tag:blogger.com,1999:blog-315678852024-03-14T00:38:03.586-07:00Globalbelai7......"Documenting innovation, science, communication and creativity for posterity".....
Belai Habte-Jeuss, MD, MPHGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.comBlogger139125tag:blogger.com,1999:blog-31567885.post-87374865297309035252011-03-18T07:41:00.000-07:002011-03-18T07:41:24.931-07:00Global Top Scientific CitiesGlobal7 the new Millennial Renaissance Vision for the Globe<br />
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Mashups Reveal World's Top Scientific Cities<br />
Combining citation data with Google Maps reveals the cities where science prospers, and those where it doesn't<br />
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KFC 03/18/2011<br />
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2 COMMENTS<br />
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There are numerous ways of evaluating the performance of individual scientists, their departments and the institutions they are part of. Most are based on the volume and quality of the research they produce.<br />
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Today, Lutz Bornmann at the Max Planck Society in Munich and Loet Leydesdorff at the University of Amsterdam put forward another method, this time for evaluating the scientific performance of cities.<br />
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Their approach is straightforward. They take the total number of papers cited by researchers from a particular city and then count how many of these appear in the top ten per cent of cited papers. By the law of averages, you'd expect ten per cent of these papers to appear in the top ten per cent.<br />
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"For example, if authors located in one city have published 10,000 papers, one would expect for statistical reasons that a thousand (that is, 10%) belong to the top10% most highly cited papers," say Bornmann and Leydesdorff.<br />
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They then compare the expected number of top papers from a city with the actual number.<br />
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Finally, they plot the results on a map, showing cities that have more than expected highly cited papers in dark green and those with fewer than expected in red. The bigger the dots, the more papers that are involved.<br />
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Bornmann and Leydesdorff have done this for physics, chemistry and psychology papers that appeared on Scopus in 2008 with the citations up until February 2011. The screen shot above shows the physics papers map.<br />
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The results for physics indicate that the best performaners are London, Paris, Karlsruhe, Munich (and Garching), Pisa, and Rome. And the top result comes from London, which has more than three times more highly cited papers than expected (46 v 14.3).<br />
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The worst performer is Moscow which has only 21 highly cited papers compared to an expected value of 78.7. Bornmann and Leydesdorff also highlight the performance of Cambridge in the UK which merely matched expectations, producing 21 highly cited papers compared to the expected number of 21.7.<br />
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Bornmann and Leydesdorff's maps raise a number of questions. Not least of these is the performance of Cambridge, MA, home to two of the world's top institutions in MIT and Harvard, which could reasonably be expected to feature strongly in the data. Yet, Cambridge, MA, does not appear at all.<br />
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They also discuss a number of other limitations such as the role of different authors, who may come from different disciplines and contributed vastly different amounts of work.<br />
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My guess is that this kind of mashup will be of much greater significance in Europe, particularly Germany, than in the US because there is considerable focus from funding agencies on geographical centres of excellence.<br />
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Whatever the merits of this approach, performance measures are part of the landscape for working scientists. And visualisation techniques like these mashups can help to present the data in easily digestible ways. Expect to see more of them.<br />
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Ref: arxiv.org/abs/1103.3216: Which Cities Produce Worldwide More Excellent Papers Than Can Be Expected? A New Mapping Approach—Using Google Maps—Based On Statistical Significance Testing<br />
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You can now follow The Physics arXiv Blog on TwitterGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com2tag:blogger.com,1999:blog-31567885.post-39996940132345477832010-11-24T09:06:00.000-08:002010-11-24T09:06:41.093-08:00Global Patriotic Network launches the Global COFFEE Party NetworkGlobal7 the new Millennial Renaissance Vision for the Globe<br />
Our Passion is 2 reach our individual & collective potential 4 excellence &Success-Always!<br />
<br />
<br />
Global Patriotic Network Launches the COFFEE Party<br />
<br />
(Coalition of Fair & Free Economic Enterprises!)<br />
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Promoting character, Leadership & integrity: protecting, preserving and promoting the Global Patriotic Future for the next generation! <br />
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The Global Patriotic Network is a public and private enterprise dedicated to protecting and preserving a Global Patriotic Future for the next generation across the globe<br />
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Our Passion<br />
• To protect and preserve a Global Patriotic Future for the next generation<br />
Our Value<br />
• Character, leadership and integrity that promotes a sustainable secure future, based on good governance and aspiring for a progressive prosperity for all<br />
Our Vision<br />
• To galvanize all Global Citizens towards sustainable security, good governance and progressive prosperity for all<br />
Our Mission<br />
• To organize a series of win-win public private enterprises dedicated to nurture patriotism, character, leadership and integrity among all citizens of the globe<br />
Our Strategic Goal<br />
• To initiate a series of public and private networks of patriotism that promotes character, leadership and integrity at individual and collective social and economic life across all cultures<br />
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Our SMART Objectives<br />
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1. Specific: Promote character, leadership and integrity at individual and collective level across all communities regardless of age, gender, culture, color, race, nationality, religious and political affiliations<br />
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2. Measurable: Promote all activities against Qualitative and Quantitative tools the measure progress over time<br />
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3. Appropriate: Ensure that all activities are appropriate to the cultural diversity of communities at individual and collective level<br />
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4. Realistic: Develop realistic goals and targets that respect the resources and potential of each community at individual and collective level<br />
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5. Time Sensitive: Ensure that each activity is delivered in a specific time frame, within the talents and resources available to each partner communities<br />
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Global Patriotic Network will be headquartered in Washington, DC with global public and private networks both at the cyber and geographical domains without borders<br />
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Your creative and innovative response is appreciated.<br />
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Global Patriotic Network launches the first Global COFFEE (Coalition of Free & Fair Enterprises) Party designed to empower global citizens!<br />
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Global COFFEE Party is a public private enterprise designed to promote Global Coalition of Fair and Free Economic Enterprises across the globe to challenge the current global economic and ecological crisis.<br />
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The natural coffee plant is known to boost the immune system and our network of memories; the Global COFFEE Party is designed to simulate the Coffee plant that grows wild in the Kafa Province of Ethiopia to stimulate a global Coalition of Fair and Free Economic Enterprises <br />
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The Global COFFEE Party will support progressive scientific and evidence based ideas, policies, technologies that promote Fair, Free Economic Enterprises within the construct of Sustainable Security, Good Governance and Progressive Prosperity for all. Our passion to reach our individual and collective potential for excellence and success-Always.<br />
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The toxic financial and ecological assets are becoming a serious burden to the current and future generations. Well established institutions such as Harvard, Oxford and London Universities are known to produce the most toxic MBA and Economic graduates that have generated a series of voodoo economic policies, hedge funds and derivates that are not based on facts or science.<br />
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The Global COFFEE Party considers science, evidence based interactions supported by qualitative and quantitative research such as the Research Pyramid (that asks what, why, how, who, when and where questions); the CORT Analysis (that identifies, challenges, opportunities, risks and threats) towards converting all challenges into opportunities; as well as the NDSI Model (the Needs, Demands, Supply, Interaction Model: <br />
<br />
Our Passion<br />
• To protect and preserve and promote the a Global Patriotic Future for the next generation via win-win Global COFFEE Party that promotes economic enterprises!<br />
Our Value<br />
• Character, leadership and integrity that promotes a sustainable secure future, based on good governance and aspiring for a progressive prosperity for all<br />
Our Vision<br />
• To galvanize all Global Citizens towards sustainable security, good governance and progressive prosperity for all<br />
<br />
<br />
Our Mission<br />
• To organize a series of win-win public private enterprises dedicated to nurture patriotism, character, leadership and integrity among all citizens of the globe<br />
Our Strategic Goal<br />
• To initiate a series of public and private networks of patriotism that promotes character, leadership and integrity at individual and collective social and economic life across all cultures<br />
<br />
Our SMART Objectives<br />
<br />
6. Specific: Promote character, leadership and integrity at individual and collective level across all communities regardless of age, gender, culture, color, race, nationality, religious and political affiliations<br />
<br />
7. Measurable: Promote all activities against Qualitative and Quantitative tools the measure progress over time<br />
<br />
8. Appropriate: Ensure that all activities are appropriate to the cultural diversity of communities at individual and collective level<br />
<br />
9. Realistic: Develop realistic goals and targets that respect the resources and potential of each community at individual and collective level<br />
<br />
10. Time Sensitive: Ensure that each activity is delivered in a specific time frame, within the talents and resources available to each partner communities<br />
<br />
Global Patriotic Network will be headquartered in Washington, DC with global public and private networks both at the cyber and geographical domains without borders<br />
<br />
Your creative and innovative response is appreciated.<br />
<br />
-- <br />
BFMHJ (BMJ)<br />
Belai Habte-Jesus,MD,MPH<br />
Global Strategic Enterprises,Inc<br />
www.SolomonicCrown.org<br />
Www.GlobalBelai4u.blogspot.com<br />
V1=571.225.5736; V2= 703.933.8737; Fx1=202.3188277<br />
GlobalBjesus@gmail.com;GloblBelaiJesus@me.comGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-19204572303385047922010-11-22T19:26:00.000-08:002010-11-22T19:26:10.304-08:00Girma Wake of Ethiopian Airlines honored for saving Boeing and Ethiopian AirlinesGlobal7 the new Millennial Renaissance Vision for the Globe<br />
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CEO Girma Wake honored at Boeing 777 Delivery Dinner. Seattle, WA. Nov 20, 2010.<br />
Boeing Co. honored the outgoing Ethiopian Airlines CEO Girma Wake at the 777-200LR delivery dinner held in Seattle, WA.<br />
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The dinner event was organized by Boeing Co. to celebrate the deliv- ery of its 900th 777 to the first and only African airlines.<br />
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Boeing recognized Mr. Wake for four decade of service in the avia- tion industry and for building and maintaining a mutually beneficial business relationship between Boeing and Ethiopian Airlines.<br />
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Boeing marketing vice president thanked Ethiopian Airlines for or- dering five 777 in 2009 when Boeing was considering closing produc- tion line due to the downturn in the world economy.<br />
Ethiopian Airlines Board Chairman His Excellency Seyum Mesfin thanked Ato Girma for his dedicated service at Ethiopian Airlines. Ato Seyum said that while he discussed with over a hundred people for the Ethiopian CEO position almost all included Ato Girma in their recommendation as the person who could turn the declining air- lines around.<br />
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Ato Seyum appreciated Ato Girma for his sacrifice, dedication and commitment to serve his country.<br />
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Ato Girma left his lucrative employment with Gulf Air where he earned over eight thousand US Dollars a month to work at Ethiopia airlines earning less than five hundred dollars a month. The only benefit package he got was a company car.<br />
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Ato Girma successfully turned Ethiopia around. He is now leaving it behind as one of the most successful airlines in the world. He has also recruited a new generation of leaders that are ready to take the airlines to new heights.<br />
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Ato Girma described Boeing 777-200LR as a beautiful airplane capable of flying non-stop for 18 hours. The first of five delivery of 777-200LR is going to allow Ethiopian to fly non-stop from Addis Ababa to Washing- ton DC or to Beijing while carrying additional 100 passengers.<br />
The event was attended by many Ethiopians living in Seattle. It was a delightful experience for attendees to hear Ethiopia mentioned in positive light.<br />
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Over 150 Ethiopians work at Boeing in different capacity and some of whom had participated in building the Ethiopian 777-200LR. At Girrma reminded Ethiopians to help build airplanes that are suitable to the unique Ethiopian conditions and to serve as a human bond between Ethiopia and United States.Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-13630928484788187922010-10-13T09:47:00.001-07:002010-10-13T09:47:49.632-07:00HIV Pandenic the new genocide among African AmericansGlobal7 the new Millennial Renaissance Vision for the Globe<br />
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The edge boston.com<br />
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HIV/AIDS Rate in America’s Capitol Exceeds Some African Nations<br />
by Kilian Melloy<br />
EDGE Contributor<br />
Monday Mar 16, 2009<br />
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Dr. Anthony Fauci, NIH infectious diseases program director <br />
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A new report shows that the HIV/AIDS epidemic in Washington, D.C., are "higher than West Africa" HIV rates, and that heterosexual transmission of the disease is increasing, although the highest incidence new infections is still among men who have sex with men.<br />
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The Washington Post reported on the new study, which only accounts for Washington, D.C. residents who have gotten tested, prompting the report’s authors to note, "we know that the true number of residents currently infected and living with HIV is certainly higher."<br />
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A one percent rate of infection would be enough to regard the epidemic as "generalized and severe," the article noted.<br />
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The article quoted Washington, D.C. HIV/AIDS Administration director Shannon L. Hader, who said, "Our rates are higher than West Africa."<br />
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Added Hader, "They’re on par with Uganda and some parts of Kenya." <br />
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Hader noted, "We have every mode of transmission going up, all on the rise, and we have to deal with them."<br />
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The principle modes of HIV transmission are unprotected sex between men, unprotected heterosexual sex, and intravenous drug use, the article said. The new report shows a 22% increase in HIV/AIDS over three years ago.<br />
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The increase is discernible in all demographics, whether racial or geographical. African-American men were hardest hit, the study indicated: the demographic alone showed a seven percent infection rate, with 33% of African American men who were HIV positive reportedly contracting the virus through heterosexual contact. <br />
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Three percent African American women in the District are HIV positive, the report says, due to increasing transmission through heterosexual contact.<br />
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Among Caucasians, over three-quarters of HIV cases (78%) were among men who have sex with men; among Latinos, sexual contact among men accounted for 49% of infections, the article said.<br />
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Only one ward out of the District’s eight wards did not reflect an increase in HIV/AIDS rates, a development that the report anticipated would "have significant implications on the District’s health care system," the article reported.<br />
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A separate report prepared by George Washington University’s School of Health and Health Services looks more closely at heterosexual transmission of HIV, noting that only three out of ten heterosexual respondents reported using condoms during their most recent sexual encounters, while three out of five said that they knew whether they were HIV positive or negative.<br />
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The National Institutes of Health’s infectious diseases program director was quoted in the article.<br />
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Said Dr. Anthony Fauci, "This is very, very depressing news, especially considering HIV’s profound impact on minority communities."<br />
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Added Fauci, "And remember, the city’s numbers are just based on people who’ve gotten tested." <br />
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Said D.C. resident Ron Simmons, a gay African American, "You have a high incidence of HIV among African Americans, and a lot of African Americans live in the city."<br />
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Simmons, who the article said is with a support group, went on to say, "D.C. also has a high number of gay men, and HIV is high among gay black men." <br />
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Said Charlene Cotton, a D.C. resident who was diagnosed as positive five years ago, "You need to start at home and talk about it."<br />
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Added Cotton, "It’s so hush-hush." <br />
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Said Washington, D.C. mayor Adrian Fenty, "In order to solve an issue as complex as HIV and AIDS, you have to step up," the article said.<br />
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"It’s the mayor and certainly other elected officials. But it’s also the community. <br />
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"You have this problem affecting us, and you tell people how serious it is and it literally goes in one ear and out the other." <br />
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But D.C. city councilor David Catina, who chairs the city council’s health committee, had hard words for the District’s government, saying, "Frankly, there can be no excuse for the state of the HIV/AIDS Administration that I found in 2005.<br />
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"I cannot speak to why it was not a priority previously" added Catina. "For years prior to 2005, mayors and previous individuals allowed things to exist in an unacceptable way. <br />
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"And I do blame this government for part of the epidemic we’re confronting," Catina added.<br />
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The article said that the AIDS Office had lacked resources, and that the office’s critics had voiced doubts about the way its existing resources had been used.<br />
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Also called into question was a Congressional ban on using District tax revenue for needle exchange programs, possibly driving the infection rate higher. The article noted that the ban had been rescinded in 2008.<br />
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The one bright spot in the report was an indication that more people are getting tested, leading to earlier detection for those who are HIV positive. Early detection and medication is crucial in ensuring that HIV positive individuals live longer lives and enjoy better health.<br />
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The article tied the improvement in early detection to the fact that publicly funded testing had enjoyed a 70% increase over the last three years.<br />
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Kilian Melloy reviews media, conducts interviews, and writes commentary for EDGEBoston, where he also serves as Assistant Arts Editor.Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-74921287548555131772010-10-13T08:30:00.000-07:002010-10-13T09:20:10.389-07:00Alternative perspective on Vaccine Science? or another Witchcraft?Global7 the new Millennial Renaissance Vision for the Globe,<br />
Our Passion is to reach our individual and collective potential-Always!<br />
<br />
Millennium Wellness Enterprises, inc<br />
<br />
Wellness can be a profitable enterprise as well people and fit people can continue to be productive, creative and enterprising. Sick people tend to be disabled and lose their productivity over time.<br />
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So, it is sound business practice and social practice to stay healthy, well and fit.<br />
<br />
Unfortunately, we do not spend time on getting fit, healthy and well as these attributes are not converted into risk management insurance premiums and have value attached to them.<br />
<br />
As a result, the medical industry is creating disease via vaccines, to imitate disease and sell the product as beneficial to the unsuspecting public via highly exaggerated scientific credo that has not been yet proven of its benefits. <br />
<br />
The scientific tools and models of Risk assessment demand, the pragmatic use of Scientific tools such as Research Pyramid, CORT Analysis, NDSIM, 3As and 3Es and FoC as well as Option Appraisals.<br />
<br />
Risk management strategy demands that we under take, Research Pyramid questions of what, why, how, who, when and where to understand the cause and effect relationships. CORT Analysis demands that we look at challenges, opportunities, risks and threats in detail and convert our challenges into opportunities. Most importantly the NDSIM, the Needs, Demands, Supply Interaction Model demands that we look at the question of 3As and 3Es, that is Accessibility, Afford ability, Accountability, in line with Equity, Efficiency and Effectiveness and their delivery in an environment of Freedom of Choice.<br />
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Option Appraisal science demands that we look at options and alternatives as well as making choices in the principle of Best Option, Win-Win Option and Compromise Option for an improved opportunity of success.<br />
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So, where does vaccine science fall within this bigger picture of empirical science for wellness and optimum health. <br />
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It is important to consider wellness science as an alternative to health science, as traditional perspectives have converted health science into sickness science.<br />
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The Medical profession is about producing medicines, marketing them and selling them to the public to make profit. However, this does not sound enlightened, so disease and sickness will be through in the mix to make it sound scientific and beneficial to humanity. After all, we are <br />
talking about recovery or the healing profession.<br />
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The real science is about staying healthy and well. So, wellness demands pre-emptive fitness and optimum wellness strategy.<br />
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All the same it is critical that we appreciate that vaccines should be made accountable to our value system of optimum health and sustainable wellness.<br />
<br />
Dr Belai Habte-Jesus<br />
Millennium Wellness Enterprises, Inc<br />
<br />
<br />
Evidence-based vaccinations: A scientific look at the missing science behind flu season vaccines<br />
<br />
Thursday, September 02, 2010<br />
by Mike Adams, the Health Ranger<br />
Editor of NaturalNews.com (See all articles...) <br />
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(NaturalNews) As someone with a good deal of education in scientific thinking and the scientific method, I have put considerable effort into attempting to find any real scientific evidence backing the widespread use of influenza vaccines (flu season shots). Before learning about nutrition and holistic health, I was a computer software entrepreneur, and I have a considerable scientific background in areas such as astronomy, physics, human physiology, microbiology, genetics, anthropology and human psychology. One of my most-admired thought leaders is, in fact, the late physicist Richard Feynman.<br />
<br />
I don't speak from a "scientific" point of view on NaturalNews very often because it's often a dry, boring presentation style. But I do know the difference between real science and junk science, and I find examples of junk science in both the "scientific" side of things as well as the "alternative" side of things.<br />
<br />
For example, so-called "psychic surgery," as least in the way it has been popularized, is nothing more than clever sleight-of-hand where the surgeon palms some chicken gizzards and then pretends to pull diseased organs out of the abdominal cavity of some patient. The demonstrations I've seen on film are obvious quackery.<br />
<br />
Similarly, flu season vaccines are mainstream medicine's version of psychic surgery: It's all just "medical sleight of hand" based on nothing more than clever distractions and the obfuscation of scientific facts. Flu season shots, you see, simply don't work on 99 out of 100 people (and that's being generous to the vaccine industry, as you'll see below).<br />
<br />
A year ago, I offered a $10,000 reward to any person who could find scientific proof that H1N1 vaccines were safe and effective (http://www.naturalnews.com/027985_H...). No one even made a claim to collect that reward because no such evidence exists.<br />
<br />
Conventional medicine, they say, is really "Evidence-Based Medicine" (EBM). That is, everything promoted by conventional medicine is supposed to be based on "rigorous scientific scrutiny." It's all supposed to be statistically validated and proven beyond a shadow of a doubt that it works as advertised. And in the case of flu vaccines, they are advertised as providing some sort of absolute protection against influenza. "Don't miss work this flu season. Get a flu shot!" The idea, of course, is that getting a flu shot offers 100% protection from the flu. If you get a shot, they say, you won't miss work from sickness.<br />
<br />
This implication is wildly inaccurate. In fact, it's just flat-out false. As you'll see below, it's false advertising wrapped around junk science.<br />
<br />
You see, there was never an independent, randomized, double-blind, placebo-controlled study proving either the safety or effectiveness of the H1N1 swine flu vaccines that were heavily pushed last year (and are in fact in this year's flu shot cocktail). No such study has ever been done. As a result, there is no rigorous scientific basis from which to sell such vaccines in the first place.<br />
<br />
To try to excuse this, vaccine hucksters claim that it would be "unethical" to conduct a placebo-controlled study of such vaccines because they work so well that to deny the placebo group the actual vaccine would be harmful to them. Everybody benefits from the influenza vaccine, they insist, so the mere act of conducting a scientifically-controlled test is unethical.<br />
<br />
Do you smell some quackery at work yet? This is precisely the kind of pseudoscientific gobbledygook you might hear from some mad Russian scientist who claims to have "magic water" but you can't test the magic water because the mere presence of measurement instruments nullifies the magical properties of the water.<br />
<br />
Similarly, vaccine pushers often insist it's unethical to test whether their vaccines really work. You just have to "take it on faith" that vaccines are universally good for everybody.<br />
<br />
Yep, I used the word "faith." That is essentially what the so-called scientific community is invoking here with the vaccine issue: Just BELIEVE they work, everybody! Who needs scientific evidence when we've got FAITH in vaccines?<br />
<br />
Forget about evidence-based medicine. Forget about any rational cost-benefit analysis. Forget about the risk-to-benefit ratio calculations that should be part of any rational decision making about vaccines. No, the vaccine industry (and its apologist bloggers) already know that vaccines are universally good for you, therefore no such rigorous scientific assessment is even required!<br />
<br />
The Scientific Method, in other words, doesn't really apply to the things they already believe in. Faith can override reason in the "scientific" community, if you can believe that! What's next, are they going to claim vaccines work because some sort of "vaccine God" makes them work?<br />
<br />
Here, take your vaccine shot. And don't forget to pray to the Vaccine God because that's how these things really work. Vaccine voodoo, in other words. (Hey, that would have been a great title for the vaccine song, come to think of it...)<br />
<br />
Unethical to find out if they work?<br />
<br />
I got to wondering about the whole explanation of how it would be "unethical" to test whether the H1N1 vaccines actually work. This deflection strikes me as particularly odd, because it comes with an implied follow-up statement. Here's what they're actually saying when they invoke this excuse:<br />
<br />
#1) It is "unethical" to conduct placebo-controlled studies on seasonal flu vaccines to find out if they actually work.<br />
<br />
#2) But at the same time, it is entirely ethical to give these shots to hundreds of millions of people, even while lacking any real evidence that they are safe or effective.<br />
<br />
In other words, it's unethical to conduct any real science, but entirely ethical to just keep injecting people with a substance that might be entirely useless (or even harmful). That's just a hint of the kind of warped logic and failed ethics that typify our modern vaccine industry.<br />
<br />
Vaccine advocates claim that H1N1 vaccines are so effective that NOT giving vaccines to a placebo group would "put their lives at risk." That alone is apparently enough reason to avoid conducting any real science on these vaccines.<br />
<br />
But I'm not buying this. I think it's just a cover story -- an excuse to avoid subjecting such vaccines to rigorous scientific inquiry because, deep down inside, they know vaccines would be revealed as an elaborate medical fraud.<br />
<br />
So I poked around to see if there were other randomized studies being conducted that might actually put people's lives at risk. It didn't take long to find some. For example, the New England Journal of Medicine recently published two studies regarding post heart-attack patient cooling which seeks to minimize brain damage by physically lowering the temperature of the brain of the heart attack patient until they can reach the acute care technicians at a nearby hospital.<br />
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In two studies, researchers who already knew that "cooling" would save lives nevertheless subjected 350 heart attack patient to a randomized study protocol that assigned comatose (but resuscitated) patients to either "cooling" temperatures or normal temperatures.<br />
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In one study, while half the cooled patients recovered with normal brain function, only a quarter of those exposed to normal temperatures did. In other words, patient cooling saved their brains. And yet the importance of knowing whether or not this procedure really worked was apparently enough to justify withholding the treatment from over a hundred other patients, most of whom suffered permanent brain damage as a result.<br />
<br />
You see, when scientists really want to know the answers to questions like, "Does this brain cooling work?" they have no qualms about subjecting people to things like permanent brain damage in a randomized clinical trial. The knowledge gained from such an experiment is arguably worth the loss of a few patient brains because, armed with scientific evidence, such procedures can be rolled out to help save the brains of potentially hundreds of thousands of patients in subsequent years.<br />
<br />
But when it comes to testing vaccines like the recent H1N1 variety, the official explanation is that it's too dangerous to withhold vaccines from a treatment group. They say it's not really important to determine if vaccines are statistically validated, and it's not worth the "risk" of withholding vaccines from anyone in a randomized clinical trial.<br />
<br />
Now, sure, there have been some clinical trials done on many different vaccines over the years, but most of those are industry funded, and there are almost never rigorous trials conducted on each year's seasonal flu vaccines before they are released for public consumption. As a result, each year's vaccine is a brand new experiment, carried out across the guinea pig masses of patients who just do whatever they're told without questioning whether it's backed by real science.<br />
<br />
Because, of course, it isn't. And I'm not the only one who recognizes this inconvenient fact.<br />
<br />
The Cochrane Collaboration<br />
<br />
The Cochrane Collaboration, as described on its own website, is, "...an international, independent, not-for-profit organization of over 28,000 contributors from more than 100 countries, dedicated to making up-to-date, accurate information about the effects of health care readily available worldwide."<br />
<br />
"We are world leaders in evidence-based health care," the site goes on to say, followed by a quote from The Lancet which states, "The Cochrane Collaboration is an enterprise that rivals the Human Genome Project in its potential implications for modern medicine."<br />
<br />
Working for the Cochrane Collaboration, an epidemiologist named Dr. Tom Jefferson decided to take a close look at the scientific evidence behind influenza vaccines (seasonal flu vaccines).<br />
<br />
The objectives of the study were to: "Identify, retrieve and assess all studies evaluating the effects of vaccines against influenza in healthy adults."<br />
<br />
The Search Criteria: "We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2010, issue 2), MEDLINE (January 1966 to June 2010) and EMBASE (1990 to June 2010)."<br />
<br />
Selection Criteria (for inclusion in the study): "Randomized controlled trials (RCTs) or quasi-RCTs comparing influenza vaccines with placebo or no intervention in naturally-occurring influenza in healthy individuals aged 16 to 65 years. We also included comparative studies assessing serious and rare harms."<br />
<br />
The Total Scope of the study encompassed over 70,000 people. And just so you know, these the results may strongly favor the vaccine industry. The author even went out of his way to warn that "15 out of 36 trials [were] funded by industry (four had no funding declaration)."<br />
<br />
In other words, close to half of the studies included in this analysis were funded by the vaccine industry itself, which as we know consistently manipulates data, bribes researchers or otherwise engages in scientific fraud in order to get the results they want.<br />
<br />
The author even goes on to warn how industry-funded studies always get more press, saying, "...industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size."<br />
<br />
See the study detail page at: http://onlinelibrary.wiley.com/o/co...<br />
<br />
Study results show influenza vaccines are nearly worthless<br />
<br />
Now here comes the interesting part: Even though nearly half the studies were funded by the vaccine industry itself, the study results show that in most circumstances, influenza vaccines are virtually worthless:<br />
<br />
"The corresponding figures [of people showing influenza symptoms] for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%)" say the study authors. And by "poor vaccine matching," they mean that the strain of influenza viruses in the vaccine are a poor match for the strains circulating in the wild. This is usually the case in the real world because the vaccine only incorporates last year's viral strains and cannot predict which strains will be circulating this year.<br />
<br />
In other words, you would have to vaccinate 100 people to reduce the number of people showing influenza symptoms by just one. For ninety-nine percent of the people vaccinated, the vaccine makes no difference at all!<br />
<br />
In a "best case" scenario when the viral strain in the influenza vaccine just happens to match the strain circulating in the wild -- a situation that even the study authors call "uncommon" -- the results were as follows: "4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%, 95% confidence interval (CI) 2% to 5%)."<br />
<br />
In other words, the matching vaccine (which is uncommon in the real world) reduced influenza infections in 3 out of 100 people. Or, put another way, 97% of those injected with the vaccine received no benefit (and no different outcome).<br />
<br />
Furthermore, the study's conclusions go on to state:<br />
<br />
• "Vaccination had... no effect on hospital admissions or complication rates."<br />
<br />
• "Vaccine use did not affect the number of people hospitalized or working days lost."<br />
<br />
• "The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions..."<br />
<br />
• "There is no evidence that [influenza vaccines] affect complications, such as pneumonia, or transmission." (Got that? Vaccines do not affect transmission of the disease, yet that's the whole reason vaccines are pushed so heavily during pandemics -- to block disease transmission.)<br />
<br />
• "In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms."<br />
<br />
And finally, the study author's summary concludes with this whopper of a statement: "Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited."<br />
<br />
In other words, taking into account the industry bias, the actual results may be that vaccines prevent influenza symptoms in only 1 out of 1,000 people.<br />
<br />
Putting it in perspective<br />
<br />
So let's put all this in perspective in a rational, intelligent way. This far-reaching analysis of influenza vaccine trials shows that under common conditions, seasonal influenza vaccines have no benefit for 99 out of 100 people.<br />
<br />
Furthermore, even this result is describe as being "an optimistic estimate" because nearly half of the vaccine trials were funded by the vaccine industry which tends to "produce results favorable to their products."<br />
<br />
Furthermore, some of the studies were carried out in "ideal" viral matching scenarios that rarely happen in the real world.<br />
<br />
And finally, some evidence of harm from vaccines was simply thrown out of this analysis, resulting in a "harms evidence base" that was quite limited and likely doesn't reveal the full picture.<br />
<br />
Are you getting all this? Even with industry-funded studies likely distorting the results in their favor, if you take a good hard look at the scientific evidence surrounding the effectiveness of vaccines, you quickly come to realize that influenza vaccines don't work on 99 out of 100 people. (And the real answer may be even worse.)<br />
<br />
Now that's a far cry from the false advertising of the vaccine industry, which implies that if you get a shot you're "protected" from influenza. They claim you won't miss work, you'll stay well, and so on. Through these messages, they are cleverly implying that vaccines work on 100% of the people.<br />
<br />
But based on the available scientific evidence, these are blatantly false statements. And the wild exaggeration of the supposed benefits from vaccines crosses the threshold of "misleading advertising" and enters the realm of "criminal marketing fraud." Where is the FTC or FDA on speaking out against this quackery?<br />
<br />
Vaccine marketing is, essentially, scientific fraud. To claim that vaccines protect everyone when, in reality, they may reduce symptoms in only one out of 100 people is intellectually dishonest and downright fraudulent.<br />
<br />
It is, simply put, just pure B.S. quackery.<br />
<br />
Now, imagine if an herbal product were advertised on television as offering some health benefit, but it turned out that the product only worked on 1 out of 100 people who took it. That herbal product would be widely branded as "quackery" and the company selling it would be accused of false advertising. The company owners might even be charged with criminal fraud.<br />
<br />
But vaccines get a free pass on this issue. While an herbal product might be heavily investigated or even confiscated by the FDA, vaccines that only work on 1% of the people receive the full backing of the FDA, CDC, WHO, FTC and local hospitals and clinics to boot. The fact that the vaccine is pure quackery apparently doesn't matter to any of these organizations: It's full speed ahead, regardless of what the science actually says.<br />
<br />
Once you understand all this, you now understand why it is an accurate statement to say "The FDA promotes medical fraud."<br />
<br />
Similarly, "The CDC promotes medical fraud." As does the WHO.<br />
<br />
These are scientifically accurate statements, assuming you agree that a product that only works on 1 out of 100 people fits the definition of "fraud" when it is marketed as if it helped everyone. And most people would agree with that reasonable definition of fraud.<br />
<br />
It's a totally different story if the efficacy ratio is higher. If influenza vaccines actually produced some benefit in 25 out of 100 people, that might be worth considering. But it's nowhere near that.<br />
<br />
The FDA, by the way, will often approve pharmaceuticals that only produce results in 5 percent of the clinical trial subjects. The world of modern medicine, in fact, is full of pharmaceuticals that simply don't work on 95% of the patients who take them.<br />
<br />
Read the Cochrane summary yourself at:<br />
http://onlinelibrary.wiley.com/o/co...<br />
<br />
It's entitled, "Vaccines for preventing influenza in healthy adults"<br />
<br />
Authors: "Tom Jefferson, Carlo Di Pietrantonj, Alessandro Rivetti, Ghada A Bawazeer, Lubna A Al-Ansary, Eliana Ferroni"<br />
<br />
Enter the vaccine zombies!<br />
<br />
With these study results in mind, take a look at some of the lyrics in my recent hip hop song, "Vaccine Zombie" (http://www.naturalnews.com/vaccine_...)<br />
<br />
I forgot how to think for myself<br />
I don't understand a thing about health<br />
I do the same as everyone else<br />
I'm a vaccine zombie, zombie<br />
<br />
Now you can see where these lyrics come from. If influenza vaccines are worthless for 99 percent of those who receive them, then why are people lining up to get injected?<br />
<br />
The answer is because they fail to think critically about vaccines and their health. They don't understand health, so they just go along with everybody else and do what they're told. Hence their earning of the "Vaccine Zombie" designation.<br />
<br />
The song goes on to say:<br />
<br />
I'm a sucker for the ads, a sucker for the labs<br />
A sucker for the swine flu jabs<br />
and I don't mind followin' a medical fad<br />
Cause livin' without a brain ain't half bad<br />
<br />
Yes, people who line up for influenza vaccines are "suckers" who have been bamboozled by fraudulent vaccine propaganda. But they're following a "medical fad" and it's easier to just do what you're told rather than engage your brain and think critically about what you're doing.<br />
<br />
"Livin' without a brain ain't half bad" because it takes the burden of decision making out of the loop and allows you to just rely on whatever the doctors and health officials tell you to do.<br />
<br />
How the scientific community lost touch with real science<br />
<br />
But what if they were all lying to you? Or what if they, themselves, were ignorant about the fact that influenza vaccines are worthless on 99% of those who receive them? (Very few doctors and scientists, it turns out, are aware of this simple truth.)<br />
<br />
Or what if the vaccine pushers had all convinced themselves of a falsehood? What if they truly believed that vaccines were really, really good for everyone but that belief was based on wishful thinking rather than rigorous scientific review?<br />
<br />
Because that, my friends, is exactly what has happened. We have an entire segment of the scientific community that has been suckered into vaccine propaganda. They've convinced themselves that seasonal flu shots really work and that virtually everyone should be injected with such shots. And they believe this based on irrational faith, not on scientific thinking or rigorous statistical evidence.<br />
<br />
They are, in other words, pursuing a vaccine religion (or cult). The is especially curious, given that most vaccine pushers don't believe in God or any organized religion -- except for their own vaccine religion, where real scientific evidence isn't required. All you gotta do is believe in vaccines and you can join their religion, too.<br />
<br />
And so all across the 'net, so-called "science bloggers" embarrass themselves by promoting near-useless influenza vaccines as "evidence-based medicine," apparently unaware that the evidence shows such vaccines to be all but worthless.<br />
<br />
They might as well say they support vaccines "Just 'cuz."<br />
<br />
And "just 'cuz" is no reason to inject yourself with a chemical cocktail that even the industry admits causes extremely dangerous neurological side effects in a small number of vaccine recipients.<br />
<br />
Vitamin D would actually make vaccines work better<br />
<br />
To top this all off, here's the real kicker of this story: You can beat the minimal protective benefits of vaccines with a simple, low-cost vitamin D supplement. Vitamin D, you see, is the nutrient that activates your immune system to fight off infectious disease. Without it, vaccines hardly work at all.<br />
<br />
In fact, the very low rate of vaccine efficacy (1%) is almost certainly due to the fact that most people receiving the vaccines are vitamin D deficient. (Anywhere from 75% - 95% of Americans are deficient in vitamin D, depending on whom you ask.)<br />
<br />
Hilariously, the way to make vaccines work better would be to hand out vitamin D supplements to go along with the shots! Even more hilariously, if people were taking vitamin D supplements, they wouldn't need the vaccine shots in the first place!<br />
<br />
Influenza vaccines, in other words, have no important role whatsoever in preventing influenza infections. This goal can be accomplished more safely, reliably and at far lower cost by promoting vitamin D supplements for the population at large.<br />
<br />
What we really need to see from the scientific world is a study comparing vitamin D supplements to influenza vaccines (and using realistic vitamin D doses, not just 200 or 400 IUs per day). I have absolutely no doubt that healthy-dose vitamin D supplementation (4000 IUs a day) would prove to be significantly more effective than influenza vaccines at preventing flu infections.<br />
<br />
But such a study will almost certainly never be done (at least not anytime soon) because it would expose the false propaganda of the vaccine industry while giving consumers a far better way of protecting themselves from influenza that doesn't involve paying money to vaccine manufacturers.<br />
<br />
In medicine, as in war, truth is often the first casualty. And when the lies are repeated with enough frequency, they begin to be believed. The flu shot lie has been repeated with such ferocity and apparent authority that it has snookered in virtually the entire "scientific" community.<br />
<br />
That even rational-minded scientists can be so easily hoodwinked by the vaccine industry is causing more and more people to question the credibility of not just modern medicine, but the entire scientific community as well.<br />
<br />
Because if so-called "rational" scientists and thought leaders can be so easily suckered into an obvious falsehood, what other fictions might they be promoting as fact?<br />
<br />
Medicine, you see, makes all the other sciences look bad. The obvious scientific fraud going on in the name of "science" in the pharmaceutical industry makes a mockery of real scientific thought. The ease of which medical scientists have been hoodwinked by the drug industry calls into question the rationality of all sciences.<br />
<br />
And in doing so, it brings up an even bigger question: Is science the best path to gaining knowledge in the first place? This is obviously a philosophical question, not a scientific question, and it's beyond the scope of this article, but it's one I will likely visit here on NaturalNews very soon in an upcoming article.<br />
<br />
There are many paths to truth, you see. Science -- good science -- is one of them, but it is not the only one. Any scientist who believes that science has a monopoly on all knowledge is himself a fool. Just read a little Feynman and you'll quickly come to discover that the very brightest minds in the history of science consistently recognized there were other pathways leading to truth.<br />
<br />
I believe if Feynman were alive today and saw the vaccine propaganda taking place in the name of "science," he would respond with something like, "Surely you're joking."<br />
<br />
Articles Related to This Article:<br />
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• Facebook crowdsourced investigation exposes vaccine denials of SIGA Technologies<br />
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• The great thimerosal cover-up: Mercury, vaccines, autism and your child's health<br />
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• Flu vaccines revealed as the greatest quackery ever pushed in the history of medicine<br />
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About the author: Mike Adams is a consumer health advocate and award-winning journalist with a mission to teach personal and planetary health to the public He has authored more than 1,800 articles and dozens of reports, guides and interviews on natural health topics, impacting the lives of millions of readers around the world who are experiencing phenomenal health benefits from reading his articles. <br />
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Adams is an honest, independent journalist and accepts no money or commissions on the third-party products he writes about or the companies he promotes. <br />
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In 2010, Adams launched NaturalNews.TV, a natural health video site featuring videos on holistic health and green living. He also founded an environmentally-friendly online retailer called BetterLifeGoods.com that uses retail profits to help support consumer advocacy programs. He's also the CEO of a highly successful email newsletter software company that develops software used to send permission email campaigns to subscribers. <br />
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Adams volunteers his time to serve as the executive director of the Consumer Wellness Center, a 501(c)3 non-profit organization, and practices nature photography, Capoeira, martial arts and organic gardening. He's also author of numerous health books published by Truth Publishing and is the creator of several consumer-oriented grassroots campaigns, including the Spam. Don't Buy It! campaign, and the free downloadable Honest Food Guide. He also created the free reference sites HerbReference.com and HealingFoodReference.com.<br />
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Adams believes in free speech, free access to nutritional supplements and the ending of corporate control over medicines, genes and seeds. Known as the 'Health Ranger,' Adams' personal health statistics and mission statements are located at www.HealthRanger.orgGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-82697708944717671502010-10-13T07:40:00.003-07:002010-10-13T07:40:33.398-07:00Connecting our humanity via geneology even when we have to fight to surviveGlobal7 the new Millennial Renaissance Vision for the Globe<br />
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Obama Distant Kin to Palin, Limbaugh, Bush, Ancestry.com Says<br />
By Traci McMillan - Oct 13, 2010 12:01 AM ET<br />
Tweet (40) LinkedIn Share Print Email<br />
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U.S. President Barack Obama speaking in Washington. Photographer: Joshua Roberts/Bloomberg<br />
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<br />
Sarah Palin, former governor of Alaska and 2008 vice presidential candidate, attending the Southern Republican Leadership Conference in New Orleans. Photographer: Patrick Semansky/Bloomberg<br />
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President Barack Obama is distantly related to two of his most outspoken critics -- Tea Party favorite Sarah Palin and talk-radio host Rush Limbaugh -- as well as to former President George W. Bush, according to a genealogy website.<br />
<br />
Family trees revealed Obama and Palin, the former Alaska Governor and 2008 Republican vice presidential nominee, are 10th cousins through common ancestor John Smith, according to Ancestry.com Inc. Smith was Obama’s and Palin’s 12th-great- grandfather. Smith, a Protestant pastor, was an early settler in Massachusetts and was criticized by the ecclesiastical community for supporting Quakers, said Anastasia Tyler, a genealogist for the website.<br />
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Obama and Limbaugh are 10th cousins once removed through shared connections to Richmond Terrell, a Virginia settler who came to America in the mid-1600s, Tyler said.<br />
<br />
Palin and Obama have ties to Bush, both through links to Samuel Hinckley. Maybe leadership “runs in the family,” the website said, because Hinckley’s son, Thomas, became the governor of Plymouth Colony before it united with Massachusetts.<br />
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“Despite political differences, they do have similarities,” Tyler said. “We are all tied together; we are all part of America.”<br />
<br />
The family-tree website also found that Palin is related to U.S. Senate Majority Leader Harry Reid, a Nevada Democrat, and author and commentator Ann Coulter. The three are tied to John Lathrop, an Englishman who was banished to Boston after he served as minister of an illegal church independent of the Church of England, Tyler said.<br />
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Family Trees<br />
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Tyler’s team at Provo, Utah-based Ancestry.com works on discovering famous relations to show how people can build family trees from the site, using its library of 5 billion historical records.<br />
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“We are always looking for ways to show how interesting family history can be,” Tyler said.<br />
<br />
The site has previously linked Obama to billionaire Warren Buffett and actor Brad Pitt. It also found family ties between Palin and Princess Diana.<br />
<br />
To contact the reporter on this story: Traci McMillan in Washington at tmcmillan1@bloomberg.net<br />
<br />
To contact the editor responsible for this story: Mark Silva in Washington at msilva34@bloomberg.net.Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-19765802364813230692010-10-05T11:36:00.000-07:002010-10-05T11:36:41.919-07:00Nobel Prize for Medicine goes to Invitro Fertilization ScientistsGlobal7 the new Millennial Renaissance Vision for the Globe<br />
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Our Passion is to reach our individual and collective potential 4 Excellence & Success!<br />
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IVF doctors, families celebrate creator's Nobel Prize<br />
By Elizabeth Landau and Jamie Gumbrecht, CNN<br />
<br />
October 4, 2010 6:43 p.m. EDT<br />
Brendan Harley and his wife, Kathryn Clancy, had their daughter, Joan, through in vitro fertilization.<br />
<br />
STORY HIGHLIGHTS<br />
<br />
In vitro fertilization, once controversial, is practically an everyday procedure today<br />
About 1 percent of infants born in U.S. are conceived through assisted reproduction<br />
High cost of in vitro is still prohibitive for many couples<br />
Next goal is to improve the success rate, reduce multiple births<br />
(CNN) -- Brendan Harley beat cancer once as an infant, then faced leukemia as a teen. He survived, but the illnesses left him infertile and feeling guilty.<br />
<br />
"He knew that I wanted children and was excited to have children, and I think he was sad that he was complicating things," said Harley's wife, Kathryn Clancy, 31. "But if anything, I feel like things just worked out so wonderfully that there was just no need to be upset."<br />
Clancy and Harley, both assistant professors at the University of Illinois, now have a 2 ½-year-old daughter, Joan. She was conceived through in vitro fertilization, a technology that involves combining sperm and egg outside the body and implanting the resulting embryos.<br />
<br />
"You look at this child and you think, 'How could my life be any different?' I can't imagine how sad I'd be if this wasn't how my life looked right now," said Clancy, a biological anthropologist.<br />
<br />
Just a few decades ago, the technology that allowed Joan to be born didn't exist. One of its creators, Robert G. Edwards, won the Nobel Prize for medicine on Monday. Many families and doctors said it's a well-earned prize that brought precious lives into the world.<br />
Share your 'test-tube baby' story: Send an iReport<br />
"Bob Edwards certainly made a major impact on what we do we do every day, and the four million babies born as a result," said Dr. James Goldfarb, president of the Society for Assisted Reproductive Technology and director of infertility services at the Cleveland Clinic Health Systems.<br />
In vitro fertilization technology has evolved since the first successful birth in 1978, Goldfarb said, but he uses another word to describe the work of Edwards and his partner, Dr. Patrick Steptoe, who died in 1988: Revolution.<br />
<br />
Robert G. Edwards wins Nobel Prize<br />
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Today, about 1 percent of infants born in the United States are conceived through assisted reproductive technologies, and 99 percent of those use in vitro fertilization, the U.S. Department of Health and Human Services reported in 2009. It's a medical procedure the public knows, doctors said, and infertile couples expect for it to be on the list of treatments.<br />
They're well-aware that since 1978, miracles have been possible.<br />
Controversial births<br />
The first baby ever born through IVF was Louise Joy Brown, delivered through a Caesarean section on July 25, 1978, at a hospital in England. She gave birth to a son in 2006.<br />
<br />
Elizabeth Comeau, born Elizabeth Jordan Carr in 1981, was the first so-called "test tube baby" in the United States, and recently had a child of her own.<br />
<br />
Dr. Dorothy Mitchell-Leef, a fertility specialist in private practice in Atlanta, Georgia, remembers the buzz surrounding Brown's birth at the American Society of Reproductive Medicine meeting shortly after.<br />
<br />
"It was extremely exciting to hear about it and know that it could be achieved," she said.<br />
Early on, Edwards' and Steptoe's work on in vitro fertilization met opposition from some government officials, who were concerned with potential overpopulation, and some religious groups. Catholic church leaders have long opposed in vitro fertilization because, they said, it depersonalizes conception and disposes of some embryos, which they argue is the equivalent to abortion.<br />
<br />
Doctors remember protesters at medical conventions and fertility clinics that struggled to stay open. Now, they said, curiosity and science fiction-style reporting have calmed. Families celebrate unlikely births, schools might have multiple sets of twins and triplets and the first babies born through in vitro fertilization are having their own babies the natural way.<br />
<br />
"I don't think it's a stigma to parents or the child," said Dr. Louis DePaolo, chief of the National Institute of Child Health and Human Development's Reproductive Sciences Branch. "There are couples who go through hell, the stress of infertility and going through these treatments. There's no question [why they do it] -- the desire to have a family."<br />
<br />
A costly procedure<br />
<br />
The barrier for many couples now is cost. One round of in vitro fertilization can cost about $15,000. Many insurance policies don't cover it, and some couples require more than one attempt.<br />
Kathryn Clancy's child, Joan, was born through a procedure that combined Clancy's egg with the sperm from one of Harley's brothers. Harley's other brother had been a bone marrow donor when he had leukemia at 17.<br />
Clancy and Harley met with a fertility specialist in January 2007. The following six months were a mix of paperwork, testing, hormones and medications to prepare Clancy's body for the embryo transfer. The process of injecting herself frightened Clancy, so her husband did it for her the first week; cancer had made him comfortable with needles.<br />
<br />
The first trimester was scariest, Clancy said. Early on, she had cramps and fears of a miscarriage. But the process worked on the first try, with a single embryo.<br />
Joan Adele Clancy-Harley was born after a natural labor at a midwife-attended birth center in Massachusetts. It was a "textbook" pregnancy and a nonmedical end to an intense medical experience, Clancy noted.<br />
<br />
Next challenges<br />
<br />
Those are the types of fertility stories doctors like.<br />
<br />
The in vitro process has been simplified to ease the initial removal of a woman's eggs, to help men with low numbers of sperm and to use the most viable embryos. Long-term studies have shown that children born as a result of in vitro fertilization are as healthy as children born after natural conception. Still, not all attempts are successful and not all pregnancies go smoothly.<br />
Some doctors transfer more than one embryo to improve chances of a pregnancy, but multiple births can lead to greater risks during pregnancy and after delivery. Widespread attention to Nadya Suleman, the mother of octuplets born in California in 2009, has led to more discussions about ethics and limits of in vitro fertilization.<br />
<br />
Doctors say the goals now are to improve the success rate, especially for older parents, while reducing the number of multiple births. Then there's the bigger question: How to prevent or treat infertility altogether?<br />
<br />
"We're bypassing. The couples are still infertile," DePaolo said. "We need to pursue the root causes of infertility and have better treatments, and ameliorate the major reasons to need in vitro fertilization."<br />
<br />
That, they said, could be the work of future Nobel Prize.<br />
CNN's Madison Park contributed to this report.<br />
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<br />
Stroke (CVA)-<br />
Update and Revision s<br />
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<br />
Introduction<br />
<br />
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A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue (cerebral infarction) and causing sudden symptoms.<br />
<br />
1. Most strokes are ischemic (usually due to blockage of an artery), but some are hemorrhagic (due to rupture of an artery).<br />
<br />
2. Transient ischemic attacks resemble ischemic strokes except the symptoms resolve within 1 hour.<br />
3. Symptoms occur suddenly and can include muscle weakness, paralysis, abnormal or lost sensation on one side of the body, difficulty speaking, confusion, problems with vision, dizziness, and loss of balance and coordination.<br />
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4. Diagnosis is based on symptoms, but imaging and blood tests are also done.<br />
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5. Recovery after a stroke depends on many factors, such the location and amount of damage, the person's age, and the presence of other disorders.<br />
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6. Controlling high blood pressure, high cholesterol levels, and high blood sugar levels and not smoking help prevent strokes.<br />
7. Treatment may include drugs to make blood less likely to clot or to break up clots and sometimes surgery.<br />
A stroke is called a cerebrovascular disorder because it affects the brain (cerebro-) and the blood vessels (vascular).<br />
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Supplying the Brain With Blood<br />
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Blood is supplied to the brain through two pairs of large arteries:<br />
• Internal carotid arteries, which carry blood from the heart along the front of the neck<br />
• Vertebral arteries, which carry blood from the heart along the back of the neck<br />
Understanding the Pato- physiology of stroke<br />
In the skull, the vertebral arteries unite to form the basilar artery (at the back of the head). The internal carotid arteries and the basilar artery divide into several branches, including the cerebral arteries. Some branches join to form a circle of arteries (circle of Willis) that connect the vertebral and internal carotid arteries. Other arteries branch off from the circle of Willis like roads from a traffic circle. The branches carry blood to all parts of the brain.<br />
When the large arteries that supply the brain are blocked, some people have no symptoms or have only a small stroke. But others with the same sort of blockage have a massive ischemic stroke. Why? Part of the explanation is collateral arteries. Collateral arteries run between other arteries, providing extra connections.<br />
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Cerebral Arteries<br />
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These arteries include the circle of Willis and connections between the arteries that branch off from the circle. Some people are born with large collateral arteries, which can protect them from strokes. Then when one artery is blocked, blood flow continues through a collateral artery, sometimes preventing a stroke. Other people are born with small collateral arteries. Small collateral arteries may be unable to pass enough blood to the affected area, so a stroke results.<br />
Protection against stroke<br />
The body can also protect itself against strokes by growing new arteries. When blockages develop slowly and gradually (as occurs in atherosclerosis), new arteries may grow in time to keep the affected area of the brain supplied with blood and thus prevent a stroke. If a stroke has already occurred, growing new arteries can help prevent a second stroke (but cannot reverse damage that has been done).<br />
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Epidemiology<br />
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In Western countries, strokes are the third most common cause of death and the most common cause of disabling neurologic damage. In the United States, over 600,000 people have a stroke and about 160,000 die of stroke each year. <br />
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Older people<br />
Strokes are much more common among older people than among younger adults, usually because the disorders that lead to strokes progress over time. Over two thirds of all strokes occur in people older than 65. Slightly more than 50% of all strokes occur in men, but more than 60% of deaths due to stroke occur in women, possibly because women are on average older when the stroke occurs. Blacks are more likely than whites to have a stroke and to die of it.<br />
Types of Stroke (Ischemic 80%; and hemorrhagic, 20%)<br />
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Types: There are two types of strokes: ischemic and hemorrhagic. About 80% of strokes are ischemic—usually due to a blocked artery, often blocked by a blood clot. Brain cells, thus deprived of their blood supply, do not receive enough oxygen and glucose (a sugar), which are carried by blood.<br />
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Oxygen deprivation<br />
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The damage that results depends on how long brain cells are deprived of blood. If they are deprived for only a brief time, brain cells are stressed, but they may recover. If brain cells are deprived longer (but possibly for only several minutes), brain cells die, and some functions may be lost. However, in such cases, a different area of the brain can sometimes learn how to do the functions previously done by the damaged area.<br />
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Transient Ischemic Attacks (TIAs) - Ministrokes<br />
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Transient ischemic attacks (TIAs), sometimes called ministrokes, are often an early warning sign of an impending ischemic stroke. They are caused by a brief interruption of the blood supply to part of the brain. Because the blood supply is restored quickly, brain tissue may not die, as it does in a stroke<br />
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Hemorrhagic strokes..<br />
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The other 20% of strokes are hemorrhagic—due to bleeding in or around the brain. In this type of stroke, a blood vessel ruptures, interfering with normal blood flow and allowing blood to leak into brain tissue. Blood that comes into direct contact with brain tissue irritates the tissue and can cause scarring, leading to seizures.<br />
Risk Factors: The major risk factors for both types of stroke are<br />
1. Atherosclerosis (narrowing or blockage of arteries by patchy deposits of fatty material in the walls of arteries)<br />
2. High cholesterol levels<br />
3. High blood pressure<br />
4. Diabetes<br />
5. Smoking<br />
Atherosclerosis is a more important risk factor for ischemic stroke, and high blood pressure is a more important risk factor for hemorrhagic stroke. These risk factors can be controlled to some extent.<br />
Other risk factors include<br />
1. Having relatives who have had a stroke<br />
2. Consuming too much alcohol<br />
3. Using cocaine or amphetamines<br />
4. Having an abnormal heart rhythm called atrial fibrillation<br />
5. Having inflamed blood vessels (vasculitis)<br />
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For hemorrhagic stroke, risk factors also include using anticoagulants, having a bulge (aneurysm) in arteries within the skull, and having an abnormal connection between arteries and veins (arteriovenous malformation).<br />
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Incidence <br />
The incidence of strokes has declined in recent decades, mainly because people are more aware of the importance of controlling high blood pressure and high cholesterol levels and stopping cigarette smoking. Controlling these factors reduces the risk of atherosclerosis.<br />
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Symptoms<br />
Symptoms of a stroke or transient ischemic attack occur suddenly. They vary depending on the precise location of the blockage or bleeding in the brain (Brain Dysfunction: Dysfunction by Location and Brain Dysfunction: When Specific Areas of the Brain Are Damaged ).<br />
Each area of the brain is supplied by specific arteries. For example, if an artery supplying the area of the brain that controls the left leg's muscle movements is blocked, the leg becomes weak or paralyzed. If the area of the brain that senses touch in the right arm is damaged, sensation in the right arm is lost.<br />
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Early treatment<br />
Because early treatment can help limit loss of function and sensation, everyone should know what the early symptoms of stroke are. People who have any of these symptoms should see a doctor immediately, even if the symptom goes away quickly.<br />
Most strokes, whether ischemic or hemorrhagic, typically cause one or more of the following symptoms:<br />
1. Sudden weakness or paralysis on one side of the body (for example, half of the face, one arm or leg, or all of one side)<br />
2. Sudden loss of sensation or abnormal sensations on one side of the body<br />
3. Sudden difficulty speaking, sometimes with slurred speech<br />
4. Sudden confusion, with difficulty understanding speech<br />
5. Sudden dimness, blurring, or loss of vision, particularly in one eye<br />
6. Sudden dizziness or loss of balance and coordination, leading to falls<br />
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Symptoms of a transient ischemic attack are the same, but they usually disappear within minutes and rarely last more than 1 hour.<br />
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Why Strokes Affect Only One Side of the Body<br />
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Strokes usually damage only one side of the brain. Because nerves in the brain cross over to the other side of the body, symptoms appear on the side of the body opposite the damaged side of the brain.<br />
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Symptoms of a hemorrhagic stroke may also include the following:<br />
1. Sudden severe headache<br />
2. Nausea and vomiting<br />
3. Temporary or persistent loss of consciousness<br />
4. Very high blood pressure<br />
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Other symptoms that may occur early include problems with memory, thinking, attention, or learning. People may be unable to recognize parts of the body and may be unaware of the stroke's effects. The peripheral field of vision may be reduced, and hearing may be partially lost. <br />
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Dizziness and vertigo may develop or persist. Control of bowel or bladder function may be lost.<br />
Later symptoms may include stiffening and spasms of the muscles (spasticity) and inability to control emotions. A stroke can cause depression, or people may feel depressed because of the stroke.<br />
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In most people who have had an ischemic stroke, loss of function is usually greatest immediately after the stroke occurs. However, in about 15 to 20%, the stroke is progressive, causing greatest loss of function after a day or two. In people who have had a hemorrhagic stroke, function usually is lost progressively over minutes to hours.<br />
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Over days to months, some function is usually regained because even though some brain cells die, others are only stressed and may recover. Also, certain areas of the brain can sometimes switch to the functions previously done by the damaged part—a characteristic called plasticity. However, the early effects of a stroke, including paralysis, can become permanent. Muscles that are not used usually become permanently spastic and stiff, and painful muscle spasms may occur.<br />
Walking, swallowing, physically saying words clearly, and doing daily activities may remain difficult. <br />
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Various problems with memory, thinking, attention, learning, or controlling emotions may persist. Depression, impairments in hearing or vision, or vertigo may be continuing problems. Control of bowel or bladder function may be permanently impaired.<br />
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Complications: When a stroke is severe, the brain swells, increasing pressure within the skull. Increased pressure can damage the brain directly or indirectly by forcing the brain downward in the skull. <br />
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The brain may be forced through the rigid structures that separate the brain into compartments, resulting in a serious problem called herniation (see Head Injuries:Introduction ). The pressure affects the respiratory center in the lower part of the brain stem and can cause irregular breathing, loss of consciousness, coma, and death.<br />
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The symptoms caused by a stroke can lead to other problems. If swallowing is difficult, people may inhale food, fluids, or other particles from the mouth. Such inhalation (called aspiration) can cause aspiration pneumonia, which may be serious. <br />
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Difficulty swallowing can also interfere with eating, resulting in under nutrition and dehydration. Not being able to move can result in pressure sores, muscle loss, and the formation of blood clots in deep veins of the legs and groin (deep vein thrombosis). Clots can break off, travel through the bloodstream, and block an artery to a lung (pulmonary embolism). If bladder control is impaired, urinary tract infections are more likely to develop.<br />
Diagnosis<br />
Symptoms suggest the diagnosis, but tests are needed to help doctors determine the following:<br />
1. Whether stroke has occurred<br />
2. Whether it is ischemic or hemorrhagic<br />
3. Whether immediate treatment is required<br />
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Computed tomography (CT–see Common Imaging Tests: Computed Tomography) or magnetic resonance imaging (MRI–see Common Imaging Tests: Magnetic Resonance Imaging) of the brain is done. These tests can detect most hemorrhagic strokes, except for some subarachnoid hemorrhages. These tests can also detect many ischemic strokes but sometimes not until several hours after symptoms appear. The blood sugar level is measured immediately because a low blood sugar level (hypoglycemia) can cause symptoms similar to those of stroke.<br />
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Doctors evaluate people who have had a stroke for problems that can contribute to or cause a stroke, such as infection, a low blood oxygen level, and dehydration, Tests are done as needed. <br />
People are asked about depression. The ability to swallow is evaluated, sometimes with x-rays taken after a radiopaque dye such as barium is swallowed. Depending on the type of stroke, more tests are done to identify the cause.<br />
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Prognosis<br />
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Certain factors suggest that the outcome of a stroke is likely to be poor. Strokes that cause unconsciousness or that affect a large part of the left side of the brain (which is responsible for language) may be particularly grave.<br />
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In adults who have had an ischemic stroke, problems that remain after 6 months are likely to be permanent, but children continue to improve slowly for many months. Older people fare less well than younger people. For people who already have other serious disorders (such as dementia), recovery is more limited.<br />
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If a hemorrhagic stroke is not massive and pressure within the brain is not very high, the outcome is likely to be better after than that after an ischemic stroke. Blood (in a hemorrhagic stroke) does not damage brain tissue as much as an inadequate supply of oxygen (in an ischemic stroke) does.<br />
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Prevention<br />
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Preventing strokes is preferable to treating them. The main strategy for preventing a first stroke is managing the major risk factors. High blood pressure (see High Blood Pressure) and diabetes (see Diabetes Mellitus (DM): Diabetes Mellitus)should be controlled. Cholesterol levels should be measured and, if high, lowered to reduce the risk of atherosclerosis (see Cholesterol Disorders: Treatment). <br />
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Smoking and use of amphetamines or cocaine should be stopped, and alcohol should be limited to no more than 2 drinks a day. Exercising regularly and, if overweight, losing weight help people control high blood pressure, diabetes, and high cholesterol levels. Having regular checkups enables a doctor to identify risk factors for stroke so that they can be managed quickly.<br />
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If people have had an ischemic stroke, taking an antiplatelet drug can reduce the risk of another ischemic stroke. Antiplatelet drugs make platelets less likely to clump and form clots, a common cause of ischemic stroke. (Platelets are tiny cell-like particles in blood that help it clot in response to damaged blood vessels.) <br />
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Aspirin , one of the most effective antiplatelet drugs, is usually prescribed. One adult's tablet or 1 children's tablet (which is about one fourth the dose of an adult aspirin ) is taken each day. Either dose seems to prevent strokes about equally well. <br />
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Taking a combination tablet that contains a low dose of aspirin and dipyridamole (an antiplatelet drug) is slightly more effective than taking aspirin alone. <br />
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Clopidogrel , another antiplatelet drug, is also slightly more effective than aspirin alone. It may be given to people who cannot tolerate aspirin. <br />
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Some people are allergic to antiplatelet drugs or similar drugs and cannot take them. Also, people who have gastrointestinal bleeding should not take antiplatelet drugs.<br />
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If an ischemic stroke or a transient ischemic attack is due to blood clots originating in the heart, warfarin , an anticoagulant, may be given to inhibit blood clotting. Because taking warfarin and an antiplatelet drug or taking aspirin plus clopidogrel greatly increases the risk of bleeding, these drugs are rarely used together for stroke prevention.<br />
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Treatment<br />
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Anyone with symptoms of a stroke should seek medical attention immediately.<br />
Doctors check the person's vital functions, such as heart rate, breathing, temperature, and blood pressure, to make sure they are adequate. If they are not, measures to correct them are taken immediately.<br />
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For example, if people are in a coma or unresponsive (as may result from brain herniation), mechanical ventilation (with a breathing tube inserted through the mouth or nose) may be needed to help them breathe. <br />
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If symptoms suggest that pressure within the skull is high, drugs may be given to reduce swelling in the brain, and a monitor may be put in the brain to periodically measure the pressure.<br />
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Other treatments used during the first hours depend on the type of stroke. These treatments include drugs (such as antiplatelet drugs, anticoagulants, drugs to break up clots, and drugs to control high blood pressure) and surgery to remove blood that has accumulated.<br />
Later and ongoing treatments focus on preventing subsequent strokes, treating and preventing problems that strokes can cause, and helping people regain as much function as possible (rehabilitation).<br />
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Preventing and Treating Problems After a Stroke<br />
Problem Measures<br />
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Blood clots in the legs To prevent blood clots, doctors may give anticoagulants, such as heparin or low molecular weight heparin, put elastic or air-filled support stockings on the person's legs to improve blood circulation, or both.Moving the legs, which improves blood flow, can also help. People, if able, are encouraged to walk or simply move their legs (for example, extending and flexing their ankles). If people cannot move their legs, a therapist or other staff member moves their legs for them (called passive exercise).<br />
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Pressure sores Nurses, other staff members, or caregivers should frequently turn or reposition people who are confined to a bed or wheelchair. Areas likely to develop pressures sores should be inspected every day.<br />
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Permanent shortening of muscles that limits movement (contractures) Moving the limbs can prevent contractures. People, if able, are encouraged to move and change positions regularly. Or a therapist or other staff member moves their limbs for them and makes sure the limbs are placed in appropriate resting positions. Sometimes splints are used to keep the limbs in place.<br />
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Difficulty swallowing People are evaluated for difficulty swallowing. If they have difficulty, care is taken to provide them with enough fluids and nourishment. Sometimes learning simple techniques (for example, how to position the head, how to breathe when swallowing) can help the person swallow safely. Tube feedings may be necessary until the ability to swallow returns.<br />
Difficulty breathing If people smoke, they are encouraged to stop. Therapists also teach them to do deep breathing exercises and to cough to clear the airways. Therapists may provide a handheld breathing device. If needed, oxygen is provided through a face mask or a tube inserted in the nose or in the mouth.<br />
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Urinary tract infections If possible, a urinary catheter, which can cause urinary infections, is not used. If a catheter is needed, it is removed as soon as possible.<br />
Discouragement and depression Doctors discuss the effects of the stroke with affected people and their family members or other caregivers. The discussion includes the type of recovery that can be expected and ways to cope with limitations of function. People and their caregivers are put in contact with stroke support groups. Formal counseling or drugs may be necessary to treat depression.<br />
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Rehabilitation: Intensive rehabilitation can help many people overcome disabilities after a stroke (see Rehabilitation: Brain Injuries). The exercises and training of rehabilitation encourage unaffected areas of the brain to learn to perform functions that were done by the damaged area. Also, people are taught new ways to use muscles unaffected by the stroke to compensate for losses in function.<br />
The goals of rehabilitation are the following:<br />
1. To regain as much normal function as possible<br />
2. To maintain and improve physical condition<br />
3. To help people relearn old skills and learn new ones as needed<br />
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Success depends on the area of the brain damaged and the person's general physical condition, functional and cognitive abilities before the stroke, social situation, learning ability, and attitude. Patience and perseverance are crucial. Participating actively in the rehabilitation program can help people avoid or lessen depression.<br />
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Rehabilitation is started in the hospital as soon as people are physically able—usually within 1 or 2 days of admission. After discharge from the hospital, rehabilitation can be continued on an outpatient basis, in a nursing home, in a rehabilitation center, or at home. Occupational and physical therapists can suggest ways to make life easier and the home safer for people with disabilities.<br />
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Family members and friends can contribute to a person's rehabilitation by keeping in mind what effects a stroke can have, so that they can better understand and support the person. Support groups can provide emotional encouragement and practical advice for people who have had a stroke and for those who care for them.<br />
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End-of-Life Issues<br />
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For some people who have had a stroke, quality of life is predicted to remain very poor despite treatment. For such people, care focuses on control of pain, comfort measures, and provision of fluids and nourishment. People who have had a stroke should establish advance directives (seeLegal and Ethical Issues: Advance Directives) as soon as possible because the recurrence and progression of strokes are unpredictable. Advance directives can help a doctor determine what kind of medical care people want if they become unable to make these decisions.<br />
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Notes and Comments<br />
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Stroke<br />
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Stroke<br />
Classification and external resources<br />
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CT scan slice of the brain showing a right-hemispheric ischemic stroke (left side of image).<br />
ICD-10 I61.-I64.<br />
ICD-9 434.91<br />
OMIM 601367<br />
DiseasesDB 2247<br />
MedlinePlus 000726<br />
eMedicine neuro/9 emerg/558 emerg/557 pmr/187<br />
MeSH D020521<br />
<br />
A stroke, known medically as a cerebrovascular accident (CVA), is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage (leakage of blood).[1] As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field.[2]<br />
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A stroke is a medical emergency and can cause permanent neurological damage, complications, and even death. It is the leading cause of adult disability in the United States and Europe and it is the number two cause of death worldwide.[3] Risk factors for stroke include advanced age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and atrial fibrillation.[4] High blood pressure is the most important modifiable risk factor of stroke.[2]<br />
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A stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"). Post-stroke prevention may involve the administration of antiplatelet drugs such as aspirin and dipyridamole, control and reduction of hypertension, the use of statins, and in selected patients with carotid endarterectomy, the use of anticoagulants.[2] Treatment to recover any lost function is stroke rehabilitation, involving health professions such as speech and language therapy, physical therapy and occupational therapy.<br />
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Contents [hide]<br />
1 Definition<br />
2 Classification<br />
2.1 Ischemic stroke<br />
2.2 Hemorrhagic stroke<br />
3 Signs and symptoms<br />
3.1 Early recognition<br />
3.2 Subtypes<br />
3.3 Associated symptoms<br />
4 Causes<br />
5 Pathophysiology<br />
5.1 Ischemic<br />
5.2 Hemorrhagic<br />
6 Diagnosis<br />
6.1 Physical examination<br />
6.2 Imaging<br />
6.3 Underlying etiology<br />
7 Prevention<br />
7.1 Risk factors<br />
7.1.1 Blood pressure<br />
7.1.2 Atrial fibrillation<br />
7.1.3 Blood lipids<br />
7.1.4 Diabetes mellitus<br />
7.1.5 Anticoagulation drugs<br />
7.1.6 Surgery<br />
7.1.7 Nutritional and metabolic interventions<br />
8 Treatment<br />
8.1 Stroke unit<br />
8.2 Treatment of ischemic stroke<br />
8.2.1 Thrombolysis<br />
8.2.2 Mechanical thrombectomy<br />
8.2.3 Angioplasty and stenting<br />
8.2.4 Therapeutic hypothermia<br />
8.3 Secondary prevention of ischemic stroke<br />
8.4 Treatment of hemorrhagic stroke<br />
8.5 Care and rehabilitation<br />
9 Prognosis<br />
10 Epidemiology<br />
11 History<br />
12 References<br />
13 Further reading<br />
[edit]Definition<br />
<br />
The traditional definition of stroke, devised by the World Health Organization in the 1970s,[5] is a "neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours". This definition was supposed to reflect the reversibility of tissue damage and was devised for the purpose, with the time frame of 24 hours being chosen arbitrarily. The 24-hour limit divides stroke from transient ischemic attack, which is a related syndrome of stroke symptoms that resolve completely within 24 hours.[2] With the availability of treatments that, when given early, can reduce stroke severity, many now prefer alternative concepts, such as brain attack and acute ischemic cerebrovascular syndrome (modeled after heart attack and acute coronary syndrome respectively), that reflect the urgency of stroke symptoms and the need to act swiftly.[6]<br />
[edit]Classification<br />
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A slice of brain from the autopsy of a person who suffered an acute middle cerebral artery (MCA) stroke<br />
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Strokes can be classified into two major categories: ischemic and hemorrhagic.[7] Ischemic strokes are those that are caused by interruption of the blood supply, while hemorrhagic strokes are the ones which result from rupture of a blood vessel or an abnormal vascular structure. About 87% of strokes are caused by ischemia, and the remainder by hemorrhage. Some hemorrhages develop inside areas of ischemia ("hemorrhagic transformation"). It is unknown how many hemorrhages actually start as ischemic stroke.[2]<br />
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[edit]Ischemic stroke<br />
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Main articles: Cerebral infarction and Brain ischemia<br />
In an ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. There are four reasons why this might happen:<br />
Thrombosis (obstruction of a blood vessel by a blood clot forming locally)<br />
Embolism (obstruction due to an embolus from elsewhere in the body, see below),[2]<br />
Systemic hypoperfusion (general decrease in blood supply, e.g. in shock)[8]<br />
Venous thrombosis.[9]<br />
Stroke without an obvious explanation is termed "cryptogenic" (of unknown origin); this constitutes 30-40% of all ischemic strokes.[2][10]<br />
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There are various classification systems for acute ischemic stroke. The Oxford Community Stroke Project classification (OCSP, also known as the Bamford or Oxford classification) relies primarily on the initial symptoms; based on the extent of the symptoms, the stroke episode is classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) or posterior circulation infarct (POCI). These four entities predict the extent of the stroke, the area of the brain affected, the underlying cause, and the prognosis.[11][12] The TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification is based on clinical symptoms as well as results of further investigations; on this basis, a stroke is classified as being due to (1) thrombosis or embolism due to atherosclerosis of a large artery, (2) embolism of cardiac origin, (3) occlusion of a small blood vessel, (4) other determined cause, (5) undetermined cause (two possible causes, no cause identified, or incomplete investigation).[2][13]<br />
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[edit]Hemorrhagic stroke<br />
Main articles: Intracranial hemorrhage and intracerebral hemorrhage<br />
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CT scan showing an intracerebral hemorrhage with associated intraventricular hemorrhage.<br />
Intracranial hemorrhage is the accumulation of blood anywhere within the skull vault. A distinction is made between intra-axial hemorrhage (blood inside the brain) and extra-axial hemorrhage (blood inside the skull but outside the brain). Intra-axial hemorrhage is due to intraparenchymal hemorrhage or intraventricular hemorrhage (blood in the ventricular system). The main types of extra-axial hemorrhage are epidural hematoma (bleeding between the dura mater and the skull), subdural hematoma (in the subdural space) and subarachnoid hemorrhage (between the arachnoid mater and pia mater). Most of the hemorrhagic stroke syndromes have specific symptoms (e.g. headache, previous head injury).<br />
[edit]Signs and symptoms<br />
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Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive the area of brain affected, the more functions that are likely to be lost. Some forms of stroke can cause additional symptoms. For example, in intracranial hemorrhage, the affected area may compress other structures. Most forms of stroke are not associated with headache, apart from subarachnoid hemorrhage and cerebral venous thrombosis and occasionally intracerebral hemorrhage.<br />
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[edit]Early recognition<br />
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Various systems have been proposed to increase recognition of stroke by patients, relatives and emergency first responders. A systematic review, updating a previous systematic review from 1994, looked at a number of trials to evaluate how well different physical examination findings are able to predict the presence or absence of stroke. It was found that sudden-onset face weakness, arm drift (e.g. if a person, when asked to raise both arms, involuntarily lets one arm drift downward) and abnormal speech are the findings most likely to lead to the correct identification of a case of stroke (+ likelihood ratio of 5.5 when at least one of these is present). Similarly, when all three of these are absent, the likelihood of stroke is significantly decreased (– likelihood ratio of 0.39).[14] While these findings are not perfect for diagnosing stroke, the fact that they can be evaluated relatively rapidly and easily make them very valuable in the acute setting.<br />
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Proposed systems include FAST (face, arm, speech, and time),[15] as advocated by the Department of Health (United Kingdom) and The Stroke Association, the American Stroke Association (www.strokeassociation.org) , National Stroke Association (US www.stroke.org), the Los Angeles Prehospital Stroke Screen (LAPSS)[16] and the Cincinnati Prehospital Stroke Scale (CPSS).[17] Use of these scales is recommended by professional guidelines.[18]<br />
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For people referred to the emergency room, early recognition of stroke is deemed important as this can expedite diagnostic tests and treatments. A scoring system called ROSIER (recognition of stroke in the emergency room) is recommended for this purpose; it is based on features from the medical history and physical examination.[18][19]<br />
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[edit]Subtypes<br />
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If the area of the brain affected contains one of the three prominent central nervous system pathways—the spinothalamic tract, corticospinal tract, and dorsal column (medial lemniscus), symptoms may include:<br />
hemiplegia and muscle weakness of the face<br />
numbness<br />
reduction in sensory or vibratory sensation<br />
In most cases, the symptoms affect only one side of the body (unilateral). Depending on the part of the brain affected, the defect in the brain is usually on the opposite side of the body. However, since these pathways also travel in the spinal cord and any lesion there can also produce these symptoms, the presence of any one of these symptoms does not necessarily indicate a stroke.<br />
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In addition to the above CNS pathways, the brainstem also consists of the 12 cranial nerves. A stroke affecting the brain stem therefore can produce symptoms relating to deficits in these cranial nerves:<br />
<br />
altered smell, taste, hearing, or vision (total or partial)<br />
drooping of eyelid (ptosis) and weakness of ocular muscles<br />
decreased reflexes: gag, swallow, pupil reactivity to light<br />
decreased sensation and muscle weakness of the face<br />
balance problems and nystagmus<br />
altered breathing and heart rate<br />
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weakness in sternocleidomastoid muscle with inability to turn head to one side<br />
weakness in tongue (inability to protrude and/or move from side to side)<br />
If the cerebral cortex is involved, the CNS pathways can again be affected, but also can produce the following symptoms:<br />
aphasia (inability to speak or understand language from involvement of Broca's or Wernicke's area)<br />
apraxia (altered voluntary movements)<br />
visual field defect<br />
memory deficits (involvement of temporal lobe)<br />
hemineglect (involvement of parietal lobe)<br />
disorganized thinking, confusion, hypersexual gestures (with involvement of frontal lobe)<br />
anosognosia (persistent denial of the existence of a, usually stroke-related, deficit)<br />
If the cerebellum is involved, the patient may have the following:<br />
trouble walking<br />
altered movement coordination<br />
vertigo and or disequilibrium<br />
[edit]Associated symptoms<br />
Loss of consciousness, headache, and vomiting usually occurs more often in hemorrhagic stroke than in thrombosis because of the increased intracranial pressure from the leaking blood compressing on the brain.<br />
If symptoms are maximal at onset, the cause is more likely to be a subarachnoid hemorrhage or an embolic stroke.<br />
[edit]Causes<br />
<br />
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Thrombotic stroke<br />
<br />
In thrombotic stroke a thrombus (blood clot) usually forms around atherosclerotic plaques. Since blockage of the artery is gradual, onset of symptomatic thrombotic strokes is slower. A thrombus itself (even if non-occluding) can lead to an embolic stroke (see below) if the thrombus breaks off, at which point it is called an "embolus." Two types of thrombosis can cause stroke:<br />
Large vessel disease involves the common and internal carotids, vertebral, and the Circle of Willis. Diseases that may form thrombi in the large vessels include (in descending incidence): atherosclerosis, vasoconstriction (tightening of the artery), aortic, carotid or vertebral artery dissection, various inflammatory diseases of the blood vessel wall (Takayasu arteritis, giant cell arteritis, vasculitis), noninflammatory vasculopathy, Moyamoya disease and fibromuscular dysplasia.<br />
<br />
Small vessel disease involves the smaller arteries inside the brain: branches of the circle of Willis, middle cerebral artery, stem, and arteries arising from the distal vertebral and basilar artery. Diseases that may form thrombi in the small vessels include (in descending incidence): lipohyalinosis (build-up of fatty hyaline matter in the blood vessel as a result of high blood pressure and aging) and fibrinoid degeneration (stroke involving these vessels are known as lacunar infarcts) and microatheroma (small atherosclerotic plaques).<br />
Sickle cell anemia, which can cause blood cells to clump up and block blood vessels, can also lead to stroke. A stroke is the second leading killer of people under 20 who suffer from sickle-cell anemia.[20]<br />
<br />
Embolic stroke<br />
An embolic stroke refers to the blockage of an artery by an arterial embolus, a travelling particle or debris in the arterial bloodstream originating from elsewhere. An embolus is most frequently a thrombus, but it can also be a number of other substances including fat (e.g. from bone marrow in a broken bone), air, cancer cells or clumps of bacteria (usually from infectious endocarditis).<br />
<br />
Because an embolus arises from elsewhere, local therapy only solves the problem temporarily. Thus, the source of the embolus must be identified. Because the embolic blockage is sudden in onset, symptoms usually are maximal at start. Also, symptoms may be transient as the embolus is partially resorbed and moves to a different location or dissipates altogether.<br />
Emboli most commonly arise from the heart (especially in atrial fibrillation) but may originate from elsewhere in the arterial tree. In paradoxical embolism, a deep vein thrombosis embolises through an atrial or ventricular septal defect in the heart into the brain.<br />
<br />
Cardiac causes can be distinguished between high and low-risk:[21]<br />
<br />
High risk: atrial fibrillation and paroxysmal atrial fibrillation, rheumatic disease of the mitral or aortic valve disease, artificial heart valves, known cardiac thrombus of the atrium or vertricle, sick sinus syndrome, sustained atrial flutter, recent myocardial infarction, chronic myocardial infarction together with ejection fraction <28 percent, symptomatic congestive heart failure with ejection fraction <30 percent, dilated cardiomyopathy, Libman-Sacks endocarditis, Marantic endocarditis, infective endocarditis, papillary fibroelastoma, left atrial myxoma and coronary artery bypass graft (CABG) surgery<br />
<br />
Low risk/potential: calcification of the annulus (ring) of the mitral valve, patent foramen ovale (PFO), atrial septal aneurysm, atrial septal aneurysm with patent foramen ovale, left ventricular aneurysm without thrombus, isolated left atrial "smoke" on echocardiography (no mitral stenosis or atrial fibrillation), complex atheroma in the ascending aorta or proximal arch<br />
<br />
Systemic hypoperfusion<br />
<br />
Systemic hypoperfusion is the reduction of blood flow to all parts of the body. It is most commonly due to cardiac pump failure from cardiac arrest or arrhythmias, or from reduced cardiac output as a result of myocardial infarction, pulmonary embolism, pericardial effusion, or bleeding. Hypoxemia (low blood oxygen content) may precipitate the hypoperfusion. Because the reduction in blood flow is global, all parts of the brain may be affected, especially "watershed" areas - border zone regions supplied by the major cerebral arteries. A watershed stroke refers to the condition when blood supply to these areas is compromised. Blood flow to these areas does not necessarily stop, but instead it may lessen to the point where brain damage can occur. This phenomenon is also referred to as "last meadow" to point to the fact that in irrigation the last meadow receives the least amount of water.<br />
<br />
Venous thrombosis<br />
<br />
Cerebral venous sinus thrombosis leads to stroke due to locally increased venous pressure, which exceeds the pressure generated by the arteries. Infarcts are more likely to undergo hemorrhagic transformation (leaking of blood into the damaged area) than other types of ischemic stroke.[9]<br />
Intracerebral hemorrhage<br />
<br />
It generally occurs in small arteries or arterioles and is commonly due to hypertension, intracranial vascular malformations (including cavernous angiomas or arteriovenous malformations), cerebral amyloid angiopathy, or infarcts into which secondary haemorrhage has occurred.[2] Other potential causes are trauma, bleeding disorders, amyloid angiopathy, illicit drug use (e.g. amphetamines or cocaine). The hematoma enlarges until pressure from surrounding tissue limits its growth, or until it decompresses by emptying into the ventricular system, CSF or the pial surface. A third of intracerebral bleed is into the brain's ventricles. ICH has a mortality rate of 44 percent after 30 days, higher than ischemic stroke or even the very deadly subarachnoid hemorrhage (which, however, also may be classified as a type of stroke[2]).<br />
[edit]Pathophysiology<br />
<br />
[edit]Ischemic<br />
<br />
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<br />
Ischemic stroke occurs due to a loss of blood supply to part of the brain, initiating the ischemic cascade.[22] Brain tissue ceases to function if deprived of oxygen for more than 60 to 90 seconds and after approximately three hours, will suffer irreversible injury possibly leading to death of the tissue, i.e., infarction. (This is why TPA's (e.g. Streptokinase, Altapase) are given only until three hours since the onset of the stroke.) Atherosclerosis may disrupt the blood supply by narrowing the lumen of blood vessels leading to a reduction of blood flow, by causing the formation of blood clots within the vessel, or by releasing showers of small emboli through the disintegration of atherosclerotic plaques. Embolic infarction occurs when emboli formed elsewhere in the circulatory system, typically in the heart as a consequence of atrial fibrillation, or in the carotid arteries, break off, enter the cerebral circulation, then lodge in and occlude brain blood vessels. Since blood vessels in the brain are now occluded, the brain becomes low in energy, and thus it resorts into using anaerobic respiration within the region of brain tissue affected by ischemia. Unfortunately, this kind of respiration produces less ATP but releases a by-product called lactic acid. Lactic acid is an irritant which could potentially destroy cells since it is an acid and disrupts the normal acid-bace balance in the brain. The ischemia area is referred to as the "ischemic penumbra".[23]<br />
<br />
Then, as oxygen or glucose becomes depleted in ischemic brain tissue, the production of high energy phosphate compounds such as adenosine triphosphate (ATP) fails, leading to failure of energy-dependent processes (such as ion pumping) necessary for tissue cell survival. This sets off a series of interrelated events that result in cellular injury and death. A major cause of neuronal injury is release of the excitatory neurotransmitter glutamate. The concentration of glutamate outside the cells of the nervous system is normally kept low by so-called uptake carriers, which are powered by the concentration gradients of ions (mainly Na+) across the cell membrane. However, stroke cuts off the supply of oxygen and glucose which powers the ion pumps maintaining these gradients. As a result the transmembrane ion gradients run down, and glutamate transporters reverse their direction, releasing glutamate into the extracellular space. Glutamate acts on receptors in nerve cells (especially NMDA receptors), producing an influx of calcium which activates enzymes that digest the cells' proteins, lipids and nuclear material. Calcium influx can also lead to the failure of mitochondria, which can lead further toward energy depletion and may trigger cell death due to apoptosis.<br />
<br />
Ischemia also induces production of oxygen free radicals and other reactive oxygen species. These react with and damage a number of cellular and extracellular elements. Damage to the blood vessel lining or endothelium is particularly important. In fact, many antioxidant neuroprotectants such as uric acid and NXY-059 work at the level of the endothelium and not in the brain per se. Free radicals also directly initiate elements of the apoptosis cascade by means of redox signaling.[20]<br />
<br />
These processes are the same for any type of ischemic tissue and are referred to collectively as the ischemic cascade. However, brain tissue is especially vulnerable to ischemia since it has little respiratory reserve and is completely dependent on aerobic metabolism, unlike most other organs.<br />
<br />
Brain tissue survival can be improved to some extent if one or more of these processes is inhibited. Drugs that scavenge reactive oxygen species, inhibit apoptosis, or inhibit excitatory neurotransmitters, for example, have been shown experimentally to reduce tissue injury due to ischemia. Agents that work in this way are referred to as being neuroprotective. Until recently, human clinical trials with neuroprotective agents have failed, with the probable exception of deep barbiturate coma. However, more recently NXY-059, the disulfonyl derivative of the radical-scavenging spintrap phenylbutylnitrone, is reported to be neuroprotective in stroke.[24] This agent appears to work at the level of the blood vessel lining or endothelium. Unfortunately, after producing favorable results in one large-scale clinical trial, a second trial failed to show favorable results.[20]<br />
<br />
In addition to injurious effects on brain cells, ischemia and infarction can result in loss of structural integrity of brain tissue and blood vessels, partly through the release of matrix metalloproteases, which are zinc- and calcium-dependent enzymes that break down collagen, hyaluronic acid, and other elements of connective tissue. Other proteases also contribute to this process. The loss of vascular structural integrity results in a breakdown of the protective blood brain barrier that contributes to cerebral edema, which can cause secondary progression of the brain injury.<br />
<br />
As is the case with any type of brain injury, the immune system is activated by cerebral infarction and may under some circumstances exacerbate the injury caused by the infarction. Inhibition of the inflammatory response has been shown experimentally to reduce tissue injury due to cerebral infarction, but this has not proved out in clinical studies.<br />
[edit]Hemorrhagic<br />
<br />
<br />
Head CT showing deep intracerebral hemorrhage due to bleeding within the cerebellum, approximately 30 hours old.<br />
<br />
Hemorrhagic strokes result in tissue injury by causing compression of tissue from an expanding hematoma or hematomas. This can distort and injure tissue. In addition, the pressure may lead to a loss of blood supply to affected tissue with resulting infarction, and the blood released by brain hemorrhage appears to have direct toxic effects on brain tissue and vasculature.[20]<br />
[edit]Diagnosis<br />
<br />
Stroke is diagnosed through several techniques: a neurological examination (such as the Nihss), CT scans (most often without contrast enhancements) or MRI scans, Doppler ultrasound, and arteriography. The diagnosis of stroke itself is clinical, with assistance from the imaging techniques. Imaging techniques also assist in determining the subtypes and cause of stroke. There is yet no commonly used blood test for the stroke diagnosis itself, though blood tests may be of help in finding out the likely cause of stroke.[25]<br />
[edit]Physical examination<br />
<br />
A physical examination, including taking a medical history of the symptoms and a neurological status, helps giving an evaluation of the location and severity of a stroke. It can give a standard score on e.g. the NIH stroke scale.<br />
[edit]Imaging<br />
For diagnosing ischemic stroke in the emergency setting:[26]<br />
CT scans (without contrast enhancements)<br />
sensitivity= 16%<br />
specificity= 96%<br />
MRI scan<br />
sensitivity= 83%<br />
specificity= 98%<br />
For diagnosing hemorrhagic stroke in the emergency setting:<br />
CT scans (without contrast enhancements)<br />
sensitivity= 89%<br />
specificity= 100%<br />
MRI scan<br />
sensitivity= 81%<br />
specificity= 100%<br />
For detecting chronic hemorrhages, MRI scan is more sensitive.[27]<br />
For the assessment of stable stroke, nuclear medicine scans SPECT and PET/CT may be helpful. SPECT documents cerebral blood flow and PET with FDG isotope the metabolic activity of the neurons.<br />
[edit]Underlying etiology<br />
When a stroke has been diagnosed, various other studies may be performed to determine the underlying etiology. With the current treatment and diagnosis options available, it is of particular importance to determine whether there is a peripheral source of emboli. Test selection may vary, since the cause of stroke varies with age, comorbidity and the clinical presentation. Commonly used techniques include:<br />
an ultrasound/doppler study of the carotid arteries (to detect carotid stenosis) or dissection of the precerebral arteries<br />
an electrocardiogram (ECG) and echocardiogram (to identify arrhythmias and resultant clots in the heart which may spread to the brain vessels through the bloodstream)<br />
a Holter monitor study to identify intermittent arrhythmias<br />
an angiogram of the cerebral vasculature (if a bleed is thought to have originated from an aneurysm or arteriovenous malformation)<br />
blood tests to determine hypercholesterolemia, bleeding diathesis and some rarer causes such as homocysteinuria<br />
[edit]Prevention<br />
<br />
Given the disease burden of stroke, prevention is an important public health concern.[28] Primary prevention is less effective than secondary prevention (as judged by the number needed to treat to prevent one stroke per year).[28] Recent guidelines detail the evidence for primary prevention in stroke.[29] Because stroke may indicate underlying atherosclerosis, it is important to determine the patient's risk for other cardiovascular diseases such as coronary heart disease. Conversely, aspirin prevents against first stroke in patients who have suffered a myocardial infarction or patients with a high cardiovascular risk.[30][31]<br />
[edit]Risk factors<br />
The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation (although magnitude of this effect is small: the evidence from the Medical Research Council trials is that 833 patients have to be treated for 1 year to prevent one stroke[32][33]). Other modifiable risk factors include high blood cholesterol levels, diabetes, cigarette smoking[34][35] (active and passive), heavy alcohol consumption[36] and drug use,[37] lack of physical activity, obesity and unhealthy diet.[38] Alcohol use could predispose to ischemic stroke, and intracerebral and subarachnoid hemorrhage via multiple mechanisms (for example via hypertension, atrial fibrillation, rebound thrombocytosis and platelet aggregation and clotting disturbances).[39] The drugs most commonly associated with stroke are cocaine, amphetamines causing hemorrhagic stroke, but also over-the-counter cough and cold drugs containing sympathomimetics.[40][41]<br />
<br />
No high quality studies have shown the effectiveness of interventions aimed at weight reduction, promotion of regular exercise, reducing alcohol consumption or smoking cessation.[42] Nonetheless, given the large body of circumstantial evidence, best medical management for stroke includes advice on diet, exercise, smoking and alcohol use.[43] Medication or drug therapy is the most common method of stroke prevention; carotid endarterectomy can be a useful surgical method of preventing stroke.<br />
<br />
[edit]Blood pressure<br />
<br />
Hypertension accounts for 35-50% of stroke risk.[44] Epidemiological studies suggest that even a small blood pressure reduction (5 to 6 mmHg systolic, 2 to 3 mmHg diastolic) would result in 40% fewer strokes.[45] Lowering blood pressure has been conclusively shown to prevent both ischemic and hemorrhagic strokes.[46][47] It is equally important in secondary prevention.[48] Even patients older than 80 years and those with isolated systolic hypertension benefit from antihypertensive therapy.[49][50][51] Studies show that intensive antihypertensive therapy results in a greater risk reduction.[52] The available evidence does not show large differences in stroke prevention between antihypertensive drugs —therefore, other factors such as protection against other forms of cardiovascular disease should be considered and cost.[52][53]<br />
[edit]Atrial fibrillation<br />
<br />
Patients with atrial fibrillation have a risk of 5% each year to develop stroke, and this risk is even higher in those with valvular atrial fibrillation.[54] Depending on the stroke risk, anticoagulation with medications such as coumarins or aspirin is warranted for stroke prevention.[55]<br />
<br />
<br />
[edit]Blood lipids<br />
<br />
High cholesterol levels have been inconsistently associated with (ischemic) stroke.[47][56] Statins have been shown to reduce the risk of stroke by about 15%.[57] Since earlier meta-analyses of other lipid-lowering drugs did not show a decreased risk,[58] statins might exert their effect through mechanisms other than their lipid-lowering effects.[57]<br />
[edit]Diabetes mellitus<br />
<br />
Patients with diabetes mellitus are 2 to 3 times more likely to develop stroke, and they commonly have hypertension and hyperlipidemia. Intensive disease control has been shown to reduce microvascular complications such as nephropathy and retinopathy but not macrovascular complications such as stroke.[59][60]<br />
<br />
[edit]Anticoagulation drugs<br />
<br />
Oral anticoagulants such as warfarin have been the mainstay of stroke prevention for over 50 years. However, several studies have shown that aspirin and antiplatelet drugs are highly effective in secondary prevention after a stroke or transient ischemic attack[30]. Low doses of aspirin (for example 75–150 mg) are as effective as high doses but have fewer side effects; the lowest effective dose remains unknown.[61] Thienopyridines (clopidogrel, ticlopidine) "might be slightly more effective" than aspirin and have a decreased risk of gastrointestinal bleeding, but they are more expensive.[62] Their exact role remains controversial. Ticlopidine has more skin rash, diarrhea, neutropenia and thrombotic thrombocytopenic purpura.[62] Dipyridamole can be added to aspirin therapy to provide a small additional benefit, even though headache is a common side effect.[63] Low-dose aspirin is also effective for stroke prevention after sustaining a myocardial infarction.[31] Oral anticoagulants are not advised for stroke prevention —any benefit is offset by bleeding risk.[64]<br />
<br />
In primary prevention however, antiplatelet drugs did not reduce the risk of ischemic stroke while increasing the risk of major bleeding.[65][66] Further studies are needed to investigate a possible protective effect of aspirin against ischemic stroke in women.[67][68]<br />
[edit]Surgery<br />
<br />
Surgical procedures such as carotid endarterectomy or carotid angioplasty can be used to remove significant atherosclerotic narrowing (stenosis) of the carotid artery, which supplies blood to the brain. There is a large body of evidence supporting this procedure in selected cases.[43] Endarterectomy for a significant stenosis has been shown to be useful in the secondary prevention after a previous symptomatic stroke.[69] Carotid artery stenting has not been shown to be equally useful.[70][71] Patients are selected for surgery based on age, gender, degree of stenosis, time since symptoms and patients' preferences.[43] Surgery is most efficient when not delayed too long —the risk of recurrent stroke in a patient who has a 50% or greater stenosis is up to 20% after 5 years, but endarterectomy reduces this risk to around 5%. The number of procedures needed to cure one patient was 5 for early surgery (within two weeks after the initial stroke), but 125 if delayed longer than 12 weeks.[72][73]<br />
<br />
Screening for carotid artery narrowing has not been shown to be a useful screening test in the general population.[74] Studies of surgical intervention for carotid artery stenosis without symptoms have shown only a small decrease in the risk of stroke.[75][76] To be beneficial, the complication rate of the surgery should be kept below 4%. Even then, for 100 surgeries, 5 patients will benefit by avoiding stroke, 3 will develop stroke despite surgery, 3 will develop stroke or die due to the surgery itself, and 89 will remain stroke-free but would also have done so without intervention.[43]<br />
<br />
[edit]Nutritional and metabolic interventions<br />
<br />
Nutrition, specifically the Mediterranean-style diet, has the potential of more than halving stroke risk.[77]<br />
<br />
With regards to lowering homocysteine, a meta-analysis of previous trials has concluded that lowering homocysteine with folic acid and other supplements may reduce stroke risk.[78] However, the two largest randomized controlled trials included in the meta-analysis had conflicting results. One reported positve results;[79] whereas the other was negative.[80]<br />
<br />
The European Society of Cardiology and the European Association for Cardiovascular Prevention and Rehabilitation have developed an interactive tool for prediction and managing the risk of heart attack and stroke in Europe. HeartScore is aimed at supporting clinicians in optimising individual cardiovascular risk reduction. The Heartscore Programme is available in 12 languages and offers web based or PC version [81].<br />
[edit]Treatment<br />
<br />
[edit]Stroke unit<br />
Ideally, people who have had a stroke are admitted to a "stroke unit", a ward or dedicated area in hospital staffed by nurses and therapists with experience in stroke treatment. It has been shown that people admitted to a stroke unit have a higher chance of surviving than those admitted elsewhere in hospital, even if they are being cared for by doctors without experience in stroke.[2]<br />
<br />
When an acute stroke is suspected by history and physical examination, the goal of early assessment is to determine the cause. Treatment varies according to the underlying cause of the stroke, thromboembolic (ischemic) or hemorrhagic. A non-contrast head CT scan can rapidly identify a hemorrhagic stroke by imaging bleeding in or around the brain. If no bleeding is seen, a presumptive diagnosis of ischemic stroke is made.<br />
<br />
[edit]Treatment of ischemic stroke<br />
An ischemic stroke is caused by a thrombus (blood clot) occluding blood flow to an artery supplying the brain. Definitive therapy is aimed at removing the blockage by breaking the clot down (thrombolysis), or by removing it mechanically (thrombectomy). The more rapidly blood flow is restored to the brain, the fewer brain cells die.[82]<br />
<br />
Other medical therapies are aimed at minimizing clot enlargement or preventing new clots from forming. To this end, treatment with medications such as aspirin, clopidogrel and dipyridamole may be given to prevent platelets from aggregating[30].<br />
<br />
In addition to definitive therapies, management of acute stroke includes control of blood sugars, ensuring the patient has adequate oxygenation and adequate intravenous fluids. Patients may be positioned with their heads flat on the stretcher, rather than sitting up, to increase blood flow to the brain. It is common for the blood pressure to be elevated immediately following a stroke. Although high blood pressure may cause some strokes, hypertension during acute stroke is desirable to allow adequate blood flow to the brain.<br />
<br />
[edit]Thrombolysis<br />
<br />
In increasing numbers of primary stroke centers, pharmacologic thrombolysis ("clot busting") with the drug tissue plasminogen activator (tPA), is used to dissolve the clot and unblock the artery. However, the use of tPA in acute stroke is controversial. On one hand, it is endorsed by the American Heart Association and the American Academy of Neurology as the recommended treatment for acute stroke within three hours of onset of symptoms as long as there are not other contraindications (such as abnormal lab values, high blood pressure, or recent surgery). This position for tPA is based upon the findings of two studies by one group of investigators[83] which showed that tPA improves the chances for a good neurological outcome. When administered within the first three hours, 39% of all patients who were treated with tPA had a good outcome at three months, only 26% of placebo controlled patients had a good functional outcome.<br />
<br />
A recent study using alteplase for thrombolysis in ischemic stroke suggests clinical benefit with administration 3 to 4.5 hours after stroke onset.[84] However, in the NINDS trial 6.4% of patients with large strokes developed substantial brain hemorrhage as a complication from being given tPA. A recent study found the mortality to be higher among patients receiving tPA versus those who did not.[85] Additionally, it is the position of the American Academy of Emergency Medicine that objective evidence regarding the efficacy, safety, and applicability of tPA for acute ischemic stroke is insufficient to warrant its classification as standard of care.[86].<br />
Intra-artial fibrinolysis, where a catherter is passed up an artery into the brain and the medication is injected at the site of thrombosis, has been found to improve outcomes in people with acute ischemic stroke.[87][original research?]<br />
[edit]Mechanical thrombectomy<br />
<br />
<br />
Merci Retriever L5.<br />
Another intervention for acute ischemic stroke is removal of the offending thrombus directly. This is accomplished by inserting a catheter into the femoral artery, directing it into the cerebral circulation, and deploying a corkscrew-like device to ensnare the clot, which is then withdrawn from the body. Mechanical embolectomy devices have been demonstrated effective at restoring blood flow in patients who were unable to receive thrombolytic drugs or for whom the drugs were ineffective,[88][89][90][91] though no differences have been found between newer and older versions of the devices.[92] The devices have only been tested on patients treated with mechanical clot embolectomy within eight hours of the onset of symptoms.<br />
[edit]Angioplasty and stenting<br />
<br />
Angioplasty and stenting have begun to be looked at as possible viable options in treatment of acute ischemic stroke. In a systematic review of six uncontrolled, single-center trials, involving a total of 300 patients, of intra-cranial stenting in symptomatic intracranial arterial stenosis, the rate of technical success (reduction to stenosis of <50%) ranged from 90-98%, and the rate of major peri-procedural complications ranged from 4-10%. The rates of restenosis and/or stroke following the treatment were also favorable.[93] This data suggests that a large, randomized controlled trial is needed to more completely evaluate the possible therapeutic advantage of this treatment.<br />
<br />
[edit]Therapeutic hypothermia<br />
<br />
Main article: therapeutic hypothermia<br />
<br />
Most of the data concerning therapeutic hypothermia’s effectiveness in treating ischemic stroke is limited to animal studies. These studies have focused primarily on ischemic as opposed to hemorrhagic stroke, as hypothermia has been associated with a lower clotting threshold. In these animal studies investigating the effect of temperature decline following ischemic stroke, hypothermia has been shown to be an effective all-purpose neuroprotectant.[94] This promising data has led to the initiation of a variety of human studies. At the time of this article’s publishing, this research has yet to return results. However, in terms of feasibility, the use of hypothermia to control intracranial pressure (ICP) after an ischemic stroke was found to be both safe and practical. The device used in this study was called the Arctic Sun.[95]<br />
[edit]Secondary prevention of ischemic stroke<br />
<br />
Anticoagulation can prevent recurrent stroke. Among patients with nonvalvular atrial fibrillation, anticoagulation can reduce stroke by 60% while antiplatelet agents can reduce stroke by 20%.[96]. However, a recent meta-analysis suggests harm from anti-coagulation started early after an embolic stroke.[97] Stroke prevention treatment for atrial fibrillation is determined according to the CHADS/CHADS2 system.<br />
<br />
If studies show carotid stenosis, and the patient has residual function in the affected side, carotid endarterectomy (surgical removal of the stenosis) may decrease the risk of recurrence if performed rapidly after stroke.<br />
[edit]Treatment of hemorrhagic stroke<br />
<br />
Patients with intracerebral hemorrhage require neurosurgical evaluation to detect and treat the cause of the bleeding, although many may not need surgery. Anticoagulants and antithrombotics, key in treating ischemic stroke, can make bleeding worse and cannot be used in intracerebral hemorrhage. Patients are monitored and their blood pressure, blood sugar, and oxygenation are kept at optimum levels.<br />
[edit]Care and rehabilitation<br />
<br />
Stroke rehabilitation is the process by which patients with disabling strokes undergo treatment to help them return to normal life as much as possible by regaining and relearning the skills of everyday living. It also aims to help the survivor understand and adapt to difficulties, prevent secondary complications and educate family members to play a supporting role.<br />
A rehabilitation team is usually multidisciplinary as it involves staff with different skills working together to help the patient. These include nursing staff, physiotherapy, occupational therapy, speech and language therapy, and usually a physician trained in rehabilitation medicine. Some teams may also include psychologists, social workers, and pharmacists since at least one third of the patients manifest post stroke depression. Validated instruments such as the Barthel scale may be used to assess the likelihood of a stroke patient being able to manage at home with or without support subsequent to discharge from hospital.<br />
<br />
Good nursing care is fundamental in maintaining skin care, feeding, hydration, positioning, and monitoring vital signs such as temperature, pulse, and blood pressure. Stroke rehabilitation begins almost immediately.<br />
<br />
For most stroke patients, physical therapy (PT) and occupational therapy (OT) are the cornerstones of the rehabilitation process, but in many countries Neurocognitive Rehabilitation is used, too. Often, assistive technology such as a wheelchair, walkers, canes, and orthosis may be beneficial. PT and OT have overlapping areas of working but their main attention fields are; PT involves re-learning functions as transferring, walking and other gross motor functions. OT focusses on exercises and training to help relearn everyday activities known as the Activities of daily living (ADLs) such as eating, drinking, dressing, bathing, cooking, reading and writing, and toileting. Speech and language therapy is appropriate for patients with problems understanding speech or written words, problems forming speech and problems with swallowing.<br />
Patients may have particular problems, such as complete or partial inability to swallow, which can cause swallowed material to pass into the lungs and cause aspiration pneumonia. The condition may improve with time, but in the interim, a nasogastric tube may be inserted, enabling liquid food to be given directly into the stomach. If swallowing is still unsafe after a week, then a percutaneous endoscopic gastrostomy (PEG) tube is passed and this can remain indefinitely.<br />
<br />
Stroke rehabilitation should be started as quickly as possible and can last anywhere from a few days to over a year. Most return of function is seen in the first few months, and then improvement falls off with the "window" considered officially by U.S. state rehabilitation units and others to be closed after six months, with little chance of further improvement. However, patients have been known to continue to improve for years, regaining and strengthening abilities like writing, walking, running, and talking. Daily rehabilitation exercises should continue to be part of the stroke patient's routine. Complete recovery is unusual but not impossible and most patients will improve to some extent : proper diet and exercise are known to help the brain to recover.<br />
<br />
[edit]Prognosis<br />
<br />
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Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (September 2008)<br />
<br />
Disability affects 75% of stroke survivors enough to decrease their employability.[98] Stroke can affect patients physically, mentally, emotionally, or a combination of the three. The results of stroke vary widely depending on size and location of the lesion.[99] Dysfunctions correspond to areas in the brain that have been damaged.<br />
<br />
Some of the physical disabilities that can result from stroke include muscle weakness, numbness, pressure sores, pneumonia, incontinence, apraxia (inability to perform learned movements), difficulties carrying out daily activities, appetite loss, speech loss, vision loss, and pain. If the stroke is severe enough, or in a certain location such as parts of the brainstem, coma or death can result.<br />
<br />
Emotional problems resulting from stroke can result from direct damage to emotional centers in the brain or from frustration and difficulty adapting to new limitations. Post-stroke emotional difficulties include anxiety, panic attacks, flat affect (failure to express emotions), mania, apathy, and psychosis.<br />
30 to 50% of stroke survivors suffer post stroke depression, which is characterized by lethargy, irritability, sleep disturbances, lowered self esteem, and withdrawal.[100] Depression can reduce motivation and worsen outcome, but can be treated with antidepressants.<br />
<br />
Emotional lability, another consequence of stroke, causes the patient to switch quickly between emotional highs and lows and to express emotions inappropriately, for instance with an excess of laughing or crying with little or no provocation. While these expressions of emotion usually correspond to the patient's actual emotions, a more severe form of emotional lability causes patients to laugh and cry pathologically, without regard to context or emotion.[98] Some patients show the opposite of what they feel, for example crying when they are happy.[101] Emotional lability occurs in about 20% of stroke patients.<br />
<br />
Cognitive deficits resulting from stroke include perceptual disorders, speech problems, dementia, and problems with attention and memory. A stroke sufferer may be unaware of his or her own disabilities, a condition called anosognosia. In a condition called hemispatial neglect, a patient is unable to attend to anything on the side of space opposite to the damaged hemisphere.<br />
Up to 10% of all stroke patients develop seizures, most commonly in the week subsequent to the event; the severity of the stroke increases the likelihood of a seizure.[102][103]<br />
[edit]Epidemiology<br />
<br />
Stroke could soon be the most common cause of death worldwide.[104] Stroke is currently the second leading cause of death in the Western world, ranking after heart disease and before cancer,[2] and causes 10% of deaths worldwide.[105] Geographic disparities in stroke incidence have been observed, including the existence of a "stroke belt" in the southeastern United States, but causes of these disparities have not been explained.<br />
<br />
The incidence of stroke increases exponentially from 30 years of age, and etiology varies by age.[106] Advanced age is one of the most significant stroke risk factors. 95% of strokes occur in people age 45 and older, and two-thirds of strokes occur in those over the age of 65.[100][20] A person's risk of dying if he or she does have a stroke also increases with age. However, stroke can occur at any age, including in fetuses.<br />
<br />
Family members may have a genetic tendency for stroke or share a lifestyle that contributes to stroke. Higher levels of Von Willebrand factor are more common amongst people who have had ischemic stroke for the first time.[107] The results of this study found that the only significant genetic factor was the person's blood type. Having had a stroke in the past greatly increases one's risk of future strokes.<br />
<br />
Men are 25% more likely to suffer strokes than women,[20] yet 60% of deaths from stroke occur in women.[101] Since women live longer, they are older on average when they have their strokes and thus more often killed (NIMH 2002).[20] Some risk factors for stroke apply only to women. Primary among these are pregnancy, childbirth, menopause and the treatment thereof (HRT).<br />
[edit]History<br />
<br />
<br />
<br />
Hippocrates first described the sudden paralysis that is often associated with stroke.<br />
Episodes of stroke and familial stroke have been reported from the 2nd millenium BC onward in ancient Mesopotamia and Persia[108]. Hippocrates (460 to 370 BC) was first to describe the phenomenon of sudden paralysis that is often associated with ischemia. Apoplexy, from the Greek word meaning "struck down with violence,” first appeared in Hippocratic writings to describe this phenomenon.[109][110]<br />
<br />
The word stroke was used as a synonym for apoplectic seizure as early as 1599,[111] and is a fairly literal translation of the Greek term.<br />
<br />
In 1658, in his Apoplexia, Johann Jacob Wepfer (1620–1695) identified the cause of hemorrhagic stroke when he suggested that people who had died of apoplexy had bleeding in their brains.[109][20] Wepfer also identified the main arteries supplying the brain, the vertebral and carotid arteries, and identified the cause of ischemic stroke [also known as cerebral infarction] when he suggested that apoplexy might be caused by a blockage to those vessels.[20]<br />
Rudolf Virchow first described the mechanism of thromboembolism as a major factor.[112]<br />
[edit]References<br />
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^ a b Coffey C. Edward, Cummings Jeffrey L, Starkstein Sergio, Robinson Robert (2000). Stroke - the American Psychiatric Press Textbook of Geriatric Neuropsychiatry (Second ed.). Washington DC: American Psychiatric Press. pp. 601–617.<br />
^ Stanford Hospital & Clinics. "Cardiovascular Diseases: Effects of Stroke". Retrieved 2005.<br />
^ a b Senelick Richard C., Rossi, Peter W., Dougherty, Karla (1994). Living with Stroke: A Guide for Families. Contemporary Books, Chicago. ISBN 0809226073. OCLC 42835161 40856888 42835161.<br />
^ a b Villarosa, Linda, Ed., Singleton, LaFayette, MD, Johnson, Kirk A. (1993). Black Health Library Guide to Stroke. Henry Holt and Company, New York.<br />
^ Reith J, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS (August 1997). "Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study". Stroke 28 (8): 1585–9. PMID 9259753.<br />
^ Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C (December 1997). "Epileptic seizures after a first stroke: the Oxfordshire Community Stroke Project". BMJ 315 (7122): 1582–7. PMID 9437276. PMC 2127973.<br />
^ Murray CJ, Lopez AD (1997). "Mortality by cause for eight regions of the world: Global Burden of Disease Study". Lancet 349 (9061): 1269–76. doi:10.1016/S0140-6736(96)07493-4. PMID 9142060.<br />
^ (PDF) The World health report 2004. Annex Table 2: Deaths by cause, sex and mortality stratum in WHO regions, estimates for 2002.. Geneva: World Health Organization. 2004.<br />
^ Ellekjær, H; Holmen J, Indredavik B, Terent A (November 1, 1997). "Epidemiology of Stroke in Innherred, Norway, 1994 to 1996 : Incidence and 30-Day Case-Fatality Rate". Stroke 28 (11): 2180–2184. PMID 9368561. Retrieved 2008-01-22.<br />
^ Bongers T, de Maat M, van Goor M et al. (2006). "High von Willebrand factor levels increase the risk of first ischemic stroke: influence of ADAMTS13, inflammation, and genetic variability". Stroke 37 (11): 2672–7. doi:10.1161/01.STR.0000244767.39962.f7. PMID 16990571.<br />
^ Ashrafian H (2010). "Familial stroke 2700 years ago". Stroke 41 (4): e187. PMID 20185778.<br />
^ a b Thompson JE (August 1, 1996). "The evolution of surgery for the treatment and prevention of stroke. The Willis Lecture". Stroke 27 (8): 1427–34. PMID 8711815.<br />
^ Kopito, Jeff (September 2001). "A Stroke in Time" ([dead link]). MERGINET.com 6 (9).<br />
^ R. Barnhart, ed. The Barnhart Concise Dictionary of Etymology (1995)<br />
^ Schiller F (April 1970). "Concepts of stroke before and after Virchow". Med Hist 14 (2): 115–31. PMID 4914683.<br />
[edit]Further reading<br />
<br />
J. P. Mohr, Dennis Choi, James Grotta, Philip Wolf (2004). Stroke: Pathophysiology, Diagnosis, and Management. New York: Churchill Livingstone. ISBN 0-443-06600-0. OCLC 52990861 50477349 52990861.<br />
Charles P. Warlow, Jan van Gijn, Martin S. Dennis, Joanna M. Wardlaw, John M. Bamford, Graeme J. Hankey, Peter A. G. Sandercock, Gabriel Rinkel, Peter Langhorne, Cathie Sudlow, Peter Rothwell (2008). Stroke: Practical Management (3rd ed.). Wiley-Blackwell. ISBN 1-4051-2766-X.<br />
[hide]<br />
v • d • e<br />
CNS disease, Vascular disease: Cerebrovascular diseases (G45-G46 and I60-I69, 430-438)<br />
Brain ischemia/<br />
cerebral infarction<br />
(ischemic stroke/TIA) <br />
TACI, PACI<br />
precerebral: Carotid artery stenosis<br />
cerebral: MCA · ACA · Amaurosis fugax<br />
Moyamoya disease<br />
POCI<br />
precerebral: Anterior spinal artery syndrome · Vertebrobasilar insufficiency (Subclavian steal syndrome)<br />
brainstem: medulla (Medial medullary syndrome, Lateral medullary syndrome) · pons (Medial pontine syndrome/Foville's, Lateral pontine syndrome/Millard-Gubler) · midbrain (Weber's, Benedikt, Claude's)<br />
cerebral: PCA · Lacunar stroke · Thalamic syndrome<br />
cerebellar<br />
General<br />
cerebral: Cerebral venous sinus thrombosis · CADASIL · Binswanger's disease · Transient global amnesia<br />
Intracranial hemorrhage<br />
(hemorrhagic stroke) <br />
Extra-axial<br />
Epidural · Subdural · Subarachnoid<br />
Cerebral/Intra-axial<br />
Intraventricular<br />
Brainstem<br />
Duret haemorrhage<br />
Aneurysm <br />
Cerebral aneurysm (Intracranial berry aneurysm, Charcot-Bouchard aneurysm)<br />
Other/general <br />
Cerebral vasculitis<br />
M: CNS<br />
anat(s,m,p,4,e,b,d,c,a,f,l,g)/phys/devp/cell<br />
noco(m,d,e,h,v,s)/cong/tumr,sysi/epon,injr<br />
proc,drug(N1A/2AB/C/3/4/7A/B/C/D)<br />
M: VAS<br />
anat(a:h,u,t,a,l,v:h,u,t,a,l)/phys/devp<br />
noco/syva/cong/tumr, sysi/epon<br />
proc, drug(C3,C4,C5,C9)Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com1tag:blogger.com,1999:blog-31567885.post-30334185614858412862010-09-02T10:07:00.001-07:002010-09-23T17:14:55.799-07:00Visiting National Hurricane Center as Earl Approaches, Laborday 2010Global7 the new Millennial Renaissance Vision for the Globe<br />
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Last Modified: Wednesday, 11-Aug-2010 14:45:58 EDTGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-63170535597101970742010-08-09T12:04:00.001-07:002010-08-09T12:04:40.560-07:00US IVF Baby has a natural baby of her own <br />
Examiner Bio Fertility News Info 101: First US IVF baby has baby of her own <br />
August 7, 1:11 PMSalt Lake City Fertility ExaminerLibbii Armstrong-BrownPrevious <br />
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Elizabeth Carr delivers baby boy.<br />
Photo: David Comeau <br />
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Fertility News Info 101: IVF chromosome tests could be a waste of money <br />
Fertility Info 101: Polluted Air Stops IVF Babies In 1981, America's first 'test-tube' baby, Elizabeth Carr, was born. On Thursday, 5 August 2010, Elizabeth gave birth to a son, Trevor.<br />
<br />
Elizabeth's mother had suffered through three ecptopic pregnancies and was sadly informed that she would most probably never be able to conceive a child naturally. <br />
<br />
Although there had recently been a successful IVF birth in England, there hadn't yet been one in the USA and Doctor Howard Jones wanted to change that and, along with his wife Georgeanna, began an IVF program in Norfolk, Virginia.<br />
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Even though Elizabeth's parents currently lived in Massachusetts, IVF was still illegal in that state and so they had to travel to Virginia instead.<br />
<br />
Soon after the Carr's welcomed their baby daughter into the world in 1981. And now, almost 29 years later that same baby has had a baby of her very own.<br />
<br />
Elizabeth is quick to admit that her son was conceived naturally and was born naturally too.<br />
<br />
Rather than have her story overly-publicized, Elizabeth opted instead to write her own story in which she states:<br />
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I follow the same principle my parents did: If my story helps couples or families learn about in-vitro fertilization, then the loss of privacy is worthwhile. People who have fertility issues deserve to know they can have healthy, normal babies.<br />
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According to the most recent data available from the Centers for Disease Control and Prevention, fertility treatments led to the birth of nearly 60,000 babies in 2007. <br />
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More About: Fertility ShareThisGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-80528181141418552142010-08-09T09:24:00.000-07:002010-08-09T09:24:01.960-07:00A new Ariane Rocket launched to Serve NileSat 201 Satellite to serve Africa and MidEastGlobal7 the new Millennial Renaissance Vision for the Globe<br />
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<table class="contentpaneopen" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 13px; margin-bottom: 5px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 5px; padding-right: 5px; padding-top: 0px; width: 389px;"><tbody style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">
<tr style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><td class="contentheading" style="color: #333333; font-family: Arial, Helvetica, sans-serif; font-size: 16px; font-style: inherit; font-weight: bold; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: left; text-transform: none; width: 313px;" width="100%"><span name="KonaFilter" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Satellites launched to serve Africa and Mideast</span></td><td align="right" class="buttonheading" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" width="100%"><a href="http://www.waltainfo.com/index2.php?option=com_content&do_pdf=1&id=22753" style="color: #009933; font-size: 12px; list-style-type: decimal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none;" target="_blank" title="PDF"><img align="middle" alt="PDF" border="0" name="PDF" src="http://www.waltainfo.com/templates/rhuk_solarflare_ii/images/pdf_button.png" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" /></a></td><td align="right" class="buttonheading" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" width="100%"><a href="http://www.waltainfo.com/index2.php?option=com_content&task=view&id=22753&pop=1&page=0&Itemid=134" style="color: #009933; font-size: 12px; list-style-type: decimal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none;" target="_blank" title="Print"><img align="middle" alt="Print" border="0" name="Print" src="http://www.waltainfo.com/templates/rhuk_solarflare_ii/images/printButton.png" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" /></a></td><td align="right" class="buttonheading" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" width="100%"><a href="http://www.waltainfo.com/index2.php?option=com_content&task=emailform&id=22753&itemid=134" style="color: #009933; font-size: 12px; list-style-type: decimal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none;" target="_blank" title="E-mail"><img align="middle" alt="E-mail" border="0" name="E-mail" src="http://www.waltainfo.com/templates/rhuk_solarflare_ii/images/emailButton.png" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" /></a></td></tr>
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<tr style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><td class="createdate" colspan="2" style="color: #cccccc; font-family: Arial, Helvetica, sans-serif; font-size: 10px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" valign="top">Thursday, 05 August 2010</td></tr>
<tr style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><td colspan="2" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" valign="top"><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="float: left; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 8px; padding-left: 8px; padding-right: 8px; padding-top: 8px;"><img alt=" " height="120" src="http://www.waltainfo.com/resource/sat_12.jpg" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" width="180" /></span>August 5, 2010 -- An Ariane rocket launched two satellites into orbit on Wednesday to provide telecommunications for<a class="kLink" href="http://www.waltainfo.com/index.php?option=com_content&task=view&id=22753&Itemid=134#" id="KonaLink0" style="background-attachment: initial !important; background-clip: initial !important; background-color: transparent !important; background-image: none !important; background-origin: initial !important; background-position: initial initial !important; background-repeat: initial initial !important; border-bottom-color: transparent !important; border-bottom-style: none !important; border-bottom-width: 0px !important; border-left-color: transparent !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: transparent !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: transparent !important; border-top-style: none !important; border-top-width: 0px !important; bottom: 0px; color: rgb(0, 200, 0) !important; cursor: pointer; display: inline !important; font-family: verdana; font-size: 12px; font-variant: normal; left: 0px; list-style-type: decimal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: none; outline-width: initial; padding-bottom: 0px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; right: 0px; text-decoration: underline !important; text-transform: none !important; top: 0px;" target="undefined"><span style="color: rgb(0, 200, 0) !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: static;"><span class="kLink" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: initial; border-bottom-style: solid; border-bottom-width: 1px; border-left-color: initial !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: initial !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: initial !important; border-top-style: none !important; border-top-width: 0px !important; color: rgb(0, 200, 0) !important; display: inline !important; float: none !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 1px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; width: auto !important;">Africa</span></span></a> and the <a class="kLink" href="http://www.waltainfo.com/index.php?option=com_content&task=view&id=22753&Itemid=134#" id="KonaLink2" style="background-attachment: initial !important; background-clip: initial !important; background-color: transparent !important; background-image: none !important; background-origin: initial !important; background-position: initial initial !important; background-repeat: initial initial !important; border-bottom-color: transparent !important; border-bottom-style: none !important; border-bottom-width: 0px !important; border-left-color: transparent !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: transparent !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: transparent !important; border-top-style: none !important; border-top-width: 0px !important; bottom: 0px; color: rgb(0, 200, 0) !important; cursor: pointer; display: inline !important; font-family: verdana; font-size: 12px; font-variant: normal; left: 0px; list-style-type: decimal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: none; outline-width: initial; padding-bottom: 0px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; right: 0px; text-decoration: underline !important; text-transform: none !important; top: 0px;" target="undefined"><span style="color: rgb(0, 200, 0) !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: static;"><span class="kLink" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: rgb(0, 200, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: initial !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: initial !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: initial !important; border-top-style: none !important; border-top-width: 0px !important; color: rgb(0, 200, 0) !important; display: inline !important; float: none !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 1px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; width: auto !important;">Middle </span><span class="kLink" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: rgb(0, 200, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: initial !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: initial !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: initial !important; border-top-style: none !important; border-top-width: 0px !important; color: rgb(0, 200, 0) !important; display: inline !important; float: none !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 1px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; width: auto !important;">East</span></span><span class="preLoadWrap" id="preLoadWrap2" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: relative;"></span></a>, European space officials said.</span></span></div><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"></span></span> <div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The Ariane-5 rocket blasted off from the European Space Agency's launch centre in Kourou, French Guiana on the northeast coast of <a class="kLink" href="http://www.waltainfo.com/index.php?option=com_content&task=view&id=22753&Itemid=134#" id="KonaLink1" style="background-attachment: initial !important; background-clip: initial !important; background-color: transparent !important; background-image: none !important; background-origin: initial !important; background-position: initial initial !important; background-repeat: initial initial !important; border-bottom-color: transparent !important; border-bottom-style: none !important; border-bottom-width: 0px !important; border-left-color: transparent !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: transparent !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: transparent !important; border-top-style: none !important; border-top-width: 0px !important; bottom: 0px; color: rgb(0, 200, 0) !important; cursor: pointer; display: inline !important; font-family: verdana; font-size: 12px; font-variant: normal; left: 0px; list-style-type: decimal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: none; outline-width: initial; padding-bottom: 0px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; right: 0px; text-decoration: underline !important; text-transform: none !important; top: 0px;" target="undefined"><span style="color: rgb(0, 200, 0) !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: static;"><span class="kLink" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: rgb(0, 200, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: initial !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: initial !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: initial !important; border-top-style: none !important; border-top-width: 0px !important; color: rgb(0, 200, 0) !important; display: inline !important; float: none !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 1px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; width: auto !important;">South </span><span class="kLink" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: rgb(0, 200, 0); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: initial !important; border-left-style: none !important; border-left-width: 0px !important; border-right-color: initial !important; border-right-style: none !important; border-right-width: 0px !important; border-top-color: initial !important; border-top-style: none !important; border-top-width: 0px !important; color: rgb(0, 200, 0) !important; display: inline !important; float: none !important; font-family: Verdana; font-size: 13px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 1px !important; padding-left: 0px !important; padding-right: 0px !important; padding-top: 0px !important; position: static; width: auto !important;">America</span></span><span class="preLoadWrap" id="preLoadWrap1" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: relative;"></span></a>.</span></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The NILESAT 201 satellite was designed to help Egyptian operator Nilesat provide telecommunications throughout the Middle East and north Africa.</span></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">It was built by Thales Alenia Space, a joint venture company owned by France's Thales SA and Italy's Finmeccanica.</span></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The RASCOM-QAF1R satellite for pan-African operator RascomStar-QAF will provide telecommunications in rural Africa and urban African centres. It was also manufactured by Thales Alenia Space.</span></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"Certain countries like mine are waiting for much in (telecommunications) connections between distant centres," Thierry Savonarole Malevombo, the Central African Republic's post and telecommunications minister, said after the launch.</span></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"We are now in a position to bridge the digital divide," said Toure Hamadoun, Secretary General of the International Telecommunications Union.</span></span></div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 18px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: justify;"><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Wednesday marked the 38th consecutive successful launch of an Ariane rocket.</span></span></div><span style="font-family: Verdana; font-size: 10pt; line-height: 19px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span style="color: black; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"> <strong style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><em style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">(Reuters)</em></strong></span></span></td></tr>
</tbody></table><span class="Apple-style-span" style="color: #666666; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 13px;"><span class="article_seperator" style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"> </span></span>Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-31699713747652927402010-08-03T14:23:00.000-07:002010-08-03T14:23:18.892-07:00As Americans Get Obese, Africans get Malnourished! where is the Justice?Global7 the new Millennial Renaissance Vision for the Globe<br />
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<span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">Our Passion is to reach our Individual and Collective Potential-Always!</span><br />
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<span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">RE: Disparity in Nutrition: Americans Obesity and Africans Malnutrition</span><br />
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<span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">The Globe demands a Nutrition Justice where every one is optimally nourished. Both obesity and Malnutrition are not fair to those who suffer them.</span><br />
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<span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">Please read on</span><br />
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<span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">Dr BMJ</span><br />
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<span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">By </span><span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;"><a href="http://blogs.reuters.com/search/journalist.php?edition=us&n=maggie.fox&" style="color: #006e97; cursor: pointer; font-weight: bold; outline-color: initial; outline-style: none; outline-width: initial; text-decoration: none;">Maggie Fox</a></span><span class="Apple-style-span" style="color: #666666; font-family: arial, helvetica, sans; font-size: 12px; line-height: 19px;">, Health and Science Editor</span><br />
<div id="articleInfo" style="font-family: arial, helvetica, sans; margin-bottom: 10px;"><div style="color: #666666; font-size: 11px; line-height: 1.6; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><span class="location" style="font-weight: bold;">WASHINGTON</span> | <span class="timestamp" style="color: #666666; font-size: 11px; font-weight: normal; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">Tue Aug 3, 2010 3:32pm EDT</span></div></div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_0"></span></span><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span class="focusParagraph"><div style="font-size: 20px; line-height: 1.5; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">(Reuters) - More than 72 million U.S. adults, or 26.7 percent, are obese, up 1 percent in two years, the U.S. government reported on Tuesday.</div></span></span><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_1"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Obesity has become "a major public health threat" and is steadily worsening, the U.S. Centers for Disease Control and Prevention reported.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_2"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"We need intensive, comprehensive and ongoing efforts to address obesity," CDC director Dr. Thomas Frieden said in a statement.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_3"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"If we don't more people will get sick and die from obesity-related conditions such as heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death."</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_4"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The CDC examined data from the national Behavioral Risk Factor Surveillance System, which surveys 400,000 people and asks about height and weight, among other things.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_5"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Looking state-by-state, the CDC found that 30 percent of adults in nine states are now obese. In 2000, no states reported obesity rates of 30 percent or more.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_6"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Height and weight are used to calculate body mass index or BMI, the medically accepted way to measure obesity.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_7"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">A BMI of 25 or more makes someone overweight and obesity begins at a BMI of 30.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_8"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">A 5-foot-4 inch tall person who weighs 174 pounds (79 kg) or more or a 5-foot-10 inch (1.8 meter) tall person who weighs 209 pounds (95 kg) or more has a BMI of 30, and is considered obese.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_9"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The survey found 2.4 million more people admitted to being obese in 2009 than in 2007, a 1.1 percent increase. And the CDC said this is almost certainly an underestimate, as people often say they are taller and weigh less than they actually do.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_10"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"Recent estimates of the annual medical costs of obesity are as high as $147 billion. On average, persons who are obese have medical costs that are $1,429 more than persons of normal weight," the report reads.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_11"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Blacks were the most likely to be obese, with 36.8 percent of U.S. black adults having a BMI of 30 or more -- more than 41 percent of black women.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_12"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">More than 30 percent of Hispanic adults were obese.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_13"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">As in previous surveys, Mississippi had the most obese people and Colorado the fewest.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_14"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">The federal government and some states have been moving toward using legislation to help people to exercise and eat healthier foods.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_15"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">New York and California have been considering a tax on sweetened soft drinks to defray the cost of treating obesity-related diseases. President Barack Obama has made reducing obesity a priority, assigning his wife Michelle Obama and cabinet secretaries to tackle childhood obesity in particular.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_0"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"People in all communities should be able to make healthy choices, but in order to make those choices there must be healthy choices to make," the CDC's Dr. William Dietz said.</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_1"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">"We need to change our communities into places where healthy eating and active living are the easiest path."</div><span class="Apple-style-span" style="font-family: arial, helvetica, sans;"><span id="midArticle_2"></span></span><div style="font-family: arial, helvetica, sans; font-size: 14px; line-height: 1.6; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">(Editing by <a href="http://blogs.reuters.com/search/journalist.php?edition=us&n=vicki.allen&" style="color: #006e97; cursor: pointer; outline-color: initial; outline-style: none; outline-width: initial; text-decoration: none;">Vicki Allen</a>)</div>Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-21401781040379665262010-07-12T14:33:00.000-07:002010-07-12T14:35:57.171-07:00Gender Inequality- Ethiopia's Challenge in the New MillenniumGlobal7 the new Millennial Renaissance Vision for the Globe<div><br /></div><div>Our Passion is to reach our Individual and Collective Potential 4 Excellence & Success-Always</div><div><br /></div><div><span class="Apple-style-span" style="font-family: tahoma, verdana, sans-serif; font-size: medium; color: rgb(74, 73, 73); "><table border="0" width="664" cellspacing="0" cellpadding="0" id="table1696"><tbody><tr><td height="20" valign="top" style="border-top-color: rgb(234, 234, 234); border-top-width: 1px; border-top-style: solid; border-bottom-color: rgb(234, 234, 234); border-bottom-width: 1px; border-bottom-style: solid; "><p class="MsoNormal" align="center" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The World Bank’s country policy and institutional assessment (CPIA) rating is conducted annually and one of the factors that determine how much money each country is granted. Ethiopia performed best in its economic management, writes TAMRAT G. GIORGIS, FORTUNE STAFF WRITER.</span></p></td></tr><tr><td height="20" valign="top" style="border-top-color: rgb(234, 234, 234); border-top-width: 0px; border-top-style: solid; border-bottom-color: rgb(234, 234, 234); border-bottom-width: 0px; border-bottom-style: solid; "><p class="MsoNormal" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-family: Verdana; font-weight: 700; "><span style="font-size:6;">WB Rating Slams Ethiopia’s Gender Inequality</span></span></p><p class="MsoNormal" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><img border="0" src="http://addisfortune.com/icons/icons.gif" width="9" height="9" style="border-top-width: 0px; border-left-width: 0px; border-bottom-width: 0px; border-right-width: 0px; " /> Country fares above average but stands lower than its peers in region</span></p></td></tr><tr><td><table border="0" width="664" cellspacing="0" cellpadding="0" id="table1698"><tbody><tr><td><table cellspacing="7" cellpadding="5" width="98%" align="center" id="table1699" style="border-collapse: collapse; text-align: justify; "><tbody><tr><td valign="top" height="60" style="border-right-color: rgb(204, 204, 204); border-right-width: 1px; border-right-style: solid; border-top-color: rgb(204, 204, 204); border-top-width: 1px; border-top-style: solid; border-left-color: rgb(204, 204, 204); border-left-width: 1px; border-left-style: solid; border-bottom-color: rgb(204, 204, 204); border-bottom-width: 1px; border-bottom-style: solid; "><p style="font-size: 11px; margin-top: 0px; margin-right: 3px; margin-bottom: 0px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; line-height: 11px; "> </p><table border="0" width="628" cellspacing="0" cellpadding="0" id="table1700"><tbody><tr><td height="21"><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The World Bank has made public its annual assessments of the policies and institutional qualities of member countries eligible for grants from the International Development Association (IDA), an organisation in the World Bank Group.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Known as Country Policy and Institutional Assessment (CPIA), the rating is conducted under the watchful eye of the chief economists of the regions. CPIA ratings constitute one third of the factors determining how much of the IDA’s annual seven billion dollars will go to each member country.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Apart from the CPIA ratings, the World Bank also considers factors such as a country’s population size and record of utilising grants, in deciding how much money to contribute to that country.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“We have only so much to give to all the countries under the IDA,” said Shantayanan Devarajan, chief economist of the World Bank for Africa region. “That is where selection comes [in]. But if we are to base our selection only on population size, India would take all the grants earmarked under the programme [and the] Maldives would get nothing.”</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Seeing as countries with higher population sizes are constrained by their CPIA ratings, the Bank has a policy of not granting an amount of less than seven million dollars to any small country, according to the chief economist. However, many countries are in the middle of this matrix.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The CPI assessments are first compiled by a team of experts at a country level, before being sent to World Bank headquarters for review by chief economists from the six regions the bank is working in. Members of country teams always favour higher ratings for the countries they work on, according to the chief economist.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“[However], we want to look at policies not intended for implementation, but [which] are actually being implemented and bear results,” Devarajan told participants of the meeting.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The assessments are then sent to regional experts at the central departments who compare countries’ scores with each other. The final ratings, however, are decided at a meeting of experts from different regions, networks and central departments of the World Bank.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">In 2004, the Bank reviewed the set of criteria used to judge countries; subsequently the criterion was downsized by four, to only 16. Moreover, the Bank’s management decided to begin disclosing these ratings on August 9, 2004.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">For over four decades the World Bank has been very reluctant to disclose the content of these assessments. There were very few officials with access to these documents in the countries’ offices of the Bank, according to a staff member from the Bank’s office in Addis Abeba.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“It [was] a profound shift,” Devarajan said.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">However, there appears to be a good reason for the Bank officials to have kept the assessments confidential seeing that many political leaders, whose countries are subjects of the review, do not like them.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Prime Minister Meles Zenawi, views the CPIA ratings as an ideological instrument of western neoliberals, interested only to impose the Washington Consensus, a list of policy manuals prescribed by the World Bank, including fiscal discipline, liberalisation of the financial sector, and privatisation.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Devarajan and his colleague had a three-hour debate with Meles in Addis Abeba in June 2009; they parted after agreeing to disagree, according to reliable sources. Their attempt to persuade Meles that aid works better in recipient countries where there are good policies in place and the institutions to implement these policies are strong did not fly high with him. </span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“He wants to be judged by the results his policies produce, not by the means that allow him to reach the end,” Devarajan told Fortune. This appears to be the message the Ethiopian government wished to send through its representative attending the meeting.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“We want the assessment to be more result orientated,” Hashim Ahmed, macroeconomic advisor to the government, told the meeting. “The results are what matter at the end. Look at how well we performed in meeting the Millennium Development Goals (MDGs).”</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Meeting the MDGs does not stop the World Bank from passing judgment on the quality of a country’s policies and the strengths of its institutions. The latest judgment, for 2009, was revealed last week.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Ethiopia’s overall rating in the assessment, which comprises four categories and 16 sub-categories, stands at 3.4 points out of six. It is one decimal point above the average for countries borrowing from the IDA, but three decimal points lower than Kenya, and four decimal points below Rwanda and Tanzania.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Ethiopia performed best in its economic management, where it scored 3.7 points for its macroeconomic management and the quality of its fiscal and debt policies.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The lowest point, like most IDA borrowers, is registered in structural policies such as trade, the financial sector, and its business regulatory environment. Ethiopia’s rating of 3.2 points is lower than the average borrower by two decimal points.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The Bank’s assessment sees resource mobilisation by the Ethiopian financial sector as “modest and below potential,” and emphasises that long-term finance is unavailable from private banks.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“The coverage of [the] national land registration system is still not able to furnish the market with details of available land,” according to the assessment. “The use of land as collateral by investors is still not practical with banks as the market value of land is difficult to determine.”</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">However, none of the ratings were as controversial as the Bank’s conclusion on gender issues. Ethiopia’s social inclusion policies for gender equality scored three points, lower by four points from the average borrower and five points below Rwanda and Tanzania, although equal with Kenya.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“We are not happy with the rating on gender,” Hashim told Fortune. “Women’s empowerment and girls’ education take time, even generations.”</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Hashim raises issues of women suffrage in the United States, which was enacted in 1960s.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“Even today, for every one dollar an American male makes, a woman gets only 72 cents,” he said. “Rating on gender ought to be taken within context of culture, history and laws.”</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">While the government is not happy about its ratings on gender equality, neither are delegates from non-governmental organisations.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The World Bank lacks acknowledging improvements made on the gender front and in areas of environmental protection, said Meshesha Shewarega (PhD), executive director for Christian Relief and Development Association (CRDA), the largest consortium representing 304 NGOs in Ethiopia.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The existence of laws that empower women and the enrolment of girls in elementary schools have increased, said Meshesha. By the bank’s own admission female participation in schools from first to eighth grades improved from 84pc in 2006, to 85pc the following year, and 91pc in 2009.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">“So much has been achieved in bridging the gap over the past five years, and in meeting MDGs in areas of gender and health provisions,” Meshesha told Fortune. “All these have not been properly credited.”</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">These were the sort of acknowledgments that enabled Ethiopia to get the points it did. In their absence, its ratings, particularly compared to other countries, would have deteriorated further, Devarajan argues.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">Despite these ideological objections, the assessment for 2009 is complete and has already contributed to the decision of the IDA to grant Ethiopia one billion dollars in loans in the current fiscal year.</span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; "><br /></span></p><p class="MsoNormal" align="justify" style="font-size: 11px; margin-top: 6px; margin-right: 3px; margin-bottom: 6px; margin-left: 3px; font-family: tahoma, verdana, sans-serif; "><span style="font-size: 9pt; font-family: Verdana; ">The revealing and influential documents are available on the Bank’s website, www.worldbank.org</span></p></td></tr></tbody></table></td></tr></tbody></table></td></tr></tbody></table></td></tr></tbody></table></span></div>Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-30435082090738617112010-06-29T08:25:00.000-07:002010-06-29T08:35:01.157-07:00Priority Focus Area: Managing Communication and Informaton<span class="Apple-style-span" style="font-family:georgia;"><b><i>GlobalBelai7- the new Millennial Renaissance Vision for the Globe!</i></b></span><div><b><i><br /></i></b></div><div><b><i>Our Passion is to reach our individual and collective potential-Always!</i></b></div><div><p class="MsoNormal" align="center" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal;mso-layout-grid-align:none;text-autospace: none"><b><i><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Priority Focus Areas<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">The Priority Focus Process is a data-driven methodology that consistently uses pre-survey information about<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">healthcare organizations to create priorities for reviewing standards compliance, thus lending consistency to the </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Survey process.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Pre-survey information is gleaned from data in your organization’s application for accreditation, your organization's past survey findings, our Quality Monitoring System database of complaints and non-self reported sentinel events, any ORYX core measure data, and certain external data, if available.</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> External data consists of publicly available data that are applicable to the accreditation program(s) being surveyed, such as HCAHPS for Hospitals, Nursing Home Compare, Home Health Compare, and failed laboratory proficiency testing data from CMS.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p><br /></o:p></span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b><b><i style="mso-bidi-font-style: normal"><span style="font-size:12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Priority Focus Process Summary Report</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">This summary report contains results for your organization. For a User’s Manual on the Priority Focus<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Process, and a Definitions Guide on the Priority Focus Areas and Clinical/Service Groups, please refer to the<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Joint Commission Connect Extranet site. These documents are located under the Priority Focus Process<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">link, by clicking on the link for Reference Documents.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Priority Focus Process Reports are updated quarterly and pull in data up to 3 years back from the date the<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">tool is run, except for laboratories which pull in data up 2 years back.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">The Priority Focus Process brings consistency to the survey process for organizations having similar pre-survey data for the early part of their surveys as surveyors use the Priority Focus Areas and Clinical/Service Groups depicted in this report.</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> However, based on initial findings, surveyors will broaden or change focus appropriately. Organizations performing their own standards compliance assessment for their Periodic Performance Review and/or other quality improvement activities can use this information to enhance their evaluations, as well.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">2 Staffing</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">2 Rights & Ethics<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">2 Patient Safety<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">1 Infection Control<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">1 Assessment and Care/Services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">2 Information Management<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">2 Communication<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">2 HH- Home Personal Care/Support Services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">1 HH- Home Health Services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Priority Focus Areas Clinical Service Groups<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Assessment and Care/Services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Assessment and Care/Services for patients/clients/residents comprise the execution of a series of processes </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">including, as relevant: assessment; planning care, treatment, and/or services; provision of care; ongoing </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">reassessment of care; and discharge planning, referral for continuing care, or discontinuation of services.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Assessment and Care/Services are fluid in nature to accommodate a patient’s/client's/resident's needs while in a </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">care setting.</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> While some elements of Assessment and Care/Services may occur only once, other aspects may be </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">repeated or revisited as the patient’s/client's/resident's needs or care delivery priorities change.</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> Successful </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">implementation of improvements in Assessment and Care/Services rely on the full support of leadership.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Assessment and Care/Services include:</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Assessment<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Reassessment<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Planning care, treatment and/or services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Provision of care, treatment and services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Discharge planning or discontinuation of services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Infection Control<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Infection Control includes the surveillance/identification, prevention, and control of infections among </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">patients/clients/residents, employees, physicians, and other licensed independent practitioners, contract service </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">workers, volunteers, students, and visitors. </span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><br /></span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">This is a system-wide, integrated process that is applied to all programs, services, and settings.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Infection Control include:<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Surveillance/identification<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Prevention and control<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Reporting<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Measurement<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Priority Focus Areas<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Priority Focus Areas (PFAs) are defined as processes, systems or structures in a health care organization that<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">significantly impact the quality and safety of care. They can be used to guide assessmet of standards compliance in<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">relation to the patient/resident/client experience.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Home Care Accreditation Program Home Care Accreditation Program<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:12.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:black">Home Care Accreditation Program<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-size:100%;color:#DDDDDD;"><span class="Apple-style-span" style="font-size: 11px;"><b><i><br /></i></b></span></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Communication<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Communication is the process by which information is exchanged between individuals, departments, or </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">organizations. Effective Communication successfully permeates every aspect of </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">a health care organization, from the provision of care to performance</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Improvement, resulting in a marked improvement in the quality of care delivery<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">and functioning.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Communication include:<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Provider and/or staff-patient/client/resident communication<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Patient/client/resident and family education<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Staff communication and collaboration<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Information dissemination<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Multidisciplinary teamwork<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p></o:p></span></i></b><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Information Management</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Information Management is the interdisciplinary field concerning the timely and accurate creation, collection, storage, retrieval, transmission, analysis, control, dissemination, and use of data or information, both within an organization and externally, as allowed by law and regulation. In addition to written and verbal information, supporting information technology and information services are also included in Information Management.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Information Management include:<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Planning<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Procurement<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Implementation<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Collection<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Recording<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Protection<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Aggregation<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Interpretation<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Storage and retrieval<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Data integrity<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Information dissemination<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-size:100%;color:#DDDDDD;"><span class="Apple-style-span" style="font-size: 11px;"><b><i><br /></i></b></span></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Human Resource Management: Staffing<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Effective Staffing entails providing the optimal number of competent personnel with the appropriate skill mix to meet the needs of a health care organization's patients/clients/residents based on that organization's mission, values, and vision. </span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">As such, it involves defining competencies and expectations for all staff (the competency of licensed independent practitioners and medical staff are addressed in the Credentialed Practitioners priority focus area for all accreditation programs);</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> Staffing includes assessing those defined competencies and allocating human resources necessary for patient/client/resident safety and improved patient/client/resident outcomes.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Staffing include:<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Competency<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Skill mix<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Number of staff<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Rights & Ethics<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Rights & Ethics include patient/client/resident rights and organizational ethics as they pertain to patient/client/resident </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">care. </span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Rights & Ethics addresses issues such as patient/client/resident privacy, confidentiality and protection of health </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">information, advance directives (as appropriate), organ procurement, use of restraints, informed consent for various procedures, and the right to participate in care decisions.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Rights & Ethics include:<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Patient/client/resident rights</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Organizational ethics pertaining to patient/client/resident care<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Organizational responsibility<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Consideration of patient/client/resident<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Care sensitivity<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Informing patients/clients/residents and/or family<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue">Patient Safety<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b><i style="mso-bidi-font-style: normal"><span style="font-size:10.0pt;mso-bidi-font-family:Calibri;mso-bidi-theme-font: minor-latin;color:blue"><o:p> </o:p></span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Effective Patient Safety entails proactively identifying the potential and actual risks to safety, identifying the </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Underlying cause(s) of the potential, and making the necessary improvements so risk is reduced.</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> It also entails </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Establishing processes to respond to sentinel events, identifying cause through root cause analysis, and making </span></i></b><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">necessary improvements. </span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">This involves a systems-based approach that examines all activities within an organization that contribute to the maintenance and improvement of patient/client/resident safety, such as performance improvement and risk management to ensure the activities work together, not independently, to improve care and safety.</span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><span style="mso-spacerun:yes"> </span>The systems-based approach is driven by organization leadership, anchored in the organization's mission, vision, and strategic plan, endorsed and actively supported by medical staff and nursing leadership, implemented by directors, integrated and coordinated throughout the organization's staff, and continuously re-engineered using proven, proactive performance improvement modalities.</span></i></b></p><p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"> In addition, effective reduction of errors and other factors that contribute to unintended adverse outcomes in an organization requires an environment in which patients/clients/residents, their families, and organization staff and leaders can identify and manage actual and potential risks to safety.<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black"><o:p> </o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">Sub-processes of Patient Safety include:<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Planning and designing services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Directing services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Integrating and coordinating services<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Error reduction and prevention<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• The use of Sentinel Event Alerts<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• The Joint Commission's National Patient Safety Goals<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Clinical practice guidelines<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal"><i style="mso-bidi-font-style:normal"><span style="font-size:10.0pt; mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;color:black">• Active patient/client/resident involvement in their care<o:p></o:p></span></i></b></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-size:100%;color:#DDDDDD;"><span class="Apple-style-span" style="font-size: 11px; "><b><i><br /></i></b></span></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-size:100%;color:#0000FF;"><span class="Apple-style-span" style="font-size: 13px;"><b><i><br /></i></b></span></span></p></div>Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-28593339736735968132010-06-09T11:13:00.001-07:002010-06-09T11:14:12.657-07:00Mother and Child Survival is at stake!Global7 the new Millennial Renaissance Vision for the Globe<br /><br />Our Passion is to reach our individual and collective potential 4 excellence & Success<br /><br />UN Says Clock Ticking To Reduce Childbirth Mortality Rate by 75%<br />Washington. United Nations Secretary General Ban Ki-moon has called on governments around the world to kick-start efforts to improve women’s health or risk missing a UN-set deadline to cut maternal deaths. <br /><br />Speaking on Monday at Women Deliver, the largest international women’s health conference in a decade, Ban said women’s and children’s health issues had been the slowest of the UN Millennium Development Goals to make progress. <br /><br />He unveiled a “joint-action plan” to help save women and children. The plan calls on governments, nonprofit aid groups, and the private sector and UN agencies to provide money and services and to develop policies that will help countries reach goals set previously to reduce death rates among mothers and children. <br /><br />“Our joint-action plan demands that all women and children should benefit from the relatively simple, proven health practices and known technologies that save lives,” Ban said. <br /><br />Among the UN targets — set in 2000 by 189 countries — is a commitment to efforts to reduce by 75 percent the number of women who die in childbirth. The deadline to achieve the goals is 2015. <br /><br />Reports published last month by The Lancet, a British medical journal, say that with just five years to go to achieve the Millennium Development Goals, only about two dozen countries are on track to cut maternal deaths by 75 percent. <br /><br />“Women are dying because their lives are not important enough to policy makers around the world,” said Guttmacher Institute president and chief executive Sharon Camp. <br /><br />She noted that while less than $12 billion was spent last year to promote maternal health — a sum she said should be at least doubled — “Wall Street bosses paid themselves twice that in bonuses last year.” <br /><br />Studies say that although few countries are on track to meet the Millennium goals for women and children, progress has been made on both fronts. <br /><br />In April, for the first time in decades, researchers reported a significant drop worldwide in the number of women dying annually from pregnancy and childbirth, to about 342,900 in 2008 from 526,300 in 1980. The findings, published in The Lancet, challenged the prevailing view that high rates of maternal mortality were an insoluble problem. <br /><br />“The state of mothers and children worldwide is brighter than it was during the period that gave rise to the Millennium Development Goals,” it said. <br /><br />Camp cited Rwanda’s success story, saying that if the African country was able to reduce maternal mortality substantially in the 16 years since the genocide, “it’s not unreasonable for the rest of the world to do the same.” <br /><br />Similarly, a Lancet study published online in May found that death rates in children under 5 had dropped in many countries at a surprisingly fast pace from 1970 to 2010. The study predicted that worldwide, 7.7 million children would die this year — still an enormous number, but a vast improvement over the 1990 figure of 11.9 million. <br /><br />Ban said this was the time to build on growing global momentum to save women and children. <br /><br /><br />Associated Press & Agence FranceGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-20199127231734691552010-04-21T13:45:00.000-07:002010-04-21T13:52:01.218-07:00African Millennial Renaissance announces a new Political Action Group Network for People of African DescentGlobal7 the new Millennial Renaissance Vision for the Globe<br /><br />Belai FM Habte-Jesus to ethiolistforum, admin, nwmariam, Getwondimu, Helen, me, Samuel.Assefa, Drmelesse, wossene, Michael, Michael, Negusse, Nega, EPRDF<br />show details Apr 19 (3 days ago)<br />Strategy for Continuous Improvement of the Unique Heritage of People of African Descent!<br /> <br />Improving US-Africans-Ethiopia & Africa Relations in the Period of African Millennium Renaissance Network<br /> <br />– the case of African-American-Ethiopian Political Action Group (AAEPAC)<br /> <br />Introduction<br /> <br />The African Millennium Renaissance is launching the AAEPAC Network as a tool for improving the plight of one billion people of African Decent by promoting a unique and powerful political action Group called AAEPAC to galvanize the vision and mission of its youth and new leadership around the globe.<br /> <br />The Challenge<br /> <br />The global ecological, economic and security challenges demand a unique interactive response that matches the Intricacies and complexities of the impending threats to our security and survival.<br /> <br />One Billion and counting! Today, the people of African descent are scattered all over the world and have reached the unique One billion statistics where some 800 million reside in Africa and the rest 200 million around the world with the majority in Northern America, Caribbean and Latin America mainly in the USA, and Brazil.<br /> <br />The African Millennium Renaissance demands that we galvanize our resources and talents in a unique network of African Millennium Renaissance. Ethiopia is home of the African Union and the original Nile Basin Civilization that is recorded in historical, anthropological, scientific and faith literatures as home to ARDI, Lucy, Selam, Adam and Eve, etc. It is truly the cradle of African Civilization.<br /> <br />The US and Ethiopian/African Unique Place in history<br /> <br />The US-Ethiopia /Africa Diplomatic Relations has lasted more than one century and is one of the strongest alliances in Africa and the Middle East Region.<br /> <br />Seats of Global Good Governance institutions. The US is the seat of United Nations, whereas Ethiopia is the seat of African Union and the UN African Economic Commission. The advent of global climate and economic challenges is demanding that the US and Africa lead in the unique role of ensuring the sources of clean energy like Solar, Hydro and Wind energy are harnessed to its maximum. <br /> <br />The Centers of Global Diplomatic hub. Africa and the US and especially Ethiopia are both countries are centers of diplomatic and international affairs not that is not matched by any other set of countries for its diversity, and global reach.<br /> <br />The Unique Ethio-American/African relationship is based on common shared value of democracy, good governance, sustainable development, trade and investment supported by common shared global and regional peace and security.<br /> <br />The Opportunity<br /> <br />Ethiopia at the heart of US-Africa Relations. Ethiopia seeks a strong US-Ethiopia relationship as it is undergoing unique modern Millennial Renaissance transformations by builds its five pillars of infrastructure in innovative Education, clean Energy, sustainable ecology and creative enterprises and rapidly growing economic ventures as it develops its ICT (Information, Communication and Technology) capacity to integrate its system with global economies.<br /> <br />Synergy of the old and new. As one of the oldest civilizations in the world, Ethiopia offers a unqiue perspective on the global stage and continues to lead in critical issues such as the Global Climate Change movement for sustainable development by harnessing its clean energy sources such as hydro and solar energy.<br /> <br /><span style="font-weight:bold;">Win-Win Partnerships!<span style="font-style:italic;"></span></span> The US is in a special stage in its development as it seeks international support for its efforts to stabilize global economy and the every changing security challenges around the world. Ethiopia is at present the only island of Good Governance in a sea of instability and insecurity in the Horn, Africa and the Middle East. The current fourth series of modern elections is to take place on 23 May 2010, making Ethiopia one of the unique democratic transition countries in the Horn.<br /> <br />Island of Good Governance. The Good Governance and democratic efforts have to be supported by the US Government, Congress, Senate and several private for profit and non profit institutions that includes the US Government ran communication centers like the VoA and other private Human Rights and Development institutions including the Unite Nations and the World Bank series of institutions that have their headquarters in New York and Washington, DC. respectively.<br /> <br />The Strategic Solution.<br /> <br />Win-Win Partnerships! The strategic solution to global challenges and opportunities lies in creating a unique Partnership for Sustainable development with the establishment of the African-Ethiopian American Political Action Group that will transform this unique relationship and the future of one billion people of African descent.<br /> <br />After all- We are all Ethiopians! After, all according to the Discovery Channel ARDI producers, we are all Ethiopians, African and Americans due to our common shared ancestory of ARDI, LUCY and SELMAM. We are all Ethiopians and children of one race of humanity!<br /> <br />The AAEPAC is a unique instrument for changing the current status quo by ensuring our common shared values and destinies are protected and promoted in all field of life including the 5Es or pillars of this Unique partnership;<br /> <br />E1= Education. Innovative Education that produces solutions to our changing challenges in the 21st Century<br />E2= Energy: Clean Energy by harnessing the natural sources of Solar, Wind, Hydro powers<br />E3= Ecology: Sustainable econoly that utilizes clean energy sources to sustain biodiversity<br />E4= Economy. Creative, free, fair and accountable economy to the local and global community<br />E=5= Enterprises. Unleashing the creative energies and enterprises of small business enterprises<br /> <br />The AAEPAC. The AAEPAC is established to promote prosperity and security for all. Our Passion is to reach our individual and collective potential for Success and Excellence and ask all good intentioned global citizens to join us.<br /> <br /> <br />For further information and membership to this unique opportunity please do not hesitate to contact us;<br /> <br />Belai Habte-Jesus, MD, MPH<br />African Millennium Renaissance.<br />GlobalBJesus@gmail.com<br />703.933.8737<br />www.AfricanRenaissance.com<br /> <br /> <br />Changing the Status Quo of hopeless ness to creative enterprises of prosperity!<br /> <br /> <br /> <br />Background Reading on US-Ethiopia Relations – The Challenges is Change!<br /> <br /> <br /> <br />Home » Under Secretary for Public Diplomacy and Public Affairs » Bureau of Public Affairs » Bureau of Public Affairs: Electronic Information and Publications Office » Background Notes » Ethiopia (12/09)<br />Background Note: Ethiopia<br /><br /> <br />December 2009<br />Bureau of African Affairs<br /><br />Obelisk in Axum, Ethiopia, April 1, 2005. [© AP Images]<br /><br /><br />PROFILE<br /><br />OFFICIAL NAME: <br />Federal Democratic Republic of Ethiopia<br /><br />Geography <br />Area: 1.1 million sq. km (472,000 sq. mi.); about the size of Texas, Oklahoma, and New Mexico combined. <br />Cities: Capital--Addis Ababa (pop. 5 million). Other cities--Dire Dawa (237,000), Nazret (189,000), Gondar (163,000), Dessie (142,000), Mekelle (141,000), Bahir Dar (140,000), Jimma (132,000), Awassa (104,000). <br />Terrain: High plateau, mountains, dry lowland plains. <br />Climate: Temperate in the highlands; hot in the lowlands. <br /><br />People <br />Nationality: Noun and adjective--Ethiopian(s). <br />Population (est.): 80 million.<br />Annual growth rate (est.): 3.2%.<br />Ethnic groups (est.): Oromo 40%, Amhara 25%, Tigre 7%, Somali 6%, Sidama 9%, Gurage 2%, Wolaita 4%, Afar 4%, other nationalities 3%.<br />Religions (est.): Ethiopian Orthodox Christian 40%, Sunni Muslim 45-50%, Protestant 5%, remainder indigenous beliefs. <br />Languages: Amharic (official), Tigrinya, Arabic, Guaragigna, Oromifa, English, Somali. <br />Education: Years compulsory--none. Attendance (elementary)--57%. Literacy--43%. <br />Health: Infant mortality rate--93/1,000 live births. <br />Work force: Agriculture--80%. Industry and commerce--20%.<br /><br />Government <br />Type: Federal republic.<br />Constitution: Ratified 1994. <br />Branches: Executive--president, Council of State, Council of Ministers. Executive power resides with the prime minister. Legislative--bicameral parliament. Judicial--divided into federal and regional courts. <br />Administrative subdivisions: 9 regions and 2 special city administrations: Addis Ababa and Dire Dawa.<br />Political parties: Ethiopian People's Revolutionary Democratic Front (EPRDF), the Unity for Democracy and Justice (UDJ) party, the United Ethiopian Democratic Forces (UEDF), Oromo Federalist Democratic Movement (OFDM), and other small parties. <br />Suffrage: Universal starting at age 18.<br />Central government budget (2006 est.): $3.4 billion.<br />Defense: $348 million (5.6% of GDP FY 2003).<br />National holiday: May 28.<br /><br />Economy <br />GDP (FY 2007-2008): $26.6 billion.<br />Annual growth rate (2008): 8.5%. <br />GDP per capita (2008, PPP): $800. <br />Average inflation rate (FY 2008-2009): 36%.<br />Natural resources: Potash, salt, gold, copper, platinum, natural gas (unexploited). <br />Agriculture (45% of GDP): Products--coffee, cereals, pulses, oilseeds, khat, meat, hides and skins. Cultivated land--17%. <br />Industry (13% of GDP): Types--textiles, processed foods, construction, cement, and hydroelectric power. <br />Services (42% of GDP). <br />Trade (2008): Exports--$1.5 billion. Imports--$6.8 billion; plus remittances--official est. $970 million; unofficial est. $815 million.<br />Fiscal year: July 8-July 7.<br /><br />GEOGRAPHY <br />Ethiopia is located in the Horn of Africa and is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. The country has a high central plateau that varies from 1,800 to 3,000 meters (6,000 ft.-10,000 ft.) above sea level, with some mountains reaching 4,620 meters (15,158 ft.). Elevation is generally highest just before the point of descent to the Great Rift Valley, which splits the plateau diagonally. A number of rivers cross the plateau--notably the Blue Nile flowing from Lake Tana. The plateau gradually slopes to the lowlands of the Sudan on the west and the Somali-inhabited plains to the southeast.<br /><br />The climate is temperate on the plateau and hot in the lowlands. At Addis Ababa, which ranges from 2,200 to 2,600 meters (7,000 ft.-8,500 ft.), maximum temperature is 26o C (80o F) and minimum 4o C (40o F). The weather is usually sunny and dry with the short (belg) rains occurring February-April and the big (meher) rains beginning in mid-June and ending in mid-September.<br /><br />PEOPLE <br />Ethiopia's population is highly diverse. Most of its people speak a Semitic or Cushitic language. The Oromo, Amhara, and Tigreans make up more than three-fourths of the population, but there are more than 77 different ethnic groups with their own distinct languages within Ethiopia. Some of these have as few as 10,000 members. In general, most of the Christians live in the highlands, while Muslims and adherents of traditional African religions tend to inhabit lowland regions.<br /><br /> English is the most widely spoken foreign language and is taught in all secondary schools. Amharic is the official language and was the language of primary school instruction but has been replaced in many areas by local languages such as Oromifa and Tigrinya.<br /><br />HISTORY <br />Hominid bones discovered in eastern Ethiopia dating back 4.4 million years make Ethiopia one of the earliest known locations of human ancestors. Ethiopia is the oldest independent country in Africa and one of the oldest in the world. <br /><br />Herodotus, the Greek historian of the fifth century B.C., describes ancient Ethiopia in his writings. The Old Testament of the Bible records the Queen of Sheba's visit to Jerusalem. According to legend, Menelik I, the son of King Solomon and the Queen of Sheba, founded the Ethiopian Empire. <br /><br />Missionaries from Egypt and Syria introduced Christianity in the fourth century A.D. Following the rise of Islam in the seventh century, Ethiopia was gradually cut off from European Christendom. The Portuguese established contact with Ethiopia in 1493, primarily to strengthen their influence over the Indian Ocean and to convert Ethiopia to Roman Catholicism. <br /><br />There followed a century of conflict between pro- and anti-Catholic factions, resulting in the expulsion of all foreign missionaries in the 1630s. This period of bitter religious conflict contributed to hostility toward foreign Christians and Europeans, which persisted into the 20th century and was a factor in Ethiopia's isolation until the mid-19th century.<br /><br />Under the Emperors Theodore II (1855-68), Johannes IV (1872-89), and Menelik II (1889-1913), the kingdom was consolidated and began to emerge from its medieval isolation. When Menelik II died, his grandson, Lij Iyassu, succeeded to the throne but soon lost support because of his Muslim ties. The Christian nobility deposed him in 1916, and Menelik's daughter, Zewditu, was made empress.<br /><br />Her cousin, Ras Tafari Makonnen (1892-1975), was made regent and successor to the throne. In 1930, after the empress died, the regent, adopting the throne name Haile Selassie, was crowned emperor. His reign was interrupted in 1936 when Italian Fascist forces invaded and occupied Ethiopia. The emperor was forced into exile in England. Five years later, British and Ethiopian forces defeated the Italians, and the emperor returned to the throne.<br /><br />Following civil unrest, which began in February 1974, the aging Haile Selassie I was deposed on September 12, 1974 by a provisional administrative council of soldiers, known as the Derg ("committee"). The Derg seized power, installing a government that was socialist in name and military in style. It then summarily executed 59 members of the royal family and ministers and generals of the emperor's government; Emperor Haile Selassie I was strangled in the basement of his palace on August 22, 1975.<br /><br />Lt. Col. Mengistu Haile Mariam assumed power as head of state and Derg chairman, after having his two predecessors killed. Mengistu's years in office were marked by a totalitarian-style government and the country's massive militarization, financed by the Soviet Union and the Eastern Bloc, and assisted by Cuba. From 1977 through early 1978 thousands of suspected enemies of the Derg were tortured and/or killed in a purge called the "red terror." Communism was officially adopted during the late 1970s and early 1980s with the promulgation of a Soviet-style constitution, Politburo, and the creation of the Workers' Party of Ethiopia (WPE).<br /><br />In December 1976, Ethiopia signed a military assistance agreement with the Soviet Union. The following April, Ethiopia abrogated its military assistance agreement with the United States and expelled the American military missions. In July 1977, sensing the disarray in Ethiopia, Somalia attacked across the Ogaden Desert in pursuit of its irredentist claims to the ethnic Somali areas of Ethiopia. Ethiopian forces were driven back deep inside their own frontier but, with the assistance of a massive Soviet airlift of arms and Cuban combat forces, they stemmed the attack. The major Somali regular units were forced out of the Ogaden in March 1978.<br /><br />The Derg's collapse was hastened by droughts, famine, and insurrections, particularly in the northern regions of Tigray and Eritrea. In 1989, the Tigrayan People's Liberation Front (TPLF) merged with other ethnically based opposition movements to form the Ethiopian Peoples' Revolutionary Democratic Front (EPRDF). In May 1991, EPRDF forces advanced on Addis Ababa. Mengistu fled the country for asylum in Zimbabwe, where he still resides.<br /><br />In July 1991, the EPRDF, the Oromo Liberation Front (OLF), and others established the Transitional Government of Ethiopia (TGE) comprised of an 87-member Council of Representatives and guided by a national charter that functioned as a transitional constitution. In June 1992 the OLF withdrew from the government; in March 1993, members of the Southern Ethiopia Peoples' Democratic Coalition left the government.<br /><br />In May 1991, the Eritrean People's Liberation Front (EPLF), led by Isaias Afwerki, assumed control of Eritrea and established a provisional government. This provisional government independently administered Eritrea until April 23-25, 1993, when Eritreans voted overwhelmingly for independence in a UN-monitored free and fair referendum. Eritrea, with Ethiopia’s consent, was declared independent on April 27. The United States recognized its independence the next day.<br /><br />In Ethiopia, President Meles Zenawi and members of the TGE pledged to oversee the formation of a multi-party democracy. The election for a 547-member constituent assembly was held in June 1994. The assembly adopted the constitution of the Federal Democratic Republic of Ethiopia in December 1994. The elections for Ethiopia's first popularly chosen national parliament and regional legislatures were held in May and June 1995. Most opposition parties chose to boycott these elections, ensuring a landslide victory for the EPRDF. International and non-governmental observers concluded that opposition parties would have been able to participate had they chosen to do so. The Government of the Federal Democratic Republic of Ethiopia was installed in August 1995.<br /><br />In May 1998, Eritrean forces attacked part of the Ethiopia-Eritrea border region, seizing some Ethiopian-controlled territory. The strike spurred a two-year war between the neighboring states that cost over 100,000 lives. Ethiopian and Eritrean leaders signed an Agreement on Cessation of Hostilities on June 18, 2000 and a peace agreement, known as the Algiers Agreement, on December 12, 2000. The agreements called for an end to the hostilities, a 25-kilometer-wide Temporary Security Zone along the Ethiopia-Eritrea border, the establishment of a United Nations peacekeeping force to monitor compliance, and the establishment of the Eritrea Ethiopia Boundary Commission (EEBC) to act as a neutral body to assess colonial treaties and applicable international law in order to render final and binding border delimitation and demarcation determinations. The United Nations Mission to Eritrea and Ethiopia (UNMEE) was established in September 2000. <br /><br />The EEBC presented its border delimitation decision on April 13, 2002, awarding the town of Badme and much of the disputed border region to Eritrea. In November 2007, after making very little progress on encouraging Ethiopia and Eritrea to demarcate the boundary, the EEBC issued its demarcation decision by map coordinates and announced that its work was done. Ethiopia, however, refused to accept this decision. In mid-2008, under pressure from the Eritrean Government, UNMEE units were withdrawn from the region. Since then neither Ethiopia nor Eritrea has taken steps to demarcate the border.<br /><br />Opposition candidates won 12 seats in national parliamentary elections in 2000. The next national elections were held in May 2005. Ethiopia held the most free and fair national campaign period in the country’s history prior to May 15, 2005 elections. Unfortunately, electoral irregularities and tense campaign rhetoric resulted in a protracted election complaints review process. Public protests turned violent in June 2005. <br /><br />The National Electoral Board released final results in September 2005, with the opposition taking over 170 of the 547 parliamentary seats and 137 of the 138 seats for the Addis Ababa municipal council. Opposition parties called for a boycott of parliament and civil disobedience to protest the election results. In November 2005, Ethiopian security forces responded to public protests by arresting scores of opposition leaders, as well as journalists and human rights advocates, and detaining tens of thousands of civilians in rural detention camps for up to three months. In December 2005, the government charged 131 opposition, media, and civil society leaders with capital offenses including "outrages against the constitution." Key opposition leaders and almost all of the 131 were pardoned and released from prison 18 months later.<br /><br />As of March 2008, approximately 150 of the elected opposition members of parliament had taken their seats and currently remain in parliament. Ruling and opposition parties have engaged in little dialogue since the opposition leaders were freed. Government harassment made it very difficult for opposition candidates to compete in local elections in April 2008. As a result, the ruling party won more than 99% of the local seats throughout Ethiopia.<br /><br />In June 2008, former CUD vice-chairman Birtukan Mideksa was elected the party chairman of the new Unity for Democracy and Justice (UDJ) party at its inaugural session in Addis Ababa. In October 2008 the Ethiopian Government arrested over 100 Oromo leaders, accusing some of being members of the outlawed Oromo Liberation Front (OLF). At the end of December 2008, after detaining Birtukan several times briefly during the month, the government re-arrested her, saying that she had violated the conditions of her pardon (she was one of the prominent opposition leaders pardoned by the government in the summer of 2007). Her original sentence of life imprisonment was reinstated.<br /><br />In April 2009 the Ethiopian Government arrested 40 individuals, mostly Amhara military or ex-military members allegedly affiliated with Ginbot 7, an external opposition party, for their suspected involvement in a terrorist assassination plot of government leaders. This party was founded in May 2008 in the United States by Berhanu Nega, one of the opposition leaders in the 2005 elections, and advocates for change in the government "by any means." In August 2009, the Federal High Court found 13 of the defendants guilty in absentia and one not guilty in absentia. In November 2009, the court found another 27 guilty and is seeking the death penalty for all 40 defendants.<br /><br />Presidential and parliamentary elections are scheduled to take place in May 2010. As of December 2009, however, leading opposition politicians voiced skepticism that the Ethiopian Government would permit free and fair elections. In September, the Forum for Democratic Dialogue, a coalition of major opposition parties, walked out of interparty talks after complaining that the ruling EPRDF refused to hold bilateral Forum-EPRDF talks. Opposition party leaders reported an intensification of harassment, arbitrary arrest, and intimidation of their supporters, especially in rural areas, nine months before the scheduled elections.<br /><br />GOVERNMENT AND POLITICAL CONDITIONS<br />Ethiopia is a federal republic under the 1994 constitution. The executive branch includes a president, Council of State, and Council of Ministers. Executive power resides with the prime minister. There is a bicameral parliament; national legislative elections were held in 2005. The judicial branch comprises federal and regional courts.<br /><br />Political parties include the Ethiopian People's Revolutionary Democratic Front (EPRDF), Unity for Democracy and Justice (UDJ), Oromo People's Congress (OPC), Arena Tigay for Democracy and Sovereignty, Oromo Federalist Democratic Movement (OFDM), Coalition for Unity and Democracy Party (CUDP), the United Ethiopian Democratic Forces (UEDF), All Ethiopia Unity Party (AEUP), and other small parties. Suffrage is universal at age 18.<br /><br />The EPRDF-led government of Prime Minister Meles Zenawi has promoted a policy of ethnic federalism, devolving significant powers to regional, ethnically based authorities. Ethiopia has 9 semi-autonomous administrative regions and two special city administrations (Addis Ababa and Dire Dawa), which have the power to raise their own revenues. Under the present government, Ethiopians enjoy wide, albeit circumscribed, political freedom.<br /><br />Principal Government Officials <br />President--Girma Wolde-Giorgis<br />Prime Minister--Meles Zenawi<br />Deputy Prime Minister--Addisu Legesse<br />Minister of National Defense--Siraj Fegisa<br />Minister of Foreign Affairs--Seyoum Mesfin <br />Mayor of Addis Ababa--Kuma Demeska<br /><br />Ethiopia maintains an embassy in the U.S. at 3506 International Drive, NW, Washington, DC 20008 (tel. 202-364-1200) headed by Ambassador Samuel Assefa. It also maintains a UN mission in New York and consulates in Los Angeles, Seattle (honorary), and Houston (honorary).<br /><br />ECONOMY <br />The current government has embarked on a cautious program of economic reform, including privatization of state enterprises and rationalization of government regulation. While the process is still ongoing, so far the reforms have attracted only meager foreign investment, and the government remains heavily involved in the economy.<br /><br />The Ethiopian economy is based on agriculture, which contributes 45% to GDP and more than 80% of exports, and employs 85% of the population. The major agricultural export crop is coffee, providing approximately 35% of Ethiopia's foreign exchange earnings, down from 65% a decade ago because of the slump in coffee prices since the mid-1990s. Other traditional major agricultural exports are leather, hides and skins, pulses, oilseeds, and the traditional "khat," a leafy shrub that has psychotropic qualities when chewed. Sugar and gold production has also become important in recent years.<br /><br />Ethiopia's agriculture is plagued by periodic drought, soil degradation caused by inappropriate agricultural practices and overgrazing, deforestation, high population density, undeveloped water resources, and poor transport infrastructure, making it difficult and expensive to get goods to market. Yet agriculture is the country's most promising resource. Potential exists for self-sufficiency in grains and for export development in livestock, flowers, grains, oilseeds, sugar, vegetables, and fruits.<br /><br />Gold, marble, limestone, and small amounts of tantalum are mined in Ethiopia. Other resources with potential for commercial development include large potash deposits, natural gas, iron ore, and possibly oil and geothermal energy. Although Ethiopia has good hydroelectric resources, which power most of its manufacturing sector, it is totally dependent on imports for oil. <br /><br />A landlocked country, Ethiopia has relied on the port of Djibouti since the 1998-2000 border war with Eritrea. Ethiopia is connected with the port of Djibouti by road and rail for international trade. Of the 23,812 kilometers of all-weather roads in Ethiopia, 15% are asphalt. Mountainous terrain and the lack of good roads and sufficient vehicles make land transportation difficult and expensive. However, the government-owned airline’s reputation is excellent. Ethiopian Airlines serves 38 domestic airfields and has 42 international destinations.<br /><br />Dependent on a few vulnerable crops for its foreign exchange earnings and reliant on imported oil, Ethiopia is suffering a severe lack of foreign exchange while simultaneously battling high inflation.<br /><br /> The financially conservative government has taken measures to solve these problems, including stringent import controls, focused sectors for export development, eliminated subsidies on retail gasoline prices, and capped lending limits for banks. Nevertheless, the largely subsistence economy is incapable of meeting the budget requirements for drought relief, an ambitious development plan, and indispensable imports such as oil. The gap has largely been covered through foreign assistance inflows.<br /><br />DEFENSE <br />The Ethiopian National Defense Forces (ENDF) numbers about 200,000 personnel, which makes it one of the largest militaries in Africa. During the 1998-2000 border war with Eritrea, the ENDF mobilized strength reached approximately 350,000. Since the end of the war, some 150,000 soldiers have been demobilized. <br /><br />The ENDF continues a transition from its roots as a guerrilla army to an all-volunteer professional military organization with the aid of the U.S. and other countries. Training in peacekeeping operations, professional military education, military training management, counterterrorism operations, and military medicine are among the major programs sponsored by the United States. Ethiopia has one peacekeeping contingent in Liberia. In January 2009, Ethiopian peacekeeping troops had begun deploying in Darfur. When at full strength, the Ethiopian contingent there will consist of 2,500 troops and five attack helicopters.<br /><br />FOREIGN RELATIONS <br /><br />Ethiopia was relatively isolated from major movements of world politics until Italian invasions in 1895 and 1935. Since World War II, it has played an active role in world and African affairs. Ethiopia was a charter member of the United Nations and took part in UN operations in Korea in 1951 and the Congo in 1960. Former Emperor Haile Selassie was a founder of the Organization of African Unity (OAU), now known as the African Union (AU). Addis Ababa also hosts the UN Economic Commission for Africa. Ethiopia is also a member of the Intergovernmental Authority on Development, a Horn of Africa regional grouping.<br /><br />Although nominally a member of the Non-Aligned Movement, after the 1974 revolution, Ethiopia moved into a close relationship with the Soviet Union and its allies and supported their international policies and positions until the change of government in 1991. Today, Ethiopia has good relations with the United States and the West, especially in responding to regional instability and supporting counterterrorism efforts.<br /><br /><br />The AAEPAC. The AAEPAC is established to promote prosperity and security for all. Our Passion is to reach our individual and collective potential for Success and Excellence and ask all good intentioned global citizens to join us.<br /> <br /> <br />For further information and membership to this unique opportunity please do not hesitate to contact us;<br /> <br />Belai Habte-Jesus, MD, MPH<br />African Millennium Renaissance.<br />GlobalBJesus@gmail.com<br />703.933.8737<br />www.AfricanRenaissance.com<br /> <br /> <br />Changing the Status Quo of hopeless ness to creative enterprises of prosperity!<br /> <br /> <br /> <br />Background Reading on US-Ethiopia Relations – The Challenges is Change!<br /> <br /> <br /> <br /> <br /> <br /> <br />Home » Under Secretary for Public Diplomacy and Public Affairs » Bureau of Public Affairs » Bureau of Public Affairs: Electronic Information and Publications Office » Background Notes » Ethiopia (12/09)<br />Background Note: Ethiopia<br /><br /> <br /><br /><br />December 2009<br />Bureau of African Affairs<br /><br />Obelisk in Axum, Ethiopia, April 1, 2005. [© AP Images]<br /><br /><br /><br />PROFILE<br /><br />OFFICIAL NAME: <br />Federal Democratic Republic of Ethiopia<br /><br />Geography <br /><br />Area: 1.1 million sq. km (472,000 sq. mi.); about the size of Texas, Oklahoma, and New Mexico combined. <br /><br />Cities: Capital--Addis Ababa (pop. 5 million). Other cities--Dire Dawa (237,000), Nazret (189,000), Gondar (163,000), Dessie (142,000), Mekelle (141,000), Bahir Dar (140,000), Jimma (132,000), Awassa (104,000). <br /><br />Terrain: High plateau, mountains, dry lowland plains. <br />Climate: Temperate in the highlands; hot in the lowlands. <br /><br />People <br />Nationality: Noun and adjective--Ethiopian(s). <br />Population (est.): 80 million.<br /><br />Annual growth rate (est.): 3.2%.<br />Ethnic groups (est.): Oromo 40%, Amhara 25%, Tigre 7%, Somali 6%, Sidama 9%, Gurage 2%, Wolaita 4%, Afar 4%, other nationalities 3%.<br /><br />Religions (est.): Ethiopian Orthodox Christian 40%, Sunni Muslim 45-50%, Protestant 5%, remainder indigenous beliefs. <br /><br />Languages: Amharic (official), Tigrinya, Arabic, Guaragigna, Oromifa, English, Somali. <br /><br />Education: Years compulsory--none. Attendance (elementary)--57%. Literacy--43%. <br />Health: Infant mortality rate--93/1,000 live births. <br />Work force: Agriculture--80%. Industry and commerce--20%.<br /><br />Government <br />Type: Federal republic.<br /><br />Constitution: Ratified 1994. <br /><br />Branches: Executive--president, Council of State, Council of Ministers. Executive power resides with the prime minister. Legislative--bicameral parliament. Judicial--divided into federal and regional courts. <br /><br />Administrative subdivisions: 9 regions and 2 special city administrations: Addis Ababa and Dire Dawa.<br /><br />Political parties: Ethiopian People's Revolutionary Democratic Front (EPRDF), the Unity for Democracy and Justice (UDJ) party, the United Ethiopian Democratic Forces (UEDF), Oromo Federalist Democratic Movement (OFDM), and other small parties. <br />Suffrage: Universal starting at age 18.<br /><br />Central government budget (2006 est.): $3.4 billion.<br />Defense: $348 million (5.6% of GDP FY 2003).<br />National holiday: May 28.<br /><br />Economy <br />GDP (FY 2007-2008): $26.6 billion.<br />Annual growth rate (2008): 8.5%. <br /><br />GDP per capita (2008, PPP): $800. <br />Average inflation rate (FY 2008-2009): 36%.<br /><br />Natural resources: Potash, salt, gold, copper, platinum, natural gas (unexploited). <br />Agriculture (45% of GDP): Products--coffee, cereals, pulses, oilseeds, khat, meat, hides and skins. Cultivated land--17%. <br /><br />Industry (13% of GDP): Types--textiles, processed foods, construction, cement, and hydroelectric power. <br />Services (42% of GDP). <br /><br />Trade (2008): Exports--$1.5 billion. Imports--$6.8 billion; plus remittances--official est. $970 million; unofficial est. $815 million.<br />Fiscal year: July 8-July 7.<br /><br />GEOGRAPHY <br /><br />Ethiopia is located in the Horn of Africa and is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. The country has a high central plateau that varies from 1,800 to 3,000 meters (6,000 ft.-10,000 ft.) above sea level, with some mountains reaching 4,620 meters (15,158 ft.).<br /><br />Elevation is generally highest just before the point of descent to the Great Rift Valley, which splits the plateau diagonally. A number of rivers cross the plateau--notably the Blue Nile flowing from Lake Tana. The plateau gradually slopes to the lowlands of the Sudan on the west and the Somali-inhabited plains to the southeast.<br /><br />The climate is temperate on the plateau and hot in the lowlands. At Addis Ababa, which ranges from 2,200 to 2,600 meters (7,000 ft.-8,500 ft.), maximum temperature is 26o C (80o F) and minimum 4o C (40o F). The weather is usually sunny and dry with the short (belg) rains occurring February-April and the big (meher) rains beginning in mid-June and ending in mid-September.<br /><br />PEOPLE <br /><br />Ethiopia's population is highly diverse. Most of its people speak a Semitic or Cushitic language. The Oromo, Amhara, and Tigreans make up more than three-fourths of the population, but there are more than 77 different ethnic groups with their own distinct languages within Ethiopia.<br /><br />Some of these have as few as 10,000 members. In general, most of the Christians live in the highlands, while Muslims and adherents of traditional African religions tend to inhabit lowland regions. English is the most widely spoken foreign language and is taught in all secondary schools. Amharic is the official language and was the language of primary school instruction but has been replaced in many areas by local languages such as Oromifa and Tigrinya.<br /><br />HISTORY <br /><br />Hominid bones discovered in eastern Ethiopia dating back 4.4 million years make Ethiopia one of the earliest known locations of human ancestors. Ethiopia is the oldest independent country in Africa and one of the oldest in the world. Herodotus, the Greek historian of the fifth century B.C., describes ancient Ethiopia in his writings. <br /><br />The Old Testament of the Bible records the Queen of Sheba's visit to Jerusalem. According to legend, Menelik I, the son of King Solomon and the Queen of Sheba, founded the Ethiopian Empire. Missionaries from Egypt and Syria introduced Christianity in the fourth century A.D.<br /><br /> Following the rise of Islam in the seventh century, Ethiopia was gradually cut off from European Christendom. The Portuguese established contact with Ethiopia in 1493, primarily to strengthen their influence over the Indian Ocean and to convert Ethiopia to Roman Catholicism. <br /><br />There followed a century of conflict between pro- and anti-Catholic factions, resulting in the expulsion of all foreign missionaries in the 1630s. This period of bitter religious conflict contributed to hostility toward foreign Christians and Europeans, which persisted into the 20th century and was a factor in Ethiopia's isolation until the mid-19th century.<br /><br />Under the Emperors Theodore II (1855-68), Johannes IV (1872-89), and Menelik II (1889-1913), the kingdom was consolidated and began to emerge from its medieval isolation. When Menelik II died, his grandson, Lij Iyassu, succeeded to the throne but soon lost support because of his Muslim ties. The Christian nobility deposed him in 1916, and Menelik's daughter, Zewditu, was made empress. Her cousin, Ras Tafari Makonnen (1892-1975), was made regent and successor to the throne. <br /><br />In 1930, after the empress died, the regent, adopting the throne name Haile Selassie, was crowned emperor. His reign was interrupted in 1936 when Italian Fascist forces invaded and occupied Ethiopia. The emperor was forced into exile in England. Five years later, British and Ethiopian forces defeated the Italians, and the emperor returned to the throne.<br /><br />Following civil unrest, which began in February 1974, the aging Haile Selassie I was deposed on September 12, 1974 by a provisional administrative council of soldiers, known as the Derg ("committee"). The Derg seized power, installing a government that was socialist in name and military in style. It then summarily executed 59 members of the royal family and ministers and generals of the emperor's government; Emperor Haile Selassie I was strangled in the basement of his palace on August 22, 1975.<br /><br />Lt. Col. Mengistu Haile Mariam assumed power as head of state and Derg chairman, after having his two predecessors killed. Mengistu's years in office were marked by a totalitarian-style government and the country's massive militarization, financed by the Soviet Union and the Eastern Bloc, and assisted by Cuba. <br /><br />From 1977 through early 1978 thousands of suspected enemies of the Derg were tortured and/or killed in a purge called the "red terror." Communism was officially adopted during the late 1970s and early 1980s with the promulgation of a Soviet-style constitution, Politburo, and the creation of the Workers' Party of Ethiopia (WPE).<br /><br />In December 1976, Ethiopia signed a military assistance agreement with the Soviet Union. The following April, Ethiopia abrogated its military assistance agreement with the United States and expelled the American military missions.<br /><br /> In July 1977, sensing the disarray in Ethiopia, Somalia attacked across the Ogaden Desert in pursuit of its irredentist claims to the ethnic Somali areas of Ethiopia. Ethiopian forces were driven back deep inside their own frontier but, with the assistance of a massive Soviet airlift of arms and Cuban combat forces, they stemmed the attack. The major Somali regular units were forced out of the Ogaden in March 1978.<br /><br />The Derg's collapse was hastened by droughts, famine, and insurrections, particularly in the northern regions of Tigray and Eritrea. In 1989, the Tigrayan People's Liberation Front (TPLF) merged with other ethnically based opposition movements to form the Ethiopian Peoples' Revolutionary Democratic Front (EPRDF). In May 1991, EPRDF forces advanced on Addis Ababa. Mengistu fled the country for asylum in Zimbabwe, where he still resides.<br /><br />In July 1991, the EPRDF, the Oromo Liberation Front (OLF), and others established the Transitional Government of Ethiopia (TGE) comprised of an 87-member Council of Representatives and guided by a national charter that functioned as a transitional constitution. In June 1992 the OLF withdrew from the government; in March 1993, members of the Southern Ethiopia Peoples' Democratic Coalition left the government.<br /><br />In May 1991, the Eritrean People's Liberation Front (EPLF), led by Isaias Afwerki, assumed control of Eritrea and established a provisional government. This provisional government independently administered Eritrea until April 23-25, 1993, when Eritreans voted overwhelmingly for independence in a UN-monitored free and fair referendum. Eritrea, with Ethiopia’s consent, was declared independent on April 27. The United States recognized its independence the next day.<br /><br />In Ethiopia, President Meles Zenawi and members of the TGE pledged to oversee the formation of a multi-party democracy. The election for a 547-member constituent assembly was held in June 1994. The assembly adopted the constitution of the Federal Democratic Republic of Ethiopia in December 1994. <br /><br />The elections for Ethiopia's first popularly chosen national parliament and regional legislatures were held in May and June 1995. Most opposition parties chose to boycott these elections, ensuring a landslide victory for the EPRDF. International and non-governmental observers concluded that opposition parties would have been able to participate had they chosen to do so. The Government of the Federal Democratic Republic of Ethiopia was installed in August 1995.<br /><br />In May 1998, Eritrean forces attacked part of the Ethiopia-Eritrea border region, seizing some Ethiopian-controlled territory. The strike spurred a two-year war between the neighboring states that cost over 100,000 lives. Ethiopian and Eritrean leaders signed an Agreement on Cessation of Hostilities on June 18, 2000 and a peace agreement, known as the Algiers Agreement, on December 12, 2000. <br /><br />The agreements called for an end to the hostilities, a 25-kilometer-wide Temporary Security Zone along the Ethiopia-Eritrea border, the establishment of a United Nations peacekeeping force to monitor compliance, and the establishment of the Eritrea Ethiopia Boundary Commission (EEBC) to act as a neutral body to assess colonial treaties and applicable international law in order to render final and binding border delimitation and demarcation determinations. The United Nations Mission to Eritrea and Ethiopia (UNMEE) was established in September 2000. The EEBC presented its border delimitation decision on April 13, 2002, awarding the town of Badme and much of the disputed border region to Eritrea.<br /><br /> In November 2007, after making very little progress on encouraging Ethiopia and Eritrea to demarcate the boundary, the EEBC issued its demarcation decision by map coordinates and announced that its work was done. Ethiopia, however, refused to accept this decision. In mid-2008, under pressure from the Eritrean Government, UNMEE units were withdrawn from the region. Since then neither Ethiopia nor Eritrea has taken steps to demarcate the border.<br /><br />Opposition candidates won 12 seats in national parliamentary elections in 2000. The next national elections were held in May 2005. Ethiopia held the most free and fair national campaign period in the country’s history prior to May 15, 2005 elections. <br /><br />Unfortunately, electoral irregularities and tense campaign rhetoric resulted in a protracted election complaints review process. Public protests turned violent in June 2005. The National Electoral Board released final results in September 2005, with the opposition taking over 170 of the 547 parliamentary seats and 137 of the 138 seats for the Addis Ababa municipal council. <br /><br />Opposition parties called for a boycott of parliament and civil disobedience to protest the election results. In November 2005, Ethiopian security forces responded to public protests by arresting scores of opposition leaders, as well as journalists and human rights advocates, and detaining tens of thousands of civilians in rural detention camps for up to three months. <br /><br />In December 2005, the government charged 131 opposition, media, and civil society leaders with capital offenses including "outrages against the constitution." Key opposition leaders and almost all of the 131 were pardoned and released from prison 18 months later. As of March 2008, approximately 150 of the elected opposition members of parliament had taken their seats and currently remain in parliament. <br /><br />Ruling and opposition parties have engaged in little dialogue since the opposition leaders were freed. Government harassment made it very difficult for opposition candidates to compete in local elections in April 2008. As a result, the ruling party won more than 99% of the local seats throughout Ethiopia.<br /><br />In June 2008, former CUD vice-chairman Birtukan Mideksa was elected the party chairman of the new Unity for Democracy and Justice (UDJ) party at its inaugural session in Addis Ababa.<br /><br /> In October 2008 the Ethiopian Government arrested over 100 Oromo leaders, accusing some of being members of the outlawed Oromo Liberation Front (OLF). At the end of December 2008, after detaining Birtukan several times briefly during the month, the government re-arrested her, saying that she had violated the conditions of her pardon (she was one of the prominent opposition leaders pardoned by the government in the summer of 2007). Her original sentence of life imprisonment was reinstated.<br /><br />In April 2009 the Ethiopian Government arrested 40 individuals, mostly Amhara military or ex-military members allegedly affiliated with Ginbot 7, an external opposition party, for their suspected involvement in a terrorist assassination plot of government leaders. <br /><br />This party was founded in May 2008 in the United States by Berhanu Nega, one of the opposition leaders in the 2005 elections, and advocates for change in the government "by any means." In August 2009, the Federal High Court found 13 of the defendants guilty in absentia and one not guilty in absentia. In November 2009, the court found another 27 guilty and is seeking the death penalty for all 40 defendants.<br /><br />Presidential and parliamentary elections are scheduled to take place in May 2010. As of December 2009, however, leading opposition politicians voiced skepticism that the Ethiopian Government would permit free and fair elections. In September, the Forum for Democratic Dialogue, a coalition of major opposition parties, walked out of interparty talks after complaining that the ruling EPRDF refused to hold bilateral Forum-EPRDF talks. <br /><br />Opposition party leaders reported an intensification of harassment, arbitrary arrest, and intimidation of their supporters, especially in rural areas, nine months before the scheduled elections.<br /><br />GOVERNMENT AND POLITICAL CONDITIONS<br />Ethiopia is a federal republic under the 1994 constitution. The executive branch includes a president, Council of State, and Council of Ministers. Executive power resides with the prime minister. There is a bicameral parliament; national legislative elections were held in 2005. The judicial branch comprises federal and regional courts.<br /><br />Political parties include the Ethiopian People's Revolutionary Democratic Front (EPRDF), Unity for Democracy and Justice (UDJ), Oromo People's Congress (OPC), Arena Tigay for Democracy and Sovereignty, Oromo Federalist Democratic Movement (OFDM), Coalition for Unity and Democracy Party (CUDP), the United Ethiopian Democratic Forces (UEDF), All Ethiopia Unity Party (AEUP), and other small parties. Suffrage is universal at age 18.<br /><br />The EPRDF-led government of Prime Minister Meles Zenawi has promoted a policy of ethnic federalism, devolving significant powers to regional, ethnically based authorities. Ethiopia has 9 semi-autonomous administrative regions and two special city administrations (Addis Ababa and Dire Dawa), which have the power to raise their own revenues. Under the present government, Ethiopians enjoy wide, albeit circumscribed, political freedom.<br /><br />Principal Government Officials <br />President--Girma Wolde-Giorgis<br />Prime Minister--Meles Zenawi<br />Deputy Prime Minister--Addisu Legesse<br />Minister of National Defense--Siraj Fegisa<br />Minister of Foreign Affairs--Seyoum Mesfin <br />Mayor of Addis Ababa--Kuma Demeska<br /><br />Ethiopia maintains an embassy in the U.S. at 3506 International Drive, NW, Washington, DC 20008 (tel. 202-364-1200) headed by Ambassador Samuel Assefa. It also maintains a UN mission in New York and consulates in Los Angeles, Seattle (honorary), and Houston (honorary).<br /><br />ECONOMY <br />The current government has embarked on a cautious program of economic reform, including privatization of state enterprises and rationalization of government regulation. While the process is still ongoing, so far the reforms have attracted only meager foreign investment, and the government remains heavily involved in the economy.<br /><br />The Ethiopian economy is based on agriculture, which contributes 45% to GDP and more than 80% of exports, and employs 85% of the population. The major agricultural export crop is coffee, providing approximately 35% of Ethiopia's foreign exchange earnings, down from 65% a decade ago because of the slump in coffee prices since the mid-1990s. Other traditional major agricultural exports are leather, hides and skins, pulses, oilseeds, and the traditional "khat," a leafy shrub that has psychotropic qualities when chewed. Sugar and gold production has also become important in recent years.<br /><br />Ethiopia's agriculture is plagued by periodic drought, soil degradation caused by inappropriate agricultural practices and overgrazing, deforestation, high population density, undeveloped water resources, and poor transport infrastructure, making it difficult and expensive to get goods to market. Yet agriculture is the country's most promising resource. Potential exists for self-sufficiency in grains and for export development in livestock, flowers, grains, oilseeds, sugar, vegetables, and fruits.<br /><br />Gold, marble, limestone, and small amounts of tantalum are mined in Ethiopia. Other resources with potential for commercial development include large potash deposits, natural gas, iron ore, and possibly oil and geothermal energy. Although Ethiopia has good hydroelectric resources, which power most of its manufacturing sector, it is totally dependent on imports for oil.<br /><br /> A landlocked country, Ethiopia has relied on the port of Djibouti since the 1998-2000 border war with Eritrea. Ethiopia is connected with the port of Djibouti by road and rail for international trade. <br /><br />Of the 23,812 kilometers of all-weather roads in Ethiopia, 15% are asphalt. Mountainous terrain and the lack of good roads and sufficient vehicles make land transportation difficult and expensive. However, the government-owned airline’s reputation is excellent. Ethiopian Airlines serves 38 domestic airfields and has 42 international destinations.<br /><br />Dependent on a few vulnerable crops for its foreign exchange earnings and reliant on imported oil, Ethiopia is suffering a severe lack of foreign exchange while simultaneously battling high inflation. <br /><br />The financially conservative government has taken measures to solve these problems, including stringent import controls, focused sectors for export development, eliminated subsidies on retail gasoline prices, and capped lending limits for banks. Nevertheless, the largely subsistence economy is incapable of meeting the budget requirements for drought relief, an ambitious development plan, and indispensable imports such as oil. The gap has largely been covered through foreign assistance inflows.<br /><br />DEFENSE <br /><br />The Ethiopian National Defense Forces (ENDF) numbers about 200,000 personnel, which makes it one of the largest militaries in Africa. During the 1998-2000 border war with Eritrea, the ENDF mobilized strength reached approximately 350,000. Since the end of the war, some 150,000 soldiers have been demobilized. <br /><br />The ENDF continues a transition from its roots as a guerrilla army to an all-volunteer professional military organization with the aid of the U.S. and other countries. Training in peacekeeping operations, professional military education, military training management, counterterrorism operations, and military medicine are among the major programs sponsored by the United States. <br /><br />Ethiopia has one peacekeeping contingent in Liberia. In January 2009, Ethiopian peacekeeping troops had begun deploying in Darfur. When at full strength, the Ethiopian contingent there will consist of 2,500 troops and five attack helicopters.<br /><br />FOREIGN RELATIONS <br />Ethiopia was relatively isolated from major movements of world politics until Italian invasions in 1895 and 1935. Since World War II, it has played an active role in world and African affairs. Ethiopia was a charter member of the United Nations and took part in UN operations in Korea in 1951 and the Congo in 1960. <br /><br />Former Emperor Haile Selassie was a founder of the Organization of African Unity (OAU), now known as the African Union (AU). Addis Ababa also hosts the UN Economic Commission for Africa. Ethiopia is also a member of the Intergovernmental Authority on Development, a Horn of Africa regional grouping.<br /><br />Although nominally a member of the Non-Aligned Movement, after the 1974 revolution, Ethiopia moved into a close relationship with the Soviet Union and its allies and supported their international policies and positions until the change of government in 1991. Today, Ethiopia has good relations with the United States and the West, especially in responding to regional instability and supporting counterterrorism efforts.<br /><br />Ethiopia's relations with Eritrea remained tense and unresolved following a brutal 1998-2000 border war in which an estimated 70,000 died. The two countries signed a peace agreement in December 2000. A five-member independent international commission--the Eritrea Ethiopia Boundary Commission (EEBC)--issued a decision in April 2002 delimiting the border. <br /><br />In November 2007 the EEBC issued a decision that the border was demarcated based on map coordinates (usual demarcation based on pillars on the ground had not yet occurred due to disagreement between Ethiopia and Eritrea) and disbanded. Ethiopia does not consider the border to be demarcated, though Eritrea does. <br /><br />In July 2008 the United Nations Mission in Ethiopia and Eritrea (UNMEE) peacekeeping mission was terminated due to Eritrean restrictions impeding its ability to operate. Both countries have stationed approximately 100,000 troops along the border, which has become more dangerous due to the departure of UNMEE.<br /><br /> Both countries insist they will not instigate fighting, but both also remain prepared for any eventuality. Regarding its neighbor Somalia, the weakness of the Transitional Federal Government (TFG) and factional fighting in Somalia contributes to tensions along the boundaries of the two countries. Ethiopia recently entered into a loose tripartite (nonmilitary) cooperation with Sudan and Yemen.<br /><br />The irredentist claims of the extremist-controlled Council of Islamic Courts (CIC) in Somalia in 2006 posed a legitimate security threat to Ethiopia and to the TFG of Somalia. In December 2006, the TFG requested the assistance of the Ethiopian military to respond to the CIC's aggression. <br /><br />Within a few weeks, the joint Ethiopian-TFG forces routed the CIC from Somalia. Subsequently, Ethiopia stationed troops in Somalia (largely around Mogadishu), awaiting full deployment of the African Union's Mission in Somalia (AMISOM). <br /><br />However, the slow buildup of AMISOM troop levels pushed the Ethiopian Government to announce that its army would withdraw from the country in a matter of weeks. By the end of January 2009, all of its 3,000-4,000 troops had left the country. While Ethiopia does not currently have a military presence in Somalia, it is highly cognizant of the ongoing conflict as a key national security concern.<br /><br />U.S.-ETHIOPIA RELATIONS <br /><br />U.S.-Ethiopian relations were established in 1903 and were good throughout the period prior to the Italian occupation in 1935. After World War II, these ties strengthened on the basis of a September 1951 treaty of amity and economic relations. <br /><br />In 1953, two agreements were signed: a mutual defense assistance agreement, under which the United States agreed to furnish military equipment and training, and an accord regularizing the operations of a U.S. communication facility at Asmara.<br /><br /> Through fiscal year 1978, the United States provided Ethiopia with $282 million in military assistance and $366 million in economic assistance in agriculture, education, public health, and transportation. A Peace Corps program emphasized education, and U.S. Information Service educational and cultural exchanges were numerous.<br /><br />After Ethiopia's revolution, the bilateral relationship began to cool due to the Derg's linking with international communism and U.S. revulsion at the Derg's human rights abuses. The United States rebuffed Ethiopia's request for increased military assistance to intensify its fight against the Eritrean secessionist movement and to repel the Somali invasion. <br /><br />The International Security and Development Act of 1985 prohibited all U.S. economic assistance to Ethiopia with the exception of humanitarian disaster and emergency relief. In July 1980, the U.S. Ambassador to Ethiopia was recalled at the request of the Ethiopian Government, and the U.S. Embassy in Ethiopia and the Ethiopian Embassy in the United States were headed by Charges d'Affaires.<br /><br />With the downfall of the Mengistu regime, U.S.-Ethiopian relations improved dramatically. Legislative restrictions on assistance to Ethiopia other than humanitarian assistance were lifted. Diplomatic relations were upgraded to the ambassadorial level in 1992. Total U.S. Government assistance, including food aid, between 1991 and 2003 was $2.3 billion. <br /><br />The U.S. Government provided $455 million in assistance in FY 2008, $337 million of it for combating HIV/AIDS. In addition, the U.S. Government donated more than $550 million in food assistance in 2008 to help the government cope with a severe drought.<br /><br />Today, Ethiopia is an important partner of the United States in regional security and counterterrorism efforts. U.S. development assistance to Ethiopia is focused on reducing famine vulnerability, hunger, and poverty and emphasizes economic, governance, and social sector policy reforms.<br /><br /> Some military training funds, including training in such issues as the laws of war and observance of human rights, also are provided but are explicitly limited to non-lethal assistance and training.<br /><br />Principal U.S. Officials <br />Charge d'Affaires--Roger A. Meece <br />Deputy Chief of Mission--Tulinabo Mushingi<br /><br />Chiefs of Sections <br />Management--Alan Roecks<br />Consular--Abigail Rupp<br />Political/Economic--Kirk McBride<br />U.S. Agency for International Development (USAID)--Tom Staal<br />Defense Attaché Officer--Col. Brad Anderson<br />Public Affairs--Alyson Grunder<br /><br />The address and telephone/fax numbers for the U.S. Embassy in Ethiopia are P.O. Box 1014, Entoto Street, Addis Ababa, Ethiopia (tel: 251/11/517-40-00; fax: 251/11/517-40-01). The U.S. Embassy's Washington address is: 2030 Addis Ababa Place, Washington, DC, 20521-2030. Embassy website: http://ethiopia.usembassy.gov/.<br /><br />TRAVEL AND BUSINESS INFORMATION<br /><br />The U.S. Department of State's Consular Information Program advises Americans traveling and residing abroad through Country Specific Information, Travel Alerts, and Travel Warnings. Country Specific Information exists for all countries and includes information on entry and exit requirements, currency regulations, health conditions, safety and security, crime, political disturbances, and the addresses of the U.S. embassies and consulates abroad. <br /><br />Travel Alerts are issued to disseminate information quickly about terrorist threats and other relatively short-term conditions overseas that pose significant risks to the security of American travelers. Travel Warnings are issued when the State Department recommends that Americans avoid travel to a certain country because the situation is dangerous or unstable.<br /><br />For the latest security information, Americans living and traveling abroad should regularly monitor the Department's Bureau of Consular Affairs Internet web site at http://www.travel.state.gov, where the current Worldwide Caution, Travel Alerts, and Travel Warnings can be found. Consular Affairs Publications, which contain information on obtaining passports and planning a safe trip abroad, are also available at http://www.travel.state.gov. For additional information on international travel, see http://www.usa.gov/Citizen/Topics/Travel/International.shtml.<br /><br />The Department of State encourages all U.S. citizens traveling or residing abroad to register via the State Department's travel registration website or at the nearest U.S. embassy or consulate abroad. Registration will make your presence and whereabouts known in case it is necessary to contact you in an emergency and will enable you to receive up-to-date information on security conditions.<br /><br />Emergency information concerning Americans traveling abroad may be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or the regular toll line 1-202-501-4444 for callers outside the U.S. and Canada.<br />The National Passport Information Center (NPIC) is the U.S. Department of State's single, centralized public contact center for U.S. passport information. Telephone: 1-877-4-USA-PPT (1-877-487-2778); TDD/TTY: 1-888-874-7793. Passport information is available 24 hours, 7 days a week. You may speak with a representative Monday-Friday, 8 a.m. to 10 p.m., Eastern Time, excluding federal holidays.<br /><br />Travelers can check the latest health information with the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia. A hotline at 800-CDC-INFO (800-232-4636) and a web site at http://wwwn.cdc.gov/travel/default.aspx give the most recent health advisories, immunization recommendations or requirements, and advice on food and drinking water safety for regions and countries. The CDC publication "Health Information for International Travel" can be found at http://wwwn.cdc.gov/travel/contentYellowBook.aspx.<br /><br />Further Electronic Information<br /><br />Department of State Web Site. Available on the Internet at http://www.state.gov, the Department of State web site provides timely, global access to official U.S. foreign policy information, including Background Notes and daily press briefings along with the directory of key officers of Foreign Service posts and more.<br /><br /> The Overseas Security Advisory Council (OSAC) provides security information and regional news that impact U.S. companies working abroad through its website http://www.osac.gov<br /><br />Export.gov provides a portal to all export-related assistance and market information offered by the federal government and provides trade leads, free export counseling, help with the export process, and more.<br /><br />STAT-USA/Internet, a service of the U.S. Department of Commerce, provides authoritative economic, business, and international trade information from the Federal government. The site includes current and historical trade-related releases, international market research, trade opportunities, and country analysis and provides access to the National Trade Data Bank.<br /> <br /> <br /><br /> <br />Belai Habte-Jesus, MD, MPH<br />Global Strategic Enterprises, Inc. 4 Peace & Prosperity<br />Win-win synergestic Partnership 4P&P-focusing on<br />5Es: Education+Energy+Ecology+Economy+Enterprises<br />www.Globalbelai4u.blogspot.com; Globalbelai@yahoo.com<br />V: 571.225.5731; C: 703.933.8738; F: 703.531.0540<br />Our Passion is to reach our Individual and Collective Potenti<br /><br /><br />Ethiopia's relations with Eritrea<br />...<br /><br />[Message clipped] View entire messageGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-85845704955931869712010-04-21T13:13:00.001-07:002010-04-21T13:15:31.334-07:00Will IPad cannibalize the Lap Tod Industries and not just Mac SalesGlobal7 the new Millennial Renaissance Vision for the Globe<br /><br />Will iPad cannibalize Mac sales?<br />By Joe Wilcox | Published April 21, 2010, 2:01 PM<br />Print ArticleE-mail Article<br />4 Comments<br /><br />Clearly Apple is preparing for such a circumstance, or that's my interpretation of last night's fiscal 2010 second quarter earnings call. The question isn't if iPad will cannibalize Mac sales but when. If the cannibals are coming, they'll first strike during back-to-school buying season.<br /><br />Apple CFO Peter Oppenheimer tipped off the company's thinking early in the conference call: "We expect gross margins to be about 36 percent down from 41.7 percent in the March quarter and reflecting approximately $36 million related to stock based compensation expense. We expect about 25 percent of the sequential gross margin decline to be driven by the first quarter of iPad sales." Whoa, one-quarter?<br /><br /> "As we said in January when we announced the iPad we have been very aggressive with pricing and are delivering tremendous value to customers," Oppenheimer asserted. "We think the market for the iPad will be large, and we want to capitalize on our first-mover advantage."<br /><br />There are two intertwined issues related to Oppenheimer's statements: Mac cannibalization and margins. I'll start with margins. Whenever Apple launches a new product, the company absorbs additional upfront costs. Apple secrecy means that CEO Steve Jobs announces his "one more thing" product on Day X but availability is Weeks Y or Months Z later. Manufacturing ramps up in earnest after the product announcement, which is atypical of most industries. To get the product from Asia to Western retail, Apple typically absorbs higher upfront airfreight costs.<br /><br />This dynamic is one reason why purchasers of new "one more thing" products pay more upfront. Their privilege of being among the first buyers helps to soften the blow Apple's cockeyed manufacturing and distribution system places on margins. This process is underway now in the United States, and Apple will repeat it in nine additional countries next month.<br /><br />Margins Teardown<br /><br />Based on various iPad teardowns, the tablet's base hardware cost ranges from $230 to $300. The teardown by iSuppli puts the $499 iPad product cost around $260 and $348.10 for the $699 model (both are WiFi; 3G models ship next week in the United States). By comparison, Apple makes oodles more on iPhone. <br /><br />Right after iPhone 3GS launched, iSuppli put component cost at around $179. While consumers pay $199 for the smartphone, carrier AT&T subsidizes what Apple charges, which is in the $500-$600 range (ASP is $600, according to Apple, which includes 32GB model). Additionally, falling component prices and economies of scale should put Apple's iPhone 3GS margins much higher today than June 2009.<br /><br />Like iPhone and Mac products, Apple's base profit for iPad is pretty good. However, the aforementioned higher initial manufacturing and distribution costs sap profits by as much as half (based on my guesstimates). <br /><br />Assuming Oppenheimer is right about iPad demand, greater upfront sales volume would further sap margins, since Apple would pay more to get the product to market before achieving benefits from economies of scale. Higher sales volume would mean lower margins and a lowering of broder Apple margins.<br />During yesterday's Apple conference call, Sanford Bernstein analyst Toni Sacconaghi put startling perspective on Apple's falling margin guidance and iPad's contribution to it:<br />Let me just switch to one other topic if I may and Peter I think this is probably for you. Bear with me, I'm gonna, I'm gonna just plug through some numbers. You said gross margin is going to decline 600 basis points sequentially in the quarter that would be due to the iPad. So that is 150 basis point negative impact from the iPad.<br /><br /><br />If you assume the iPad is 10 points lower gross margin than the company average which is way, way lower than most, you know, third-party tear-down services which it would suggest it basically means for that contribution to be true for your guidance iPad would need to be 15 percent of your revenue or $2 billion. <br /><br />So either iPad is gonna be more than $2 billion in terms of revenue per your guidance for next quarter and have a gross margin that is less than 10 points less than the company average or the gross margins of the iPad are more than 10 points lower than the company average.<br /><br />Apple COO Timothy Cook partly dodged, party answered the question, nearly repeating what Oppenheimer said earlier in the call:<br /><br />I would point out that when we priced iPad we priced it very aggressively in order to deliver tremendous value to our customers. We think the market size for the iPad is very large, and we want to capitalize on our first mover advantage. So, as we have done in other products, although I am not forecasting it, you can see that we have a good track record of writing down the cost curves with value engineering and volume manufacturing or at least that's certainly been our experience with other products.<br /><br />For iPad to reach 15 percent of revenue, Apple would have to ship 3.3 million units at an average selling price of $600 or 4 million at $500 ASP. The impact on margins would be colossal. But the margin pulldown could be just as strong if Apple shipped 1-2 million iPads, in process cannibalizing some Mac sales.<br /><br />Wading the Price Gap<br /><br />Until iPad, Apple computer selling prices were quite high, with the $999 white Macbook being entry point for most people to join the elite -- some might say elitist -- Mac club. In February, I reported that "Nine out of 10 premium PCs sold at retail is a Mac." Apple sells high and also reaps some of the highest margins in the tech industry. The Mac tablet changes the dynamic. Now, suddenly, the cheapest, functional Mac you can buy is $499, filling a hole between $399 and $999.<br /><br />As I explained in a separate late-January post, "iPad fills a gaping hole in the Mac product line between the aforementioned $399 and $999." Various iPad models sell between $429 and $829. "Apple now offers portable computers -- and that's how I classify iPhone, iPod touch and iPad along with Macs -- ranging from $99 to $2,499. From a pricing strategy perspective, iPad is a brilliant product, because it fills the gap between iPhone/iPod touch and Macbook without price cuts or risk to the Mac's premium brand status."<br /><br />But there is risk to Mac sales, which would be greater during back-to-school buying season than any other time of year. Suddenly the cheapest Mac that schools can buy costs $499, too. Particularly for K-12 institutions, iPad could be a viable alternative to MacBook, particularly with budgets crimped by the lingering effects of recession on the tax base. Back-to-school buying season would also be the test of iPad's sales mettle, whether or not the product can succeed or will be doomed to ruin like the Power Mac G4 Cube. Low back-to-school iPad sales would perhaps be worse than many.<br /><br />There are positive benefits to consider, as well -- schools that: might not buy any Apple product this year, otherwise would purchase Windows PCs or would swap out Macs for Windows computers; because of price. Now they could buy iPad. By whatever measure of increasing sales -- higher in general or cannibalizing Mac sales -- iPad would crimp Apple margins.<br /><br />Yesterday, RBC Capital Markets analyst Mike Abramsky asked the obvious question: "Just wondering why you didn't see, or whether you expect any touch cannibalization from the iPad and what is your sense or do you think iPad is cannibalizing maybe competitive netbooks?"<br /><br />Cook responded:<br /><br />I can only tell you in the quarter we finished, Q2 that we finished in March. Although we announced the iPad in January there was nothing obvious in the iPod numbers or the Mac numbers to suggest cannibalization. There is an obvious difference announcing and people know it is coming and it is starting to sell.<br /><br /> So that part of the equation we don't know yet. We will find out. We are thrilled with how the iPad is selling and the enormous response that we have received. We also announced new MacBook Pros that you probably saw last week and the whole line change. So we are also happy about how the Mac business is positioned and the level of product innovation in those notebooks. It is enormous. It is taking battery life up to 10 hours. That is absolutely amazing.<br /><br />That's executive-speak for: "Yeah, we think so but aren't sure and so don't want to say for fear of causing a run on Apple shares." On the one hand, Cook lets be the possibility of cannibalization, while at the same time emphasizing newly upgraded MacBook Pros. The response is oh-so media-trained executive deflection. Media professionals teach executives at companies like Apple to deflect tough questions by ignoring them and shifting focus to strengths.<br /><br />Of course, Apple executives expect at least some cannibalization of Macs by iPad. Apple's iPad pricing tells the story -- the aforementioned filling the pricing gap between $399 and $999. Then there is the guidance about margins declines to consider. Cannibalization is inevitable. The questions are: "When?" and "By how much?" Will there be a big surge of iPad orders during back-to-school season or will the lower pricing release pent-up sales among consumers pining for a Mac but unwilling or unable to spend $999? Or both?<br /><br />[Editor's Note: I initially used quotes provided courtesy of Seeking Alpha but corrected them after re-listening to Apple's FY 2010 Q2 conference call.]<br />Print ArticleE-mail Article<br /><br />4 CommentsAdd a CommentYou must be logged in to post comments.<br />View comments by with a score of at least <br />ece Apr 21, 2010 - 2:58 PM edited<br />That's it, leaving ABN, might as well go to gizmodo, at least I get news beyond Apple even if their practices may be shady...<br /><br />Score: -1<br />|Post Reply Parv Apr 21, 2010 - 2:47 PM<br />an ipad is not a replacement for a mac (you cannot sync without a mac!!). It may replace a laptop but only if you have a desktop.<br /><br />I will no longer buy a macbook pro. Instead I will buy an imac and an ipad. (probably more than one ipad since i have 2 kids).<br />Score: -1<br />|Post Reply Niro Apr 21, 2010 - 3:27 PM edited<br />"an ipad is not a replacement for a mac (you cannot sync without a mac!!). It may replace a laptop but only if you have a desktop."<br /><br />Uh...no. If I understand correctly, you just need itunes to activate your ipad. Everything else you can pretty much do on the ipad (as limited as what you CAN actually do is)...you can do that with a $200 netbook...or a friends computer. The whole idea of you needing to plug it in to a pc just to activate it with itunes is ridiculous if you ask me, but that's Apple for you. I wonder if the 3G model will have the same "requirement".<br />Score: -1<br /><br />|Post Reply rebradley Apr 21, 2010 - 2:46 PM<br />More iPad news on ABN (AppleBetaNews), the newest voice of the Apple press corps.<br />Score: -1<br />|Post Reply<br /><br />Adobe gives up on Flash for iPhone and iPad, but leaves the door open<br />You can use the tools Adobe created for CS5 developers to make Flash apps for the next iPhone OS, but at your own risk, says a company product manager.<br /><br />Apple Q2 2010 by the numbers: Best non-holiday quarter ever<br />Apple revenue grew 49 percent, beating Wall Street consensus by more than $1 billion and earnings by nearly 90 cents a share.<br /><br />Global privacy leaders to Google: We hope Buzz taught you a lesson<br />How does Google recover from the negative attention heaped upon Buzz in the wake of privacy failures? Hopefully, say world leaders, not by just being Google.<br /><br />Apple should sue Gizmodo over stolen iPhone prototype<br />Gadget geeks' desire to know doesn't supplant a company's right to protect trade secrets. Gizmodo did more than cross the line here. The blog lept a chasm no less wide than the Grand Canyon. The legal ramifications could, and quite probably should, be as deep.<br /><br />Twelve billion iBalls fall into Gizmodo's lap<br />Carmi Levy | Wide Angle Zoom: While we present polite applause to the tech blog for showing us Apple's secrets, shouldn't we care that theft happened here?<br /><br />Firefox starts reining in Flash, Silverlight, QuickTime<br />The latest point release to the leading alternative browser will run major plug-ins as protected processes, but Mozilla needs more people to test it now.<br /><br />Another service named 'Buzz?' What gives?<br />Today, AT&T launched the public beta of its social media implementation of the Yellow Pages called Buzz.com<br /><br />3G iPads, new AT&T data plans, arrive on April 30<br />Apple announced today that the 3G-equipped iPad will be available in U.S. retailers on April 30 at 5:00pm.<br /><br />New Facebook 'Connections' may expose users' likes, filter likes from profiles<br />If you're fond of some special hobby or band or person, you can make that fact known to just about everyone on Facebook. Or perhaps you already have.<br /><br />Palm's browser-based webOS development tool leaves beta<br />Palm has released Project Ares 1.0, the first complete version of Palm's Web-based development environment.<br /><br />Microsoft fixes Windows: Automated troubleshooter encourages assistance<br />An alternative to the blue screen of death, Microsoft's latest Fix-It Center of tool offers a white window of hope.<br /><br />Go to Fileforum<br />True Launch Bar 4.4.8 Beta<br />April 21 - 3:00 PM ET<br />Microsoft SQL Server JDBC Driver 3.0.1.301.01<br />April 21 - 2:39 PM ET<br />Spider 2.4.3<br />April 21 - 2:18 PM ET<br />PC Wizard 2010.1.94<br />April 21 - 1:57 PM ET<br />Canon RAW Codec 1.7.0<br />April 21 - 1:36 PM ET<br />Free Download Manager 3.4 Build 902 Alpha<br />April 21 - 1:15 PM ET<br />Opera (v10.52) 10.52 Build 3367 Beta<br />April 21 - 12:54 PM ETGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-90400060132056911202010-04-19T11:39:00.000-07:002010-04-19T12:23:22.057-07:00African Millennial Renaissance announces a new Political Action Group Network for People of African DescentGlobal7 the new Millennial Renaissance Vision for the Globe<br /><br />Strategy for Continuous Improvement of the Unique Heritage of People of African Descent!<br /> <br />Improving US-Africans-Ethiopia & Africa Relations in the Period of African Millennium Renaissance Network<br /> <br />– the case of African-American-Ethiopian Political Action Group (AAEPAC)<br /> <br />Introduction<br /> <br />The African Millennium Renaissance is launching the AAEPAC Network as a tool for improving the plight of one billion people of African Decent by promoting a unique and powerful political action Group called AAEPAC to galvanize the vision and mission of its youth and new leadership around the globe.<br /> <br />The Challenge<br /> <br />The global ecological, economic and security challenges demand a unique interactive response that matches the Intricacies and complexities of the impending threats to our security and survival.<br /> <br />One Billion and counting! Today, the people of African descent are scattered all over the world and have reached the unique One billion statistics where some 800 million reside in Africa and the rest 200 million around the world with the majority in Northern America, Caribbean and Latin America mainly in the USA, and Brazil.<br /> <br />The African Millennium Renaissance demands that we galvanize our resources and talents in a unique network of African Millennium Renaissance. Ethiopia is home of the African Union and the original Nile Basin Civilization that is recorded in historical, anthropological, scientific and faith literatures as home to ARDI, Lucy, Selam, Adam and Eve, etc. It is truly the cradle of African Civilization.<br /> <br />The US and Ethiopian/African Unique Place in history<br /> <br />The US-Ethiopia /Africa Diplomatic Relations has lasted more than one century and is one of the strongest alliances in Africa and the Middle East Region.<br /> <br />Seats of Global Good Governance institutions. The US is the seat of United Nations, whereas Ethiopia is the seat of African Union and the UN African Economic Commission. The advent of global climate and economic challenges is demanding that the US and Africa lead in the unique role of ensuring the sources of clean energy like Solar, Hydro and Wind energy are harnessed to its maximum. <br /> <br />The Centers of Global Diplomatic hub. Africa and the US and especially Ethiopia are both countries are centers of diplomatic and international affairs not that is not matched by any other set of countries for its diversity, and global reach.<br /> <br />The Unique Ethio-American/African relationship is based on common shared value of democracy, good governance, sustainable development, trade and investment supported by common shared global and regional peace and security.<br /> <br />The Opportunity<br /> <br />Ethiopia at the heart of US-Africa Relations. Ethiopia seeks a strong US-Ethiopia relationship as it is undergoing unique modern Millennial Renaissance transformations by builds its five pillars of infrastructure in innovative Education, clean Energy, sustainable ecology and creative enterprises and rapidly growing economic ventures as it develops its ICT (Information, Communication and Technology) capacity to integrate its system with global economies.<br /> <br />Synergy of the old and new. As one of the oldest civilizations in the world, Ethiopia offers a unique perspective on the global stage and continues to lead in critical issues such as the Global Climate Change movement for sustainable development by harnessing its clean energy sources such as hydro and solar energy.<br /> <br />Win-Win Partnerships! The US is in a special stage in its development as it seeks international support for its efforts to stabilize global economy and the every changing security challenges around the world. Ethiopia is at present the only island of Good Governance in a sea of instability and insecurity in the Horn, Africa and the Middle East. The current fourth series of modern elections is to take place on 23 May 2010, making Ethiopia one of the unique democratic transition countries in the Horn.<br /> <br />Island of Good Governance. The Good Governance and democratic efforts have to be supported by the US Government, Congress, Senate and several private for profit and non profit institutions that includes the US Government ran communication centers like the VoA and other private Human Rights and Development institutions including the Unite Nations and the World Bank series of institutions that have their headquarters in New York and Washington, DC. respectively.<br /> <br />The Strategic Solution.<br /> <br />Win-Win Partnerships! The strategic solution to global challenges and opportunities lies in creating a unique Partnership for Sustainable development with the establishment of the African-Ethiopian American Political Action Group that will transform this unique relationship and the future of one billion people of African descent.<br /> <br />After all- We are all Ethiopians! After, all according to the Discovery Channel ARDI producers, we are all Ethiopians, African and Americans due to our common shared ancestory of ARDI, LUCY and SELMAM. We are all Ethiopians and children of one race of humanity!<br /> <br />The AAEPAC is a unique instrument for changing the current status quo by ensuring our common shared values and destinies are protected and promoted in all field of life including the 5Es or pillars of this Unique partnership;<br /> <br />E1= Education. Innovative Education that produces solutions to our changing challenges in the 21st Century:<br /><br />E2= Energy: Clean Energy by harnessing the natural sources of Solar, Wind, Hydro powers<br />E3= Ecology: Sustainable ecology that utilizes clean energy sources to sustain biodiversity<br />E4= Economy. Creative, free, fair and accountable economy to the local and global community<br />E=5= Enterprises. Unleashing the creative energies and enterprises of small business enterprises<br /> <br />The AAEPAC. The AAEPAC is established to promote prosperity and security for all. Our Passion is to reach our individual and collective potential for Success and Excellence and ask all good intentioned global citizens to join us.<br /> <br /> <br />For further information and membership to this unique opportunity please do not hesitate to contact us;<br /> <br />Belai Habte-Jesus, MD, MPH<br />African Millennium Renaissance.<br />GlobalBJesus@gmail.com<br />703.933.8737<br />www.AfricanRenaissance.com<br /> <br /> <br />Changing the Status Quo of hopeless ness to creative enterprises of prosperity!<br /> <br /> <br /> <br />Background Reading on US-Ethiopia Relations – The Challenges is Change!<br /> <br /> <br /> <br /> <br /> <br /> <br />Home » Under Secretary for Public Diplomacy and Public Affairs » Bureau of Public Affairs » Bureau of Public Affairs: Electronic Information and Publications Office » Background Notes » Ethiopia (12/09)<br />Background Note: Ethiopia<br /><br /> <br /><br /><br />December 2009<br />Bureau of African Affairs<br /><br />Obelisk in Axum, Ethiopia, April 1, 2005. [© AP Images]<br /><br /><br /><br />PROFILE<br /><br />OFFICIAL NAME: <br />Federal Democratic Republic of Ethiopia<br /><br />Geography <br /><br />Area: 1.1 million sq. km (472,000 sq. mi.); about the size of Texas, Oklahoma, and New Mexico combined. <br /><br />Cities: Capital--Addis Ababa (pop. 5 million). Other cities--Dire Dawa (237,000), Nazret (189,000), Gondar (163,000), Dessie (142,000), Mekelle (141,000), Bahir Dar (140,000), Jimma (132,000), Awassa (104,000). <br /><br />Terrain: High plateau, mountains, dry lowland plains. <br />Climate: Temperate in the highlands; hot in the lowlands. <br /><br />People <br />Nationality: Noun and adjective--Ethiopian(s). <br />Population (est.): 80 million.<br /><br />Annual growth rate (est.): 3.2%.<br />Ethnic groups (est.): Oromo 40%, Amhara 25%, Tigre 7%, Somali 6%, Sidama 9%, Gurage 2%, Wolaita 4%, Afar 4%, other nationalities 3%.<br /><br />Religions (est.): Ethiopian Orthodox Christian 40%, Sunni Muslim 45-50%, Protestant 5%, remainder indigenous beliefs. <br /><br />Languages: Amharic (official), Tigrinya, Arabic, Guaragigna, Oromifa, English, Somali. <br /><br />Education: Years compulsory--none. Attendance (elementary)--57%. Literacy--43%. <br />Health: Infant mortality rate--93/1,000 live births. <br />Work force: Agriculture--80%. Industry and commerce--20%.<br /><br />Government <br />Type: Federal republic.<br /><br />Constitution: Ratified 1994. <br /><br />Branches: Executive--president, Council of State, Council of Ministers. Executive power resides with the prime minister. Legislative--bicameral parliament. Judicial--divided into federal and regional courts. <br /><br />Administrative subdivisions: 9 regions and 2 special city administrations: Addis Ababa and Dire Dawa.<br /><br />Political parties: Ethiopian People's Revolutionary Democratic Front (EPRDF), the Unity for Democracy and Justice (UDJ) party, the United Ethiopian Democratic Forces (UEDF), Oromo Federalist Democratic Movement (OFDM), and other small parties. <br />Suffrage: Universal starting at age 18.<br /><br />Central government budget (2006 est.): $3.4 billion.<br />Defense: $348 million (5.6% of GDP FY 2003).<br />National holiday: May 28.<br /><br />Economy <br />GDP (FY 2007-2008): $26.6 billion.<br />Annual growth rate (2008): 8.5%. <br /><br />GDP per capita (2008, PPP): $800. <br />Average inflation rate (FY 2008-2009): 36%.<br /><br />Natural resources: Potash, salt, gold, copper, platinum, natural gas (unexploited). <br />Agriculture (45% of GDP): Products--coffee, cereals, pulses, oilseeds, khat, meat, hides and skins. Cultivated land--17%. <br /><br />Industry (13% of GDP): Types--textiles, processed foods, construction, cement, and hydroelectric power. <br />Services (42% of GDP). <br /><br />Trade (2008): Exports--$1.5 billion. Imports--$6.8 billion; plus remittances--official est. $970 million; unofficial est. $815 million.<br />Fiscal year: July 8-July 7.<br /><br />GEOGRAPHY <br /><br />Ethiopia is located in the Horn of Africa and is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. The country has a high central plateau that varies from 1,800 to 3,000 meters (6,000 ft.-10,000 ft.) above sea level, with some mountains reaching 4,620 meters (15,158 ft.).<br /><br />Elevation is generally highest just before the point of descent to the Great Rift Valley, which splits the plateau diagonally. A number of rivers cross the plateau--notably the Blue Nile flowing from Lake Tana. The plateau gradually slopes to the lowlands of the Sudan on the west and the Somali-inhabited plains to the southeast.<br /><br />The climate is temperate on the plateau and hot in the lowlands. At Addis Ababa, which ranges from 2,200 to 2,600 meters (7,000 ft.-8,500 ft.), maximum temperature is 26o C (80o F) and minimum 4o C (40o F). The weather is usually sunny and dry with the short (belg) rains occurring February-April and the big (meher) rains beginning in mid-June and ending in mid-September.<br /><br />PEOPLE <br /><br />Ethiopia's population is highly diverse. Most of its people speak a Semitic or Cushitic language. The Oromo, Amhara, and Tigreans make up more than three-fourths of the population, but there are more than 77 different ethnic groups with their own distinct languages within Ethiopia.<br /><br />Some of these have as few as 10,000 members. In general, most of the Christians live in the highlands, while Muslims and adherents of traditional African religions tend to inhabit lowland regions. English is the most widely spoken foreign language and is taught in all secondary schools. Amharic is the official language and was the language of primary school instruction but has been replaced in many areas by local languages such as Oromifa and Tigrinya.<br /><br />HISTORY <br /><br />Hominid bones discovered in eastern Ethiopia dating back 4.4 million years make Ethiopia one of the earliest known locations of human ancestors. Ethiopia is the oldest independent country in Africa and one of the oldest in the world. Herodotus, the Greek historian of the fifth century B.C., describes ancient Ethiopia in his writings. <br /><br />The Old Testament of the Bible records the Queen of Sheba's visit to Jerusalem. According to legend, Menelik I, the son of King Solomon and the Queen of Sheba, founded the Ethiopian Empire. Missionaries from Egypt and Syria introduced Christianity in the fourth century A.D.<br /><br /> Following the rise of Islam in the seventh century, Ethiopia was gradually cut off from European Christendom. The Portuguese established contact with Ethiopia in 1493, primarily to strengthen their influence over the Indian Ocean and to convert Ethiopia to Roman Catholicism. <br /><br />There followed a century of conflict between pro- and anti-Catholic factions, resulting in the expulsion of all foreign missionaries in the 1630s. This period of bitter religious conflict contributed to hostility toward foreign Christians and Europeans, which persisted into the 20th century and was a factor in Ethiopia's isolation until the mid-19th century.<br /><br />Under the Emperors Theodore II (1855-68), Johannes IV (1872-89), and Menelik II (1889-1913), the kingdom was consolidated and began to emerge from its medieval isolation. When Menelik II died, his grandson, Lij Iyassu, succeeded to the throne but soon lost support because of his Muslim ties. The Christian nobility deposed him in 1916, and Menelik's daughter, Zewditu, was made empress. Her cousin, Ras Tafari Makonnen (1892-1975), was made regent and successor to the throne. <br /><br />In 1930, after the empress died, the regent, adopting the throne name Haile Selassie, was crowned emperor. His reign was interrupted in 1936 when Italian Fascist forces invaded and occupied Ethiopia. The emperor was forced into exile in England. Five years later, British and Ethiopian forces defeated the Italians, and the emperor returned to the throne.<br /><br />Following civil unrest, which began in February 1974, the aging Haile Selassie I was deposed on September 12, 1974 by a provisional administrative council of soldiers, known as the Derg ("committee"). The Derg seized power, installing a government that was socialist in name and military in style. It then summarily executed 59 members of the royal family and ministers and generals of the emperor's government; Emperor Haile Selassie I was strangled in the basement of his palace on August 22, 1975.<br /><br />Lt. Col. Mengistu Haile Mariam assumed power as head of state and Derg chairman, after having his two predecessors killed. Mengistu's years in office were marked by a totalitarian-style government and the country's massive militarization, financed by the Soviet Union and the Eastern Bloc, and assisted by Cuba. <br /><br />From 1977 through early 1978 thousands of suspected enemies of the Derg were tortured and/or killed in a purge called the "red terror." Communism was officially adopted during the late 1970s and early 1980s with the promulgation of a Soviet-style constitution, Politburo, and the creation of the Workers' Party of Ethiopia (WPE).<br /><br />In December 1976, Ethiopia signed a military assistance agreement with the Soviet Union. The following April, Ethiopia abrogated its military assistance agreement with the United States and expelled the American military missions.<br /><br /> In July 1977, sensing the disarray in Ethiopia, Somalia attacked across the Ogaden Desert in pursuit of its irredentist claims to the ethnic Somali areas of Ethiopia. Ethiopian forces were driven back deep inside their own frontier but, with the assistance of a massive Soviet airlift of arms and Cuban combat forces, they stemmed the attack. The major Somali regular units were forced out of the Ogaden in March 1978.<br /><br />The Derg's collapse was hastened by droughts, famine, and insurrections, particularly in the northern regions of Tigray and Eritrea. In 1989, the Tigrayan People's Liberation Front (TPLF) merged with other ethnically based opposition movements to form the Ethiopian Peoples' Revolutionary Democratic Front (EPRDF). In May 1991, EPRDF forces advanced on Addis Ababa. Mengistu fled the country for asylum in Zimbabwe, where he still resides.<br /><br />In July 1991, the EPRDF, the Oromo Liberation Front (OLF), and others established the Transitional Government of Ethiopia (TGE) comprised of an 87-member Council of Representatives and guided by a national charter that functioned as a transitional constitution. In June 1992 the OLF withdrew from the government; in March 1993, members of the Southern Ethiopia Peoples' Democratic Coalition left the government.<br /><br />In May 1991, the Eritrean People's Liberation Front (EPLF), led by Isaias Afwerki, assumed control of Eritrea and established a provisional government. This provisional government independently administered Eritrea until April 23-25, 1993, when Eritreans voted overwhelmingly for independence in a UN-monitored free and fair referendum. Eritrea, with Ethiopia’s consent, was declared independent on April 27. The United States recognized its independence the next day.<br /><br />In Ethiopia, President Meles Zenawi and members of the TGE pledged to oversee the formation of a multi-party democracy. The election for a 547-member constituent assembly was held in June 1994. The assembly adopted the constitution of the Federal Democratic Republic of Ethiopia in December 1994. <br /><br />The elections for Ethiopia's first popularly chosen national parliament and regional legislatures were held in May and June 1995. Most opposition parties chose to boycott these elections, ensuring a landslide victory for the EPRDF. International and non-governmental observers concluded that opposition parties would have been able to participate had they chosen to do so. The Government of the Federal Democratic Republic of Ethiopia was installed in August 1995.<br /><br />In May 1998, Eritrean forces attacked part of the Ethiopia-Eritrea border region, seizing some Ethiopian-controlled territory. The strike spurred a two-year war between the neighboring states that cost over 100,000 lives. Ethiopian and Eritrean leaders signed an Agreement on Cessation of Hostilities on June 18, 2000 and a peace agreement, known as the Algiers Agreement, on December 12, 2000. <br /><br />The agreements called for an end to the hostilities, a 25-kilometer-wide Temporary Security Zone along the Ethiopia-Eritrea border, the establishment of a United Nations peacekeeping force to monitor compliance, and the establishment of the Eritrea Ethiopia Boundary Commission (EEBC) to act as a neutral body to assess colonial treaties and applicable international law in order to render final and binding border delimitation and demarcation determinations. The United Nations Mission to Eritrea and Ethiopia (UNMEE) was established in September 2000. The EEBC presented its border delimitation decision on April 13, 2002, awarding the town of Badme and much of the disputed border region to Eritrea.<br /><br /> In November 2007, after making very little progress on encouraging Ethiopia and Eritrea to demarcate the boundary, the EEBC issued its demarcation decision by map coordinates and announced that its work was done. Ethiopia, however, refused to accept this decision. In mid-2008, under pressure from the Eritrean Government, UNMEE units were withdrawn from the region. Since then neither Ethiopia nor Eritrea has taken steps to demarcate the border.<br /><br />Opposition candidates won 12 seats in national parliamentary elections in 2000. The next national elections were held in May 2005. Ethiopia held the most free and fair national campaign period in the country’s history prior to May 15, 2005 elections. <br /><br />Unfortunately, electoral irregularities and tense campaign rhetoric resulted in a protracted election complaints review process. Public protests turned violent in June 2005. The National Electoral Board released final results in September 2005, with the opposition taking over 170 of the 547 parliamentary seats and 137 of the 138 seats for the Addis Ababa municipal council. <br /><br />Opposition parties called for a boycott of parliament and civil disobedience to protest the election results. In November 2005, Ethiopian security forces responded to public protests by arresting scores of opposition leaders, as well as journalists and human rights advocates, and detaining tens of thousands of civilians in rural detention camps for up to three months. <br /><br />In December 2005, the government charged 131 opposition, media, and civil society leaders with capital offenses including "outrages against the constitution." Key opposition leaders and almost all of the 131 were pardoned and released from prison 18 months later. As of March 2008, approximately 150 of the elected opposition members of parliament had taken their seats and currently remain in parliament. <br /><br />Ruling and opposition parties have engaged in little dialogue since the opposition leaders were freed. Government harassment made it very difficult for opposition candidates to compete in local elections in April 2008. As a result, the ruling party won more than 99% of the local seats throughout Ethiopia.<br /><br />In June 2008, former CUD vice-chairman Birtukan Mideksa was elected the party chairman of the new Unity for Democracy and Justice (UDJ) party at its inaugural session in Addis Ababa.<br /><br /> In October 2008 the Ethiopian Government arrested over 100 Oromo leaders, accusing some of being members of the outlawed Oromo Liberation Front (OLF). At the end of December 2008, after detaining Birtukan several times briefly during the month, the government re-arrested her, saying that she had violated the conditions of her pardon (she was one of the prominent opposition leaders pardoned by the government in the summer of 2007). Her original sentence of life imprisonment was reinstated.<br /><br />In April 2009 the Ethiopian Government arrested 40 individuals, mostly Amhara military or ex-military members allegedly affiliated with Ginbot 7, an external opposition party, for their suspected involvement in a terrorist assassination plot of government leaders. <br /><br />This party was founded in May 2008 in the United States by Berhanu Nega, one of the opposition leaders in the 2005 elections, and advocates for change in the government "by any means." In August 2009, the Federal High Court found 13 of the defendants guilty in absentia and one not guilty in absentia. In November 2009, the court found another 27 guilty and is seeking the death penalty for all 40 defendants.<br /><br />Presidential and parliamentary elections are scheduled to take place in May 2010. As of December 2009, however, leading opposition politicians voiced skepticism that the Ethiopian Government would permit free and fair elections. In September, the Forum for Democratic Dialogue, a coalition of major opposition parties, walked out of interparty talks after complaining that the ruling EPRDF refused to hold bilateral Forum-EPRDF talks. <br /><br />Opposition party leaders reported an intensification of harassment, arbitrary arrest, and intimidation of their supporters, especially in rural areas, nine months before the scheduled elections.<br /><br />GOVERNMENT AND POLITICAL CONDITIONS<br />Ethiopia is a federal republic under the 1994 constitution. The executive branch includes a president, Council of State, and Council of Ministers. Executive power resides with the prime minister. There is a bicameral parliament; national legislative elections were held in 2005. The judicial branch comprises federal and regional courts.<br /><br />Political parties include the Ethiopian People's Revolutionary Democratic Front (EPRDF), Unity for Democracy and Justice (UDJ), Oromo People's Congress (OPC), Arena Tigay for Democracy and Sovereignty, Oromo Federalist Democratic Movement (OFDM), Coalition for Unity and Democracy Party (CUDP), the United Ethiopian Democratic Forces (UEDF), All Ethiopia Unity Party (AEUP), and other small parties. Suffrage is universal at age 18.<br /><br />The EPRDF-led government of Prime Minister Meles Zenawi has promoted a policy of ethnic federalism, devolving significant powers to regional, ethnically based authorities. Ethiopia has 9 semi-autonomous administrative regions and two special city administrations (Addis Ababa and Dire Dawa), which have the power to raise their own revenues. Under the present government, Ethiopians enjoy wide, albeit circumscribed, political freedom.<br /><br />Principal Government Officials <br />President--Girma Wolde-Giorgis<br />Prime Minister--Meles Zenawi<br />Deputy Prime Minister--Addisu Legesse<br />Minister of National Defense--Siraj Fegisa<br />Minister of Foreign Affairs--Seyoum Mesfin <br />Mayor of Addis Ababa--Kuma Demeska<br /><br />Ethiopia maintains an embassy in the U.S. at 3506 International Drive, NW, Washington, DC 20008 (tel. 202-364-1200) headed by Ambassador Samuel Assefa. It also maintains a UN mission in New York and consulates in Los Angeles, Seattle (honorary), and Houston (honorary).<br /><br />ECONOMY <br />The current government has embarked on a cautious program of economic reform, including privatization of state enterprises and rationalization of government regulation. While the process is still ongoing, so far the reforms have attracted only meager foreign investment, and the government remains heavily involved in the economy.<br /><br />The Ethiopian economy is based on agriculture, which contributes 45% to GDP and more than 80% of exports, and employs 85% of the population. The major agricultural export crop is coffee, providing approximately 35% of Ethiopia's foreign exchange earnings, down from 65% a decade ago because of the slump in coffee prices since the mid-1990s. Other traditional major agricultural exports are leather, hides and skins, pulses, oilseeds, and the traditional "khat," a leafy shrub that has psychotropic qualities when chewed. Sugar and gold production has also become important in recent years.<br /><br />Ethiopia's agriculture is plagued by periodic drought, soil degradation caused by inappropriate agricultural practices and overgrazing, deforestation, high population density, undeveloped water resources, and poor transport infrastructure, making it difficult and expensive to get goods to market. Yet agriculture is the country's most promising resource. Potential exists for self-sufficiency in grains and for export development in livestock, flowers, grains, oilseeds, sugar, vegetables, and fruits.<br /><br />Gold, marble, limestone, and small amounts of tantalum are mined in Ethiopia. Other resources with potential for commercial development include large potash deposits, natural gas, iron ore, and possibly oil and geothermal energy. Although Ethiopia has good hydroelectric resources, which power most of its manufacturing sector, it is totally dependent on imports for oil.<br /><br /> A landlocked country, Ethiopia has relied on the port of Djibouti since the 1998-2000 border war with Eritrea. Ethiopia is connected with the port of Djibouti by road and rail for international trade. <br /><br />Of the 23,812 kilometers of all-weather roads in Ethiopia, 15% are asphalt. Mountainous terrain and the lack of good roads and sufficient vehicles make land transportation difficult and expensive. However, the government-owned airline’s reputation is excellent. Ethiopian Airlines serves 38 domestic airfields and has 42 international destinations.<br /><br />Dependent on a few vulnerable crops for its foreign exchange earnings and reliant on imported oil, Ethiopia is suffering a severe lack of foreign exchange while simultaneously battling high inflation. <br /><br />The financially conservative government has taken measures to solve these problems, including stringent import controls, focused sectors for export development, eliminated subsidies on retail gasoline prices, and capped lending limits for banks. Nevertheless, the largely subsistence economy is incapable of meeting the budget requirements for drought relief, an ambitious development plan, and indispensable imports such as oil. The gap has largely been covered through foreign assistance inflows.<br /><br />DEFENSE <br /><br />The Ethiopian National Defense Forces (ENDF) numbers about 200,000 personnel, which makes it one of the largest militaries in Africa. During the 1998-2000 border war with Eritrea, the ENDF mobilized strength reached approximately 350,000. Since the end of the war, some 150,000 soldiers have been demobilized. <br /><br />The ENDF continues a transition from its roots as a guerrilla army to an all-volunteer professional military organization with the aid of the U.S. and other countries. Training in peacekeeping operations, professional military education, military training management, counterterrorism operations, and military medicine are among the major programs sponsored by the United States. <br /><br />Ethiopia has one peacekeeping contingent in Liberia. In January 2009, Ethiopian peacekeeping troops had begun deploying in Darfur. When at full strength, the Ethiopian contingent there will consist of 2,500 troops and five attack helicopters.<br /><br />FOREIGN RELATIONS <br />Ethiopia was relatively isolated from major movements of world politics until Italian invasions in 1895 and 1935. Since World War II, it has played an active role in world and African affairs. Ethiopia was a charter member of the United Nations and took part in UN operations in Korea in 1951 and the Congo in 1960. <br /><br />Former Emperor Haile Selassie was a founder of the Organization of African Unity (OAU), now known as the African Union (AU). Addis Ababa also hosts the UN Economic Commission for Africa. Ethiopia is also a member of the Intergovernmental Authority on Development, a Horn of Africa regional grouping.<br /><br />Although nominally a member of the Non-Aligned Movement, after the 1974 revolution, Ethiopia moved into a close relationship with the Soviet Union and its allies and supported their international policies and positions until the change of government in 1991. Today, Ethiopia has good relations with the United States and the West, especially in responding to regional instability and supporting counterterrorism efforts.<br /><br />Ethiopia's relations with Eritrea remained tense and unresolved following a brutal 1998-2000 border war in which an estimated 70,000 died. The two countries signed a peace agreement in December 2000. A five-member independent international commission--the Eritrea Ethiopia Boundary Commission (EEBC)--issued a decision in April 2002 delimiting the border. <br /><br />In November 2007 the EEBC issued a decision that the border was demarcated based on map coordinates (usual demarcation based on pillars on the ground had not yet occurred due to disagreement between Ethiopia and Eritrea) and disbanded. Ethiopia does not consider the border to be demarcated, though Eritrea does. <br /><br />In July 2008 the United Nations Mission in Ethiopia and Eritrea (UNMEE) peacekeeping mission was terminated due to Eritrean restrictions impeding its ability to operate. Both countries have stationed approximately 100,000 troops along the border, which has become more dangerous due to the departure of UNMEE.<br /><br /> Both countries insist they will not instigate fighting, but both also remain prepared for any eventuality. Regarding its neighbor Somalia, the weakness of the Transitional Federal Government (TFG) and factional fighting in Somalia contributes to tensions along the boundaries of the two countries. Ethiopia recently entered into a loose tripartite (nonmilitary) cooperation with Sudan and Yemen.<br /><br />The irredentist claims of the extremist-controlled Council of Islamic Courts (CIC) in Somalia in 2006 posed a legitimate security threat to Ethiopia and to the TFG of Somalia. In December 2006, the TFG requested the assistance of the Ethiopian military to respond to the CIC's aggression. <br /><br />Within a few weeks, the joint Ethiopian-TFG forces routed the CIC from Somalia. Subsequently, Ethiopia stationed troops in Somalia (largely around Mogadishu), awaiting full deployment of the African Union's Mission in Somalia (AMISOM). <br /><br />However, the slow buildup of AMISOM troop levels pushed the Ethiopian Government to announce that its army would withdraw from the country in a matter of weeks. By the end of January 2009, all of its 3,000-4,000 troops had left the country. While Ethiopia does not currently have a military presence in Somalia, it is highly cognizant of the ongoing conflict as a key national security concern.<br /><br />U.S.-ETHIOPIA RELATIONS <br /><br />U.S.-Ethiopian relations were established in 1903 and were good throughout the period prior to the Italian occupation in 1935. After World War II, these ties strengthened on the basis of a September 1951 treaty of amity and economic relations. <br /><br />In 1953, two agreements were signed: a mutual defense assistance agreement, under which the United States agreed to furnish military equipment and training, and an accord regularizing the operations of a U.S. communication facility at Asmara.<br /><br /> Through fiscal year 1978, the United States provided Ethiopia with $282 million in military assistance and $366 million in economic assistance in agriculture, education, public health, and transportation. A Peace Corps program emphasized education, and U.S. Information Service educational and cultural exchanges were numerous.<br /><br />After Ethiopia's revolution, the bilateral relationship began to cool due to the Derg's linking with international communism and U.S. revulsion at the Derg's human rights abuses. The United States rebuffed Ethiopia's request for increased military assistance to intensify its fight against the Eritrean secessionist movement and to repel the Somali invasion. <br /><br />The International Security and Development Act of 1985 prohibited all U.S. economic assistance to Ethiopia with the exception of humanitarian disaster and emergency relief. In July 1980, the U.S. Ambassador to Ethiopia was recalled at the request of the Ethiopian Government, and the U.S. Embassy in Ethiopia and the Ethiopian Embassy in the United States were headed by Charges d'Affaires.<br /><br />With the downfall of the Mengistu regime, U.S.-Ethiopian relations improved dramatically. Legislative restrictions on assistance to Ethiopia other than humanitarian assistance were lifted. Diplomatic relations were upgraded to the ambassadorial level in 1992. Total U.S. Government assistance, including food aid, between 1991 and 2003 was $2.3 billion. <br /><br />The U.S. Government provided $455 million in assistance in FY 2008, $337 million of it for combating HIV/AIDS. In addition, the U.S. Government donated more than $550 million in food assistance in 2008 to help the government cope with a severe drought.<br /><br />Today, Ethiopia is an important partner of the United States in regional security and counterterrorism efforts. U.S. development assistance to Ethiopia is focused on reducing famine vulnerability, hunger, and poverty and emphasizes economic, governance, and social sector policy reforms.<br /><br /> Some military training funds, including training in such issues as the laws of war and observance of human rights, also are provided but are explicitly limited to non-lethal assistance and training.<br /><br />Principal U.S. Officials <br />Charge d'Affaires--Roger A. Meece <br />Deputy Chief of Mission--Tulinabo Mushingi<br /><br />Chiefs of Sections <br />Management--Alan Roecks<br />Consular--Abigail Rupp<br />Political/Economic--Kirk McBride<br />U.S. Agency for International Development (USAID)--Tom Staal<br />Defense Attaché Officer--Col. Brad Anderson<br />Public Affairs--Alyson Grunder<br /><br />The address and telephone/fax numbers for the U.S. Embassy in Ethiopia are P.O. Box 1014, Entoto Street, Addis Ababa, Ethiopia (tel: 251/11/517-40-00; fax: 251/11/517-40-01). The U.S. Embassy's Washington address is: 2030 Addis Ababa Place, Washington, DC, 20521-2030. Embassy website: http://ethiopia.usembassy.gov/.<br /><br />TRAVEL AND BUSINESS INFORMATION<br /><br />The U.S. Department of State's Consular Information Program advises Americans traveling and residing abroad through Country Specific Information, Travel Alerts, and Travel Warnings. Country Specific Information exists for all countries and includes information on entry and exit requirements, currency regulations, health conditions, safety and security, crime, political disturbances, and the addresses of the U.S. embassies and consulates abroad. <br /><br />Travel Alerts are issued to disseminate information quickly about terrorist threats and other relatively short-term conditions overseas that pose significant risks to the security of American travelers. Travel Warnings are issued when the State Department recommends that Americans avoid travel to a certain country because the situation is dangerous or unstable.<br /><br />For the latest security information, Americans living and traveling abroad should regularly monitor the Department's Bureau of Consular Affairs Internet web site at http://www.travel.state.gov, where the current Worldwide Caution, Travel Alerts, and Travel Warnings can be found. Consular Affairs Publications, which contain information on obtaining passports and planning a safe trip abroad, are also available at http://www.travel.state.gov. For additional information on international travel, see http://www.usa.gov/Citizen/Topics/Travel/International.shtml.<br /><br />The Department of State encourages all U.S. citizens traveling or residing abroad to register via the State Department's travel registration website or at the nearest U.S. embassy or consulate abroad. 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Available on the Internet at http://www.state.gov, the Department of State web site provides timely, global access to official U.S. foreign policy information, including Background Notes and daily press briefings along with the directory of key officers of Foreign Service posts and more.<br /><br /> The Overseas Security Advisory Council (OSAC) provides security information and regional news that impact U.S. companies working abroad through its website http://www.osac.gov<br /><br />Export.gov provides a portal to all export-related assistance and market information offered by the federal government and provides trade leads, free export counseling, help with the export process, and more.<br /><br />STAT-USA/Internet, a service of the U.S. Department of Commerce, provides authoritative economic, business, and international trade information from the Federal government. The site includes current and historical trade-related releases, international market research, trade opportunities, and country analysis and provides access to the National Trade Data Bank.<br /> <br /> <br /><br /> <br />Belai Habte-Jesus, MD, MPH<br />Global Strategic Enterprises, Inc. 4 Peace & Prosperity<br />Win-win synergestic Partnership 4P&P-focusing on<br />5Es: Education+Energy+Ecology+Economy+Enterprises<br />www.Globalbelai4u.blogspot.com; Globalbelai@yahoo.com<br />V: 571.225.5731; C: 703.933.8738; F: 703.531.0540<br />Our Passion is to reach our Individual and Collective Potential<br /> <br /> <br /><br /><br />--- On Mon, 4/19/10, IZell44395@aol.com <IZell44395@aol.com> wrote:<br /><br />From: IZell44395@aol.com <IZell44395@aol.com><br />Subject: Re: {EthiolistForum} +++ Zombie observers +++<br />To: ethiolistforum@googlegroups.com<br />Date: Monday, April 19, 2010, 9:13 AM<br /><br />Selam,<br /> <br />You should direct your question to the EU.<br /> <br />In a message dated 4/19/2010 8:15:32 A.M. Eastern Daylight Time, yehagerlij@yahoo.com writes:<br /><br /><br />From: Nebiy Ezekiel <nezkiel@yahoo.com><br />Sent: Sunday, April 18, 2010 2:39 PM<br />To: ethiolistforum@googlegroups.com<br />Subject: {EthiolistForum} +++ Zombie observers +++<br /><br /> <br /><br />--- On Fri, 4/16/10, IZell44395@aol.com <IZell44395@aol.com> wrote:<br /><br />From: IZell44395@aol.com <IZell44395@aol.com><br />Subject: {EthiolistForum} Re: Election observers<br />To: EEDN@HOME.EASE.LSOFT.COM, EthioForum@EthioList.com<br />Date: Friday, April 16, 2010, 7:48 AM<br /><br /> <br /> <br />Selam all,<br /> <br />According to Reuters news hereunder the EU will be sending 200 observers with a budget of 10 million dollars ($50.000.00 per observer) to the 2010 Ethiopian election organized by the TPLF/EPRDF.<br /> <br />If I remember correctly the EU sent 370 observers for the 2005 election, (budget unknown) to cover 35000 poling stations, of which they were able tGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-27320731934701513332010-04-14T09:18:00.000-07:002010-04-14T09:22:15.199-07:00Micro-enterprises the rock of future sustainable development in AfricaGlobal7 the new Millennial Renaissance Vision for the Globe<br /><br />Read More: Backpack Farm , Friends Of The WFP , Southern Sudan , Sudan , World Food Programme , Impact News <br />vote<br />nowBuzz up!254<br /><br />views Get Breaking News Alerts <br /> <br /> Share Comments 2 In 2007, I arrived in Southern Sudan to research new agriculture development models designed to stabilize South Sudan's development. Despite having previously worked in other post-conflict regions, such as Kosovo and Iraq, my experiences in East and the Horn of Africa have both inspired me and brought me to the verge of emotional bankruptcy. <br /><br />Africa's stability and independent success lie not with solutions imposed upon her by well-meaning internationals; rather by providing modern technologies and techniques to rural farmers.<br /><br />Over the past three years, I have worked in East Africa incubating new Base of the Pyramid (BOP) programs, encompassing income generation, food security and sustainable value chains. My goal has been to tap the latent potential of East and the Horn of Africa's rural farmers. <br /><br />I represent a new breed of "agri-preneur" in Africa. By clarifying the links between drought, food security, malnutrition and food aid, we can incubate practical solutions to a preventable genocide. <br /><br />At the moment, droughts have severely impacted the region's grain belts; fields lie barren. According to UN data, 24 million people in Djibouti, Ethiopia, Eritrea, Somalia (Horn of Africa) and Kenya, Tanzania, and parts of Uganda (East Africa) now need food aid, up from 20 million in early 2009. <br /><br />Coupled with wildly fluctuating grain prices, drought adversely affects regional trade patterns. If one country is affected by diminished rainfall and a weak harvest, then the region as a whole suffers, with the most vulnerable--children and nursing mothers - suffering most. <br /><br />Since May 2009, the number of children in need of emergency assistance in the Horn of Africa has grown by nearly one million - an increase of nearly 25%. According to Save the Children, the average child needs 40 vital nutrients to grow. Absent that, their brains and bodies suffer permanent damage.<br /><br />Admittedly, living in Kenya, I am perhaps numb to the reality of children starving in plain view. For the average American, though, the reality has been further masked by a deluge of fundraising campaigns and images of starving children in refugee camps. Unfortunately these campaigns fail to adequately explain the causal realities of malnutrition or the inadequate programs supported by both international NGOs and UN agencies, such as World Food Program (WFP). <br /><br />Last week, Friends of the WFP published a blog post, Nutrition: 10 Reasons to Face the Challenge. It uses language like "poor nutrition," as if children in Darfur's refugee camps are sneaking a Twinkie instead of a well balanced meal. According to the World Bank, $3.6 billion would feed all the undernourished children (under the age of 5). Such campaigns concern me for three reasons: <br /><br />Not enough food is being produced to supply these programs. Currently, not enough grain exists in East Africa for WFP to meet the needs of refugee camps in Darfur. How ethical is it to commit to this goal? <br /><br />Food aid does not address nutrition. According to UNICEF, from 2004-2007 only 1.7% of interventions reported as 'development food aid/food security' and 'emergency food aid' actually addressed nutrition needs." Our taxes are wasted on programs that that fill stomachs with empty calories. <br /><br />What about the malnourished children over 5 years suffering from severe malnutrition? Instead of addressing a global picture, it seems WFP has spent millions of dollars to design "Sprinkles," a micronutrient power with no mention of more sustainable food production models.<br /><br />With an estimated 80-100 million small-landholder farmers in East Africa and 25 million in South Africa, farming is a tangible and practical solution to the food insecurity catastrophe in both East and the Horn of Africa. Additionally, it will impact rural incomes and national GDPs, independent of new trade agreements with countries exporting eco-friendly agro-technologies, such as India, Israel, Holland, and the United States. <br /><br />75 years ago the British Empire envisioned Sudan as a global breadbasket. It still could be. The solution: empowering rural farmers. This can be accomplished, where the UN and so many NGOs have failed by financing commercially viable value chains in cooperation with available agro technologies. <br /><br />In April 2009, I and my team of wonder team of agriculture experts launched the Backpack Farm Agriculture Program (www.Backpackfarm.org). The program supports rural farmers in East and the Horn of Africa with cutting-edge agricultural programs, training, and monitoring to support regional food security and income generation through sustainable value chains. <br /><br />Programs such as mine are imperative because small-landholder farmers still lack the technical capacity and financial equity to enter wholesale markets. Their yields are typically poor, estimated at one-quarter of the global average.<br /><br /> To counter this, we designed a "fusion farming" model, eliminating the need for traditional DAP/CAN fertilizers. My team has married it with cost- effective drip irrigation and a training program on eco-friendly farming, including modules on rain water harvesting, perma-culture, non-tillage, and composting. <br /><br />We are actively working with rural farmers in Kenya, Tanzania, Sudan and Rwanda. One of our recent successes is a joint venture agreement with Mt. Kenya Gardens to help expand their out-grower network with 5,000 new farmers in the next 18 months. There is too much work to be done; however every milestone has been accomplished without a single dollar of international donor finance. I truly believe that agro-based, social enterprises like the Backpack Farm can and will play an essential role in solving East and the Horn of Africa's food crisis. <br /><br />The international community appears to be taking note. The Food and Agriculture Organization (FAO_ and World Bank have recently rediscovered rural 'family' farming as the most important source of development, and target for investments to fight hunger. <br /><br />The [published by whom?] 2008 "International Assessment of Agricultural Knowledge, Science and Technology for Development (IAASTD)," produced a single, relevant message: small-scale family farming is the best available option to change the perverted global system of commodity trade and production and to limit the use of fossil fuels and chemical inputs. It is now the 'the best hope we have for not exceeding the limits of this planet, while still feeding the population.' <br /><br />The Backpack Farm has just been named by Sotokoto Magazine in Japan as one of their "100 Green Fighters," as successful social enterprise due to our commitment to eco-farming and community development.. <br /><br />I deeply respect the professionals who are committed to emergency relief and humanitarian development programs. These men and women are some of the bravest souls living in unbelievable conditions exposed to disease, kidnapping, rape and attack from rebel groups, local security forces. <br /><br />I don't question their commitment to such noble work The problem is that the system they work within is deeply flawed and is incapable of providing sustainable food security for the worlds most vulnerable; women and children. <br /><br />Come learn more about the Backpack farm and its farmers at Facebook or Twitter @Backpackfarm or email me at grow@backpackfarm.orgGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-6538477806255605632010-04-12T14:15:00.000-07:002010-04-12T14:22:02.298-07:00Understanding and managing Diabetes MellitusGlobal7 the new Millennial Renaissance Vision for the Globe<br /><br />Diabetes mellitus type 2<br />From Wikipedia, the free encyclopedia<br />Main article: Diabetes mellitus<br /><br />This article needs additional citations for verification.<br />Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (July 2009)<br />Diabetes mellitus<br />Related articles<br />Types of diabetes<br />Prediabetes:<br /> • Impaired fasting glycaemia<br /> • Impaired glucose tolerance<br />Diabetes mellitus type 1<br />Diabetes mellitus type 2<br />Gestational diabetes<br />Blood tests<br />Blood sugar<br />Glycosylated hemoglobin<br />Glucose tolerance test<br />Fructosamine<br />Diabetes management<br />Diabetic diet<br />Anti-diabetic drugs<br />Insulin therapy<br />Glossary of diabetes<br />Complications<br />Cardiovascular disease<br />Diabetic comas:<br /> • Diabetic hypoglycemia<br /> • Diabetic ketoacidosis<br /> • Nonketotic hyperosmolar<br />Diabetic myonecrosis<br />Diabetic nephropathy<br />Diabetic neuropathy<br />Diabetic retinopathy<br />Diabetes and pregnancy<br /><br />Diabetes mellitus type 2 or type 2 diabetes (formerly called non -insulin-dependent diabetes mellitus (NIDDM), or adult-onset diabetes) is a disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[1] Diabetes is often initially managed by increasing exercise and dietary modification. <br /><br />As the condition progresses, medications are typically needed.<br />There are an estimated 23.6 million people in the U.S. (7.8% of the population) with diabetes with 17.9 million being diagnosed,[2] 90% of whom are type 2.[3] With prevalence rates doubling between 1990 and 2005, CDC has characterized the increase as an epidemic.[4]<br /><br /> Traditionally considered a disease of adults, type 2 diabetes is increasingly diagnosed in children in parallel to rising obesity rates [5] due to alterations in dietary patterns as well as in life styles during childhood.[6]<br /><br />Unlike type 1 diabetes, there is very little tendency toward ketoacidosis in type 2 diabetes, though it is not unknown.[7] One effect that can occur is nonketonic hyperglycemia which also is quite dangerous, though it must be treated very differently. Complex and multifactorial metabolic changes very often lead to damage and function impairment of many organs, most importantly the cardiovascular system in both types.<br />Contents [hide]<br />1 Signs and symptoms<br />2 Cause<br />2.1 Medical conditions<br />2.2 Genetics<br />2.3 Medications<br />3 Pathophysiology<br />4 Diagnosis<br />5 Screening and prevention<br />5.1 Prevention<br />5.2 Accuracy of tests for early detection<br />5.3 Benefit of early detection<br />6 Management<br />6.1 Goals<br />6.2 Lifestyle modification<br />6.3 Monitoring of blood glucose<br />6.4 Medications<br />6.4.1 Oral<br />6.4.2 Injectable peptide analogs<br />6.4.3 Insulin<br />6.5 Gastric bypass surgery<br />7 Epidemiology<br />8 References<br />9 External links<br />9.1 Organizations<br />9.2 Authorities<br />9.3 Further reading<br />[edit]Signs and symptoms<br /><br />The symptoms of type 2 diabetes include:<br />Early symptoms may be nothing more than chronic fatigue, generalised weakness and malaise (feeling of unease)<br />Excessive urine production<br />Excessive thirst and increased fluid intake<br />Blurred vision (typically from lens shape alterations, due to osmotic effects, e.g., high blood glucose levels)<br />Unexplained weight loss<br />Lethargy<br />Itching of external genitalia<br />Excessive bowel movements<br />[edit]Cause<br /><br />[edit]Medical conditions<br />There are many factors which can potentially give raise or exacerbate type 2 diabetes. These include obesity, hypertension, elevated cholesterol (combined hyperlipidemia), and with the condition often termed Metabolic syndrome (it is also known as Syndrome X, Reavan's syndrome, or CHAOS). Other causes include acromegaly, Cushing's syndrome, thyrotoxicosis, pheochromocytoma, chronic pancreatitis, cancer and drugs. Additional factors found to increase the risk of type 2 diabetes include aging,[8] high-fat diets[9] and a less active lifestyle.[10]<br /><br />[edit]Genetics<br />There is also a strong inheritable genetic connection in type 2 diabetes: having relatives (especially first degree) with type 2 increases risks of developing type 2 diabetes very substantially. In addition, there is also a mutation to the Islet Amyloid Polypeptide gene that results in an earlier onset, more severe, form of diabetes.[11][12]<br /><br />About 55 percent of type 2 patients are obese at diagnosis[13] —chronic obesity leads to increased insulin resistance that can develop into Type 2, most likely because adipose tissue (especially that in the abdomen around internal organs) is a (recently identified) source of several chemical signals to other tissues (hormones and cytokines).<br /><br />Other research shows that type 2 diabetes causes obesity as an effect of the changes in metabolism and other deranged cell behavior attendant on insulin resistance.[14]<br />However, environmental factors (almost certainly diet and weight) play a large part in the development of Type 2 in addition to any genetic component. This can be seen from the adoption of the Type 2 epidemiological pattern in those who have moved to a different environment as compared to the same genetic pool who have not. Immigrants to Western developed countries, for instance, as compared to lower incidence countries of origins.[15]<br /><br />[edit]Medications<br />Some drugs, used for any of several conditions, can interfere with the insulin regulation system, possibly producing drug induced hyperglycemia. Some examples follow, giving the biochemical mechanism in each case:<br />Atypical Antipsychotics - Alter receptor binding characteristics, leading to increased insulin resistance.<br /><br />Beta-blockers - Inhibit insulin secretion.<br />Calcium Channel Blockers - Inhibits secretion of insulin by interfering with cytosolic calcium release.<br /><br />Corticosteroids - Cause peripheral insulin resistance and gluconeogensis.<br />Fluoroquinolones - Inhibits insulin secretion by blocking ATP sensitive potassium channels.<br />Niacin - causes increased insulin resistance due to increased free fatty acid mobilization.<br /><br />Phenothiazines - Inhibit insulin secretion.<br />Protease Inhibitors - Inhibit the conversion of proinsulin to insulin.<br />Somatropin - May decrease sensitivity to insulin, especially in those susceptible.<br />Thiazide Diuretics - Inhibit insulin secretion due to hypokalemia. They also cause increased insulin resistance due to increased free fatty acid mobilization.<br />[edit]Pathophysiology<br /><br /><br />Insulin resistance means that body cells do not respond appropriately when insulin is present. Unlike type 1 diabetes mellitus, insulin resistance is generally "post-receptor", meaning it is a problem with the cells that respond to insulin rather than a problem with the production of insulin.<br /><br />Other important contributing factors:[citation needed]<br />increased hepatic glucose production (e.g., from glycogen -> glucose conversion), especially at inappropriate times (typical cause is deranged insulin levels, as those levels control this function in liver cells)<br />decreased insulin-mediated glucose transport in (primarily) muscle and adipose tissues (receptor and post-receptor defects)<br />impaired beta-cell function—loss of early phase of insulin release in response to hyperglycemic stimuli<br /><br />This is a more complex problem than type 1, but is sometimes easier to treat, especially in the early years when insulin is often still being produced internally. Severe complications can result from improperly managed type 2 diabetes, including renal failure, erectile dysfunction, blindness, slow healing wounds (including surgical incisions), and arterial disease, including coronary artery disease. The onset of type 2 has been most common in middle age and later life, although it is being more frequently seen in adolescents and young adults due to an increase in child obesity and inactivity. A type of diabetes called MODY is increasingly seen in adolescents, but this is classified as a diabetes due to a specific cause and not as type 2 diabetes.<br /><br />Diabetes mellitus with a known etiology, such as secondary to other diseases, known gene defects, trauma or surgery, or the effects of drugs, is more appropriately called secondary diabetes mellitus or diabetes due to a specific cause. Examples include diabetes mellitus such as MODY or those caused by hemochromatosis, pancreatic insufficiencies, or certain types of medications (e.g., long-term steroid use).<br />[edit]Diagnosis<br /><br />1999 WHO Diabetes criteria[16]<br />Condition 2 hour glucose Fasting glucose<br />mmol/l(mg/dl) mmol/l(mg/dl)<br />Normal <7.8 (<140) <6.1 (<110)<br />Impaired fasting glycaemia <7.8 (<140) ≥ 6.1(≥110) & <7.0(<126)<br />Impaired glucose tolerance ≥7.8 (≥140) <7.0 (<126)<br />Diabetes mellitus ≥11.1 (≥200) ≥7.0 (≥126)<br />The World Health Organization definition of diabetes is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either:[17]<br />fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl)<br />or<br />With a glucose tolerance test, two hours after the oral dose a plasma glucose ≥ 11.1 mmol/l (200 mg/dl)<br />[edit]Screening and prevention<br /><br />[edit]Prevention<br />Onset of type 2 diabetes can often be delayed through proper nutrition and regular exercise.[18]<br /><br />Interest has arisen in preventing diabetes due to research on the benefits of treating patients before overt diabetes. Although the U.S. Preventive Services Task Force concluded that "the evidence is insufficient to recommend for or against routinely screening asymptomatic adults for type 2 diabetes, impaired glucose tolerance, or impaired fasting glucose,"[19][20] this was a grade I recommendation when published in 2003. However, the USPSTF does recommend screening for diabetics in adults with hypertension or hyperlipidemia (grade B recommendation).<br />In 2005, an evidence report by the Agency for Healthcare Research and Quality concluded that "there is evidence that combined diet and exercise, as well as drug therapy (metformin, acarbose), may be effective at preventing progression to DM in IGT subjects".[21]<br /><br />Milk has also been associated with the prevention of diabetes. A questionnaire study was done by Choi et al. of 41,254 men which including a 12 year follow up showed this association. In this study, it was found that diets high in low-fat dairy might lower the risk of type 2 diabetes in men. Even though these benefits are being considered linked to milk consumption, the effect of diet is only one factor that is affecting the body’s overall health.[22]<br /><br />[edit]Accuracy of tests for early detection<br />If a 2-hour postload glucose level of at least 11.1 mmol/L (≥ 200 mg/dL) is used as the reference standard, the fasting plasma glucose > 7.0 mmol/L (126 mg/dL) diagnoses current diabetes with[20]:<br />sensitivity about 50%<br />specificity greater than 95%<br />A random capillary blood glucose > 6.7 mmol/L (120 mg/dL) diagnoses current diabetes with[23]:<br />sensitivity = 75%<br />specificity = 88%<br />Glycosylated hemoglobin values that are elevated (over 5%), but not in the diabetic range (not over 7.0%) are predictive of subsequent clinical diabetes in US female health professionals.[24] In this study, 177 of 1061 patients with glycosylated hemoglobin value less than 6% became diabetic within 5 years compared to 282 of 26281 patients with a glycosylated hemoglobin value of 6.0% or more. This equates to a glycosylated hemoglobin value of 6.0% or more having:<br /><br />sensitivity = 16.7%<br />specificity = 98.9%<br />[edit]Benefit of early detection<br /><br />Since publication of the USPSTF statement, a randomized controlled trial of prescribing acarbose to patients with "high-risk population of men and women between the ages of 40 and 70 years with a body mass index (BMI), calculated as weight in kilograms divided by the square of height in meters, between 25 and 40. They were eligible for the study if they had IGT according to the World Health Organization criteria, plus impaired fasting glucose (a fasting plasma glucose concentration of between 100 and 140 mg/dL or 5.5 and 7.8 mmol/L) found a number needed to treat of 44 (over 3.3 years) to prevent a major cardiovascular event.[25]<br /><br />Other studies have shown that lifestyle changes,[26] orlistat[27] and metformin[28] can delay the onset of diabetes.<br />[edit]Management<br /><br />Main article: Diabetes management<br /><br />Left untreated, diabetes mellitus type 2 is a chronic, progressive condition, but there are well-established treatments which can delay or prevent entirely the formerly inevitable consequences of the condition. Often, the condition is viewed as progressive since poor management of blood sugar leads to a myriad of steadily worsening complications. However, if blood sugar is properly maintained, then the condition is, in a limited sense, cured - that is, patients are at no heightened risk for neuropathy, blindness, or any other high blood sugar complication, though the underlying isssue, a tendency to hyperglycemia has not been addressed directly.<br /><br /> A study at UCLA in 2005 showed that the Pritikin Program of diet and exercise brought dramatic improvement to a group of diabetics and pre-diabetics in only three weeks, so that about half no longer met the criteria for the condition.[29] [30] [31]<br />There are two main goals of treatment:<br /><br />reduction of mortality and concomitant morbidity (from assorted diabetic complications)<br />preservation of quality of life<br /><br />The first goal can be achieved through close glycemic control (i.e., to near 'normal' blood glucose levels); the reduction in severity of diabetic side effects has been very well demonstrated in several large clinical trials and is established beyond controversy.<br /><br /> The second goal is often addressed (in developed countries) by support and care from teams of diabetic health workers (usually physician, PA, nurse, dietitian or a certified diabetic educator). Endocrinologists, family practitioners, and general internists are the physician specialties most likely to treat people with diabetes. Knowledgeable patient participation is vital to clinical success, and so patient education is a crucial aspect of this effort.<br /><br />Type 2 is initially treated by adjustments in diet and exercise, and by weight loss, most especially in obese patients. The amount of weight loss which improves the clinical picture is sometimes modest (2–5 kg or 4.4-11 lb); this is almost certainly due to currently poorly understood aspects of fat tissue activity, for instance chemical signaling (especially in visceral fat tissue in and around abdominal organs). In many cases, such initial efforts can substantially restore insulin sensitivity. In some cases strict diet can adequately control the glycemic levels.<br />Diabetes education is an integral component of medical care.<br /><br />[edit]Goals<br /><br />Treatment goals for type 2 diabetic patients are related to effective control of blood glucose, blood pressure and lipids to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies.<br />The targets are:<br /><br />HbA1c of 6%[32] to 7.0%[33]<br />Preprandial blood glucose: 4.0 to 6.0 mmol/L (72 to 108 mg/dl)[34]<br />2-hour postprandial blood glucose: 5.0 to 8.0 mmol/L (90 to 144 mg/dl)[34]<br />In older patients, clinical practice guidelines by the American Geriatrics Society states "for frail older adults, persons with life expectancy of less than 5 years, and others in whom the risks of intensive glycemic control appear to outweigh the benefits, a less stringent target such as HbA1c of 8% is appropriate".[35]<br />[edit]Lifestyle modification<br /><br />Exercise<br /><br />In September 2007, a joint randomized controlled trial by the University of Calgary and the University of Ottawa found that "Either aerobic or resistance training alone improves glycemic control in type 2 diabetes, but the improvements are greatest with combined aerobic and resistance training than either alone."[36][37] The combined program reduced the HbA1c by 0.5 percentage point. Other studies have established that the amount of exercise needed is not large or extreme, but must be consistent and continuing. Examples might include a brisk 45 minute walk every other day.<br /><br />Theoretically, exercise does have benefits in that exercise would stimulate the release of certain ligands that cause GLUT4 to be released from internal endosomes to the cell membrane. Insulin though, which no longer works effectively in those afflicted with type 2 diabetes, causes GLUT1 to be placed into the membrane. Exercise also allows for the uptake of glucose independently of insulin, i.e. by adrenaline.<br />Dietary management<br /><br />Main article: Diabetic diet<br /><br />Modifying the diet to limit and control glucose (or glucose equivalent, e.g., starch) intake, and in consequence, blood glucose levels, is known to assist type 2 patients, especially early in the course of the condition's progression. Additionally, weight loss is recommended and is often helpful in persons suffering from type 2 diabetes (see above).<br /><br />[edit]Monitoring of blood glucose<br /><br />Main article: Blood glucose monitoring<br /><br />Self-monitoring of blood glucose may not improve outcomes in some cases, that is among "reasonably well controlled non-insulin treated patients with type 2 diabetes".[38] Nevertheless, it is very strongly recommended for patients in whom it can assist in maintaining proper glycemic control, and is well worth the cost (sometimes considerable) if it does.<br /><br /> It is the only source of current information on the glycemic state of the body, as changes are rapid and frequent, depending on food, exercise, and medication (dosage and timing with respect to both diet and exercise), and secondarily, on time of day, stress (mental and physical), infection, etc.<br /><br />The National Institute for Health and Clinical Excellence (NICE), UK released updated diabetes recommendations on 30 May 2008. They indicate that self-monitoring of blood glucose levels for people with newly diagnosed type 2 diabetes should be part of a structured self-management education plan.[39] However, a recent study found that a treatment strategy of intensively lowering blood sugar levels (below 6%) in patients with additional cardiovascular disease risk factors poses more harm than benefit, and so there appear to be limits to benefit of intensive blood glucose control in some patients.[40][41]<br /><br />[edit]Medications<br />Main article: Anti-diabetic drug<br /><br /><br />Metformin 500mg tablets<br />There are several drugs available for type 2 diabetics—most are unsuitable or even dangerous for use by type 1 diabetics. They fall into several classes and are not equivalent, nor can they be simply substituted one for another. All are prescription drugs.<br /><br />One of the most widely used drugs now used for type 2 diabetes is the biguanide metformin; it works primarily by reducing liver release of blood glucose from glycogen stores and secondarily by provoking some increase in cellular uptake of glucose in body tissues.<br /><br /> Both historically, and currently, the most commonly used drugs are in the Sulfonylurea group, of which several members (including glibenclamide and gliclazide) are widely used; these increase glucose stimulated insulin secretion by the pancreas and so lower blood glucose even in the face of insulin resistance.<br /><br />Newer drug classes include:<br />Thiazolidinediones (TZDs) (rosiglitazone, pioglitazone, and troglitazone -- the last, as Rezulin, was withdrawn from the US market because of an increased risk of systemic acidosis). These increase tissue insulin sensitivity by affecting gene expression<br />α-glucosidase inhibitors (acarbose and miglitol) which interfere with absorption of some glucose containing nutrients, reducing (or at least slowing) the amount of glucose absorbed<br />Meglitinides which stimulate insulin release (nateglinide, repaglinide, and their analogs) quickly; they can be taken with food, unlike the sulfonylureas which must be taken prior to food (sometimes some hours before, depending on the drug)<br />Peptide analogs which work in a variety of ways:<br /><br />Incretin mimetics which increase insulin output from the beta cells among other effects. These includes the Glucagon-like peptide (GLP) analog exenatide, sometimes referred to as lizard spit as it was first identified in Gila monster saliva<br />Dipeptidyl peptidase-4 (DPP-4) inhibitors increase Incretin levels (sitagliptin) by decreasing their deactivation rates<br />Amylin agonist analog, which slows gastric emptying and suppresses glucagon (pramlintide)<br /><br />[edit]Oral<br /><br />A systematic review of randomized controlled trials found that metformin and second-generation sulfonylureas are the preferred choices for most with type 2 diabetes, especially those early in the course of the condition.[42]<br /><br /> Failure of response after a time is not unknown with most of these agents: the initial choice of anti-diabetic drug has been compared in a randomized controlled trial which found "cumulative incidence of monotherapy failure at 5 years to be 15% with rosiglitazone, 21% with metformin, and 34% with glyburide".[43] Of these, rosiglitazone users showed more weight gain and edema than did non-users.[43] Rosiglitazone may increase risk of death from cardiovascular causes though the causal connection is unclear.[44] Pioglitazone and rosiglitazone may also increase the risk of fractures.[45][46]<br /><br />For patients who also have heart failure, metformin may be the best tolerated drug.[47]<br />The variety of available agents can be confusing, and the clinical differences among type 2 diabetes patients compounds the problem. At present, choice of drugs for type 2 diabetics is rarely straightforward and in most instances has elements of repeated trial and adjustment.<br /><br />[edit]Injectable peptide analogs<br /><br />DPP-4 inhibitors lowered HbA1c by 0.74% (points), comparable to other antidiabetic drugs.[48] GLP-1 analogs resulted in weight loss and had more gastrointestinal side effects, while DPP-4 inhibitors were weight neutral and increased risk for infection and headache, but both classes appear to present an alternative to other antidiabetic drugs.<br /><br />[edit]Insulin<br /><br />In rare cases, if antidiabetic drugs fail (i.e., the clinical benefit stops), insulin therapy may be necessary – usually in addition to oral medication therapy – to maintain normal or near normal glucose levels.[49][50]<br /><br />Typical total daily dosage of insulin is 0.6 U/kg.[51] But, of course, best timing and indeed total amounts depend on diet (composition, amount, and timing) as well the degree of insulin resistance. More complicated estimations to guide initial dosage of insulin are:[52]<br /><br />For men, [(fasting plasma glucose [mmol/liter]–5)x2] x (weight [kg]÷(14.3xheight [m])–height [m])<br /><br />For women, [(fasting plasma glucose [mmol/liter]–5)x2] x (weight [kg]÷(13.2xheight [m])–height [m])<br /><br />The initial insulin regimen are often chosen based on the patient's blood glucose profile.[53] Initially, adding nightly insulin to patients failing oral medications may be best.[54] Nightly insulin combines better with metformin than with sulfonylureas.[51] The initial dose of nightly insulin (measured in IU/d) should be equal to the fasting blood glucose level (measured in mmol/L). If the fasting glucose is reported in mg/dl, multiply by 0.05551 to convert to mmol/L.[55]<br /><br />When nightly insulin is insufficient, choices include:<br /><br />Premixed insulin with a fixed ratio of short and intermediate acting insulin; this tends to be more effective than long acting insulin, but is associated with increased hypoglycemia.[56][57].[58] <br /><br />Initial total daily dosage of biphasic insulin can be 10 units if the fasting plasma glucose values are less than 180 mg/dl or 12 units when the fasting plasma glucose is above 180 mg/dl".[57] A guide to titrating fixed ratio insulin is available.[53]<br /><br />Long acting insulins such as insulin glargine and insulin detemir. A meta-analysis of randomized controlled trials by the Cochrane Collaboration found "only a minor clinical benefit of treatment with long-acting insulin analogues for patients with diabetes mellitus type 2".[59]<br /><br /> More recently, a randomized controlled trial found that although long acting insulins were less effective, they were associated with reduced hypoglycemic episodes.[56]<br /><br />Insulin Pump therapy in Type 2 diabetes is gradually becoming popular.In an original published study, in addition to reduction of blood sugars, there is evidence of profound benefits in resistant neuropathic pain and also improvements in sexual performance.[60]<br /><br />[edit]Gastric bypass surgery<br /><br />Gastric Bypass procedures are currently considered an elective procedure with no universally accepted algorithm to decide who should have the surgery. In the diabetic patient, certain types result in 99-100% prevention of insulin resistance and 80-90% clinical resolution or remission of type 2 diabetes. <br /><br />In 1991, the NIH (National Institutes of Health) Consensus Development Conference on Gastrointestinal Surgery for Obesity proposed that the body mass index (BMI) threshold to consider surgery should drop from 40 to 35 in the appropriate patient. More recently, the American Society for Bariatric Surgery (ASBS) and the ASBS Foundation suggested that the BMI threshold be lowered to 30 in the presence of severe co-morbidities.[61]<br /><br /> Debate has flourished about the role of gastric bypass surgery in type 2 diabetics since the publication of The Swedish Obese Subjects Study. The largest prospective series showed a large decrease in the occurrence of type 2 diabetes in the post-gastric bypass patient at both 2 years (odds ratio was 0.14) and at 10 years (odds ratio was 0.25).[62]<br /><br />A study of 20-years of Greenville (US) gastric bypass patients found that 80% of those with type 2 diabetes before surgery no longer required insulin or oral agents to maintain normal glucose levels. Weight loss occurred rapidly in many people in the study who had had the surgery. The 20% who did not respond to bypass surgery were, typically, those who were older and had had diabetes for over 20 years.[63]<br /><br />In January 2008, The Journal of the American Medical Association (JAMA) published the first randomized controlled trial comparing the efficacy of laparoscopic adjustable gastric banding against conventional medical therapy in the obese patient with type 2 diabetes. Laparoscopic Adjustable Gastric Banding results in remission of type 2 diabetes among affected patients diagnosed within the previous two years according to a randomized controlled trial.[64]<br /><br /> The relative risk reduction was 69.0%. For patients at similar risk to those in this study (87.0% had type 2), this leads to an absolute risk reduction of 60%. 1.7 patients must be treated for one to benefit (number needed to treat = 1.7). Click here to adjust these results for patients at higher or lower risk of type 2 diabetics.<br /><br />These results have not yet produced a clinical standard for surgical treatment of Type 2 patients, as the mechanism, if any, is currently obscure. Surgical cure of Type 2 diabetes must be, as a result, considered currently experimental.<br />[edit]Epidemiology<br /><br />About 90–95% of all North American cases of diabetes are type 2,[65] and about 20% of the population over the age of 65 has diabetes mellitus type 2. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons, though these are not known in detail. Diabetes affects over 150 million people worldwide and this number is expected to double by 2025.[65]<br /><br />According to CDC, about 23.613 million people in the United States, or 8% of the population, have diabetes. The total prevalence of diabetes increased 13.5% from 2005-2007.<br />[edit]References<br /><br />^ Robbins and Cotran, Pathologic Basis of Disease, 7th Ed. pp 1194-1195.<br />^ American Diabetes Association title =Total Prevalence of Diabetes and Pre-diabetes url =http://www.diabetes.org/diabetes-statistics/prevalence.jsp | accessdate =2008-11-29<br />^ Inzucchi SE, Sherwin RS, The Prevention of Type 2 Diabetes Mellitus. Endocrinol Metab Clin N Am 34 (2205) 199-219.<br />^ Gerberding, Julie Louise (2007-05-24). Diabetes. Atlanta: Centres for Disease Control. Retrieved 2007-09-14.<br />^ Diabetes rates are increasing among youth NIH, November 13, 2007<br />^ Steinberger J, Moran A, Hong CP, Jacobs DR Jr, Sinaiko AR: Adiposity in childhood predicts obesity and insulin resistance in young adulthood. J Pediatr 138:469–473, 2001<br />^ Brian J. Welch, MD and Ivana Zib, MD: Case Study: Diabetic Ketoacidosis in Type 2 Diabetes: “Look Under the Sheets”, Clinical Diabetes, October 2004, vol. 22 no. 4, 198-200<br />^ Jack L, Boseman L, Vinicor F (April 2004). "Aging Americans and diabetes. A public health and clinical response". Geriatrics 59 (4): 14–7. PMID 15086069.<br />^ Lovejoy JC (October 2002). "The influence of dietary fat on insulin resistance". Curr. Diab. Rep. 2 (5): 435–40. doi:10.1007/s11892-002-0098-y. PMID 12643169.<br />^ Hu FB (February 2003). "Sedentary lifestyle and risk of obesity and type 2 diabetes". Lipids 38 (2): 103–8. doi:10.1007/s11745-003-1038-4. PMID 12733740.<br />^ Sakagashira S, Sanke T, Hanabusa T, et al. (September 1996). "Missense mutation of amylin gene (S20G) in Japanese NIDDM patients". Diabetes 45 (9): 1279–81. doi:10.2337/diabetes.45.9.1279. PMID 8772735.<br />^ Cho YM, Kim M, Park KS, Kim SY, Lee HK (May 2003). "S20G mutation of the amylin gene is associated with a lower body mass index in Korean type 2 diabetic patients". Diabetes Res. Clin. Pract. 60 (2): 125–9. doi:10.1016/S0168-8227(03)00019-6. PMID 12706321. Retrieved 19 July 2008.<br />^ Eberhart, M. S.; Ogden, C, Engelgau, M, Cadwell, B, Hedley, A. A., Saydah, S. H., (November 2004). "Prevalence of Overweight and Obesity Among Adults with Diagnosed Diabetes --- United States, 1988--1994 and 1999--2002". Morbidity and Mortality Weekly Report (Centers for Disease Control and Prevention) 53 (45): 1066–8. PMID 15549021. Retrieved 19 July 2008.<br />^ Camastra S, Bonora E, Del Prato S, Rett K, Weck M, Ferrannini E (December 1999). "Effect of obesity and insulin resistance on resting and glucose-induced thermogenesis in man. EGIR (European Group for the Study of Insulin Resistance)". Int. J. Obes. Relat. Metab. Disord. 23 (12): 1307–13. doi:10.1038/sj.ijo.0801072. PMID 10643689.<br />^ Cotran, Kumar, Collins; Robbins Pathologic Basis of Disease, Saunders Sixth Edition, 1999; 913-926.<br />^ "www.who.int" (pdf). World Health Organization.<br />^ World Health Organization. "Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus". Retrieved 29 May 2007.<br />^ Raina Elley C, Kenealy T (December 2008). "Lifestyle interventions reduced the long-term risk of diabetes in adults with impaired glucose tolerance". Evid Based Med 13 (6): 173. doi:10.1136/ebm.13.6.173. PMID 19043031.<br />^ U.S. Preventive Services Task Force (February 2003). "Screening for type 2 diabetes mellitus in adults: recommendations and rationale". Ann. Intern. Med. 138 (3): 212–4. PMID 12558361. Retrieved 19 July 2008.<br />^ a b Harris R, Donahue K, Rathore SS, Frame P, Woolf SH, Lohr KN (February 2003). "Screening adults for type 2 diabetes: a review of the evidence for the U.S. Preventive Services Task Force". Ann. Intern. Med. 138 (3): 215–29. PMID 12558362. Retrieved 19 July 2008.<br />^ Santaguida PL, Balion C, Hunt D, et al. (August 2005). "Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose" (PDF). Evid Rep Technol Assess (Summ) (128): 1–11. PMID 16194123. Retrieved 19 July 2008.<br />^ Choi HK, Willett WC, Stampfer P, Vasson MP, Maubois JL, Beaufrere B (2005). "Dairy consumption and risk of type 2 diabetes mellitus in men". Archives of Internal Medicine 165: 997–1003.<br />^ Rolka DB, Narayan KM, Thompson TJ, et al. (2001). "Performance of recommended screening tests for undiagnosed diabetes and dysglycemia". Diabetes Care 24 (11): 1899–903. doi:10.2337/diacare.24.11.1899. PMID 11679454.<br />^ Pradhan AD, Rifai N, Buring JE, Ridker PM (2007). "Hemoglobin A1c predicts diabetes but not cardiovascular disease in nondiabetic women". Am. J. Med. 120 (8): 720–7. doi:10.1016/j.amjmed.2007.03.022. PMID 17679132.<br />^ Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M (July 2003). "Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial". JAMA 290 (4): 486–94. doi:10.1001/jama.290.4.486. PMID 12876091. Retrieved 19 July 2008.<br />^ Lindström J, Ilanne-Parikka P, Peltonen M, et al. (November 2006). "Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study". Lancet 368 (9548): 1673–9. doi:10.1016/S0140-6736(06)69701-8. PMID 17098085. Retrieved 19 July 2008.<br />^ Torgerson JS, Hauptman J, Boldrin MN, Sjöström L (January 2004). "XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients". Diabetes Care 27 (1): 155–61. doi:10.2337/diacare.27.1.155. PMID 14693982. Retrieved 19 July 2008.<br />^ Knowler WC, Barrett-Connor E, Fowler SE, et al. (February 2002). "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin". N. Engl. J. Med. 346 (6): 393–403. doi:10.1056/NEJMoa012512. PMID 11832527. PMC 1370926. Retrieved 19 July 2008.<br />^ "Physical activity and dietary intervention for chronic diseases: a quick fix after all?", Frank W. Booth & Manu V. Chakravarthy, J Appl Physiol, May 1, 2006; 100(5): 1439 - 1440.<br />^ Roberts CK, Won D, Pruthi S, Kurtovic S, Sindhu RK, Vaziri ND, and Barnard RJ. "Effect of a short-term diet and exercise intervention on oxidative stress, inflammation, MMP-9, and monocyte chemotactic activity in men with metabolic syndrome factors", J Appl Physiol 100: 1657-1665, 2006. First published December 15, 2005<br />^ "Three-week diet curbs diabetes", New Scientist, 13 January 2006 by Shaoni Bhattacharya.<br />^ American Diabetes (January 2006). "Standards of medical care in diabetes--2006". Diabetes Care 29 Suppl 1: S4–42. PMID 16373931. Retrieved 19 July 2008.<br />^ Qaseem A, Vijan S, Snow V, Cross JT, Weiss KB, Owens DK (September 2007). "Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians". Ann. Intern. Med. 147 (6): 417–22. PMID 17876024. Retrieved 19 July 2008.<br />^ a b "Clinical Practice Guidelines". Retrieved 19 July 2008.<br />^ Brown AF, Mangione CM, Saliba D, Sarkisian CA (May 2003). "Guidelines for improving the care of the older person with diabetes mellitus". J Am Geriatr Soc 51 (5 Suppl Guidelines): S265–80. doi:10.1046/j.1532-5415.51.5s.1.x. PMID 12694461. Retrieved 19 July 2008.<br />^ Sigal RJ, Kenny GP, Boulé NG, et al. (2007). "Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial". Ann. Intern. Med. 147 (6): 357–69. PMID 17876019. Non-technical summary<br />^ Song S. "Study: The Best Exercise for Diabetes". Time Inc. Retrieved 28 September 2007.<br />^ Farmer A, Wade A, Goyder E, et al. (2007). "Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial". BMJ 335 (7611): 132. doi:10.1136/bmj.39247.447431.BE. PMID 17591623.<br />^ "Clinical Guideline:The management of type 2 diabetes (update)".<br />^ Gerstein, H. C., M. E. Miller, et al. (2008). "Effects of intensive glucose lowering in type 2 diabetes.". New England Journal of Medicine, the 358 (358(24)): 2545–59. doi:10.1056/NEJMoa0802743. PMID 18539917.<br />^ http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf<br />^ Bolen S et al. Systematic Review: Comparative Effectiveness and Safety of Oral Medications for Type 2 Diabetes Mellitus. Ann Intern Med 2007;147:6<br />^ a b Kahn SE, Haffner SM, Heise MA, et al. (2006). "Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy". N. Engl. J. Med. 355 (23): 2427–43. doi:10.1056/NEJMoa066224. PMID 17145742.<br />^ "NEJM -- Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes". Retrieved 21 May 2007.<br />^ "MedWatch - 2007 Safety Information Alerts (Actos (pioglitazone))". Retrieved 21 May 2007.<br />^ "MedWatch - 2007 Safety Information Alerts (Rosiglitazone)". Retrieved 21 May 2007.<br />^ Eurich DT, McAlister FA, Blackburn DF, et al. (2007). "Benefits and harms of antidiabetic agents in patients with diabetes and heart failure: systematic review". BMJ 335 (7618): 497. doi:10.1136/bmj.39314.620174.80. PMID 17761999.<br />^ Amori RE, Lau J, Pittas AG (2007). "Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis". JAMA 298 (2): 194–206. doi:10.1001/jama.298.2.194. PMID 17622601.<br />^ Diabetes . MyOptumHealth. (Report). Retrieved on Jan 21, 2010.<br />^ Diabetes and Medication . Diabetes New Zealand. (Report). Retrieved on Jan 21, 2010.<br />^ a b Yki-Järvinen H, Ryysy L, Nikkilä K, Tulokas T, Vanamo R, Heikkilä M (March 1999). "Comparison of bedtime insulin regimens in patients with type 2 diabetes mellitus. A randomized, controlled trial". Ann. Intern. Med. 130 (5): 389–96. PMID 10068412. Retrieved 19 July 2008.<br />^ Holman RR, Turner RC (January 1985). "A practical guide to basal and prandial insulin therapy". Diabet. Med. 2 (1): 45–53. doi:10.1111/j.1464-5491.1985.tb00592.x. PMID 2951066.<br />^ a b Mooradian AD, Bernbaum M, Albert SG (July 2006). "Narrative review: a rational approach to starting insulin therapy". Ann. Intern. Med. 145 (2): 125–34. PMID 16847295.<br />^ Yki-Järvinen H, Kauppila M, Kujansuu E, et al. (November 1992). "Comparison of insulin regimens in patients with non-insulin-dependent diabetes mellitus". N. Engl. J. Med. 327 (20): 1426–33. PMID 1406860.<br />^ Kratz A, Lewandrowski KB (October 1998). "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Normal reference laboratory values". N. Engl. J. Med. 339 (15): 1063–72. doi:10.1056/NEJM199810083391508. PMID 9761809. Retrieved 19 July 2008.<br />^ a b Holman RR, Thorne KI, Farmer AJ, et al. (October 2007). "Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes". N. Engl. J. Med. 357 (17): 1716–30. doi:10.1056/NEJMoa075392. PMID 17890232. Retrieved 19 July 2008.<br />^ a b Raskin P, Allen E, Hollander P, et al. (February 2005). "Initiating insulin therapy in type 2 Diabetes: a comparison of biphasic and basal insulin analogs". Diabetes Care 28 (2): 260–5. doi:10.2337/diacare.28.2.260. PMID 15677776. Retrieved 19 July 2008.<br />^ Malone JK, Kerr LF, Campaigne BN, Sachson RA, Holcombe JH (December 2004). "Combined therapy with insulin lispro Mix 75/25 plus metformin or insulin glargine plus metformin: a 16-week, randomized, open-label, crossover study in patients with type 2 diabetes beginning insulin therapy". Clin Ther 26 (12): 2034–44. doi:10.1016/j.clinthera.2004.12.015. PMID 15823767. Retrieved 19 July 2008.<br />^ Horvath K, Jeitler K, Berghold A, et al. (2007). "Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus". Cochrane Database Syst Rev (2): CD005613. doi:10.1002/14651858.CD005613.pub3. PMID 17443605.<br />^ Jothydev Kesavadev, Shyam Balakrishnan, Ahammed S,Sunitha Jothydev, et al. (2009). "Reduction of glycosylated hemoglobin following 6 months of continuous subcutaneous insulin infusion in an Indian population with type 2 diabetes". Diabetes Technol Ther 11 (8): 517–521. doi:10.1089/dia.2008.0128. PMID 19698065.<br />^ Cummings DE, Flum DR (2008). "Gastrointestinal surgery as a treatment for diabetes". JAMA 299 (3): 341–3. doi:10.1001/jama.299.3.341. PMID 18212321.<br />^ Folli F, Pontiroli AE, Schwesinger WH (2007). "Metabolic aspects of bariatric surgery". Med. Clin. North Am. 91 (3): 393–414, x. doi:10.1016/j.mcna.2007.01.005. PMID 17509385.<br />^ Gastric Bypass Surgery - Diabetes Health<br />^ Dixon JB, O'Brien PE, Playfair J, et al. (2008). "Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial". JAMA 299 (3): 316–23. doi:10.1001/jama.299.3.316. PMID 18212316.<br />^ a b Zimmet P, Alberti KG, Shaw J (December 2001). "Global and societal implications of the diabetes epidemic". Nature 414 (6865): 782–7. doi:10.1038/414782a. PMID 11742409. Retrieved 19 July 2008.<br />[edit]External links<br /><br />Diabetes mellitus type 2 at the Open Directory Project<br />Diabetes mellitus type 2<br />Type 2 Diabetes - General Information<br />[edit]Organizations<br />IDF Diabetes Atlas<br />International Diabetes Federation<br />World Diabetes Day (International Diabetes Federation)<br />Diabetes UK - Largest organisation in the UK working for people with diabetes<br />American Diabetes Association<br />Types and Pathogenesis of Diabetes<br />[edit]Authorities<br />National Diabetes Information Clearinghouse<br />Centers for Disease Control (Endocrine pathology)<br />[edit]Further reading<br /><br />This article's further reading may not follow Wikipedia's content policies or guidelines. Please improve this article by removing excessive, less relevant or many publications with the same point of view; or by incorporating the relevant publications into the body of the article through appropriate citations.<br />Diabetes Symptoms Revisited: Are They Too Vague and Too Late?<br />ABC Radio National transcript on hypothesised aetiology involving gut hormone<br />Does what we eat manage Type 2 Diabetes effectively?Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-14591225283816912692010-04-06T07:03:00.000-07:002010-04-06T07:04:03.366-07:00Sexual abuse a sign of new wave of violence or misguided notion of celibacy driving sexually active young priests to abuseGlobal7 the new Millennial Renaissance Vision for the Globe<br /><br />Does Catholic celibacy contribute to child sex abuse? <br />With the Roman Catholic Church facing a series of paedophilia scandals, some observers have begun to ask whether the tradition of celibacy in the priesthood has contributed to child abuse. The BBC's Paul Henley raises the question with Catholics in Cologne.<br /><br /> <br />Child sex abuse allegations have caused anger in Germany <br />In Pope Benedict XVI's home country, Germany, the Catholic Church could have hoped for a better Easter in terms of public relations. <br /><br />While the media deal, nearly daily, with fresh allegations of priests sexually abusing children, opinion polls published by Stern magazine suggest almost a fifth of German Catholics have considered leaving the Church because of the abuse scandal and only 17% of Germans now trust the Church as an institution. <br /><br />Typical of the kind of comment Catholic leaders would have preferred not to have faced,was a contribution to a recent ZDF television discussion programme by Professor Klaus Beier, head of the Institute of Sexology and Sexual Medicine at Berlin's Charite Hospital. <br /><br />"If you are already struggling with a conflicted sexuality, including paedophile tendencies, then it is attractive to become part of an institution that obliges you to be celibate," he said. <br /><br />"I have seen many of these cases... and it is something the Catholic Church should be made aware of." <br /><br />'Abnormal sexuality'<br /><br />More surprising has been the contribution to the debate of senior figures from inside the Church, including Hamburg Auxiliary Bishop Hans-Jochen Jaschke, who seemed to add fuel to the fire of those making a connection between priestly celibacy and paedophilia.<br /><br /> <br /> The offenders always say 'we are not the guilty ones; society is guilty, the church is guilty, celibacy is the problem, not us'" <br /><br />Manfred Luetz<br />Psychiatrist <br />He was quoted as saying that the "celibate lifestyle can attract people who have an abnormal sexuality and cannot integrate sexuality into their lives." <br /><br />But even those outspoken Catholic rebels who have long called for a discussion about the future of celibacy - including Father Hans Kung, a contemporary of the Pope and well-known thorn in the side of the Vatican - have distanced themselves from any attempt to link paedophile offences and priestly vows of chastity. <br /><br />Now another theologian, Manfred Luetz, psychiatrist, author and organiser of a 2003 Vatican congress about the abuse of children, has been defending the Church's stance, resisting any link between celibacy and paedophilia. <br /><br />"I do not think that the Vatican is trying to prevent any debate about celibacy," he said, speaking in his office at Cologne's Alexianer Hospital, where he is director. <br /><br />"Catholics are free to talk about it. Celibacy is no dogma. But I think when we have a discussion about abuse, then this is not the moment to discuss celibacy, because then we make the same strategies as the offenders do. <br /><br />"The offenders always say 'we are not the guilty ones; society is guilty, the church is guilty, celibacy is the problem, not us'. And I do not want to be an accomplice to such escape strategies". <br /><br />Modernisation?<br /><br />Dr Luetz dismisses any suggestion of a scientific correlation between celibacy and abuse. <br /><br />"The father of a family", he says, "is 36 times more likely to abuse than a celibate priest. So it is not good to discuss celibacy in this context. <br /><br />"Instead, we have to discuss how to prevent other abuses, we have to speak about the victims and we have to speak about the way we approach these topics with transparency." <br /><br />Dr Luetz says the Church has already been doing this for six years, noting that guidelines are now in place and praising a campaign in Germany for victims to come forward. <br /><br />But he also notes that most of the cases now emerging date back to long before these measures were put in place. <br /><br />"I know many think that reforming celibacy rules would be a modernisation, but what is modernising?" he asks. <br /><br />"The Protestant Church doesn't have celibacy and the number of people leaving their clergy is higher than ours." <br /><br />Worldly experience<br /><br />Many German Catholics visiting Cologne's famous cathedral during Easter week do appear, however, to fix on priestly celibacy as one of the issues contributing to the church's current problems. <br /><br />One woman in her 20s suggested marriage for priests would be a healthy step forward for the institution.<br /><br /><br />Former Jesuit priest says he left the priesthood because of celibacy rules<br />"If it would be allowed I think there wouldn't be so many problems and so many secrets that they have to keep," she said. <br /><br />Another church-goer said she thought more worldly experience had to be a good thing among priests. <br /><br />"The family and children - they should experience what they are talking about," she said. <br /><br />A man visiting the cathedral with his wife and daughters agreed. <br /><br />"It should be possible for priests to marry," he said. <br /><br />"It would be a good face for the church, so people can see they make a first step to be more modern and to be actual." <br /><br />Damian Sassin, who served as a Jesuit priest for 20 years before leaving the priesthood and getting married, is also among those who supports reform. <br /><br />"The celibacy rule is a part of the current crisis of the Church. It's definitely not the only one but it plays a role in it," he said. <br /><br />"It took me a while for me to... finally admit that I just couldn't live this [way] happily and healthily, knowing quite a few priests who obviously couldn't do that either, but kept doing it, and became more and more strange people."Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-35364059894372110392010-04-06T06:56:00.001-07:002010-04-06T06:56:50.471-07:00The Deutch Settler's Ugly face murdered at last!Global7 the new Millennial Renaissance Vision for the Globe<br /><br />Racist leader's murder rattles South Africa<br />Terreblanche once vowed to lead race war<br /><br />Peter Goodspeed, National Post <br />Published: Tuesday, April 06, 2010 <br /><br />More On This Story<br />History or hate speech? Apartheid-era songs open old wounds <br /><br />South Africa’s ANC defends singing of apartheid-era 'Kill the Boer' song <br /><br />Mandela's dream still long way off <br />Related Topics<br />Eugene Terreblanche <br /><br />Andre Visagie <br /><br />African Politics <br /><br />Politics <br /><br />Afrikaner Weerstandsbeweging <br /><br /> Story Tools<br />- + Change font size <br /><br />Comment on this story <br /><br />Print this story <br /><br />E-Mail this story <br />Share This Story<br />Facebook <br /><br />Digg <br /><br />LinkedIn <br /><br />More <br /> Howard Burditt/Files/Reuters <br />Eugene Terreblanche, the notorious leader of a neo-Nazi-style political movement in South Africa, was killed on Saturday. <br />South Africa braced for a possible wave of racial violence yesterday after the weekend murder of Eugene Terreblanche, the notorious leader of the neo-Nazi-style Afrikaner Weerstandsbeweging (Afrikaner Resistance Movement or AWB).<br /><br />The former policeman who demanded a whites-only republic had once vowed to lead an apocalyptic race war to prevent black majority rule.<br /><br />In the end, his followers staged a brief but abortive armed rebellion in 1994 in which nearly 100 people died. Terreblanche was sentenced to six years in prison in 2001 for the attempted murder of a black farm worker and the savage beating of a black gas station service attendant, whom he left permanently brain damaged.<br /><br />On Saturday, Terreblanche was beaten and hacked to death while he slept in his Ventersdorp farm, just north of Pretoria.<br /><br />His murder is believed to be linked to a pay dispute involving two black farm hands. It came as South Africa struggles with controversy over African National Congress Youth leader Julius Malema's singing an anti-apartheid war song that urges people to "shoot the Boer ... shoot the farmer."<br /><br />A South African court recently ruled the song is tantamount to "hate speech."<br /><br />Yesterday, Andre Visagie, the AWB secretary-general, called Terreblanche's death a "declaration of war by the black community" and vowed to seek revenge. He also warned foreigners not to attend the World Cup of soccer in South Africa this summer.<br /><br />"You are sending your soccer teams to a land of murder," he said. "Don't do that if you don't have sufficient protection for them."<br /><br />The hint of possible violence echoes the sort of threats Terreblanche made regularly in the 1980s and 1990s when he led the AWB.<br /><br />The short, stocky bearded leader surrounded himself with hero-worshipping, brown-shirted and jack-booted "Storm Falcons," who wore red, white and black arm bands and waved a Nazi-like flag based on a logo of three 7s pivoting round each other in a circle.<br /><br />His rallies were filled with stiff-arm salutes, hysteria, hatred and promises of violence to protect the privileges and power apartheid gave South Africa's whites.<br /><br />Few ever took Terreblanche and the AWB seriously politically. But they represent a potentially violent fringe.<br /><br />In 1979, Terreblanche and some supporters were charged with assault for tarring and feathering a Pretoria university professor who ridiculed Afrikaner nationalist claims of a covenant with God.<br /><br />In the 1980s, Terreblanche received a suspended sentence for burying weapons on a Transvaal farm.<br /><br />At about the same time, two of his closest supporters were jailed for 15 years for plotting to blow up multi-racial hotels in South Africa, to plant bombs in the president's council chambers, to assassinate black politicians and clergymen and to release syphilis-infected mice at the multi-racial Sun City holiday resort.<br /><br />Later, as apartheid began to crumble, the AWB tried to derail the country's first all-race elections.<br /><br />Terreblanche and his followers stormed Johannesburg's World Trade Centre to disrupt negotiations on the post-apartheid constitution. They also claimed responsibility for several bomb attacks that killed about a dozen bystanders.<br /><br />In 1994, AWB members attacked Johannesburg's main airport and briefly invaded the apartheid-era black homeland of Bophuthatswana.<br /><br />Nearly 100 black soldiers and civilians died in that clash, which ended abruptly when the AWB retreated after the Bophuthatswana Defence Force summarily executed three AWB members, in front of television cameras.<br /><br />In the wake of Terreblanche's murder, Jacob Zuma, the South African President, has appealed for calm, asking both black and white South Africans "not to allow agents provocateurs to take advantage of this situation by inciting or fuelling racial hatred."<br /><br />pgoodspeed@nationalpost.com<br /><br /><br /><br />Read more: http://www.nationalpost.com/news/world/story.html?id=2767031#ixzz0kKR1we4yGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-12161137126882223342010-04-06T06:43:00.000-07:002010-04-06T06:44:24.823-07:00Ipad Survey over Twitter- Why replace iPhone?Global7 the new Millennial Renaissance Vision for the Globe<br /><br />Twitter users' biggest complaint with iPad: it can't replace an iPhone<br /><br />By Katie Marsal<br /><br />Published: 08:45 AM EST <br /> <br />Twitter users reacting to Apple's iPad after it launched on Saturday were overwhelmingly happy with the new device, with the biggest complaint being that the device can't replace their iPhone, a new survey of the social networking Web site found.<br /><br />On Tuesday, Attensity Group released its analysis of public reaction from Twitter, which analyzed 50,000 "tweets" related to the iPad. The survey found that 67 percent of people "like the iPad," and another 6 percent "love" it." For those against the product, 24 percent were said to be "not thrilled" with the iPad, while 2 percent "hate" Apple's new device.<br /><br />In perhaps the best bit of news for Apple from the survey, 87 percent of those talking about the iPad on Twitter after the product launched indicated they will buy an iPad, while just 13 percent said they will not purchase one.<br /><br />The biggest complaint from new iPad users was the fact that the device will not replace an iPhone. The study found that 26 percent of those complaining about the device wish it could replace their handset. Another 19 percent were upset over the lack of support for Adobe Flash, while 17 percent believe the pricing of applications on the App Store is too high.<br /><br />The mention of iPhone replacement could suggest that users who bought the Wi-Fi-only iPad on Saturday wish they had waited for the 3G model, due to arrive later this month. Like the iPhone, the 3G model will offer a persistent wireless data connection through carrier AT&T in the U.S. There's also the iPad's custom-built, speedy A4 processor, which makes the large-screen device more responsive than the iPhone 3GS.<br /><br /><br /><br /><br /><br /><br />Unsurprisingly, the thing that made users most happy about the iPad is the range of applications from the App Store, with 38 percent of positive Twitter comments related to iPad software. Another 26 percent said the new device could replace some of the functions of their iPhone, while 17 percent were satisfied with the screen and 9 percent praised the soft keyboard.<br /><br />Users' favorite iPad application, with 34 percent of the Twitter discussion, was Apple's iBooks, the book reading and purchasing application that users are prompted to download upon launching the App Store. Another 31 percent spoke positively of Netflix, while the iWork suite of applications was represented by 27 percent.<br /><br /><br /><br /><br /><br />Apple revealed on Monday that the iPad got off to a strong start in sales, with 300,000 of the new device being sold on its first day alone. That's a number better than the 270,000 the first-generation iPhone sold at launch.Globalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-8297903843816646222010-03-31T09:39:00.000-07:002010-03-31T14:19:25.059-07:00Why the need to defend a modern Clean Energy Project in Ethiopia?Global7 the new Millennial Renaissance Vision for the Globe!<br /><br /><br />Dear Patriotic Global Citizens and Friends of African Union, Greater Ethiopia Without Borders and Global Diaspora Nations and Nationalities.<br /><br />I read with interest the need for a Clean Energy Developer to defend his work and associates from the criticism of those who claim are " Friends of the Earth, Rivers, lakes and the Sun" and not friends of people who are the center of this project.<br /><br />Imagine the whole civilized world be it in Europe, Asia or America developed their energy by galvanizing the natural resources especially Rivers, Lakes, the Sun and Wind energy. When the world is moving towards clean natural energies, the out of date pseudo environmentalists want to stop clean energy projects in developing countries.<br /><br />Mind you the rivers of Asia, Europe and Americas continue to be the main source of energy to day. The Hudson River Basins, the Mississauga River Basin and the Colorado River Basin continue to be the source of the new world energy in the Americas. Just imagine where these Friends of International Rivers were when these great projects have been underway for such a long time.<br /><br />Are these real Friends of the Earth, Rivers, Lakes, the Sun and the Moon or racist saboteurs who want to continue to see the developing world impoverished by their cynical but suicidal campaigns.<br /><br />The recent famous book entitled "The White man's Buden" by William Easterly, the Director of the World Bank Research Department says it all. According to Mr Easterly, we have spent over 2.3 trillion on forieng aid over the past 50 years for developing countries and we have nothing to show for it. These series of Friends of the Environment are former World Bank and IMF associates trying to milk the money meant for development with their negative campaigns against development.<br /><br />We need to expose these crocodile tears once for all! The next 50 years will not be sucked by these parasites of development shedding crocodile tears but by gallant small business enterprises that will transform the Billion Poor in the world.<br /><br />Just imagine, such backward set of organizations trying to block the road to development by their cynical but poisonous netative campaigns!<br /><br />Just imagine what will happen if we keep quiet. It is time to speak and expose these wolves in sheep skin covering themselves with all assumed environmental credentials which they do not have.<br /><br />Let us fight misguide negative campaigns with facts and scientific truth and the following article is just doing that.<br /><br />I look forward to lean from your perspective. The time to speak and be heard is now!<br /><br />Yes we can change the tide of negative campaigns towards positive sustainable clean energy enterprises.<br /><br />Yes We can and get involved! The Nile Basin Civilization will see its Millennial Renaissance as it has done for millennia (7,502 Years), that trail blazed the Greatest Human Civilization!<br /><br />Seeking your creative input, I remain;<br /><br />Yours sincerely<br /><br />Belai Habte-Jesus, MD, MPH<br />The writer can be contacted at GlobalBJesus@gmail.com, 703.933.8737<br /><br />March 30, 2010, 2:27 PM<br />Developer Defends Ethiopian Hydro Project<br />By PETE BROWNE<br /><br />The Gibe III Hydroelectric dam project in Ethiopia is at the center of a dispute between environmental groups and developers.<br />Responding to complaints about the Gibe III hydroelectric dam project in Ethiopia, Salini Costruttori, the Italian hydropower developer behind the project, issued a statement late last week arguing that the project’s critics are opposed to Africa’s development.<br /><br />“The campaign against the construction of the Gibe plant in Ethiopia is merely another initiative without a technical and scientific basis,” the company said.<br /><br />“We are dealing with an irresponsible campaign, based on critical statements founded on blatant factual errors and mainly due to elementary arithmetic and technical mistakes,” the statement continued. “These statements have already been assessed and denied by authoritative international organizations, such as the European Investment Bank and the African Development Bank.”<br /><br />As we noted last week, a coalition of environmental and human rights groups has mounted a campaign to pressure financiers to cease financing for the project, which is already under way. It is slated to become Africa’s second largest hydroelectric dam.<br /><br />The sides disagree over the accuracy of documents relating to the potential environmental impacts of the Gibe III project — you can see closeup footage of the project under way in the video above — on the Omo River, which flows from the south of Ethiopia into Lake Turkana in Kenya.<br /><br /><br />After complaints from Friends of Lake Turkana, one of the groups in the coalition, the African Development Bank agreed to undertake a hydrological assessment of the lake.<br /><br />The report has twice been delayed, said Terri Hathaway, a spokeswoman for one International Rivers, another of the coalition member, in an e-mail message.<br /><br />”The European Investment Bank has also put out a bid for an environmental impact assessment on Lake Turkana for Gibe III,” Ms. Hathaway added, “so clearly, the issue has not already been properly studied by project developers.”<br /><br />Two previous environmental impact assessments conducted for the Ethiopian Electric Power Corporation – an initial 2006 study and an additional analysis of the downstream effects in 2008 – have been challenged by the Africa Resources Working Group, a collective of academics from Europe, the United States, and East Africa with experience in large hydro-dam and river basin development.<br /><br />The working group asserted in 2009 that earlier environmental assessments were based on “faulty premises” and that they were “compromised by pervasive omissions, distortions and obfuscation.”<br /><br />But Salini argued in its statement that the Gibe III project is the “fruit of the work of hundreds of engineers of worldwide renown in the sector and that thousands of technicians and workers of different nationalities are involved in the project, which has been submitted for approval by authoritative Ethiopian and international organizations.”<br /><br />The company also said it would “continue to defend its image from further unmotivated and defamatory attacks, which are causing serious damage not only to the company and the dignity of its technicians and workers, but also, especially, to the development of the Horn of Africa.”<br />E-mail This Print<br />Share<br />Twitter<br />Sign in to Recommend<br />Commerce, Conventional Energy, Efficiency, Energy Business, Energy Economics, Energy Politics, Environmental Politics, General Business, Government Policy, Health and Safety, The Environment, conservation, environmental impact statement, ethiopia, gibe iii, hydropower, omo river<br />Related Posts<br /><br />FROM GREEN INC.<br />Critics Seek to Halt Ethiopian Hydro Project<br />Ethiopian Hydro Plant Suffers Setback<br />Drought Has Venezuela Looking at Alternatives to Hydropower<br />California Dams to Feel Impact of Climate Change<br />Hydro-Quebec’s Green Power Export Plans<br />Previous post<br /><br />Kaiser Permanente Invests in Solar Power<br />Next post<br />Koch Industries Responds to Greenpeace<br />5 Readers' Comments Post a Comment »<br />ALL COMMENTS, HIGHLIGHTS<br />READERS' RECOMMENDATIONS, REPLIES. Oldest Newest<br />1.African LA, USA March 31st, 20107:44 am<br /><br />I agree. This compaign by the fringe "green environmental" groups is not well-founded and full of far-fetched assumptions. Even if we are to believe the worst case scenario they are pushing, the positive impact of this project far outweighs it. The 1800 MW from this dam will bring more economic transformation than all the western handout given to Ethiopia so far.<br /><br />Once this dam is complete, 90 percent of Ethiopia that is not now electrified will get electricity and be brought into the modern age. No more blackouts. No more power rationing. No more factory closings. Of course, these groups can't allow such development on the African Continent--no way jose!<br /><br />They will fight to death to cut funding to this partially complete dam and hold 82 million poor Ethiopians hostage because they feel the livelihood of 300,000 Omo tribesmen along the omo river and Lake Turkana may be affected somewhat. What they conveniently forget to point out is that the Ethiopian Government has already prepared a mitigation and massive community-centred development for these tribes that will be rolled as soon as the Dam is completed in 2013.<br /><br />Recommend Recommended by 0 Readers<br />2.Hannibal Washington, DC, March 31st, 2010, 7:45 am<br /><br />The policy implication of International Rivers’ position is that Ethiopia should stay as underdeveloped and a beggar. This way of thinking comes from a neo-colonialist mentality.<br /><br />Ethiopia is the second most populous nation in Africa with over 80 million people. Only about 2 percent of this population gets electricity, usually for three to four hours per day. The rest – about 78, 400,000 – do not get any type of electricity at all. If you do not have electricity, forget industrialization, you do not even have tap water. As a result, millions of people are dying from water related diseases per year. Besides, if you do not have electricity, you need to resort to other forms of energy to cook food. As a result, large amount of forests are being cleared each day to provide firewood for cooking and similar other things. Consequently, Ethiopia has lost about 97% of its forestry during the last five decades.<br /><br />As compared to other alternative means of energy, hydro-power energy is environmentally friendly. Besides, Ethiopia has, like any other country, a sovereign right to harness one of its natural resources.<br /><br />I think International Rivers does not undertake its own environmental impact study. For that matter, I do not think it has the skill, expertise, and resource to undertake such a complex study. As a result, it is just accusing the Ethiopian government without any type of scientific evidence. Besides, I do not think it will care for Ethiopians more than Ethiopians do for their own kind.<br /><br />It is one thing to ask for an environmental impact study by an independent body, but another thing to ask for the total cancellation of the project, which is insanity.<br />Recommend Recommended by 0 Readers<br />3.<br />Wang Suya<br />Japan<br />March 31st, 2010<br />7:45 am<br />Pity now money go through to end is unresponsibility. Just the dam is supported by many companies and ignore the consequence of dam to ecosystem is not ethics. This dam should be down by life cycle assessment even it is on the way. If life cycle assessment does not get good result, it is should be stoped. Stop before it finish is wisdom decide. If we want to go sustainable, we should strict on every project to understand whether it is destory our envrionment. LCA is the method.<br />Recommend Recommended by 0 Readers<br />4.<br />Abiye<br />Tokyo<br />March 31st, 2010<br />7:45 am<br />White people, and their NGOs, forever want African nations to remain undeveloped. If all African nations developed, what would white people do with their time that would allow them to feel good about themselves.<br /><br />This campaign against this dam is bogus. They have their motives and they want the people of Ethiopia to suffer. When its about development in the west, its always okay. But in Africa, they have to treat living nations as if they are studies from their anthropology class.<br />Recommend Recommended by 0 Readers<br /><br />5.Gecho, Beijing, March 31st, 2010, 7:46 am<br />1. I have yet to come across a single mention on what the people who will be directly affected by the Project actually think (even from Journalists who went to the area and "talked" to the people).<br /><br />2. Haven't heard strong and fact based argument against the Project.<br /><br />4. I have yet to come across any Ethiopian who opposes this project (which is quite surprising given the extreme nature of the criticism of these groups).<br /><br />5. The media seems to be paying more attention to the critics of the project (may be because they are loud). This is clearly seen from the alarming and conclusive titles and the first few paragraphs of most articles on this issue.<br /><br />Recommend Recommended by 0 Readers<br />Post a Comment<br />You must log in to post a comment (Register).<br />Ads by Google what's this?<br />Clean Tech Consulting<br />Technology, Engineering, Scale-up, and Investment Due Diligence<br />GardeniaVentures.com<br /> <br />Belai Habte-Jesus, MD, MPH<br />Global Strategic Enterprises, Inc. 4 Peace & Prosperity<br />Win-win synergestic Partnership 4P&P-focusing on<br />5Es: Education+Energy+Ecology+Economy+Enterprises<br />www.Globalbelai4u.blogspot.com; Globalbelai@yahoo.com<br />V: 571.225.5731; C: 703.933.8738; F: 703.531.0540<br />Our Passion is to reach our Individual and Collective Potential<br /> <br /> <br /><br /><br />--- On Fri, 3/26/10, Belai FM Habte-Jesus <globalbelai@yahoo.com> wrote:<br /><br />From: Belai FM Habte-Jesus <globalbelai@yahoo.com><br />Subject: Fw: [Voice of America] Council on Foreign Relations Report Argues United States Should Pursue New Approach to Somalia<br />To: "EPRDF Support Group EPRDF Support Group" <eprdf_group@yahoo.com><br />Cc: EPRDF-Supporters-Forum@yahoogroups.com, Edtior@aigaforum.com, "Abraha Belai" <editor@ethiomedia.com>, ethioforum@ethiolist.com<br />Date: Friday, March 26, 2010, 12:52 PM<br /><br />Dear Patriotic Global Citizens, Friends of African Union, Greater Ethiopia Without Border and Global Diaspora Nations and Nationalities without border:<br /><br />Greetings:<br /><br />If the Israeli Lobby can shake America, why cannot the Diaspora Nations and Nationalities Shake up the VoA and Human Rights Network of America?<br /><br />We all have 24 hours, two fingers and two eyes and on mouth per person.<br /><br />We have 7502 years of track record and 110 years of Diplomatic Relations with US, the Israel have 3,000 years of track record and 53 years of diplomatic relations with the US.<br /><br />No excuses, we do better than this zomby existence to promote and protect the interests of 80 Million indigenous and 5 Million Diaspora Ethiopians.<br /><br />They have less than 20 Million people across the world. We have both the numbers interms of bodies on earth and 4,000 years more track record.<br /><br />Wake up, No excuses! Let us see Change we can believe in!<br /><br />The barrier is all between our ears, our cerebrum and delinquent behavior of blaming others!<br /><br />Let us work and create a strong Ethiopian caucus and AEPAC right now!<br /><br />If Obama can change America just in 3 years of campaign and one year of Governance based on Yes We Can!<br /><br />Why not us?<br /><br />with regards and looking for Action Soon<br /><br /><br />Dr BMJ<br /><br /> <br />Belai Habte-Jesus, MD, MPH<br />Global Strategic Enterprises, Inc. 4 Peace & Prosperity<br />Win-win synergestic Partnership 4P&P-focusing on<br />5Es: Education+Energy+Ecology+Economy+Enterprises<br />www.Globalbelai4u.blogspot.com; Globalbelai@yahoo.com<br />V: 571.225.5731; C: 703.933.8738; F: 703.531.0540<br />Our Passion is to reach our Individual and Collective Potential<br /> <br /> <br /><br /><br />--- On Thu, 3/25/10, ZEGEYE BELETE <abamechal@yahoo.com> wrote:<br /><br />From: ZEGEYE BELETE <abamechal@yahoo.com><br />Subject: [Voice of America] Council on Foreign Relations Report Argues United States Should Pursue New Approach to Somalia<br />To: "Zegeye Belete" <abamechal@yahoo.com><br />Date: Thursday, March 25, 2010, 7:51 PM<br /><br />Voice of America<br /> <br />Somalia Report<br /> <br />DATE=03/22/10<br />TYPE=BACKGROUND REPORT<br />TITLE=SOMALIA BRUTON<br />NUMBER=5-63557<br />BYLINE=TEWELDE TESFAGABIR<br />DATELINE=WASHINGTON<br /> <br />HEADLINE: Council on Foreign Relations Report Argues United States Should Pursue New Approach to Somalia<br /> <br />INTRO: A new Council on Foreign Relations report calls for the U.S. government to pursue a policy of constructive disengagement in Somaliaand, recommends the international community to adopt a position of neutrality, and to abandon efforts to pick a winner in the war-torn country. VOA`s Horn of Africa reporter Tewelde Tesfagabir spoke with the author of the report.<br /> <br />TEXT: The report, "Somalia: A new Approach", sponsored by the Council on Foreign Relations says the odds of Somalia's Transitional Federal Government emerging as an effective body are "extremely poor."<br /> <br />Report author Bronwyn Bruton maintains the current U.S approach is counterproductive and it is encouraging some Somalis to radicalize.<br /> <br />/// BRUTON ACT 1 ///<br /> <br />"Although the TFG in Mogadishu has got some very good people in it, and it has certainly managed to win the hearts and minds of some Somalis, the odds that it will emerge as an effective institution with the critical mass of supporters is very unlikely. If the U.S and the broader international community continues to back the TFG as one side over others, it will perpetuate a military stalemate and this will be very costly to the U.S because it is hurting the Somalia`s population and it is encouraging some Somalis to radicalize."<br /> <br />/// END ACT ///<br /> <br />The report says that the United States should work with United Nations and African Union to promote reform of Somalia's TFG structures to allow it to become a more inclusive governing mechanism.<br /> <br />Bruton believes it is necessary for the United States to make a final push to try to turn the Transitional Federal Government into an institution that can eventually govern Somalia, and suggested the use of a presidential model in a country fractured along clan lines should be abandoned.<br /> <br />/// BRUTON ACT 2 ///<br /> <br />"In my opinion a presidential model is not a very good model for Somalia. Because there are a lot of different factions, and I do not really see any credible national leaders, and I do not think Somaliahad credible leaders for 30 or 40 years. So, what I would recommend is having a technocratic prime minster consisting of a council of leaders including Sheik Sharif."<br /> <br />/// END ACT ///<br /> <br />At a recent briefing U.S. Assistant Secretary of State Johnnie Carson denied recent media reports the United States is leading military efforts to help Somalia's government. He said, "There is no desire to Americanize the conflict in Somalia."<br /> <br />/// REST OPTIONAL ///<br /> <br />In her interview with VOA, Bruton welcomed his comment.<br /> <br />/// BRUTON ACT 3 ///<br /> <br />"I was very gland when Ambassador Carson came out and made this statement, because I think the Somali people need to hear that. It is exactly the right approach to not want to Americanize the conflict. And the U.S should continue to make that point."<br /> <br />/// END ACT ///<br /> <br />Bruton says, the conflict between Ethiopia and Eritrea poses more danger to the regional instability than the Somali conflict.<br /> <br /> /// BRUTON ACT 4 ///<br /> <br />"In a certain way, the conflict of Somalia is tied up in the conflict between Eritrea and Ethiopia. Most analysts agree that Eritrea does not really have a stake in Somali conflict, does not have a reason to backal-Shabab over TFG. Eritrea wants to be a bother to Ethiopia, and for that reason Eritrea has allegedly been providing arms to al-Shabab and Hisbul Islam. As to the sanctions on Eritrea, I think diplomatic solutions are what are going to be required here."<br /> <br />/// END ACT ///<br /> <br />Bronwyn Bruton says Eritrea also needs to come around to take a more constructive approach to its neighbors. She says the international community has got to find a way to assist Ethiopia and Eritrea in resolving their dispute and the United States should dissuade Ethiopia from any military action in Somalia in response to possible events in Mogadishu. (SIGNED)<br />NEB/TT/RAE/KBKGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0tag:blogger.com,1999:blog-31567885.post-80849581418935529272010-03-31T09:37:00.001-07:002010-03-31T09:37:47.912-07:00Ethiopia Solaris Elettra- The Electric Car of the Future!Global7 the new Millennial Renaissance Vision for the Globe<br /><br /><br /><br />Ethiopia gets first electric car<br />Ethiopia has launched an electric car, despite suffering from power shortages. It is only the second African country to do so, after South Africa.<br /><br />Two versions of the Solaris Elettra will be manufactured in Addis Ababa, costing around $12,000 and $15,000.<br /><br />The cars will be sold in Ethiopia and exported to Africa and Europe.<br /><br />But some doubt if Africa, where erratic power supplies, low levels of personal wealth and poor infrastructure are common, is ready for electric cars.<br /><br />Carlo Pironti, general manager of Freestyle PLC, the company producing the Solaris, told the BBC's Uduak Amimo in Addis Ababa that Ethiopia's electricity shortages were not a major obstacle to operating an electric car.<br /><br />"Ethiopia in future will have lots of power supply," he said.<br /><br />"In any case, the car can be recharged by generator and by solar power."<br /><br />“ From a green country to a green world ” <br />Carlo Pironti <br />Taxes on cars in Ethiopia can be more than 100% and many Ethiopians with low incomes will struggle to afford an electric car.<br /><br />To overcome this problem, Mr Pironti says his company will develop a credit system for less affluent customers.<br /><br />Six Solaris Elettras will be produced every week for the next three months, rising to 30 per week when Freestyle's factory in Addis Ababa is fully operational, he says.<br /><br />Mr Pironti says he wants to take the Solaris "from a green country to a green world," referring to the company's plans to export the car from Ethiopia to Africa and beyond.<br /><br />But Wayne Batty, senior writer at South Africa's Topcar magazine, believes only a small percentage of Africa has the necessary infrastructure to support an electric car.<br /><br />Mr Batty told the BBC's Focus on Africa programme that electric cars are fine for short trips of 40 to 50 km (25 to 31 miles), but African countries lack the recharging points for longer journeys.<br /><br />Ethiopia's electric car comes after Rwanda launched its first bio-diesel bus last week.<br /><br />It is currently building a huge hydro-electric dam on the Omo river and hopes to become a major exporter of energy when that is completed.<br /><br />Story from BBC NEWS:<br />http://news.bbc.co.uk/go/pr/fr/-/2/hi/africa/8596455.stm<br /><br />Published: 2010/03/31 12:21:46 GMT<br /><br />© BBC MMXGlobalbelai7http://www.blogger.com/profile/14987573270468779267noreply@blogger.com0