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Farmer Still Under Consideration For Obama Administration Position, Takes Harvard Medical School Appointment
While Partners in Health co-founder Paul Farmer is still being considered for a senior role in the Obama administration, Farmer has been appointed chair of Harvard Medical School"s Department of Global Health and Social Medicine -- Jeffrey Flier, the medical school"s dean, said on Wednesday -- the Boston Globe reports. Flier said that Farmer will take a leave of absence from the medical school if he is offered a position with the administration. For now, Farmer is slated to succeed the current chair, Jim Kim, on July 1 (Smith, Boston Globe, 5/28). Foreign Policy"s "The Cable" reports that Farmer is "under consideration to head" USAID or "serve in a top administration international assistance post that would encompass it." An unnamed "international health activist" said that Farmer might be appointed USAID administrator "as an interim thing" and that he might go on to lead a new position focused on "global health in the process of foreign assistance reform over the coming year." Rep. Howard Berman (D-Calif.), chair of the House Foreign Affairs Committee, is organizing efforts to reform the Foreign Assistance Act later this year. The act was originally written in 1961 (Rozen, "The Cable," Foreign Policy, 5/26).On Tuesday, Jack Lew, Deputy Secretary Of State for Management and Res, said that the government is considering ways to significantly improve coordination of various agencies that work with global health assistance. "We"re open to creative ideas about how to bring appropriate res to bear," Lew said, adding, "When we look at public-private partnerships and recruiting, we"re looking at how to cast the broadest net to bring in the right talent and commitment to address the challenge" (Boston Globe, 5/28). Partners in Health said it is pleased that Farmer is being considered along with other strong candidates. Wendy Sherman, an advisor to Secretary of State Hillary Clinton, and Aaron Williams, a former USAID official who is now with RTI International, are among some of the "[p]reviously rumored contenders for the USAID administrator job," according to "The Cable." Last week, Farmer had a meeting with Clinton, Partners in Health said. Andrew Marx, a spokesman for the group, said that one of the reasons why people are "excited about the idea of Paul is that he and Partners in Health in the past have been quite prepared to challenge the accepted wisdom." According to Marx, Farmer did not buy into the conventional approach to multi-drug resistant tuberculosis in the 1990s, when WHO"s official policy was not to treat people who were diagnosed with the disease because it was complicated and the costs were high. When asked if Farmer would be interested in a USAID administrator position that has strong democracy and governance components, Marx said, "Good governance and democracy are important to us," adding that the group"s work focuses on building up countries" public health systems rather than creating independent health clinics. David Bryden, senior program policy officer for the Center for Global Health Policy, said, "There are many exciting things about Paul Farmer." According to Bryden, Farmer "has been a person with a very practical mindset, he knows how to get the job done, put aside conventional wisdom when it"s wrong. ... It"s really exciting" ("The Cable," Foreign Policy, 5/26).

Montana Abortion-Rights Opponents Renew Attempts At 'Personhood' Ballot Initiative
The Montana ProLife Coalition last week launched a campaign seeking a state ballot initiative that would propose defining "personhood" in the state constitution as "from the beginning of the biological development of that human being," the Great Falls Tribune reports. A required 48,674 signatures are needed to place the initiative on the November 2010 ballot. Abortion-rights opponents failed to collect enough signatures for a similar proposal last year. Former state Rep. Rick Jore, a member of the Constitution Party, on Wednesday submitted three versions of the proposal to the Montana Secretary of State"s Office. Jore also authored last year"s proposal.Allyson Hagen, executive director for NARAL Pro-Choice Montana, said, "Whether or not they get it on the ballot, I think that the vast majority of Montanans are going to oppose an extreme initiative like this one." She added, "I think Montanans believe very strongly in the right to privacy and [that] the decisions regarding pregnancy should be between a woman and her doctor, not with the Legislature or the government."Abortion-rights opponents last year tried and failed to put similar proposals before voters in Georgia and Oregon, and Colorado voters rejected a similar measure by a 3 to 1 margin. Hagen said that because the president supports abortion rights and Democrats have a majority in Congress, "antiabortion groups are looking to make movements in the states, feeling powerless at the federal level." Earlier this year, two bills (SB 406, SB 46) in the Montana Legislature that sought to grant constitutional rights to embryos failed to make it out of committee. The North Dakota Legislature recently rejected a similar proposal (Adams, Great Falls Tribune, 7/2).
News of the day
Diabetes UK Launches Its National Measure Up Roadshows
Diabetes UK launches its national Measure Up Roadshow today to tackle the diabetes epidemic, as it reveals that more than 1.7 million people in the UK could have avoided developing Type 2 diabetes.
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What Is Heart Failure? What Causes Heart Failure?

The test may also reveal any damage to the heart from a heart attack. Heart attacks are often the underlying cause of heart failure. *An echocardiogram - this is an ultrasound scan that checks the pumping action of the patient"s heart. This test also helps distinguish systolic heart failure from diastolic heart failure (the heart is stiff and does not fill properly). Sound waves are used to create a video image of the patient"s heart, which helps the doctor see how well the heart is pumping. The doctor measures the percentage of blood pumped out of the patient"s left ventricle (the main pumping chamber) with each heartbeat - this measurement is call the ejection fraction. An ejection fraction is a crucial measurement which determines how well the heart is pumping. It is used to help classify heart failure and determine the best treatment. A healthy heart pumps out approximately 60% of the blood that fills the ventricle with each beat - a healthy heart has an ejection factor of 60%. The doctor may also carry out the following additional tests: *Stress test - the aim here is to stress the heart and study it. The patient may have to use a treadmill or exercise machine, or take a medication that stresses the heart. Sometimes nuclear medicine or echocardiographic techniques are used to take pictures of the heart to find out whether there are any blockages in the heart arteries - such a blockage could be causing the heart failure. An oxygen uptake stress test will determine how well the patient"s body is making up for his/her condition. *Cardiac MRI (magnetic resonance imaging) or CT (computed tomography) scan - they can measure ejection fraction as well as the heart arteries and valves. They can also determine whether the patient had a heart attack. These scans are also useful in seeking out unusual heart failure causes. *Angiogram (coronary catheterization) - a catheter (thin, flexible tube) is introduced into a blood vessel until it goes through the aorta into the patient"s coronary arteries. The catheter usually enters the body at the groin or arm. A dye is injected through the catheter into the arteries. This dye stands out on images created by an X-ray and helps doctors detect coronary artery disease (arteries to the heart that have narrowed) - another cause of heart failure. What is the treatment for heart failure? Damage to the heart"s pumping action caused by heart failure cannot be repaired. Nevertheless, current treatments can significantly improve the quality of life of the patient by keeping the condition under control and helping relieve many of the symptoms. Treatment also focuses on treating any conditions that may be causing the heart failure, which in turn lessens the burden on the heart. A GP or cardiologist will discuss treatments options with the patient and suggest the best choices, depending on individual circumstances. Some of the treatments include: *Stem cell therapy Stem cell therapy is still in its initial stages regarding heart failure. However, studies have provided promising results so far, as this article reveals. Long-term gene therapy resulted in improved cardiac function and reversed deterioration of the heart in rats with heart failure, according to a study carried out by researchers at Thomas Jefferson University"s Center for Translational Medicine. *Medications Patients aged 80 or more who suffer from a certain type of heart failure do not appear to benefit from most commonly prescribed heart medications, according to a study conducted at the Cedars-Sinai Heart Institute - these patients have heart failure but an ejection fraction of at least 50 percent. *ACE inhibitors (inhibitors of Angiotensin-Converting Enzyme) - these drugs help the arteries relax, lower blood pressure, making it easier for the heart to pump blood around the body - they lower the heart"s workload. Ace inhibitors generally boost the performance of the heart and invariably improve the quality of life of the heart failure patient. These drugs are unsuitable for some patients, though. They can cause an irritating cough in some people. *Diuretics - these help patients with swollen ankles. They also relieve breathlessness caused by heart failure. Diuretics remove water and salt from the kidneys in the urine. There are three main types of diuretics - loop diuretics, thiazide diuretics and potassium-sparing diuretics. *Anticoagulants - these drugs make it harder for the blood to clot; they help thin the blood and help prevent a stroke. The most commonly used anticoagulant is Warfarin. However, it has to be carefully monitored by the doctor to ensure the blood thinning effect is not excessive. *Digoxin - a drug for patients with a fast irregular heart rhythm. Digoxin slows down the heartbeat. *Beta-blockers - some heart failure patients benefit from beta-blockers. Patients with asthma should not take them. *Antiplatelet medicine - these stop the blood platelets from forming clots in the blood. Aspirin is an antiplatelet drug. If the patient is taking warfarin he/she should not take aspirin. Patients who take low-dose aspirin for heart failure will need to continue taking it for the rest of their life. Preserving kidney function - Mayo Clinic cardiology researchers found a peptide (a unique link of amino acids) that helps preserve and improve kidney function during heart failure, without affecting blood pressure. *Surgery Not everybody with heart failure responds to drug treatment. However, there are several devices which may be implanted, such as LVADs (left-ventricular assist devices), pacemakers, or cardioverter defibrillators. Another option for people with severe heart failure is to have a heart transplant. A type of surgery which reshapes the scarred left ventricle, the main pumping chamber of the heart, and is often done in conjunction with heart bypass, not only failed to reduce deaths and hospitalizations in heart failure patients but also did not improve patients" quality of life compared to bypass alone, a large US study found. A landmark study successfully demonstrated a 29% reduction in heart failure or death in patients with heart disease who received an implanted cardiac resynchronization therapy device with defibrillator (CRT-D) versus patients who received only an implanted cardiac defibrillator (ICD-only). *Exercise training Patients with heart failure who participated in aerobic exercise training had modest improvements in self-reported health status compared to those patients who did not have exercise training, a study found. Prevention There are many things we can do regarding our lifestyles to reduce the chances of ever developing heart failure in the first place, or at least to slow down its progression. These include: *Give up smoking. *Eat sensibly, this includes plenty of fruit and vegetable, good quality fats, unrefined carbohydrates, whole grains, and the right amount of daily calories. This article explains how heart-healthy eating recommended for heart failure patients need not be a of frustration or misery - even for a Frenchman. *Do exercise regularly and stay physically active (check with your doctor). *Go easy on your salt intake. *Make sure your bodyweight is ideal for your height. *Consume alcohol within your national recommended limits. *Get at least 7 hours good quality sleep each night. *Mental stress may be bad for the heart over the long-term. Try to find ways of reducing your exposure to mental stress. *If you already suffer from heart failure make sure you are up-to-date with all your vaccinations, and have your yearly flu-jab. Written by Christian Nordqvist Copyright: Medical News Today Not to be reproduced without permission of Medical News Today

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