to fund.

“The water is wide, I cannot cross over,” well-known soprano Renee Fleming belted out, not from a concert stage but from inside an MRI machine at the NIH campus.

The opera star, who partnered with Collins to start the Sound Health initiative, spent two hours in the scanner to help researchers tease out what brain activity is key for singing. How? First, Fleming spoke the lyrics. Then she sang them. Finally, she imagined singing them.

“We’re trying to understand the brain not just so we can address mental disorders or diseases or injuries, but also so we can understand what happens when a brain’s working right and what happens when it’s performing at a really high level,” said NIH researcher David Jangraw, who shared the MRI data with The Associated Press.

To Jangraw’s surprise, several brain regions were more active when Fleming imagined singing than when she actually sang, including the brain’s emotion center and areas involved with motion and vision. One theory: It took more mental effort to keep track of where she was in the song, and to maintain its emotion, without auditory feedback.

Fleming put it more simply: “I’m skilled at singing so I didn’t have to think about it quite so much,” she told a spring workshop at the John F. Kennedy Center for the Performing Arts, where she is an artistic adviser.

Indeed, Jangraw notes a saying in neuroscience: Neurons that fire together, wire together. Brain cells communicate by firing messages to each other through junctions called synapses. Cells that regularly connect — for example, when a musician practices — strengthen bonds into circuitry that forms an efficient network for, in Fleming’s case, singing.

But that’s a healthy brain. In North Carolina, a neuroscientist and a dance professor are starting an improvisational dance class for Alzheimer’s to tell whether music and movement enhance a diseased brain’s neural networks.

Well before memory loss becomes severe, Alzheimer’s patients can experience apathy, depression, and gait and balance problems as the brain’s synaptic connections begin to falter. The NIH-funded study at Wake Forest University will randomly assign such patients to the improvisation class — to dance playfully without having to remember choreography — or to other interventions.

What will scans show?

The test: If quality-of-life symptoms improve, will MRI scans show correlating strengthening of neural networks that govern gait or social engagement?

With senior centers increasingly touting arts programs, “having a deeper understanding of how these things are affecting our biology can help us understand how to leverage resources already in our community,” noted Wake Forest lead researcher Christina Hugenschmidt.

Proof may be tough. An international music therapy study failed to significantly help children with autism, the Journal of the American Medical Association recently reported, contradicting earlier promising findings. But experts cited challenges with the study and called for additional research.

Unlike music therapy, which works one on one toward individual outcomes, the arts and humanities program at Georgetown Lombardi Comprehensive Cancer Center lets musicians-in-residence play throughout the hospital. Palliative care nurses often seek Vance, the cellist, for patients anxious or in pain. She may watch monitors, matching a tune’s tempo to heart rate and then gradually slowing. Sometimes she plays for the dying, choosing a gently arrhythmic background and never a song that might be familiar.

Julia Langley, who directs Georgetown’s program, wants research into the type and dose of music for different health situations: “If we can study the arts in the same way that science studies medication and other therapeutics, I think we will be doing so much good.”
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U.S. health officials on Tuesday approved the nation’s first gene therapy for an inherited, rare form of blindness, marking another major advance for the emerging field of genetic medicine.

The approval for pharmaceutical company Spark Therapeutics offers a life-changing intervention for a small group of patients with a vision-destroying genetic mutation and hope for many more people with other inherited diseases.

The drugmaker said it would not disclose the price until next month, delaying debate about the affordability of a treatment that analysts predict will be priced around $1 million.

The injection, called Luxturna, is the first gene therapy approved by the Food and Drug Administration in which a corrective gene is given directly to patients. The gene mutation interferes with the production of an enzyme needed for normal vision.

Patients who got the treatment have described seeing snow, stars or the moon for the first time.

“One of the best things I’ve ever seen since surgery are the stars. I never knew that they were little dots that twinkled,” said Mistie Lovelace of Kentucky, one of several patients who urged the FDA to approve the therapy at a public hearing in October.

Patients with the condition generally start losing their sight before 18, almost always progressing to total blindness. The defective gene that causes the disease can be passed down for generations undetected before suddenly appearing when a child inherits a copy from both parents. Only a few thousand people in the U.S. are thought to have the condition.

One injection per eye

Luxturna is delivered via an injection for each eye; they replace the defective gene that prevents the retina — tissue at the back of the eye — from converting light into electronic signals sent to the brain.

The FDA has approved three gene therapies since August, as decades of research into the genetic building blocks of life begin translating into marketable treatments. The previous two were custom-made treatments for forms of blood cancer. Novartis’ Kymriah is priced at $475,000 for a one-time infusion of genetically enhanced cells. Gilead Sciences’ similar treatment, Yescarta, costs $373,000 per treatment.

Philadelphia-based Spark Therapeutics said it would announce its price in early January, but suggested its own analysis put the value of the therapy at about $1 million. Key to the company’s reasoning is the assumption that Luxturna will be given once, with lasting benefits. To date, the company has tracked patients enrolled in a key study for as long as four years and hasn’t seen their vision deteriorate.

“All the data we have today suggests it’s long-lasting, if not lifelong,” said Spark CEO Jeffrey Marrazzo.

Given Luxturna’s FDA approval and strong study results, many experts expect U.S. insurers, including both the federal government and private plans, to cover the treatment.

The spate of new genetic therapies marks a boom for a field once plagued by safety concerns. Gene therapy research suffered a setback in 1999 with the death of a patient treated for a rare metabolic disorder at the University of Pennsylvania. In another case, patients treated for an immune disorder later developed leukemia.

Dr. David Valle said initial excitement about the wide-ranging possibilities for genetic medicine has given way to a more deliberative approach focused on individual diseases. He applauded researchers at the University of Pennsylvania for decades of work that led to the treatment.

“The hype for gene therapy has been without many successes and actually a few failures, so chalk this one up in the win column,” said Valle, a geneticist and pediatrician at Johns Hopkins University, who was not involved in Luxturna’s development.

Development took years

University of Pennsylvania researcher Dr. Jean Bennett said she and her husband, Dr. Albert Maguire, first imagined using genetic medicine to treat retinal blindness in the mid-1980s. But it took decades to develop the science and technology, with the first animal tests in 2000 and the first human trials in 2007.

“We didn’t know what genes caused the disease, we didn’t have animal models with those genes, we didn’t have the ability to clone genes and deliver them to the retina, so it took time to develop all that,” said Bennett, an eye specialist.

Bennett and Maguire tested the treatment by recording patients’ ability to complete an obstacle course at varying levels of light, simulating real-world conditions. A hallmark of the disorder is difficulty seeing at night.

One year after treatment, patients who received the injection showed significant improvements in navigating the obstacle course at low-light levels compared with those who had not received the therapy.

Goldman Sachs analyst Salveen Richter predicted Luxturna would cost $500,000 per injection, or $1 million for both eyes. She pointed out that many current drugs for ultra-rare diseases were priced at $250,000 per year or more, putting their long-term cost over $1 million after several years.

But David Mitchell, a cancer patient and advocate for lower drug prices, worries that the cost of genetic therapies won’t be sustainable.

“We don’t have unlimited dollars in this country,” said Mitchell, founder of Patients for Affordable Drugs. “You get 50 of these drugs in the system and I don’t know how we will handle it as a country.”
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Each time teenager Freddy Sei hears the rumble of thunder, sees rains pound the earth in his small coastal village or watches strong winds whip palm trees, he is gripped with fear.

The 15-year-old lives in Vanuatu, a Pacific island nation that two years ago was ravaged by monster cyclone Pam with Freddy watching as huts were blown away and water rushed in to submerge his village of South River on Erromango island.

“I was scared because the winds just took the houses away, there was heavy rain and the river banks was overflowing,” said Freddy, speaking through a translator.

“I’m scared that if it ever floods at night, it will come into my house and the flood will take me away. That’s one of my greatest fears,” said the small-framed boy, one of nearly 200 residents of the isolated seaside community of South River — vulnerable to flooding, landslides and rising seas.

A barrage of natural disasters across the low-lying Pacific islands is inflicting lasting mental trauma on children, with one healthcare expert describing it as a “ticking time bomb.”

Post-traumatic stress disorder (PTSD) depression, anxiety, and suicide tend to increase after a natural disaster, according to a March report by American Psychological Association (APA).

People who survive multiple disasters, such as those living in disaster-prone areas, are likely to experience severe trauma, depression and other mental health problems, the APA said.

But children suffer the most.

“After climate events, children typically demonstrate more severe distress than adults … Similar to physical experiences, traumatic mental experiences can have lifelong effects” and even impair brain development, said the report.

‘Time bomb’

As climate change exacerbates the frequency and severity of natural disasters, mental health problems are going to worsen for children, said counsellor Sisilia Siga from Empower Pacific, a mental health service provider in Fiji.

“It’s going to get worse, if [climate change] continues, especially with children since it’s hard for them to handle all these things that’s happening,” she said in an interview in Fiji’s capital Suva.

Siga said she treated villagers in coastal areas during the aftermath of Cyclone Winston last year, the worst storm ever recorded in the southern hemisphere, which crashed into Fiji, killing at least 43 and leaving tens of thousands homeless.

She said she saw many children too traumatized to swim in the sea again, or having flashbacks when there were strong winds or when the ocean was at high tide.

Psychologist Loyda Santolaria, who was deployed in disasters like the 2010 Haiti earthquake, said children are often left to their own devices in the aftermath of a disaster, since many parents are too busy trying to secure food and shelter.

“The parents are unable to cope in a natural disaster, neither are they able to support their children’s vulnerability and needs,” Santolaria, who now works in Vanuatu with aid agency CARE International.

She said many of these children will grow up not knowing how to deal with these traumatic emotions and will become more susceptible to stressful situations.

This may lead to violence, depression, drug use or even suicide, said Alex Pheu, a mental health nurse working in Vanuatu’s capital Port Vila.

“It’s like a ticking time bomb. You have people who are scarred for life,” said Pheu. “[Children] learn to live with it until someone commits suicide, or someone hangs themselves on a tree, which I’ve heard has happened.”

With few mental health workers in the Pacific region, Pheu said training villagers in psychological “first aid,” such as spotting signs of depression or anxiety before it becomes a full-blown issue, could help to boost resilience.

“Prevention and detection — that’s the most important thing we should aim for,” he said. “But we always come too late and when we try to undo the knots it’s very, very hard to manage.”

As for children like Freddy, living in a small community accessible only by boat, surviving the next inevitable flood or cyclone preoccupies his young mind.

“Climate change is getting worse,” he said. “I’m scared of it because there could be another flood and I don’t want that to happen.”

Reporting by Lin Taylor. Editing by Ros Russell and Belinda Goldsmith.
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