Archive for March 2009
A type 2 diabetes drug taken orally and in widespread use for more than a decade has been found to have distinct advantages over nine other, mostly newer medications used to control the chronic disease, according to a study by researchers at Johns Hopkins.
In their report, published online July 16 in the journal Annals of Internal Medicine, the Hopkins team found that metformin, first approved by the U.S. Food and Drug Administration in 1995 (and sold as Glucophage, Riomet and Fortamet), not only controlled blood sugar levels but also was less likely to cause weight gain and more likely than others to lower bad cholesterol levels in the blood.
Researchers say these health benefits are important because they can potentially ward off heart disease and other life-threatening consequence from diabetes. More than 15 million Americans have type 2 diabetes.
“Sometimes newer is not necessarily better,” says lead study author Shari Bolen, M.D., an internist at Hopkins. “Issues like blood sugar levels, weight gain and cost could be significant factors to many patients struggling to stay in good health,” says Bolen, an instructor at The Johns Hopkins University School of Medicine.
In what is believed to be the largest drug comparison of its kind, the scientists showed that all of the commonly used oral medications worked much the same at lowering and controlling blood sugar levels, and were equally safe. But metformin stood out because it offered the same level of effectiveness without lowering glucose measurements too much, and it did so for a lower price.
Metformin was found to lower LDL or bad cholesterol by about 10 milligrams per deciliter of blood, while newer medications studied, such as pioglitazone (Actos) and rosiglitazone (Avandia), or so-called thiazolidinediones, were found to have the opposite effect, increasing levels of the artery-clogging fat by the same amount.
Researchers say the main drawbacks to metformin are digestive problems and diarrhea. Previous reports have found evidence that the medication leads to the buildup of lactic acid in the blood in people with moderate kidney or heart disease, and they note that it should not be prescribed to anyone with either of these conditions. The main advantages to both newer thiazolidinediones were a small increase in HDL or good cholesterol, and less too-low blood sugar levels than three other older, cheaper drugs studied — glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Micronase, DiabBeta, Glynase PresTab) — known as second-generation sulfonylureas.
Annual treatment with metformin or the sulfonylureas, they note, costs on average $100, roughly one-fourth the cost of oral diabetes medications FDA-approved since then, including the two newer thiazolidinediones, both approved in 1999. (Their price is expected to drop once generic versions become available.)
“When you are dealing with an epidemic like diabetes, it is important for people to weigh their treatment options with their physician and to make informed decisions about which medication best suits their needs,” says Bolen.
In the study, Bolen and her colleagues reviewed the scientific evidence from 216 previous studies and compared each drug for its clinical effectiveness, risks and costs. In addition to metformin, the thiazolidinediones and sulfonylureas, drugs included in their analysis were repaglinide (Prandin), miglitol (Glyset), acarbose (Precose), and nateglinide (Starlix).
Among the team’s other findings were that glimepiride, glipizide, and glyburide led more frequently to too-low blood sugar levels than the other drugs. The sulfonylureas and acarbose appeared to have no effect on bad cholesterol. And except for metformin and acarbose, drug treatment led to an increase in weight from 2 to 11 pounds.
Researchers also noted the increased risk of heart failure, albeit small (less than three people in a hundred), in people taking thiazolidinediones who did not have a history of heart disease. They also caution that despite recent reports about the potential for increased risk of heart attack from rosiglitazone, there is not yet sufficient information to verify the finding.
Researchers say further studies are needed to compare the long-term effectiveness of one treatment to another and to compare drug effects on quality of life and life expectancy. Additional research will also be needed to compare these findings with results for injectible medications for diabetes, most notably insulin, which was not included in the latest report.
The study, conducted solely at Hopkins, was supported with funding from the federal Agency for Health Care Research and Quality. The agency has posted the analysis, along with a question-and-answer document, on its Web site at http://www.effectivehealthcare.ahrq.gov/reports/final.cfm. And the consumer watchdog publication, Consumer Reports, has posted a related report at http://www.CBestBuyDrugs.org.
Besides Bolen, other researchers involved in the study were Leonard Feldman, M.D.; Jason Vassy, M.D., M.P.H.; Lisa Wilson, B.S., Sc.M.; Hsin-Chieh Yeh, Ph.D.; Spyridon Marinopoulos, M.D., M.B.A.; Crystal Wiley, M.D., M.P.H.; Elizabeth Selvin, Ph.D.; Renee Wilson, M.S.; Eric Bass, M.D., M.P.H.; and Frederick Brancati, M.D., M.H.S.
For the goals for future, the world athletics governing body IAAF has introduced a scholarship in three categories. This article is on the B-Project which is an idea of the IAAF president Lamine Diack.
IAAF ‘B’ Standard Project
President Lamine Diack has set the goal for the IAAF that at least one athlete of each Member Federation be capable of achieving the ‘B’ Qualification Standard for the World Championships in Athletics or the Olympic Games.
This is an ambitious objective considering the level of the performances to be achieved and the fact that nearly half of the IAAF Member Federations have not yet achieved this level.
Athletes deemed to have a chance to achieve the ‘B’ Standard in an event will be offered one of 3 programmes:
· Short Term programme – Those who are close to the set ‘B’ Standard objective could participate in short term preparation, usually accompanied by their personal coach (3 months duration).
· Medium Term programme – Designed for athletes who have the potential to achieve the ‘B’ Standard with one year of specific preparation (one year duration).
· Long Term programme – Athletes currently under the age of 23 who obviously need longer time to achieve the ‘B’ Standard will be offered this programme (two, or more, years duration).
In all three programmes, the IAAF will ensure access to adequate facilities, coaching and competition.
You will find in the right hand side column a
Please Note: Individual athletes, coaches or other interested parties should contact their National Federation for further information. Only IAAF Member Federations may make application for an athlete and National Federations will submit an application for those athletes who are deemed eligible.
Should you need any further information related to this project please contact, in the first instance, your National Federation. Then, if needed:
IAAF Member Services Department
17 rue Princesse Florestine
For a more detailed description of the ‘B’ Standard Project, including Entry Standards and Application Form please click
Source : iaaf.org
Iran’s supreme leader Ayatollah Ali Khamenei said Saturday he sees no change in U.S. policy toward Iran despite the U.S. promise of a “new beginning.”
Khamenei said a change in rhetoric is not enough, and Washington must practice what it preaches, according to the English-language Press TV channel in Iran.
He also promised that Iran will change its policy if the United States does so as well, Press TV reported.
Khamenei’s comments, which he made in a televised address to mark the start of the Iranian New Year on Friday, come a day after U.S. President Barack Obama reached out to Iran in a videotaped message.
A spokesman for Iranian President Mahmoud Ahmadinejad condemned U.S. foreign policy Friday in response to the video.
Obama’s message spoke of “new beginnings” with the promise of a new year.
“My administration is now committed to diplomacy that addresses the full range of issues before us, and to pursuing constructive ties among the United States, Iran and the international community,” the president said in his message Friday.
Obama said the United States seeks engagement with Iran that is “honest and grounded in mutual respect.”
The president’s message is part of a dramatic shift in tone from that of the Bush administration, which branded Iran as part of an “axis of evil” along with North Korea and Iraq. It also echoes Obama’s inaugural speech in which he told the Muslim world, “We seek a new way forward, based on mutual interest and mutual respect.”
Ahmadinejad said last month that Iran would welcome talks with the United States “in a fair atmosphere with mutual respect.”
Khamenei also said world powers have come to realize they are not able to block Iran’s nuclear progress. He looked back on the February 25 testing of Iran’s first nuclear power plant, at Bushehr, as one of the “joyful developments” of the past year.
Last month, the Washington-based Institute for Science and International Security released a report saying that Iran has reached “nuclear weapons breakout capability” — it has enough uranium to make a nuclear bomb.
The report was based on an analysis of data from the International Atomic Energy Agency. However, an IAEA official who asked not to be named cautioned against drawing such dramatic conclusions from the data, saying Iran’s stock of low-enriched uranium would have to be turned into highly enriched uranium to be weapons-grade material. That hasn’t been done, the official said.
The United States has had tortuous relations with Tehran since the Islamic revolution in 1979.
Meanwhile, the widow of the late founder of the Islamic Republic, Ayatollah Ruhollah Khomeini, died Saturday morning after a long period of illness, the Iranian-run Islamic Republic News Agency said.
A funeral for Khadije Saghafi was scheduled to be held Sunday in Tehran and she was set to be laid to rest in Khomeini’s tomb, the agency reported.
Khomeini was the leader of the 1979 revolution that led to the toppling of the shah of Iran and the ushering in of an Islamic state. He died in 1989.
Source : yahoo news
The family unit in the United Arab Emirates is an important social unit for an Arab. Loyalty to family or surname influences all aspects of family life and society United Arab Emirates. The Arab honor and respect for his family, particularly children. Therefore, it is very paternalistic, patriarchal and hierarchical, with elders and parents who make the decisions.
UAE national families are large, with families citing God going from one to procreate. Therefore, the bigger the better, giving economic and spiritual benefit. Children, when growing older are expected to care for parents, especially for children that much to bear the financial burden, if necessary. Also, it is noted thatlarger families demonstrate the virility of the father.
As far as fidelity passes, family comes first, then clan and tribe. The UAE nationals also reflect national identity and, moreover, are proud of their culture. There is also a strong loyalty to the royal families. Demonstrating this includes photos of the leaders in all walks of life. The UAE Nationals his beloved founding father, Sheikh Zayed, and there was massive show of grief over his death. The people still comment on their generosity for what he did for them and for the construction of the UAE.
Women are respected in the UAE society, as they are the ones who bring life in the world, and raise children. This perception is lost in the west, where it is seen that they are subordinate to men, but increasingly, woman are most prominent in the workplace and in other walks of life. Some guidelines for the West are: respect for privacy and the role of women in society; stand when a woman enters the room, and I understand that there are many households in different areas of residence, so that when you visit a house, you wouldn’t socialize with women.
Things that men should not include:
– Do not talk publicly professionals UAE National Women, unless it is business related. You will understand that when they are allowed to cross the limit, when approached to discuss other matters
– Do not shake hands with a UAE National female, unless prompted.
– Suffice it to say, not flirting, touching or embracing women
– Do not look at women or maintain eye contact
– Do not ask an Arab man about his wife or female members of his family
of course, it’s better to be strict in yourself first, to understand the situation, and with Western values, and an increasingly diverse society to make up, things are changing, but traditions remain and what is best to take this into account.
Working in a team environment provides an excellent opportunity to develop invaluable skills, positive energy and innovative approaches to problem-solving. The best of these activities uses the dynamics of play and the right amount of humor to encourage brainstorming abilities. In short, an atmosphere of playfulness and a team building exercise with a built-in ‘fun factor’ helps relieve individual and group stress. Without stress, team skills can flourish.
The oft-used term ‘out-of-the-box thinking’ refers to the ability to generate new ideas, as opposed to derivative ones. To think that creatively, individuals and teams must have their intellectual boundaries removed. They must have the freedom to scatter their toys on the floor and make a mess. As a game designer, I find that ‘making a mess’ is often the only way to discover new approaches to solving a problem.
In a team building game, an amount of structure is obviously needed to achieve desired results. However, as with any game design, team activities can be cleverly created with enough ‘play room’ that a real fun factor exists. If the teams feel free enough, perhaps to the point where they don’t notice the structure of the exercise, they will have the play experience we are seeking. This is why very cleverly designed games have what I call ‘Invisible Rules’, a set of rules that are so seamlessly integrated that they never hamper the experience. If team members feel too restricted by rules, they may resist contributing fully and this undermines the activity’s purpose.
The freedom to play is often accompanied by, and supported by, a healthy sense of humor. This combination of play and lightheartedness is difficult to beat.
As Psychologist Rollo May puts it, “Humor is a healthy way of feeling a ‘distance’ between one’s self and the problem.” Finding ways to laugh as we confront challenges gives us perspective-often allowing us to find solutions more quickly”.
When the challenge is difficult, stress will only makes the climb to the top of the mountain much harder. Determination without humor is a recipe for disaster. Humor keeps the mind and spirit flexible enough to cope with sudden changes and longer-term issues. In a team setting, a group that is laughing together is already getting a head-start on the team building process. They trust each other. They have relaxed their individual egos. Laughing together is an immediate way to begin bonding. Play becomes more productive with humor as an undercurrent.
Anyone that a plays a game seriously may concentrate and win that game, but in a team environment, individual victory is not the focus. It is more important to learn to work together, grow together, and explore new options for problem-solving. It is less about winning than it is about trying new approaches. This requires freedom to play. This requires laughter along the way!
A teenager who went on a bloody rampage in his old school had announced his intentions on the Internet just hours earlier, it emerged Thursday as Germany mourned the 15 people he gunned down.
“I have weapons here and tomorrow morning I will go to my old school and really whip up a storm,” Tim Kretschmer said in a chat room, according to the interior minister of the state where Wednesday’s massacre took place.
“I have had enough of this crummy life … Always the same. People are laughing at me, no one recognises my potential … You will hear about me tomorrow. Make note of the name of the place: Winnenden,” the 17-year-old said.
The entry, made in a conversation with another 17-year-old from Bavaria who told his father about it after the shooting, was made at 2:45 am (0145 GMT), said Heribert Rech, interior minister of Baden-Wuerttemberg state.
Less than seven hours later, at around 9:30 am, Kretschmer entered the school in Winnenden near Stuttgart, armed with a handgun taken from his father’s bedroom and more than 100 rounds of ammunition.
He killed eight girls, one boy and three female teachers, mostly expertly with shots to the head. He then fled, hijacked a car and randomly shot dead three bystanders.
Three hours later Kretschmer was dead after a manhunt ended in a shootout 30 kilometres (20 miles) away. State police chief Erwin Hetger said it was believed he had turned the gun on himself.
Kretschmer went into one classroom three times, the Bild daily said. On the third visit he told the class: “Aren’t you all dead yet?” A teacher threw herself in front of a female pupil — and was shot by the gunman, Bild said.
The bloodbath left Germany in shock. Flags flew at half mast across the country, and in Winnenden hundreds of candles were left outside the school.
Thousands of people packed churches for special services on Wednesday night and a vigil was held outside the school on what Chancellor Angela Merkel called “a day of mourning for all of Germany.”
“Our thoughts go out to the families and the friends. We are thinking of you and we are praying for you,” she said.
Details also emerged on Thursday on Kretschmer’s background.
His father is a successful businessman who employs 150 people at a packaging firm, according to police, but his son found it difficult to fit in at school and had few friends.
“He was simply not accepted by anyone and just sat all day in front of his computer,” Mario, a schoolmate, told German television station N24.
Reports also said he was very keen on computer shooting games — especially the violent “Counter-Strike” — and had become a real-life crack shot at the shooting range where his father was a member.
After leaving school last year, Kretschmer had enrolled on a course to train as a salesman. He regularly worked out at the gym and belonged to a sports club.
“He was completely unremarkable, there was nothing in his background to suggest this could have happened,” Rech said. Fellow students described him as “quiet” and “reserved,” even “friendly.”
His father owned more than a dozen guns, all locked away except the nine millimetre Beretta pistol that caused the carnage.
Rech said Kretschmer had “destroyed the soul of an entire school and ripped into the heart of a town.”
The school remains cordoned off and there have been calls for it to stay closed for ever.
The tragedy brought back haunting memories of a similar bloodbath in Erfurt in eastern Germany in 2002 that left 17 dead, including the gunman, and reheated a debate over gun control.
Gun laws were tightened after Erfurt and there have already been calls for even stricter laws and a ban on violent computer games.
Wolfgang Dicke, a police gun crime expert told Spiegel: “Our gun laws can barely be tightened because they are already so tight.”
But a Bild editorial said: “The best laws in the world are useless, if parents do not know what is going on in their children’s heads, what they are thinking and dreaming and what are their fears.”
There were some news on leading nations of the world. Germany, France and Britain reportedly want Danish Prime Minister Anders Fogh Rasmussen as the next secretary general of the NATO military alliance.
German Chancellor Angela Merkel, French President Nicolas Sarkozy and British Prime Minister Gordon Brown want Rasmussen to replace Jaap de Hoop Scheffer when he steps down in July, the Süddeutsche Zeitung daily said Saturday.
US President Barack Obama’s administration is expected to say whom it favours just ahead of a NATO summit on April 3-4 in Baden-Baden and Kehl, Germany, and in Strasbourg, France, the paper said in its Saturday edition.
Usually the post of NATO secretary general is held by a European while an American, currently General John Craddock, is supreme allied commander Europe, the paper said.
Rasmussen, 56, supported the 2003 US-led invasion of Iraq and favours a strong NATO involvement in Afghanistan, it said.
Seen as a strong candidate for some time, he has been touring European capitals drumming up support in recent weeks, and is due to meet James Jones, Obama’s national security advisor, before the April summit, the paper added.
A spokesman for the German government said NATO member countries were still in talks over the appointment and the no decisions had been taken.