pred_label
stringclasses
2 values
pred_label_prob
float64
0.5
1
wiki_prob
float64
0.25
1
text
stringlengths
133
991k
source
stringlengths
39
45
__label__wiki
0.608953
0.608953
UPDATE: Court date set for Brad Hill MELBOURNE, AUSTRALIA - SEPTEMBER 17: Bradley Hill of the Hawks marks the ball during a Hawthorn Hawks AFL training session at Waverley Park on September 17, 2015 in Melbourne, Australia. (Photo by Michael Dodge/Getty Images) Hawthorn premiership player Brad Hill will face Dandenong Magistrates Court on Monday, June 27. On Tuesday, Hill was charged with assault following an alleged altercation at a Narre Warren nightclub in Melbourne’s south-east on January 24. A 22-year-old woman has also been charged with one count of unlawful assault. Hill, 22, was a member of Hawthorn’s 2013, 14 and 15 premiership sides and has played 80 games with the Hawks. Buckley takes a whack at Cats’ home game advantage MELBOURNE, AUSTRALIA – SEPTEMBER 17: Bradley Hill of the Hawks marks the ball during a Hawthorn Hawks AFL training session at Waverley Park on September 17, 2015 in Melbourne, Australia. (Photo by Michael Dodge/Getty Images) Hawthorn released the following statement on Tuesday night confirming the charge: Hawthorn Football Club can advise that Bradley Hill has today been charged with assault following an investigation into a report of an alleged altercation on January 24. Hill notified the club at the time of the incident and has cooperated fully with police. Hawthorn GM – Football Operations Manager Chris Fagan said: “Bradley has kept the club informed throughout this entire process. The leadership group has already met on this matter and has decided that no sanction will be applied at this stage. “The matter is now before the court and any sanction is in the hands of the judicial system.” The club will not make further comment at this time. Bradley Hill Hawthorn Hawks Very confronting: McGuire opens up on Goodes documentary Jack Darling signs five-year extension
cc/2019-30/en_middle_0041.json.gz/line1614244
__label__wiki
0.839509
0.839509
The ZIMBABWE Situation An extensive and up-to-date website containing news, views and links related to ZIMBABWE - a country in crisis Please note: You need to have 'Active content' enabled in your IE browser in order to see the index of articles on this webpage Pledge to non violence As you know I have been trying to broker peace between the two factions of the MDC since the 12th October 2005. I know that some of you are skeptical about this and about my ability to play this role but nevertheless I am convinced in my mind at least that this is the right thing to do. I have been deeply concerned about the vitriolic statements made by both sides and by individuals on both sides since the 12th October as I believe they have greatly lessened any chance of reconciliation being achieved. However in recent weeks I have discerned an even more disturbing trend and that is that violence has been increasingly threatened and used. A vehicle has been hijacked by youths and at least one rally threats have been made to crush members of an opposing faction. This is of course just a continuation of the violence we have seen perpetrated by both sides against each other in the last 18 months. I do not propose at this juncture to delve into who is responsible for that violence. Nor will I try to assess which side is most culpable at this stage. What is needed now is a deep rooted commitment from both sides to refrain from violence, not just in word but more importantly in action. Anyone can simply condemn violence – Robert Mugabe and Zanu PF do that all the time at the very time they are plotting evil. Violent tendencies can only be quashed if leaders demonstrate that they are not prepared to tolerate violence in any form or fashion. Furthermore it is clear that one or other, or both, of the two factions in the coming months will engage in mass action against the regime. I am concerned that if violence is tolerated or condoned in intra party disputes that the same policy may be applied in opposing the regime. In this regard I draw your attention to the “Pledge to non violence” drafted by Martin Luther King for the Alabama Christian Movement for Human Rights which I have both attached and set out in full below. I think the following points about it should be noted: Our aim in both the settlement of intra party disputes and in our struggle against the regime should be to achieve “justice and reconciliation – not victory”. The organisation we represent is after all the Movement for Democratic Change not the Movement for Change. In other words mere victory over the other faction or Zanu PF should never be our goal – our goal should be to bring about a new order of peace, justice and reconciliation, not the continuation of the hatred, pain, intolerance and overwhelming power we have experienced under Zanu PF. We need to “walk and talk in the manner of love”. We cannot just talk about non violence; our entire demeanour must reflect our commitment to non violence. This applies particularly when confronting the regime. If we begin marches with prayer and ensure that no weapons of any sort are used then the regime will find it hard to crush protests because its objective will be so obviously noble. But our walk begins with how we treat our own brothers and sisters in the struggle. How can we possibly convince the regime that we have noble objectives if in the settlement of our internal disputes we are so quick to resort to violence or to turn a blind eye to violence? We need to blanket our entire actions in “prayer”. It is more difficult to engage in violence if one takes the time to pray before undertaking any activity. But this needs to be genuine, heartfelt prayer not prayer by rote. And when we pray we should not be asking God just to end tyranny but to examine our own hearts and motives. We need to ask God to give us restraint in our words and actions. And if we are confronted by law enforcement agencies then our first reaction should be to get down on our knees and pray, not to fight. The regime will have no answer to such action and also I have no doubt that God’s mighty power will be unleashed in such situations. We need to “sacrifice personal wishes in order that all men shall be free”. One of the things that has distressed me the most in the split is the realisation that many in both sides are not interested in reconciliation because that is the very thing that will obstruct their path to higher office. There is no doubt that there are people on both sides who have now attained high office in one or other faction; office they would never have dreamt of had the MDC remained united. They fully understand that if the party were to unify they would lose those lofty positions. We have not seen sufficient people on both sides who have been prepared to sacrifice their personal goals for the greater good. But the same applies to our attitude in confronting the regime. I have heard at least one member of the MDC National Executive complain in the last year about not being prepared to wait any longer to become a Minister. Our goal should not be the attainment of high office in Government – our goal must be to liberate Zimbabweans whether that results in us becoming Ministers or not. If our struggle is indeed a noble one, if we are to maintain the moral high ground, then we must observe “the ordinary rules of courtesy” with both “friend and foe”. How can it be that we have allowed ourselves to be so uncouth towards colleagues, comrades and friends who have been to hell and back together with us in the last 6 years? What has caused us to stoop so low to sling all manner of unsubstantiated barbs against each other in the last 6 months? Why is it that we have not afforded each other the courtesy of testing “facts” before publishing untrue and wildly defamatory statements about former colleagues? Why have we resorted to making such vile and vitriolic statements about former colleagues in public? I have been utterly appalled by the use of words like “sell outs”, “dissidents”, “rebels” , “dictators” to describe colleagues who only yesterday were in the trenches with us. But this principle applies equally as we tackle the regime and law enforcement agencies. Indeed what has greatly diminished the moral authority of our struggle against the regime has been our distinct lack of courtesy shown to each other. It is now perfectly reasonable for the regime to argue that they are up against uncouth people who do not care for truth or the observation of ordinary rules of courtesy. Our commitment to non violence should be all embracing; we need to “refrain from the violence of fist, tongue or heart”. In other words we need to watch our physical actions, what we say and importantly what motivates us. One can pay lip service to non violence and even refrain ourselves from the violence of the fist, whilst at the same time entertaining deep rooted malice which eventually spills out. It is no good putting on a façade of commitment to non violence whilst at the same time encouraging others, especially young people, behind closed doors to engage in violence. Recently I have been given the excuse that violent acts and statements committed by young men and low ranking officials were not done in the presence of leaders. That is simply not good enough. In my experience young people rarely engage in acts of violence unless they are encouraged to do so by leaders behind closed doors. The history of Zimbabwe is littered with examples of young men and women being sacrificed to achieve the personal political goals of their elders. We must break this cycle both in the settlement of our intra party disputes and in tackling the regime. The cycle can only be broken if leaders consistently demonstrate in their words and actions their deep rooted commitment to using non violence. Unless those who have engaged in violence are disciplined and expelled from the party young people will inevitably be left with the impression that leaders simply do not want to be associated with violence but actually support the use of violence. There is a need for discipline – all must “follow the directions of the movement”. Even if leaders are committed to non violent methods being used, undisciplined and over exuberant people can get carried away in attempting to achieve what is otherwise a noble goal. I have been alarmed by the cavalier attitude displayed by some in dealing with both the intra party dispute and the national crisis. Some seem to be prepared to throw caution to the wind and not to care how their strategies and tactics may unfold. Zimbabwe is a tinderbox as a result of the great pressures that all people are under. Leaders have a responsibility to consider carefully what they say and do and also leaders need to ensure that their followers are highly disciplined. If this approach is not adopted there is a great danger that a wildfire will be ignited that will be difficult to extinguish and indiscriminate in its destruction. I recognise that some of you may be deeply skeptical about what I have written. Some of you may just think that these are irrelevant musings of a naïve Christian who does not understand the nature of this regime and what is needed to remove it. I hold to these views not just because I think they are morally correct but because I also believe that these principles provide the best and most effective means of bringing democratic change to our beloved nation. I think if we engage in intra party violence we will simply perpetuate the struggle for freedom and never deal with the root causes of our nation’s distress. I believe that if we try to tackle the Zanu PF regime using the methods they are most experienced in and familiar with, we will lose that battle. When Mugabe speaks of having “degrees in violence”, that is no idle boast. I think the one thing they are longing for is the excuse to crush a violent uprising. I think the one thing they have no answer to is a genuinely peaceful, non violent movement that does not care about power but is more concerned with rooting justice and reconciliation in Zimbabwe. Let me conclude by saying that whether you commit yourself to these principles or not I am determined to do everything in my power to continue persuading anyone who will listen that this is the right way. I can do no better than to quote Martin Luther King again in this regard. “I’ve decided that I’m going to do battle for my philosophy. You ought to believe something in life, believe that thing so fervently that you will stand up with it till the end of your days. I can’t make myself believe that God wants me to hate. I’m tired of violence. And I’m not going to let my oppressor dictate to me what method I must use. We have a power, power that can’t be found in Molotov cocktails, but we do have a power. Power that cannot be found in bullets and guns, but we have a power. It is a power as old as the insights of Jesus of Nazareth and as modern as the techniques of Mahatma Gandhi.” It would be wonderful if all democratic leaders in Zimbabwe would make a similar pledge themselves to the one drafted by Martin Luther King 43 years ago. David Coltart Bulawayo 12 April 2006 I HEREBY PLEDGE MYSELF – MY PERSON AND BODY – TO THE NONVIOLENT MOVEMENT. THEREFORE I WILL KEEP THE FOLLOWING TEN COMMANDMENTS:* 1. MEDIATE daily on the teachings and life of Jesus. 2. REMEMBER always that the non-violent movement in Birmingham seeks justice and reconciliation – not victory. 3. WALK and TALK in the manner of love, for God is love. 4. PRAY daily to be used by God in order that all men might be free. 5. SACRIFICE personal wishes in order that all men might be free. 6. OBSERVE with both friend and foe the ordinary rules of courtesy. 7. SEEK to perform regular service for others and for the world. 8. REFRAIN from the violence of fist, tongue, or heart. 9. STRIVE to be in good spiritual and bodily health. 10. FOLLOW the directions of the movement and of the captain on a demonstration. I sign this pledge, having seriously considered what I do and with the determination and will to preserve. Name ____________________________________________ Address ___________________________________________ Phone ____________________________________________ Nearest Relative ____________________________________ Besides demonstrations, I could also help the movement by: (Circle the proper items) Run errands, Drive my car, Fix food for volunteers, Clerical work, Make phone calls, Answer phones, Mimeograph, Type, Print signs, Distribute leaflets. Alabama Christian Movement For Human Rights Birmingham Affiliate of S.C.L.C. 505½ North 17th Street F. L. Shuttleworth, President * Pledge signed by volunteers for sit-in demonstrations to protest segregated eating facilitates in Birmingham, Alabama, in 1963. Drafted by Martin Luther King, Jr. Click here or ALT-T to return to TOP Growing poverty seen stoking Zimbabwe protests Wed 12 Apr 2006 8:38 AM ET By Cris Chinaka HARARE, April 12 (Reuters) - Zimbabwe's rapid economic decline has triggered desperation among city dwellers that could turn planned opposition protests against President Robert Mugabe's government into a potent force. Opposition leader Morgan Tsvangirai dramatically raised the stakes last month when he proposed mass protests at a time when the country is battling its worst economic downturn since independence and has the world's highest inflation rate. "We are on the brink ... and anyone who thinks the political situation is manageable at this rate of economic deterioration is going to be shocked," John Makumbe, a political scientist at Harare's University of Zimbabwe, told Reuters. "For many people, especially in the urban areas, life has become unaffordable and unbearable and these people are waiting to vent their anger through mass demonstrations," said Makumbe, a critic of the government. The government, while acknowledging the economic crisis, says it remains optimistic but in private officials say rising prices and unemployment above 70 percent are stoking anger, especially in cities. Last week Zimbabwe's annual inflation rate, measured through the consumer price index (CPI), jumped to 913.6 percent for the year to March from 782 percent in February. Experts expect the rate to soar way over 1,000 percent by mid-year and Zimbabwe also faces shortages of fuel, food and foreign currency and breaking sewerage systems, power and water cuts, uncollected domestic garbage and deteriorating roads. It amounts to the worst economic situation since Mugabe led the country to independence from Britain in 1980 and the time when Zimbabwe was one of Africa's most prosperous states is a distant memory, political and economic analysts say. "DICING WITH DEATH" The government employed tough policing methods against mass protests in 1998 and subsequent demonstrations, cowing many people but now there was a generation of unemployed youths ready for confrontation, Makumbe said. "The element of fear is exaggerated ... and I think that point is going to become clearer if the government fails to sort out the economy in the next few months," Makumbe said. Mugabe, 82, warned Tsvangirai he would be "dicing with death" if he tries to use protests to drive him from power but officials sources said the government was worried and working on plans to clamp down on the opposition. "There is no denial that the political and economic climate is not ideal for the government and the system must be ready to overcome all those who may try to subvert law and order," said one official who declined to be named. The ruling ZANU-PF party -- which co-led Zimbabwe's independence war -- warned Tsvangirai it was a battle-hardened movement and any street protests by his main faction of the MDC would end up in bloodbath. Tsvangirai is yet to name a date for protests, which could start small, and analysts say Mugabe's strategy could be to stifle any campaign before it takes off in the coming months. A key opposition demand is for a new constitution, viewed as essential for fair elections. Tsvangirai says ZANU-PF party has rigged three major elections since 2000, a charge Mugabe denies. The government's own view of the economy is upbeat. The state-controlled Herald daily said on Wednesday industry's capacity utilisation fell more than 50 percent and Gross Domestic Product shrunk by 35 percent over the past seven years. "These negatives could soon begin to fizzle out if spirited efforts to resuscitate the economy are sustained," it said. Lovemore Madhuku, chairman of political pressure group National Constitutional Assembly, said while Tsvangirai appeared to have the numbers on his side, his real challenge would be to capitalise on the growing national frustration. "If the whole democratic movement comes together, and it looks like that is beginning to happen, I see this programme of mass action getting off (the ground)," he said. Tsvangirai to unveil mass action programme Zim Online Thu 13 April 2006 HARARE - Zimbabwe opposition leader Morgan Tsvangirai is next week expected to unveil his Movement for Democratic Change (MDC) party's timetable for mass anti-government protests to more than 100 civic society allies, insiders told ZimOnline on Wednesday. Tsvangirai has in the past two weeks visited Zimbabwe's main cities to rally supporters for mass protests, defying a stern warning by President Robert Mugabe that he was "dicing with death" by attempting to instigate revolt against the government. But the opposition leader has not said when exactly the protests will take place only saying it will be this winter. Insiders said Tsvangirai will spell out his party's "programme of action" at a meeting with representatives of 130 civic society groups dubbed, the all stakeholders' conference and to be held in the southern city of Masvingo on April 20. "Mr Tsvangirai will table the roll out programme (for protests) at the all stakeholders' conference in Masvingo next week," said a senior official of Tsvangirai's faction of the MDC, considered the main wing of the divided opposition party. The official would not be drawn to give out details of the protest programme before next week's conference. MDC spokesman Nelson Chamisa confirmed the party will meet its civic society allies next week to discuss mass action. Chamisa said: "We will use the all stakeholders meeting to fashion out our way forward on dismantling Mugabe's dictatorship. We have to appraise our allies, and with them launch the drive to free this country. The meeting was supposed to be held two weeks ago but had to be postponed as we refined our strategies." The meeting will be convened by the National Constitutional Assembly (NCA) pro-democracy civic alliance. Church organisations, human and civic rights groups, lawyers, the student and labour movements are among some of the groups expected to attend the meeting. A NCA official Earnest Mudzengi confirmed the meeting, adding that civic society groups wanted to complement efforts by Tsvangirai and the MDC to mobilise Zimbabweans to force Mugabe and his ruling ZANU PF party to embrace democracy. He said: "As civic groups we are going to play a complementary role to the MDC's democratic resistance programme because we are fighting for the same values. Masvingo will be the launch pad for the resistance programme." Tsvangirai, who says the MDC has lost faith in elections as a democratic tool to change the government because Mugabe always rigs polls, has vowed to call mass anti-government protests to force the government to accept a new and democratic constitution that would ensure free and fair polls. But the government, which has in the past deployed anti-riot police and the military to crush street protests, has strongly cautioned Tsvangirai that it will not allow him to instigate an uprising against it, warning the MDC leader that mass action could lead to bloodshed and that he himself could be "physically eliminated". Political analysts say the MDC that enjoys strong support in urban areas is best placed to organise streets protests against the government. But they also caution that the opposition party is at the moment too weakened to confront the government and its army in the streets after it split into two rival political parties last year. Besides the Tsvangirai-led MDC - that is widely seen as the main rival to Mugabe and ZANU PF - there is another faction of the opposition party that is led by former student activist Arthur Mutambara. - ZimOnline White farmers seek solution to land reform impasse HARARE - Zimbabwe's white farmers have initiated dialogue with the government in a bid to improve frosty relations between the two and to seek a solution to the impasse over the land reform programme, ZimOnline has learnt. Authoritative government sources said Commercial Farmers Union (CFU) president Doug Taylor-Freeme and other union officials met with Agriculture Minister Joseph Made and Lands, Land Reform and Resettlement Minister Didymus Mutasa in the past two weeks. "The farmers want a normalisation of the situation in agriculture and want to re-establish cordial relations with the government," said a senior official from the Ministry of Agriculture. He said both parties agreed to work together to mend bridges destroyed soon after the government embarked on its land reform programme that saw more than 4 500 white farmers losing their properties. The government has accused the CFU of supporting the opposition Movement for Democratic Change and of pushing for economic sanctions imposed by the West on senior ruling ZANU PF officials. The CFU confirmed the meetings in a statement posted on its website last week and said both Made and Mutasa had made "encouraging remarks regarding the ongoing issues of offer letters, disturbances on farms and creating an environment to enhance agricultural production." "This last week has seen both the president and vice president having several meetings with four different ministers and permanent secretaries of certain ministries," said the CFU. Zimbabwe has witnessed a free-fall in agricultural output since 2000, a situation largely blamed on the government's programme of compulsorily acquiring land from white farmers and redistributing it to landless blacks. The impasse between the government and white farmers has sucked in other countries, with the West siding with the commercial farmers and mainly African governments supporting Zimbabwe. - ZimOnline Mutambara warns Mugabe of a revolution HARARE - The leader of a faction of the opposition Movement for Democratic Change (MDC) party Arthur Mutambara has warned President Robert Mugabe he is sawing the seeds of a revolution if he does not abandon his autocratic rule. Mutambara, chosen last February to head the faction that broke ranks with MDC founder Morgan Tsvangirai last October after disagreeing on how to unseat Mugabe, appeared to endorse Tsvangirai's calls for mass revolt, saying he and his group were not afraid to "engage in confrontation" against the government. "We are saying to Mugabe change the way you are doing things, if you don't change immediately, you are creating a revolution and we are presenting ourselves as leaders of this revolution," Mutambara told about 200 supporters at Mount Pleasant hall near the University of Zimbabwe (UZ) in Harare on Tuesday night. He added: "We are not afraid to engage in confrontation through democratic resistance. If jambanja (protests) does not work we have other plans, Plan B, Plan C, Plan D and so on and so forth." Tsvangirai has held rallies in major cities urging Zimbabweans to brace up for a winter of protests to force Mugabe to give up power to a transitional government to be tasked to lead the writing of a new constitution and organise fresh elections. Mugabe, who has in the past sent in soldiers and the police to crush protests by MDC supporters, has warned he will not allow the opposition to foment a popular uprising against his government. Mutambara, a popular student leader in the 80s, also used the meeting to lambast civic society groups he said were partisan, clearly referring to the groups' apparent backing of Tsvangirai. He said: "The National Constitutional Assembly, Zimbabwe Congress of Trade Unions, Zimbabwe National Students Union and other civic society groupings such as the churches are partisan. If you are partisan we will be forced to form parallel structures." Mutambara, an American-trained professor of robotics, also touted himself as the best qualified to run Zimbabwe. "I am the only one with the capacity to rule this country. Ask Tsvangirai, ask Jonathan Moyo (former government information minister), ask Daniel Shumba (former Mugabe associate) if they have the capacity. I am capable of ruling this country. I am the champion of the people's project," said Mutambara to cheering from his supporters, many of them apparently UZ students. - ZimOnline Govt denies militarising state, goal is economic rescue [ This report does not necessarily reflect the views of the United Nations] JOHANNESBURG, 12 Apr 2006 (IRIN) - The Zimbabwean government has defended using security and intelligence personnel to oversee the revival of the economy, described as the fastest shrinking in the world outside of a war Last month local media reported that a new economic and food security revival body, known as the Zimbabwe National Security Council (ZNSC), which includes officials from the Central Intelligence Organisation, the army, police, prison services and the Registrar-General's office, had been set up to oversee and enhance the capacity of ministries. "There is nothing sinister with involving security force personnel in areas like the economy and food security: the government is doing what is best for Zimbabwe. Any complaints to the contrary are only meant to rubbish a genuine economic revival and food security programme," Obert Mpofu, the minister of industry and international trade, told IRIN. Henri Boschoff, a military analyst at the Institute for Security Studies, an African think-tank, said the Zimbabwean government's decision to involve the security services in governance was two-pronged. "It helps to stem any chance of a revolt from within its ranks by taking control and keeping those in authority informed, but the security forces with their trained personnel will also provide much needed leadership and management capacity to drive each sector." The ZNSC, headed by President Robert Mugabe, is a key component of a National Economic Development Priority Plan, comprising sub-committees responsible for various issues such as mobilising foreign exchange and tourism, restructuring public enterprises, and managing local authorities and food security, according to the Zimbabwe Independent, a privately owned Zimbabwe has been grappling with food shortages for the past four years, mainly due to erratic weather conditions and the impact of the chaotic fast-track land reform programme on the agricultural sector. A current inflation rate of more than 900 percent is proving a considerable hurdle, while the lack of foreign currency has affected the country's capacity to import even basic requirements such as fuel, fertiliser and The sub-committee responsible for mobilising foreign exchange has reportedly been asked to raise a minimum of US $2.5 billion in three months, beginning from March. Contrary to popular opinion that the flurry of stopgap measures indicated a slide into total economic collapse, the sub-committees would enable government to stay in touch with all the key sectors of the economy, said Mpofu. He denied there had been a militarisation of basic government Didymus Mutasa, minister of national security, said the deployment of security personnel to civilian ministries was to ensure that "things move"; the government needed to closely monitor the performance of all sectors of the economy to ensure that the goal of recovery was met. Troubled Air Zimbabwe Announces Turnaround Strategy By Tendai Maphosa Air Zimbabwe, the failing national carrier, is to restructure its operations in a bid to regain viability. The plan announced by Air Zimbabwe chairman Mike Bimha will see the airline split into five strategic business units to ensure better performance. It will also lay off 30 percent of the airline's employees. Bimha is quoted in the state-controlled daily, The Herald, as saying staff levels had remained the same against the backdrop of a shrinking fleet and huge losses. He attributed he losses to a drastic drop in the number of passengers flying Air Zimbabwe. But last week the newspaper quoted the airline's acting chief executive officer Oscar Madombwe as saying in 2005 it ferried less than a quarter of the million passengers who used it in 1999. Air Zimbabwe's passenger fleet has dropped from more than 20 aircraft in the 1980s to less than 10. In the past few years the airline has had cash flow problems that have seen it temporarily suspended by the International Air Transport Association for non-payment of dues. Last November, the airline ran out of jet fuel and failed to service its routes. The fuel problem persists and sometimes aircraft have to fly via Lilongwe in Malawi to refuel. Airline CEO Madombwe said this is expensive. He also blamed the negative publicity about the political and economic situation in the country and the shortage of hard currency to buy equipment and new planes. Madombwe said there is a perception that because the airlines planes are old, they are unsafe. Some of Air Zimbabwe's planes are more than 30 years old. Madombwe pointed out that Air Zimbabwe has an excellent safety record. He said the fact it was not on the list of 93 airlines banned from European Union air space for safety reasons earlier this year confirms it is a safe airline. But a regular Air Zimbabwe flier, speaking to VOA on condition of anonymity said delays and cancellations with little or no notice, rather than safety is the problem with the airline. He said while these problems also happened with other airlines, Air Zimbabwe has shown a certain disregard for its passengers. UK wins appeal against deportations to Zim April 12 2006 at 06:32PM London - Britain's Court of Appeal overturned a decision Wednesday that prevented failed Zimbabwean asylum seekers from being deported to their home country, which has been wracked by political violence for years. Home Secretary Charles Clarke, the country's top immigration official, welcomed the decision but said the government wouldn't deport any Zimbabweans until an immigration tribunal had ruled on two sample cases. "We have always argued that decisions on asylum claims should be based on their individual merits and the court's judgment is consistent with that approach," Clarke said. Wednesday's ruling said the Asylum and Immigration Tribunal had "erred in law" in October when it barred deportations to Zimbabwe. The judges said the cases of two Zimbabweans should go back to the immigration tribunal for reconsideration. "I cannot emphasise strongly enough that we would not enforce the return of a failed asylum seeker to Zimbabwe if we believed that they were at real risk of mistreatment," Clarke said. Zimbabwe's economy has been in free fall since President Robert Mugabe's government began seizing thousands of white-owned commercial farms for redistribution to blacks in 2000, disrupting the agriculture-based economy and leading to acute shortages of food, gasoline and essential imports. Inflation has soared to 782 percent in the past year. More than 15 000 Zimbabweans fled to Britain between 2000 and 2004. Many asylum seekers say their lives would be in danger if they returned. The government has agreed to defer the deportation of any failed Zimbabwean asylum seekers until the case was settled. - Sapa-AP Government must ensure the safety of those returned to Zimbabwe can be monitored conservatives.com Commenting after the Home Office successfully appealed against a court ruling which prevented it from deporting failed asylum seekers to Zimbabwe, Shadow Home Secretary, David Davis, said: "The reason for this whole court case is the abject failure of the Government's policy on Zimbabwe, with its dreadful consequences for the citizens of Zimbabwe and their opposition to the Mugabe regime. "Last year we called for the Government to put in place a rigorous method of monitoring the continuing safety of those returned to Zimbabwe. The Government must now show they have done this and not simply wasted the past few months. Otherwise, we will not know the fate of the people sent back and what the Mugabe regime does to them." Rt Hon David Davis MP Facing up to an uncertain future As the home secretary wins an appeal against a ruling which prevented failed Zimbabwean asylum-seekers from being deported, some of those affected tell the BBC News website of their concerns over the judgement. NOBLE SIBANDA, POLITICAL ACTIVIST I'm afraid if I was sent back to Zimbabwe I would face a lot of difficulties since I'm a political activist and the government of Robert Mugabe does not take kindly to political opposition. I was a youth activist for the opposition and we used to rally the youth and distribute flyers and mobilise people. I was kidnapped by the regime's agents, tortured and beaten, electrocuted, it was a horrible time I had so I know what they are capable of doing. So I would be in great danger because as soon as I arrived I would be taken from the airport by the security services and goodness knows what would happen. But the result would be grave, we are talking about death here. Most of my family back home have disappeared or died. I don't think it's going to be safe to go back until there's a change of government. LUCIA, FORMER SECRETARY If I had to go back to Zimbabwe I would be killed just for having claimed asylum in a foreign country, which is not allowed by the regime. I think sending people back to Zimbabwe is a error of judgement on the part of the government, they should consider our cases and grant us asylum. In Zimbabwe I was a secretary but I fell out with the government. Most of my family have had to flee the country, some are in South Africa, some in America and some in the UK. I think it's too dangerous for people to be sent back, I think there would be suicides or people going into hiding. HARRIS NYATSANZA, UNITED NETWORK OF DETAINED ZIMBABWEANS I'm involved in a group which helps Zimbabweans in detention centres and fights for them to be released into their communities. The High Court decision is sad for us because we thought we would finally have a decision and an end to this whole case. I think it just throws people back into an uncertain state as to what is going to happen with their case. Right now this case is going back to the tribunal and possibly back to the court of appeal and then the House of Lords, this could take a couple of years. In the meantime people will remain destitute. We have people who are living on the streets, because they cannot get any support from the state. I think the politicians need to bold and take a decision. Everyone is agreed the situation in Zimbabwe is grim. Politicians agreed the situation was grim in Iraq, it's the same thing in Zimbabwe and we need a resolution. So I would call on the politicians to reconsider their position on Zimbabwe and grant some relief to Zimbabweans. Zim Must Learn Chinese The Herald (Harare) Posted to the web April 12, 2006 Sifelani Tsiko FOR a long time as Zimbabweans we had become accustomed to thinking that speaking and writing English was sufficient for all our needs. This had also crippled us into believing that we could not learn any other language besides English. Early this year, talk about plans to introduce Chinese into the country's education system was met with resistance. I was also sceptical about learning Chinese, joining the bandwagon of people with a stunted view of the world. But travelling is seeing. When I was in Beijing recently, I realised the importance of learning a foreign language. I was mistaken to think that English as influential as it was, is spoken in every corner of the world. In Beijing, the Chinese speak in their native tongue. My failure to understand Chinese created barriers. I couldn't enjoy the experience of being in China until I met a young Zimbabwean who was fluent in Chinese. Her language skills made a difference for me and made my stay in Beijing enjoyable. Linguists say a traveller who knows the language of the country not only has an easier time solving everyday problems associated with travel, but also has a more pleasant experience and greater understanding both of the people of a foreign country and their culture. During my stay in Beijing, I realised that many business, political and educational leaders are belatedly realising that the whole world does not speak English. Whilst critics in Zimbabwe deride policies aimed at promoting the learning of Chinese, their Western counterparts -- the owners of the same English we boast about -- are busy opening up universities and other institutions to promote the learning of and understanding of Chinese Western universities are fighting for the Chinese educational market, to help prepare their own people as well as Chinese students for a role in a multilingual global society. Zimbabweans must be encouraged to learn Chinese, not by making it compulsory, but by communicating the benefits that go with it. Zimbabweans do not live in isolation. They have to take their rightful place in this ever-changing interdependent w orld in which diverse cultural and linguistic groups converge. The Chinese prefer to converse, to do business and to negotiate in their native tongue. And by learning Chinese, Zimbabweans can develop the tools for dealing with various types of survival challenges, technical skills, interpersonal exchanges and to clinch better business deals with their counterparts. It also leads to an expanded awareness of the need to conduct not only business, but also diplomatic relations in the language of the host country. Growing joint university programmes between Chinese and Western institutions combine global and local approaches to learning, something that if adopted here can help open up opportunities for young Zimbabweans who are increasingly becoming mobile. There is a growing desire among the young generation to travel abroad and learning Chinese can help them prepare for future opportunities. Western countries are "looking East" in a big way as a result of increased activities in international business and the inflow of huge amounts of foreign capital into China. In the United States, there is a new foreign language policy that has now seen the Chinese language being taught at primary, high school and university level. It aims to prepare students to take up business opportunities in one of the world's fastest growing economies. The Americans now see sense in learning Chinese after years of mistrust and a stunted anti-communist world view. Zimbabwe must also take up the challenge to promote joint university programmes between itself and China to prepare our young scholars for the future. Given the giant economic strides registered in China, there is no doubt that this giant Asian country will continue to play a prominent role in world affairs. This role demands that Zimbabweans be able to understand the language and culture of the Chinese to promote business and other bilateral relations. Learning a foreign language, of course, takes time and shoul d be started at an early stage. And moves by Old Windsor Primary School to introduce Chinese are laudable and can open the doors for young Zimbabweans to the future. We should not discourage but interest students about learning Chinese in much the same way as we interest them to learn English, French, Afrikaans, Spanish and Portuguese. Learning foreign languages will also help to build our corps of foreign language translators and interpreters. Other students can even open up language translation businesses in future. China is prepared to fund programmes that promote the learning of Chinese. Conversely, China is also benefiting from a small but growing army of Zimbabwean English language teachers who are going to China to teach English at a number of institutions in the giant Asian nation. These Zimbabweans are now mastering Chinese while at the same time using their skills to teach the English language to the Chinese. And, I believe every language Zimbabweans master will en hance their enjoyment and reduce their frustration and isolation as they travel around UNICEF: 1 in 3 Zimbabwe children an orphan Wednesday, April 12, 2006; Posted: 8:39 a.m. EDT (12:39 GMT) HARARE, Zimbabwe (AP) -- The U.N. Children's Fund is embarking on an ambitious program to improve the care, health, education and nutrition of vulnerable children in Zimbabwe, where one child dies of AIDS and another is orphaned every 20 minutes. In a statement Wednesday, UNICEF said it had received a British donation of 22 million pounds ($38.4 million) to help children facing some of the worst hardships anywhere in the world, given the extent of the economic crisis. The British donation will also go toward increasing school enrollments for affected children and family and community support programs as part of Zimbabwe's National Plan of Action, which enjoys government backing. "Almost one in three children in Zimbabwe, 1.6 million, are now orphaned, having lost at least one parent, and this number is growing," UNICEF Executive Director Ann M. Veneman said in the statement. "HIV and AIDS have dramatically increased children's vulnerability in recent years." UNICEF said a child is orphaned and one dies of AIDS every 20 minutes; three infants are infected with the AIDS virus every hour, mainly from their mothers; and one in eight children now die before the age of 5, compared to one in 13 children 15 years ago. At least 3,000 people die every week in Zimbabwe from AIDS-related causes. The AIDS epidemic has lowered average life expectancy to below 40, from 69 after independence in 1980. UNICEF said, however, despite the country's economic collapse Zimbabweans still continued to lead by example in their care for vulnerable children. More than 90 percent of orphans were absorbed into extended families, sometimes even distant relatives. Two in five households in the poorest rural areas took in orphans and the vulnerable, adding to their burden of economic hardship. Less than half of these households received any form of aid or support in the past year, UNICEF said. In November, UNAIDS reported a decline in Zimbabwe in infection from 26 percent to 21 percent of the population. But it acknowledged that collecting accurate data on the rate of infection in the 12.5 million traditionally polygamous population was hindered by poor responses in research surveys and a common stigma associated with HIV infection in Africa. With spiraling inflation, up to 913 percent last month, collapsing health services and acute shortages of food, gasoline and medicines in Zimbabwe, more AIDS-related illnesses are being nursed at home and many burials in rural areas go unrecorded. Zim says aid agencies must stop crop forecasts Mail and Guardian Harare, Zimbabwe Zimbabwe's government has said aid agencies do not have permission to compile food production forecasts after some organisations projected the country faced a huge grain deficit, local reports said on Agriculture Minister Joseph Made complained that aid organisations were conducting "backdoor assessment exercises" and urged rural communities not to cooperate with the studies, the state-run Herald newspaper reported. Zimbabwe has been plagued by meagre harvests since the government began implementing a controversial land reform programme in 2000, and the authorities are keen for this year's growing season to be a success. But recent reports have suggested Zimbabwe's food woes are far from over. According to some reports, a harvest of only around 700 000 tonnes of the staple maize is expected this year, falling far short of the country's annual requirements of 1,8-million tonnes of the crop. Made also said the state's Agriculture and Rural Extension Services should "stop giving speculative reports" on crop yields, the paper reported. The minister said only a new committee that will operate under the stewardship of the Central Statistics Office had the mandate to carry out such assessments, the paper reported. - Sapa-DPA Makwavarara acquires council house for $780m From The Herald, 12 April Herald Reporter Harare City Council has sold its commission chairperson Ms Sekesayi Makwavarara a plush seven-roomed house in the upmarket Highlands suburb for a paltry $780 million - less than 5 percent of what similar properties in the area are fetching. The house is on 4 068 square metres of land and that plot alone, without any development, could be sold for around $8 billion. The council could have sold the property - which has a three-bedroomed house and a workers' cottage - for close to $20 billion even if a bit of work was needed on the main house and garden. The price was fixed in a municipal valuation done last month and questions are already being asked about how the value was arrived at. Some commissioners are reportedly most unhappy with the sale and want the house revalued to reflect proper market prices. Ms Makwavarara stays in the mayoral mansion in the equally plush Gunhill suburb and has at least 11 domestic workers there - all paid for by the council. She owns another property in Mabvuku, which she deserted two years ago after rowdy MDC youths attacked the house after she quit the opposition party. Ms Makwavarara elbowed out the then chief legal officer Mrs Ottilia Dangwa, who is now the acting chamber secretary, from the Highlands property after the latter allegedly refused to occupy two other houses identified for her in Belvedere and Eastlea. The house has been refurbished at a cost of about $500 million and council sources say Mrs Dangwa was also interested in buying the property in line with council's policy to avail decent accommodation to senior managers as an incentive to retain them. Ms Makwavarara has not stayed in the house as she moved from a council-rented house in Gunhill to the mayoral mansion in the same suburb. The physical address of the property sold by the council to Ms Makwavarara is given as 19 Nigel Lane in Reitfontein, which is a part of Highlands. It is described as an institutional residential property being sold to the commission chairperson as the occupying tenant. "That the property be sold to the sitting tenant, being Her Honour Ms Sekesayi Makwavarara, at the price recorded in the valuation report and in terms of council resolution which authorised the sale of stands to senior officials and commissioners," reads a recommendation by officials to the finance committee. A valuation of the property was done last July but a formal recommendation to sell the house was only made on March 14 this year. Council recently adopted a resolution to charge interest on all land sales between fixing the price and getting the purchase price as a measure to curb the loss of money due to inflation. The house has three bedrooms with built-in cupboards, a lounge with French door leading to the veranda, dining room, bathroom with ceramic tub and wash basin and built-in cupboards, kitchen featuring single bowl stainless steel draining sink with built-in cupboards which are under overhead built-in cupboards. There is a passage leading to the bedrooms, toilets and bathroom and veranda under lean-to translucent roof sheets supported on round steel pipes with slasto floors. The property has two-bedroomed staff quarters with a kitchen area and toilet. It also has a storeroom and carport. Although some commissioners are not happy with the move, a full commission meeting recently resolved to seek authority from the Minister of Local Government, Public Works and Urban Development, Cde Ignatius Chombo, to be given residential, industrial and commercial stands despite the fact that most of them already own residential and commercial properties in the city. MDC-UK Demonstration FROM THE ZIMBABWE VIGIL The MDC-UK has asked the Zimbabwe Vigil to host a demonstration this Saturday (15th April). The protest is to mark Zimbabwe Independence Day (18th April) and to show solidarity with the big MDC rallies taking place in Zimbabwe. We are also showing solidarity with other MDC districts in the Diaspora including MDC Canada Province who are holding a demonstration on the same day. The demo in London will be held outside the Zimbabwe Embassy, London, at the usual Vigil time of 2 - 6 pm. - Please come and support us. - Bring posters and banners. Please pass this on by text to 5 other people so we can make sure people turn out in their numbers. Vigil Co-ordinators The Vigil, outside the Zimbabwe Embassy, 429 Strand, London, takes place every Saturday from 14.00 to 18.00 to protest against gross violations of human rights by the current regime in Zimbabwe. The Vigil which started in October 2002 will continue until internationally-monitored, free and fair elections are held in Zimbabwe. http://www.zimvigil.co.uk MDC Mutambara Faction Hit by Defection, More Expected By Blessing Zulu, Chinedu Offor & Irwin Chifera Washington & Harare The faction of Zimbabwe's opposition Movement for Democratic Change led by Arthur Mutambara took a blow Tuesday with the resignation of its director for elections and parliamentary whip, Blessing Chebundo, member for Kwekwe in the Midlands. Chebundo said he has rejoined the MDC faction led by its founding president, Morgan Tsvangirai, under pressure from his constituents. More defections are said to be in the works as Mutambara faction members grow discouraged at their president's seeming inability to drum up popular support even as Tsvangirai rallies draw thousands. The faction now led by Mutambara emerged late last year after a group considered to be led by Welshman Ncube, former secretary general of the pre-split MDC, broke with Tsvangirai over whether to contest November 2005 senate elections. Tsvangirai was adamant that the party should boycott elections for a senate brought into being under ruling party constitutional amendments. The pro-senate faction won seven seats. Mutambara, a student leader and associate of Tsvangirai in the 1970s, was recruited by the so-called pro-senate faction earlier this year amid high expectations. But since the rival factions held their respective congresses in February-March, Tsvangirai has consistently drawn larger crowds and generated enthusiasm among his grass roots followers by calling for protests and civil disobedience to topple the ruling party. Chebundo was the second high-profile Mutambara faction member to cross the floor, following Binga parliamentarian Joel Gabuza, who joined the Tsvangirai camp during its March congress and reclaimed his post as spokesman on environmental issues. Reporter Blessing Zulu of VOA's Studio 7 for Zimbabwe asked Chebundo to explain why he decided to rejoin the Tsvangirai column of the opposition. Meanwhile, a senior official of the Mutambara faction said Chebundo's decision came as disappointment, attributing it to heavy pressure from the rival faction to jump ship. Priscilla Misahairambwi-Mushonga, who is deputy secretary general of the Mutambara faction, told Studio 7 reporter Chinedu Offor that other members of her camp have been coming under similar pressure and what she described as "intimidation." Despite Chebundo's resignation and reports of more defections to come, Mutambara seemed determined Tuesday to continue with his efforts to build a popular base, addressing a political meeting at the University of Zimbabwe. Reporter Offor spoke with Studio 7 Harare correspondent Irwin Chifera who said that the onetime student activist's speech drew only a few hundred Sent: Wednesday, April 12, 2006 8:36 AM Subject: Resignations Dear SG, Kindly be advised that the following people have with immediate effect ceased to be members of the MDC Led by Professor Mutambara. Silence Chihuri, Givemore Chindawi, Frank Mamvura, Ignacio Mushoperi, and Nyasha Munjoma. We have come to the conclusion that our aspirations and contributions to the Zimbabwean political process will not be realised by our affiliation to that grouping. We will no longer act, speak, or engage in any activity on the supposed behalf of that group. We have notified our colleagues accordingly. We wish you well in your endearvours to enhance the democratic process in Zimbabwe. Silence Chihuri MDC (Tsvangirai) has People's Mandate Sent: Wednesday, April 12, 2006 6:22 PM Subject: Editorial in changezimbbwe.com for posting A new constitution and UN supervised elections - this is the crystallisation of what needs to happen in Zimbabwe now to get the country out of crisis. MDC supporters in Chitungwiza and Bulawayo have given the party the mandate to carry the hopes of the nation to their final conclusion, with or without the Mutambara faction. The Chitungwiza and Bulawayo rallies - after successful ones at Gweru and Masvingo speak for themselves that the MDC led by President Tsvangirai and the Liberation Team, should now deliver. The people have defied threats and intimidation to attend rallies where everybody who is anybody was present, which means MDC is now the people and the people are MDC. The only thing that the Mutambara factionalists can do is offer their support or miss the boat. President Tsvangirai told the more than 20 000 people at Huruyadzo Shopping Centre in St Mary's, Chitungwiza, and 16 000 people at White City Stadium that all democratic forces should unite in fighting tyranny and building a new and democratic society. He was being very magnanimous, bending backwards to bring into the coalition people who have shown treachery and disloyalty. It is about time the students, workers, religious and civic groups took a stand with the only party that has the potential. The rebels can remain in political oblivion if they so wish. Blessing Chebundo, who has resigned as the group's elections director and chief whip, has seen the light. Many more should follow. A new Constitution has already been demanded by the people in a referendum in 2002, but the government has refused to accept this - so now people have the right to demand it together with fresh elections supervised by the United Nations and international observers. Surely this is not too much to ask. By sheer numbers and with the MDC's commitment to non-violent action, the change can be achieved without any shots fired - the people just have to show that they are united. If their provocation agents can be neutralised by being ignored, so that no violence breaks out, then the people's army, the Zimbabwe National Army will not have any reason to intervene. As President Tsvangirai said the crisis in Zimbabwe cannot not be wished away, but it will not go away either. Mugabe is now forced to face reality, that it is the people of Zimbabwe who don't want him anymore - not Tony Blair. President Tsvangirai: The solution to the country's multi-layered crisis lies in Zimbabwe and nowhere else! Together with his secretary general, Comrade Tendai Biti and Vice-President Thokozani Khupe President Tsvangirai has already given the Mugabe regime notice to start preparing to move out - it is up to them whether they move out with dignity or wait to be pushed out - which Zimbabweans are now ready to do. There is definitely a cause to be euphoric, because efforts at weakening the MDC by dividing it have failed and once again the party is moving with the people who are more resolute that they do not care what happens - the Mugabe government must go. The Mutambara factor New Zimbabwe By Bekithemba Mhlanga IT IS difficult to ignore the Arthur Mutambara effect. It's all over the place and forcing people, organisations, men, women and children to take positions about Zimbabwe. Everyone senses that this time around, something could just happen. A few months ago Mutamabara's entry onto the political scene was being derided as some desperate move by an ethnic clique wanting to establish some sort of national colour by having a Shona leader. All this now sounds like claptrap in the light of what is happening in Take Morgan Tsvangirai, for instance. When the whole of Zimbabwe was urging him to lead them out of the hell that the country has become, he flatly said he was no martyr and would not embark on a silly exercise of such folly. It was refreshing then to learn that all this has changed and that he is now ready to be interred kumbudzi for the sake of a free Zimbabwe. I am sure Susan Tsvangirai will have something to say about this seeing that the cake she once fashioned as Zimbabwe House for her better half never saw the day of light in Chancellor Avenue. Not much has changed to convince me that Tsvangirai is simply not reacting to the Mutambara effect in his grandstanding. What he needs now is to stop speaking in tongues and tell people what he expects them to be talking about to each other in bars, shops, schools or even soccer matches. Don't leave them to their imagination Morgan - leadership is about action and not position! And surely no one would have missed the energy around Nelson Chamisa. The spokesperson has never been more enterprising. He can be at a rally without being there! He counts more accurately than anybody else and therefore is in a better position to tell us how many people attended the Tsvangirai rallies at any one time. He has even mastered the art of swearing at all and sundry in public without flinching a muscle - a preserve that once belonged Zanu PF. His combative mood leaves you in no doubt that the he is a man on a mission. The question only is which mission? Is it to deflate the Mutambara crusade or to mobilise against the Mugabe charade? Its not in dispute that this is not the Chamisa we knew before Mutambara came round . The Mutambara factor is all over the place, even in Zanu PF. The succession debate is said to have reached a crescendo within Zanu PF. Didymus Mutasa is not speaking to Shamuyarira, we are told. Gideon Gono has a public spat with Murerwa, say reports. Everyone feels that the stakes have been raised so much now and that anytime in the not too distant future, the power balance will shift and no one is prepared to see the future happening without them. One cannot ignore it in other areas. The other day we had Reverend Obadiah Msindo's position raising all sorts of well founded noises within the women's groups and the next we knew the poor chap had been arraigned before the courts facing rape charges. He belonged to the untouchables a few months Oh! and there is that sorry musician who made a name for himself by likening Tony Blair to an ablution facility. Now he has been kicked out of a property that never was his. A few years ago Deputy Minister Kasukuwere gave this man a whole splosh of Wonga so that he could continue his tirade at a concert about Tony Blair. He must now know that he has been flushed down the pits. Now that is a real toilet my friend! How things have changed. As any first year political science student will tell you, those in power simple do not hand it over. It must be wrested from them, and in a democracy, this happens peacefully. In dictatorship there is no guarantee that this happens peacefully as well. Now we await the Mutambara effect on this turf. Bekithemba Mhlanga is a Zimbabwean journalist based in London. He can be contacted at: bekithemba68@yahoo.com Bleak future for children with a double burden From IPS, 4 April Vusa Nyathi Harare - The child squirms drowsily as it struggles to roll over on the bunk bed, eventually succumbing to sleep. The skin on its face is too taught. Wisps of hair look as if they could fall out at any minute. "He is just from his daily ARVs (anti-retroviral drugs)," says the woman who takes care of him at Fairfield Children's Home, an orphanage in the eastern Zimbabwean city of Mutare, which houses 74 children up to the age of 14. Several of Fairfield's charges are HIV-positive. "We try to accommodate everyone and never discriminate against babies infected with the virus. We take them on board and give them special care," says Peter Mufute, administrative officer of the home. However, the extra needs of children infected with the AIDS virus have placed a heavy financial burden on Fairfield -- and raised questions about whether government is doing enough to care for children who face the double burden of parental loss and HIV. According to the National Aids Council (NAC), a government body, Zimbabwe's orphan population has grown from 345,000 just under a decade ago to some 1.3 million today. About 165,000 of these children are infected with HIV - and the United Nations Children's Fund (UNICEF) estimates that just over 20,000 need ARVs. However, only 2,000 are receiving the life-prolonging medication. "Both national HIV/AIDS plans and poverty reduction strategies (in Zimbabwe and various other nations in sub-Saharan Africa) are stronger on proposed policy actions than on budget allocations and clear statements of targets to be achieved for children, young people and HIV/AIDS," said a December 2004 report by the World Bank and UNICEF, titled 'Poverty Reduction Strategy Papers: Do they matter for young people made vulnerable by HIV/AIDS?'. "The situation of children who have been orphaned or made vulnerable by AIDS receives little attention," added the document. These words are echoed by Festo Kavishe, UNICEF's representative in Zimbabwe. "There remains an urgent need to boost prevention, care and treatment programmes in Zimbabwe, ensuring the rights of orphans, while preventing HIV infection in infants and young children," he said. The plight of HIV-positive orphans reflects the situation in society at large. According to UNICEF, about 1.6 million of the approximately 13 million Zimbabweans have contracted HIV. Just over 340,000 require anti-retroviral treatment, but only a fraction of these persons are on ARVs. "There is still a huge gap between those who need and those under anti-retroviral therapy (ART)," Health and Child Welfare Minister David Parirenyatwa said recently. "By December 2005 only 26,000 were on ARVs. Of these, 20,000 were on government ART programmes, while the remainder were being taken care of by the private sector." Latest figures from the Joint United Nations Programme on HIV/AIDS (UNAIDS) put adult prevalence in Zimbabwe at 24.6 percent. However, the 'AIDS Epidemic Update' for 2005, published by UNAIDS and the World Health Organisation, also notes a drop in HIV prevalence among pregnant women from 26 percent in 2002 to 21 percent in 2004. John Robertsen, an economist based in the capital of Harare, says worsening economic conditions are undermining efforts to address the ARV crisis. "Crushing poverty, high unemployment and low wages have reduced the ability of households to take care of their sick, and this has increased the burden the government has to bear in welfare interventions," he noted. "But the government is currently trying to reduce its welfare expenditures because already it is in a fix with its economy which has the highest inflation rate, the highest unemployment rate and among the highest economic shrinkage (rates) in the world." For several years, Zimbabwe has suffered from acute shortages of foreign exchange, fuel and food -- this in the wake of a controversial programme of farm seizures ostensibly aimed at rectifying racial imbalances in land ownership that dated back to the colonial era. Zimbabwe's involvement in the Democratic Republic of Congo's five-year civil conflict, which ended in 2002, also proved a drain on state coffers. Although Zimbabwe launched a 'National Plan of Action for Orphans and Vulnerable Children' in 2004 in a bid to provide comprehensive care for these children, Parirenyatwa admits that much more needs to be done. "Because a majority of our people are poor we have a big financing problem. The money allocated to us from the budget is too little to do anything much about the orphan crisis," he said. IPS was not able to obtain figures for how much of the national budget is spent on orphans at present. According to Parirenyatwa, however, "The most visible HIV/AIDS support programme run by government is BEAM (Basic Education Assistance Module) which is implemented by the Ministry of Public Service, Labour and Social Welfare in conjunction with the Ministry of Education. It provides school fees, uniforms and supplementary feeding for AIDS orphans." NAC Executive Director Tapiwa Magure says government would like to phase out orphanages in favour of placing orphans in community care. "Our thrust is to discourage institutional care. We are therefore exploring possibilities of facilitating an exit plan for institutionalised children," he noted earlier this year. However, another NAC official who did not wished to be named told IPS that such initiatives seemed ill-advised when incidents of baby dumping, and the proliferation of child-headed households and street children suggested communities were already unable to cope with orphans. "Community-based care may be the best rehabilitative model, but more resources will be needed in terms of mobilising community-led initiatives, paying community outreach workers and government care coordinators," said the official. "In Zimbabwe this is wishful thinking considering that the government is perennially broke. If the government had that money, would we be having orphanages in the first place?" NAC statistics indicate that there are about 60 registered children's homes in Zimbabwe providing care for about 800 children. Zim Piece-Workers Become a Nuisance in Phikwe Mmegi/The Reporter (Gaborone) Onalenna Modikwa Selebi-Phikwe The influx of Zimbabweans to the mining town is becoming an irritant as they roam residential areas continuously knocking on doors looking for piece jobs - sometimes as early as 6a:m. The Zimbabweans, who are mainly female, move from house-to-house in pairs looking for piece jobs ranging from weeding to laundry. Though the plight of Zimbabweans, mostly those without work permits seeking jobs, has occurred in the past, the situation has worsened and has become almost uncontrollable. Their impact has been strongly felt in the locations of Newstance, BCL Residential Area, Western Area and the Mall. Most of them stay in Botshabelo and walk in groups towards the town every morning, where they later disperse in different directions to hunt for work. Even though they are illegal workers, they freely negotiate for piece jobs. At times they even offer services on credit, keep records and round up payments at month end. At lunch time most of them sit in shop corridors and eat their packed meals or buy loaves of bread. Others target women to plait their hair. A Zimbabwean woman, who has been in the business for a year - and declined to be identified - says it is fina ncially rewarding and is easy to give customers service on credit when you know them. "There are those who are trustworthy and those who give us headaches. Sometimes they turn against the agreement we initially made and pay with a plate of food or a less amount than previously agreed." She said she had come across situations where male customers demanded sexual intercourse. "It is disheartening because we did not come here of our own will, but we are driven by the economic situation back home and the fact that we have families to look after," she said. She acknowledged that they are often trading illegally without work permits and said they often lock themselves up in houses when the police and members of Botswana Defence Force are on patrol. A resident of Newstance, Kaelo Moses said the situation causes concern because the Zimbabweans knock on their doors very early and disturb their sleep. He said they negotiate for reasonable prices but keep on reducing until they finally do the laundry at only P10. "They are a complete nuisance, but at times I feel pity and even offer them something to eat." Moses said even though he normally complies with the Zimbabweans' request for piece jobs, he is aware that he is running the risk of being arrested if he is discovered by the police. He stated that at times he sympathises because he understands the current situation in Zimbabwe but said it is now a concern in that they compete with the locals for the small amount of work available and beat the locals with their low prices. "They are really worsening the current poverty situation because they are at every spot where the locals wish to try their luck and they will eventually outnumber us," he said. Another resident, Diketso Batsweleng called on the government to take stern measures to control the influx of Zimbabweans and blamed them for perpetuating the increase in crime. She said the locals had now begun to hide behind the Zimbabweans when committing cr ime, knowing it would be blamed on the Zimbabweans. "There is no sleep nowadays, Zimbabweans knock one after the other and there is no way you can fail to attend to them as they are patient enough to stick around and wait until you wake up. At times you miss very important people when you mistake them for the Zimbabweans and ignore them." Phikwe Police Station Commander Isaiah Makala acknowledged the situation but said the way of controlling the situation is only if Batswana comply with the law and stop employing Zimbabweans without work permits. He said most of the Zimbabweans have got valid passports hence it is difficult to charge them except in a situation where they are found working. "During our stop, question and search operation they produced valid passports so it is not easy to monitor if locals are hiring them behind our backs," Makala said. He disclosed that during the recent operation between the Police and BDF, 16 Batswana; two males and 14 females were charged P1, 000 for employing non-citizens without work permits. He said in most of the cases Zimbabweans were hired to harvest Mophane worms. Ex-Zanu PF Chairman Convicted Of Defamation Zim Daily Wednesday, April 12 2006 @ 12:05 AM BST Contributed by: correspondent The Bulawayo Magistrate Court has found suspended ZANU PF chairman for Matabeleland South Province, Lloyd Siyoka guilty of having criminally defamed Home Affairs minister, Kembo Mohadi. Matabeleland North regional magistrate John Masimba, sitting at the Bulawayo Magistrate Court yesterday convicted Siyoka of having defamed the minister during a meeting with President Robert Mugabe in Bulawayo in 2004. Handing down his judgment, Masimba said he had no reason to doubt that Siyoka said the statements in order to defame the minister as there was no foundation to the said statements. Charges against the former chairman arose at a meeting at Elangeni Training centre in Bulawayo when the ruling ZANU PF party held a meeting for three of its Matabeleland provinces, whose aim, the court understands, was called to iron out all the problems, politically and economically, that had besieged the province. Politburo and central committee members from the three provinces attended the meeting together with some other members of the party from Harare and other areas. It was allegedly at this meeting where Siyoka told President Mugabe that the minister had threatened to shoot him with a gun. Reading from submissions made during the trial, Masimba said that when Siyoka was asked to describe the color of the gun, the former chairman failed to describe the gun, but instead changed goalposts, saying that he was forced to assume that Mohadi wanted to shoot him as he was shivering and very angry. Masimba however ruled that the evidence supplied by the four state witnesses in the trial showed that Siyokamade the statements with a clear intentionof soiling Minister Mohadi`s name and making him appear as a "trigger happy cowboy. "The allegations made against the appelant (Kembo Mohadi) by the respondent (Lloyd Siyoka) are unlawful and sufficiently serious to constitute defamation. The state has been able to prove that the allegations against the appelant are untrue and thus, you are hereby found guilty of crimimal defamation," Masimba said. The sentence in the case is expected to be delivered on the 24th of April when Siyoka re-appears in court. Mining tycoon faces new multimillion blow Basildon Peta April 12 2006 at 11:57AM South African businessman Mzi Khumalo, who was recently ordered by the Zimbabwe High Court to pay another company $7,4-million (about R45-million) in damages, is being sued again. This time a consortium of prominent black Zimbabwean businessmen is seeking damages for breach of contract. They are accusing him of having unfairly ditched them in a business deal. Khumalo's Metallon Corporation is now Zimbabwe's largest gold producer, after having bought the largest mines in the country from their former Canadian and British owners, who decided to pull out of Zimbabwe, citing the poor economic climate. Now it seems the businessman's Zimbabwe investments, which constitute the largest portion of his global gold-mining portfolio, are mired in mounting problems. About two weeks ago, Zimbabwe High Court Judge Yunus Omerjee ordered Khumalo to pay $7,4-million, Zimbabwe's biggest-ever damages claim, to Stanmaker Mining, led by prominent businessman Lloyd Hove. Stanmaker had agreed on a partnership with Khumalo to jointly purchase Independence Gold Mining, which controlled Khumalo's five mines in Zimbabwe. Stanmaker would buy 15 percent equity in Metallon's Zimbabwe operations and would become Khumalo's empowerment partner in Zimbabwe in line with the country's regulations to empower locals. However, Khumalo ditched Hove's Stanmaker Mining in favour of another Zimbabwean group called Manyame Consortium, led by prominent lawyer and businessman Honour Mkushi. However, Mkushi's consortium has now also filed papers at the Zimbabwe High Court alleging that it has fallen into a similar predicament to Stanmaker. Mkushi alleges that Manyame is also being side-stepped by Khumalo who is "acting in bad faith" and wants to control all the shares in Independence Gold Mining. Mkushi's consortium wants the High Court to order Khumalo to comply with their shareholder agreement and allow Manyame to acquire its stake in the mining operations. Khumalo's five mines in Zimbabwe: Acturus, How, Mazowe, Redwing and Shamva, account for more than 50 percent of Zimbabwe's annual gold production. They also represent more than 90 percent of Khumalo's gold-mining Metallon has already hinted that it would appeal against Judge Omerjee's $7,4-million award No comment could be obtained from the company over the latest lawsuit. In the latest application, Mkushi also wants the High Court to order Khumalo to comply with provisions of the Companies Act and to meet all his obligations to his partners in terms of their shareholder agreement. Mkushi alleges that his consortium agreed to acquire a stake in Metallon's mines in 2003, with a payment of $1-million having been agreed to be made within 45 days of the signing of the agreement, and the remaining $8-million to be paid from dividends over some time. However, Khumalo later refused to recognise Manyame as a shareholder in the mines and claimed to have cancelled the agreements. Mkushi insists in his court papers that the agreements are still valid and wants Khumalo to honour his obligations. It seems that if Khumalo's ultimate goal is to retain the ownership of his Zimbabwean operations on his own and side-step indigenous players, then he might run into problems with the Zimbabwe government. It has made it very clear that it wants majority stakes in the country's mines to be owned locally. Metallon is one of the major South African firms which have already protested loudly at draft mining regulations requiring foreign mining conglomerates to cede at least 51 percent equity to the state, largely for The draft regulations have since been withdrawn after the protests, to pave way for more dialogue and new ones are being drafted. This article was originally published on page 6 of The Star on April Zimbabwe's Mhangura copper smelter needs $500 mil to be repaired metalsplace.com Source: Platts Find books on Copper Mining ? Copper Concentrate Board Copper Concentrate Catalog The copper smelter at Mhangura in Zimbabwe, will need a huge cash infusion in order to rehabilitate it and increase its mineral treatment capacity, said an official at the Minerals Marketing Corporation of Zimbabwe. Nhlanhla Mpofu told Platts from Harare, that the smelting plant will need not less than $500 million to rebuild it and increase its mineral treatment capacity. "I am afraid the plant has deteriorated over the years and the cost of repairing it has also gone up," the MMCZ executive official said. He stated that government efforts to have the plant rehabilitated has not yielded positive results because of the harsh economic situation prevailing in the Mpofu said at the time of its closure in the middle of the 1990s there was talk that the plant would be leased to Mwana Africa Holdings of South Africa but this had not happened. "Government is still looking for serious investors who could run the refining and smelting facility," he said. Firm cuts off food supplies to Mpilo By Andnetwork .com A major supplier of patients' food to Mpilo and United Bulawayo Hospitals has cut off grocery supplies to the two hospitals. Sources said Willsgrove Farm Enterprises, which has a tender to provide the two hospitals with food stuffs from its supermarkets and vegetables from its fresh produce farms, stopped delivering food at the end of last month after the two hospitals had accumulated debts. Supplies to Ingutsheni Central Hospital were not affected as the hospital was making efforts to pay its arrears. Food supplies to patients have been erratic since deliveries stopped, a source said, adding it was a matter of time before stocks run out unless the debts are settled and supplies resumed. "The company has suspended all its food supplies to the hospital and will only resume supplies on condition that the hospital clears the hefty amount owing," said a source at Mpilo. He said Mpilo Hospital owed from January but paid some of it off in March 2006, leaving an outstanding amount not paid. "This debt has accumulated since the beginning of the year and failure by the hospital to clear the debt might seriously affect the patients as the hospital will run out of food," he said. A source at Willsgrove Farm Enterprises confirmed that the hospitals owed the company lots of money. When contacted for a comment a manager at Willsgrove who only identified himself as Mr Mutero said the issue was confidential and up to their company and the hospitals to resolve the matter. Efforts to get an official comment from Dr Godwin Gwisai the UBH medical superintendent and his Mpilo counterpart, Dr Lindiwe Mlilo were fruitless as they both referred Chronicle to Health and Child Welfare Permanent secretary Dr Edward Mabhiza, who in turn asked for questions in Last week, Matebele Steam Laundry impounded linen belonging to the two institutions after they failed to settle debts. Source: Zimbabw Chronicle Salaries Gap Continues to Widen Kudzai Chawafambira SALARY disparities continue to widen with top managers now earning more than $500 million while shop floor workers are taking home less than $5 million each month. The disparities in earnings are partly influenced by those with scarce skills that can individually negotiate salaries with management while low-ranking workers depend on collective representation for quarterly or half-yearly salary reviews. Although workers' earnings are influenced by a number of factors that include qualifications, experience and position of influence, trade unions have called for salaries to be automatically adjusted in line inflation to ensure the purchasing power remains stable. Purchasing power for most -- whether professional or self-employed -- oscillated around a mean that allowed most groups, from the very top to the bottom of the economic heap, to maintain a reasonable standard of living. However, since inflation picked an upward momentum around May last year the situation has never been the same. The general cost of living has drastically risen to unprecedented levels leaving millions of families living below the poverty datum line (PDL). Most com pany executives were earning around $30 million this time last year, but because of the high inflation regular reviews have seen salaries rising to the current figures. Middle level managers are now earning half of what chief executives are getting while shopfloor workers have seen only a marginal increase in earnings. The majority of shopfloor workers are getting weekly wages of between $2 million and $4 million. Collective bargaining is currently underway and this is going to push the salaries of those at the top even further up. While inflation is still high at 913 percent the existing disparities are a result of the upward momentum in inflation from almost a year ago. Senior management in the manufacturing, information technology, engineering and financial sectors top the list with executives earning up to $750 million a month. These high salaries are also complemented by attractive perks, which include membership to exclusive social clubs, huge cellphone and fuel allowa nces, and domestic help, among others. There are other benefits, which include car and holiday allowances and school fees for their dependants. This allows their children to attend some of the elite schools and universities abroad. Some of the chief executives also own shares in the companies they run and are entitled to dividends on a regular basis. Others are allowed to dispose a certain percentage of their shares at agreed intervals. However, it is shop floor employees who have lost out due to inflation as their salaries have remained stagnant and have not been aligned to the rate of inflation as is the case with top level managers. Some human resources practitioners said the issue of salaries remained critical in any company's endeavour to recruit the best personnel. "High salaries are a major factor in any company's desire to attract the best person for the job and most firms are prepared to give substantial amounts. "There are a number of reasons why salaries have been shooting up and one of the major reasons has been the high rate of inflation. "Other factors include the brain drain which has seen a reduction in the number of skilled personnel which means there are many companies pursuing few experienced people," said a human resources consultant. He added that some directors of non-governmental organisations were earning much higher salaries than chief executives. This was partly explained by the fact that some of them are paid in hard currency.
cc/2019-30/en_middle_0041.json.gz/line1614245
__label__wiki
0.528709
0.528709
BPG Management System F6Publishing-Submit a Manuscript F6Publishing-世界华人消化杂志在线投稿 BPG is committed to discovery and dissemination of knowledge Full Article (PDF) Full Article (HTML) Similar Articles (34) Article Quality Tracking (0) Citation of this article Gasbarrini G, Candelli M, Graziosetto RG, Coccheri S, Iorio FD, Nappi G. Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation. World J Gastroenterol 2006; 12(16): 2556-2562 Corresponding Author of This Article Professor Giovanni Gasbarrini, MD, Department of Internal Medicine, Catholic University, Gemelli Hospital, Largo A Gemelli 800135, Roma, mcandelli@gmail.com Article-Type of This Article Open-Access Policy of This Article This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Times Cited Counts in Google of This Article Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation Number of Hits and Downloads for This Article Total Article Views (1138) All Articles published online Full Article (PDF) 140 Full Article (Html) 998 Sum=1138 Apr 28, 2006 (publication date) through Jul 19, 2019 Times Cited of This Article Times Cited (10) Journal Information of This Article World Journal of Gastroenterology Publisher of This Article Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved. World J Gastroenterol. Apr 28, 2006; 12(16): 2556-2562 Published online Apr 28, 2006. doi: 10.3748/wjg.v12.i16.2556 Giovanni Gasbarrini, Marcello Candelli, Riccardo Giuseppe Graziosetto, Sergio Coccheri, Ferdinando Di Iorio, Giuseppe Nappi Giovanni Gasbarrini, Marcello Candelli, Riccardo Giuseppe Graziosetto, Department of Internal Medicine, Catholic University of Rome, Italy Sergio Coccheri, Department of Angiology, University of Bologna, Italy Ferdinando Di Iorio, Department of Biomedical Sciences and Technologies, University of L'Aquila Giuseppe Nappi, Department of Thermal Medicine, University of Milan, italy ORCID number: $[AuthorORCIDs] Author contributions: All authors contributed equally to the work. Correspondence to: Professor Giovanni Gasbarrini, MD, Department of Internal Medicine, Catholic University, Gemelli Hospital, Largo A Gemelli 800135, Roma, mcandelli@gmail.com Telephone: +39-06-30155394 Fax: +39-06-35502775 Received: June 1, 2005 Revised: July 2, 2005 Accepted: July 8, 2005 Published online: April 28, 2006 AIM: To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowe syndrome (IBS) accompanying predominant constipation. METHODS: A total of 3 872 patients with functional dyspepsia and 3 609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres. Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy. A questionnare to collect personal data on social and occupational status, family and pathological case history, life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment. Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis. Breath test was performed at basal time and after water supplementaton therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T1/2 and T-lag for octanoic acid breath test and as oro-cecal transit time for lactulose breath test. RESULTS: A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients. The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients. Both T1/2 and T-lag were significantly reduced after the therapy compared to basal values [91 ± 12 (T1/2) and 53 ± 11 (T-lag), Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the beginning of the study. CONCLUSION: Mineral water supplementation treatment for functional dyspepsia or conspipation accompanying IBS can improve gastric acid output and intestinal transit time. Key Words: Mineral water, Constipation, Dispepsia, Thermal therapy Citation: Gasbarrini G, Candelli M, Graziosetto RG, Coccheri S, Iorio FD, Nappi G. Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation. World J Gastroenterol 2006; 12(16): 2556-2562 URL: https://www.wjgnet.com/1007-9327/full/v12/i16/2556.htm DOI: https://dx.doi.org/10.3748/wjg.v12.i16.2556 Functional dyspepsia and irritable bowel syndrome accompanying predominant constipation (IBSc) are two of the most prevalent diseases in the industrialized world. These disturbances are among the first diseases for a gastroenterologic examination with high social and economical costs. In particular, dyspepsia is the first cause of specialized blood and invasive examination in Europe and USA[1]. Dyspepsia may be organic when associated with specific gastrointestinal or liver diseases. To diagnose functional dyspepsia gastroenterologists need specific criteria known as “Roma criteria”[2]. Prevalence of dyspepsia in general population is variable in different studies between 14% and 41%[3-5]. About 65% of dyspeptic patients result from functional dyspepsia[6]. About 35% of patients with functional dyspepsia present a delayed gastric output which is related to clinical symptoms[7,8] or other disturbances of gastrointestinal motility[9,10]. On the contrary, the link between gastric H pylori infection and functional dyspepsia has not been clarified yet[6] because the data on the effect of H pylori eradication on dyspeptic symptoms are discordant[11,12]. Treatment of dyspepsia is based on drugs that inhibit the gastric acid secretion (such as proton pump inhibitors or H2 blocker agents) or drugs that stimulate gastrointestinal motility (prokinetics agents). However, the efficacy of such therapies is often unsatisfactory in particular for the short duration of the improvement of symptoms. It should be underlined that a prolonged treatment with these drugs is related to a high incidence of side effects. Although there is no scientific evidence, several dietetic regimens have been used in combination with drugs by dyspeptic patients. A high enrichment of fibers in diet is the first therapeutic steps for constipation[13]. In fact, a high fiber intake is related to an increased fecal mass in healthy subjects (with high interindividual variability)[14,15]. The efficacy of this treatment seems to be time-related, probably for an intestinal adaptation to the high intake of fibers[16]. IBSc is a chronic functional disorder associated with psychological, environmental, emotional, social factors (drugs, stress, lifestyle)[17]. A reduction of water intake may play an important role in the pathogenesis of constipation and water supplementation is often suggested by a general practitioner in clinical practice to IBSc patients[18,19]. Recently, it has been described that an increased water intake up to 1.5 liters of mineral water is able to increase the effect of a diet with fiber enrichment in patients with constipation[20]. In Europe, especially in Italy, Germany and France, a large number of thermal centers stress on the real role of a treatment with thermal mineral water in functional gastrointestinal diseases. For this reason we need international studies or controlled trial to evaluate the effect of mineral water on functional dyspepsia or IBSc. These studies may allow a medical prescription by physicians and evaluate the socio-economical impact on public health systems of these treatments compared to pharmacological therapies. The efficacy of thermal treatment with mineral water on gastrointestinal diseases[21] remains to be further clarified. This study was to evaluate the economic and health indicators for the assessment of the efficacy of thermal therapies in reducing the health costs. Moreover, the effect of water supplementation therapy on functional dyspepsia and IBSc was also evaluated. A total of 3 872 patients with functional dysepsia and 3 609 patients with IBSc were enrolled in the study from 1999 to 2000 by the medical staff of 18 thermal centres distributed throughout Italy (Bagni di Lucca, Chianciano, Comano, Franciacorta, Pejo e Rabbi, Recoaro, Sangemini, Sant’Andrea Bagni, San Carlo, S. Elena, SanPellegrino, Sarnano, DI Stabia, Vallio, Vulpacchio, Montecatini, Angolo, Boario). Patients with a history of gastrointestinal, liver, pancreatic, gall bladder, neurological, muscular, rheumatological, autoimmunitary and immunological diseses were excluded from the study. Moreover, patients with severe high blood pressure (diastolic>110, systolic>180), cancer, recent surgical resection, and pregnant women were also excluded from the study. All enrolled patients underwent abdominal ultrasonography and fecal occult blood test. Only patients negative in both tests were enrolled in the study and underwent a first cycle of thermal therapy for a standard period (2 000 mL of mineral water for 21 d). Compliance was evaluated by the percentage of empty bottles returned by patients at the end of the cycle. Before the first cycle of thermal therapy was started, an informed consent was obtained from all enrolled subjects. The anamnestic and clinical data were collected by submitting a questionnaire. The questionnaire included approximately 1 400 closed-answer questions (Table 1) for identifying the exposure variables and risk indicator, with special reference to the social-demographic and clinical variables including different sections (personal data, social and occupational status, family and pathological case history, life style, clinical records and social data, also including indicators of the standard living, utilisation of welfare and health structure and devices). According to the first study plan, the patients were re-examined at the same thermal centre one year after the first therapeutic cycle and received a second cycle of thermal treatment. A second follow-up was made after another year. During the follow-up the effect of the treatment was evaluated by assigning a score on side effects, personal opinion of the treatment and overall tolerability of therapy (Table 1). Moreover a retrospective assessment of the clinical follow-up, drug intake and utilisation of welfare and health service between the first and second cycles was carried out. Statistical analysis was performed using Bowker’s symmetry test and ANOVA to compare uncontinuos variables. Table 1 Main items included in the questionnaire. Anagraphic data Blood pressur, heart rate Physical activity1 Disease duration Main symptoms1 Admission to hospital (d)1 Missed work days1 Clinical relapse1 Drugs comsumption12 Igienic-dietary habit1 Personal opinions on therapy2 Reasons of Good opinions on therapy2 Side effects2 1During past 12 mo; 2Evaluation after treatment. Sixty patients (30 females, 30 males, mean age 44±6 years) with functional dyspepsia and 60 healthy controls (30 males, 30 females, the mean age of 41±5 years) were enrolled. All patients underwent upper digestive endoscopy and abdominal ultrasonography to exclude peptic ulcer disease, gastroesophageal reflux disease, liver, pancreatic and gall bladder diseases. Diagnosis of functional dyspepsia was made based on the Roma II criteria. All patients underwent 13C octanoic acid breath test (OBT) and filled in a questionnaire for evaluation of gastrointestinal symptoms (post-prandial fullness, epigastric pain, bloating, heartburn, nausea, vomiting). After OBT, all patients started a diet supplemented with mineral water (2 000 mL of mineral water/d for 3 wk). During the mineral water treatment, patients were controlled with a standardized diet (similar caloric and fiber intake)[20]. Compliance to thermal therapy was evaluated by the number of empty bottles returned at the end of the study (20% or more of full bottles returned were considered as the indicator of in adequate compliance). After 3 wk of mineral water supplementation treatment, the OBT was repeated and a new questionnaire for evaluation of gastrointestinal symptoms was administered. Patients after an overnight fasting had 91 mg of 13-C octanoic acid dissolved in an egg with a standardized meal (50 g ham, 150 mL fruit juice, 100 g white bread and 100 mL water) in 10 min. Breath samples were collected in a test tube before and every 15 min for 4 h after ingestion of the labeled substrate. Analysis of 13C in the breath was performed using a mass spectrometer (Breath Mat; FinniganMat; Bremen, Germany). 0T1/2 and T-lag values were used to express the results after a regression analysis of exhaled air curves. Results were expressed as T1/2 and Tlag. T-test for coupled or uncoupled data was used to compare the difference between groups. Difference in symptoms was evaluated by χ2 test or Fisher’s exact test. P < 0.05 was considered statistically significant. Twenty patients (10 females, 10 males, mean age 41 ± 5 years) with IBSc and 20 sex and age matched healthy controls (10 females, 10 males, mean age 40 ± 7 years) were enrolled. Diagnosis of IBSc was made based on the Roma II criteria. All patients underwent H2-lactulose breath test (LBT) to evaluate the oro-cecal transit time. Then, all patients started a controlled diet with standard fiber and caloric intake supplemented with 2 000 mL of mineral water. After 3 wk the diet was stopped and LBT was performed. All enrolled patients filled in a questionnaire for evaluation of gastrointestinal symptoms (bloating, hard stools, number of evacuations in a week, incomplete evacuation) before and after mineral water supplementation. Compliance to thermal therapy was evaluated by the number of empty bottles returned at the end of the study (20% or more of full bottles returned were considered as the indicator of in adequate compliance). LBT was performed after 20 g of lactulose dissolved in 100 mL of water was administered. Breath samples were collected at basal time and every 15 min for 4 h in a specific test tube after the assumption of lactulose. The presence of hydrogen in the breath samples was evaluated by gascchromatography (Quintron Milwaukee, Wisconsin USA). The oro-cecal transit time was evaluated by curves of hydrogen exhaled during the test. The Student t test for coupled or uncoupled data was used to compare the difference between groups. Difference in symptom prevalence was evaluated by χ2 test or Fisher’s exact test as appropriate. P < 0.05 was considered statistically significant. A totae of 3 872 patients with functional dyspepsia and 3 069 patients with IBSc were enrolled in the first part of the study. After a year 74% and 69.5% came for follow up visit and to perform a second cycle of thermal therapy (Table 2). No difference among different mineral content of water supplemented was observed. Table 2 Patients enrolled and re-evaluated after the first and second cycles of thermal therapy with mineral water. Water Type Pathology 1st yr 2nd yr 3rd yr Bicarbonate 1 667 966 110 Salse 1 282 979 30 Solfate 923 923 24 Total 3 872 2 868 164 IBSc Bicarbonate 1 471 861 59 Figures 1A and 1B show the prevalence of dyspeptic symptoms (epigastric pain and post-prandial fullness) during the two cycles of thermal therapy. A significant reduction in the prevalence of dyspeptic symptoms was observed both at the end of the first and second cycles. In particular, 80% of the patients were symptom free after the first cycle of thermal therapy. Moreover, the score during the pretreatment period was similar between the two cycles. However, ANOVA showed reduction of symptoms when the whole follow-up period was considered. Similar results were observed for post-prandial fullness. The analysis of variance showed a real and persistant improvement of symptoms in all patients. Figure 1 Prevalence of epigastric pain and heartbum (A) and postprandial gastric fullness (B) at the 4 time points of follow-up in dyspeptic patients. When the main symptoms of IBSc (bloating, hard stools, incomplete evacuation) were considered, significant improvement was observed with ANOVA (Figures 2A-2C). Figure 2 Prevalence of bloating (A), incomplete evacuation (B), and epigastric hard stool (C) at the 4 time points of follow-up in patients with IBS-c. To better underline the temporal evolution of syptoms we reported the mean of scores for symptoms of dyspepsia and IBS at the 4 time points (Figures 3A and 3B). Figure 3 Mean score of symptoms in dyspeptic (A) and IBSc (B) patients at the 4 time points of follow-up. The data on the number of hospitalization, days of absence from work and the clinical recrudescence before and after two cycles of thermal therapy were decreased by about 30% (Table 3). Moreover, data on overall tolerablity of treatment and reasons of acceptance of this treatment are shown in Table 4. About 80% of patients appreciated the treatment and about 95% gave a positive result of the treatment Table 3 Dyspepsia-IBSc: relapse after two cycles of thermal therapy. 1 cycle (%)2 2 cycles (%)2 Admission to hospital1 5.6 2.0 Work lack2 3.4 2.2 Clinical relapse 29.6 21.9 1 In previous 12 mo. 2 On yearly working days. Table 4 Subjective evaluation of dyspepsia and IBSc. Personal opinions on therapy (%) Reasons of good opinion (%) Excellen 42 Care 95.6 Good 41.8 Relax 68 Lean 1.2 Stay 55.8 Null 6.3 Climate 45.3 No comment 8.4 Sixty patients and 60 healthy controls were enrolled in the study. Fifty-eight patients had a slow gastric output measured by OBT (mean T1/2: 131 ± 18; Table 2). Patients with a normal gastric output were excluded. One patient and 2 controls refusing to give their consent were excluded. One patient was excluded for low compliance with the treatment (more than 20% of full bottles returned). Dyspeptic patients presented an alterated gastric output and a significant difference at enollment compared with healthy controls when both T1/2 (131 ± 18 vs 81 ± 7; P < 0.01) and T-lag (92 ± 11 vs 51±10; P < 0.01) were considered. After mineral water supplementation for 3 weeks, a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients. Both T1/2 and T-lag were significantly reduced after the therapy compared to the basal values (91 ± 12 for T1/2 and 53 ± 11 for T-lag, Table 5) with OBT similar to that in healthy controls. In controls and 7 patients, the gastric output did not change after mineral water supplementation treatment. Table 5 Parameters of gastric emptyng rate (13C octanoic acid breath test) in dyspeptic patients before and after mineral water supplementation therapy (mean ± SD). Pre-treatment Post-treatment P T1/2 131 ± 18 91 ± 12 < 0.001 T-lag 92 ± 11 53 ± 11 < 0.001 The prevalence of dyspeptic symtoms was significantly lower after the therapy than at enrolment. The prevalence of bloating and gastric fullness was significantly lower after mineral water supplementation treatment (Table 6). The overall prevalence of gastrointestinal symptoms was reduced after mineral water supplementation treatment too. At the basal point, a mean global score of symptoms was 15 ± 4. After 30 d of mineral water supplementation treatment, the score was 7 ± 3. A lower prevalence of abdominal pain, nausea, vomiting was also observed. No severe side effects were reported by patients. Only one control experienced mild diarrhea but treatment was not stopped. Five patients and 7 controls reported an increased number of evacuations during treatment. No effects of mineral water supplementation trealment on blood pressure, glycaemic control and heart rate were observed. Table 6 Prevalence of gastrointestinal symptoms before and after mineral water supplementation therapy in dyspeptic patients. Symptomatology T0 % (n/n) T2 % (n/n) P Gastric fullness 86 (48/56) 25 (14/56) < 0.0001 Epigastric pyrosis 52 (29/56) 30 (17/56) < 0.05 Bloating 52 (29/56) 23 (13/56) < 0.005 Epigastric pain 24 (12/56) 11 (6/56) NS Nausea 5 (3/56) 0.2 (1/56) NS Vomiting 0.2 (1/56) 0 (0/56) NS Overall 100 (56/56) 68 (38/56) < 0.0001 Oro-cecal transit time was longer in patients with IBSc than in controls (Table 7). All patients and 3 healthy controls had an abnormal oro-cecal transit time. After minere water supplementation treatment for 3 wk, the oro-cecal transit time was shorter than at the beginning of the study. A slight reduction in transit time was observed in healthy controls especially in those presenting a pathological transit time at the start of the treatment. The number of evacuations in a week was increased and bloating was reduced during mineral water supplementation treatment in patients with IBSc (Table 8). No side effects were reported by patients and controls. Table 7 Oro-cecal transit time in IBC patients before and after mineral water based diet (mean ± SD). Pre treatament Post treatament P Patients 120 ± 12 97 ± 8 < 0.001 Controls 85.5 ± 14 81 ± 8 NS P < 0.001 < 0.001 Table 8 Gastrointestinal symptoms before and after mineral water supplementation therapy in patients with IBS. Symptoms T0 % (n/n) T21 % (n/n) P Bloating 90 (9/10) 20 (2/10) < 0.005 Abdominal Pain 40 (4/10) 20 (2/10) NS T0 Media T21 Media Evacuation/wk (n) 1.7 3.3 < 0.001 T0: Basal time T21: After mineral water supplementation therapy NS: Not significant Several diseases have been treated with thermal therapies for a long time in different countries. However, whether thermal therapy should be considered as pertinent to alternative medicines is a matter of debate and largely depends on the different cultural settings in which this practice is performed. In the Scandinavian, British and North American countries the therapeutic value and benefits of thermal (spa) treatment are seen with scepticism and looked at as an alternative and unorthodox practice. On the contrary, spa has been considered a credible medical treatment and supported by official undergraduate and postgraduate university teaching in most countries of the continent, Southern and Eastern Europe (France, Germany and Italy). It should also be mentioned that, differently from various forms of alternative medicine, spa therapy is firmly maintained in medical hands and undergoes orthodox medical control. As a consequence, thermal medicine appears as a supportive rather than alternative practice. Thus in the mentioned countries, spa therapy cannot be labelled as “alternative” medicine, but should be defined as “complementary” or “auxiliary” medicine. Nevertheless, also in these settings, an alignment to the Anglo-Saxon scepticism towards spa therapies has recently developed within the medical and academic community, although not all do so among patients and within the “civic” society. Such scepticism is based on the scant number of studies published in medical journals of good reputation, apt to investigate with correct methodology and design the real benefits of spa therapies in various clinical conditions in term of efficacy and cost-effectiveness. Even in those countries in which “hydrology” is a recognized medical speciality with an academic background (as in Italy) most researcher work done in the past has been characterized by an approach mainly pathophysiologic and pharmacological, aimed at investigating the mechanism and biological effects of the mineral water rather than at assessing the related clinical and health economic effects with appropriate methods. As in a number of European countries, variable kinds of financial support (public and private) have been provided for different forms of thermal treatment applied to various diseases. This issue is not a simple question of medical and academic relevance but has great implications from the socioeconomic point of view. In Italy, almost 340 thermal industries are crucial economics and social factor for many geographic areas. The yearly financial turnover related to the thermal activities amounts to 300 million dollars and 2 000 million dollars as for health aspects and linked activities, respectively, and is a key element of the national economy. The evaluation of literature on the efficacy of spa therapies in the international bibliography can clearly show how wide the gap is in this context, if compared to traditional clinical domains and other nonconventional therapies. The limited impact of scientific research on the efficacy of spa therapies accounts the reservations of the scientific world to the actual efficacy of spa therapies, thus paving the way in Italy to discuss the public funding of these activities. On these bases in 1995, the Association of Thermal Industries and Curative Mineral Waters (Federterme”, which officially represents all 340 Italian “medical” spa centres) have developed the epidemiological, health and cost-effectiveness aspects related to spa activities to assess the efficacy of thermal therapies in reducing the health costs. The observational study has given very important results. The high number of patients who decided to come back for a second period of thermal treatment suggests a very good impact of the therapy on symptoms evaluted by ANOVA test. The data cannot be ascribed only to a placebo effect. We however, cannot conclude that thermal therapies are able to influence the natural history of studied diseases (dyspepsia and IBSc). It is possible that the beneficial effet of a single thermal treatment can influence the perception of symptoms as less severe even in a long follow-up period. This hypotesis was supported by reduction of day and number of hospitalization and day of absence by work during the follow-up period. It should be important to evaluate the economical impact of such results but it was not possible in this study. However, all cited parameters showed a reduction of about one third during the follow-up perion when compared to the former years. No reduction in drug use was observed (data not shown). It is possible to conclude that mineral water supplementation treatment for functional dyspepsia and IBSc can improve symptoms and reduce the medical cost as well as deserves further attentions. However, a best detailed analysis on cost/effectiveness should be performed. Our data showed that mineral water supplementation therapy could reduce the gastric output of solid food and improve symptoms in patients with functional dyspepsia. The improvement of both studied parameters (T1/2 and Tlag) suggests that mineral water can normalize both gastric output time and redistribution of alimentary bolus in the stomach. The pathophysiologic mechanism causing these effects are unknown. Our study demonstrated that mineral water supplementation therapy could improve symptoms and gastric acid output in functional dyspeptic patients evaluated by a questionnaire and OBT. The effects exerted by mineral water include stimulation of chemoreceptors and baroceptors in the gastric walls. The well known effect of water on intestinal motility (due to osmotic properties) with increased intestinal transit time induces an early duodenal transit of food with an earlier relaxation of pylorus and a faster transit of bolus from stomach to duodenum. Moreover, the presence of liquid in the stomach accelerates food disintegration and solubilization.The chemical content of particular water plays a role in the stimulation of specific gastric receptors that increases the gastric motility by secreting local hormones (gastrin, secretin, vasoactive intestinal peptide). The evidence that the effect of water is limited in patients suggests that hormones may be dysrequlated in such patients. The presence of large amounts of calcium and magnesium in mineral water may directly stimulate the gastric smooth muscle to increase its motility and relax pylorus, thus producing its effect on gastric output and symptoms. The restoration of a correct gastric output reduces the time of exposition of bolus to intestinal bacteria, thus reducing the intensity of bloating due to intestinal bacteria overgrowth. Constipation predominant irritable bowel sindrome is one of the frequent gastroenterological diseases in general population. Several pharmacological treatments have been proposed and used. Although therapies for constipation are efficacious, most of them are self-prescribed by patients with a high cost. Laxatives for example are widely used without medical control and may produce side effects. Moreover, the efficacy of laxative treatment is temporary and induces patients to increase dosage of drugs. A diet containing high fibers has been demonstrated to be a valid alternative to drugs for chronic constipation[20]. In our study, mineral water supplementation theray (2 000 mL) for 3 wk accelerated oro-cecal transit time and improved symptoms in patients with IBSc. Compliance to therapy was excellent. The mechanisms of action of mineral water are not completely clear. Others iones present in mineral water may directly or indirectly (via neuroendocrine secretion of vasointestinal active peptides) stimulate smooth muscle to increase its motility. These actions reduce the transit time and increase the number of evacuations in a day with improvement of symptoms in IBSc patients. The decreased transit time improves bloating and reduces the time of contact between intestinal content and saprophytic flora with reduction in gas production. In conclusion, mineral water supplementation theray can improve gastiric acid output, oro-cecal transit time and symptoms in patients with functional dyspepsia or IBSc. Mineral water supplementation therapy seems to be a simple, well-tolerated, cheap therapy for functional dyspepsia or IBSc and should be taken into account by physicians in the treatment of dyspepsia ad IBSc. S- Editor Wang J L- Editor Wang XL E- Editor Bi L 1. Morrissey JF, Reichelderfer M. Gastrointestinal endoscopy (2). N Engl J Med. 1991;325:1214-1222. [PubMed] [DOI] 2. Colin-Jones DG. The management of dyspepsia. Scand J Gastroenterol Suppl. 1988;155:96-100. [PubMed] [DOI] 3. Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ 3rd. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol. 1992;136:165-177. [PubMed] [DOI] 4. Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ 3rd. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992;102:1259-1268. [PubMed] [DOI] 5. Jones RH, Lydeard SE, Hobbs FD, Kenkre JE, Williams EI, Jones SJ, Repper JA, Caldow JL, Dunwoodie WM, Bottomley JM. Dyspepsia in England and Scotland. Gut. 1990;31:401-405. [PubMed] [DOI] 6. Shaib Y, El-Serag HB. The prevalence and risk factors of functional dyspepsia in a multiethnic population in the United States. Am J Gastroenterol. 2004;99:2210-2216. [PubMed] [DOI] 7. Wegener M, Börsch G, Schaffstein J, Reuter C, Leverkus F. Frequency of idiopathic gastric stasis and intestinal transit disorders in essential dyspepsia. J Clin Gastroenterol. 1989;11:163-168. [PubMed] [DOI] 8. Corinaldesi R, Stanghellini V, Raiti C, Rea E, Salgemini R, Barbara L. Effect of chronic administration of cisapride on gastric emptying of a solid meal and on dyspeptic symptoms in patients with idiopathic gastroparesis. Gut. 1987;28:300-305. [PubMed] [DOI] 9. Camilleri M, Brown ML, Malagelada JR. Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroenterology. 1986;91:94-99. [PubMed] [DOI] 10. Labò G, Bortolotti M, Vezzadini P, Bonora G, Bersani G. Interdigestive gastroduodenal motility and serum motilin levels in patients with idiopathic delay in gastric emptying. Gastroenterology. 1986;90:20-26. [PubMed] [DOI] 11. Blum AL, Talley NJ, O'Moráin C, van Zanten SV, Labenz J, Stolte M, Louw JA, Stubberöd A, Theodórs A, Sundin M. Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. Omeprazole plus Clarithromycin and Amoxicillin Effect One Year after Treatment (OCAY) Study Group. N Engl J Med. 1998;339:1875-1881. [PubMed] [DOI] 12. McColl K, Murray L, El-Omar E, Dickson A, El-Nujumi A, Wirz A, Kelman A, Penny C, Knill-Jones R, Hilditch T. Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med. 1998;339:1869-1874. [PubMed] [DOI] 13. Badiali D, Corazziari E, Habib FI, Tomei E, Bausano G, Magrini P, Anzini F, Torsoli A. Effect of wheat bran in treatment of chronic nonorganic constipation. A double-blind controlled trial. Dig Dis Sci. 1995;40:349-356. [PubMed] [DOI] 14. Müller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis. Br Med J (Clin Res Ed). 1988;296:615-617. [PubMed] [DOI] 15. Cummings JH. Constipation, dietary fibre and the control of large bowel function. Postgrad Med J. 1984;60:811-819. [PubMed] [DOI] 16. Read NW. Dietary fiber and the gut: action in gastrointestinal disorders in Sleisenger MH, and Fordtran JS (eds). Gastrointestinal Disease: Pathophisiology, Diagnosis, Management, 5th ed. Philadelphia: WB Saunders 1993; 288-296. [PubMed] [DOI] 17. Devroede G. constipation in Sleisenger MH, and Fordtran JS (eds). Gastrointestinal Disease: Pathophisiology, Diagnosis, Management, 5th ed. Philadelphia: WB Saunders 1993; 837-887. [PubMed] [DOI] 18. Alessi CA, Henderson CT. Constipation and fecal impaction in the long-term care patient. Clin Geriatr Med. 1988;4:571-588. [PubMed] [DOI] 19. Sàez LR. Therapeutic proposals for the treatment of idiopathic constipation. Ital J Gastroenterol. 1991;23:30-35. [PubMed] [DOI] 20. Anti M, Pignataro G, Armuzzi A, Valenti A, Iascone E, Marmo R, Lamazza A, Pretaroli AR, Pace V, Leo P. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepatogastroenterology. 1998;45:727-732. [PubMed] [DOI] 21. Scalabrino A, Buzzelli G, Raggi VC. [Clinical-epidemiological study of the efficacy of thermal therapy in gastroenterologic diseases]. Clin Ter. 1998;149:127-130. [PubMed] [DOI] ALL AUTHOR RESOURCES Common Usage of Quantities and Units Copyright License Agreement Criteria for Authorship Guidelines for Manuscript Type and Related Ethics Documents Guidelines for the Manuscript Publishing Process Language Editing Process for Manuscripts Submitted by Non-Native Speakers of English Publication Misconduct Quality of Publications Steps for Submitting Manuscripts ALL PEER-REVIEWER RESOURCES Peer-Review Process Peer-Reviewer Tracking for Manuscripts Reviewer Acknowledgment Association of Learned and Professional Society Publishers (ALPSP) Committee on Publication Ethics (COPE) Open Access Scholarly Publishers Association (OASPA) ALL PUBLISHER RESOURCES About the BPG BPG Home Committee on Publication Ethics ICMJE Conformity Publishing Credentials Special Statement © 2004-2019 Baishideng Publishing Group Inc. All rights reserved. 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA California Corporate Number: 3537345
cc/2019-30/en_middle_0041.json.gz/line1614253
__label__wiki
0.508387
0.508387
Direct Link Between illness and the need for more sleep Humans spend nearly one-third of their lives in slumber, yet sleep is still one of biology's most enduring mysteries. Little is known about what genetic or molecular forces drive the need to sleep -- until now. In a study of over 12,000 lines of fruit flies, researchers have found a single gene, called nemuri, that increases the need for sleep. Humans spend nearly one-third of their lives in slumber, yet sleep is still one of biology's most enduring mysteries. Little is known about what genetic or molecular forces drive the need to sleep -- until now. In a study of over 12,000 lines of fruit flies, researchers from the Perelman School of Medicine at the University of Pennsylvania have found a single gene, called nemuri, that increases the need for sleep. These findings are published today in Science. The NEMURI protein fights germs with its inherent antimicrobial activity and it is secreted by cells in the brain to drive prolonged, deep sleep after an infection. "While it's a common notion that sleep and healing are tightly related, our study directly links sleep to the immune system and provides a potential explanation for how sleep increases during sickness," said senior author Amita Sehgal, PhD, a professor of Neuroscience and director of Penn's Chronobiology Program. Without the nemuri gene, flies were more easily aroused during daily sleep, and their acute need for an increase in sleep -- induced by sleep deprivation or infection -- was reduced. On the other hand, sleep deprivation, which increases the need for sleep, and to some extent infection, stimulated nemuri to be expressed in a small set of fly neurons nestled close to a known sleep-promoting structure in the brain. Overexpression of nemuri increased sleep in bacteria-infected flies and led to their increased survival compared to non-infected control flies. In response to infection, NEMURI appears to kill microbes, most likely in the peripheral parts of the fruit fly body, and increases sleep through its action in the brain. Several molecules like NEMURI, which is an antimicrobial peptide (AMP), have multiple functions that help combat infection, but its sleep-promoting role may be just as important for host defense, the researchers suggest, given that increased sleep during sickness promotes survival in the flies. What's more, the authors note that cytokines such as interleukin-1 (IL-1), an immune cell molecule, are implicated in human sleep. IL-1 can function in the same pathway as AMPs, and it accumulates after prolonged wakefulness and appears to promote sleep. In mammals, cytokines can induce production of AMPs, but AMPS may also affect the expression of cytokines. Given this interwoven relationship, the researchers conclude that NEMURI is a working link between immune function and sleep. "The NEMURI protein is a genuine driver of keeping sleep on track under conditions of high sleep need like when we're sick," said first author Hirofumi Toda, PhD, a postdoctoral fellow in Sehgal's lab. "In the next phase of our work, we plan to investigate the mechanism by which NEMURI drives sleep." Julie Williams and Michael Gulledge, both from Sehgal's lab, are also co-authors on this paper. This work was funded by the Howard Hughes Medical Institute and the National Institutes of Health (R01GM123783 402). Story Source: Materials provided by University of Pennsylvania School of Medicine. Note: Content may be edited for style and length. Alabama governor signs near-total abortion ban into law "Stand Your Ground" Shooter Arrested in Fla Flag lowered to Half-Staff Again Fayetteville Man Sentenced for Felon in Possession Charge "Novel" Man Impersonated FBI Agent to Steal from Area Businesses Sentenced Chain Closes NC stores over Racist Receipts EPA rules on issue pitting oil producers, corn farmers Advance Auto Parts Raleigh as Corporate Headquarters President George H. W. Bush: Legacy Lives On 1924-2018
cc/2019-30/en_middle_0041.json.gz/line1614254
__label__wiki
0.563423
0.563423
New friction emerges between Pelosi, AOC House speaker is tired of tweets from progressive Democrats (NEWSER) – “You got a complaint? You come and talk to me about it,” House Speaker Nancy Pelosi told Democrats in a closed-door meeting Wednesday, chiding members who’ve been airing frustrations over Twitter. “Do not tweet about our members and expect us to think that that is just OK,” Pelosi said in an attempt to reunite the party follow weeks of infighting, a source tells Politico. Some of the internal friction was generated by Pelosi herself, the result of an interview with Maureen Dowd that ran Sunday in the New York Times. The course of events: “All these people have their public whatever and their Twitter world,” Pelosi told Dowd. “But they didn’t have any following. They’re four people and that’s how many votes they got.” The four she was referring to: Reps. Rashida Tlaib, Ilhan Omar, Ayanna Pressley, and Alexandria Ocasio-Cortez, all critical of Pelosi for siding with moderates in sending a Senate-passed $4.6 billion border bill to the House floor without stronger protections for child migrants. The four voted against the measure. Pelosi’s lines drew tweeted responses. What Ocasio-Cortez had to say: “That public ‘whatever’ is called public sentiment. And wielding the power to shift it is how we actually achieve meaningful change in this country.” Omar then tweeted a response to Ocasio-Cortez’s tweet: “Patetico! You know they’re just salty about WHO is wielding the power to shift ‘public sentiment’ these days, sis. Sorry not sorry.” Read the full story ›
cc/2019-30/en_middle_0041.json.gz/line1614255
__label__cc
0.732127
0.267873
KennyChesneyVEVO Kenny Chesney - Boston (Live) 1,258,003 views 1 year ago Live in No Shoes Nation - the new live album available now: http://smarturl.it/liveinno...... Show less Vevo - Country Play all The latest country videos are all here in this exclusive playlist. Caylee Hammack - Just Friends (NYC Cut) - Duration: 2 minutes, 50 seconds. Caylee Hammack Tucker Beathard - "Better Than Me" Live Performance | Vevo - Duration: 3 minutes, 25 seconds. Tucker Beathard Jordan Davis - Slow Dance In A Parking Lot - Duration: 4 minutes, 2 seconds. Jordan Davis Tenille Townes - I Kept the Roses - Duration: 4 minutes, 23 seconds. Leah Turner - Blah Blah Blah (Official Video) - Duration: 2 minutes, 56 seconds. LeahTurnerVEVO Ryan Hurd - To a T (Stripped) - Duration: 3 minutes, 36 seconds. Ryan Hurd Kassi Ashton - Field Party (Official Music Video) - Duration: 3 minutes, 33 seconds. Emily Hackett - Easy (Official Video) - Duration: 4 minutes, 27 seconds. Emily Hackett Lady Antebellum - "What If I Never Get Over You" Live Performance | Vevo - Duration: 3 minutes, 23 seconds. MacKenzie Porter - These Days (Lyric) - Duration: 2 minutes, 53 seconds. Stephanie Quayle - If I Was A Cowboy (Official Music Video) - Duration: 3 minutes, 23 seconds. Stephanie Quayle Midland - "Mr. Lonely" Live Performance | Vevo - Duration: 3 minutes, 4 seconds. Midland Official Kenny Chesney - Trip Around the Sun - Duration: 2 minutes, 56 seconds. Kenny Chesney - Boston (Live) - Duration: 6 minutes, 46 seconds. Kenny Chesney - David Lee Murphy - Guest on Live in No Shoes Nation - Duration: 2 minutes, 11 seconds. Kenny Chesney - Dave Matthews - Guest on Live in No Shoes Nation - Duration: 107 seconds. Kenny Chesney - Hemingway's Whiskey (Live) - Duration: 3 minutes, 59 seconds. Kenny Chesney - Zac Brown Band - Guest on Live in No Shoes Nation - Duration: 2 minutes, 24 seconds. Kenny Chesney - Save It for a Rainy Day (Live with Old Dominion) - Duration: 4 minutes, 14 seconds. Kenny Chesney - Dust on the Bottle (Live with David Lee Murphy) - Duration: 3 minutes, 45 seconds. Kenny Chesney - Medley: The Joker / Three Little Birds (Live With Dave Matthews) (Audio) - Duration: 5 minutes, 16 seconds. Kenny Chesney - I'm Alive (Live) (Audio) - Duration: 3 minutes, 55 seconds. Kenny Chesney - American Kids (Live) (Audio) - Duration: 5 minutes, 31 seconds. Kenny Chesney - Coastal (Live) (Audio) - Duration: 3 minutes, 14 seconds. Kenny Chesney - There Goes My Life (Official Music Video) - Duration: 4 minutes, 56 seconds. Kenny Chesney - Don't Blink (Official Music Video) - Duration: 5 minutes, 7 seconds. Kenny Chesney - Come Over (Official Music Video) - Duration: 4 minutes, 8 seconds. Kenny Chesney - American Kids (Official Music Video) - Duration: 3 minutes, 23 seconds. Kenny Chesney - You And Tequila ft. Grace Potter (Official Music Video) - Duration: 4 minutes, 6 seconds. Kenny Chesney - All the Pretty Girls (Official Music Video) - Duration: 3 minutes, 29 seconds. Kenny Chesney - Save It for a Rainy Day (Official Music Video) - Duration: 3 minutes, 5 seconds. Kenny Chesney - No Shoes, No Shirt, No Problems (Official Music Video) - Duration: 3 minutes, 30 seconds. Kenny Chesney - When The Sun Goes Down (Duet with Uncle Kracker) - Duration: 5 minutes, 15 seconds. Kenny Chesney - I Go Back - Duration: 4 minutes, 34 seconds. Kenny Chesney - The Good Stuff (Official Music Video) - Duration: 3 minutes, 18 seconds. Kenny Chesney - She Thinks My Tractor's Sexy (2-Channel Stereo Mix) - Duration: 4 minutes, 9 seconds. Vevo - Channel
cc/2019-30/en_middle_0041.json.gz/line1614263
__label__cc
0.698413
0.301587
Lived Experiences with Arthritis among Older People - EISRJC eisrjc.com Arthritis, Respondents, Frequency, Experiences, Percentage, Majority, Descriptive, Perceived, Defensor, Eisrjc, Www.eisrjc.com Vol. 1 No. 1 January 2011 ISSN: 2094-9243 pp. 93-110 International Peer Reviewed Journal Asian Journal of Health Social Descriptive Section Lived Experiences with Arthritis among Older People JOEL P. DEFENSOR joel_defensor@yahoo.com Liceo de Cagayan University, Cagayan de Oro City Date Submitted: Aug. 24, 2010 Plagiarism Detection: Passed Final Revision Complied: Oct. 30, 2010 Flesch Reading Ease: 36.78 Gunning Fog Index: 15.47 Abstract - Arthritis is one of the many disabling diseases in the Philippines today. Its effects on the older persons are paramount in terms of productivity and quality of life. This study identified the experiences of older people with arthritis in Cagayan de Oro City. A descriptive method was used. The study was conducted at the office of Senior Citizen’s Organization, Cagayan de Oro City. The respondents were members of OSCA (Office of Senior Citizen Affairs) who are affected by arthritis. An interview schedule was used in the gathering of data. The majority of older people are still living under the debilitative and disabling effects of arthritis despite the advancement of medical management. Without proper medical management of arthritis, quality life for older people with arthritis shall remain to be attained. Effective ways must be done to deliver education, knowledge and understanding of arthritis to the older individuals. Keywords - lived experiences, arthritis, older people The years of medical and nursing advancement changed the faces of different disorders affecting older people. With the discovery of new drugs and the application of preventive measures, the problems brought about by the signs and symptoms of these diseases have been remarkably reduced. However, there are still a lot of people who suffer from the effects of these diseases, not only physically but also psychosocially. Among these disorders, arthritis could be considered one of the most debilitating conditions affecting mostly the older people in the Philippines, not to mention other groups in their early age. The disabling effects of arthritis may be manifested in an individual’s personal, social and employment activities (Porth 2002). Arthritis is now increasing in terms of prevalence affecting people in their 60’s. There are over a hundred types of arthritis (Smeltzer 2008). However, the three most common types are rheumatoid arthritis (RA), osteoarthritis (OA) and gouty arthritis (GA). These three common types of arthritis are the focus of this study because of their increased prevalence in the Philippines. Most of the older Filipino people are now commonly suffering from these debilitative conditions. Age groups under the cohort of baby boomers are most likely candidates for arthritic disorders in this decade (http://livinginthephilippines. com). Arthritis is increasing significantly, affecting every race but there are differences in the prevalence and distributions in different populations and countries. About one (1) percent of world’s population is affected by arthritis (http://www.informanthealthcare.com). And it is estimated that around 350 million people have arthritis worldwide (http://www.medicinenet.com). Majority of affected individuals are women; children are also victims of this disorder. In the Philippines, arthritis is also increasing every year, particularly affecting older individuals who do not seek medical attention since they do not have enough resources for the treatment. For some, the hindrances of treatment are their cultural beliefs (Ringsven 1997). These different cultural beliefs are sometimes the hindrance to preventive and treatment management. Some minority groups in a given community have unique practices in the treatment of arthritis. Cultural diversity also contributes to the widespread increased of arthritis cases (Tan 2003). Treatments are neglected because older people think that arthritis is part of the aging process. This is further discussed J. P. Defensor in the theoretical framework of the study. According to the Philippine Rheumatoid Association, the number of arthritis sufferers and those with soft tissue rheumatism is now climbing at 2.6 million Filipinos and increasing in number yearly (http:showbizandlifestyle.inquirer.net). The researcher considered this study because of his interest in musculoskeletal and immunological problems particularly arthritis. Based on the researcher’s observation in the community today, there are individuals who take risk of just ignoring their symptoms of arthritis because they consider it as part of the aging process. In the near future, majority of Cagayanons will suffer from the effects of this disorder if no preventive intervention will be followed. Many older persons are now suffering from the negative impact of arthritis in this generation. In the community where the researcher was exposed as a clinical instructor in Community Health Nursing, a lot of aging populations are showing manifestations of arthritis. These older individuals are not only complaining of the joint pain (arthralgia) brought about by the disorder but also having problems with immobility and deformity due to joint deterioration. The patient’s knowledge and understanding of the disease are important to decrease the discomfort and disabling effects of arthritis. The researcher believed that older persons have the right to enjoy their remaining years as healthy individuals with minimal physical, emotional, and spiritual discomforts in life. The researcher conducted this study to further understand the perceived behavior of older people pertaining to the causes, signs and symptoms, disabling effects, treatments, treatment responses, family and individual coping and how this perceived behavior affects their well-being as senior citizens. Health care providers play an important role in the management of arthritis by helping older people with arthritis their quality of life, free from discomfort, and remain productive in society. This study is anchored on the health belief theory contending that concepts about health that an individual believes are true. Such beliefs may or may not be based or in line with facts (Kozier 2007). This theory has six important elements. Perceived Threat has two types such as perceived susceptibility (one’s subjective perception of contracting the disease) and perceived severity (feeling of seriousness in contracting the disease or leaving the disease untreated). Perceived Benefits connote believed effectiveness designed to reduce the threat of illness. Perceived Barriers are possible negative consequences that might result from taking health actions (physical, psychological and financial demands). Cues to Action, refers to physical symptoms of health condition that motivate older people to take action. Other Variables refer to the demographics, psychosocial, and structural variables that affect individual perception and influence healthrelated behavior. Lastly, Self-Efficacy refers to the belief of individual about the disease and its treatment is successfully done, thus producing the desired effects-reduction of symptoms (http://www.familyhealthinternational.com). This theory tries to explain how individuals respond to disease psychologically and how they cope based on their behaviors. In line with arthritis, older individuals have different attitudes and beliefs in the prevention and treatment of this disorder. These attitudes and beliefs are manifested, for instance, in the “pasmo” system. People tend to believe that arthritis is caused mainly by habitual washing of extremities (hands and feet) after long periods of tiring and strenuous physical activities. The disabling effects of arthritis may be manifested in an individual’s personal, social, and employment activities. To help persons with arthritis, health care providers must have a working knowledge of the specific disease and an understanding of the underlying pathologic processes. Basic education is fundamental in rectifying misconceptions. OBJECTIVES OF THE STUDY This study sought to answer to the following objectives: (1) to describe the profile of the respondents with arthritis (2) to describe the experiences of the respondents in terms of types of arthritis, symptoms, causative factors and diagnostic/laboratory examinations done; (3) to determine the respondents’ management and prevention practices in terms of coping, medications, lifestyle modification and its effects, other alternative treatments and preventive modalities; and, (4) to determine the prognoses of the respondents. This study used the descriptive design and was conducted in the office of the Senior Citizen’s Organization, Cagayan de Oro City. The respondents were members of OSCA (Office of Senior Citizen Affairs) who were affected by arthritis. The study was conducted among the 34 members of the Office of Senior Citizen Affairs in Cagayan de Oro City. The OSCA is a regulatory body of different organizations of older people having the advocacy of uplifting the protection, promotion of health, and prevention of diseases among older people. The respondents were selected based on the following criteria: male or female who have signs and symptoms of arthritis (either medically diagnosed or undiagnosed), 60 years old and above, resident of Cagayan de Oro City, and willing to participate in the study. An interview schedule was used to obtain information on the respondents’ profile, their experiences with arthritis to include, management and prevention of arthritis, their prognosis and interview tool was tested for clarity to ensure the accuracy of data. The tool was translated into the local dialect for the respondents to understand the information asked for. The study had clearance from the Ethics Board. Informal consent from the participants was obtained. Permission to conduct the study was obtained from the Dean of the Graduate School of Liceo de Cagayan. Also, the comment of the office-incharge of the OSCA to conduct the study among its members was sought. The researcher and research assistants then distributed the instrument to the respondents who were given directions on how to accomplish it. The study complied with the ethical requirements of research involving human subjects. An informed consent was sought prior to the data collection An interview with the respondents then followed. The gathered data were analyzed using descriptive and inferential statistics. Table 1 shows the profile of the respondents. As to age, majority of the respondents were young old (60-70 years) old), while 29% were middle old and five percent were old/old. The result denotes that, majority of the respondents affected by arthritis are usually young old (60-70 year old). Commonly, onset of arthritis is seen at the age of 60 years old. Young old people are still actively involved in various activities; hence they are more at risk of developing arthritis. Those who were middle old (71-80 year old) might have suffered from the disease since their early 60’s. This finding implies that the life expectancy among Filipinos is not that high. As to marital status, 71% of the elderly were married and majority of older people with arthritis has support system. On the other hand, widows accounted for 24% and single for 6% of the sample size. The occupations of the respondents before retiring were highly distributed to the different government and non-government institutions. The occupations of highest number were government employee and housekeepers. Others were blue color jobs. The data further reveal that the majority of respondents had income below minimum wage. Their previous income could be related to the severity of arthritis. Low income could mean poor diet, lack of medical consultation, non-compliance with medication, and less monitoring of the disease. Furthermore, in terms of weight, most of them (70%) were overweight, taking into account their average height of 5’2”. An association as to educational attainment, 35% finished college while 26% obtained elementary education only. The rest of the respondents were unable to finish college (11%) and high school (11%). These data reveal that majority did not have college education, a factor that could have an impact on the understanding of the disease process and its treatment. In terms of socio-economic status, 50% of the respondents had below average life status, while other 44% had average and only 6% above average. Financially impoverished, they could hardly sustain their medication and some would not even bother to go to the doctor for check-up. As to received monthly income and source of income, 62% of respondents received below P3, 500.00 mostly sourced from pension, while 32% earned P3, 500.00 to P10, 000.00. Only 14% got financial support from their children. The data suggest that most of the respondents are self-reliant. However, the money they receive monthly is only enough for their daily expenses, not enough to cover medication and medical consultation. In terms of support system, 97% of the respondents had their own families for support while only 3% received support from an organization. Filipinos are indeed very family oriented, providing the aged the needed support. Table 1. Profile of older people with arthritis Age Frequency Percentage 60-70 years old 22 65 81 years old above 2 6 Overall 34 100.00 Gender Frequency Percentage Male 14 41 Female 20 59 Marital Status Frequency Percentage Single 2 6 Married 24 71 Widow 8 24 Previous Occupation Frequency Percentage Self employed 2 6 Businessman 2 6 Electrician 1 3 Teacher 3 9 Government Employee 6 18 Carpenter 2 6 Laundry Woman 1 2 Mechanic 1 3 Housekeeper 4 12 Vendor 2 6 Village Health Worker 2 6 Helper 2 6 Factory Worker 2 6 Ship Captain 1 3 Salesman 1 3 Driver 2 6 Continuation of Table 1 Weight Frequency Percentage 50 lbs. below 2 6 51-60 kg. 10 29 81 kg above 1 3 Educational Attainment Frequency Percentage Elementary level 0 0 Elementary Graduate 9 26 High School level 4 12 High School Graduate 5 15 College level 4 12 College Graduate 12 35 Socio Economic Status Frequency Percentage Below average 17 50 Average 15 44 Above average 2 6 Source of Income Frequency Percentage Pension 17 50 Self-employed 11 32 Children 5 15 Others 1 3 Income Frequency Percentage 3,500.00 below 21 62 3,501.00 to 10,000.00 11 32 10,001.00 above 2 6 Support System Frequency Percentage Family 33 97 Friends 0 0 Senior Citizen Organization 1 3 Table 2 shows that the most frequent type of arthritis the respondents had was rheumatoid arthritis, followed by osteoarthritis (29%) and gouty arthritis (11%). However, a few others were not able to identify their type of arthritis and had two types of arthritis at the same time. The data imply that a significant number of people, most of whom are women, are affected by rheumatoid arthritis. Rheumatoid arthritis is five times higher in women than in men (Smeltzer 2008). Osteoarthritis is generally common among the overweight/obese. Weight is found to be the usual causal factor of osteoarthritis. Gouty arthritis affected only very few but it is considered to be the most debilitating type of arthritis. Majority of the respondents believed that arthritis is caused by the food they consumed. Acknowledging the cause of the disease decreases the risk of having the disease. Table 2. Older people with types of arthritis Types of arthritis Frequency Percentage Rheumatoid Arthritis 15 44 Osteoarthritis 10 30 Gouty Arthritis 4 12 Don’t know/not sure 5 15 In terms of signs and symptoms, Table 3 shows that pain was the most common symptom. Pain is caused by joint inflammation, degradation of membrane, and destruction of ball and socket of the joints. The second most common symptom was numbness, which is caused by the decrease sensation of the peripheral nerve that might be related to the decrease conduction of electrical nerve impulses in the joint area. Deformity was also identified. Deformity is considered to be chronic; this is usually the late sign of rheumatoid arthritis. Uncommon symptoms included tophi, swelling, podagra, and redness, which are cardinal signs of gouty arthritis. Fever was not a usual symptom. Table 3. Older people with arthritis Signs/Symptoms Frequency Percentage pain 34 100 Swelling 4 12 Numbness 26 76 Redness 1 3 podagra (swelling of the big toe) 3 9 tophi (formation of nodules in between joint) 5 15 Immobility 2 6 Deformity 6 18 Fever 0 0 In relation to the frequency of signs and symptoms, Table 4 shows that 67% of the respondents experienced the symptoms of arthritis every week while 20% experienced the symptoms daily. Less than ten percent had the symptoms once a month or few times a year. The debilitative effects of arthritis were evident among the majority of the respondents, affecting their day-to-day activities and their psychosocial functioning. in terms of frequency of signs and symptoms Frequency of S/Sx Frequency Percentage Always (everyday) 7 20 Often (every week) 23 68 Sometimes (every month) 3 9 Seldom (few times a year) 1 3 As to severity of discomfort, Table 5 reveals that 44% experienced moderate pain while 29% experienced severe pain. As cited by Black (2005), experiencing chronic pain for a longer period of time can sometimes increase tolerance to pain. Only 3% had very severe pain while 24% had mild pain. The severity of discomfort may necessitate medical attention or alternative treatment to alleviate the pain. The data imply that despite the advent of medical management, majority of people with arthritis are still suffering from moderate to severe pain. This problem should be thoroughly addressed in the management of arthritis. in terms of severity of pain Severity of pain Frequency Percentage 10 (very severe) 1 3 7-9 (severe) 10 29 4-6 (moderate) 15 44 1-3 (mild) 8 24 Table 6 shows that 67% of the respondents believed that arthritis is a problem caused by “pasmo” or muscular pain, which is a layman’s term for muscular fatigue merely caused by muscle strain/muscular overwork. Arthritis is believed to be caused mainly by habitual washing of extremities (hands and feet) after long period of tiring and strenuous physical activities. Though “pasmo” is not accepted in medical practices and has no medical basis at all, it is still considered the main cause of arthritis among Cagayanons. Moreover, 59% of the respondents believed that aging is also one reason for having arthritis. According to them, it is normal to have arthritis when the person ages. In short, arthritis is considered a normal part of aging. Furthermore, the data show that 41% believed that arthritis is caused by the food they eat. Consumption of food high in fats and internal organs can lead to arthritis. However, 20% believed that it is hereditary or genetic in nature; that is, it runs in the family, hence can be avoided. Less than 10% believed that arthritis is caused by obesity and sedentary lifestyle. According to health belief theory, perceived threat has bigger impact on the treatment of arthritis. When an individual has knowledge on how he could acquire the disease, he would be serious about avoiding the possibility of contracting the disease. If majority of the respondents believe that consumption of certain food groups can cause arthritis, then they will avoid those foods to lessen symptoms or avoid or manage arthritis. Perceived benefits of an individual could help reduce the risk of acquiring arthritis. Some respondents think that arthritis is merely a problem due to overwork or “over fatigue”. However, beliefs find no medical support. Thus, by reducing workload, they thought they could avoid arthritis. Hence, older people should be educated on this matter to correct their misconceptions. The researcher totally should also be considered as combination and part of the Table 6. Experiences of older people with arthritis in terms of causative factors Causative factors Frequency Percentage aging (degenerative in nature) 20 59 bad diet (unhealthy food) 14 41 hereditary/genetic 7 20 Obesity 1 3 “pasmo’ 23 68 kidney problem 0 0 secondary factor (diseases) 0 0 ( minimal activity with less time to do physical exercises) Trauma 0 0 As regards diagnostic examination underwent by the respondents, in Table 7, shows that almost 80% did not seek any diagnostic examinations. Less than 20% of the respondents had blood exams, X-ray and arthrocenthesis. These data reveal that most of the respondents were unmindful of their condition, a behavior that could be due to financial inability to pay for those medical exams. Table 7. Experiences of older people with arthritis in terms of diagnostic and laboratory examinations Diagnostic/laboratory exams Frequency Percentage Never been to a Doctor for check-up 27 79 Blood exams (ANA, C reactive protein, anti CCP) X-ray 4 12 Arthrocenthesis 1 3 Arthroscopy 0 0 Coping with physical and psychosocial effects is a challenge for someone who has arthritis. As shown in Table 8, when asked about their way of coping with the disease, 38% answered just rest and enjoy doing other activities to ignore the discomforts like pain. However such coping will not cause the pain to subside. Others just ignored the discomforts (29%) or simply accepted and bore (20%) the discomforts. All of the respondents were active members of the Office of the Senior Citizen Affairs. Support system is important for an individual who is suffering from arthritis. in terms of coping Coping Frequency Percentage “Pahulay/lingaw-lingaw” 13 38 Ignore 10 29 Acceptance 7 20 Use of Cane 3 9 OSCA activities 34 100 As revealed in Table 9, many of the respondents used alternative medication like herbal to alleviate their discomfort, accounting for about 47% of respondents. This finding suggests the respondents, dependence on alternative or herbal medication, rather than on medical management. The respondents experienced relief after taking alternative treatment. Under the health belief theory, people tend to adapt behaviors that produce the desired effects. Moreover, 32% of the respondents used drugs like None Steroidal Antiinflammatory Drugs (NSAID) to decrease the symptoms and alleviate pain. These drugs are mostly over-the-counter drugs taken without prescription at all. Self-medication is a dangerous practice among older individuals. Prescribed medication is important to lessen the possible side-effects that could add up to the problems. Other drugs like colchicines, allopurinol and probenecid are prescribed drugs but were not taken by the respondent. These drugs are also intended for gouty arthritis, which affected only a very few of the respondents. in terms of medications Medications Frequency Percentage NSAIDS 11 32 Herbal 16 47 Others: 7 20 Lifestyle modification is important in the management of arthritis. Table 10 shows the different modifications that the respondents perceived to be helpful. Regular exercise was perceived by 79% of the respondents a good option to prevent arthritis attack or relapse of symptoms. There are still individuals with arthritis who do not exercise. Physical activity is important to lessen symptoms of arthritis (Smeltzer 2008). On the other hand, 59% of the respondents identified the importance of healthy diet. Based on the earlier data, food is considered as one of the many causes of arthritis. Thus, the respondents would avoid food that could cause arthritis. In the case of gout, this is exacerbated by the consumption of food high in purine, such as the internal organs of animals and nuts. Moreover, 32% of the respondents made use of relaxation techniques while only one was into stress modification, implying that only few of the respondents believe that relaxation and stress modification techniques affect exacerbation of arthritic symptoms. About 67% claimed that they improved in their daily functioning after following a healthy lifestyle. More than half of the respondents (53%) had lesser symptoms while 32% did not notice any improvement of their condition. Lifestyle change should be made a lifetime effort. Table 10. Experiences of older people with arthritis in terms of lifestyle change Lifestyle Change Frequency Percentage Healthy Diet 20 59 Regular Exercises 27 79 Stress modification 1 3 Relaxation techniques 11 32 Improvement of ADL 23 68 Less symptoms attack 18 53 None 11 32 Table 11 shows the different alternative and treatment modalities resorted by the respondents. As shown, 88% took time to rest the affected part to alleviate the discomforts of arthritis, while 41% massaged the affected area, which is a good alternative to lessen pain (Kozier 2007). Less than 30% of the respondents used warm compress and elevated the affected area. Further, 11% applied herbal liniments to the affected area. The data show that almost half of the respondents used alternative modalities while a greater number of them just took a rest to improve the condition. Table 11. Experiences of older people with arthritis in terms of alternative treatment and preventive modalities Alternative Treatment/ Preventive Modalities Warm compress 10 29 Rest 30 88 Immobilization of the area affected 1 3 Deep breathing exercises 0 0 Massage/rub affected area 14 41 Elevation of affected area 8 24 Herbal medications 4 12 As to the source of information on the alternative modalities, Table 12 shows that 41% of respondents were informed by their health providers (doctors, midwives, and nurses) in the health center. Forty – one percent of the respondents learned about them from the multimedia, while less than 23% from family, relatives and friends. Only a few of the respondents went to see a doctor for consultation. Table 12. Experiences of older people with arthritis in terms of source of information for treatment (multiple responses) Source of information for treatment Frequency Percentage Health care provider 14 41 Family or relatives 8 24 Friends 7 20 Multimedia (TV, Radio, Newspaper, Magazine, Brochures, Internet) Table 13 shows the different indicators on the experiences of older people with arthritis in terms of prognosis. The indicator “Good” means the absence of signs and symptoms for longer period of time on improvement of the quality of life. The second indicator is “fair”; means decreasing frequency and severity of signs and symptoms, but they are still evident. The indicator is “poor” improvement at all or the condition is worsening. As revealed, 73% of the respondents had fair prognosis. That is, they experienced minimal reduction of signs/symptoms. As shown in Table 2, majority of the respondents suffered from severe pain. On the other hand, 14% of the respondents never noted any improvement of their condition while 12% had good prognosis. The findings could be linked with the fact that majority of them did not have medical check-up at all. Instead, they relied on their cultured beliefs. If adherence to such beliefs persists, arthritis will remain a health problem among the people in Cagayan de Oro City. Table 13. Experiences of older people with arthritis in terms of prognosis Indicators Frequency Percentage Good (absence of S/Sx) 4 12 Fair (decreased frequency and Severity of symptoms) Poor (no improvement of S/Sx) 5 15 Overall 34 100 The elderly in Cagayan de Oro City are beset by pain or discomfort brought about by the three common types of arthritis. More women than men at their young - old stage are affected by the disease. Rheumatoid arthritis is the most common type in both sexes. The disabling effects of arthritis are not properly addressed by the elderly because of the belief that arthritis is a normal part of aging and because of lack of financial resource to pay for health care services. Most of them manage their illness through self-medication and the use of herbal plants and non-prescribed drugs. Finally, majority of them have fair prognosis due to a lack of effective means of managing the disease. Based on the findings and the conclusions, the following recommendations are advanced: 1. The City Health Office and OSCA should formulate specific programs for the members with arthritis. 2. The OSCA should hold lecture on arthritis for its members. The lecture should include topics on causal factors, risks, types of joint damage, medical treatments, alternative treatments, and preventive 3. OSCA members who have attended seminars treatment should help disseminate the information to their fellows. 4. OSCA should hold free clinic, weekly to provide the elderly free diagnostic service. 5. The City Health Office should hold monthly activities for the elderly with arthritis and free consultation program. 6. Nursing schools should intensify their extension program to help the government in its effort to provide assistance to the elderly with 7. Researchers should consider of doing similar study that look into other areas, like the debilitating effects of arthritis in relation to physical and psychosocial functioning of the affected. Pursuant to the international character of this publication, the journal is indexed by the following agencies: (1)Public Knowledge Project, a consortium of Simon Fraser University Library, the School of Education of Stanford University, and the British Columbia University, Canada:(2) E - International Scientific Research Journal Consortium; (3) Journal Seek - Genamics, Hamilton, New Zealand; (4) Google Scholar; (5) Philippine Electronic Journals (PEJ);and,(6) PhilJol by INASP. Arthritis in the Philippines, retrieved on June 20 from http://www. showbizandlifestyle.inquirer.net Kozier, B.,Berman, A., Snyder, S., & Erb, G. 2007. Fundamentals of nursing. Philippine: Pearson Education South Asia. Porth, C. 2002. Pathophysiology concepts of altered health states. Philippine: Lippincott Williams and Wilkins. Ringsven, M., & Bond, D. 1997. Gerontology and leadership skills for nurses. Albany, New York: Delmar Publishers Tan, P. 2003. Arthritis. The Philippine Star, p 21 Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. 2008. Textbook of medical-surgical nursing. Philippine: Lippincott Williams and Wilkins. Vol. 1 No. 1 January 2011 ISSN: 2094-9243 pp. 93-110 International Peer Reviewed Journal Asian Journal of Health Social Descriptive Section Lived Experiences with Arthritis among Older People JOEL P. DEFENSOR joel_defensor@yahoo.com Liceo de Cagayan University, Cagayan de Oro City Date Submitted: Aug. 24, 2010 Plagiarism Detection: Passed Final Revision Complied: Oct. 30, 2010 Flesch Reading Ease: 36.78 Gunning Fog Index: 15.47 Abstract - Arthritis is one of the many disabling diseases in the Philippines today. Its effects on the older persons are paramount in terms of productivity and quality of life. This study identified the experiences of older people with arthritis in Cagayan de Oro City. A descriptive method was used. The study was conducted at the office of Senior Citizen’s Organization, Cagayan de Oro City. The respondents were members of OSCA (Office of Senior Citizen Affairs) who are affected by arthritis. An interview schedule was used in the gathering of data. The majority of older people are still living under the debilitative and disabling effects of arthritis despite the advancement of medical management. Without proper medical management of arthritis, quality life for older people with arthritis shall remain to be attained. Effective ways must be done to deliver education, knowledge and understanding of arthritis to the older individuals. Keywords - lived experiences, arthritis, older people 93 Page 2 and 3: Asian Journal of Health Social Desc Page 10 and 11: Asian Journal of Health Social Desc Page 18: Asian Journal of Health Social Desc Magazine: Lived Experiences with Arthritis among Older People - EISRJC
cc/2019-30/en_middle_0041.json.gz/line1614264