The Star Online: Lifestyle: Health
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| How to get your kids to eat more veggies Posted: WHAT'S the best way to get your kid to eat more vegetables? Smother the broccoli in sauce, cut cucumbers into fun shapes, or ban dessert until they've eaten their spinach? A new study reveals what could be the best approach – simply teach them about nutrition. Scientists from Stanford University in the US have found that even very young children can benefit from a conceptual framework that encourages them to understand why eating a variety of foods is healthy, the researchers said. The result: kids eat more vegetables by choice. "Children have natural curiosity – they want to understand why and how things work," the researchers explained. "Of course we need to simplify materials for young children, but oversimplification robs children of the opportunity to learn and advance their thinking." Researchers Sarah Gripshover and Ellen Markman developed five storybooks aimed at revising what children already know about various nutrition-related themes, such as dietary variety, digestion, food groups, and nutrients. In a study involving more than 160 children between the ages of four and five, the researchers assigned some preschool classrooms to read nutrition books during snack time for about three months, while other classrooms were assigned to conduct snack time as usual. Later, the children were asked questions about nutrition. Findings showed that the children who had been read the nutrition books were more likely to understand that food had nutrients, and that different kinds of nutrients were important for various bodily functions (even functions that weren't mentioned in the books), the researchers said. They were also more knowledgeable about digestive processes, understanding, for example, that the stomach breaks down food and blood carries nutrients. These children also more than doubled their voluntary intake of vegetables during snack time after the three-month intervention, whereas the amount that the control group ate stayed about the same. Further research is needed to determine whether the conceptual intervention encourages healthy eating habits outside of snack time and whether it's effective over the long-term, the researchers said. The study, announced July 1, appears online in the journal Psychological Science. A separate 2010 conducted by researchers from Penn State in the US found that increasing the amount of vegetables in the first course of preschool lunch could be a clever way to get children to eat more vegetables. – AFP Relaxnews |
| Posted: RESEARCHERS speaking on the final day of the 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) have focused on HIV epidemic trends in Asia and the Pacific, new vaccine insights and HIV and Hepatitis C co-morbidity. The presentations reflected the breadth of expertise among more than 5,200 researchers, clinicians and community leaders attending the conference, which runs from June 30 to July 3 in Kuala Lumpur, Malaysia. "Thanks to tremendous efforts, in the last few years most countries in the Asia and the Pacific region have registered a reduction of new HIV infections," said IAS 2013 local co-chair Adeeba Kamarulzaman, director of the Centre of Excellence for Research in AIDS (CERiA) and Dean of the Faculty of Medicine at Universiti Malaya in Kuala Lumpur. "HIV comorbidity is one of the most pressing issues that we need to address in HIV," said Françoise Barré-Sinoussi, IAS 2013 International Chair and International AIDS Society President. "There is no doubt that new studies on tuberculosis and hepatitis C (HCV) will contribute to better integrate research and improve multidisciplinary coordination. In the case of HCV, injecting drug use is the main driver of infection, and we face similar challenges in terms of stigma and discrimination towards infected people." Tracking the HIV epidemic in Asia and the Pacific In his plenary presentation, J.V.R. Prasada Rao, UN Secretary-General's special envoy for AIDS in Asia and in the Pacific, described how Asian AIDS epidemics are characterised by high levels of HIV prevalence among key populations, including sex workers and their clients, injecting drug users (IDUs), men who have sex with men (MSM), and transgender women. As a region, Asia witnessed the highest HIV incidence from 1990 to 2000, which plateaued and reversed during the next decade in a number of countries. Asian countries have conducted systematic surveillance, data collection and analysis, helping them to monitor the progress of the epidemic with a fair degree of accuracy. Rates of new HIV infections are decreasing or stable, except in a few countries, and mortality rates peaked from 2000 to 2005. Mortality among children, however, has not reduced that appreciably, largely due to low coverage of prevention of mother-to-child transmission (PMTCT) programmes. There is high coverage of interventions among sex workers and their clients, but coverage levels of interventions for IDUs, MSM, and transgender women continue to be low – largely due to political apathy and criminalisation.High levels of stigma persist because of the prevailing adverse legal environment and criminalisation of key populations. Looking beyond 2015, the situation remains hopeful, but uncertain, with a great opportunity for progress at the UN General Assembly in September 2013 where countries will meet to deliberate the reports of the Intergovernmental Working Group (IMG) of Rio + 20 Conference and a high level panel appointed by the UN Secretary General to define post-2015 development agenda.Vaccine: new developments in protecting antibodies Dennis Burton (United States), professor of immunology and microbiology, Scripps Research Institute, noted that many now consider that in order to be successful, an HIV vaccine will need to induce broadly neutralising antibodies capable of neutralising many different strains of virus. Induction of such antibodies by classical vaccination strategies, such as live attenuated virus and killed virus, has not been successful. An alternative approach is a rational one based on understanding, at the molecular level, the structure of the HIV envelope spike at the surface of the virus, and how broadly neutralising antibodies interact with this spike. It is the binding of antibodies to the spike that makes virus non-infectious. Great progress has been made in recent years in isolating broadly neutralising antibodies and understanding how these antibodies interact with the envelope spike. The next stage, which is to take this knowledge and design proteins that may be capable of inducing broadly neutralising antibodies, has begun. With examination of more and more of the broadly neutralising antibodies, some of the hurdles to inducing them through vaccination become clearer.At this moment, many insights are being obtained and many vaccine candidates are being designed and tested. It is hoped that this rational design approach will begin to give signs of success within the near future. HCV in HIV patients: cure and beyond Around 25% of HIV-infected patients are also chronic carriers of hepatitis C virus (HCV) and because of the intricate and deleterious influence both viruses have upon one another, liver-related morbidity and mortality have been lately increasing in the co-infected population. Karine Lacombe (France), associate professor of the Infectious and Tropical Diseases Department, Saint-Antoine Hospital, Paris, France, reviewed the latest data regarding the evolving epidemics of co-infection around the world and gave some insights on the physiopathological pathways by which both viruses may lead to end-stage liver disease.HCV cure is becoming a reality thanks to the major changes occurring in the treatment paradigms: care is shifting from a long course of Peg-Interferon – ribavirin-based bitherapy with major side effects and low response rate to well-tolerated and short courses based on two, three or four-drug regimens with a very high rate of success. But this reality may stay out of touch for the most parts of the HIV-HCV infected world because of cost and human resources constraints. In her address, Lacombe advocated for an easier access to innovative therapies for those most at need. — IAS |
| Posted: THE price of first- and second-line antiretrovirals (ARVs) to treat HIV is falling because of increased competition among generic producers, but newer ARVs continue to be priced astronomically high, according to the annual report Untangling the Web of ARV Price Reductions, released by the international medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) at the International AIDS Society conference in Kuala Lumpur. "It's good news that the price of key HIV drugs continues to fall as more generic companies compete for the market, but the newer medicines are still priced far too high," said Dr Jennifer Cohn, medical director at MSF's Access Campaign. "MSF and other care providers need the newer treatments for people that have exhausted all other options, but patents keep them priced beyond reach. We need to watch carefully as newer, better medicines reach the market in the coming years, as these are the drugs that we'll quickly be needing to roll out. The price question is far from resolved." With the arrival of additional quality-assured sources in the past year, the best possible price of a WHO-recommended one-pill-a-day first-line combination (tenofovir/lamivudine/efavirenz) has fallen 19% since last year – from US$172 to US$139 per person per year (from RM516 to RM417), with some countries able to achieve even lower prices in large volume orders. Likewise, as new generic competitors have emerged, the prices of two key medicines used in second-line treatment – atazanavir/ritonavir and lopinavir/ritonavir – have each fallen by 28% over the last year, with the most affordable second-line combination (zidovudine/lamivudine + atazanavir/ritonavir) now priced at US$303 (RM909) per year. This represents a 75% drop in the price of second-line treatment since 2006. But these significantly lower-priced second-line drugs cannot reach many developing countries that need them desperately, as local patent barriers are effectively blocking procurement of the most affordable versions from India. And for newer HIV medicines—including critical new classes of ARVs such as integrase inhibitors – generic competition is mostly blocked because of patents. As a result, these are much more expensive. The best price of a possible salvage regimen for people who have failed second-line treatment (raltegravir + etravirine + darunavir + ritonavir) is US$2,006 (RM6,018) per year in the poorest countries – nearly 15 times the price of first-line treatment. Countries that do not have access to these lowest available prices are paying many times more. For example, Thailand and Jamaica pay US$4,760 and US$6,570 (RM14,280 and RM19,710) respectively for the new drug darunavir alone; Paraguay pays US$7,782 (RM23,346) just for etravirine; and Armenia pays US$13,213 (RM39,639) just for raltegravir – just one of the three or four drugs that are needed for a full regimen. Making sure future medicines are affordable is a priority. HIV experts highlight that new potent and well-tolerated drugs such as the integrase inhibitor dolutegravir could in the future be used in improved first- or second-line treatment, making affordable access to these newer drugs even more urgent. "Scaling up HIV treatment and sustaining people on treatment for life will depend on bringing the price of newer drugs down," said Arax Bozadjian, HIV pharmacist at MSF's Access Campaign. "Today, there are no quality-assured generic options for the large majority of the newer HIV drugs. Prices in middle-income countries are a major concern. The terms of existing voluntary licence agreements aren't good enough, most of them don't have terms that are public-health oriented, and most middle-income countries are excluded, which limits these countries' access to much-needed regimens." It was thanks to 'patent oppositions' in generics-producing India that the price of first- and second-line combinations were able to fall, as additional generic producers entered the market. With newer HIV medicines increasingly being patented in countries with significant generic production capacity, like India, it will be critical for solutions to be identified to bring prices down. Patent applications should be opposed when they do not meet a country's patentability requirements, as reaffirmed by the Indian Supreme Court's decision against Novartis in April 2013. When patents prevent access, compulsory licences should be issued in the interest of public health. India issued its first compulsory licence in 2012 for a cancer drug that was deemed unaffordable, and similar moves should be taken to overcome unaffordable HIV drug prices. "In our clinic in Mumbai, more and more patients need the newest expensive HIV drugs, but we can't afford these prices long-term, nor can the government," said Leena Menghaney, manager of MSF's Access Campaign in India. "Countries need to tackle the problem of high drug prices head on, by making sure unwarranted patents are not granted, and by overcoming patents through 'compulsory licences' when drugs are priced out of reach, so that more affordable generic versions can be made." A second report released by MSF at the IAS conference, "Putting HIV Treatment to the Test", looks at the price of HIV viral load tests. Viral load testing is the gold standard for HIV treatment monitoring in developed countries, because compared with either clinical or immunological (CD4) monitoring, it can more accurately and quickly detect when people are having problems adhering to their treatment and need additional counselling, or in fact are failing their treatment. WHO's new treatment recommendations strongly recommend the use of regular viral load monitoring in developing countries. But price and complexity so far have hindered the roll out of these technologies in developing countries. "The goal of all HIV treatment programmes should be for ARVs to suppress the virus so people have 'undetectable' levels of virus in their blood," said Dr Cohn. "Viral load testing is the best way to keep people on their more affordable first-line combination of HIV drugs for as long as possible, and to switch only those people to newer drugs who really need it. "With the price of second-line treatment coming down, it's really time to start testing people's viral load and making sure people are on treatment that works for them, instead of waiting until it's too late and they get sick again or die." – MSF |
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