Dhaka, June 20 (UNB) - African countries with small to medium-sized economies pay far more money for less effective drugs, a leading health expert has told BBC Newsday.

In countries such as Zambia, Senegal and Tunisia, everyday drugs like paracetamol can cost up to 30 times more than in the UK and USA.

Drug markets in poorer countries "just don't work", said Kalipso Chalkidou from the Centre for Global Development.

She said "competition is broken" due to a "concentrated supply chain".

Ms Chalkidou, director of global health policy at the organisation, co-authored a report on drug procurement that concluded that small to middling economy countries buy a smaller range of medicines, leading to weaker competition, regulation and quality.

It says richer countries, thanks to public money and strong processes for buying drugs, are able to procure cheaper medicines.

Poorer countries, however, tend to buy the most expensive medicines, rather than cheaper unbranded pharmaceuticals which make up 85% of the market in the UK and US.

The very poorest countries are not affected when foreign donors purchase medicine on their behalf, meaning their over-the-counter medicines remain at low cost.

"In the middle it's very problematic," Ms Chalkidou said.

Low- to middle-income countries "have little ability to negotiate prices down and quality assure products" and there are lots of mark-ups, often due to taxes and corruption.

She said less stringent regulation meant the quality of the drugs was also not as high.

"Without regulation, people perceive the products don't work, so pay extra money for things they think will work and won't work either," Ms Chalkidou explained.

The report recommends greater global co-operation and reforming World Health Organisation policy as well as policy in targeted countries to improve procurement practices.

Geneva, Jun 15 (AP/UNB) — The World Health Organization on Friday said the Ebola outbreak in Congo — which spilled into Uganda this week — is an "extraordinary event" of deep concern but does not yet merit being declared a global emergency.

The U.N. health agency convened its expert committee for the third time to assess the outbreak, which some experts say met the criteria to be designated an international emergency long ago.

This outbreak, the second-deadliest in history, has killed more than 1,400 people since it was declared in August. Three members of the family who brought the virus into Uganda have died after attending the burial of an infected relative, a popular pastor, in Congo.

Speaking to journalists after the meeting, Dr. Preben Aavitsland, the acting chair of the committee, announced that the outbreak is "a health emergency in the Democratic Republic of the Congo" but that the situation should not be declared a global one.

For such a declaration, an outbreak must constitute a risk to other countries and require a coordinated response. The declaration typically triggers more funding, resources and political attention.

Aavitsland said the committee was "deeply disappointed" that WHO and the affected countries have not received the funding needed to stop the outbreak and delivered a blunt message to donors: "Step up."

WHO said $54 million is needed.

Aavitsland added that declaring an emergency could have "unintended consequences" such as airlines stopping flights or governments closing borders.

"It was the view of the committee that there is really nothing to gain by declaring a (global emergency) but there is potentially a lot to lose," he said.

The outbreak, occurring close to the borders of Uganda, Rwanda and South Sudan, has been like no other. Mistrust has been high in a region that had never faced Ebola before and attacks by rebel groups have undermined aid efforts. Several health workers have been killed.

On Thursday, WHO's emergencies chief acknowledged the agency has been unable to track the origins of nearly half of new Ebola cases in Congo amid the challenges, suggesting it doesn't know where the virus is spreading.

Friday's announcement quickly drew criticism from some experts.

"I respect the advice of the emergency committee but do believe a public health emergency of international concern would have been justified," said Dr. Jeremy Farrar, director of Wellcome, one of Britain's biggest donors and a funder of Ebola vaccine research. "The epidemic is in a frightening phase and shows no sign of stopping anytime soon," he said in a statement.

Congo's health minister, Dr. Oly Ilunga, told The Associated Press that WHO's decision to not declare the outbreak a global emergency was a testament to the country's response efforts, which he called "effective."

In Uganda, authorities said the country now had just one suspected Ebola case, who had no contact with the infected family and remained in isolation. They did not give more details. Ninety-eight contacts with infected people have been identified. The health minister on Friday asked Ugandans not to shake hands or otherwise touch each other "until we are Ebola-free."

Alexandra Phelan, a global health expert at Georgetown University, said the legal criteria for declaring Ebola a global emergency have long been met, even before the virus reached Uganda.

"Given that we are still seeing daily numbers of cases in the double digits and we do not have adequate surveillance, this indicates the outbreak is a persistent regional risk," she said.

Phelan said she was concerned WHO might have been swayed by political considerations.

As the far deadlier 2014-16 Ebola outbreak raged in West Africa, WHO was heavily criticized for not declaring a global emergency until nearly 1,000 people had died and the virus had spread to at least three countries. Internal WHO documents later showed the agency feared the declaration would have economic and social implications for Liberia, Guinea and Sierra Leone.

Dr. Axelle Ronsse, emergency coordinator for Medecins Sans Frontieres, was unsure whether a declaration would help. She said outbreak responders, including WHO, should reevaluate their strategies to contain the spiraling outbreak.

"It's quite clear that it's not under control," she said. "Now may be the time to reset and see what should be changed at this point."

Ogden, Jun 11 (AP/UNB) — When doctors said her youngest child would be a girl, Amie Schofield chose the name Victoria. Then doctors said the child would be a boy, so she switched to Victor.

It turned out neither was exactly right. The blue-eyed baby was intersex, with both male and female traits.

So Schofield and her husband decided to call the infant Victory. The name is a hope for triumph over the secrecy and shame and the pain and discrimination suffered by intersex people.

Amie Schofield knows the suffering better than most: This was not her first intersex child.

Some two decades earlier, she gave birth to another child whose body did not align with common expectations of boys or girls. Schofield agreed to have that child undergo surgery that tipped the scales of gender to masculine.

But the operation did not settle the issue of gender in the child's mind, or protect them from a savage beating decades later.

With Victory, Schofield has been given an opportunity to try again. Her parents want her to be accepted for who she is. Instead of changing Victory, they are intent on changing the world so it is more accepting of intersex people.

"What I hope is what every parent hopes for their kid," Schofield said. "We don't want her to look at herself and think there's something wrong just because she's different."

___

Amie first married when she was young, and had her first child more than 20 years ago. Instead of having one X chromosome and one Y chromosome, as men have, or two X chromosomes, as is typically female, the child had two X's and a Y.

Intersex people are not to be confused with transgender. Intersex is an umbrella term for a number of conditions where internal or external sex characteristics aren't exactly like typical male or female bodies. They are a larger group than is commonly acknowledged; estimates range from about 3 in every 200 births to 1 in 2,000.

"I'm convinced every single person on this planet has met someone who's intersex," said Georgiann Davis, a sociologist at the University of Nevada-Las Vegas who is intersex and is the board president of interACT: Advocates for Intersex Youth.

Some intersex conditions are known to run in families, though that's rare for XXY chromosomes, said Dr. Adrian Dobs, director of the Klinefelter Center at Johns Hopkins University School of Medicine. Not everyone with the disorder is considered intersex, and most identify as male.

Doctors have long performed surgery and administered hormones to intersex kids to make their bodies more like typical boys or girls, but there's a growing pushback. Five states have considered banning surgery until they're old enough to consent, citing serious potential side effects, but most bills have stalled amid pushback from doctors' groups who say the proposals go too far.

Amie took doctors' advice and raised her first baby as a boy, agreeing to surgery to bring down undescended testicles.

But the onset of puberty brought hips and breasts, something that didn't go unnoticed by other teenagers in the small Idaho town where mother and child lived at the time.

"It's not something I really thought about until they started making fun of me," said Amie's eldest, speaking on condition of anonymity because of fear of violence.

The teenager developed a kind of armor: binders and sports bras, then layers of shirts for bulk, followed by a jacket that never came off, all in a goth style to create a distraction. There were beatings, and the teen developed a strategy: Keep a straight face. Don't scream. Don't say anything. The startled bully might just back off.

Amie Schofield allowed her child to experiment with nail polish and dresses at home, but in the years after the fatal beating of gay man Matthew Shepard in nearby Wyoming, she was terrified to go public. She aches when she thinks about those years.

"I wish that we could have been open," she said. "I wish I had understood more so that maybe I could have made it easier."

The move to Utah put the teenager in touch with other LGBTQ people, and for the first time exploring femininity publicly seemed possible. Instead of a beating, wearing a dress might earn supportive shouts like "keep doing you!"

That all changed one night in 2014. As they (the pronoun preferred by this person) walked to a Salt Lake City bar wearing a favorite tie-dye dress, a man shouted, "Where you going mama? You're looking pretty good in that dress!"

Never having been hit on before, they turned to say thank you. But the man's face changed when he heard a deep voice that didn't match that female body. He blew up, spewing gay slurs, and charged, weighted pipe in hand.

He landed a number of powerful blows. Blood sprayed everywhere before he fled, leaving the young person for dead.

A large gash to the head was treated with staples at a hospital. Police investigated, but couldn't catch the assailant, according to officials.

___

Amie was in the hospital after giving birth to Victory when she heard about the attack on her eldest child.  She felt angry, helpless — and determined to protect her baby. She didn't want her youngest child to live with the secrecy and fear that colored her first child's teenage years.

"I don't want her to live that kind of life," she said.

Like her half-sibling, Victory has XXY chromosomes. She also has a separate condition that means her body doesn't fully respond to male hormones. Her genitalia are ambiguous, but due to the Y chromosome doctors marked the birth certificate as male, and encouraged Victory's parents to raise the baby as a boy.

Amie and her husband took newborn Victory home. The family lives north of Salt Lake City on a plot of land ringed by mountains where they raise chickens, goats and pigs along with Victory and her two brothers.

They decided to raise the baby without pushing either gender. There would be no surgery. At 18 months, Victory began gravitating toward dresses and bows, and loudly insisting on wearing her hair long. Their then-pediatrician Nisha Baur said Victory's parents took things as they came during her earliest years. "They were very open to just accepting whatever was going to happen," she said.

Today, Victory is a vivacious 5-year-old with a toothy grin, blond hair and a quick mind. She's mostly deaf due to a separate genetic condition, but communicates clearly with signs, some words and sheer force of personality. She runs around the house at top speed, cradling a reluctant kitten, perching next to her great-grandmother to read a book or running for the bus in a sparkling silver backpack with butterfly wings.

Victory knows her body is different from those of her mother, father or brothers, but it doesn't seem to bother her, Amie Schofield said.

Her eldest child lives outside the state. They recovered physically from the attack, but for months afterward there was a constant sense of deep fear. They retreated into masculine clothing, affecting as deep a voice as possible, attempting to grow out what little facial hair they have.

Knowing Victory was born intersex brought a sense of comradeship but also fear for her.  "I'm scared of how society will treat her," they said.

Victory's parents share that apprehension. There are so many hazards ahead.

Victory's father, Michael Schofield, formally left the Utah-based Church of Jesus Christ of Latter-day Saints shortly after she was born. The faith doesn't have an official position on intersex people, but is doctrinally opposed to same-sex marriage and intimacy.

"Will she marry a boy or a girl? Which one is right? Which one is wrong?" said Schofield, a federal worker. "I don't want to do that ... she's free to make her own choices."

Her parents would like to change the designation on her birth certificate from boy to girl, but Utah law requires a court order and some judges in their area won't approve the changes. Amie Schofield and Victory have gone to the capitol to speak out in favor of changing the law, so far unsuccessfully.

The deaf school she attends has single-user, non-gendered restrooms, but what happens if she changes schools? What will dating be like one day? Will she have trouble as she applies for jobs, or apartments, or schools? Could she also be targeted by violence? How will she feel about not being able to have children?

Her mother can only hope to teach her to handle these dilemmas herself. "It's not something I can save her from," Amie Schofield said.

But whatever comes, the family isn't going to hide.

"I hate the secrecy," she said. "She's just so smart, so full of life. She's just a normal girl."

New York, June 7 (AP/UNB) — When dog owners go through a stressful period, they’re not alone in feeling the pressure — their dogs feel it too, a new study suggests.

Dog owners experiencing long bouts of stress can transfer it to their dogs, scientists report in a study published Thursday in Scientific Reports.

The Swedish researchers focused on 58 people who own border collies or Shetland sheepdogs. They examined hair from the dog owners and their dogs, looking at the concentrations of a hormone called cortisol, a chemical released into the bloodstream and absorbed by hair follicles in response to stress.

Depression, excessive physical exercise and unemployment are just a few examples of stress that can influence the amount of cortisol found in your hair, said Lina Roth of Linkoping University in Sweden.

Roth and her team found that the patterns of cortisol levels in the hair of dog owners closely matched that found in their dogs in both winter and summer months, indicating their stress levels were in sync.

She thinks the owners are influencing the dogs rather than the other way around because several human personality traits appear to affect canine cortisol levels.

The researchers don’t know what causes the synchronization in cortisol levels between humans and their pups. But a hint might lie in the fact that the link is stronger with competitive dogs than in pet pooches.

 

The bond formed between owner and competitive dogs during training may increase the canines’ emotional reliance on their owners, she said. That in turn could increase the degree of synchronization.

But why do people influence their dogs rather than vice versa? Perhaps people are “a more central part of the dog’s life, whereas we humans also have other social networks,” Roth said in an email.

The study results are no surprise, said Alicia Buttner, director of animal behavior with the Nebraska Humane Society in Omaha.

“New evidence is continually emerging, showing that people and their dogs have incredibly close bonds that resemble the ones that parents share with their children,” she said in an email.

But she said there isn’t enough evidence to assume that the influence goes only one way; it may go both ways.

“It’s not just as simple as owner gets stressed, dog gets stressed,” she said.

Many other factors could affect a person or dog’s stress levels and possibly even dampen them, she said.

Buttner said cortisol levels don’t necessarily indicate “bad” stress. They instead can indicate a good experience like getting ready to go for a walk, she said.

Roth and her team plan to investigate whether other dog breeds will react to their owners the same way.

In the meantime, she offered advice to minimize how much stress dog owners may be causing their pets. Dogs that play more show fewer signs of being stressed, she said.

So “just be with your dog and have fun,” Roth said.

 

Dhaka, June 3 ( UNB) - Coffee lovers who drink up to 25 cups a day can rest assured the drink is not bad for their heart, scientists say, reports The Guardian.

Some previous studies have suggested that coffee stiffens arteries, putting pressure on the heart and increasing the likelihood of a heart attack or stroke, with drinkers warned to cut down their consumption.

But a new study of more than 8,000 people across the UK found that drinking five cups a day, and even up to 25, was no worse for the arteries than drinking less than a cup a day.

The research, part-funded by the British Heart Foundation (BHF), is being presented at the British Cardiovascular Society conference in Manchester.
Experts from Queen Mary University of London (QMUL) divided 8,412 people into three groups for the study.

The first group was of those who drink less than one cup of coffee a day, the second was of those who drink between one and three cups a day, and the third was those who drink more than three.

Some people in the latter group drank up to 25 cups a day, although the average number for people in this group was five cups a day.

Researchers found that even those drinking up to 25 cups of coffee a day were no more likely to have stiffening of arteries than those who drank less than one cup a day.

All the participants in the latest study underwent MRI heart scans and infrared pulse wave tests, and the results held true even after factors such as age, weight and smoking status were taken into account.

Dr Kenneth Fung, from QMUL, said: “Despite the huge popularity of coffee worldwide, different reports could put people off from enjoying it.

“Whilst we can’t prove a causal link in this study, our research indicates coffee isn’t as bad for the arteries as previous studies would suggest.”

Prof Metin Avkiran, associate medical director at the BHF, said the study “rules out one of the potential detrimental effects of coffee on our arteries”.

A second study presented at the same conference found that people admitted to several NHS hospitals with a cardiac arrest at a weekend did not face a higher risk of dying compared to those admitted during the week.

The study, led by experts at Aston University, included 4,803 people going to hospital with a cardiac arrest and assessed their five-year survival.