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When a teacher noticed what looked like smoke rising in her Eastern Middle School classroom one day this fall, she quickly investigated, finding an eighth-grade boy holding an e-cigarette.
The “smoke” was vapor, but for Casey B. Crouse, principal at the Silver Spring school, the episode was the first signal of what she would learn is a troubling teen trend nationally: An increasing number of students using electronic devices that simulate tobacco smoking.
E-cigarettes are beginning to show up in the hallways of the nation’s middle schools and high schools. Just as health officials have begun to debate their potential dangers and school districts have started to pay attention to them, educators are grappling with how to deal with students who are found puffing on e-cigarettes while at school.
A report from the federal Centers for Disease Control and Prevention released Thursday underscored the popularity of products such as e-cigarettes, cigars and hookahs among the nation’s youth. In just one year, from 2011 to 2012, e-cigarette use among middle and high school students nearly doubled, a fact that troubles researchers who worry that e-cigarettes could lead to nicotine addiction or be a gateway to tobacco products; about 90 percent of smokers pick up the habit as teenagers.
(From The Washington Post)
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A 20% tax on sugary drinks would reduce the number of obese adults in the UK by 180,000, say researchers writing in the British Medical Journal.
The impact would be greatest in the under-30s, the Oxford and Reading university study suggests.
But some groups say a tax is misguided and simplistic, and would not have an impact on older age groups who might benefit most from losing weight.
Earlier this year doctors called for a soft drinks tax to reduce sugar intake.
Sugar-sweetened drinks, when taken regularly, have been shown to increase the risk of obesity, diabetes and tooth decay.
A typical sugary drink can contain six to 15 teaspoons of sugar. One teaspoon of sugar is equivalent to 4g of sugar or 16 calories.
A 20% tax would add about 12p to the price of a 330ml can of fizzy drink bought in a supermarket or about 40p to the cost of two-litre bottle.
The researchers in this study estimated that such a tax could cut drinks purchases by 15% and lead to a reduced energy intake of 28 calories per person per week.
Overall, they estimated that such a tax would reduce the number of obese UK adults by 1.3% and the number of overweight adults by 0.9%.Among younger adults, aged 16-29, who drink larger quantities of sugary drinks (300ml per day) than older adults (60ml per day), the researchers predicted a reduction of 128,000 in the number of obese adults - a bigger impact than for other age groups.
But Gavin Partington, director general of the British Soft Drinks Association, said soft drinks were not to blame for obesity.
"There’s ample evidence to suggest that taxing soft drinks won’t curb obesity, not least because its causes are far more complex than this simplistic approach implies.
"Indeed, the latest official guidance from the National Institute for Health and Care Excellence points to the need to look at overall diet and lifestyle.
"Trying to blame one set of products is misguided, particularly when they comprise a mere 2% of calories in the average diet."
Dr Adam Briggs, lead study author from the Nuffield Department of Population Health at Oxford University, said their research led them to conclude that taxing sugar-sweetened drinks “is a promising population measure”.
He said: “Sugar-sweetened drinks are known to be bad for health and our research indicates that a 20% tax could result in a meaningful reduction in the number of obese adults in the UK.
"Such a tax is not going to solve obesity by itself, but we have shown it could be an effective public health measure and should be considered alongside other measures to tackle obesity in the UK."
The study modelled the health effects of a 20% tax using data from a number of different surveys, which provided information on drinks consumption, drinks-purchasing trends and the prevalence of obesity in the four countries of the UK.
Some experts, including Tom Sanders, professor of nutrition and dietetics at King’s College London, felt the findings were “naive”.
He said: “Most nutritionists agree it would be better to drink water than sugar-sweetened beverages. However, many consumers like sweet drinks and if they could not afford to buy sugary fizzy drinks they can always revert to drinking tea with added sugar as in the past.
"The cost of sugar-sweetened beverages is currently so low that any price increase would be so marginal that it would be unlikely to affect intake."
In the past year, however, there have been calls for a tax on fizzy drinks from the Academy of Medical Royal Colleges and from food and farming charity Sustain.
Malcolm Clark, from Sustain, said the BMJ study provided more evidence that a duty on sugary drinks would improve the diet and health of children and young people.
He said the duty should cover all sugar-sweetened drinks, including those - like flavoured waters and juice drinks - that parents often don’t realise have added sugar.
He added: “We challenge the government to show it has a public health backbone by introducing a sugary drinks duty, alongside better protection for children from junk food marketing and robust nutrition and sustainability standards for all the food served in schools, hospitals and other publicly funded places.”
A spokesperson from the Department of Health said the Responsibility Deal, which a number of soft drinks companies have voluntarily signed up to pledging to reduce sugar in their drinks, was helping people to make healthier choices.
(From BBC News)
Mengenalmu. Antara bahagia dan sedih. Antara senang dan sakit hati. Antara berani dan takut. Antara mukjizat dan bencana. Antara anugerah dan ujian. Antara diperjuangkan dan berhenti berharap. Antara dipertahankan dan dilepaskan. Antara sabar dan nafsu. Antara jodoh dan tidak.
New drugs could extend cancer patients’ lives—by days. At a cost of thousands and thousands of dollars. Prompting some doctors to refuse to use them.
On August 3, 2012, the Food and Drug Administration approved a new cancer drug called Zaltrap as a safe and effective treatment for patients with advanced colon cancer. The approval was based on a large-scale clinical trial that showed that Zaltrap, given in combination with three previously approved drugs to patients who had failed initial therapy, extended median overall survival by 42 days.
No one knew the price of Zaltrap at that point, but Leonard Saltz, who heads the gastrointestinal oncology group at Memorial Sloan-Kettering Cancer Center, had a sense of what was coming. Zaltrap’s effectiveness, in his opinion, was almost identical to that of Avastin, an FDA-approved cancer drug that had also been targeted at that same patient population. Several weeks earlier, Saltz had traveled to Chicago to inflict a little premonitory sticker shock on his medical colleagues. He reviewed the recent clinical results of both Zaltrap and Avastin when used as a “second line” treatment, after initial treatment had failed. As Saltz reminded the other oncologists, Avastin was modestly effective as a second-line treatment—it extended median overall survival by 42 days, the same as Zaltrap—but it cost about $5,000 a month and, like Zaltrap, would have to be taken for many months to achieve that modest clinical benefit. The overall cost was so high that Saltz devoted the end of his talk to a back-of-the-envelope calculation, delivered via PowerPoint, that recast the question in terms of health-care costs: If you extended the 42 days survival to a year, “what is the cost of Avastin for one year of human life saved?”
The answer was astounding, even to doctors who have grown inured to the zero-gravity economics of cancer pharmaceuticals. As Saltz worked his way through slide 73 of 78, he arrived at the bottom line: $303,000.
“Now, that’s essentially the cost of the bare-bones drug,” Saltz later explained to me in his office at Sloan-Kettering. “It’s parts, not labor. No money for doctors; no money for nurses; no money for pharmacists; no money for real estate, heat, and lights; no money for the needles, the IV tubing, the IV fluids, the anti-nausea medicines, the other chemotherapies that are given, because Avastin doesn’t do anything by itself. It has to be given with other drugs … I want to emphasize it’s not that we can have a year of life saved for $303,000. That’s probably less than half of what the actual cost would be when you factor in everything.” Zaltrap, he figured, was probably going to be in the same range.
Saltz’s message was not entirely unexpected. He has been warning about the danger of rising drug prices, to patients and to the health-care system in general, for the last decade. Having made this point to his colleagues, Saltz packed up his computer, took the next flight back to New York, and, after the FDA approved Zaltrap in early August, began to prepare—“not with great enthusiasm,” he conceded—the Zaltrap presentation he would deliver to the hospital committee responsible for approving any new drugs for Sloan-Kettering’s pharmacy.
Then, on August 31, he received an e-mail from a pharmacist at the hospital about the price that Zaltrap’s manufacturers, Sanofi and Regeneron Pharmaceuticals, had set. The pharmacist said, in effect, “Are you aware that this drug is twice as expensive as Avastin?”
“No,” Saltz replied, “I wasn’t aware.”
The pharmacist e-mailed the numbers, and Saltz stared at the figures on his computer screen. Zaltrap, the drug that was extremely similar to Avastin, cost roughly $11,000 a month. (And because that extra 42 days wouldn’t be possible without taking the drug for, say, seven months before—which was roughly what was happening in clinical trials—the price for that six-week life extension could be as high as $75,000.)
“Wow,” he said to himself, “that’s a deal-changer for me.”
That may not seem like a heretical statement, but the unspoken rule in American health care is that doctors should never consider the cost of a medicine that might be beneficial to patients. When the FDA approves a new cancer drug, it analyzes safety and effectiveness only. Medicare is obliged to reimburse payment for the drug, and private insurers in most states must cover the cost. Any doctor who considers cost—or the value of a costly drug—risks being accused of “rationing” health care.
Saltz felt compelled to consider the cost. He didn’t see any medical advantage to Zaltrap for his patients—or any disadvantage, for that matter—but, as he contemplated its price, he thought, I can’t see why I would use this.
That same day, he sent an e-mail to every physician at the hospital who treated patients with colon cancer. “I said, essentially, ‘You all know the data. You were at the meetings. You know what the situation is. What I just learned is this issue regarding the price. Within this context, I can’t envision a scenario where I would plan to use this drug. Can you?’ ”