The United States made dramatic health gains during the 20th century, as shown by average life expectancy rocketing from age 48 in 1900 to 77.7 in 2006. Similarly, infant mortality dropped from 47 per 1,000 births in 1940 to 6.7 deaths in 2006.But as those health gains have shifted the health care landscape, a host of new — or newly revealed — issues have emerged concerning the health of the nation’s children. Addressing those issues will require a systematic, system-wide approach, according to José Cordero, dean of the School of Public Health at the University of Puerto Rico.Cordero, who spoke Thursday (March 4) at the Harvard School of Public Health (HSPH), delivered this year’s Yerby Diversity in Public Health Lecture, which brings minority scientists and scholars to Harvard to address health topics. Cordero was introduced by HSPH Dean Julio Frenk and by Alissa Myrick, a research fellow in the HSPH Department of Immunology and Infectious Diseases.In his talk, “Children’s Health: Learning from the Consequences of our Success,” Cordero said that today’s leading cause of child mortality is birth defects, making that area a prime target for intervention.He used the example of neural tube disorders such as spina bifida, where a portion of the spine doesn’t close during development, leaving the spinal cord exposed, and anencephaly, a condition where the brain, skull, and scalp don’t fully form. Research in the 1990s, he said, showed that folic acid given during pregnancy effectively lowered the risk of neural tube disorders. In response, the Food and Drug Administration in 1998 required cereal grain products, such as bread, rolls, rice, and pasta, that are labeled “enriched” to include a minimum level of folic acid.In the years since, he said, neural tube disorders have fallen, but not uniformly among ethnic groups. Hispanic rates, though lower, remain above those for whites and blacks, something traced to the high use of corn flour in Hispanic households. Corn flour in the United States is not typically enriched and so does not include folic acid supplements.While public health officials work with industry and regulators to change that, Cordero said there are other interventions that could help. One is to have providers recommend that pregnant women take folic acid supplements. He cited a survey exploring public knowledge versus action with relation to folic acid and said surveys showed that knowledge of the potential beneficial effects of folic acid rose considerably between 1997 and 2006, but that public action, such as taking supplements, increased only slightly.In exploring that discrepancy, researchers found that many said they would take folic acid if recommended by their doctors, but only 30 to 40 percent of providers actually make that recommendation. Cordero said that points to more interventions with physicians, reminding them to recommend it to pregnant women.Such system-wide interventions are also seen in other conditions of childhood. Cordero said that children born with Down syndrome present another instance where system-wide changes are needed. As recently as the 1970s, he said, children born with the syndrome weren’t expected to live past their teens. Advances since then have pushed life expectancy of Down syndrome babies into their 50s. While that is a health care success, he said, it also presents problems, as providers aren’t typically educated about the health needs of mature and older adults with Down syndrome.That highlights a need for education and training that was less pressing decades ago because of the rarity of people with the condition living so long. Care for older people living with Down syndrome now needs to be front and center because decades ago they typically didn’t outlive their care-giving parents.“This is not a child with special needs. This is a person who will have special needs through their lifetime,” Cordero said.Cordero said it makes sense to aim interventions at women of reproductive age to lower rates of a variety of birth defects. The list of potential conditions that could harm a developing fetus is long. He said interventions should seek to curb smoking and alcohol use, to control diabetes and obesity, to be mindful of the effects of prescribed medications, and to take steps to avoid transmission of HIV to babies from their mothers.“Success in the 21st century will require a systems approach … to meet the new needs of the population,” Cordero said. “Sometimes there are consequences of success that are unexpected. We need to monitor them to ensure that [past] success will lead to greater success.”
VIEW THE PHOTO GALLERYPhotos: Matthew Murphy | Styling: David Withrow | Photography Assistant: Evan Zimmerman | Hair & Makeup: KeLeen Snowgren | Some Wardrobe Provided By: Austin Scarlett Ever wonder what it’s like to be a Schuyler Sister in the greatest city in the world? Hamilton’s Angelica Mandy Gonzalez showed us how she makes it all “werk” with a peek into a day in her life through the lens of Broadway.com contributor Matthew Murphy. Here’s Gonzalez’s typical day, from heading into New York City in style to rehearsing for her upcoming 54 Below show to ending each day starring in a revolutionary hit. Check out the photos here and let Gonzalez talk you through the gallery of her non-stop day in our video below! Related Shows from $149.00 View Comments Hamilton
FacebookTwitterLinkedInEmailPrint分享CNBC:Chesapeake Energy, the poster child of the U.S. shale revolution, filed for bankruptcy protection on Sunday. The move comes as the company and industry more broadly has been rocked by a drop in oil and gas prices amid the coronavirus pandemic.Chesapeake said that $7 billion in debt will be wiped out through the restructuring. The company has secured $925 million in debtor-in-possession financing in order to continue operations during the bankruptcy process. In addition, Chesapeake has secured an agreement in principle from certain existing lenders for $2.5 billion in debt financing on emergence from bankruptcy, as well as a backstop commitment for $600 million in new equity.Franklin Resources and Fidelity are among the biggest creditors, according to people close to the company, and they will be among the primary equity holders following the company’s restructuring. The company will continue operations at a much reduced capacity, with a handful of gas rigs and no oil rigs, according to those familiar with the company’s plans.“We are fundamentally resetting Chesapeake’s capital structure and business to address our legacy financial weaknesses and capitalize on our substantial operational strengths,” CEO Doug Lawler said in a statement.Chesapeake Energy was founded in 1989 by Aubrey McClendon. An early pioneer of horizontal drilling, he built the company into a key player in the U.S. gas industry. At its peak, Chesapeake had 175 operating rigs, with operations across the U.S. including in Texas, Louisiana, Pennsylvania and Ohio. But the company took on a lot of debt to fuel its rapid expansion, and from 2010 to 2012 spent $30 billion more in drilling and leasing than it made from its operations.Chesapeake’s downturn is not unique. Whiting Petroleum is among the other once great drillers that couldn’t survive a historic plunge in oil prices. The company filed for bankruptcy protection on April 1.[Pippa Stevens and Brian Sullivan]More: Chesapeake Energy, a pioneer in the U.S. shale revolution, files for bankruptcy protection U.S. shale pioneer Chesapeake Energy files for bankruptcy
Related Articles Irish racing cancelled as Varadkar increases COVID-19 measures March 25, 2020 StumbleUpon Paris tracks face second shutdown as government changes coronavirus policy May 20, 2020 Share Share BHA extends racing suspension beyond end of April April 16, 2020 Submit British racecourses have appointed i-neda to provide technology support for the sport’s forthcoming pool betting operation. This means that the company will provide the technology platform for the new pool betting operation which is set to go live across the bulk of British racecourses in July 2018. UK based i-neda was founded in 2002 and has extensive experience of delivering pool betting solutions in the UK, USA, Europe and Asia. Since 2009 i-neda has provided Tote Ireland with its online wagering solution for online users across platforms in addition to account management, call centre and payment management systems. The i-neda systems have managed over 30 million transactions and it’s now the largest provider of international pool bets for British Racing, with customers including the likes of OPAP in Greece and MaltCo in Malta. In addition, i-neda provides the total wagering solution for British Racing’s largest international customer, the Israel Sports Betting Board.Nigel Roddis, Managing Director of the Project Steering Board which is overseeing British Racing’s future pool betting operation, said: “After an extensive tender process we are delighted to have appointed i-neda. The company has the experience and innovative approach that will help ensure we develop a technology infrastructure that will provide a first -class customer betting experience. “We are aiming for this to enhance the appeal and experience of betting on racing for existing and new fans of the sport. We look forward to providing further details about our plans in due course.” Martin Pickering, i-neda CEO, commented: “We are pleased to be have been selected as the technology provider for this exciting project. Our development team and support staff, based in Farnborough, have a proven track record of delivering successful, innovative wagering solutions and we look forward to playing our part in this landmark project for British Racing.”As of the time of writing, a total of 54 racecourses have signed commitments to launch this new service. These include those under the banners of Jockey Club Racecourses, such as Aintree, Cheltenham, Epsom Downs and both Newmarket racecourses; and Arena Racing Company, including Chepstow, Doncaster and Lingfield Park; large independent tracks including the likes of Goodwood, Newbury and York; smaller independent courses Cartmel, Ludlow, Plumpton and Salisbury; and all of Scottish Racing: Ayr, Hamilton Park, Kelso, Perth and Musselburgh.
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