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March 7th, 2012 posted by Paul Rega, MD, FACEP March 7, 2012 @ 6:14 am

Women & Chest Pain

Inequalities in the early treatment of women and men with acute chest pain?
Published online: 02 March 2012
Annica Ravn-Fischer, Thomas Karlsson, Marco Santos, Bo Bergman, Johan Herlitz,
Per Johanson
DOI: 10.1016/j.ajem.2011.12.020
American Journal of Emergency Medicine, The, http://www.ajemjournal.com/article/S0735-6757%2811%2900584-5/abstract

Among patients hospitalized due to chest pain, when adjusting for differences at baseline, female sex was associated with a prolonged delay time until admission to a hospital ward, to administration of aspirin, and to performing a coronary angiography. There was no difference in delay to the first ECG recording.



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March 7th, 2012 posted by Paul Rega, MD, FACEP @ 5:23 am

WHO’s Key Terms on Water and Sanitation

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http://www.who.int/water_sanitation_health/monitoring/jmp2012/key_terms/en/index.html

Water

Access to safe drinking water is measured by the percentage of the population using improved drinking-water sources.

Drinking water is water used for domestic purposes, drinking, cooking and personal hygiene.

Safe drinking water is water considered safe if it meets certain microbiological and chemical standards on drinking water quality; guidance provided by the WHO Drinking-water Quality Guidelines (4th edition 2011).

Access to safe drinking water is measured against the proxy indicator: the proportion of people using improved drinking water sources: household connection; public standpipe; borehole; protected dug well; protected spring; and rainwater collection.

On premises piped drinking water connections – running water in dwelling, yard or plot.

Improved drinking water source is a source that, by nature of its construction, adequately protects the water from outside contamination, in particular from faecal matter. Common examples:

Unimproved drinking water sources include:

Sanitation

Access to sanitation is measured by the percentage of the population using improved sanitation facilities.

Improved sanitation includes sanitation facilities that hygienically separate human excreta from human contact.

Access to basic sanitation is measured against the proxy indicator: the proportion of people using improved sanitation facilities (such as those with sewer connections, septic system connections, pour-flush latrines, ventilated improved pit latrines and pit latrines with a slab or covered pit)

Shared sanitation facilities are otherwise-acceptable improved sanitation facilities that are shared between two or more households. Shared facilities include public toilets and are not considered improved.

Unimproved sanitation facilities do not ensure a hygienic separation of human excreta from human contact and include:

 



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March 7th, 2012 posted by Paul Rega, MD, FACEP @ 5:21 am

WHO’s Fast Facts on Water and Sanitation

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http://www.who.int/water_sanitation_health/monitoring/jmp2012/fast_facts/en/index.html

WHO/UNICEF joint monitoring report 2012: Progress on drinking water and sanitation

 

An improved sanitation facility is one that hygienically separates human excreta from human contact.

An improved drinking-water source is one that by the nature of its construction adequately protects the source from outside contamination, in particular from faecal matter.

 

Water

Sanitation

Regions and countries

Sub-Saharan Africa accounts for more than 40% of the global population without access to improved drinking water.

Sub-Saharan Africa is not on track for meeting the drinking water target, but some countries have already met the target: Malawi, Burkina Faso, Ghana, Namibia, and Gambia. Liberia is on track to meet the target.

593 million in China and 251 million in India gained access to improved sanitation since 1990.

China and India account for just under half the global progress on sanitation.

India

China

Countries that account for almost three-quarters of the people who practice open defecation:



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March 7th, 2012 posted by Paul Rega, MD, FACEP @ 5:18 am

WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation

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http://www.who.int/water_sanitation_health/publications/2012/jmp_report/en/index.html

Overview

The WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) reports every two years on progress towards the drinking-water and sanitation target under Millennium Development Goal 7. This target calls for halving the proportion of the population without sustainable access to safe drinking water and basic sanitation between 1990 and 2015. Estimates presented in its 2012 update report describe the situation at the end 2010 and supersede those of the JMP update published in March 2010.

The report brings welcome news: measured by the proxy-indicator consistently used by the JMP since 2000, the MDG drinking-water target was met in 2010, five years ahead of schedule. However, the job is far from done. An estimated 780 million still lacked safe drinking water in 2010, and the world is unlikely to meet the MDG sanitation target. A reduction in urban-rural disparities and inequities associated with poverty; drinking-water coverage in countries in sub-Saharan Africa and Oceania; putting sanitation ‘on track’; and universal coverage beyond 2015 all remain high on the development and public health agenda.

Related links



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March 7th, 2012 posted by Paul Rega, MD, FACEP @ 5:14 am

WHO: The world has met the Millennium Development Goal (MDG) target of halving the proportion of people without sustainable access to safe drinking water

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http://www.who.int/mediacentre/news/releases/2012/drinking_water_20120306/en/index.html

Millennium Development Goal drinking water target met

Sanitation target still lagging far behind

Joint news release: UNICEF/WHO

6 March 2012 | Geneva/New York -The world has met the Millennium Development Goal (MDG) target of halving the proportion of people without sustainable access to safe drinking water, well in advance of the MDG 2015 deadline, according to a report issued today by UNICEF and WHO. Between 1990 and 2010, over two billion people gained access to improved drinking water sources, such as piped supplies and protected wells.

First MDG target to be met

United Nations Secretary-General Ban Ki-moon said, “Today we recognize a great achievement for the people of the world. This is one of the first MDG targets to be met. The successful efforts to provide greater access to drinking water are a testament to all who see the MDGs not as a dream, but as a vital tool for improving the lives of millions of the poorest people.”

The report, Progress on Drinking Water and Sanitation 2012, by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, says at the end of 2010 89% of the world’s population, or 6.1 billion people, used improved drinking water sources. This is one per cent more than the 88% MDG target. The report estimates that by 2015 92% of the global population will have access to improved drinking water.

“For children this is especially good news,” said UNICEF Executive Director Anthony Lake. “Every day more than 3 000 children die from diarrhoeal diseases. Achieving this goal will go a long way to saving children’s lives.”

Millions still without safe drinking water

Lake warned that victory could not yet be declared as at least 11% of the world’s population – 783 million people – are still without access to safe drinking water, and billions without sanitation facilities.

“The numbers are still staggering,” he said, “But the progress announced today is proof that MDG targets can be met with the will, the effort and the funds.”

Sanitation still far from target

The report highlights, however, that the world is still far from meeting the MDG target for sanitation, and is unlikely to do so by 2015. Only 63% of the world now have improved sanitation access, a figure projected to increase only to 67% by 2015, well below the 75% aim in the MDGs. Currently 2.5 billion people still lack improved sanitation.

UNICEF and WHO also cautioned that since the measurement of water quality is not possible globally, progress towards the MDG target of safe drinking water is measured through gathering data on the use of improved drinking water sources. Significant work must be done to ensure that improved sources of water are and remain safe.

Water, sanitation and hygiene are key to improving health and development

“Providing sustainable access to improved drinking water sources is one of the most important things we can do to reduce disease,” said WHO Director-General Dr. Margaret Chan. “But this achievement today is only the beginning. We must continue to ensure this access remains safe. Otherwise our gains will be in vain.”

Challenges remain

The report highlights the immense challenges that remain. Global figures mask massive disparities between regions and countries, and within countries.

Only 61% of the people in sub-Saharan Africa have access to improved water supply sources compared with 90% or more in Latin America and the Caribbean, Northern Africa, and large parts of Asia. Over 40% of all people globally who lack access to drinking water live in sub-Saharan Africa.

The report confirms that in cases where water supplies are not readily accessible, the burden of carrying water falls disproportionately on women and girls. In many countries, the wealthiest people have seen the greatest improvement in water and sanitation access, while the poorest still lag far behind.

The report provides the latest update on rural areas across the globe, highlighting the need for greater attention both to water and sanitation. In rural areas in least developed countries, 97 out of every 100 people do not have piped water and 14% of the population drinks surface water – for example, from rivers, ponds, or lakes.

Of 1.1 billion people who still practice open defecation, the vast majority (949 million) live in rural areas. This affects even regions with high levels of improved water access. For instance, 17% of rural dwellers in Latin America and the Caribbean and 9% in Northern Africa still resort to open defecation. Even the so-called BRIC countries, with rapidly growing economies, have large numbers of people who practice open defecation: 626 million in India, 14 million in China, and 7.2 million in Brazil.

“We have reached an important target, but we cannot stop here,” the Secretary-General said. “Our next step must be to target the most difficult to reach, the poorest and the most disadvantaged people across the world. The United Nations General Assembly has recognized drinking water and sanitation as human rights. That means we must ensure that every person has access.”

About the JMP

The WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) monitors progress towards the MDG target to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. The JMP publishes a report every two years which presents an update on the progress made towards reaching the MDG target for drinking water and sanitation using proxy indicators for use of improved drinking-water sources and the use of improved sanitation facilities.

About WHO

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. From its inception, WHO has recognized the importance of water and sanitation.

About UNICEF

UNICEF works in 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.

For more information, please contact:

Gregory Hartl
WHO Media coordinator
Telephone: +41 22 791 4458
Mobile: +41 79 203 6715
E-mail: hartlg@who.int

Ms. Nada Osseiran
WHO Communications Officer
Telephone: +41 22 791 4475
Mobile: +41 79 445 1624
E-mail: osseirann@who.int



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March 7th, 2012 posted by Paul Rega, MD, FACEP @ 5:11 am

Maryland Department of Health and Mental Hygiene : Cluster report

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http://www.calverthealth.org/

Dori Henry
Director of Communications
Maryland Department of Health and Mental Hygiene

BALTIMORE (March 6, 2012) – The Maryland Department of Health and Mental Hygiene (DHMH) is working in conjunction with the Calvert County Health Department to investigate a cluster of respiratory illnesses in Calvert County. As the Calvert County Health Department has reported, DHMH is aware of four cases in adults from a single family with severe respiratory illness; three have died. At this time, no other similar clusters have been reported from Calvert County or elsewhere in the state.

The cause for these illnesses is under investigation and testing is being conducted by the DHMH Laboratories Administration. Preliminary testing at the DHMH Laboratories Administration indicates that two of the fatal cases had influenza, and these cases may have been complicated by bacterial co-infections. Bacterial co-infection is a known complication of influenza infection. Additional testing is being conducted for all cases.

DHMH recommends all individuals continue to take the following precautions during influenza season: hand washing, staying home if sick, and staying up to date with influenza vaccinations. DHMH also reminds Maryland residents with influenza-like illness (fever and sore throat or cough) to consult their healthcare providers for evaluation. DHMH is not recommending any additional measures at this time. The Department will provide additional updates as more information becomes available.

There have been no new cases reported as of 11:30 p.m.
For current info call 410-535-5400 x349



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March 7th, 2012 posted by Paul Rega, MD, FACEP @ 5:01 am

Cluster of respiratory deaths in Maryland; autopsies to find the cause……

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http://www.nbcwashington.com/news/local/Investigation-Begins-in-Mysterious-Calvert-Co-Deaths-141560013.html

Cluster of Deaths Following Flu-Like Symptoms in Calvert County

Cause of illness not immediately determined

Tuesday, Mar 6, 2012 | Updated 9:14 PM EST

“The Calvert County Health Department is investigating a cluster of deaths following respiratory illnesses in the Lusby area.

The county health department told News4 four family members who live near the Calvert Cliffs nuclear facility fell ill with an unidentified respiratory illness at the end of February, and three died this month……”



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