Saudi health care booms as state scrambles to close gap

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RIYADH/DUBAI: Stock market listings planned by two of Saudi Arabias biggest private hospital operators point to a boom in its health care industry, as political pressures prompt the government to pour huge sums into the underdeveloped sector.

Many areas of Saudi consumption, including the retail industry, housing and travel, have ballooned in the past decade because of oil-fueled growth in national income. But health care has lagged, partly because of government inefficiency and bureaucracy.

Now the mediocre quality of state-run health care has become a political liability for the government, especially in the wake of the 2011 uprisings elsewhere in the Arab world, which underlined the risks of social discontent. Many Saudis complain about overcrowded hospitals and shortages of medications.

So the government has embarked on a drive to reform the sector, building hundreds of hospitals, providing interest-free loans to private companies and changing health insurance rules.

This could make Saudi Arabia the worlds fastest-growing major health care market over the next few years, helping to diversify the economy beyond oil and providing a bonanza to foreign companies selling medicines, equipment and services.

It is a case of chronic underinvestment and reactive over-expenditure, said Mohammad Kamal, an analyst at financial firm Arqaam Capital in Dubai.

The standard of Saudi Arabian health care provision has long contrasted with its wealth. The kingdom, which the IMF ranked 30th in the world by GDP per capita for 2012, has 2.2 hospital beds per 1,000 residents, according to Arqaam, lower than the global average of 3 and far below the average of 5.5 in developed countries.

Local newspapers routinely report complaints about issues such as overcrowding with some patients receiving intravenous drips in hospital corridors and poor hygiene and maintenance, resulting in pest infestations and infections.

Abdul-Karim al-Thobeiti, a Saudi engineer working in the public sector, said he would never set foot in a state-run hospital because they were either fully booked or poorly maintained.

If you want to make an appointment to see a doctor you have to wait for months, unless you have some connection or know someone who can pull a few strings, Thobeiti said.

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Saudi health care booms as state scrambles to close gap

Health Care Price Increases Stay At Historic Lows, Health Job Growth Declines

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CBS Detroit (con't)

Affordable Care Act Updates: CBSDetroit.com/ACA

Health News & Information: CBSDetroit.com/Health

ANN ARBOR (WWJ) National health expenditures for the first 11 months of2013 came in just 4 percent above the first 11 months of 2012, according tothe Center for Sustainable Health Spending of the Ann Arbor-based researchorganization Altarum Institute.

Preliminary spending data for November 2013 showed year over year growth of 4.5 percent in spending from November 2012.

Depending on the December data, 2013 could wind up the fifth consecutive year of health spending growth below 4 percent, a rate that had not been seen before in the 50-plus years of national health expenditure accounting.

The data also showed national health care prices in December, 2013 were 1.1 percent higher than in December 2012, barely above the all-time low of 1 percent recorded in October 2013. The December, 2013 12-month moving average, at 1.3 percent, represents a new all-time low for the study. Year over year, hospital prices grew 1.5 percent in December, physician and clinical services prices rose by 0.2 percent, and home health care prices actually fell 0.5 percent.

The full report is at http://www.altarum.org/HealthIndicators.

The data showed the share of gross domestic product spent on health care was 17.2 percent in November, the lowest reading since September 2012 indicating that health care may be absorbing a smaller share of the economy, especially if GDP growth accelerates in 2014, as is widely predicted.

The data also showed the U.S. health care industry shed 6,000 jobs in December. If this estimate stands, it will be the first monthly drop since July 2003, and only the second since 1989. The health sector added about two-thirds as many jobs in calendar year 2013 (208,000) as in 2012 (321,000), with particular slowing in hospitals and nursing homes. The health sector share of total employment fell to 10.71 percent, below the all-time high of 10.73 percent recorded in August 2013.

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Health Care Price Increases Stay At Historic Lows, Health Job Growth Declines

Letter: Health care providers can help smokers quit

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Health care providers can help smokers quit

As a health care provider, I see the progress that New York State has made with its tobacco control program. I have worked closely with the Western New York Tobacco Cessation Center. Through this program I have received training and materials on treating tobacco dependence for my patients who are trying to quit this deadly addiction.

We often hear that one event or one day can change our lives forever. This is surely true in respect to quitting tobacco. Quitting tobacco has the power to change our individual lives, our families, our community and even our state. It is a great feeling when I have been able to help one of my patients quit. The impact, of course, is good for their health but also for their wallet.

As a reminder to all people who are trying to quit this habit, I urge you to talk to your health care provider. We can be a great resource to assist you with treating this addiction.

Pat Smith, N.P.

Eden

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Letter: Health care providers can help smokers quit

Market forces can benefit patients, health economist warns

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Canadian health care will wallow in mediocrity and consume wealth until governments allow private insurers and require patients to pay more cost directly out of pocket to providers, a health economist warns.

Writing for the Macdonald-Laurier Institute, a public policy think tank, the University of Torontos Audrey Laporte steps on a third rail for Canadian politicians who talk of health care as a national icon.

She said she did so with trepidation, concerned shed be dismissed as a radical, her message unheeded.

Were probably not going to get radical change until we run out of money, she said.

In her just-published report, Laporte said health policy-makers ignore economics at their peril.

If they took basic economic theory the least bit seriously, the medical system could be much more efficient, and vitally, much more attuned to the needs of that often neglected and forgotten stakeholder the patient.

For too long, Canadians have been smug about their health care simply because it was more sensible than whats found in the U.S., she argues. Laporte describes American health care as a Rube Goldberg device, in which a series of quick fixes causes more and more chaos and problems.

She argues Canada should look to Europe and Australia, and at home, at dentistry, to see how market forces benefit patients. It begins with having patients pay for a share of their care.

You have to have some skin in the game, Laporte said.

Governments should set minimum standards but allow the private sector to set prices and services. They are the individuals with the greatest incentive for getting it right, Laporte said.

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Market forces can benefit patients, health economist warns

Genetic Cures for the Gut

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Image: Marek Haiduk

We rely on trillions of bacteria, fungi, archaea and viruses in our mouth, on our skin and in our gut to get through the day and to stay healthy. Scientists had no way to study most of these microbes, which do not seem to want to grow in laboratory cultures. Rapidly improving, low-cost genetic-sequencing technologies are finally making it possible, however. By working with our microbes instead of against them, scientists are coming up with intriguing approaches to tackling persistent diseases and improving our overall health.

A few years ago scientists could only dream of studying large communities of microorganisms, but now such experiments are manageable and affordable, says David Relman, a professor at the Stanford University School of Medicine. This new field of metagenomics is giving scientists profiles of what microbe populations look like in the gut of people who are healthyand in the gut of people who have various conditions and diseases. Armed with these data, scientists are poised to explore the possibility of manipulating the balance of our microbiota as treatments for obesity, inflammatory bowel disease and many other common and uncommon ailments.

For example, researchers have profiled the populations of organisms in people with ulcerative colitis, which forms ulcers in the colon and is linked to changes in the gut's flora. Building on the results, this summer pharmaceutical giant Johnson & Johnson (J&J) announced a $6.5-million deal with Second Genome, a microbiome start-up, to develop treatments. Current approaches, which center on anti-inflammatory drugs, immunosuppressant medications and surgery, are often unsuccessful. A therapy that directly alters the microbiome would potentially create fewer side effects and fend off other infections down the road.

The J&J deal is a watershed, says Rita Colwell, who holds health appointments at the University of Maryland and Johns Hopkins University. There's a moment for any new biotechnology that's critically important: when it moves from being an area of academic interest to one that companies are founded on, she notes. And then there is the next step: when the big pharma money arrives.

The new treatments would be a big improvement over current attempts to improve the microbiome, which consist mainly of fecal transplants and probioticslive bacterial cultures in supplements or foods such as yogurt. Fecal transplants have alleviated Clostridium difficile, a tough, often drug-resistant, toxin-producing bacterial infection, but the practice can require multiple transplants, and not all patients are cured. Probiotics have generated only weak evidence for positively changing the gut. Both treatments amount to throwing a bunch of organisms at the gut and seeing what sticks.

Metagenomics is more specific, providing precise genetic profiles of what organisms are in the gut and offering the possibility of deducing how they might be interactingwith one another and with us.

One of the biggest challenges of metagenomics is how to handle the onslaught of data. Now that scientists can rapidly sequence entire swaths of microbial communities, they need to figure out what the information means for our health. Biologists are teaming up with mathematicians to develop new methods of analyzing the DNA fragments they collect from our body. Physicians will then need to understand what changes occur in an individual's microbiomeand whyto protect or improve health.

For example, many people routinely carry Escherichia coli bacteria without getting sick. Relman likens the hope of curating better gut microbiota to maintaining a healthy ecosystem, one that will keep nasty creatures such as the intestinal equivalent of invasive weeds at bay.

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Genetic Cures for the Gut

What Fetal Genome Screening Could Mean for Babies and Parents

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A noninvasive screening method could provide expectant parents with unprecedented and comprehensive fetal genetic data, but it also presents new ethical quandaries

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Todays genetic technologies are not yet a crystal ball for seeing a childs future, but doctors are closer than ever to routinely glimpsing the full genetic blueprints of a fetus just months after sperm meets egg. That genomic reconstruction would reveal future disease risk and genetic traits even as early as the first trimester of pregnancy. Fetal screening could theoretically detect every hint of disease-associated mutations or disease-carrier status in a fetuss genomesometimes outpacing geneticists knowledge of how to interpret such information. It could also reveal nonmedical markers for eye color or athletic prowess.

Advances in fetal cell research, coupled with the ever-dropping price of whole genome sequencing, presage the possibility of making such scans commonplace. Two years ago researchers devised two tests that could reveal a fetuss complete genetic profile. Separate research groups sequenced complete fetal genomes after gathering traces of fetal DNA in a blood sample from a pregnant woman or by taking that blood in combination with a drop of saliva from the father. Those largely noninvasive screenings could be carried out early in pregnancy, without the small risks of miscarriage inherent in withdrawing placental tissue or amniotic fluid to hunt for a chromosomal condition such as Down syndrome. The technology is all there to do this, says Lisa Soleymani Lehmann, the director of the Center for Bioethics at Brigham and Womens Hospital. Part of the issue is cost and part of the issue is the ethical controversy, which is limiting the uptake of thisnot knowing how to deal with the uncertainty of this information or how to interpret this massive amount of data.

Indeed, whole genome sequencing could provide parents with an avalanche of unexpected and perhaps confusing data. Instead of targeted tests for a few dozen genes, future sequencing techniques could provide parents with three billion base pairs of data. The key issues inherent in any genome sequence work would plague fetal sequencing as wellnamely, there is no guarantee that genetic mutations will actually result in a specific disease. And grappling with information suggesting that certain conditions may emerge in adulthood, or studying mutations with unclear significance, could be fraught with risks and challengesimpacting parents decision threshold for deciding to terminate a pregnancy or influencing how they rear their child.

Despite the ambiguities, parents should still be able to obtain fetal genome information after receiving genetic counseling, Lehmann and her co-authors argue in an article in the January 16 edition of The New England Journal of Medicine. That information could better inform expectant parents and enhance their ability to plan for the childs future. Parents may emphasize diet and exercise more for a child at heightened risk of diabetes, for instance.

Whereas current prenatal tests are diagnostictelling parents about the definitive presence of diseaseprenatal whole genome sequencing would reveal susceptibility genes for issues including heart conditions, diabetes or obesity. Such a shift would drastically alter prenatal care and decision-making. Put another way, where doctors have been reluctant in the past to provide parents with genetic information for an untreatable illness, the complete genomic profile, revealed long before the fetus is born, would present genetic variants that could serve a purpose more predictive than diagnostic.

Lehmann and her colleagues are not the only ones watching the advances in prenatal screening with an arguably wary but hopeful eye. I believe that most of us think this is still a little ways out before we are seeing significant adoption of this as an option in prenatal testing, says Sandra Darilek, a certified genetic counselor and spokesperson for the National Society of Genetic Counselors. A group of bioethicists affiliated with the National Institutes of Health also penned an analysis in 2012 forecasting a future that included such scans. They called both for further recommendations about what data parents should ask for and advised that children should have the right to be told about adult-onset diseases as adults, rather than during childhood. Two years later no formal recommendations have been released by genetic societies outlining what diseases should be revealed to prospective parents, and there are still no clear answers about where a childs rights to be protected from such data end and a parents prerogative to obtain, and perhaps act on it, begin.

Whereas adults can choose to undergo genome sequencing, an unborn child cannot consent to screening its genes. Still, such concerns should not keep parents from obtaining data they want to see about their fetus, Lehmann says. Parents have a right to this information, and there may be significant benefits to the child of a parent having this information. And more genetic counselors and electronic educational resources will be needed to help guide expectant parents through such sequencing decisions, she says.

Enthusiasm for arming parents with such broad genetic profiles has stoked concern in some circles that screenings would prompt a quest for so-called perfect babies, free of any genetic abnormalities or possessing desirable traits of beauty, intelligence or athleticism. But many parents would forgo whole genome sequencing, Lehmann and her colleagues argue, adding that such concerns should not justify withholding information about genetic markers for future illness. This isnt something physicians should be deciding, Lehmann says. If parents want to have this kind of information, their voices need to be heard.

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What Fetal Genome Screening Could Mean for Babies and Parents

Advancements in Genetic Engineering to Modify Embryos Spur the Concept of Designer Babies, According to a New Trend …

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San Jose, California (PRWEB) January 20, 2014

Follow us on LinkedIn Designer babies are defined as babies with artificial genetic makeup selected through a combination of genetic engineering and in vitro fertilization to confirm inclusion or exclusion of specific traits. The term Designer Babies is not a scientific term, but is used by journalists and highlights the fact that parents could choose specific characteristics of their unborn child including physical appearance, character and sex. Advancements in genetic engineering and in vitro fertilization approaches, coupled with the need to lower the occurrence of genetic disorders in offspring, are driving interest in the concept of designer babies. Ethical issues related to commodification of children and genetic manipulation in human offspring, are however projected to present regulatory challenges in the advancement and commercialization of the concept of designer babies in the coming years.

The trend report titled Designer Babies announced by Global Industry Analysts Inc., is a focused research paper which provides cursory insights into the technology concept, its evolution, and future prospects. A part of GIAs new series of short research briefs on emerging technologies, this trend report highlights key enabling technologies including the development of Pre-implantation Genetic Diagnosis (PGD).

For more details about this trend report, please visit http://www.strategyr.com/TrendReport.asp?code=141062

About Global Industry Analysts, Inc. Global Industry Analysts, Inc., (GIA) is a leading publisher of off-the-shelf market research. Founded in 1987, the company currently employs over 800 people worldwide. Annually, GIA publishes more than 1300 full-scale research reports and analyzes 40,000+ market and technology trends while monitoring more than 126,000 Companies worldwide. Serving over 9500 clients in 27 countries, GIA is recognized today, as one of the world's largest and reputed market research firms.

Global Industry Analysts, Inc. Telephone: 408-528-9966 Fax: 408-528-9977 Email: press(at)StrategyR(dot)com Web Site: http://www.StrategyR.com/

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Advancements in Genetic Engineering to Modify Embryos Spur the Concept of Designer Babies, According to a New Trend ...

Developments in Nanobiotechnology Drive the Market for Radio-Controlled Genes, According to a New Trend Report …

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San Jose, CA (PRWEB) January 20, 2014

Follow us on LinkedIn Genes can be defined as the basic molecular units of heredity in a living organism, holding information on creating and maintaining the cells of an organism and passing genetic traits to its offspring. Radio controlled genes refers to remotely activating genes inside the human body through the use of electromagnetic waves to guide the movement of nanoparticles injected inside the body. As the next frontier of medical science, radio controlled genes is attracting immense R&D interest and investment, given its potential to offer non-invasive and non-pharmacological treatment possibilities. Using radio waves to control gene expression has the advantage of being safe as radio waves, unlike electrical waves, do not damage tissues. Advancements in nanobiotechnology and development of antibody coated metal nanoparticles as carriers to absorb radio frequency energy are expected to help drive growth in the market. Currently, being researched is the possibility of using radiowaves to induce insulin-gene expression and activate insulin production in the body to treat diabetes.

The trend report titled Radio-Controlled Genes announced by Global Industry Analysts Inc., is a focused research paper which provides cursory insights into the technology, its applications, and future prospects.

For more details about this trend report, please visit http://www.strategyr.com/TrendReport.asp?code=141011.

About Global Industry Analysts, Inc.

Global Industry Analysts, Inc., (GIA) is a leading publisher of off-the-shelf market research. Founded in 1987, the company currently employs over 800 people worldwide. Annually, GIA publishes more than 1300 full-scale research reports and analyzes 40,000+ market and technology trends while monitoring more than 126,000 Companies worldwide. Serving over 9500 clients in 27 countries, GIA is recognized today, as one of the world's largest and reputed market research firms.

Global Industry Analysts, Inc. Telephone: 408-528-9966 Fax: 408-528-9977 Email: press(at)StrategyR(dot)com Web Site: http://www.StrategyR.com/

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Developments in Nanobiotechnology Drive the Market for Radio-Controlled Genes, According to a New Trend Report ...

Man Saved From Blindness By Gene Therapy

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At age 10 Nick Tuftnell knew he was going to end up blind after being diagnosed with the genetic condition choroideremia.

The condition leads to the death of light-absorbing cells in the eye. The cells die because of a mutated gene in certain ocular cells, which eventually leads to blindness.

I knew my granddad had it. I remember seeing him in the latter stages of life and he was completely blind, said Tuftnell, now 38.

After his condition was confirmed, Tuftnell said he had nothing to do but wait for his eyesight to slowly dim and darken over time.

All the doctors could say is Your son is going to go blind, see you later, said Tufnell of receiving his diagnosis.

As he grew older his eyesight has diminished to the point where he can no longer drive due to poor peripheral vision and has severe difficulty moving around at night.

I cant walk around at night, its that bad, said Tuftnell. I dont have any peripheral visioneventually itll get like Im looking through toilet rolls.

Tuftnell said his doctors estimated that he had around ten years of useful vision left.

However, two years ago Tuftnell took part in a groundbreaking study where gene therapy was used to treat his deteriorating condition.

The results of the study were published last week in the Lancet Medical Journal.

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Man Saved From Blindness By Gene Therapy

Spark’s gene therapy to reverse blindness hopes to be first commercialized therapy of its kind

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A video that shows a 13-year-old child kicking a soccer ball would be a fairly typical scene were it not for the fact that for much of his life he was profoundly blind. He is one of 12 patients that have received a gene therapy developed by Childrens Hospital of Philadelphias Center for Cellular and Molecular Therapeutics to reverse the effects of inherited retinal degeneration from mutations associated with the RPE65 gene.

Spark Therapeutics is a CHOP spinout thats advancing the gene therapy and other treatments through Phase 3 clinical trial and FDA submission.

The treatment is designed to address an unmet need for patients with inherited Lebers congenital amaurosis and retinitis pigmentosa. In an interview with MedCity News at the JP Morgan Healthcare conference, CEO Jeff Marrazzo likened the effects of retinal dystrophy to film that degrades in a camera that produces a blurry or distorted image.

Spark Therapeutics has enrolled 24 patients in a Phase 3 trial, including 16 in the treatment arm and eight in the control group. The open-label, randomized controlled trial will assess the safety and effectiveness of its therapy approach as a possible treatment for blindness caused by mutations of the RPE65 gene. Participants receive a subretinal injection and are monitored for any improvements to orientation, mobility and navigational ability, as well as performance on tests of visual and retinal function, according to the companys website. At the end of one year, subjects randomized to the non-intervention control group will cross over to receive vector injection. The Phase 3 trial means they can also treat patients as young as age 3, compared with earlier studies which have an age minimum of 8.

Marrazzo said Spark expects to have final data from the clinical trial available in the first half of 2015.

We are in the midst of a remarkable chapter in medicine right now, he said.

If successful, the company could have the first FDA-approved gene therapy and could contribute to Philadelphias profile as a life science center.

Separately, the company has a disruptive Hemophilia B gene therapy treatment and is currently enrolling patients in a Phase 1/2 study. Although the dosing schedule has not yet been defined, a patient in the current study has been able to go six months so far without receiving any infusions of traditional therapy.

The treatment delivers a disarmed adeno-associated virus carrying a healthy gene to the liver, where factor IX is normally produced. Marrazzo sees the treatment as having the potential to have a huge impact in reducing the doses of clotting factor that hemophiliacs need to take to avoid excessive bleeding. There are about 20,000 people with the condition in the U.S., according to the Centers for Disease Control.

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Spark’s gene therapy to reverse blindness hopes to be first commercialized therapy of its kind

Dominic Dousa – Evocations from the Plains, Mvt 2: "The Freedom of the Open Skies" – Video

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Dominic Dousa - Evocations from the Plains, Mvt 2: "The Freedom of the Open Skies"
Centro Cultural Paso del Norte (Teatro Victor Hugo Rascn Banda) Ciudad Jurez, Chihuahua, Mxico November 11, 2013 Iliana Vasileva Fileva, violin Roberto Ju...

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Dominic Dousa - Evocations from the Plains, Mvt 2: "The Freedom of the Open Skies" - Video

1/18/2014 — Fracking Earthquakes, Steam Plumes, and Volcanoes — Freedom Frequency – Video

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1/18/2014 -- Fracking Earthquakes, Steam Plumes, and Volcanoes -- Freedom Frequency
Covering the topics of Fracking Earthquakes, New Madrid seismic zone, Steam Plumes, and Dormant volcanoes.... Last nights 2 hour show was great!! This video ...

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1/18/2014 -- Fracking Earthquakes, Steam Plumes, and Volcanoes -- Freedom Frequency - Video