Author: Seoyeon kim

RESEARCH SPOTLIGHT: DR. Nori Comello

Dr. Maria Leonora “Nori” Comello is an assistant professor here at UNC in the School of Media and Journalism as well as a teacher so much loved by students.

Having expertise in public relations and health communication, Dr. Comello’s research has focused on intersection of strategic communication, health, and identity.

Especially, Dr. Comello is an insightful researcher fascinated by “identity.” She was first inspired for the concept by a quote of William James, a psychologist in the late 1800s: “Neither threats nor pleadings can move a man unless they touch some one of his potential or actual selves.”

She has worked on a variety of health communication research exploring effects of valued and activated identities on behavioral decision-making, including tobacco-prevention research among Mexican-American youth audiences and substance-prevention research incorporating ideas of self-concepts and behavioral willingness to use substances.

Her recent research interest includes the potential for games to support identities in a health communication context (e.g, how cancer survivors or patients with chronic diseases use games to achieve meaning in life). In one of the relevant studies, she looked at if game playing had beneficial effects on cancer survivors who often experience physical symptoms as well as emotional symptoms, such as anxiety, fatigue, and fear of recurrence. She found that intrinsic motivation cancer survivors has while playing games was positively associated with cancer self-efficacy, resilient coping, and flourishing; sense of community was also positively associated with resilient coping and flourishing.

Heavy foodborne illness burden for children, WHO’s first global estimates find

The World Health Organization (WHO) announced its first ever global foodborne disease estimates, which show that about 1 out of 10 individuals become sick each year due to tainted food and 420,000 die as a result. Other major findings include: kids younger than 5 are at particularly high risk, with 125,000 children dying from foodborne diseases every year; the WHO’s African and South-East Asia regions had the highest burden of foodborne diseases, with the highest incidence and highest death rates.

It is especially notable that almost one third of all deaths from foodborne diseases are in children under the age of 5 years, despite the fact that they make up only 9% of the global population.

Foodborne diseases’ short-term symptoms include nausea, vomiting and diarrhoea (commonly referred to as food poisoning), but there are also longer-term illnesses that can caused by foodborne diseases, such as cancer, kidney or liver failure, brain and neural disorders. Such diseases are often more threatening for children, pregnant women, and those who with a weakened immune system. Children who survive some of the more serious foodborne diseases may suffer from delayed physical and mental development, impacting their quality of life permanently.

The WHO hopes this report will shed light on better understanding which foodborne pathogens are causing the biggest problems in which parts of the world can generate targeted action by the public, governments, and the food industry.

Ejiofor Ezekwe Researches New Ways to Fight Infection

UNC Institute for Global Health & Infectious Diseases (IGHID) has shared insightful news and information about the organization’s efforts to save lives and improve quality of healthcare at a global level. The following content was created by the organization and borrowed from its quarterly e-newsletter.

Ejiofor Ezekwe was recently awarded the Robert Watkins Graduate Research Fellowship from the American Society of Microbiology (ASM) to support his ongoing research on the causes of inflammation.

Ejiofor Ezekwe was recently awarded the Robert Watkins Graduate Research Fellowship from the American Society of Microbiology (ASM) to support his ongoing research on the causes of inflammation.

UNC graduate student Ejiofor Ezekwe realizes that antibiotics are not the be-all and end-all of infectious disease. He is researching how the body responds to infection in order to better understand how to treat disease by modifying the body’s own immune system.

“Some time we’re going to need, in the absence of new antibiotics, new ways to help a person battle the bug,” Ezekwe explains. “If we can find better ways to engage that immune response where it’s appropriate, and dampen it down where it’s not, we can hopefully lead to better outcomes for patients in the future.”

Ezekwe is part of the MD-PhD program at UNC, where he is in his seventh year. He was recently awarded the Robert Watkins Graduate Research Fellowship from the American Society of Microbiology (ASM) to support his ongoing research on the causes of inflammation. The Watkins Fellowship is awarded to high-achieving graduate students and aims to increase the diversity of students completing doctoral degrees in microbiology. Through his research in the lab of his PI (Principal Investigator) Joseph A. Duncan, MD, PhD, Ezekwe works to better understand how a bacterial toxin called alpha-hemolysin can trigger inflammation and the activation of the immune system.

Hemolysins are toxins secreted by some bacterial pathogens. When these pathogens infect a person they release the toxin, which attacks the host cells by binding to their membranes and forming pores, literally causing the cells to overfill and pop. To combat this, the host cells respond by mounting an immune response to fight off the invading bacteria. This immune response causes inflammation. Though we tend to think of our body’s immune response against infection as a good thing, Ezekwe and other researchers in the Duncan Lab are finding out that a vigorous immune response isn’t always beneficial.

“We were surprised to find that activation of this pathway, which we thought was important in helping us recognize bacteria and defend against them, actually made mice sicker during S. aureus infection,” explains Duncan. The pathway he is referring to is the microbiological sequence that leads from hemolysins to an inflammatory response triggered by the toxins. And the surprise is that activating the mouse’s own immune response during an infection was detrimental to the animal.

“There’s a happy medium. You want a good amount of immune activation, but too much immune activation in the wrong context can be bad,” Ezekwe says. “An over response can lead to deleterious effects and death. It can lead to worse tissue destruction– it’s kind of like the SARS virus. The reason why the SARS virus is so deadly is not necessarily just the virus itself, it’s the body’s immune response against the virus. Ebola works the same way.”

Joseph A. Duncan, MD, PhD, is mentoring Ejiofor Ezekwe.

Joseph A. Duncan, MD, PhD, is mentoring Ejiofor Ezekwe.

Ezekwe hopes that better understanding the steps by which infection leads to immune activation will allow doctors to control the immune response in order to better treat disease. Learning the exact mechanism by which the immune system is activated would help researchers develop ways to throw a wrench in that process in order to dial back the immune response where appropriate. By studying how alpha-hemolysin leads to an immune response, Ezekwe’s research could lead to developments in the treatment of patients with infectious diseases in which the body’s inflammatory response drives the progression of disease. This includes SARS, Ebola, and even non-infectious, inflammatory diseases like rheumatoid arthritis.

“The key here in infectious disease now is trying to modulate the immune system rather than interface with the bacteria. Our bodies are very good at eliminating infection if you prime them the right way and you work them the right way,” Ezekwe says. “What we’re trying to do is remove the ability of your body to do damage to yourself while you’re clearing the infection.”

For Ezekwe, a Baltimore native who grew up in Nigeria, getting the Watkins Fellowship was a big moment in part because it recognized the efforts made by the people who have supported him. “I think it was nice not only for me, but also for my PI and for everyone I’m representing back home,” he says. “I’m really grateful for the investment they have made in me.”

Going forward, Ezekwe hopes to stay involved in tackling immune system challenges, but remains open to where specifically that will land him, whether in pediatrics, allergy and immunology, or in a lab studying infectious diseases. He is also deeply devoted to increasing diversity in science and medicine, something the Watkins Fellowship is also committed to.

“I want to continue to promote this idea that science is open to everybody, it’s not an exclusive thing,” Ezekwe says. “And that’s what I enjoy and I think that part of my mission going into the future is to be really involved in medical education, in science education, in science outreach– to groups that may not always be so well-represented in science. And I think that’s what this fellowship is all about.”

WHO survey reveals communication gaps in antibiotics

The World Health Organization (WHO) recently released its survey results on perceptions and use of antibiotics. The results revealed that misconceptions about antibiotics were prevalent and that communication efforts were needed to bridge the gap.

The survey asked people in 12 countries (Barbados, China, Egypt, India, Indonesia, Mexico, Nigeria, Russian Federation, Serbia, South Africa, Sudan and Viet Nam) 14 questions about antibiotics use, knowledge of antibiotics, and knowledge of antibiotic resistance.

Although antibiotic resistance occurs when bacteria become resistant to the antibiotics used to treat the infections they cause, three quarters (76%) of respondents answered that antibiotic resistance would happen when the body became resistant to antibiotics.

Two thirds (66%) said that they did not have to worry about drug-resistant infection if they personally took antibiotics as prescribed. Also, 44% believed that antibiotic resistance would matter only for those who take antibiotics regularly. However, anyone, of any age, in any country can be at risk of an antibiotic-resistant infection.

To address such growing communication gap problem and to improve awareness and understanding of antibiotic resistance at individual, community, and societal levels, the WHO has launched a global campaign ‘Antibiotics: Handle with care.’ This week, November 16 through 22, is the first World Antibiotic Awareness Week. The United States has also participated in the campaign as the White House has proclaimed this week as “Get Smart About Antibiotics Week,” hoping the effort will help the public better understand antibiotics and change the way antibiotics are used.

More detailed information about the survey can be found at the following hyperlink: Antibiotic resistance: Multi-country public awareness survey

Health impacts of climate change is already evident, WHO says

The World Health Organization (WHO) discusses about significant public health impacts of climate change in the upcoming United Nations Climate Change Conference (COP-21) to be held in Paris in Nov 30 through Dec 11.

Climate change is attributed to tens of thousands of deaths every year. Changes in the patterns of diseases, heat-waves and floods, air quality, food and water supplies, and sanitation have brought significant impacts on global public health.

According to the WHO’s estimation in 2012, 7 million died from diseases related to air pollution. It also predicted that 250,000 deaths per year would be added through malaria, diarrhea, heat stress, and under-nutrition between 2030 and 2050 in the consequence of climate change.

The WHO suggests that efforts to reduce emissions of short-lived climate pollutants (e.g., black carbon, methane) can prevent approximately 2.4 million people from dying every year. Putting a price on polluting fuels is also expected to curb air pollution-related deaths by half, along with raising revenue up to approximately $3 trillion per year which is over half the total value of health spending by the governments over the world.

End of Ebola transmission in Sierra Leone

On November 7, the World Health Organization (WHO) declared the end of Ebola transmission in Sierra Leone with the passage of two incubation periods with no positive tests.

Nearly 18 months has passed since the first Ebola case was reported in Sierra Leone. More than 8,704 got infected and 3,589 have died, including 221 healthcare worker fatalities.

Sierra Leone was also one of three worst-affected outbreak countries along with Guinea and Liberia, reporting the highest number of cases. However, the country now transits from an outbreak control stage to a 90-day enhanced surveillance stage as it has achieved the stop of virus transmission. The enhanced surveillance period will end on the 5th of February, 2016, and the WHO will continue to support the country during this period to ensure early detection of any possible new cases of Ebola virus disease.

The WHO highlighted that there has been tremendous domestic/international effort and commitment to fight against the most unprecedented Ebola virus disease outbreak in human history. Particularly, the government showed strong leadership with working closely with global healthcare partners and mobilized the necessary expertise needed to contain the outbreak. The sharp increase of cases in September and October 2014 declined as the community worked hard with the treatment facilities and dignified burial teams to stop the disease.

Although there are problems still left to be solved and recovered, the path Sierra Leone and global healthcare partners have walked through during the outbreak has been shedding light on building a strong and resilient public health system that will better prepare us for the next possible public health threat.

Download and get your workout done in 7 minutes

Let me introduce interesting apps the New York Times has recently launched for those who feel difficulty coming up with a quick and nice set of workouts.

The apps “Scientific 7-Minute Workout” and “Advanced 7-Minute Workout” offer a set of popular workouts that can be done in only 7 minutes. The composition of workouts were designed based on scientific findings on high intensity interval training by Mr. Jordan and his colleagues. The researchers suggest that high intensity exercises can be still beneficial even if it’s performed in much less time than regular exercises usually take. But, it should be noted that interval training requires brief periods of recovery between each workout, so that the muscles can catch their breath before they get to the next one.

Wonder what’s in it? The Scientific 7-Minute Workout is composed of 12 exercises, and it only requires your body weight, a chair, and a wall: jumping jacks, wall sit, push up, abdominal crunch, step-up onto chair, squat, triceps dip on chair, plank, high knees running in place, lunge, push ups with rotation, and side plank. The advanced version brings more intense workout sets and it requires dumbbells. The exercises are proceeded quite fast (30 seconds for each exercise), and 10 seconds interval exists between each exercise.

Why don’t you download the apps and try it right away?

American cancer society revises the mammogram guidelines

The American Cancer Society now suggests that women at “average risk” of breast cancer begin mammograms at 45, five years later than it had long recommended. Also according to the new guidelines, starting at 55, women can get mammograms every other year.

The American Cancer Society issued these new guidelines based on its observation of data showing that younger women are only at a slightly higher risk for breast cancer and thus mammograms may not be always necessary for them so early. Also, the newly issued guidelines can be said to be attempts to address the potential harms and unnecessary procedures that might occur from annual screenings, such as increased anxiety, false positives, unnecessary biopsies, and overtreatment.

Despite of quite understandable explanation of why the guidelines have revised, however, people, including health care professionals and women in the general public, are not sure about sticking to the new guidelines, since suggestions of the earlier or later ages to begin mammograms still hold their own strong rationales. And, of course, ecology should be counted, as well: doctors and professional groups make more money when more and earlier mammograms are conducted.

UNC and Research Partners Race to Better Prepare for Next Ebola Outbreak

UNC Institute for Global Health & Infectious Diseases (IGHID) has shared insightful news and information about the organization’s efforts to save lives and improve quality of healthcare at a global level. The following content was created by the organization and borrowed from its quarterly e-newsletter.

Morag MacLachlan, Communications Director for IGHID, wrote this story and produced the accompanying video (https://youtu.be/f3NIPU5mh7g). To learn more about the IGHID, visit http://globalhealth.unc.edu. And click here to read a blog post by Chris Evans, RN, ANP-BC, who works in UNC’s Division of Infectious Diseases and who also traveled to Liberia to work on the following studies of the Ebola virus from March-June 2015.

Fear and poverty. These are the main factors two UNC clinician-researchers feel have fueled the reoccurring outbreaks of Ebola in West Africa over the past 40 years. The most recent outbreak was the worst to date with more than 27,000 people infected and more than 11,000 dead. What is known about the virus is that it spreads quickly and those stricken suffer immensely. Instead of remaining safely stateside with their families and medical practices in Chapel Hill, William Fischer, MD, and David Wohl, MD, headed to the Ebola epicenter.

“It’s a legitimate question about why someone who is involved in the HIV epidemic would find themselves in the throes of the Ebola epidemic of this last year and a half,” says Wohl, Associate Professor of Medicine, Division of Infectious Diseases, UNC School of Medicine. “But on the other hand, I think who else would be perfectly suited to respond to an emerging, viral, infectious disease that is fatal, that is surrounded with a lot of sociological aspects, including stigma and fear. There are not a whole lot of Ebola-ologists out there. The last outbreak was around 400 people. There isn’t this reserve of veterans who know a lot about clinical management, or about infectious diseases in general, who could respond to this outbreak. So I asked myself, could I be helpful there? Could I respond? And if the answer is yes, I need to go.”

A message spray painted to a wall in Liberia. Photo credit: Chris Evans

A message spray painted to a wall in Liberia. Photo credit: Chris Evans

 

And go he did along with Fischer, who had been asked by the World Health Organization (WHO) in May 2014 to travel to its headquarters in Geneva to discuss drafting guidelines for the collection of respiratory specimens for a number of emerging infections, including Ebola in West Africa, avian influenza in China and Middle East Respiratory Syndrome (MERS). Yet upon his arrival, WHO officials informed him there had been a change of plans. His experience as a pulmonary and critical care physician, who spoke French and had served in resource-constrained environments made him a perfect first responder to travel to Guéckédou, Guinea – the African town hardest hit by Ebola at that time.

“I called my wife and she was not happy,” says Fischer, an Assistant Professor of Medicine, Division of Pulmonary and Critical Care Medicine, UNC School of Medicine. “But there was such urgency about the situation. And this is exactly what I do. I focus on severe viral infections. I focus on delivery of care in resource-constrained environments. And I am a critical care physician. So it was all of these worlds that I am passionate about that really came together. There was no way I wasn’t going to go. But the thing that really got me, the hook that made it something I could not turn down, was the focus. For 40 years the way Ebola has been treated is by isolating the people who are sick. But this time, the WHO, from the very beginning, said we have got to do better than we have done responding to past Ebola outbreaks. The goal was twofold – can we learn how to better treat people fighting Ebola and can we improve clinical outcomes now.”

Fischer’s experience in Guinea showed him how people being treated for Ebola in the US and Europe had very different treatment plans and usually better clinical outcomes than people fighting the virus in West Africa. The shear volume of patients in West Africa and the lack of electricity and running water compounded the problem of getting the virus under control. Then came a call from Clinical Research Management (ClinicalRM), a company based in Ohio with a robust clinical trial presence in Africa. ClinicalRM approached Fischer and Wohl about designing a study to test a treatment strategy in Liberia with funding secured from the Bill and Melinda Gates Foundation.

“We were introduced to David and Billy through mutual contacts at UNC about a year ago,” says Claudia Christian of ClinicalRM. “We immediately started collaborating on the Ebola efforts, and in short time, the duo rose to a leadership role in our partnership and agreed to travel to Liberia together to personally launch and oversee our clinical trials. Combined, they formed the perfect scientific leadership –Dr. Wohl bringing his significant clinical experience and Dr. Fischer bringing his significant Africa experience.”

The trial, the first implemented during an Ebola outbreak, began in December 2014 at ELWA Hospital in Monrovia, Liberia.

Stopping the Virus: Convalescent Plasma, Fluids and Lab Tests
This first trial synergized Fischer’s critical care strengths and knowledge from his experience treating people battling Ebola in Guinea with Wohl’s clinical and research expertise in treating another communicable infectious disease – HIV with ClinicalRM’s established clinical trial foundation in West Africa. The theory to be tested was the use of convalescent plasma or using the blood from survivors to treat people fighting the infection.

David Wohl, MD, has traveled to West Africa many times since the most recent Ebola virus outbreak began to provide clinical care and conduct research.

David Wohl, MD, has traveled to West Africa many times since the most recent Ebola virus outbreak began to provide clinical care and conduct research.

 

“That’s a therapeutic intervention that has been used in most people who have been infected and repatriated back home. So people from Europe and the US who worked in West Africa and got infected, or the very few cases of health care workers being infected in the US, all received convalescent plasma and recovered,” says Wohl. “The idea being that antibodies in that plasma give you a head start to treating Ebola. We do not know if that is the case and we went over to try and figure that out. We wanted to know once and for all – is this something that is worthwhile, is there something different about these antibodies, and do you need a certain concentration of these antibodies to be effective?”

In addition to receiving convalescent plasma, a more aggressive and ambitious clinical care strategy was also implemented. Providing each patient with fluids intravenously to combat dehydration and drawing labs to monitor levels, such as the amount of potassium in the blood, greatly improved the health of patients battling Ebola in the developed world. In the US or Europe, Fischer says the ratio of healthcare providers to patients is 30 to 50 clinicians for every one patient. In the field, like Liberia, the ratio of providers to patients is one clinician for every 60 patients. With the odds stacked against them, Fischer, Wohl, ClinicalRM and their Liberian counterparts still managed to improve survival rates.

“We reduced mortality rates from 75 percent to between 43-50 percent with just supportive care when I was working in Guinea at the beginning of the epidemic for the WHO,” Fischer says. “That is why I knew supportive care had to be a part of this trial in Liberia. Historically, people have been very hesitant to place IV’s because of the risk associated with a needle stick. But people suffering from Ebola can have up to 10 liters of diarrhea a day. So we decided to be more aggressive in placing IV’s in Guinea and people’s health improved. We needed to give the healthcare providers in West Africa the tools to provide better service or the kind of care available in resource-rich countries. So in the trial in Liberia, everyone got IV’s. Everyone received lab support. The whole idea behind this is combining service and clinical research. If our research operation fails, meaning if the intervention doesn’t work, we are still providing better clinical care to patients than they would have received otherwise. So that was our first trial.”

This trial has since been stopped because the number of new cases of Ebola in Liberia has waned. Wohl says getting research started in a resource-constrained area is challenging and he wished the group could’ve gotten up and running back in the summer of 2014 when Médecins Sans Frontières (Doctors Without Borders) began predicting the humanitarian crisis coming down the pike.

“I felt like we did a great job, but it was too late to really answer that question of does convalescent plasma improve clinical outcomes this time,” Wohl says.

Ebola Survivors: After Effects and Sexual Transmission
Wohl, Fischer and ClinicalRM have now turned their attention to the thousands of Ebola survivors. With further funding from the Gates Foundation, they are investigating the ongoing clinical complaints from people who have recovered from Ebola. The team is also focused on learning whether or not those who have no trace of the virus in their blood stream may still shed the virus elsewhere in the body.

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“The team on the ground became aware of the hardships being faced by Ebola survivors through the course of collecting plasma from survivors as a potential therapeutic and daily interactions on the ELWA campus with survivors as we pass through the waiting area of the survivor clinic,” says Melissa Jones Reyes of ClinicalRM. “Many have lost their homes and families, lives are turned upside down and economic livelihood lost. The stories are heart wrenching, but survivors are also plagued with continued health issues such as arthritis, malaise and eye problems to name a few. Additionally, women are unsure about the safety of conceiving and nursing. We are just trying to find a way to give them their lives back through research and possible interventions for their health issues.”

Wohl says eye drops to help with ocular issues and steroids to counter muscle pain are two ways the survivors’ clinic at ELWA Hospital in Monrovia is trying to equip those Liberians who beat Ebola with tools to combat these lingering issues from the virus. As far as viral shedding, which would put a recovered Ebola survivor at risk for transmitting the virus to an uninfected person, there has been at least one confirmed case of sexual transmission of Ebola. Thirty days after the last case of Ebola was reported in Liberia, a 40-year-old woman died of Ebola, Wohl says. Her boyfriend was a survivor and the genetic makeup of her virus was the same as his.

“Ebola as a sexually transmitted disease is something Billy and I have been very concerned about for a long time. While this is the first confirmed case, we do not believe this is the first time this has happened. In the midst of an outbreak, we believe sexual transmission of Ebola has probably just been subsumed by common contact, like cleaning a body or bodily fluids,” says Wohl. “UNC has a long history of studying sexually transmitted diseases and also understanding how there is compartmentalization within our bodies of viruses and the immune response to those viruses. So we know from HIV, where we have been a pioneer in this work, the virus in the blood can be different than the virus in the genital secretion, which can be different from the virus in the cerebral spinal fluid that bathes the brain. And the immune system reacts differently to the virus in each of theses places. The quantity of virus and the duration of infection can therefore be different depending on if the virus is in the blood or if it is in genital secretions. We know people who were infected with Ebola do clear the virus from their blood. However, there is documented evidence that they do still have it in their genital secretions and their eyes. So that is concerning because that means there are these sanctuaries in the body where the immune system was not able to eradicate the virus.”

After the initial case of sexual transmission in Liberia, Fischer says the Ministry of Health and the WHO recommended avoiding unsafe sex until semen had tested negative twice. However, testing is not widely available in Liberia, and there were no recommendations for women. Thus, Fischer, Wohl, ClinicalRM and ELWA Hospital designed their latest study to provide free testing for survivors and to couple this service with clinical research to provide evidence behind future recommendations. Wohl and Fischer are hopeful that further analysis of these samples will allow them to give survivors a timetable as to how long they will have to practice safe sex with their loved ones and could lead to interventions that penetrate the virus in genital secretions in much the same way as has been discovered in HIV.

It’s Not Over: Stigma, Future Outbreaks and the Plane Ride Effect
Continued health problems and precautions with having sex aside, Ebola survivors face another hardship – stigma.

A sign in Liberia pleading for Ebola to stop. Photo credit: Chris Evans

A sign in Liberia pleading for Ebola to stop. Photo credit: Chris Evans

 

“Like anything, there are news cycles and Ebola has faded. To some degree, that is appropriate, but it is not over. There are still some Ebola cases in Sierra Leone and Guinea. It is not a matter of if, but when the next Ebola outbreak will happen. We now know it is endemic to the forests in this part of Africa and it will happen again. We just have to prepare for that and be better able to respond to that,” Wohl says. “And secondly, there are a lot of survivors. There are more than 1,000 survivors in Liberia alone and they are suffering. They don’t have their jobs any more. They are stigmatized. These are people whose homes were burned and whose possessions were thrown away because people were afraid. Many of them were health care workers and they cannot go back to health care because many of these settings don’t want them or don’t need them now. So we are really trying very hard to support these clinics like the one at ELWA. We are not just studying plasma and then saying we are going to leave. We have a commitment to be here for the longer run and continue to provide care for people who survived Ebola.”

Fischer says what has struck him the most about his time tackling Ebola are the similarities he has noticed between basic human compassion in the resource-constrained and developed countries, but how these same actions can have such devastatingly different outcomes.

“What we have learned is that you can reduce mortality with aggressive care and you can do that during an outbreak,” Fischer says. “But Ebola, like many diseases, is a disease of poverty. There is such disparity in health care across the globe. If my son is sick with diarrhea, I will give him a hug to comfort him and I will clean him up. I can then wash my hands and I will be fine. That is exactly what people in West Africa did, but the difference is that they do not have access to the resources that keep them safe. They do not have access to the soap, water and alcohol-based hand sanitizers we have. And that is the only thing they did differently. Fundamentally, the problem is poverty.”

Yet, Fischer also points out that people can’t just watch the news and think that Ebola is a West Africa problem. Plane travel has made any disease any place in the world something each person should care about.

“The world is changing. These tropical diseases that occur in these resource-constrained, isolated environments no longer exist. We are now a plane ride away from every corner of the world. So if we let poverty accelerate, as we’re doing right now, then it’s only a matter of time before these diseases spread to other countries,” Fischer says. “I think the most frustrating thing we heard was people saying ‘we should quarantine all of West Africa.’ I think that is exactly the wrong response. Quarantines have never worked. It just causes an outbreak to spiral out of control. So I think the right way to do this is to respond to an epidemic at the source and fix the underlying problem of poverty by increasing equitably access to lifesaving interventions.”

You may get little benefit from Calcium supplements, study finds

Middle aged and seniors often try to be more than sufficient in their calcium consumption to maintain their bones strong and to reduce the risk of a fracture, since osteoporosis might become a serious issue for them. But, a recent study appeared in the BMJ has raised doubts about such a strong belief in calcium and strong bones.

New Zealand researchers found that calcium, taken either through diet or in a form of supplements, provided little benefits to increasing bone density. The researchers reviewed more than 100 previous studies conducted on people age 50 or older who increased calcium intake. Most studies showed minimal or no significant relationship between dietary calcium intake and risk of fracture.

When calcium was taken with supplements, there were about 11% less likelihood of having a vertebral fracture. They had, however, no effect on hip or forearm fractures. The highest-quality studies on calcium supplements involving more than 45,000 participants showed no association between calcium supplements and the risk of fracture.

Current guidelines for people over 50 years old recommend to consume 1,000-1,200 mg of calcium every day. Dr. Mark Bolland, the senior researcher of the study, said in an interview with the New York Times that there should not be a problem in calcium intake if you have a normal diet.