The High Costs of Low Pay - Conference Looks at Health, Safety and Wellness Issues of Low-wage Workers

What's New: The High Costs of Low Pay - Conference Looks at Health, Safety and Wellness Issues of Low-wage Workers: "Sixty per cent of Sudbury area workers earn $10 an hour or less according to statistics from the Financial Post. This and other information will be presented at “The High Costs of Low Pay: Health, Safety & Wellness Issues of Low-wage Workers”, a two-day conference Thursday, November 3 and Friday, November 4.

“Wage levels affect our health and well-being,” says Dr. Duncan Matheson, Director of Laurentian University’s School of Social Work and a member of the Working Poor Project Steering Committee. “The number of low-wage workers in Sudbury is growing – which means that, increasingly, area residents struggle to find affordable housing, food, transportation, daycare and personal services, not to mention time with their families,” he adds. “This is an opportunity to inform and educate the public on struggles of low-wage workers within our community.”"

Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity -- Rivers et al. 173 (9): 1054 -- C

Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity -- Rivers et al. 173 (9): 1054 -- Canadian Medical Association Journal:
"The pathogenic, diagnostic and therapeutic landscape of sepsis is no longer confined to the intensive care unit: many patients from other portals of entry to care, both outside and within the hospital, progress to severe disease. Approaches that have led to improved outcomes with other diseases (e.g., acute myocardial infarction, stroke and trauma) can now be similarly applied to sepsis. Improved understanding of the pathogenesis of severe sepsis and septic shock has led to the development of new therapies that place importance on early identification and aggressive management. This review emphasizes approaches to the early recognition, diagnosis and therapeutic management of sepsis, giving the clinician the most contemporary and practical approaches with which to treat these patients."/.../

The Culture and Context of Peace

Editorial: The Culture and Context of Peace: "Editorial: The Culture and Context of Peace
Wendy Harcourt

Abstract

Development (2005) 48, 1-4. doi:10.1057/palgrave.development.1100161
As I write, the Millennium Summit Five year review draft outcome document is being circulated as part of the global preparations and negotiations for the September Heads of State Summit in New York. Emerging from the same process that produced the 2005 Secretary General's Report 'In larger freedom: Towards development, security and human right for all' (http://www.un.org/largerfreedom/), it is an important summary of the key interests of the multilateral agenda. Whether or not all the wording of this draft outcome document is accepted on 16 September 2005 by the Heads of State gathered at the United Nations Headquarters, it is an important political statement of what the UN would like to be agreed upon.

As I write, the Millennium Summit Five year review draft outcome document is being circulated as part of the global preparations and negotiations for the September Heads of State Summit in New York. Emerging from the same process that produced the 2005 Secretary General's Report 'In larger freedom: Towards development, security and human right for all' (http://www.un.org/largerfreedom/), it is an important summary of the key interests of the multilateral agenda. Whether or not all the wording of this draft outcome document is accepted on 16 September 2005 by the Heads of State gathered at the United Nations Headquarters, it is an important political statement of what the UN would like to be agreed upon."/.../

Results Based Primary Health Care

Results Based Primary Health Care
Primary health care (PHC) is the foundation of Canada’s health care system. For most people, PHC is their first point of contact with the health care system, often through a family physician. It is where short-term health issues are resolved and the majority of chronic health conditions are managed. It is also where health promotion and education efforts are undertaken, and where patients in need of more specialized services are connected with secondary care. The last few years have seen increasing concern about access
to and the quality of PHC in Canada. When asked to deliberate about the various options to sustain their health care system, many Canadians suggest reform to PHC. People are ready for new models of service delivery that will improve or sustain the level of care already provided.Between 1997 and 2008, substantial federal and provincial investments are dedicated to improving the delivery of PHC in Canada. All of these financial investments have, to varying degrees, required evaluation to ensure that the policy, administrative and practice community monitor, guide and report on PHC renewal./.../

Gripe aviaria y los laboratorios

De: Marcelo Gustavo Colominas [mailto:mgcolominas@gigared.com]
Enviada em: sexta-feira, 28 de outubro de 2005 09:14
Assunto: Gripe aviaria y los laboratorios
Gripe aviaria y los laboratorios
PUEDE SER UNA CATATROFE MUNDIAL
Pablo Rieznik
Roche es uno de los mayores monopolios de la industria farmacéutica mundial, y “fenomenal” es el adjetivo usado en un informe de la semana pasada por el Wall Street Journal para calificar el “enorme impulso a sus ganancias... provocado por el miedo (a la gripe aviar)”. Roche fabrica el remedio Tamiflu –también llamado oseltamivir–, una medicina que languidecía en los estantes de las farmacias y pasó a ser ahora el producto número uno en ventas. Es el único antiviral conocido para combatir la gripe de las aves, “lo que deja en manos de un solo laboratorio, que se niega a liberar la patente, el suministro mundial” (El País, 13/10). Mientras tanto la prensa de todo el mundo habla de una pandemia (enfermedad epidémica que se extiende a muchos países), que podría provocar decenas de millones de muertes. En estas condiciones, antes que la gripe estalle, la humanidad se ha convertido en víctima del monopolio capitalista de la salud: ya se sabe que existen remedios posibles pero no son producidos en cantidad necesaria y su restringida producción se encuentra protegida por la “propiedad privada”.
Salud, militarismo y crisis
En la enorme cantidad de publicaciones sobre este tema no hay un acuerdo sobre si el estallido de la pandemia de gripe puede ser inmediato. Hasta ahora la infección pasó de las aves a los seres humanos pero el virus respectivo no ha mutado a una forma que pueda transmitirse fácilmente de persona a persona. Las proyecciones de científicos al respecto son pesimistas, y si la mutación se produce la infección se extendería rápidamente a millones de hombres y mujeres en el mundo entero. Por esto mismo, la cuestión se ha transformado en asunto de seguridad nacional. En Estados Unidos el propio Bush se refirió a la posible movilización de fuerzas militares si es necesario asegurar el mantenimiento de poblaciones en cuarentena y “organismos de inteligencia” estudiaron escenarios posibles de infección masiva de las tropas en Medio Oriente. Otra cantidad de analistas han dedicado sus afanes a analizar las consecuencias económicas que podría tener la pandemia. En estos casos parece que más que una “gripe aviar”, tenemos un “chivo expiatorio” que podría servir de pantalla tanto a una conversión más profunda de los EEUU en un Estado policial, como a las tendencias al colapso del orden económico internacional.
En cualquier caso, el abismo existente entre lo que se ha escrito y lo que se hace, en materia de prevención frente a la posible pandemia, es monstruoso. La recomendación de la Organización Mundial de la Salud es que el stock del antiviral para enfrentar la perspectiva de un estallido de la gripe debe ser el equivalente a 25% de la población. Y se sabe que hasta ahora ningún Estado obtuvo esa cantidad de dosis. Gran Bretaña, para tomar apenas un ejemplo, tiene 2,5 millones de dosis cuando necesita al menos 15 millones. Las autoridades inglesas consideran que si hay mutación del virus en el invierno próximo, podrían morir 50.000 británicos por la fiebre aviaria. Los especialistas del Instituto Pasteur de Francia y del Robert Koch en Alemania plantearon que se debe lanzar inmediatamente un plan a gran escala de investigaciones para preparar una vacuna más eficaz que las conocidas y reclaman un financiamiento de 100 millones de euros, a contramano de la política de ajuste fiscal que reina en la Unión (Clarín, 18/10).
Y por casa, ¿cómo andamos?
En esta catástrofe anunciada no faltan los teóricos que plantean que se trata de un ajuste “natural” en la especie humana que acabaría con el exceso de los ejemplares menos exitosos de la especie. Por supuesto, son los pobres y miserables. Según Mario Lozano, investigador del Conicet y director del Departamento de Ciencia de la Universidad de Quilmes, “la epidemia será grave en particular para los países donde la gente vive en peores condiciones, porque los virus de la gripe afectan a los desprotegidos, desnutridos, niños y ancianos...las pandemias, al menos de gripe, son de pobres” (Veintitrés, 20/11). Y agrega: habría que forzar al gobierno a poner la plata que se necesita para la vigilancia epidemiológica: “Con inversión genuina se pueden desarrollar protecciones sanitarias que evitarían millones de muertes”. Al mismo tiempo, La Nación informa que el antiviral Tamiflu “está completamente ausente en las farmacias de nuestro país”.

Preventing chronic diseases: how many lives can we save?

The Lancet: "Summary
35 million people will die in 2005 from heart disease, stroke, cancer, and other chronic diseases. Only 20% of these deaths will be in high-income countries --while 80% will occur in low-income and middle-income countries. The death rates from these potentially preventable diseases are higher in low-income and middle-income countries than in high-income countries, especially among adults aged 30-69 years. The impact on men and women is similar. We propose a new goal for reducing deaths from chronic disease to focus prevention and control efforts among those concerned about international health. This goal 'to reduce chronic disease death rates by an additional 2% annually' would avert 36 million deaths by 2015. An additional benefit will be a gain of about 500 million years of life over the 10 years from 2006 to 2015. Most of these averted deaths and life-years gained will be in low-income and middle-income countries, and just under half will be in people younger than 70 years. We base the global goal on worldwide projections of deaths by cause for 2005 and 2015. The data are presented for the world, selected countries, and World Bank income groups."/.../

How computers help make efficient use of consultations -- Sullivan and Wyatt 331 (7523): 1010 -- BMJ

How computers help make efficient use of consultations -- Sullivan and Wyatt 331 (7523): 1010 -- BMJ: "Efficient consultations deal with patients' problems promptly and effectively while taking into account other relevant circumstances. Sometimes the relevant circumstance is another health problem in the patient or their family, or it could be an issue affecting society at large, such as resource constraints. The immediate role of the team caring for Patrick Murphy (see box opposite) is to deal with his severe asthma.
To do so the team needs information on the current problem, which is quickly obtained from Patrick's mother (who accompanied him in the ambulance) and background details from her or from his medical records. They also need to assess Patrick's physical status using clinical examination and other diagnostic methods. The information obtained enables the clinicians caring for Patrick to take the most effective management steps. In the longer term, data from the consultation may be used to redesign the service locally, or at the level . . . [Full text of this article]"

Ten Commandments for Effective Clinical Decision Support: Making the Practice of Evidence-based Medicine a Reality -- Bates et al. 10 (6): 523 --

Ten Commandments for Effective Clinical Decision Support: Making the Practice of Evidence-based Medicine a Reality -- Bates et al. 10 (6): 523 -- Journal of the American Medical Informatics Association: "While evidence-based medicine has increasingly broad-based support in health care, it remains difficult to get physicians to actually practice it. Across most domains in medicine, practice has lagged behind knowledge by at least several years. The authors believe that the key tools for closing this gap will be information systems that provide decision support to users at the time they make decisions, which should result in improved quality of care. Furthermore, providers make many errors, and clinical decision support can be useful for finding and preventing such errors. Over the last eight years the authors have implemented and studied the impact of decision support across a broad array of domains and have found a number of common elements important to success. The goal of this report is to discuss these lessons learned in the interest of informing the efforts of others working to make the practice of evidence-based medicine a reality. "

Trajectories of Growth among Children Who Have Coronary Events as Adults

NEJM -- Trajectories of Growth among Children Who Have Coronary Events as Adults: "Background Low birth weight is a risk factor for coronary heart disease. It is uncertain how postnatal growth affects disease risk.
Methods We studied 8760 people born in Helsinki from 1934 through 1944. Childhood growth had been recorded. A total of 357 men and 87 women had been admitted to the hospital with coronary heart disease or had died from the disease. Coronary risk factors were measured in a subset of 2003 people.
Results The mean body size of children who had coronary events as adults was below average at birth. At two years of age the children were thin; subsequently, their body-mass index (BMI) increased relative to that of other children and had reached average values by 11 years of age. In simultaneous regressions, the hazard ratios associated with a 1 SD increase in BMI were 0.76 (95 percent confidence interval, 0.66 to 0.87; P<0.001) at 2 years and 1.14 (95 percent confidence interval, 1.00 to 1.31; P=0.05) at 11 years among the boys. The corresponding figures for the girls were 0.62 (95 percent confidence interval, 0.46 to 0.82; P=0.001) and 1.35 (95 percent confidence interval, 1.02 to 1.78; P=0.04). Low BMI at 2 years of age and increased BMI from 2 to 11 years of age were also associated with raised fasting insulin concentrations (P<0.001 for both).
Conclusions On average, adults who had a coronary event had been small at birth and thin at two years of age and thereafter put on weight rapidly. This pattern of growth during childhood was associated with insulin resistance in later life. The risk of coronary events was more strongly related to the tempo of childhood gain in BMI than to the BMI attained at any particular age. "

Being big or growing fast: systematic review of size and growth in infancy and later obesity -- Baird et al. 331 (7522): 929 -- BMJ

Being big or growing fast: systematic review of size and growth in infancy and later obesity -- Baird et al. 331 (7522): 929 -- BMJ: "Being big or growing fast: systematic review of size and growth in infancy and later obesity
Janis Baird, research fellow1, David Fisher, research assistant1, Patricia Lucas, lecturer2, Jos Kleijnen, director3, Helen Roberts, professor of child health4, Catherine Law, reader in children's health5

Objectives To assess the association between infant size or growth and subsequent obesity and to determine if any association has been stable over time.
Design Systematic review.
Data sources Medline, Embase, bibliographies of included studies, contact with first authors of included studies and other experts.
Inclusion criteria Studies that assessed the relation between infant size or growth during the first two years of life and subsequent obesity.
Main outcome measure Obesity at any age after infancy.
Results 24 studies met the inclusion criteria (22 cohort and two case-control studies). Of these, 18 assessed the relation between infant size and subsequent obesity, most showing that infants who were defined a"

A short introduction to epidemiology

A short introduction to epidemiology

Neil Pearce
Occasional Report Series No 2 - Centre for Public Health Research,

Second Edition - February 2005

Massey University Wellington Campus - Wellington, New Zealand
To download a PDF file [153p.] at: http://publichealth.massey.ac.nz/publications/introepi.pdf

“……Public health is primarily concerned with the prevention of disease in human population. It differs from clinical medicine both in its emphasis on prevention rather than treatment, and in its focus on populations rather than individual patients (table 1.1). Epidemiology is the branch of public health which attempts to discover the causes of disease in order to make disease prevention possible. Epidemiological methods can be used in other contexts (particularly in clinical research), but this short introductory text focuses on the use of epidemiology in public health, i.e. on its use as part of the wider process of discovering the causes of disease and preventing its occurrence in human populations….”

To download PPT files for teaching: http://publichealth.massey.ac.nz/teaching_files.htm

Contents

1. Introduction
– Germs and miasmas
– Risk factor epidemiology
– Epidemiology in the 21st century

PART 1: STUDY DESIGN OPTIONS

2. Incidence studies
– Incidence studies
– Incidence case-control studies

3. Prevalence studies
– Prevalence studies
– Prevalence case-control studies

4. More complex study designs
– Other axes of classification
– Continuous outcome measures
– Ecologic and multilevel studies

5. Measurement of exposure and health status
– Exposure
– Health status

PART 2: STUDY DESIGN ISSUES

6. Precision
– Basic statistics
– Study size and power

7. Validity

– Confounding
– Selection bias
– Information bias

8. Effect modification
– Concepts of interaction
– Additive and multiplicative models
– Joint effects

More complex study designs
– Other axes of classification
– Continuous outcome measures
– Ecologic and multilevel studies

5. Measurement of exposure and health status
– Exposure
– Health status

PART 2: STUDY DESIGN ISSUES

6. Precision
– Basic statistics
– Study size and power

7. Validity
– Confounding
– Selection bias
– Information bias

8. Effect modification
– Concepts of interaction
– Additive and multiplicative models
– Joint effects

PART 3: ANALYSIS AND INTERPRETATION OF STUDIES

9. Data analysis
– Basic principles
– Basic analyses
– Controlling for confounding

10. Interpretation
– Appraisal of a single study
– Appraisal of all of the available evidence

* * * *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic health differentials; Gender;
Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics; Information Technology - Virtual libraries; Research & Science issues. [DD/ IKM Area]3. “Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its countries members”.

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An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured

PLoS Medicine: An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured
Amir Attaran
In September 2000, 147 heads of state met at the United Nations (UN) headquarters—the largest such gathering ever—to resolve action on the most pressing problems of humanity and nature [1]. To underscore their commitment, they set numerical targets and deadlines to measure performance. These are the Millennium Development Goals (MDGs), and they span a large range of topics, including poverty, infectious disease, education, and gender equality (Box 1).

This September, the heads of state will gather again for the Millennium +5 Summit to assess the five-year progress of the MDGs. They will find that the MDGs have become all-important, not just within the UN, but also as the zeitgeist of the global development enterprise. As Professor Jeffrey Sachs, Director of the UN's Millennium Project, has declared, “To the extent that there are any international goals, they are the Millennium Development Goals”[2].

But is it wise to elevate the MDGs to the pedestal where they now sit? Could it be, despite an appearance of firm targets, deadlines, and focused urgency, that the MDGs are actually imprecise and possibly ineffective agents for development progress?

In this article, I argue that many of the most important MDGs, including those to reduce malaria, maternal mortality, or tuberculosis (TB), suffer from a worrying lack of scientifically valid data. While progress on each of these goals is portrayed in time-limited and measurable terms, often the subject matter is so immeasurable, or the measurements are so inadequate, that one cannot know the baseline condition before the MDGs, or know if the desired trend of improvement is actually occurring. Although UN scientists know about these troubles, the necessary corrective steps are being held up by political interference, including by the organisation's senior leadership, who have ordered delays to amendments that could repair the MDGs [3]. In short, five years into the MDG project, in too many cases, one cannot know if true progress towards these very important goals is occurring. Often, one has to guess./.../

Health Care Charges Associated With Physical Inactivity, Overweight, and Obesity

Preventing Chronic Disease: October 2005: 04_0118
Recommended by Marcelo Gustavo Colominas [mgcolominas@gigared.com]
Abstract
Introduction
Physical inactivity, overweight, and obesity are associated with increased morbidity and mortality. The objective of this study was to estimate the proportion of total health care charges associated with physical inactivity, overweight, and obesity among U.S. populations aged 40 years and older.

Methods
A predictive model of health care charges was developed using data from a cohort of 8000 health plan members aged 40 and older. Model cells were defined by physical activity status, body mass index, age, sex, smoking status, and selected chronic diseases. Total health care charges were estimated by multiplying the percentage of the population in each cell by the predicted charges per cell. Counterfactual estimates were computed by reclassifying all individuals as physically active and of normal weight while leaving other characteristics unchanged. Charges associated with physical inactivity, overweight, and obesity were computed as the difference between current risk profile total charges and counterfactual total charges. National population percentage estimates were derived from the National Health Interview Survey; those estimates were multiplied by the predicted charges per cell from the health plan analysis.

Results
Physical inactivity, overweight, and obesity were associated with 23% (95% confidence interval [CI], 10%–34%) of health plan health care charges and 27% (95% CI, 10%–37%) of national health care charges. Although charges associated with these risk factors were highest for the oldest group (aged 65 years and older) and for individuals with chronic conditions, nearly half of aggregate charges were generated from the group aged 40 to 64 years without chronic disease.

Conclusion
Charges associated with physical inactivity, overweight, and obesity constitute a significant portion of total medical expenditures. The results underscore the importance of addressing these risk factors in all segments of the population.

the 11th Corruption Perceptions Index (CPI) on behalf of Transparency International (TI).

http://www.icgg.org/corruption.cpi_2005_press.html
A Wake Up Call for the Bad Guys
The University of Passau compiles the 11th Corruption Perceptions Index (CPI) on behalf of Transparency International (TI).
Passau University, 18 October 2005: The new CPI index is out today: and judging from history, there will soon be a wave of international anti-corruption investigations based on its work.
In the past ten years the CPI has caused over ninety high-profile investigations around the world. The unequivocal message from these investigations: corruption is disastrous to societies. The very people who deserve the most help are the most victimized: the honest, the poor and the powerless. The honest are deprived because they do not participate in the shady deals; the poor are worse off because they cannot afford the costly bribes; the powerless are victimized because they cannot escape the extortionate demands of a greedy environment.
The CPI has become an important tool in fighting corruption. It has placed the fight against corruption firmly on the public agenda. It has helped spark major legislative reform. And it has helped change the popular perception that corruption was always "someone else's problem": Firms point to politicians as causing corruption; politicians mention unscrupulous private interests as being at the core of the problem; rich countries delegate responsibility to corrupt leaders of less developed countries; for poor countries the problem rests with bribe-willing multinationals. By putting countries in an integrity-league the CPI provides a simple sports-like logic. Whatever one may think about other countries in the league, one's home country is placed in a sequence of countries rather than being on top by force of xenophobic prejudice.
International investors also dislike countries perceived to be corrupt, fearing arbitrary decision making and a poor protection of their property. Countries with a higher score in the CPI, to the contrary, suffer less from capital flight and are preferred as safe havens. According to recent research, if a country were to improve its score in the CPI by 1 point (out of 10), foreign direct investment would increase by 15 percent.
Here is the bad news: the following countries, some of them very high-income, have deteriorated in the CPI since 1995. A reduction in the score (in descending order of significance) was observed in Poland, Argentina, Philippines, Zimbabwe, Canada, Indonesia, Ireland, Malaysia, Israel, Slovenia, Czech Republic, United Kingdom and Venezuela.
Prosperity is no guarantee against corruption. This is best seen in the oil-rich countries, scoring poorly in the CPI. For example, this year, for the first time, Equatorial Guinea enters the index. Its recent boom in oil extraction contrasts to its 152 position in the CPI, one of the lowest this year. This underpins that high income from natural resources produces ample opportunities for corruption, rather than helping development.
But there is hope. "Corruption is not a fate", argues Johann Graf Lambsdorff, the father of the CPI, "it prospers where business, society and politics turn a blind eye to its damaging effects".
Here is the good news; countries can improve their ranking in the CPI. They can "compete for integrity". The South Korea government had announced its goal to belong to the top-ten countries in the CPI. They improved their ranking from 47 in 2004 to 40 this year. This is one of the starkest improvements - and evidence that the right type of competition has been initiated by the CPI.
There are other signs of positive change, recent research at the University of Passau indicates significant improvements between 1995 and 2005 occurred (in descending order of significance) in Estonia, Italy, Spain, Colombia, Finland, Bulgaria, Hong Kong, Australia, Taiwan, Iceland, Austria, Mexico, New Zealand and Germany.
These are the places to look at when seeking good precedent. Given the international attention and support given to anti-corruption programs, the prospects of a sustainable reduction of corruption are higher than ever. Some poorer countries in the CPI are already indicative that poverty need no longer place a country in a downward spiral. Countries such as Chile, Barbados, Uruguay, Jordan and Botswana score rather well in this year's index. They are also prime candidates for improved economic and social development
In a recent study two authors, Lee and Ng, show that firms from countries scoring badly in the CPI are valued lower by international investors. If a country improves by 1 point in the CPI, the valuation of stocks of its domestic firms increases by roughly 10 percent. This illustrates that fighting corruption is not only a moral obligation - it is increasingly part of good business.
Details of Transparency International's Corruption Perceptions Index 2005 are available at: http://www.transparency.org/surveys/index.html#cpi and http://www.ICGG.org.

Conversation with Sir Michael Marmot

Conversation with Sir Michael Marmot, p. 2 of 4
What does an epidemiologist do?

Lots of things. But essentially, the thing that distinguishes epidemiology is the study of disease in populations. So to contrast what I did as a clinician, in clinical medicine, [with] what I do in epidemiology, clinicians are trained to treat individual patients, that's what they do first, last, and always, they treat individual patients. What I was doing in my own primitive way in Sydney, asking, "Why are these kids getting asthma again and again? Why are they coming back? What is it in the environment in which they live that's causing these kids to come back and back with asthma?" was thinking like an epidemiologist, was thinking about causes that are out there in the population. So what epidemiologists do is study disease in populations, and they study the causes of disease in populations.

Virtual Library

About the Virtual Library: "The WWW Virtual Library (VL) is the oldest catalogue of the Web, started by Tim Berners-Lee, the creator of html and the Web itself, in 1991 at CERN in Geneva, Switzerland. Unlike commercial catalogues, it is run by a loose confederation of volunteers, who compile pages of key links for particular areas in which they are expert; even though it isn't the biggest index of the Web, the VL pages are widely recognised as being amongst the highest-quality guides to particular sections of the Web.
Where is it?

Individual indexes live on hundreds of different servers around the world. A set of catalogue pages linking these pages is maintained at http://vlib.org/. A mirror of the Catalog is kept at East Anglia (UK).
Who runs it

Each maintainer is responsible for the content of their own pages, as long as they follow certain guidelines. The central Catalog pages are maintained by the Council of the VL. Gabriel Fenteany and Michael Chapman are currently maintaining the Catalog. The VL was first conceived and run by Tim Berners-Lee, and later expanded, organised and managed for several years by Arthur Secret, before it became a formally established association with Gerard Manning as its Council's first chairman. The late Bertrand Ibrahim was a key contributor to the pre-association phase of the VL's development, and then served as its Secretary until his untimely death.

The central affairs of the VL are now co-ordinated by an elected council, which took office in Jan 2000. Major decisions, including a set of bylaws are decided by the membership at large.

Many volunteers have given a great deal of time and effort to the VL, ever since the early days of the web. There is a partial list of VL alumni to recognise their contributions.
Interested?

Do you have a good list of sites for a particular area? Would you like to make your favourite area of the Web safe for unwary travelers? If so, consider joining the VL and bringing your expertise to a new audience. Questions about membership or the Catalog.

If you maintain a site you would like to have listed in a section of the Virtual Library, then please go to that site to find how to contact the individual maintainer. The Catalog curator is not involved in the addition of external sites to the VL.

General administrative enquiries can be made on a separate form."

Mushroom Yields First Of New Class Of Antibiotics -

Mushroom Yields First Of New Class Of Antibiotics: "Note that this study suggests a new class of antibiotics is possible, but caution patients that more study is needed before they will be available for therapy.

WASHINGTON, Oct. 13 - A small black mushroom found in the woods of northern Europe contains the first of what may be a powerful new class of antibiotics and "/.../

Link Between Tequin (gatifloxacin) and Hypoglycemia Strengthened -

IDSA: Link Between Tequin (gatifloxacin) and Hypoglycemia Strengthened - CME Teaching Brief - MedPage Today:
"This small and preliminary study supports a relationship between Tequin (gatifloxacin) and the development of hypoglycemia in older patients, especially if they have diabetes. Consider this association when selecting antibiotic therapy for elderly diabetic patients.

This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.
Review
SAN FRANCISCO, Oct. 11 - Treatment with the fluoroquinolone Tequin (gatifloxacin) was strongly associated with hypoglycemia in elderly patients, particularly those with diabetes, according to a prospective cohort study.
Of 196 elderly patients enrolled in the study, 77 were taking Tequin and 119 a non-quinolone antibiotic. Ten patients developed hypoglycemia after Tequin dosing, whereas only one case occurred in the non-quinolone group, researchers reported at a meeting here of the Infectious Disease Society of America.
The rate of hypoglycemia differed significantly between the groups, with 13% in the Tequin treatment arm becoming hypoglycemic compared with 0.8% in the non-quinolone group (P=.0004, relative risk 15.4, 95% CI 2.02 - 118.33), said the researchers. "/.../

UNFPA State of World Population 2005

UNFPA State of World Population 2005: "It is a simple message but a powerful one: Gender equality reduces poverty and saves and improves lives.
In the year 2000, the nations of the world came together to forge a unique compact. The eight Millennium Development Goals (MDGs) sketched out a bold plan to halve extreme poverty by 2015. This unprecedented global initiative holds great promise. During the next decade, hundreds of millions of people can be released from the stronghold of poverty. The lives of 30 million children and 2 million mothers can be spared. The spread of AIDS can be reversed. Millions of young people can play a larger role in their country's development and create a better world for themselves and future generations.
This year�s The State of World Population report stresses that gender equality and reproductive health are indispensable to the realization of this promise.
The UN Millennium Project, a panel of more than 250 experts from all over the world, identifies gender inequality as one of the primary drivers of poverty and social exclusion. This is because discrimination effectively squanders human capital by denying one half of humanity the right to realize their full potential. More than 1.7 billion women worldwide are in their reproductive and productive years, between the ages of 15 and 49. Targeted investments in their education, reproductive health, economic opportunity and political rights can spur growth and sustainable development for generations to come.
The report, The Promise of Equality: Gender Equity, Reproductive Health and the Millennium Development Goals, explores the degree to which the global community has fulfilled pledges made to the world�s most impoverished and marginalized peoples. It tracks progress, exposes shortfalls and examines the links between poverty, gender equality, human rights, reproductiv"/.../

Cost of War - National Priorities Project

Cost of War - National Priorities Project:
"Below is a running total of the U.S. taxpayer cost of the Iraq War. The number is based on Congressional appropriations.
The War in Iraq Costs
$200,553,537,027

See the cost in your community

Or compare to the cost of:
PRE-SCHOOL
KIDS' HEALTH
PUBLIC EDUCATION
COLLEGE SCHOLARSHIPS
PUBLIC HOUSING
WORLD HUNGER
AIDS EPIDEMIC
WORLD IMMUNIZATION

Notes and Sources
Embed a counter in your own web page!
Set up an LED counter on Main Street in your town.

In April, 2003 an intergenerational team of Niko Matsakis of Boston, MA and Elias Vlanton of Takoma Park, MD created costofwar.com. After maintaining it on their own for the first year, they gave it to the National Priorities Project to contribute to their ongoing educational efforts."

Folha Online - Cotidiano - Estudo mostra que alimentação balanceada evitaria até 260 mil mortes -

Folha Online - Cotidiano - Estudo mostra que alimentação balanceada evitaria até 260 mil mortes - 10/10/2005: "Estudo mostra que alimentação balanceada evitaria até 260 mil mortes
(da Folha Online enviado por Mário Maranhão)

Um estudo do Ministério da Saúde que será lançado na próxima semana revela que até 260 mil mortes poderiam ser evitadas, todos os anos, se o brasileiro tivesse uma alimentação equilibrada.

O 'Guia Alimentar para a População Brasileira' mostra que a alimentação vem mudando no Brasil. Segundo o Ministério da Saúde, até o arroz com feijão cada vez menos consumido, sendo substituído por refeições prontas e misturas industrializadas, que aumentaram sua participação em 82% na dieta do brasileiro. O consumo de refrigerantes também aumentou em 400%.

O estudo também mostra que estas novas formas de alimentação não dão conta de suprir as necessidades nutricionais do corpo. O guia relaciona o aumento de doenças crônicas, que atingiam 34,4% do total da população em 1979, mas em 2003 afetavam 48,3% da população mudança alimentar."

health benefits of fruits and vegetables

Health Benefits - 5 A DAY: "The health benefits of fruits and vegetables.
Increasing consumption of fruit and vegetables can significantly reduce the risk of many chronic diseases.[3-5] It has been estimated that eating at least 5 portions of a variety of fruit and vegetables a day could reduce the risk of deaths from chronic diseases such as heart disease, stroke, and cancer by up to 20%.[1]
It has been estimated that diet might contribute to the development of one-third of all cancers, and that increasing fruit and vegetable consumption is the second most important cancer prevention strategy, after reducing smoking.[2] In 1998, the Department of Health's Committee on Medical Aspects of Food Policy and Nutrition reviewed the evidence and concluded that higher vegetable consumption would reduce the risk of colorectal cancer and gastric cancer. There was also weakly consistent evidence that higher fruit and vegetable consumption would reduce the risk of breast cancer. These cancers combined represent about 18% of the cancer burden in men and about 30% in women.[4]"