Sunday, February 21, 2010

“UAB study could save a million lives per year (FOX 6 News Birmingham)” plus 2 more

“UAB study could save a million lives per year (FOX 6 News Birmingham)” plus 2 more


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UAB study could save a million lives per year (FOX 6 News Birmingham)

Posted: 21 Feb 2010 08:17 PM PST

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BIRMINGHAM, AL (WBRC) – A study led by the director of UAB's Division of Neonatology has found that the training of birth attendants in newborn-care techniques could reduce stillbirths by more than 30% and possibly save 1-million lives worldwide per year.

UAB's Dr. Waldemar A. Carlo spearheaded the study that was designed to train all types of birth attendants in 96 communities worldwide.

"The birth attendants were trained to do several easy steps that are critical for babies to survive at birth and be kept alive through the first week of life," said Carlo, the lead author who worked with a large group of American and international colleagues. "We selected the World Health Organization course on essential newborn care because it contains what we believed are the essential interventions necessary to sustain life in many infants and created an educational package that included interventions that could be used by any birth attendant anywhere in the world."

Birth attendants were trained by local trainers in rural communities in Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan and Zambia using the World Health Organization's newborn-care course and a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program.

The goal was to see if training birth attendants to use these interventions would reduce perinatal and neonatal mortality in the first week of life in infants weighing at least 1500 grams in rural communities in developing countries.

The stillbirth rate decreased significantly for nurses/midwives and traditional birth attendants following essential newborn care training. The stillbirth rate also decreased among home deliveries. There was not a significant decrease in all-cause first week mortality or stillbirth for those using the in-depth neonatal resuscitation program.

Carlo said it is plausible that the observed reduction in stillbirths may be due to essential newborn-care training. Live-born infants without obvious signs of life may have been misidentified as stillbirths before this training; such misclassifications have been reported in the literature. After training, resuscitation was more likely, and stillbirths decreased.

Carlo added that though the data show that training in basic neonatal care has an important role in improving perinatal outcomes in the developing world, more scaled-up research is needed to prove that the training reduces mortality in other health-care systems.

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Study shows states face $1T pension gap (Worcester Telegram & Gazette)

Posted: 21 Feb 2010 06:31 AM PST

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HARRISBURG, Pa. —  States may be forced to reduce benefits, raise taxes or slash government services to address a $1 trillion funding shortfall in public-sector retirement benefits, according to a new study that warns of even more debilitating costs if immediate action isn't taken.

The Pew Center on the States released a survey last week of state-administered pension plans, retiree health care and other post-employment benefits in all 50 states that blamed a decade's worth of policy decisions for leaving the funds shortchanged.

The result for some states will be "high annual costs that come with significant unfunded liabilities, lower bond ratings, less money available for services, higher taxes and the specter of worsening problems in the future," the study said.

The cost of the trillion-dollar shortfall, which will be paid over the coming decades, is about $8,800 for each American household. The study did not include many city, county and municipal pension plans, which are thought to be similarly underfunded.

"We have a significant problem now, but it's a problem that can be solved by taking relatively modest steps," said Susan K. Urahn, the center's managing director. "If they don't do anything, if they wait, eventually they will have an unmanageable crisis on their hands."

As of 2008, states had $2.4 trillion to meet $3.4 trillion in promised pension, health care and other post-retirement benefits, according to the report.

The true gap may even be wider, because the study did not account for the full impact of investment losses in late 2008, during the stock market downturn, and because many plans employ multiyear smoothing techniques to lessen the effect of a single year's losses. But more recent stock market returns could help. Earlier this month, for example, Pennsylvania's $47 billion public school pension plan reported it had earned about 12 percent on investments in the 2009 calendar year.

Pew deemed 16 states solid performers in how they fund pensions, 15 need improvement and 19 are facing serious concerns.

"Meanwhile, more and more baby boomers in state and local government are nearing retirement, and many will live longer than earlier generations — meaning that if states do not get a handle on the costs of post-employment benefits now, the problem likely will get far worse, with states facing debilitating costs," the study said.

The exploding financial burden could be a bitter pill for taxpayers, many of whom will not be collecting similar pensions or other benefits when they retire, said David Kline of the California Taxpayers' Association. About one in five private-sector workers have traditional defined benefit pensions, compared with about 90 percent of public-sector employees — including some that do not get Social Security.

"Taxpayers in the future will be paying for people who worked decades before they may have even lived in the area or begun paying taxes, because the obligation for these benefits is just snowballing," Kline said.

The study graded states on how well they have managed employees' retirement benefits. Florida, Idaho, New York, North Carolina and Wisconsin began the recession with fully funded pension systems, while eight states have left more than one-third of their pension liability unfunded.

Illinois was rated the most troubled pension system during the study period, with a 54 percent funding level and a total liability of more than $54 billion.

In Pennsylvania, a series of decisions by the Legislature and governor have shielded taxpayers from much of the pain for the past decade, but costs of less than $1 billion a year now is projected to climb to about $6 billion annually in the coming three years.

The report said policymakers have exacerbated the problem by expanding benefits, relying on overly optimistic assumptions about investment returns, and failing to fund the programs sufficiently.

"Even though the actuaries tell the states what they should be doing, the states feel free to ignore that," said Olivia Mitchell, director of the Pension Research Council at the University of Pennsylvania's Wharton School. "So putting some teeth behind the requirements is really the problem."

Pew calculated a $587 billion national cost for current and future retiree health care and other nonpension retirement benefits, with about 5 percent of that amount funded as of 2008. The cost of health care and the number of retirees are both on the rise, adding to the pressure on states.

The study found that 15 states made some legislative changes to their state-run systems last year, 12 did so in 2008, and 11 in 2007. About a third of states had formal studies of potential reforms under way last year.

"Pension plans work when they are allowed to work, and part of that dynamic is that sometimes adjustments have to be made," said Keith Brainard, research director with the National Association of State Retirement Administrators. "It's important not to take away decent retirement benefits for some of the few people that have them."

Pew said states should consider changes that have proven to be effective and politically viable. Among them: setting minimum contribution levels that are actuarially sound, sharing some of the investment risk with employees, cutting benefits, increasing the minimum retirement age, making employees pay more into the system, and providing more robust oversight and investment rules.

Mitchell said many states have constitutional prohibitions against lowering employee pension benefits, but health care programs can more easily be altered.

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Non-embryonic stem cells limited, UW study finds (Dunn County News)

Posted: 21 Feb 2010 05:03 AM PST

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Non-embryonic stem cells limited, UW study finds



DAVID WAHLBERG
dwahlberg@madison.com

A new kind of stem cells, which don't involve the destruction of embryos, can't turn into brain cells as well as embryonic stem cells can, a UW-Madison study found.

Induced pluripotent stem cells, discovered in 2007 in part by campus scientists James Thomson and Junying Yu, can morph into several types of brain cells. But they don't do so as consistently or efficiently as embryonic stem cells, which Thomson was the first to create, in 1998.

The findings, by campus neuroscientist Su-Chun Zhang, raise questions about how useful induced stem cells are for researching diseases and developing cell therapies. But the limitations of the cells can probably be overcome, Zhang said.

"At this point, there is still some work to be done to generate ideal induced pluripotent stem cells for application," he said in a news release.

Zhang's study, with fellow researcher Baoyang Hu, is published in this week's edition of the journal Proceedings of the National Academy of Sciences.

Both kinds of stem cells offer promise for medical research because of their capacity to become all of the body's 220 cell types. Scientists are using the cells to create models of diseases in the lab and develop potential therapies for Parkinson's disease, diabetes, spinal cord injuries, heart disease and other conditions.

The induced stem cells, also discovered by a competing team led by Japanese researcher Shinya Yamanaka, have been considered more promising than embryonic stem cells for two main reasons.

They are made by reprogramming skin or other cells back to their embryonic state, not by creating or destroying embryos, so the cells appease ethical concerns.

The induced stem cells also can be made from a patient's own cells, potentially reducing the risk of rejection when delivering therapies made from the cells.

But whether induced stem cells are as good as embryonic stem cells at becoming heart, kidney, pancreas, brain and other kinds of cells hasn't been shown.

Based on Zhang's study, induced stem cells aren't yet up to the job, at least regarding brain cells.

The study looked at how well a dozen groups of induced stem cells and five groups of embryonic stem cells became brain cells.

The induced stem cells didn't perform as well as the embryonic stem cells. That was true even for induced stem cells created without reprogramming genes, which had been thought to be the main barrier.

It has taken years for scientists to find ways to better grow embryonic stem cells, and it will also take some time to perfect the development of induced stem cells, the study suggests.

"It tells us the techniques for generating induced pluripotent stem cells are still not optimal," Zhang said. "There is room for improvement."

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