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Medical developments from around the world


Birds Can Better Predict the Weather

Infrasound, which can travel thousands of miles, is not audible to the human ears but birds can hear it. They can pick up the sound of large storms in the sea at least 24 hours before our radars. Watching bird migration could be a better science than electronic signals. True science is learning from nature.
“The most likely tip-off was the deep rumble that tornadoes produce, well below what humans can hear,” explains BBC News. “Noise in this ‘infrasound’ range travels thousands of kilometres, and may serve as something of an early warning system for animals that can pick it up.”
Dr Chris Hewson, a senior research ecologist at the British Trust for Ornithology, agrees with the infrasound hypothesis. Based on his understanding of weather formation patterns, warblers, falcons and other birds must have a special sense for how these weather events form, long before human understanding and technology is able to pick up the signals.

Coffee Drinking Could Be ‘Good’

“Dr Qian Xiao from the National Cancer Institute has found that people who drink three cups of coffee daily are 25% less likely than non-coffee drinkers to have abnormal levels of liver enzymes.” Please understand that this study is funded by the coffee industry. Though Dr Xioa has studied 27,000 people, the data are retrospective and based on the ability of those people to remember how many cups of coffee they had consumed in the past. Many such studies keep cropping up. Do not be surprised if you find an equal number of studies show that coffee is the villain in many human ailments! That is exactly why Mark Twain had warned us: “Do not read health reports; you might die of a misprint!”  How very true?

Lose Weight by Controlling Emotion

People who can read their emotions and control them better eat much more sensibly to keep their weight under control. Positive emotions could help lower your weight. If you are overweight and have failed to control it by eating less, try and see if you are at peace with your own self; it would help.

Free Healthcare for All?

Finances of the National Health Services (NHS) in Britain, where every kind of sickness care is free, are in dire straits. “If a crisis is the nadir, the turning point, the NHS in England can’t yet be judged to be in crisis,” said John Appleby of the health think tank—the King’s Fund—in a BBC interview. This is because things may well get worse. Hospitals around the country are declaring ‘major incidents’ because of a lack of beds or staff or both, emergency departments report that they are at breaking point, and general practice is under unprecedented pressure. And there is little sign yet of things improving. So says Fiona Godlee, the editor of the British Medical Journal, in her editorial. I think, the Modi government will take note not to give free Western medical services in our hospitals. We can still give better services, if only we had an integrated system of sickness-care where emergencies are managed with Western medical quick-fixes and the vast majority of minor illnesses can be managed by other systems after duly authenticating them. To give you an idea about how big the load is, see this data from a Canadian study. When a doctor sees ONE heart attack, he could have seen 36,000 minor illness syndromes. Most of the latter are self-curing but need something to boost their immune power which is better done with Ayurveda and other systems. This will be very healthy for the country’s Budget too. 


Panagariya's prescription - Part IV: Social Spending

What are the economic ideas of Arvind Panagariya, the vice chairman of NITI Aayog? In a speech in February last year he had expressed rather radical ideas of reform on social spending. Will they be too hot for the PM? This is fourth part of a multi-part series 


Prime Minister Narendra Modi dismissed the Planning Commission and set up the National Institution for Transforming India (NITI) Aayog. As expected, Modi appointed his long-time supporter, economist and professor Arvind Panagariya as the vice chairman of NITI Aayog. Pangariya, as an economist is known for his radical views on reforms, and it would be interesting to see, if PM Modi subscribes to his views and actually carries out the NITI Aayog vice chairman's suggestions. What are his thoughts?
For this, let us turn to CD Deshmukh Memorial Lecture 'A Reform Agenda for India's New Government' on 11 February 2014. That lecture is fairly exhaustive and is almost a blue print for reforms and growth. Pangariya outlined a strategy of reforms along two tracks, one of faster, employment intensive growth and second, expanded and more effective social spending. 
Talking about expanded and effective social spending, he said, accelerated growth in GDP leads to accelerated growth in government revenues even when their share in GDP is unchanged. "Accelerated revenues translate into accelerated government spending. To illustrate what difference growth can make, observe that given a doubling of per-capita income between 1999–2000 and 2012–13, a per-capita expenditure on education achieved by allocating 4% of GDP to it in the latter year would have required the allocation of a whopping 8% of GDP to that sector in the former year. Therefore, the scope for expanding social spending rises rapidly with growth. But, it is important that this spending is effective in targeting the objective for which it is meant."
"Sadly, our existing social spending has been disproportionately failing in targeting its objectives. For example, according to a 2005 Planning Commission report, the Targeted public distribution system (PDS), which is designed to deliver subsidized food grain to the poor, spent a gigantic Rs3.65 to transfer just Re1 worth of subsidy to the poor. There are similar problems with our other programs such as rural employment under the Mahatma Gandhi National Rural Employment Guarantee Act (MNREGA) and government delivery of health services. A large chunk of labour under MNREGA is wasted each year on projects that produce no tangible assets, public or private. Likewise, even in rural areas, nearly 80% of the population goes to private providers for outpatient care because the sub-centres and primary healthcare centres are often dysfunctional." 
"With its limited revenue resources and the vast need for the provision of food, education and health, India can ill-afford such poor delivery of services. Reforms must help make the delivery more effective," Panagariya said.
In his speech in February 2014, the now vice-chairman of NITI Aayog, focussed on six different areas, including the first two that overlap with infrastructure but are so important for human development that they bear repeating.


It is a matter of great disappointment that one-third of Indian homes still lack access to electricity. Even homes equipped with an electric connection lack its flow around the clock, seven days a week. The problem is of mega proportions in two states: Bihar and Uttar Pradesh (UP). As of 2011, only 16% of households in Bihar and 37% in UP had electricity. This contrasts with states such as Gujarat where electricity is available around the clock and reached 90% households in 2001. Other states such as Tamil Nadu, Andhra Pradesh, Punjab and Haryana have also achieved similar success. 
The next government must take electrification on war footing bringing electricity to no less than 90% of the households in every state in ten years or less.


The NDA government had launched the Prime Minister’s Gram Sadak Yojana with the aim of connecting every village to state and national highways through all-weather roads. Like electrification, the next government must give this program a new lease of life and substantially fulfil the promise of the scheme in five years.


India recently passed the Food Security Act of 2013, which promises to provide rice, wheat and millets at highly subsidized prices to 75% of the rural and 50% of the urban population. But there remain three key weaknesses of this approach to solving the problem of nutrition.
Proteins, not carbohydrates
This approach is centred on carbohydrates but the far more serious problem that India faces is the lack of protein in people’s diet. Cereal consumption at different levels of income does not vary at all in urban areas while it varies only by small margins in rural areas. But when it comes to milk, it varies between less than 1 kg per person per month among the bottom 5% to more than 10 kg per person per month among the top 5% of the households. This same discrepancy also applies to eggs and fruits and vegetables. So India needs to expand the white revolution while also taking steps to boost the production of fruits and vegetables. Above all, the country needs to boost the purchasing power of people to be able to afford these basic needs of ordinary citizens.
Information and awareness
Unless people themselves understand and appreciate the importance of a nutritious diet, giving them cereals at subsidized prices will be insufficient to persuade them to consume more of them. Chhattisgarh state has a well-functioning public distribution system with near universal coverage and yet cereal consumption at all levels of income in the state mirrors the national average. Therefore, the next government must promote sustained information campaigns on nutrition through all possible media outlets, including advertisements featuring top sports and movie stars, doctors, and even the prime minister.
Public Distribution System or cash transfers
Simple economics tells us that giving a part of the quantity of food grains consumed by households at subsidized prices has virtually no impact on the total quantity of their consumption of these grains. The experience of Chhattisgarh just mentioned testifies to this proposition. When we combine this observation with the massive leakages in the Public Distribution System—40% or more of grain provided by the Centre fails to reach the actual beneficiaries—the case for continuing this system is considerably weakened. The next government must seriously consider experimenting with direct cash transfers using all instrumentalities such as bank transfers, postal money orders and mobile phone technology. It should allow people a choice between cash and in-kind subsidies. This will empower people, who can decide whether they want cash and buy what they wish, and from whom they wish, or buy subsidized food from government shops.


We now have MNREGA fully operational in all of rural India. While the scheme has put some purchasing power into the hands of poor households, the returns on it remain poor on many fronts. First, there has been little creation of public assets. This has meant that both the material and the labour used on projects have been largely wasted. Second, the scheme has seen far less success in providing employment in the poorer states than in the richer states. 
According to the accountability initiative at the Centre for Policy Research, in 2010–11, Uttar Pradesh state generated 13% of the total MGNREGA employment despite accounting for 20% of the below-poverty-line (BPL) rural population of India. Andhra Pradesh and Tamil Nadu provided 23% of the total MGNREGA employment even though they together accounted for only 8% of the country’s rural BPL households. Finally, MNREGA produces no skills. Indeed, it requires that employment be of the unskilled nature. My own recommendation would once again be to allow households a choice between cash transfers at the rate of 75% or less of the NREGA wages and employment at full wages. 
If the government finds this politically infeasible, it must try to forge a link between MNREGA and the building of houses and toilets for the poor in the village using the labour and materials made available under the scheme. Given that those employed are also predominantly poor, this approach would produce a coincidence of the interests of those doing the building work and those benefiting from it. Such a link may also bring about some checks to corruption in the existing public works programs.


Like higher education, elementary education in India remains in crisis. Enrolments have steadily risen in the last decade to levels that now leave only a tiny proportion of children between 6 and 14 years out of school. In turn, this has made it feasible for the UPA II government to pass in 2009 legislation implementing a right to education. But, the quality of education in government schools as measured by student achievements is low and declining. We must consider at least two possible solutions:
Priority given to performance in school evaluation criteria  
In assessing schools for the purposes of recognition, the Right to Education (RTE) Act relies exclusively on input norms. Offering automatic promotions at all levels, it also does away with all board examinations. We need to revisit these provisions and perhaps consider giving the states greater room in deciding the norms. In Gujarat, the government has chosen to give 70% weight to academic achievements of students when evaluating a school for continuing recognition. In all likelihood, this practice does not conform to the RTE Act and may be challenged in the courts. This threat must be removed by empowering states to amend the RTE legislation to suit local conditions.
Greater freedom in school choice
The RTE Act reserves 25% enrolment in unaided private schools for economically and socially disadvantaged students. The Act also commits the government to funding these students at the same level as the expense incurred per student in government schools. This provision can potentially serve as an instrument for expanding private school enrolments. But a more effective means of empowerment would be to give the parents vouchers in the amount the state spends per child on education and let them decide whether they wish to go to a private or government school. 


India is in urgent need of a comprehensive health policy. Let me spell out some broad contours of what the next government must try to accomplish.
Public health
Today, public health is the weakest link in our health delivery system. By the same token, public health promises the highest social return on investment. Most states invest their meagre resources in curative care rather than public health services. The result has been the neglect of public health services such as drainage systems, supply of drinking water and sanitation. A bout of monsoon rains is often enough to clog drains and create swampy conditions conducive to the quick spread of communicable diseases. The next government must change this state of affairs. It must persuade states to create separate public health departments with their own budgets. In addition, it must take the provision of piped water and modern toilets on a war footing. It should be the goal of the next government to ensure that every house has piped water and a toilet within ten years. It must also work tirelessly to create greater awareness among citizens toward personal hygiene and sanitary conditions in the surrounding areas. Tolerance for unhygienic conditions in India remains high, relative to other countries, and this needs to be changed.
Medical personnel
India faces exceptional shortages of health related human resources—doctors, nurse practitioners, nurses, midwives and pharmacists. Unqualified providers dominate the private sector, especially in rural areas. Growing incomes, populations and efforts by the government to improve access to health services will magnify this shortage. Therefore, the next government will need to invest in improving the medical human-resource base in a major way. It must create one-year basic training programs for all rural medical providers through District Health Knowledge Institutes. It should also massively expand the number of qualified MBBS doctors. 
This requires loosening the stranglehold of the Medical Council of India. In turn, this can be achieved by allowing each state to establish its own medical council that decides the norms for opening medical colleges and the norms of medical practice within the state.
Routine healthcare
The next government should ensure that citizens have enough purchasing power to access routine healthcare services. While the government can offer these services at cost, it should let patients decide whether they wish to go to a government or private facility. This will promote efficiency. For example, many routine illnesses can be dealt with through home remedies so that citizens may sometimes wish to save the potential expense of the treatment of those illnesses for a rainy day.
Major illnesses
Major illnesses result in a large expense per episode and often involve surgical procedures. Childbirth and maternity care also fall in this category. Here we need medical insurance. Several insurance schemes are currently in operation but it is time that we aim to expand them to achieve near universal coverage. The next government must consider covering the bottom half of the families for up to Rs50,000 per year of medical expenses on major illnesses at its expense.


7 Reproductive Rights Issues to Watch in 2015
Changes for abortion, contraception and more top the agenda with Republicans in the majority in Congress and many state legislatures in the US 
To say abortion opponents are feeling fired up in 2015 would be a massive understatement.
In their first week back at work, congressional Republicans introduced a sweeping prohibition on abortions after 20 weeks of pregnancy (H.R. 36, the Pain-Capable Unborn Child Protection Act), as well as bills that would ban sex-selective abortions, target funding for groups like Planned Parenthood, require abortion providers to have hospital admitting privileges, and let doctors and nurses opt out of providing abortion care, even in emergencies.
In the states, where the 2014 elections gave Republicans control of two-thirds of state legislative chambers, incoming lawmakers also have supersized their abortion agendas.
But abortion is just one issue on the minds of activists focused on reproductive rights. There's also birth control, conscience clauses and personhood. Here are seven key trends and themes to watch for this year.

1. A New Wave of Abortion Restrictions

Despite the GOP-controlled Congress, a Democrat in the White House means that many of the most significant battles over abortion will continue to take place in statehouses and courtrooms, not on Capitol Hill.
Expect to see a torrent of 20-week bans like the one Congress has proposed (13 states already have similar laws on the books). These bills are being advanced by groups like the Susan B. Anthony List; a report by the group's research arm, the Charlotte Lozier Institute, recently noted that in most countries where abortion is legal, the procedure is limited to early pregnancy. "The U.S. is in very rare and unsavory company in allowing abortion [after 20 weeks]," Lozier's president, Chuck Donovan, said in an interview, pointing to China and North Korea as two other outliers. Even if President Obama ends up vetoing some version of the 20-week ban, Donovan said, "It could actually heighten awareness of the issue."
In a few states, lawmakers are expected to dust off retro theories (a Missouri bill, for example, would require women to get permission from the fetus's father to have an abortion, an idea ruled unconstitutional in 1992). An Indiana bill that would make it illegal for doctors to perform an abortion based on a fetal abnormality such as Down syndrome echoes abortion foes' efforts in Ohio, North Dakota and elsewhere to position themselves as protectors of the disabled.
Other bills will be aimed at tightening abortion restrictions already in place— lengthening waiting periods to 72 hours, for example, and making it harder for teens to use judicial bypass procedures to obtain an abortion without their parents' permission. (A new Alabama law gives the fetus in such cases its own attorney.) "It's possibly an easier lift to amend an existing law," said Elizabeth Nash, a senior policy associate at the Guttmacher Institute. "It's smart." Also on the horizon: a likely clampdown on medical abortions (those induced by drugs). 
Meanwhile, all sides will be watching to see how the 5th Circuit Court of Appeals, and eventually the U.S. Supreme Court, deals with Texas restrictions known as TRAP, or Targeted Regulation of Abortion Providers, laws — rules that purportedly make clinics, and abortion, safer but could shutter most of the clinics in that state. A key question: how many clinics have to shut down before the TRAP laws create an "undue burden" on women's right to abortion, effectively rendering Roe v. Wade moot?

2. The Rise of Religious Exemptions

This trend has its roots in two recent Supreme Court decisions: last June's Hobby Lobby ruling and the 2013 Windsor case upholding gay marriage.
At the center of Hobby Lobby was the federal Religious Freedom Restoration Act of 1993, which says that the government can only "substantially burden" the exercise of religion if it has a "compelling state interest." The Supreme Court's precedent-shattering interpretation — that RFRA applied to closely held companies like the retailer Hobby Lobby, whose owners objected to the Affordable Care Act's contraception mandate on religious grounds — was "a minefield," Justice Ruth Bader Ginsburg warned.
And sure enough, the past six months have brought an explosion in religious-exemption challenges involving everyone and everything from a Missouri lawmaker who didn't want his teenage daughters to have access to birth control to Native Americans battling federal rules that make it illegal to possess the feathers of certain types of endangered eagles without a permit. (The feathers are used in religious ceremonies.)
Some state lawmakers, meanwhile, have taken inspiration from the Hobby Lobby decision to fight back against the stunning gains of the marriage equality movement since Windsor. They have introduced a deluge of RFRA-type bills that would allow business owners, local government officials, and health care professionals to refuse to provide services to gay people — rent a banquet hall, issue a marriage license, perform in vitro fertilization— that violate their religious beliefs. Same-sex marriage may be the immediate target, but state RFRAs would likely have a much broader impact, said Katherine Franke, co-director of the Center for Gender and Sexuality Law at Columbia, granting "a kind of blanket indemnity from compliance with all sorts of otherwise applicable laws." That could erode not just reproductive and gender rights but eventually, Franke said, protections against race discrimination as well. Catholic hospitals —engaged in high-profile battles with the ACLU in Michigan and elsewhere over limits on reproductive care — would also benefit.

3. Conscience Clauses for Non-religious Groups

Back in Washington, anti-abortion groups have been working to extend religious-type "conscience" exemptions to non-religious organizations — starting with themselves.
Last summer, March for Life — the organization behind the demonstrations in front of the Supreme Court every January 22 on the anniversary of Roe v. Wade — filed a lawsuit demanding an exemption from the ACA's contraception mandate, arguing that it "fundamentally violates" the group's core principles.
"Because they aren't a religious organization, they can't claim an exemption under RFRA," said Casey Mattox, senior counsel at Alliance Defending Freedom, the conservative legal powerhouse that brought the suit. The same is true for many other anti-abortion organizations. "We think we have a conscience claim beyond religious belief," the Lozier Institute's Donovan said. Their argument: Denying abortion opponents the same exemption given to religious groups violates their constitutional right to equal protection.

4. Battles Over Contraception

One of the most striking aspects of the March for Life suit is its assertion that birth control — the hormonal kind, as well as intrauterine devices — are "abortifacients" (meaning they cause abortions). Indeed, the Lozier Institute published a paper last year arguing that emergency contraception is essentially no different from abortion because it purportedly prevents implantation of a fertilized egg. (Women's groups and their allies say the scientific evidence proves otherwise.)
The arguments are part of a larger strategy that reproductive rights advocates say has been gaining strength in recent years, with a major boost from Hobby Lobby. "Birth control is very much in the [anti-abortion] movement's cross-hairs," Guttmacher policy researcher Joerg Dreweke wrote in a recent analysis, "and antiabortion advocates are working to stigmatize contraception by blurring the lines between contraception and abortion."
The U.S. Catholic bishops, meanwhile, also are also likely to zero in on birth control and sterilizations as they begin the process of revising their rules governing Catholic health care.

5. A Revamped Personhood Playbook

Last November was supposed to be a turning point for the personhood movement, which argues that establishing the legal rights of "pre-born humans" is the key to overturning Roe. And the 2014 election was a turning point — but not in the way supporters had hoped. A "human life amendment" to North Dakota's constitution that had been expected to win overwhelming approval ended up being trounced at the polls; ditto for a ballot measure in Colorado. The election results triggered what Gualberto Garcia Jones, national policy director for the National Personhood Alliance, called "an existential crisis" for the movement. In a tough-talking post-election analysis on LifeSite News, he warned, "[A] lot has to change."
One sign of change is the emergence of NPA itself. Instead of the statewide ballot measures favored by Personhood USA, the heretofore leader of the movement, NPA will promote what Garcia Jones called "asymmetrical tactics ... engaging the enemy in municipalities and counties that we know we control." Daniel Becker, NPA's Georgia-based president, said he's looking for "opportunities to personalize the child in the womb" via fetal rights legislation on everything from inheritance to adoption. He also favors statutes like those in Alabama and Tennessee that target drug use during pregnancy.
A key goal, Becker said, is "to create tension in the law" that would require courts — and eventually the U.S. Supreme Court — to act. Part of that strategy, he added, is to identify potentially sympathetic judges like the ones on the Alabama Supreme Court (see ProPublica's story about one of those justices here).
As the personhood movement regroups, expect reproductive rights organizations to start talking more about personhood, too — the personhood of the mother-to-be.
"When you look at [these laws] collectively, you cannot miss the fact that people with a capacity for pregnancy have a second-class status in this country," said Lynn Paltrow, executive director of National Advocates for Pregnant Women, which fights measures like the ones Becker supports "They haven't achieved full personhood. That is what the battle really is."

6. A Broader Agenda for Reproductive Rights Activists

For years, protecting Roe v. Wade has been the almost singular focus of reproductive rights advocates. But more recently, many have become convinced that narrow focus could spell doom. The ideological divide over "choice" vs. "life" "doesn't fit the reality of many families," said Denicia Cadena of the New Mexico group Young Women United. In many parts of the country, even among those who favor abortion rights, abortion is a topic that "stops conversations," said Monica Simpson, executive director of SisterSong, which focuses on the South. "It shuts people down."
The soul-searching — some of it painfully public — has led to a shift that will become more evident in 2015.
Advocates in a number of states are focusing on proactive bills that aim to improve the lives of women and children by raising the minimum wage, requiring paid sick leave, strengthening protections against pregnancy discrimination, and pressing for education and criminal justice reforms. More groups are talking about the intersection between LGBT and reproductive issues, often in the context of transgender health. There is, said Simpson, less talk about "choice" and more about "justice."
Meanwhile, groups such as the recently formed CoreAlign are working with allies in conservative areas to develop a 30-year strategic plan that might reframe reproductive rights issues and transform public opinion. One part of the plan: Training a new generation of leaders — many from communities of color — who can see it through. Andrea Miller, president of the National Institute for Reproductive Health, a think tank that supports state activists, pointed out that anti-abortion groups did much the same thing, with considerable success. "They started local. They made a coordinated effort to work their ways into the legislative and political process, and eventually they created a tipping point," Miller said.
Which is not to say that reproductive rights groups are abandoning their core issue. Last year saw the introduction of more new state laws protecting abortion than at any time since 1990.

7. The California Exception

For reproductive rights advocates, California has been one of the few bright spots in recent years. In 2013, for example, the state passed a law that allowed trained non-doctors to perform first-trimester abortions — the largest expansion of abortion access in the U.S. in a decade. Researchers affiliated with the University of California–San Francisco are expected to publish more studies on abortion safety —as well as the real-world consequences of preventing women who want abortions from having them. This research has been influential well beyond the state's borders.
Which is one reason anti-abortion groups are paying such close attention to the next big California case on the horizon: A determination by insurance regulators last year that every health plan in the state must cover all maternity-related services, including abortion — even plans offered by Catholic schools and hospitals. Americans Defending Freedom has filed a complaint with the U.S. Department of Health and Human Services, and religious and anti-abortion groups are girding for an epic battle.
Courtesy: ProPublica.org



J L Kapur

2 years ago

Brokers are specialised skilled professionals with considerable experience in insurance particularly in General insurance. It will dificult for banks to act as broker with their existing employees even if some training is provided. They will have to open a separate subsidiary with experiance persons from insurance to achieve good results.

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