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Fight against TB gains momentum in Viet Nam: "Today's best can be made better tomorrow"
[CNS video] Viet Nam is not only a high burden country for tuberculosis (TB) but also for multidrug-resistant TB (MDR-TB) as well as HIV. Despite challenges, Viet Nam has made significant progress in fighting TB country-wide. For instance, the treatment success rate for MDR-TB hovers around 48% for most of the world, but Viet Nam is among the five countries where treatment success rate for MDR-TB has touched 70%. Despite progress, formidable challenges remain.
Citizen News Service (CNS) spoke with Dr Nguyen Viet Nhung, who leads the National TB Programme of Viet Nam, and is also the Director of National Lung Hospital (click here to watch the video of this interview).
If we do not act now, it will be too late!
Dr Nhung said: "At the last year's Global Health Security Forum, MDR-TB was one of the hot topics and need for effective advocacy came out strong. If we do not act now, it will be too late!"
"In Vietnam we had set up the MDR-TB control programme as a priority component of broader TB control programme. We cannot forget regular TB control because more than 95% of new TB patients are still drug susceptible (routine anti-TB drugs work for most patients, and they are not resistant to anti-TB drugs). We have a very effective firstline drug regimen for them. So we try to detect them as early as possible, and help stop infection transmission, reduce incidence and prevent MDR-TB. Early diagnosis is just one step: it is equally important to provide the right anti-TB regimen which is effective for a particular patient. Then we need to ensure the patient completes effective anti-TB regimen and get cured: so we need to provide adequate counselling for every patient so that patient is able to adhere to the regimen and also it helps in preventing infection transmission. For drug resistance TB, it is very important to prevent it, detect drug resistance and treat it with effective regimen."
Only 4% of newly detected TB patients have drug resistance in Viet Nam. But 23% of previously-treated TB cases are of MDR-TB.
Pilot of 9 month MDR-TB regimen begins on 1st September 2015
Viet Nam routinely provides the 20 months standard MDR-TB regimen recommended by the WHO. In addition to this routine therapy, Viet Nam is also beginning a pilot to treat 100 MDR-TB patients with a nine-month regimen from 1st September 2015 onwards.
"Globally treatment success rate for MDR-TB is around 48% whereas Viet Nam is among five countries in the world to achieve treatment success rate of 70%. Our major challenge is to deal with the 20% or so patients where the treatment is not successful and mortality may be high – may be they have extensively drug resistant TB (XDR-TB) or have MDR-TB but intolerance to current regimen becomes an issue, or might be they are pre-XDR with either resistance to quinolone or one of the injectables," said Dr Nhung.
Viet Nam provides individualized regimen for those patients with drug resistant TB based upon their drug susceptibility test (DST) results. Viet Nam is also using a new drug, Bedaquiline for one of its regimen.
Viet Nam had introduced molecular tests for TB such as Gene Xpert almost four years ago. This year 60 more Gene Xpert machines with cartridges will be introduced nationwide with support from UNITAID and Global Fund to fight AIDS, TB and Malaria (The Global Fund). "It is good for Viet Nam that we are keeping Gene Xpert roll-out to public sector where we can regulate its use."
"Last year we had enrolled 1503 MDR-TB patients and this year we aim to enroll 2,200 patients –so scale up is quite fast in Viet Nam. Apart from funding, high commitment from human resource – the people who lead the TB programme on the frontlines – is also extremely important. High commitment from the government is also very critical" emphasized Dr Nhung.
Last year Viet Nam had developed a National TB Strategy for 2020 and vision for 2030 which demonstrates increasing political commitment for accelerating progress towards ending TB.
"Viet Nam is also one of the countries to apply scientific approach to diagnosing TB in children. It is based upon three factors: 1) history of contact within one year, 2) abnormality in chest x-ray consistent with TB, 3) clinical symptom consistent with TB. This approach has increased number of TB diagnosis. Majority of TB in children is primary TB which may otherwise get ignored in the routine clinical setting. Nevertheless it is important to recognize diagnosing TB in children is a challenge. We try to overcome this challenge to some extent by training healthcare providers in how to take x-ray in children and adults to screen them for TB – and then further investigations as required. Also we train healthcare providers and have developed materials in how to read the x-ray and reports. National Conference on Lung Health in Viet Nam which ended a week ago, had a training course on chest x-ray reading, and most delegates wanted to attend it. So people are interested in doing better with existing tools too."
"Commitment from the leader is very important. Today's best can always be made better tomorrow! We need guidelines and other materials in easy to understand language and style. Counselling is a very important component of TB care and control. TB drugs may be toxic or have side effects so ongoing counselling and social support is very instrumental in ensuring early management of side effects or other related issues as well as ensuring adherence and completion of treatment. For example if a patient knows in advance of side effects then they don't get surprised by side effects and less likely to leave treatment midway. Patient support programme is so important" said Dr Nhung.
In Viet Nam, people with TB get their transportation expenses covered in addition to all other diagnostic and treatment services for TB being free too. "We also try to encourage nurses and doctors to be friendly and empathise with patients. Interaction between doctors and patients is very important. Patients too can play a key role by sharing their experience with others and help other people walk through the treatment successfully" said Dr Nhung.
Bobby Ramakant, Citizen News Service - CNS
(The author is providing thematic coverage from the 5th Asia Pacific Region Conference on Lung Health, of the International Union Against Tuberculosis and Lung Disease (The Union). He is supported by the Lilly MDR TB Partnership. Follow him on Twitter: @CNS_Health and @bobbyramakant)


Tom Lowes is a Registered Osteopath at The Putney Clinic of Physical Therapy. His interest in injury treatment and rehabilitation began after recovering from an ACL knee ligament reconstruction in 1996. Prior to working as an osteopath, he worked as a personal trainer for a number of professional athletes and sportsmen.Tom has an MSc in Sports Medicine from Queen Mary's University London. As a result, he has developed a specialist interest in hamstring injury and associated lumbar spine mechanics. He is a member of the British Association of Sport and Exercise Medicine (BASEM), the Football League Medical Association, the Royal Society of Medicine, and the General Osteopathic Council (GOsC).
During your treatment session, alongside therapy to the injured tissues, Tom will identify any inefficient movement patterns and weaknesses that have resulted from your injury. After assessing this information, he will then be able to provide you with exercises to restore them.


Promote reusable cups at the cafes on campus.
We could design our own Green team cup and include a donation to a good cause in its purchase price. I have experience working for Frank Water a Bristol based charity and social enterprise that sells and promotes the use of reusable bottles and would love the opportunity to bring my experience to help reduce single-use cup waste at UWE.
This idea opened on 12 Oct 2016 and closes for voting on 2 Oct 2016.
4:20pm on 17 Oct 16 YES!!!
4:40pm on 12 Oct 16 Very similar to the Biodegradable Coffee Cups on all campuses - love it!


Why did you decide to self-publish Lady Death again?
What do you think it is about Lady Death that connects with readers so much?
What can you tell us about the plot of the new 48-page graphic novel?
Why did you decide to use Kickstarter for this project?
What are some of the incentives for fans to contribute to your Kickstarter?
"I'll tell you a range. If a person pledges five dollars, they can get a digital download of Lady Death Chaos Rules #1. For a $20 pledge, they'll get the actual 48-page graphic novel, and then it ranges up, where we actually have Kickstarter-exclusive editions, including a jeweled edition, enhanced with actual Swarovski crystals and limited to 99; a metallic edition with a real metal cover, limited to 66, and then we get even crazier. We have an edition called the "Killed by Death" edition, limited to 6 copies, where six fans can actually be beheaded by Lady Death. We will draw them into page eight of the book. Not to be outdone, we have even one more crazier one. Our Kickstarter happens to coincide with the 21st anniversary of Lady Death, so we are presenting "Lady Death #1, diamond edition." This is an edition limited to one – the rarest Lady Death comic we've ever created. It is a metal cover, and encrusted into the hilt of Lady Death's sword is an actual high-quality, one-carat diamond, with an appraised value of over $6,000, as appraised by Scottsdale Fine Jewelers. It's off the charts. And to commemorate the event, there are assorted limited-edition prints… even a Lady Death vinyl statue. So we're coming out with guns blazing.


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'Cappuccino charge' and 'latte levy' must just be stepping stones to a 100% of single use coffee cups being recycled
The Marine Conservation Society (MCS) says it welcomes the recommendations in a report out today from the Environmental Audit Committee calling for a 'latte levy' of 25p on disposable coffee cups with the revenue raised paying for improved recycling facilities.
© Stuart Askew
In the last five years, the MCS Beachwatch beach clean and survey programme has seen an increase of 93% in coffee cups found on UK beaches.
The UK's leading marine charity says having to pay extra will highlight to consumers that their cardboard coffee cup is typically lined with plastic meaning recycling is extremely difficult.
Dr Laura Foster, MCS Head of Clean Seas, said "Just like the plastic bag charge we are all now familiar with, a charge added to our coffee at the point of purchase will help consumers think about whether to take a refillable cup to the café and encourage cafes to use traditional cups and mugs rather than hand out single-use cups when it's not necessary."
Take-away coffee cups may look like cardboard through-and-through but on the inside they are lined with a plastic, making them hard to recycle and resulting in 99% of them being destined for landfill or incineration.
"We totally agree with the committee that if 100% recycling of coffee cups isn't reached by 2023, then there should be an outright ban on providing them – and that date should be set in stone. Only by treating this issue as one that is the responsibility of both industry and consumers will re-use become the norm in place of single-use and throw away," said Laura Foster.
Last year, a YouGov survey for MCS revealed that 74% - that's almost three out of four people questioned across the UK - would support a charge on single use coffee cups.
The poll asked people if they would support paying a deposit on disposable coffee cups to encourage the use of refillable cups or cups being returned for recycling. Only 8% of responders opposed such charges. 70% of people surveyed also supported a ban on the use of polystyrene food containers and cups, with most support coming from those aged 55 or over.
The chair of the Environmental Audit Committee Chair, Mary Creagh MP, said: "The UK throws away 2.5 billion disposable coffee cups every year; enough to circle the planet five and a half times. Almost none are recycled and half a million a day are littered. Coffee cup producers and distributors have not taken action to rectify this and Government has sat on its hands.
Coffee shops have been pulling the wool over customers' eyes, telling us their cups can be recycled, when less than 1% are. The Government should set a target for all disposable coffee cups to be recycled by 2023. If a sustainable recycling system for disposable coffee cups cannot be set up by this date, they should be banned."
MCS says that reducing the use of these disposable cups by adding a charge to your cappuccino - similar to carrier bag levy - will help us to tackle the growing plastic tide that has been so brilliantly highlighted in the media towards the end of 2017.
Our Communications Team is on hand for all media enquiries
Contact our press team
Press line 01989 561580
Email info@mcsuk.org
Clare Fischer,
Jack Versiani Holt,
Communications Team Support Officer

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Мери Кингсли (; Ислингтон, 13. октобар 1862 — Симонстаун, 3. јун 1900) је била енглески писац и истраживач и утицала је на европско мишљење о Африци и народу Африке.

Детињство и младост
Рођена је у Ислингтону, као ћерка Џорџа Кингслија, који је исто био путописац. Њен отац је био доктор, а мајка јој је била инвалид, па је Мери морала да брине о њој. У школу је ишла јако мало, али имала је приступ великој очевој библиотеци и одушевљавала се кад јој је отац читао о страним земљама.

У Африци
Отац јој је умро 1892, а мајка јој је умрла пет недеља после тога. Била је ослобођена породичних обавеза, а имала је довољно новца да може да путује.
Одлучила је да посети Африку да би сакупила материјала за књигу о културама народа Африке, коју њен отац није завршио. Стигла је августа 1893. у Луанду у Анголи. Живела је са домороцима, који су је учили вештине потребне да би се преживело у џунглама. Често је ишла сама на опасна места. Вратила се у Африку 1895. да би проучавала племена канибала. Путовала је кануом дуж реке Огова и ту је сакупила примерке дотад непознате рибе. После посете племену Фанг попела се на Маунт Камерун висок 4100 m по траси, којојм ниједан Европљанин није ишао.

Постала је славна

Вести о њој појавиле су се у енглеској штампи, па када се вратила кући 1895. салетали су је новинари тражећи интервју. Постала је позната и три године је обилазила Енглеску одржавајући предавања о животу у Африци. Мери Кингсли је узрујала енглеску цркву, када је критиковала мисионаре због покушаја да промене народ у Африци. Она је бранила многе аспекта живота у Африци, који су шокирали Европљане, као нпр. полигамију. Она је објашњавала које су све биле стражне последице разбијања урежђеног полигамног друштва у неуређено моногамно друштво.

Написала је две књиге о својим искуствима. Прва књига Путовања у западну Африку (1897) одмах је постала бестселер. Друга књига је била Запдноафричка проучавања (1899). За време Другог бурског рата Кингсли се добровољно пријавила као болничарка. Умрла је од тифуса, док је лечила ратне заробљенике. Према њеним жељама сахрањена је на мору.

Литература

 Davidson, L.C. Hints to Lady Travellers, London 1889
 Dea, B. Mary Kingsley: Imperial Adventuress, Palgrave Macmillan 1992

 Kingsley, M.H. West African Studies, Frank Cass Publishers 1964
 Kingsley, M.H. 'Travels on the western coast of Equatorial Africa' Scottish Geographical Magazine, 12, pp. 113–124, 1896
 Middleton, D. 'Some Victorian Lady Travellers' The Geographical Journal, 139(1), pp. 65–75, 1973
 'Kingsley, Mary Henrietta' Oxford Dictionary of National Biography.
 Bausch, Richard Hello To The Cannibals, HarperCollins, 2002 (fictional approach)

Спољашње везе

 Кратка биографија
 Пројекат Гутенберг e-текст на Travels in West Africa

Рођени 1862.
Умрли 1900.
Британски истраживачи
Истраживачи Африке

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