Afghan security men inspect the scene of a suicide attack in Kabul, Afghanistan, Wednesday, Nov. 21, 2012. A man wearing a suicide vest blew himself up near a U.S. base in the Afghan capital early Wednesday, killing at least one person in what looked like a thwarted attempt to attack the American base, police said. (AP Photo/Musadeq Sadeq)
Afghan security men inspect the scene of a suicide attack in Kabul, Afghanistan, Wednesday, Nov. 21, 2012. A man wearing a suicide vest blew himself up near a U.S. base in the Afghan capital early Wednesday, killing at least one person in what looked like a thwarted attempt to attack the American base, police said. (AP Photo/Musadeq Sadeq)
KABUL, Afghanistan (AP) ? Two men wearing suicide vests blew themselves up near a U.S. base in the Afghan capital early Wednesday, killing two Afghan guards in what looked like a thwarted attempt to attack the American base, police said.
The blast reverberated around Kabul's Wazir Akbar Khan neighborhood shortly after 8 a.m. local time. An alarm started going off at the nearby U.S. Embassy, warning staff to take cover. The neighborhood also is home to many high-ranking Afghan officials, international organizations and the headquarters of the international military coalition.
The Taliban claimed responsibility for the bombing in an email to reporters.
The attack came as foreign and Afghan forces tightened security around the capital ahead of the holy day of Ashoura on Saturday, when Shiite Muslims commemorate the seventh century death of Imam Hussein, the Prophet Muhammad's grandson.
Last year, the commemoration saw the first major sectarian attack since the fall of the Taliban regime. In that strike, a suicide bomber on foot detonated his vest amid scores of worshippers at a Shiite shrine, killing 56 people and wounding more than 160 others.
Wednesday's bombers were on foot and were spotted by Afghan security guards as they approached Camp Eggers, the Kabul police chief's office said in a statement. The police fired on the attackers and they detonated their vests. Two Afghan security guards were killed and five civilians were injured in the explosion, the statement said.
Associated Press video of the scene shows what looks like an undetonated suicide vest, suggesting not all the explosives went off.
An international coalition vehicle was also damaged in the attack but there were no initial reports of casualties among the foreign forces, said Jamie Graybeal, a NATO troops spokesman.
PHNOM PENH, Cambodia (AP) ? President Barack Obama dispatched Secretary of State Hillary Rodham Clinton to the Middle East on Tuesday as the U.S. urgently seeks to contain the bloody conflict between Israel and Hamas.
Clinton hastily departed for the region from Cambodia, where she had joined Obama for summit meetings with Asian leaders. The White House said she would make three stops, meeting with Israeli Prime Minister Benjamin Netanyahu in Jerusalem, Palestinian officials in Ramallah, in the West Bank, and Egyptian leaders in Cairo. Clinton was expected to arrive in Israel on Tuesday night and return to Washington late Wednesday or very early Thursday after making all three stops.
Clinton's trip marks the Obama administration's most forceful engagement in the weeklong conflict that has killed more than 100 Palestinians and three Israelis, with hundreds more wounded. While the U.S. has backed Israel's right to defend itself against rocket fire from Gaza, the Obama administration has warned its ally against pursuing a ground assault that would further escalate the violence and could dramatically increase casualties on both sides.
Still, Obama's deputy national security adviser Ben Rhodes said the U.S. believes "Israel will make its own decisions about the military operations and decisions that it undertakes."
"At the same time, we believe that Israel, like the United States, like other countries, would prefer to see their interests met diplomatically and peacefully," Rhodes said. "It's in nobody's interest to see an escalation of the military conflict."
Obama and Clinton have consulted about the widening crisis throughout their three-day tour of Southeast Asia, their final joint trip before Clinton leaves her post as the top U.S. diplomat. They spoke again about the situation Tuesday morning, aides said, and made the decision for her to travel to the region.
Still, it was unclear what impact Clinton's presence would have on the spiraling violence or whether she was heading to the Mideast with any specific overtures from the U.S.
Rhodes said "there are a number of ideas that are in play," but offered no further details. And he insisted the ramped up U.S. involvement was "a matter of what's in everybody's best interests", not a matter of "leverage."
Obama and Clinton each have held multiple telephone calls with their counterparts in Israel and Egypt, which is at the center of negotiations to quell the violence. Because the U.S. considers Hamas a terrorist organization and prohibits contact between its members and American officials, it is relying on Egypt, as well as Turkey and Qatar, to deliver its message to the Hamas leadership in Gaza.
Israel and Hamas say they are open to diplomatic mediation efforts being led by Egypt, but they are far apart in their demands.
Hamas wants Israel to halt all attacks on Gaza and lift tight restrictions on trade and movement in and out of the territory that have been in place since Hamas seized Gaza by force in 2007. Israel demands an end to rocket fire from Gaza and a halt to weapons smuggling into Gaza through tunnels under the border with Egypt.
The widening conflict has threatened to overshadow Obama's three-country tour of Southeast Asia, his first overseas trip after winning re-election. The president, after a marathon day that took him from Thailand to Myanmar to Cambodia, worked the phones with Mideast leaders into the early hours of Tuesday morning, aides said.
The White House said Obama would stay in contact with the key players in the conflict while Clinton was on the ground. The president is scheduled to depart Cambodia later Tuesday, arriving back in Washington before dawn Wednesday.
___
Associated Press writer Matthew Lee in Washington contributed to this report.
Xpert test for TB could help prevent deaths in southern Africa, but at substantial costPublic release date: 20-Nov-2012 [ | E-mail | Share ]
Contact: Sumrina Yousufzai syousufzai@plos.org 415-568-3164 Public Library of Science
Press release from PLOS Medicine
A rapid test for tuberculosis (TB) could help to reduce TB deaths, improve TB treatment, and also offer reasonably good value for money if introduced in southern Africa, an area that has high rates of HIV and a type of TB that is resistant to some drugs (multi-drug resistant TB), according to a study published in this week's PLOS Medicine.
The World Health Organization (WHO) recently recommended the use of a new diagnostic test for TB (the Xpert MTB/RIF test), which can show a result within 2 hours, in people at high risk of multi-drug resistant TB and/or HIV-associated TBtwo increasingly common conditions in many countries.
In a modelling study led by Nicolas Menzies from the Harvard School of Public Health in Boston USA, the authors investigated the potential health and economic consequences of implementing the Xpert test in Botswana, Lesotho, Namibia, South Africa, and Swaziland.
When compared to the current most commonly used testing approach (based on a sputum sample), the authors found that using Xpert instead would prevent an estimated 132,000 TB cases and 182,000 TB deaths in southern Africa over 10 years, reducing by 28% the proportion of the population with active TB.
The authors calculated that health service costs would consequently increase by US$460 million, with much of this extra cost due to increased costs for anti-HIV drugs (antiretroviral therapy) for people with TB-HIV co-infection who would now survive TB infection as a result of improved testing and treatment.
The authors also calculated that using Xpert in southern Africa would cost US$959 for every year of healthy life gained, ranging from US$792 in Swaziland to US$1257 in Botswanalevels which according to WHO standards, are considered cost effective. While these results suggest that scaling up Xpert can be a good health investment, the cost per healthy year gained is substantially higher in this study than in previous reports, and the economic results raise questions about affordability that will be critical for policy makers to consider.
The authors say: "Introduction of Xpert could substantially change TB morbidity and mortality through improved case-finding and treatment."
They continue: "Adoption of Xpert evidently offers reasonable value for its cost, based on conventional benchmarks for cost-effectiveness. However, the additional financial burden would be substantial, including significant increases in costs for treating HIV and multi-drug resistant-TB. "
The authors add: "Given the fundamental influence of HIV on TB dynamics and intervention costs, care should be taken when interpreting the results of this analysis outside of settings with high HIV prevalence."
###
Funding: NAM and JAS were supported in part by funding from UNITAID. NAM was also supported by a training grant from the Massachusetts General Hospital's Program in Cancer Outcomes and Training (NIH Grant No. R25 CA092203). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: JAS and MM are members of the PLOS Medicine editorial board. The authors declare that no other competing interests exist.
Citation: Menzies NA, Cohen T, Lin H-H, Murray M, Salomon JA (2012) Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation. PLoS Med 9(11): e1001347. doi:10.1371/journal.pmed.1001347
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER (THIS LINK WILL BECOME LIVE WHEN THE EMBARGO LIFTS):
Nicolas A. Menzies
Center for Health Decision Sciences, Harvard School of Public Health, Boston Massachusetts, United States of America
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Xpert test for TB could help prevent deaths in southern Africa, but at substantial costPublic release date: 20-Nov-2012 [ | E-mail | Share ]
Contact: Sumrina Yousufzai syousufzai@plos.org 415-568-3164 Public Library of Science
Press release from PLOS Medicine
A rapid test for tuberculosis (TB) could help to reduce TB deaths, improve TB treatment, and also offer reasonably good value for money if introduced in southern Africa, an area that has high rates of HIV and a type of TB that is resistant to some drugs (multi-drug resistant TB), according to a study published in this week's PLOS Medicine.
The World Health Organization (WHO) recently recommended the use of a new diagnostic test for TB (the Xpert MTB/RIF test), which can show a result within 2 hours, in people at high risk of multi-drug resistant TB and/or HIV-associated TBtwo increasingly common conditions in many countries.
In a modelling study led by Nicolas Menzies from the Harvard School of Public Health in Boston USA, the authors investigated the potential health and economic consequences of implementing the Xpert test in Botswana, Lesotho, Namibia, South Africa, and Swaziland.
When compared to the current most commonly used testing approach (based on a sputum sample), the authors found that using Xpert instead would prevent an estimated 132,000 TB cases and 182,000 TB deaths in southern Africa over 10 years, reducing by 28% the proportion of the population with active TB.
The authors calculated that health service costs would consequently increase by US$460 million, with much of this extra cost due to increased costs for anti-HIV drugs (antiretroviral therapy) for people with TB-HIV co-infection who would now survive TB infection as a result of improved testing and treatment.
The authors also calculated that using Xpert in southern Africa would cost US$959 for every year of healthy life gained, ranging from US$792 in Swaziland to US$1257 in Botswanalevels which according to WHO standards, are considered cost effective. While these results suggest that scaling up Xpert can be a good health investment, the cost per healthy year gained is substantially higher in this study than in previous reports, and the economic results raise questions about affordability that will be critical for policy makers to consider.
The authors say: "Introduction of Xpert could substantially change TB morbidity and mortality through improved case-finding and treatment."
They continue: "Adoption of Xpert evidently offers reasonable value for its cost, based on conventional benchmarks for cost-effectiveness. However, the additional financial burden would be substantial, including significant increases in costs for treating HIV and multi-drug resistant-TB. "
The authors add: "Given the fundamental influence of HIV on TB dynamics and intervention costs, care should be taken when interpreting the results of this analysis outside of settings with high HIV prevalence."
###
Funding: NAM and JAS were supported in part by funding from UNITAID. NAM was also supported by a training grant from the Massachusetts General Hospital's Program in Cancer Outcomes and Training (NIH Grant No. R25 CA092203). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: JAS and MM are members of the PLOS Medicine editorial board. The authors declare that no other competing interests exist.
Citation: Menzies NA, Cohen T, Lin H-H, Murray M, Salomon JA (2012) Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation. PLoS Med 9(11): e1001347. doi:10.1371/journal.pmed.1001347
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER (THIS LINK WILL BECOME LIVE WHEN THE EMBARGO LIFTS):
Nicolas A. Menzies
Center for Health Decision Sciences, Harvard School of Public Health, Boston Massachusetts, United States of America
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Nobody quite puts the fun in dysfunctional like family and the holiday make that even more clear.
My immediate family, when I was young, usually did holidays on our own. Just mom, dad and four kids. Only occasionally did we try to get with extended family for the holidays.
One year, for Thanksgiving, my Mom and us four kids tried to get with one of Mom?s siblings, D and her three daughters. D?s oldest daughter, C was supposed to meet my family not far from where D lived and lead us to the house instead of us trying to find our way. We got to the meeting location about at the agreed upon time and don?t see C anywhere. So we wait. And wait. We tried calling after a while, no answer so we keep waiting. Sometime after the agreed meeting time we finally hear word from C about why she is so late. Apparently D and one of her daughters starting arguing. The fight escalated to the point of the daughter punching the mother. So C was busy trying to put out those flames instead of meeting my family.
Thanksgiving dinner was put in ?endangered? status. Might not happen but hold on, let?s see how it goes. So we waited some more. The brawling daughter got kicked out of the house so dinner was off. Then the daughter came back but was grumpy so dinner was ?maybe?. Eventually C came out and met us and led us to the house where daughter and mother were fine, no longer arguing and even joking around with each other.
Still, in the uproar dinner had been forgotten and now it was late so Thanksgiving dinner that year ended up being at a Shoney?s restaurant.
A few years later my husband and I made plans with C to join her family (now married with kids) for Thanksgiving. She then added in her mother who, at the last minute, decided making a meal was too much trouble and we again ended up at Shoney?s for Thanksgiving dinner. 1008-12
Single serve French presses are far from a new innovation, but with the Minibru you don't need a pile of separate hardware, or one of those ridiculous looking, over-engineered French press travel mugs. It's designed to look like a regular old coffee cup, and keep the brewing process simple. More »
Though it contains the word ?will,? the fact is that living wills have nothing to do with the distribution of property after death.
A misnomer, the more accurate (and modern) terminology for a living will would either be an advance directive or a durable power of attorney.
Alone or combined, these two documents allow you to plan for your medical needs should you no longer be able to make decisions for yourself.
Because both documents detail how your medical care is to be handled in the event that you become incapacitated, some states combine the advance directive and durable power of attorney into one document. However, it?s important to understand the purpose behind each separate set of instructions.
An advance directive is usually a set of instructions detailing your wishes at the end of your life. It describes acceptable and unacceptable life-sustaining treatments, such as artificial ventilation and nutrition, and may instruct caretakers as to where you would like to spend your final days. For example, here?s a sample Living Will Directive to Physicians.
Because an advance directive is broad and only deals with big decisions, states have created the durable power of attorney.
In its most basic form, a durable power of attorney is a legal document that grants a third party the ability to make your medical decisions.
Though it can be limited to certain conditions, or include specific instructions, its purpose is to guarantee that spur-of-the-moment medical decisions are made with consideration of your needs and wishes. You can click here for a sample Health Care Power of Attorney.
As you can see, if you have specific wishes about your end-of-life care, both an advance directive and durable power of attorney are important documents to have. While you can certainly draft your own documents, it?s often wise to consult an attorney to ensure that your decisions will be respected.
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Public release date: 20-Nov-2012
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