Most countries offer the Pill over-the-counter

NEW YORK (Reuters Health) – Unlike women in the U.S., Canada and much of Europe, most women in the world can access the birth control pill without a prescription, according to a new study.

As medical organizations and other groups push to ease the prescription requirements for the Pill in the U.S. and elsewhere, “we can start to use this information to… get a sense of the safety of women having access to this method where no prescription is required,” said Kari White, who studies birth control at the University of Alabama in Birmingham.

The Pill is generally considered safe, said White, who was not involved in the new work, and some studies have shown that, without a doctor’s input, women can accurately screen themselves for risk factors to steer away from using the Pill if it’s not appropriate for them.

Earlier this year, the American College of Obstetricians and Gynecologists, a leading group of women’s doctors, endorsed the idea of making the birth control pill available without a prescription (see Reuters Health report of November 20, 2012 here: http://reut.rs/UH0Zz9).

In a survey of government health officials, pharmaceutical companies, family planning groups, medical providers and other experts in 147 countries Dr. Daniel Grossman, of Ibis Reproductive Health in Oakland, California, and his colleagues found that women in the U.S. and 44 other countries need a prescription to get birth control pills.

The group reported in the medical journal Contraception that while another 56 countries had laws requiring prescriptions, in practice women could access the contraception over-the-counter.

Thirty-five countries legally allowed access to oral contraceptives over-the-counter, and 11 countries allowed over-the-counter access as long as the woman is screened to ensure that she is a good candidate.

“The patterns we saw were interesting,” said Grossman. “Higher income countries – western Europe, Australia, Japan and North America – generally require a prescription.”

Grossman told Reuters Health he couldn’t explain why these patterns have emerged.

“Perhaps in places like China and India that have pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs,” he speculated.

Dr. Ward Cates, of FHI 360, a research organization in Durham, North Carolina, said the lack of a prescription requirement might also reflect a general approach to making health care more accessible in countries where it is less available.

In some countries, “healthcare tends to be more fragmented and healthcare oversight tends to be more fragmented. Therefore the availability of products tends to percolate to outlets that tend to be more accessible to the public,” said Cates, who was not part of the study.

Grossman said it will be useful for countries looking to ease restrictions on birth control access to look to the experiences of these countries.

“Will this information about the availability of pills being over-the-counter in other countries influence policy here? Probably not,” Grossman told Reuters Health.

“But I do think it helps to put it in perspective that this is not something revolutionary.”

SOURCE: http://bit.ly/S51BnH Contraception, online December 10, 2012.

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Eleven Ways to Avoid Answering a Question: A Year in Review

When my grandfather was alive, each of his children and grandchildren was responsible for reporting to him about the world in which they worked. He loved knowledge; he always had. As the only scientist in the family, I was in charge of “science.” This never quite seemed fair and yet I did what I could until the day he asked me to explain dark matter. I am a broadly trained scientist. I have worked on bacteria, birds, plants, insects and a great deal else. But, when pressed, late in the evening, dark matter was beyond my comfort zone. I faltered. Sometimes with my grandfather, faltering could be propped up with grandstanding, but on this particular day there was no such doing. He knew I was guessing. His shoulders slumped and he announced softly, “I don’t think I am ever going to learn everything.” My ignorance was the BS that broke the camel’s back.

In part because of my grandfather I have always felt a responsibility to answer questions people ask about science. This year, I decided I would make this responsibility more conscious. I would try to focus much of my writing on answering questions that came up in my daily life, questions that I am responsible for because I am a scientist. It was a sort of New Year’s resolution. My other resolution was to write shorter articles.1–Sitting around enjoying a glass of wine with my family and our friends Ari Lit and Michelle Trautwein, Ari asked, Hey dude, why do we drink alcohol? Do monkeys drink alcohol? This led me to think about the big story of alcohol and, in as much, to write a whole series about our complex relationship with the yeasts that, as waste, produce our favorite drinks. It ended up becoming a forty thousand word online series, about alcohol, civilization and yeast. So much for the resolution to write short articles. Also, I forgot to check on the monkeys.2–My favorite questions tend to come from kids and earnest parents. This year at my daughter’s school, every third student and then every other students and then, jeez, almost every student seemed to have lice. Parents asked me, “what should we do about lice?” This was a follow-up to an article I had written years prior in response to a similar query. I was able to tell the story of how the louse problem (or success, depending on your perspective) came to be, over the last million years. But I failed to really answer what a parent should do if their kid gets lice. It turns out parents whose kids have lice don’t want to hear about ancient hominids and their lice. Go figure.Image 1. Picture of the louse species, Pthirus pubis, descended from an interaction between a human ancestor and a gorilla ancestor and that is all I am saying. Photo courtesy of the CDC. 3-In the last chapter of my book The Wild Life of Our Bodies I argue for a more serious gardening of nature in the places we live. Reading this, someone wondered about the ways in which we garden evolution itself. She emailed asking, Could we favor the evolution of good species in our houses? I wasn’t sure and am still not, but the question prompted me to reconsider the ways in which we have gardened evolution historically. I wrote the Garden of Our Neglect about this history. I then started to consider how we might favor the presence (if not evolution) of beneficial species on our bodies and in our homes. This led me to propose the Ecological Theory of Disease and to write Letting Biodiversity Get Under Our Skin, and How Clean Living is Bad for You. I also wrote an article about what our body might be doing to favor beneficial species in Your Appendix Could Save Your Life. None of these articles really told anyone which species to plant much less engender in their invisible gardens of indoor life.4-Another night with friends, we sat around talking about paleo diets. Ari asked who we should count as our ancestors, which ancestors should we consider if we were to eat ancestral diets? This debate inspired the piece Were Our Ancient Ancestors Vegetarians and then How to Eat Like a Chimpanzee. Later when Ari tried an essentially all nut and fruit super-fiber diet I found myself writing about the Hidden Truth about Calories. With these articles, I learned about diet, but I also learned that people can get very angry when it comes to discussing food. I never really answered Ari’s question.5-At one evening talk associated with the Museum of Life and Science in Durham, NC, someone asked me why her armpits smell sweet when she lives in the desert. She asked me that question in Durham, not in a desert, so I felt compelled to take her word for it rather than sniff around the story, but I did begin to wonder about what we do and don’t know about the microbial smells produced on our bodies and those of, for example, dogs, so I wrote Why Sick People Smell Bad. The article was fun, but I still don’t know why the woman had sweet pits; perhaps it is just her nature.6-My daughter (who sometimes seems to channel the pure inquisitivness of my grandfather) asked me “Why are our bodies warm and not cold?” This is the kind of question she asks so as to avoid going to bed. It led me to write the article How Killer Fungus May Have Made us Hot Blooded. The article offers a partial, possible, speculative answer to her question, which is her favorite kind of answer because it means she can stay up later as she asks follow-up questions.7–My son has started asking, “papa, who took your hair?” I told him, as I told my daughter when she was smaller, that the squirrels took it for their nest. This just seemed to make him afraid of squirrels so I decided to figure out the real answer, the result was a story in New Scientist (unfortunately pay-walled) about the mystery of baldness and its evolution. Balding, it turns out, is fascinating, but why we bald is still largely unresolved. Back to the squirrels.8–I sometimes introduce talks about social insects by mentioning the similarities between insect and human societies and the idea that insect societies can allow us to learn about our own. In response (and during election season), someone recently asked “who would the ants vote for?” The closest I could get to an answer was to discuss how other animals (mostly honey bees) choose their leaders. I figured out that we know far less about leaders in other societies, including those of ants, than I had thought.9–Piotr Naskrecki visited my house and found, in my basement, a species of camel cricket apparently native to Japan. He also found, to my wife’s dismay, two species of “interesting roaches.” This spurred me to ask other people about their camel crickets, which caused me to have to answer how a Japanese camel cricket has come to take over our basements? I don’t really have an answer yet, though if you check out the website there are ways for you to help me find one.10–For a number of years now, people have been offering me story ideas. “Man, you should totally write about…” Its often difficult to follow up on such ideas, but this year I tried. When my family and I were living in Parma, Italy Donato Grosso asked me if I knew about the species of crab living under Rome. “That,” he said, “would be a good story.” It was. It became “new species of crab living in Rome.” A visit to Girona, Spain where a friend had built a niche in his house for animals to colonize got me wondering about the niches in our cities that we have built for wild species. Pera said, “you should write about it.” I did, in the form of a story about the most common bird in the world, the house sparrow. There were no questions here, but even without a question to answer I seem to have written something slightly different from what Donato or Pera might have imagined.11-Finally, I have started to try to answer the question I have heard most often throughout my career, including from my grandfather, “what do I do about the ants in my kitchen?” Answering this question has required figuring out what the heck is going on with ants in kitchens and backyards and so I wrote one article about a backyard discovery made by English majors, another about a discovery made by an eight year old and another still about how little we seem to know about the most common ant species in eastern North America. I also recruited Eleanor Spicer to write Dr. Eleanor’s Book of Common Ants. None of these answered the question about what to do about the ants in your kitchen, though maybe the distraction bought me some time.Image 2. Camponotus pennsylvannicus, a common backyard (and occasionally kitchen) ant. Photo by Alex (the great) Wild.In short, although I’ve written something like 200,000 words this year, very few seem to have directly answered the questions I was asked. So much for my New Year’s resolution, though maybe part of the problem is that we still know so little about so many fields that it is nearly impossible to make it to the end of a story without encountering the unknown. Perhaps I can try to write shorter answers, answers short enough that I don’t get to what we don’t know. History is not on my side. I seem incapable of writing short articles (one of my shortest articles this year was repeatedly described as “long form”). Also, I come from a long history of “long form” people. My grandfather’s stories went long and, well, his father was apparently worse. When asked to comment on the history of the Episcopal church in his town, Greenville, Mississippi, my great grandfather wrote that he could not write about the history of the Episcopal church in Greenville without commenting on the history of the Episcopal church more generally. And he could not, he said, write about the Lutheran church in general without commenting upon the history of religion. And so he began. My people. It seems we start at the very beginning and answer a question similar too but not identical too the one we were asked. In this light, if my granddad were still around, I’d tell him now that, yes, I can explain dark matter now, but before I do I need to explain the big bang, which, ironically is what I do in my first article of 2013. So stay tuned and send me your questions. But don’t be surprised if, in commenting upon the history of your question, I need to comment on a broader church, the history of life or even the universe.Go ahead and post your science questions you think should be answered in 2013 here…   

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Factbox: U.S. “fiscal cliff,” tax impact of no deal

WASHINGTON (Reuters) – Higher federal taxes for millions of businesses and individuals will become law on Tuesday unless Congress acts to stop them. These taxes, worth $ 500 billion, comprise the bulk of what is known as the “fiscal cliff” problem.

The following shows the probable impact on taxpayers if Congress does not act on Monday, or does not come back later and undo these tax increases, based on data from the nonpartisan Tax Policy Center.

INDIVIDUAL TAXES

If midnight passes with no deal, lower individual tax rates enacted in 2001 on a temporary basis under former President George W. Bush will expire on December 31.

The income tax brackets will rise to 15, 28, 31, 36, and 39.6 percent from the current 10, 15, 25, 28, 33 and 35 percent for nearly 160 million taxpayers.

The poorest fifth of taxpayers, about 40 million households, will see an average tax increase of about $ 412.

The most affluent fifth, about 23 million taxpayers, will typically pay about $ 14,173 more in income tax.

The wealthiest 1 percent, about 1.1 million taxpayers, will see an average tax hike of about $ 120,000.

PAYROLL TAX

About 160 million workers will pay higher Social Security payroll taxes. The rate goes up to 6.2 percent on January 31 when the current, temporary 4.2 percent rate expires. The lower rate was extended in 2012 to give workers a little extra in their paychecks as a way to boost the economy. Unlike some of the other tax measures, there appears to be little interest from Republicans or Democrats in continuing the lower rate.

INVESTMENT TAXES

The capital gains tax rate will rise to 20 percent from 15 percent for most taxpayers who have income from gains on their investments. The tax rate on dividends will rise to the top income tax rate, 39.6 percent, from the current 15 percent dividend tax rate.

ESTATE TAX

The estate tax will rise to 55 percent from 35 percent. The value of assets exempted also drops to $ 1 million per person from its current $ 5 million per person.

ALTERNATIVE MINIMUM TAX

About 27 million Americans could be required to pay the alternative minimum tax (AMT), a tax that initially was intended to make sure the wealthy paid some tax. The AMT fix that Congress has enacted annually had resulted in only 4 million Americans paying the AMT.

UNEMPLOYMENT BENEFITS

About 2.1 million long-term unemployed Americans will see their extended jobless benefits cut off as of January 1, according to the National Employment Law Project, an advocacy groups.

EXTENSIONS OF TAX BREAKS

A mix of tax breaks for individuals and businesses worth tens of billions of dollars annually, including the research and development tax credit for business, will lapse. These include deductions for payments of state and local taxes and tax benefits for college tuition.

MEDICARE PAYMENTS TO DOCTORS

Doctors treating elderly and disabled patients who make up the Medicare population will see a double-digit cut to in rates paid by the federal government health care program. Medicare patients could have a tougher time finding doctors who will treat them.

(Editing by Fred Barbash and Jackie Frank)

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Italian Nobel scientist Montalcini dies at 103

ROME (Reuters) – Rita Levi Montalcini, joint winner of the Nobel Prize for Medicine and an Italian Senator for Life, died on Sunday at the age of 103, her family said.

The first Nobel laureate to reach 100 years of age, she won the prize in 1986 with American Stanley Cohen for their discovery of nerve growth factor (NGF), a protein that makes developing cells grow by stimulating surrounding nerve tissue.

Her research helped in the treatment of spinal cord injuries and has increased understanding of cardiovascular diseases, Alzheimer’s and conditions such as dementia and autism.

One of twins born to a Jewish family in Turin in 1909, Montalcini was the oldest living recipient of the prize.

During World War Two, the Allies’ bombing of Turin forced her to flee to the countryside where she established a mini-laboratory. She fled to Florence after the German invasion of Italy and lived in hiding there for a while, later working as a doctor in a refugee camp.

After the war she moved to St. Louis in the United States to work at Washington University, where she went on to make her groundbreaking NGF discoveries.

She also set up a research unit in Rome and in 1975 became the first woman to be made a full member of the Vatican’s Pontifical Academy of Sciences in 1975. She won several other awards for her contributions to medical and scientific research.

Her face was instantly recognizable in Italy and she was well known as a dignified and respected intellectual, a counterbalance to the image of women succeeding through their looks and sexuality, exacerbated during the scandal-plagued era of former prime minister Silvio Berlusconi.

Two days after her birthday in April this year she posted a note on Facebook saying it was important never to give up on life or fall into mediocrity and passive resignation.

“I’ve lost a bit of sight, and a lot of hearing. At conferences I don’t see the projections and I don’t feel good. But I think more now than I did when I was 20. The body does what it wants. I am not the body, I am the mind,” she said.

Italian Prime Minister Mario Monti said in a statement that Montalcini’s Nobel prize had been an honor for Italy, and praised her efforts to encourage young people, especially women, to play a central role in scientific research.

(Editing by Louise Ireland)

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Brazil president, cancer survivor, pronounced healthy

BRASILIA (Reuters) – Brazilian President Dilma Rousseff, who survived lymphoma cancer in 2009, was pronounced healthy by doctors after a routine exam on Friday.

Rousseff’s health was “within normal levels,” according to a statement released by her office following the check-up at the Sirio-Libanes Hospital in Sao Paulo, one of South America‘s leading cancer treatment centers.

Rousseff underwent chemotherapy in 2009 and briefly wore a wig, but the cancer went into remission and she appeared to be in good health by the time she staged her winning campaign for the presidency in 2010.

Concerns over her health have faded since then, although a bout with pneumonia and a lengthy recovery in 2011 have kept the issue on some investors’ radar screens.

(Reporting by Ana Flor, Writing by Brian Winter; Editing by Doina Chiacu)

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Kenya Hospital Imprisons New Moms Who Can’t Pay

The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he’s accused of: detaining mothers who can’t pay their bills. Lazarus Omondi says it’s the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn’t let them leave after delivering their babies. The bills the mothers couldn’t afford were $ 60 and $ 160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women’s behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

“We hold you and squeeze you until we get what we can get. We must be self-sufficient,” Omondi said in an interview in his hospital office. “The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers.”

“They stay there until they pay. They must pay,” he said of the 350 mothers who give birth each week on average. “If you don’t pay the hospital will collapse.”

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi’s poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi’s slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $ 12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn’t pay the $ 60 bill, and was held with what she believes was about 60 other women and their infants.

“We were sleeping three to a bed, sometimes four,” she said. “They abuse you, they call you names,” she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor’s 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family’s 50-square-foot shack, where rent is $ 18 a month. She says she was released after 20 days after Nairobi’s mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $ 160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

“I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me,” said Anyoso, a vegetable seller and a single mother with five children who makes $ 5 on a good day.

Anyoso said she didn’t have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

———

Associated Press reporter Tom Odula contributed to this report.

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Obama, Congress set for late push on “fiscal cliff”

WASHINGTON/HONOLULU (Reuters) – President Barack Obama is due back in Washington early Thursday for a final effort to negotiate a deal with Congress to avert or at least postpone the “fiscal cliff” of tax increases and government spending cuts set to begin next week.

No specific bill dealing with the cliff was on the schedule of either the U.S. Senate or House of Representatives, which are expected to return on Thursday after the holiday break. In Congress, the corridors were almost empty and the doors to members’ rooms were locked.

Investors are closely watching the talks, concerned that going over the cliff could throw the economy into recession. U.S. stocks slipped on Wednesday after retailers reported disappointing holiday sales as shoppers tightened belts possibly due to fiscal cliff worries.

Aides and members of Congress have said that a modest, last-minute measure to avoid the spending cuts and most of the tax hikes could pass the Democratic-controlled Senate if Republicans agree not use a procedural roadblock known as a filibuster, a commitment that Senate Republican leader Mitch McConnell has so far not made.

The legislative focus continues to shift from deficit reduction to averting the immediate shock of the December 31 cliff dive.

“This is the ‘Break Glass’ scenario that we have long believed would rise in probability the closer we go to December 31, which essentially calls for extending all the rates for those individuals making under $ 200K and households under $ 250K and does not address the debt ceiling or the deficit,” analyst Chris Krueger of Guggenheim Securities wrote in a research note.

But to win approval in the Republican-controlled House of any bill that raises taxes on anyone, a rare bipartisan vote would be required. All 191 Democrats would have to team with up with at least 26 Republicans to get a majority if the bill included tax hikes on the wealthiest Americans, as Obama is demanding.

Some of those votes could conceivably come from among the 34 Republican members who are either retiring or were defeated in the November elections and no longer have to worry about the political fallout.

JANUARY SCRAMBLE?

In the alternative, Congress could let income taxes go up on everyone as now scheduled and then during the first week of January, scramble and get a quick deal to cut them back except for the highest brackets, along with a measure putting off the $ 109 billion in automatic spending cuts that most lawmakers want to avoid.

Once the clock ticks past midnight on December 31, no member of Congress would have to vote for a tax increase on anyone – taxes would have risen automatically – and the only votes would be to decrease tax rates for most Americans back to their 2012 levels.

Americans’ optimism that Obama and congressional leaders will reach a budget agreement before January 1 has waned in recent days, according to a Gallup poll released on Wednesday. Fifty percent believe a deal will be reached – a drop of 7 percentage points from the previous week – and 48 percent are doubtful. The poll was taken just after talks ran into trouble last week.

Obama and congressional lawmakers left Washington on Friday for the Christmas holiday with negotiations to avert the fiscal cliff in limbo.

The president will cut short his vacation in Hawaii and leave for Washington later on Wednesday, arriving in the capital early on Thursday.

Obama is expected to turn to a trusted Democratic ally, Senate Majority Leader Harry Reid, to help craft a quick deal.

White House aides began discussing details of the year-end budget measure with Senate Democratic counterparts early this week.

Starbucks Chief Executive Howard Schultz is urging workers in the company’s roughly 120 Washington-area coffee shops to write “come together” on customers’ cups on Thursday and Friday to send a message to sharply divided politicians.

“We’re paying attention, we’re greatly disappointed in what’s going on and we deserve better,” Schultz told Reuters.

(Additional reporting by Thomas Ferraro and Richard Cowan in Washington and Lisa Baertlein in Los Angeles; Editing by Eric Beech)

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‘Bumping’ Your Way to Safer Sex With a Smartphone App

Reported by Dr. Lauren Browne:

Let’s face it.  Teens have sex.  Parents may choose to ignore it, and teens may choose to deny it, but almost 50 percent of American high school students are having sex, according to the U.S. Centers for Disease Control. And each year, millions of those sexually active teens contract sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, herpes and HIV.

Now one doctor hopes to curb the spread of STDs in this tech savvy group with a smartphone app that lets users “bump” their STD status.

It’s called ‘safe bumping,’” said Dr. Michael Nusbaum, the New Jersey developer of MedXSafe, a feature of the new app called MedXCom.  “If you happen to be out at a bar or a fraternity house or wherever, and you meet someone, you can then bump phones and exchange contact information and STD status.”

The app’s special feature, according to Nussbaum, encourages dating singles to go to the doctor for regular STD checks.  Those who screen negative can ask their doctors to document their STD-free status on the app, allowing users to share the information with whomever they choose.

An alarming 19 million new sexually transmitted infections occur each year, and rates of chlamydia and gonorrhea are on the rise, according to a new report released this month by the CDC.  More than 1.4 million chlamydia infections were reported in 2011, up 8 percent from the previous year.  Cases of gonorrhea were up by 4 percent, marking the second consecutive year of increases.

Nearly half of all infections occur in young people, between the ages of 15 to 24, a group that can be particularly devastated by the associated health effects.

“[Some] undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences, such as infertility,” said Mary McFarlane, an acting chief in the Division of STD Prevention at the CDC.  Harnessing modern social networking technology to prevent these infections may appeal to a younger tech-savvy generation.

MedXSafe is just one of several Internet-based programs devoted to easing confidential STD-status sharing between sexual partners.  Services like Qpid.me, whose slogan is Spread the Love, Nothing Else and U Should Know, designed by a former college student and his girlfriend, also allow their users to check on a partner’s STD status.

But could these services offer a false sense of security to teens who believe that, with a simple phone bump, they have the green light to have unprotected sex?

“It can take months for HIV to show up on a test,” said Renee Williams, executive director of SAFE, a nonprofit organization dedicated to abstinence education.  “So you can test negative today, go out on Friday night and have sex, and then get retested later and find out that you had HIV all along.”

The app does nothing to prevent unplanned pregnancy, and may even encourage high-risk behaviors that young people might otherwise not have been tempted to try, said Williams.

Nor is the app likely to be completely reliable, said Dr. J. Joseph Speidel, director of communication at the Bixby Center for Global Reproductive Health.

“Does it come with a condom?” asked Dr. Richard Besser, ABC’s chief health and medical editor, who’s also a pediatrician and former acting director at the CDC.

But the app’s creator said it does promote regular STD testing and encourages potential partners to openly discuss safe sex practices.

“We’re recognizing that this behavior is going to take place no matter what we do or what we say,” said Nusbaum.  “I have friends that are nuns and I’ve run this by them, and they also agree that it’s promoting safer behaviors.”

Although each program promises to keep health information strictly confidential, none are immune from cyber attacks.

But such attacks would not expose any users who have an STD, according to Nusbaum.  MedXSafe does not allow doctors to upload information about any tests that come back positive, including HIV.  A user with an infection is simply treated for the STD and then retested.  And that user is only confirmed STD-free via the app once subsequent test results come back negative.

Still, it is too early to tell whether these services will become popular with teens.  Lingering social stigma surrounding STDs might make potential partners reluctant to mention such an app when out at a party.

“It’s a big personal step to bring up using such an app,” said Noah Bloom, creator of a smartphone app called Jiber, which uses the same “bump” technology to electronically connect new friends.  “Who really wants anything in the way of getting lucky?”

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Former President George H.W. Bush remains hospitalized

(Reuters) – Former President George H.W. Bush, who has been hospitalized for a month undergoing treatment for bronchitis, may not be released from a Houston hospital in time to celebrate Christmas at home as doctors had hoped.

Bush, 88, remained in stable condition and doctors were optimistic he would make a full recovery, George Kovacik, a spokesman at Methodist Hospital, said in an emailed statement on Sunday.

But doctors were being “extra cautious” with his care and no discharge date had been set, the statement said. Earlier this month, Kovacik said doctors expected Bush would be able to spend Christmas at home with his family.

“His doctors feel he should build up his energy before going home,” the statement said.

Bush, the 41st president and a Republican, took office in 1989 and served one term in the White House. The father of former President George W. Bush, he also is a former congressman, U.N. ambassador, CIA director and vice president for two terms under Ronald Reagan.

(Reporting by Kevin Gray; Editing by Daniel Trotta and Vicki Allen)

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China probes Yum Brands’ KFC over safety of chicken products

SHANGHAI (Reuters) – Yum Brands Inc‘s fast-food chain KFC was supplied with chicken in China that contained excessive amounts of antibiotics, said food safety authorities investigating allegations of tainted KFC products.

The finding by the Shanghai Food and Drug Administration (SFDA) deals a blow to KFC’s reputation in China, where it is facing fierce competition from the likes of Taiwanese-owned fried chicken chain Dico and Japanese-style noodle chain Ajisen (China) Holdings Ltd. Yum Brands has forecast a drop in same store China sales in the fourth quarter.

Eight of the 19 batches of chicken samples Yum Brands sent to a testing laboratory in 2010 and 2011 contained overly high levels of antibiotics, the SFDA said in a statement on its Website late on Thursday.

An investigation is underway to determine whether Yum Brands had taken corrective measures at that time, and the Louisville, Kentucky-based company may face harsh penalties if the probe showed laws had been violated, the SFDA said.

Shares in Yum Brands have slumped 4 percent since December 18 when China’s state television CCTV reported that some poultry suppliers in eastern Shandong province had fed chickens with anti-viral drugs and hormones to accelerate their growth.

The SFDA is looking into the CCTV report and has not released its findings yet, but authorities in Shandong have already shut two chicken farms in eastern China, including one that supplied KFC and McDonald’s Corp, the official Shanghai Daily newspaper reported on Thursday.

Officials at Yum Brands in China could not be immediately reached for comment.

KFC’s subsidiary in China has pledged to cooperate with the authorities, while McDonald’s wrote on its official microblog that its chicken and raw materials pass through independent, third-party laboratory tests.

Shares in Yum Brands, which also owns Pizza Hut and Taco Bell, closed 1 percent lower at $ 69.49 in New York on Thursday.

China has been trying to stamp out health violations that have dogged the country’s food sector amid reports of fake cooking oil, tainted milk and even exploding watermelons. In 2008, milk laced with the industrial chemical melamine killed at least six children and sickened nearly 300,000.

(Reporting by Samuel Shen and Kazunori Takada; Editing by Ryan Woo)

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Study: Solo stars at higher death risk than bands

LONDON (AP) — Rock ‘n’ roll will never die — but it’s a hazardous occupation.

An academic study published Thursday confirms that rock and pop musicians are more likely to die prematurely than the general population, and finds that solo artists are twice as likely to die young as members of bands.

Researchers from Liverpool John Moores University and Britain’s Health Department studied 1,489 rock, pop, punk, R&B, rap, electronica and New Age stars who became famous between 1956 and 2006 — from Elvis Presley to the Arctic Monkeys.

They found that 137 of the stars, or 9.2 percent, had died, representing “higher levels of mortality than demographically matched individuals in the general population.”

The researchers dismissed the “fanciful but unsubstantiated” popular myth that rock stars tend to die at 27 — as Jim Morrison, Jimi Hendrix, Janis Joplin, Kurt Cobain and Amy Winehouse all did. The average age of death was 45.2 years for North American stars and 39.6 for European ones.

Solo performers had twice the death risk of members of bands. Lead researcher Mark Bellis speculated that could be because bands provide peer support at stressful times.

“Solo artists, even though they have huge followings, may be relatively isolated,” said Bellis, director of the Center for Public Health at Liverpool John Moores University.

Music critic John Aizlewood agreed that solo artists receive more attention and adulation — and also more pressure.

“And when you are a solo act, irrespective of what they say in interviews, it’s an incredibly egotistical thing,” he said. “So you tend to be dealing with people who are more emotionally extreme.

“They have an ego in the way a drummer or even a lead guitarist in a band doesn’t.”

In good news for aging rockers, the study found that, after 25 years of fame, stars’ death rates began to return to normal — at least in Europe. A European star still living 36 years after achieving fame faces a similar mortality rate to the European public. But U.S. artists continue to die in greater numbers.

Bellis said factors contributing to the difference could include longer careers — and thus longer exposure to rock ‘n’ roll excess — in the U.S., a huge, populous country with greater opportunities for aging stars to stay on the road. Europe’s stronger social safety net and socialized medicine may also play a role, he said.

The research, which updates a 2007 study by the same team, was published in the online journal BMJ Open.

The study suggests the infamous rock ‘n’ roll lifestyle may not be entirely to blame for rock stars‘ death risk.

The researchers looked for the first time at the role of “adverse childhood experiences” — such as physical or sexual abuse — on stars’ later behavior.

They found that performers who had had at least one adverse childhood experience were more likely to die from drug and alcohol use or “risk-related causes.”

“Substance abuse and risk-taking in stars are largely discussed in terms of hedonism, music industry culture, responses to the pressures of fame or even part of the creative process,” the researchers said.

However, they said, “adverse experiences in early life may leave some predisposed to health-damaging behaviors, with fame and extreme wealth providing greater opportunities to engage in risk-taking.”

But Ellis Cashmore, a cultural studies professor at Staffordshire University and author of the book “Celebrity/Culture,” said it would be wrong to overlook “artistic frustration” as a factor in artistic self-destruction.

He said troubled artists from Vincent Van Gogh and Ernest Hemingway to the Beach Boys’ Brian Wilson all illustrate “the torment that creativity brings with it.”

“Perhaps it is the continual striving for some sort of unattainable artistic perfection that drives them,” he said.

___

Jill Lawless can be reached at http://Twitter.com/JillLawless

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Conditional approval for Minn. health exchange

ST. PAUL, Minn. (AP) — U.S. Health and Human Services Secretary Kathleen Sebelius says Minnesota has reached a milestone in its effort to establish a health insurance exchange.

Sebelius notified Gov. Mark Dayton Thursday that the state has been granted conditional approval to operate its health insurance marketplace in 2014.

Nine other states and the District of Columbia have been given similar approval. Sebelius says the Centers for Medicare & Medicaid Services granted approval based on the state’s progress to date and its expected progress. The approval is contingent on the state’s ability to comply with regulations and meet the anticipated progress, among other things.

The health insurance marketplace will give more than a million state residents and small businesses an easy way to compare and buy private health insurance plans, using subsidies if they qualify.

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How Can Professional Santas Avoid the Flu?

A lot of kids must sit on Santa’s lap before he can hop in his sleigh on Christmas Eve, but Santa has to be extra careful during flu season if he wants to stay healthy into the New Year.

John Sullivan, a professional Santa Claus in Chicago, said he never turns down a child, even if the child’s nose is runny.

“I’ll see him. I’ll talk to him,” Sullivan said. “That’s just a risk that frankly comes with the job … Santa can’t go around wearing a surgical mask!”

Since children actually exhale more flu virus than adults because their immune systems are immature, Santa and other people who work with children are at greater risk for coming down with the flu, said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University in Tennessee.

“Of course, Santa is leaning over the child and listening carefully. He’s in the breathing zone of all these children,” Schaffner said. “They come into very close contact with a myriad of children, and children are the great distributor of respiratory viruses.”

Not only do children exhale more of the virus in each breath than adults do, but they also exhale it longer: 24 hours before they start feeling sick until after they feel better.

“It is likely because children are experiencing these viruses probably for the first time, and that their immune systems are not trained to combat the viruses and shut down the virus production mechanism quickly,” Schaffner said.

Schaffner said it’s important for professional Santa performers like Sullivan to get their flu shots, keep up their fluids and get enough sleep and exercise during the holiday season so that their bodies can fight the flu if they come in contact with it.

Sullivan has been Santa Claus every holiday season for more than two decades, and he never misses a flu shot, he said. He started in malls and now does private events at homes, offices and daycares.

“A lot of times when you pick up a baby, you can feel in their lungs that there’s congestion,” he said. “I’ll tell the parent the baby has cold … Frankly, if I’m Santa, I never reject a child.”

He said he’s gotten mild colds, but nothing serious, and he’s always mindful to avoid getting other people sick if he’s not feeling well.

Near Orlando, Greg Thompson runs The Santa Company, which has seven Santas, including Thompson himself, who has been dressing as Santa since he was 14. (“I’d discovered Santa’s secret, so I decided I wanted to be him.”) That first year, Thompson was 129 lbs., so his grandmother helped him stuff a pillow under his puffy jacket to complete the costume.

Although Thompson’s size may have been a problem, the flu wasn’t, he said. In fact, The Santa Company hasn’t had anyone call out sick since it was founded in 1999.

“We have not had it happen yet – knock on wood – but if someone were to come in and say, ‘Greg, I’m just sick and I can’t come in,’ we’d make sure to have a Santa for him,” Thompson said. “We’re more concerned about people bringing their kids to us. If a kid is obviously sick, you can look at him and tell, sometimes.”

Of the 80 appearances The Santa Company does each year, Thompson does about a quarter of them. When a child approaches Thompson-as-Santa with a runny nose and red eyes, Thompson said he will ask the child to sit down in front of him instead of on his lap.

“I’ll be happy to speak with him,” he said.

Thompson added that his Santas always wear clean gloves as part of the classic red suit with white trim, and they cough only into their elbows.

But Schaffner said gloves can quickly become contaminated, and probably don’t offer much protection against the virus as Santa touches a child and strokes his beard or touches his nose. Even surgeons are taught to wash their hands after they remove gloves, he said.

“They are at risk. There’s no doubt about it,” Schaffner said. “But maybe Santa’s beard and mustache can act like a filter and keep the virus out,” he joked with a laugh.

Santa is magical, after all.

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Merck, GE to collaborate on Alzheimer’s drug development

(Reuters) – Merck & Co and General Electric Co‘s healthcare unit have agreed to collaborate on an experimental drug for Alzheimer’s disease, the companies said on Tuesday.

GE Healthcare will supply Flutemetamol, an investigational imaging agent, to Merck for use with its experimental Alzheimer’s disease drug MK-8931.

The companies hope GE’s imaging agent will help identify patients who might benefit from a therapy such as Merck’s, which targets beta amyloid, a protein that can clump together and form plaques in the brain. Such plaques have been found in the brains of patients with Alzheimer’s disease.

MK-8931 is Merck’s lead Alzheimer’s drug candidate and is designed to modify progression of the disease as well as improve symptoms. Alzheimer’s robs patients of their memory and can cause other cognitive disturbances.

Based on promising results from an early-stage clinical trial of MK-8931, Merck plans to move forward with a larger trial, called EPOCH, at multiple sites around the world.

Flutemetamol is a positron emission tomography (PET) imaging agent that has been able, in clinical trials, to detect beta amyloid in the brain.

GE Healthcare will supply Flutemetamol to help select patients for clinical trials and evaluate the agent as a companion diagnostic tool. Financial and other terms of the agreement between the companies were not disclosed.

(Reporting By Toni Clarke; editing by John Wallace)

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Health insurance exchanges planned by 18 U.S. states: Sebelius

(Reuters) – A total of 18 U.S. states are planning to start their own health insurance marketplaces, which will be available to consumers and businesses in 2014, U.S. Health and Human Services Secretary Kathleen Sebelius said in a blog posting on Monday.

The deadline for states to inform the federal government if they would operate healthcare exchanges under President Barack Obama‘s healthcare reform law was December 14. The number of states participating was in line with expectations and leaves the government to create online marketplaces for the rest of the country.

The exchanges are one of the key aspects of the U.S. Patient Protection and Affordable Care Act, which was enacted in 2010. They will create online marketplaces where individuals can buy health insurance from companies like UnitedHealth Group, Wellpoint Inc, Aetna Inc and Cigna Corp.

“The marketplace will provide consumers and small businesses one-stop shopping for health insurance with better information about plan benefits, quality and cost – simplifying the process for buying health insurance,” Sebelius said in her post.

Between the exchanges and expansion of Medicaid government healthcare for the poor, more than 30 million people are expected to become insured in the next decade.

Sebelius said the states that submitted applications for exchanges included: California, Hawaii, Idaho, Minnesota, Mississippi, Nevada, New Mexico, Rhode Island, Vermont and Utah.

On Friday, the government conditionally approved the plans previously submitted by the District of Columbia, Kentucky and New York. It had previously backed plans from Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington.

The remaining 32 states have until February 15, 2013, to declare whether they want to set up a health exchange in partnership with the government.

(Reporting by Caroline Humerm Editing by G Crosse)

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S.Africa’s Mandela had gallstones removed, recovering: government

JOHANNESBURG (Reuters) – Nelson Mandela, the 94-year-old former South African president and Nobel Peace laureate hospitalised with a lung infection, has successfully undergone a procedure to have gallstones removed, the government said on Saturday.

“The former president underwent a procedure via endoscopy to have gallstones removed. The procedure was successful and Madiba is recovering,” President Jacob Zuma‘s office said in a statement, using Mandela’s clan name.

South Africa‘s first black president, who came to power in historic all-race elections in 1994 after decades struggling against apartheid, remains a symbol of resistance to racism and injustice at home and around the world.

Mandela was admitted to a Pretoria hospital on Saturday a week ago after being flown from his home village of Qunu in a remote, rural part of the Eastern Cape province.

Tests revealed a recurrence of a lung infection and that he had developed gallstones, the government statement said.

The medical team had decided to treat the lung infection before attending to the gallstones, it said.

Mandela spent 27 years in apartheid prisons, including 18 years on the windswept Robben Island off the coast of Cape Town.

He was released in 1990 and went on to use his unparalleled prestige to push for reconciliation between whites and blacks as the bedrock of the post-apartheid “Rainbow Nation”.

He stepped down in 1999 after one term in office and has been largely removed from public life for the last decade.

Mandela spent time in a Johannesburg hospital in 2011 with a respiratory condition, and again in February this year because of abdominal pains. He was released the following day after a keyhole examination showed there was nothing serious.

He has since spent most of his time in Qunu.

His fragile health prevents him from making any public appearances in South Africa, although he has continued to receive high-profile domestic and international visitors, including former U.S. President Bill Clinton in July.

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Hillary Clinton recovering after sustaining concussion: spokesman

WASHINGTON (Reuters) – U.S. Secretary of State Hillary Clinton is recovering after sustaining a concussion, a State Department spokesman said on Saturday.

“While suffering from a stomach virus, Secretary Clinton became dehydrated and fainted, sustaining a concussion,” Clinton spokesman Philippe Reines said in a statement.

“She has been recovering at home and will continue to be monitored regularly by her doctors. At their recommendation, she will continue to work from home next week, staying in regular contact with department and other officials. She is looking forward to being back in the office soon,” Reines added.

Clinton fell ill with a stomach virus last weekend and was forced to cancel a planned trip to the Middle East and North Africa.

(Reporting by Andrew Quinn; Editing by Will Dunham)

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FDA OKs Ariad’s drug for two rare blood cancers

(Reuters) – The U.S. Food and Drug Administration said on Friday it approved Ariad Pharmaceuticals Inc‘s drug to treat two rare types of blood cancer, three months ahead of the review date.

Iclusig was approved to treat chronic myeloid leukemia and Philadelphia chromosome positive acute lymphoblastic leukemia.

The drug, generically known as ponatinib, is being granted an orphan product status, intended for drugs that aim to treat rare diseases.

The FDA said that Iclusig was approved under its accelerated approval program, which provides patients earlier access to promising new drugs while the company conducts additional studies.

Orphan drug designation is granted by the health regulator to drugs or biologics that treat a condition affecting less than 200,000 Americans.

The status grants the drugmaker a marketing exclusivity of seven years in the United States, upon approval.

Iclusig, which blocks certain proteins that stimulate the development of cancer cells, was to be reviewed by the FDA on March 27. (http://link.reuters.com/vut64t)

(Reporting By Vrinda Manocha in Bangalore; Editing by Maju Samuel)

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Hugo Chavez’s battle against cancer

(Reuters) – Venezuela‘s President Hugo Chavez is in delicate condition after his latest cancer surgery, the government said on Wednesday in a somber assessment that could presage an end to his 14-year rule.

Following is a chronology of the 58-year-old socialist leader’s fight for his health:

JUNE 30, 2011

* A pale-looking Chavez addresses the nation by television from Cuba, where he says doctors operated on him to remove a cancerous tumor from his pelvis.

JULY 4, 2011

* The president makes a surprise return to Venezuela ahead of the country’s Independence Day celebrations.

JULY 17, 2011

* Chavez returns to Cuba to begin a course of chemotherapy.

SEPT. 22, 2011

* Finishes his fourth and final course of chemotherapy.

OCT. 20, 2011

* Following tests in Havana, Chavez declares himself free from his cancer, and his doctors say he is completely cured.

DEC. 2, 2011

* Hosts a regional summit, minus representatives from the United States, in Caracas.

DEC. 20, 2011

* Attends a Mercosur summit in Uruguay, Chavez’s first political trip overseas since his illness was diagnosed.

FEB. 21, 2012

* Chavez says he will undergo another operation after a lesion was found in the same area where he had the tumor.

FEB. 28, 2012

* The president undergoes surgery in Cuba.

MARCH 4, 2012

* Chavez says he will undergo radiation treatment in Cuba.

MARCH 16, 2012

* President returns to Venezuela after his latest operation.

MARCH 25, 2012

* Chavez returns to Havana to begin his first cycle of radiation therapy.

APRIL 5, 2012

* The president cries during Roman Catholic Mass, calls on God “not to take him yet” because he has more to do for Venezuela.

APRIL 14, 2012

* Chavez returns to Cuba for more radiation treatment, missing the Summit of the Americas in Colombia.

OCT. 7, 2012

* Chavez easily wins re-election at presidential poll.

NOV. 27, 2012

* The president says he will return to Cuba for treatment including hyperbaric oxygenation, which can be used to treat the side effects of radiation therapy.

DEC. 7, 2012

* Flies home to Venezuela in the pre-dawn hours, joking, “Where’s the party?”

DEC. 8, 2012

* Chavez says doctors in Cuba found a recurrence of malignant cells in his pelvic area and that he must undergo another operation within days.

DEC. 11, 2012

* Chavez undergoes operation of more than six hours, which the government says was completed “correctly and successfully.”

DEC. 12, 2012

* Vice President Nicolas Maduro says the surgery was “complex, difficult and delicate,” and that the post-operation process will also be “complex and tough.”

(Reporting by Caracas newsroom; Editing by Xavier Briand)

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Venezuela’s Chavez in “complex” post-operation condition: VP

CARACAS (Reuters) – Venezuelan President Hugo Chavez is in a “complex” and delicate condition after his latest surgery for cancer in Cuba, Vice President Nicolas Maduro said on Wednesday.

Looking grave-faced in an address to the nation, he urged Venezuelans to unite in prayer for their 58-year-old president, and to keep faith that Chavez would return soon.

(Reporting by Caracas newsroom; Editing by Will Dunham)

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