"Our World" theme
week on "Our World" ... A better way to treat people with HIV and TB
... Health care and the U.S. presidential candidates ... and studying forests
to learn why wildfires are on the rise...
PIERCE: "If you have a tree that kind of is at
the edge of its comfort zone, so to speak, it will be a more sensitive recorder
of those environmental stresses."
stories, how rural migrants are clustering near protected environments, and
more. I'm Art Chimes. Welcome to VOA's science and technology magazine,
highlights best way to treat HIV-TB patients
many parts of the world, patients with HIV arrive at a clinic not
because they're sick with HIV, but because they've come down with tuberculosis.
Now some new research is revealing the best way to treat these patients. Rose
is epidemic in many poor countries that have high rates of HIV. But Dr. Salim
Abdul Karim from the University of KwaZulu-Natal in South Africa says there's
no general agreement on how to treat the two diseases when a patient has them
KARIM: "And if you had to ask 10 medical
practitioners how you would treat this patient who has these two conditions,
you would get ten 10 different answers."
HOBAN: Anti-retroviral drugs used for treating HIV
were created and tested in Western countries where there aren't many people
with tuberculosis. As a result, researchers never studied the best way to treat
HIV and TB together and the possible interactions among different drugs.
in Southern Africa, patients frequently do have both diseases
simultaneously, and doctors struggle to treat them. To begin with, Karim says
medications for tuberculosis and HIV can interact with one another.
KARIM: "The TB drugs induce certain key
enzymes in the liver that result in the antiretroviral drugs being metabolized
more quickly. And the particular TB drug that does this is called rifampicin.
And rifampicin is a key drug in TB, so you cannot exclude it from TB
HOBAN: Another problem is that some patients
actually get sicker after taking their TB drugs. Karim says that's
because the body's immune system goes into overdrive once it gets some help
from medication. The third problem is that patients getting treated for TB and
HIV simultaneously end up taking a lot of pills.
KARIM: "And each of these drugs has its own
side effect profile. So we have a lot of concern that when you put patients on
anti-retrovirals, that they might then stop taking their TB drugs because of
side effects they're getting from the antiretroviral drugs. It's just the
process of having to take seven drugs… I mean, handfuls of medication."
HOBAN: Karim and colleagues from Columbia
University in the United States started a study to determine the best way to
treat these patients. They recruited more than 600 people to try different ways
of taking the drugs. The trial is still going on.
in August, Karim and his colleagues reviewed the preliminary data. They found
that patients waiting to complete TB treatment before getting HIV drugs
were 50 percent more likely to die than patients being treated for both
KARIM: "We should encourage all patients who
have both tuberculosis and HIV to receive both therapies, both sets of drugs,
at the same time. TB therapy, they have to start because they won't die from
HIV, they'll die from the TB. Don't wait for them to finish their TB treatment.
Start the antiretroviral drugs."
HOBAN: The study results were announced in a press
release, rather than the usual publication in a medical journal. Karim says in
the time it would take to publish these results, 10,000 people in South Africa
alone could die from being treated for TB before getting any
anti-retroviral drugs. So he says they've altered their study, and they're
urging doctors who see these patients to get them started on anti-retrovirals
before completing the six-month course of TB medications. I'm Rose Hoban.
identify lung cancer gene defect
say they have identified more than two-dozen genes that are frequently mutated
in people with the most common form of lung cancer. The researchers say the
findings open the possibility of developing individualized therapies to fight
the disease. VOA's Jessica Berman reports.
BERMAN: Genetics researchers at three U.S.
institutions have identified 26 genes that are frequently mutated in people
with the most common form of lung cancer, adenocarcinoma.
cancer is the number one cancer killer worldwide, accounting for one million
deaths each year. About 90 percent of those stricken with the disease are
smokers and former smokers.
study published this week in the journal Nature, the researchers
describe using the latest genetic sequencing technology to sort through 625
genes taken from the tumors of 188 lung cancer patients.
investigators then compared the tumor changes to the DNA in healthy tissue from
the same patients.
teleconference with reporters, senior study author Matthew Meyerson of the
Broad Institute at the Massachusetts Institute of Technology in Boston says the
cancer genes, known as somatic cell mutations, are not inherited and occur
nowhere else in the body.
MEYERSON: "Somatic mutations are important
because the mutated genes can be targets for anti-cancer therapy. The reason is
that the cancer gene is now different from the normal gene, and so some drugs
can now specifically kill cells with the mutated cancer gene."
BERMAN: Senior-co-author Richard Wilson of
Washington University School of Medicine in Saint Louis, Missouri, says the
development could, in time, lead to targeted therapies for lung-cancer
WILSON: "We should be able to develop much more
effective chemo [chemotherapy] drugs, including drugs that also provide for a
much better quality of life during treatment for the patients."
BERMAN: The researchers found that some
adenocarcinoma genes have been implicated in a number of other cancers,
including lymphoma, leukemia, and colon cancer.
say it is possible that some drugs that show promise against one type of tumor
might work against adenocarcinoma.
work is part of the Tumor Sequencing Project, funded by the National Human
Genome Research Institute, to assemble a genome-wide catalog of all mutations
involved in the lung disease. Jessica Berman, VOA News, Washington.
of American children do not have health insurance
million American children do not have any health insurance at all, and twice
that number have health insurance for only part of the year.
children get health insurance coverage through their parents, and most parents
get insurance through their jobs. But the number of jobs that don't provide
health insurance has been increasing, and that means workers' kids likely don't
have coverage either.
other cases, coverage for children is available, but costs extra. Which means
parents sometimes have to make hard choices.
PARENT: "There were times that we'd have to
pick — let's see, the first of the month, do we pay the insurance or do we pay
the water, sewer and electricity? I mean, if you have to choose between water and
electricity, and insurance that you're not using on a daily basis, you know you
have to pick your utilities."
was the mother of an uninsured child, interviewed for a study published this
week in JAMA, the journal of the American Medical Association.
author Jennifer DeVoe found that about four percent of U.S. children and
adolescents do not have year-round health insurance, despite having at least
one parent who does have health coverage.
DeVOE: "This is the group that I'm talking
about: parent insured all year, child not insured all year. About three million
says that gap exists despite a government program called SCHIP [State
Children's Health Insurance Program], which is supposed to help.
DeVOE: "We need to expand the State Children's
Health Insurance Program to provide relief to low and middle income families.
They are falling into this gap. They're earning too much to qualify for public
insurance in most cases, and not enough to afford private coverage."
found that uninsured children and adolescents whose parents had health
insurance were more likely to be of Hispanic origin, and more likely to live
with a single parent. Uninsured children were also more likely to be in
low-income families, though one-fifth of the uninsured kids were in high-income
journal editor criticizes candidates' vague health plans
health care system is, at its highest level, perhaps the best in the world.
for providing regular care to regular people at regular prices ... well, the
word most often used by critics to describe the system is "broken."
health care system has not been much of an issue in this year's presidential
election. War and the economy have pushed it pretty much to the sidelines.
the candidates do have their health proposals. Democratic candidate Barack
Obama wants to require larger employers to provide workers with health
insurance. His Republican counterpart, John McCain, is proposing a tax break to
help people buy their own insurance.
candidates write about their plans in this week's issue of JAMA, the same
journal that published Jennifer DeVoe's study.
Tuesday, I asked JAMA editor Dr. Catherine DeAngelis why Americans should be
paying more attention to the health insurance issue.
DeANGELIS: We're in deep trouble, and we're trying to
bring attention to it, especially now with our election only two weeks away,
we're trying to bring people to understand just how dire the situation is, and
that if we don't do something very soon, our population's going to suffer so
badly, that even though we think of ourselves as having the best health care in
the world, guess what, people? We could have the best health care in the world.
Right now we don't. I just looked at a statistic the other day. We now rank
43rd in the world in longevity. Two decades ago we were 11th. And we spend more
per capita than any other country in the world. Now what is going on? Why can't we solve this issue?
less than 1,500 words each, McCain and Obama describe their health programs.
But DeAngelis says their positions are hard to evaluate in just a page and a
DeANGELIS: "If I were to take what I read in what
they submitted to us? First of all, I don't know what they're talking about
because there isn't enough detail in there for me to decipher exactly what
they're going to do. Whichever of them gets in office, I want to see what he
does, actually does. What attention he pays to this. And if he's just going to
let it go by-the-by, we're going to be in trouble, because the health of our
nation is crashing."
assessment of Catherine DeAngelis, editor of the journal of the American
Medical Association, JAMA.
move to live near national parks and nature reserves
to the United Nations, one-eighth of the world's territorial area — land and
adjacent waters — has been designated as "protected areas."
include a variety of natural environments, from nature reserves and wilderness
areas to managed resource areas, where logging or fishing might be permitted.
some cases, protected areas have been created and sustained with the help of
donor countries and international organizations.
areas such as national parks have sometimes been criticized as the creations of
urban elites that don't benefit rural communities by depriving local residents
of access to places to hunt, fish, or farm.
study published recently in the journal Science may undercut that
from the University of California found higher population growth in buffer
zones just outside protected areas than they did in similar, nearby rural
areas. They conclude that the protected areas were actually attracting
WITTEMYER: "Many, if not most of the protected
areas that we looked at showed that there was much faster growth rates going
around them than there were on background rural [growth] rates"
George Wittemyer is one of the lead authors of the study, which included more
than 300 protected areas in 45 countries in Africa and Latin America.
co-author, Justin Brashares, explained that infrastructure related to protected
areas actually attracts migrants.
BRASHARES: "If the goal of the protected area is
to sustain biodiversity for generations, then it only makes sense that when
we're placing water treatment [facilities], schools, clinics, road networks,
and other major amenities, that we think about the likely impacts of those
amenities, those draws to human populations, for the protected areas."
two spoke this week at a symposium sponsored by the Woodrow Wilson Center in
some cases, facilities are created outside boundaries of the park or preserve
to draw people out of the protected area, but they also apparently bring
newcomers from elsewhere. People are also attracted by jobs such as park
ranger, and in some cases in the tourist industry.
says the increasing population around the protected area can do environmental
damage and possible hurt the new residents as well.
WITTEMYER: "A number of risks are occurring or
emerging around these protected areas. And first of all, the obvious one is
that biodiversity conservation objectives are being impacted by higher
deforestation rates, increasing pressure around the protected area, increased
isolation — but also there's a big health risk with emerging infectious disease
and how that relates to human [population] densities."
paper in Science combined a lot of data from a lot of different sources,
and not all of it was a perfect fit for what the researchers wanted to measure.
For example, the goal of the study was to analyze population growth in a
10-kilometer-wide buffer zone around park boundaries. But the buffer zones
didn't exactly correspond to census districts ... and in many countries,
population counts were irregular or unreliable anyway.
Bremner of the Population Reference Bureau welcomed the study, but was critical
of some aspects of the work, including the basis for the authors' conclusions.
BREMNER: "The reasons for migration I think are
diverse, and I don't think the authors provide adequate evidence to show that
conservation investments are driving migration to these areas."
kind of criticism is not unusual. Most research is published exactly for this
purpose: so the scientific community can openly evaluate it, criticize it, and
provide a roadmap for further research.
and other 'protected areas' on our Website of the Week
of th sources of raw data for this study is the World Database on Protected
Areas. It's just been published online at a brand new website. And we've chosen
it as our Website of the Week, where we showcase interesting and innovative
site, at wdpa.org, features information about some 150,000 places on Earth that
have some sort of protection against logging, mining, hunting, fishing, or
BESANÇON: "Most people think of them as national
parks. So, the Grand Canyon. The Serengeti. Many World Heritage sites. And they
also have many different objectives. The objectives are strict nature
protection, where actually people aren't allowed to go, all the way to the
other extreme, where sustainable use of natural resources is allowed by local
and indigenous peoples."
Besançon is an official with the United Nations Environment Program, which
compiles the database.
U.N. first began collecting this information 26 years ago, but the website was
launched just a few weeks ago, which means it's too early to tell who will be
using it, and for what. But Besançon has some ideas.
BESANÇON: "We're expecting that lots of armchair
environmentalists will happen across it. We also know many, many people, of
course, working in the conservation field, who use the data on a regular basis,
and they're dying to get in and see the new online version. And if you're a
scientist, you might want to do some analyses from it and make some
determinations about biodiversity protection, for example, around the
underlying database is words and numbers, which is key for scientists and other
specialists who need the data.
BESANÇON: "But what it makes real and interesting
is when you mix it with other data, like satellite imagery or aerial
photography. And then you're looking at Mount Rainier [in Washington State] and
flying around it. It makes it much more interesting."
parks, nature preserves and more at the World Database on Protected Areas,
wdpa.org, or get the link to this and more than 200 other Websites of the Week
from our site, voanews.com/ourworld.
MUSIC: Paul Winter — "Se é Tarde me Perdoa
(Forgive Me If I'm Late)"
listening to VOA's fully-protected science and technology magazine, Our World.
I'm Art Chimes in Washington.
the link between wildfires and climate change
today, wildfires have always been a part of life in the American West. But the
problem seems to have gotten worse in recent years.
say it's because fires are now spotted and quickly put out, meaning that when
fires do start, they're exceptionally large, dangerous, and destructive.
say that the increasing number and severity of wildfires is tied to climate
the past couple of decades, researchers have been working to understand the
relationship between climate and wildfire. Sadie Babits reports from the state
of Idaho, where scientists are trying to understand more about this connection.
BABITS: Jennifer Pierce wears work boots as she
plows down a steep slope in a ponderosa pine forest.
and her colleague David Wilkins are professors who work for Boise State
University's geosciences department. They're in the middle of tall pines in a
forest just outside of Boise, Idaho. Suddenly she's crashing across the
brambles and heads for this tree.
PIERCE: "Oh that's a great one! Wow!
BABITS: She drops to her knees and shows me how this
tree has been scarred by fire.
PIERCE: "You see this little V-shaped, we call
them cat face here at the bottom of the tree that's blackened? So during a fire
when the bark of the tree gets damaged that preserves a record of that fire as
a scar on the tree."
BABITS: Pierce says since the tree has annual growth
rings, she can tell when the tree got burned.
one way Pierce and Wilkins reconstruct the fire history of this forest. It's
also a key to understanding how climate has affected forest fires in the past.
PIERCE: "As we move into a likely warmer and
drier future, it's going to be increasingly important to understand the
relationship between climate and fire."
BABITS: She says climate is the primary control for
wildfires. As the [Western United States] warms, there's less control.
Recently, that's meant a lot more wildfires.
WILKINS: "There you go!"
BABITS: David Wilkins is twisting an auger into the
WILKINS: "It's a good upper body workout!"
BABITS: It's a way to take a sample of the rings of
this tree. Within a half-minute, Wilkins' auger is stuck. The tree is rotten
Pierce takes a look at this sample Wilkins twisted out. The rings — some light,
some dark — reveal just how the tree has responded to moisture and temperature.
PIERCE: "If you have a tree that kind of is at
the edge of its comfort zone, so to speak, it will be more of a sensitive
recorder of those environmental stresses."
BABITS: Tree rings aren't the only clue these
scientists use to reconstruct historic climates.
PIERCE: "I didn't bring my big shovel. I kind
of feel naked without it."
Pierce scrapes away dirt and she finds
bits of charcoal. She can sometimes use charcoal for radiocarbon dating. But
these won't do.
"But I wouldn't use them for dating because you want to make sure that the
charcoal is stratigraphically in place and that you haven't had critters
burrowing and mixing things up."
can be dated much further back than the tree rings. It helps Pierce and Wilkins
understand what happened here thousands of years ago. With samples from other
scientists, they'll get a snapshot of ancient climate and how it affects
possibly determine what climate change will mean for forests in the future.
The Environment Report, I'm Sadie Babits.
for The Environment Report comes from the Joyce Foundation, and the U.S. Dept.
of Agriculture. Send your thoughts and
ideas to feedback at EnvironmentReport.org.
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our show for this week. If you'd like to get in touch, email us at
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Voice of America
Washington, DC 20237 USA
Sivak edited the show. Bob Doughty is the technical director.
this is Art Chimes, inviting you to join us online at voanews.com/ourworld or
on your radio next Saturday and Sunday as we check out the latest in science
and technology ... in Our World.