Mosquitoes 'resist malaria drugs'

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Mosquito biting human skin.
Half the world's population is exposed to malaria


International scientists say they have found the first evidence of resistance to the world's most effective drug for treating malaria.

They say the trend in western Cambodia has to be urgently contained because full-blown resistance would be a global health catastrophe.

Drugs are taking longer to clear blood of malaria parasites than before.

This is an early warning sign of emerging resistance to a disease which kills a million people every year.

Until now the most effective drug cleared all malaria parasites from the blood within two or three days but in recent trials this took up to four or five days.

The BBC's Jill McGivering, reporting from Cambodia, says it is unclear why the region has become a nursery for the resistance - but the local public health system is weak, and the use of anti-malaria drugs is not properly controlled.

Drug defence

The artemesinin family of drugs is the world's front-line defence against the most prevalent and deadly form of malaria.

Baby with malaria, Juba Hospital, Sudan, April 2009
Malaria is the leading cause of death among infants in Africa

Two teams of scientists, working on separate clinical trials, have reported seeing the disturbing evidence that the drugs are becoming much less effective.

There is particular concern because previous generations of malaria drugs have been undermined by resistance which started in this way, in this part of the world, our correspondent reports.

Professor Nick Day is the director of the Mahidol-Oxford Tropical Medicine Research Unit, one of the teams involved in the research.

"Twice in the past, South East Asia has made a gift, unwittingly, of drug resistant parasites to the rest of the world, in particular to Africa," he said.

"That's the problem. We've had chloroquine and SP resistance, both of which have caused major loss of life in Africa," in said in reference to earlier generation anti-malarial drugs.

"If the same thing happens again, the spread of a resistant parasite from Asia to Africa, that will have devastating consequences for malaria control," he said.

Health systems

Cambodia has long been a laboratory for malaria investigators and a nursery of anti-malaria drug resistance.

Cinchona bark drying in Dutch East Indies, to be pulverized to make quinine, 1960s
The fight against malaria has lasted generations

Alongside a weak public health system and poorly-controlled drug use, there are many fake drugs, produced by international criminals.

These fakes often contain a small amount of the real drug to fool tests, which can also help to fuel resistance.

Those working to control malaria are calling for urgent action to contain this emerging resistance.

If it strengthens and spreads, they warn, many millions of lives will be at risk. About half the world's population faces exposure to the disease.



Source : http://news.bbc.co.uk

Obama 'confident' on two-state solution

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US President Barack Obama says he is confident that Israel will recognise that a two-state solution is in the best interests of its security.

Speaking after White House talks with Palestinian leader Mahmoud Abbas, Mr Obama again urged Israel to freeze settlement expansion.

Israel has insisted it will allow existing settlements to expand, despite pressure from Washington.

President Obama also said Palestinians must rein in anti-Israeli violence.

For his part, Mr Abbas said he was committed to all obligations under the Mid-East peace plan "roadmap".

However, without a halt to Jewish settlements in the occupied West Bank, the Palestinians have said there can be no progress towards peace.

'Israel's interests'

Mr Obama said he was a "strong believer in a two-state solution" and believed Israel would recognise that it was in the best interests of its long-term security.

He said it was important for all countries, but particularly Arab states, to be supportive of the two-state solution.

"I am confident that we can move this forward if all parties are ready to meet their obligations," he said.


Mr Abbas said the need for progress in the stalled process was urgent, adding: "Time is of the essence."

He said that he had shared ideas with Mr Obama based on the 2003 peace plan and the 2002 Saudi peace plan supported by the Arab league.

Under the US-backed 2003 roadmap to peace, Israel is obliged to end all settlement activity, specifically including natural growth.

The plan also requires the Palestinian Authority to crack down on militants who seek to attack Israelis.

President Obama said he had been "very clear" in his meeting with Israeli Prime Minister Benjamin Netanyahu last week on the need to "stop settlements".

Mr Netanyahu later said no new settlements would be built but natural growth in existing settlements should be allowed.

Stalled talks

The White House meeting between the two leaders is part of an effort by the Obama administration to restart stalled peace talks.

Mr Obama has already met King Abdullah of Jordan and Mr Netanyahu. He plans to meet Egyptian President Hosni Mubarak in Cairo on 4 June.

Earlier on Thursday, US Secretary of State Hillary Clinton said Washington was pushing for a two-state solution in the Middle East as it was in the "best interests" of both the Palestinians and Israelis.

Speaking after a dinner with Mr Abbas, she said: "We believe strongly in a two-state solution."

However, Israeli government spokesman Mark Regev said on Thursday that Israel would continue to allow some construction in West Bank settlements despite US calls for a freeze on its work.

He said the fate of the settlements should be decided in peace talks with the Palestinians.



Source : http://news.bbc.co.uk

What are parents' rights regarding a child's medical treatment?

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(CNN) -- Perhaps no one is watching the Daniel Hauser case in Minnesota more closely than Theresa and Greg Maxin in Ohio. Seven years ago, the Maxins found themselves fighting to keep their own son from having chemotherapy. But the two families' stories ended quite differently.

Daniel Hauser was ordered by a judge on Tuesday to undergo chemotherapy.

Daniel Hauser was ordered by a judge on Tuesday to undergo chemotherapy.


Like Daniel, Noah Maxin had a blood cancer doctors said would almost surely kill him if he didn't have chemotherapy. Like the Hausers, the Maxins rejected the doctor's recommendations in favor of supplements and other alternative treatments to boost his immune system. Both cases wound up in courtrooms.

But the similarities end there. A Minnesota court ordered Colleen and Anthony Hauser to have their son undergo chemotherapy and possibly radiation. The Maxins, however, won their case, and for a time gave Noah, who was then 7 years old, only alternative treatments.

"Our heart goes out to the Hausers," says Theresa Maxin. "They obviously weren't heard by their medical team. We felt the same way."

While the Hauser case is an example of the court going against parents' wishes, there are several cases, like the Maxins, where courts have allowed families to reject a doctor's recommendations for life-saving treatment.

"Parents really do have a lot of rights," says Gregory Beck, the Ohio lawyer who represented the Maxins. "But they have to be willing to advocate for them and provide strong alternatives." Video Watch more on parental rights »

In a situation where the child's life is not in danger, parents have quite a bit of leeway, says George Annas, chairman of the Department of Health Law, Bioethics, and Human Rights at the Boston University School of Public Health.



"Even with a cleft palate, if the parents don't want their child to have the surgery to correct it, most courts would side with the parents, and let the child make the decision when he becomes an adult," Annas says.

Even when a child is in imminent danger of dying, parents have the latitude to reject potentially life-saving treatments if they're experimental, or if the parents can show an alternative treatment would work just as well, says Art Caplan, director of the Center for Bioethics at the University of Pennsylvania.

Children can, on occasion, also have their wishes heard. Teenagers who are found to be "mature minors" have sometimes been allowed by courts to reject life-saving treatments, Annas says.

"Mature minors" are usually at least 15 years old and "can understand the nature and consequences of their decisions," says Annas.

Courts have also sided with families in life-or-death situations when the parents find a licensed physician willing to administer the alternative medicine they're seeking.

This was the case with the Maxins, who found a doctor specializing in holistic medicine to oversee Noah's treatment with supplements and a special diet -- and no chemotherapy.

"The Maxins are warm, engaging, intelligent people, and very well-read on the issues. They exhaustively researched everything," says Beck.

The Maxins say they agreed to an initial round of chemotherapy for Noah only because they felt "threatened" and pressured by time constraints.

The day he was diagnosed, the Maxins say a social worker came into Noah's hospital room and said they would begin the process of giving him chemotherapy immediately. "I told her we believe in holistic and alternative therapies, and we wanted to take him out of the hospital," Theresa Maxin says. "But she told us there would be legal implications if we tried to do that. We felt like we'd been put in a corner, like we'd been boxed in."

A mother who successfully fought to keep her child from having chemotherapy says many other parents she knows have also felt rushed to make decisions.

In 2005, a Virginia court allowed Rose and Jay Cherrix to stop using chemotherapy on their son, Abraham, who had Hodgkin's lymphoma. He'd already had three months of chemotherapy when the Cherrixes decided they wanted to try alternative treatments instead. The court agreed as long as an oncologist supervised his care.

Cherrix, who turns 19 next month, took vitamins and supplements, followed a special diet, and in addition had several rounds of radiation. After his court case, the Virginia Legislature passed a law allowing teens over age 14 to have a hand in making their own medical decisions.

Rose Cherrix says she's spoken to Colleen Hauser and other parents who want to defy doctors' orders. Her advice: Don't feel coerced into making a quick decision. "There's always the pressure that you have to do something right now, and that's not true," she said.

The Maxins' lawyer agrees. "No one would have gone to jail if they'd taken Noah out of the hospital to see someone else. You don't have a whole lot of time, but you do have some time," Beck says.


Four years after the court case, Abraham Cherrix says he is now in good health.

As for Noah Maxin, after his leukemia diagnosis, he underwent alternative treatments and chemotherapy simultaneously for one month. The cancer went into remission, and his parents won the right to take him off chemotherapy in October 2002. For the next five months, he used only alternative treatments.

When the leukemia returned in March, his parents chose to put him back on chemotherapy. He went into remission again, and was healthy for three years.


In April, 2006, the cancer came back. Noah received aggressive chemotherapy and died 14 months later at age 11.

His parents say they've asked themselves if Noah might have survived if he'd received the chemotherapy doctors recommended from October 2002 until March 2003. "I'll consider that for the rest of my life. There's no way of knowing," Greg Maxin said. "But we made the decisions for our child. At the end of the day, it was us. Not the state or the government, but us."

Source : http://edition.cnn.com

How to safeguard your data as you travel

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(CNN) -- With Wi-Fi access at airports, hotels, and aboard airplanes, business travelers don't have to look very hard for a wireless Internet connection.

Wi-Fi hotspots at airports may put users' computers at risk, but no more so than at coffee shops, experts say.

Wi-Fi hotspots at airports may put users' computers at risk, but no more so than at coffee shops, experts say.

But with these public wireless hotspots becoming more prevalent, in addition to more travelers using smart phones for Web access, are business travelers putting themselves at a security risk?

The short answer, some technology security experts say, is yes. But they add that the use of Wi-Fi at these spots is no riskier than at a coffee shop.

"It's a shared medium, and if you can connect to it, someone else can connect to it and monitor your traffic," said Marty Linder, a senior member of the technical staff at the Carnegie Mellon Software Engineering Institute CERT/Coordination Center. "That has nothing to do with the security of the network. It's just the nature of the beast."

For Fran Hanna, the convenience isn't worth the risk. The sales representative from Chapin, South Carolina, would frequently bring her computer on business trips and access Wi-Fi through her hotels. Hackers tapped into her computer, resulting in inappropriate material being sent through her account.

She had to get her computer restored twice, which cost her $900. And while she still isn't sure where she was when she picked up the malware, she said the only wireless device she will bring with her as she travels is a cell phone for voice calls.

On the other hand, picking up public wireless isn't a major concern to Brian Fitzpatrick, the chief procurement officer of a technology firm in Alpharetta, Georgia, and a frequent business traveler.


He generally avoids transmitting sensitive personal or company data using these hotspots. But as he sees it, having his information stolen "is more likely to happen in some face-to-face transaction than it is even online."

In addition to open networks, experts say the physical loss of devices poses a threat for business travelers.

The combination of replacement cost, detection, forensics, data breach, lost intellectual property costs, lost productivity, and legal, consulting and regulatory expenses sets a company back an average of $49,246 per lost laptop, according to a study released in April by the Ponemon Institute and sponsored by the Intel Corporation.

However, lost laptops with encryption saved companies nearly $20,000, compared with those that did not have encryption, according to the Ponemon study. Encrypted disks safeguard data by scrambling information on them. They unlock that information only when the user enters the proper passcode.

"I don't know how many times we've heard about laptops being stolen and they have no encryption on them. And it pretty much means that the bad guys can get to your data. Immediately. They don't have to know your password or anything, they can just get to it," said Patrik Runald, chief security adviser for F-Secure, an Internet security company.

And many businesses do not yet require their employees to use passwords on their smart phones, leaving lost devices "woefully unprotected," said Pat Clawson, CEO and chairman of Lumension Security.

Tips for staying secure

Despite the potential for security breaches, there are simple steps you can take to keep yourself armed as you connect wirelessly on your travels:

• Use an encrypted disk to safeguard the information on your laptop or smart phone, Linder said, and make sure you log off of your computer when you're not using it.

In most cases, when you hibernate your computer, its memory is recorded unencrypted. "You cannot for convenience close your lid, let your computer go to sleep and believe that if someone steals your computer, your data is protected, because it's not," Linder said.

Runald recommended free software called TrueCrypt (truecrypt.org) that you can use to encrypt the content on your local drive and on USB flash drives.

• Turn off your wireless and Bluetooth connections if you're not using them, said Clawson. "Those are electronic doorways into your devices. On my BlackBerry, I can sit there and scan for open Wi-Fi peer-to-peer connections. I [can] then gain access to what's in your files you may have stored in there, your contacts."

• Use an anti-glare shield on your computer to prevent others from spying, Linder suggested. With such shields, you must be face-to-face with the screen to be able to read it.

• Regularly back up the data on your laptop or smart phone, Runald said. Several companies offer backup services, but you can also save information on other computers and disks.

Even if your data is encrypted -- eliminating your fear of sensitive information getting stolen -- backing up the data will make it easy to transfer to a new phone or laptop, Runald said.

• If you lose your smart phone and don't want others to access your information, call your provider and request that the device be wiped of information, Runald said. He also suggested considering software that allows you to send a text message to your phone that will remotely wipe it and block others from accessing its content.

• To ensure that you're visiting an authentic Web site and not getting duped by a phishing scheme, some experts suggest logging onto those sites through your company's VPN connection.

But technology company CPO Fitzpatrick says he hesitates to use VPN from a public Wi-Fi hotspot: "Even though all the traffic is encrypted," he said, "if your machine got compromised in some way, it is sort of a gateway into your network.

Source : http://edition.cnn.com

NYC hospital settles with family in waiting room death

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NEW YORK (CNN) -- The family of a woman who died ignored on an emergency room floor has reached a settlement with Health and Hospital Corp., the family's lawyer and the company's top executive said Thursday.

Surveillance video shows Esmin Green on the hospital floor for more than an hour before anyone helps her.

Surveillance video shows Esmin Green on the hospital floor for more than an hour before anyone helps her.


The attorney, Sanford Rubenstein, said the settlement, reached Wednesday, is for $2 million.

Alan Aviles, the president and CEO of Health and Hospital Corp., said in a written statement that the company -- which operates Kings County Hospital, where Esmin Green, 49, died last year -- takes full responsibility for her death and offers a "full apology."

He said the settlement "is not meant to put a value on a life and the loss of a loved one. That remains priceless."

Last July, Green's relatives said they planned to file a $25 million lawsuit against the city and the hospital and called for criminal charges against hospital workers.

A hospital security video showed that the mother of six waited in an emergency room chair for nearly 24 hours before she slid to the floor, where she convulsed for more than a half hour and then became still.

An hour after she fell to the floor, the video showed, a hospital employee nudged Green with her foot and summoned help, but the 49-year-old woman was dead

The New York Civil Liberties Union alleges that hospital records were falsified to say that Green was "sitting quietly in the waiting room" at a time when, the video shows, she had been on the floor for 48 minutes and had not moved for more than 10 minutes.

An autopsy revealed that Green died from pulmonary thromboembolism -- blood clots that formed in her legs and eventually made their way into her lungs, according to Ellen Borakove, the medical examiner's spokeswoman. The clots came from deep vein thrombosis, which complicated Green's chronic paranoid schizophrenia.


Source : http://edition.cnn.com

 

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