Sunday, August 5, 2007

Why Patients Are Flocking Overseas for Operations

Why Patients Are Flocking Overseas for Operations
Hospitals around the world are drawing new patients with topnotch doctors, high-tech equipment and low costs. These 10 are leaders in their fields.
By Joe Cochrane
Newsweek International

Oct. 30, 2006 issue - It's not a stretch to call Jamie Johnson an accidental tourist in Thailand. While touring with a Christian singing group last month, Johnson, a diabetic from the United States, developed an infection in her ankle that shut down her kidneys. She was evacuated by airplane from Malaysia to Bumrungrad International hospital in Bangkok—a facility she had ever heard of in a country she had never been to and in a city she had associated with sex shows in beer bars. "My husband back home was thinking, 'She's going to be in a straw hut'," she says.

Johnson, though, was lucky enough to land in Asia's first internationally accredited hospital and one of the most modern and efficient medical facilities in the world. Last year the hospital treated 400,000 foreign patients—the highest of any hospital in the world—from more than 150 countries, for everything from heart disease to hip replacements to breast implants. The attraction: world-class medicine at developing-world prices. And patients get velvet-glove treatment redolent of a five-star hotel. "We deliver the one thing that people want in health care but don't expect to get—service," says Ruben Toral, the hospital's marketing director.

As medical costs skyrocket—Americans spent 16 percent of GDP on health care last year, according to the OECD, and Europeans aren't far behind—the idea of going abroad to get healthy is becoming more and more attractive. More than 150,000 North Americans and Europeans currently seek medical treatment overseas each year, estimates Josef Woodman, author of the forthcoming "Patients Without Borders." For invasive surgeries, preferred destinations include India, Thailand, Singapore and Malaysia. Large hospitals, such as Bumrungrad and the Apollo chain in India, actively court American, European and Middle Eastern patients. Slick Web sites tout their partnerships with nearby luxury hotels for post-op recovery. Bumrungrad arranges limousines to pick up patients at the airport, and sheiks and princes congregate in the Platinum Lounge of Apollo's Delhi hospital. Abacas International, a leading travel facilitator, reports that medical tourism to Asia could generate up to $4.4 billion by 2012.

Businesses are taking notice. At least 40 corporations have signed on to the overseas plan that United Group Programs, a health insurer in Boca Raton, Florida, began offering six months ago. Sending an employee abroad can save 80 percent of the costs of a procedure; a $50,000 angioplasty in the United States costs less than $6,000 in Mohali, India, according to GlobalChoice Healthcare, a firm that arranges foreign medical procedures.

Bumrungrad officials insist that foreigners come not just for cheap bills and luxury accommodations. The hospital's doctors, they say, have been trained at the best Western medical schools and use the most advanced medical equipment. And the service is eye-opening for patients accustomed to public clinics. Walk-in patients see a specialist in 17 minutes on average. Since 75 percent of hospital revenues are paid by patients directly, health and insurance companies have no say in treatment. Low labor costs allow Thai hospitals to employ more staff.

Some health-insurance companies are embracing medical tourism to reduce costs and make policyholders happy. It is only a matter of time before the phenomenon evolves into medical outsourcing, says Mack Banner, Bumrungrad's CEO. "People are going to leave their country, they're going to go overseas and they're going to get health care," he says. To make room for them, Bumrungrad is building an 18-story outpatient center, which will double the hospital's capacity to 6,000 outpatients per day. That's room for a lot of tourists, accidental or otherwise.

With Barrett Sheridan in New York

Beijing’s Olympics Face-Lift: Radical Reconstruction

Beijing's Olympics Face-Lift: Radical Reconstruction
With the Olympics approaching, China is re-creating its once grim capital on an awesome scale.
By Melinda Liu
Newsweek International

Aug. 13, 2007 issue - The transformation of Beijing for the 2008 Olympics is emerging as perhaps the most ambitious remake of any major world capital in history, short of the postwar reconstructions. The silhouettes of the spectacular new stadium and swimming center are already familiar worldwide, but they are set in a rebuilt urban core that startles return visitors. Lush new green spaces, swirling expressways, shopping arcades roofed with giant LED screens, a new downtown financial center plus a vastly expanded public trans-port system have all rapidly appeared. To some, the Olympic-driven metamorphosis evokes the remaking of Paris by Baron Haussmann between 1865 and 1887—a complete redesign of the city center, including the creation of the grand boulevards for which Paris is famous today.

For others, Beijing's radical rebuild smacks of totalitarian-power architecture, akin to the grandiose but unrealized blueprints of Albert Speer, Hitler's favorite architect. But Albert Speer Jr. disagrees. The younger Speer—also a prominent German architect—recently redesigned a central eight-kilometer-long strip running from the center of the Forbidden City north to the new Olympic green. mandated by imperial feng shui masters, this has been Beijing's heart for centuries. Speer says his scheme is a paean to the city's tradition, not a power trip—despite being "bigger, much bigger" than his father's "megalomaniac" design for New Berlin.

However you characterize it, Beijing's rulers are now permitting ultramodern design of a type Maoists have long shunned as bourgeois or Western. Many of the new taboo-busting constructions are stunning gravity-defying structures designed by some of the world's top architects, as well as China's own young guns. Some have sparked unprecedented public debate about whether Beijingers should sacrifice its old charm for modern glitz and convenience—and at what cost. "[Architects] have introduced lots of things we didn't have and didn't do before," says designer Feng Keru, senior editor of the Chinese edition of Domus, the Italian architectural bible. As a result, she says, Beijing's recent edifice complex has triggered new standards for construction and engineering nationwide.

The Olympics will be a massive coming-of-age party for the world's newest economic superpower, as planned. But President Hu Jintao's administration is not just building an Olympic village; it is overseeing the creation of a dynamic new capital with "the pyramids of the 21st century," says Prof. Zhou Rong of Tsinghua University's architecture school. The problem is that, with the 2008 deadline looming fast, even Beijing can't quite control the pell-mell process of demolition and construction. The basic concern is how to balance costly environmental projects against the raw need for economic growth. The ruling Communist Party has long based its legitimacy on providing prosperity. But for several years now it's been struggling both to restrain construction spending in a dangerously hot economy and to redistribute income more fairly. The Olympic building program is clashing head-on with both goals, by concentrating Beijing's own spending in the wealthy capital and by inspiring every province to spend heavily on grandiose buildings, too.

The communist leaders are responding by trying to rein in the provinces. The contradiction is glaring. Tough new draft legislation on urban planning proposes stiff fines for property firms guilty of wasteful land use and other violations. In the spring, the Ministry of Construction blasted local governments for single-mindedly pursuing urban development and "vanity projects." It also warned the provinces against "blindly" hiring foreign architects who are "divorced from China's national conditions and pursue novelty, oddity and uniqueness," although this describes most of the architects redesigning Beijing. Many provincial leaders are taking this mixed message to mean "full speed ahead."

Locals have come to know the new projects by wry nicknames: the futuristic 90,000-seat National Olympic Stadium, with its massive external lattice of intertwined beams, is the "bird's nest." The equally stunning National Aquatics Center, a shimmering translucent block swathed in an energy-saving skin that looks like bubble wrap, is known as the "water cube." Then there's the "duck's egg," the National Opera House designed by French architect Paul Andreu: a titanium ovoid set near Tiananmen Square. And perhaps most breathtaking of all is the new headquarters designed by Rem Koolhaas's firm for the China Central Television corporation, or CCTV. The two 230-meter-high L-shaped towers lean into each other to form a vertiginous loop; local wags call it "trouser legs."

Beijing was overdue for a face-lift. When the Red Army first marched into the capital in 1949, Mao Zedong dreamed of turning it into a city of industry with "a forest of chimneys"—a vision he soon helped realize. When China's capitalist boom began many years later, Mao's smoking factories were soon surround-ed by ugly glass-and-chrome office towers, many topped with unintentionally kitschy pagoda roofs. The result was a mess: polluted, chaotic, hard on the eyes and decidedly less than world-class. "You can't say it was all rubbish," says Professor Zhou. "But just about."

The cleanup is well underway, and much will be done by the time the Olympics open on Aug. 9, 2008. Six new subway lines, a 43km light-rail system, a third airport terminal and runway, and 25 million square meters of property development—all this will greet a projected crowd of 500,000 foreign visitors and 1 million mainland Chinese. The leadership has earmarked some $12 billion for "greening" projects, from a 125km tree belt around the city to mandatory adoption of strict European vehicle-emission standards. Earlier this year, entire blocks of run-down low-rise tenements along the northern Second Ring Road were replaced within weeks by a two-kilometer-long green belt of parkland, walkways, small playgrounds, lighting and 25-foot-tall trees. And that's just one of numerous green spaces, including a 12-square-kilometer Olympic park.

Mao's beloved chimneys are quickly disappearing. Parts of the Capital Iron and Steelworks and the entire 1.5-sq-km Beijing Coking and Chemical plant have been shuttered or moved to neighboring Hebei province. During the desperate industrialization of the Mao era, both factories were great sources of prestige. But Party leaders are now increasingly concerned with the environment—especially with reducing Beijing's eye-stinging air pollution before the Games begin. Closing the Coking and Chemical Plant alone should reduce sulfur dioxide emissions by 7,500 tons annually, says plant president Zhang Xiwen. "Still, it was a big sacrifice," he says.

And it's not the only one. The speed of Beijing's makeover has further diluted much of the sense of order in this imperial capital founded by Kublai Khan. Ming emperors built the Forbidden City, with city gates and walls revolving around it, in a rectilinear grid. On taking the capital in 1949, Mao and his Russian advisers collectivized single-family courtyard homes, built factories and razed the city wall to make way for the Second Ring Road. (Now Beijing has six ring roads.) "Regrettably, very, very little of Old Beijing's look has been preserved," laments Ma Zishu, formerly deputy director of the high city's cultural-relics bureau. "The problems of disorder and high density began with the plans of Mao's Soviet experts," says Domus's Feng. "Now all of a sudden the government is trying to turn Beijing into an international city, so all of the tensions and conflicts [of spacing] have been intensified."

Many experts worry that insufficient thought is being given to preserving community and historical continuity. Ancient neighborhoods are vanishing. Beijing pre-servationists lament the disappearance of charming labyrinthine residential lanes known as hutongs—a Mongol word for "alleyway," many of which have been razed to make way for wide, modern boulevards.

Patchy central planning has created a city with a disjointed, deracinated feel. Entire villages near the Olympic facilities were demolished to make way for space-age-looking structures; nearby clumps of skyscrapers seem as if they'd been airlifted from Tokyo or New York and plunked down at random. Chinese "starchitect" Zhu Pei complains that Beijing's uprooted "ghettoes"—all business buildings here, all luxury residences there—make him feel as if he's "living in an urban archipelago." This approach, says James Brearley, head of the Shanghai-based architecture practice BAU, is typical of Chinese planners' preference for "superscaled segregated-zoning practices" once common in the West during the last century, with central business districts (CBDs) that emptied out at night and apartment complexes lacking retail outlets. The Chinese approach to city design thus far, he says, "is based on one single model, and the model is f—-ing disastrous. You can quote me on that."

Bad as it is, the provincial copies of this model are worse, and even cruder. Every mayor of a second- or third-tier city now seems to want to set a building record. The Jiangxi capital of Nanchang, for example, has constructed the world's largest Ferris wheel. Zhengzhou (population: 6.6 million) is competing with Chongqing (population: 31 million) for the title of the "Chicago of China," and its apparatchiks boast that they have more construction cranes per capita than any other city in the country. In Zhejiang province, city officials in Shaoxing reacted to the central government's order to limit new CBDs by simply rebranding theirs as a mixed-use "commercial center" with residential facilities. The makeover is grand, with a vast empty plaza (a Shaoxing version of Tiananmen Square), a pyramid-shaped building that is home to (what else?) the city's planning center, and a theater that looks like a knockoff of the Sydney Opera House. There are now about 100 small cities in China that, like Shaoxing, have built grand new opera houses, estimates Professor Zhou. Even Shaoxing officials regret having paved over ancient canals and humpbacked bridges that once gave the place a lyrical "water-city ambience"; officials are now trying to preserve what's left of the old town.

The type of city that emerges could be critical to President Hu Jintao's legacy. In contrast to the hypercapitalist policies of his predecessor, Jiang Zemin, Hu wants to close the alarming rich-poor gap and repair the tattered social safety net that has kept many Chinese mired in poverty. And he aims to do all this at a time when rural migrants are flocking to cities for jobs in services and on construction sites. To accommodate an influx of up to 300 million peasants in the next 15 years, China will not only have to "build almost the same amount of urban infrastructure as already exists," says Karl Traeger of Woodhead, the Australian firm that designed the original Shaoxing CBD. It will also need to plan more carefully. Showcase buildings and endless ranks of pricey luxury flats will do little to house the incoming army of workers, to advance Hu's "harmonious society," or to restrain the runaway construction sector that poses perhaps the single greatest threat to stable growth.

It's an open question how China will handle all this. The nation is now expected to surpass Germany as the world's third largest economy this year, a fitting opening act for the Olympic spectacle Beijing plans. But will the capital emerge as a metropolis of beauty and soul (like Paris) or a brawny show of power (à la Speer's vision for Berlin)? The latter seems far more likely unless China's top leaders—nine men trained as engineers—get serious about promoting "human" values, as they've promised.

With Jonathan Ansfield in Beijing and Duncan Hewitt in Shaoxing

Thursday, August 2, 2007

Secrets of human attraction

A gene that could explain how humans pick up powerful chemical signals called pheromones may have been pinpointed for the first time.

The discovery promises to give scientists a new understanding of our basic instincts.

Pheromones are known to trigger physical responses including sexual arousal and defensive behaviour in many species of insects, fish and animals.

There has long been speculation that humans may also use these chemicals to communicate instinctive urges.

Women living together often synchronise their menstrual cycles because they secrete an odourless chemical in underarm sweat.

But until now scientists have not been able to explain how and where in the body the chemicals are picked up and their messages passed to the brain.

Special organ

Many animals, including mice, rabbits and pigs, have a special organ called the vomeronasal organ (VNO).

This relays chemical signals directly to the most primitive centres of the brain, stimulating instinctive reactions.

In human embryos these organs exist but they appear to perform no function after birth.

Now, scientists at Rockefeller University in New York and Yale University in Connecticut believe they have found a gene which may create pheromone receptors.

A receptor is an area on a cell that binds to specific molecules.

Called V1RL1, the gene resembles no other type of mammalian gene and bears a strong similarity to those thought to create pheromone receptors in rats and mice.

"People have taken an anatomical approach to the issue in the past. This is the first attempt to look at the molecular biology," said Dr Peter Mombaerts from Rockefeller University in the journal Nature Genetics.

Ancient clues

Dr Mombaerts and his colleagues also found seven related snippets of DNA which should produce a protein but appear to have been turned off at some stage in their evolution.

Why these "pseudogenes" exist is a mystery. One possible explanation could be that in their distant evolutionary past humans made more use of pheromones than they do now.

Much work still needs to be done to prove V1RL1 is a gene and does create pheromone receptors.

A biotechnology company called Senomyx in California is looking at how the gene may work and which aspects of human behaviour are controlled by pheromones.

Some ethicists are worried research could lead to pheromone abuse. Carefully targeted artifical pheromones could be misused to modify human behaviour in advertising, politics and even warfare.


From BBC NEWS

Clues Behind Pheromones and Sex

Clues Behind Pheromones and Sex

WebMD Medical News

Sept. 5, 2002 -- Pheromones, those mysterious, scentless chemicals that some say drive human sexual behavior, have been studied for decades. But now researchers say they've finally found proof that mammals -- such as humans and mice -- are actually programmed to detect and use them.

A new study, published in the Sept. 5 issue of the journal Nature, shows the first real evidence that the nervous system of mice is wired to detect pheromones. And when that wiring is tampered with, their mating behavior is disrupted.

Researchers say mice contain pheromone receptors in a specialized organ in the smelling system of the body.

In their study, researchers at The Rockefeller University and the University of Maryland found that when these pheromone receptors were turned off through genetic mutation, the mice developed normally but were different in terms of aggression and sexual activity. The study authors say these differences might yield clues about pheromones' role in influencing sexual behavior and species development.

For example, nursing female mice are normally aggressive toward other mice that invade their nest. But nursing mice without the pheromone receptors were less aggressive and slower to attack invaders.

Among male mice, researchers found several differences between the normal and genetically altered mice.

Sometimes, young, socially inexperienced mice exhibit sexual behavior toward other males until they learn to distinguish males from females. But the mutant males made fewer sexual advances toward males. Researchers say this could indicate that either the mutants are better at distinguishing between the sexes at an early age, or their overall sexual drive is reduced without the ability to detect pheromones.

In addition, mutant male mice tended to mount female mice fewer times than would otherwise be expected.

According to the authors, the existence of a functioning specialized pheromone organ in humans has been widely debated, and the role of pheromones in human behavior has yet to be clearly understood.

But since a functional role for this organ has now been shown in mice through genetic manipulation, they say the findings should stimulate more research into the counterparts of these genes in humans.

Drug boosts sex drive, company says

Drug boosts sex drive, company says
Early trial results shows inhaler stimulates brain arousal
Updated: 12:11 p.m. ET May 19, 2006

FORT LEE, N.J. - A New Jersey drug company says an inhaler it's working on could be the long-sought female version of Viagra.

Palatin Technologies of Fort Lee says it's had encouraging results in both men and women with Bremolanotide, which stimulates the brain, rather than the genitals.

The company's director of preclinical development says it may help women who lack desire and have trouble getting aroused.

She says it works differently from Viagra and other drugs, which increase blood flow to the genitals.

They facilitate sexual arousal, Annette Shadiack reports. "Bremolanotide initiates sexual arousal."

URL: http://www.msnbc.msn.com/id/12867311/


© 2007 MSNBC.com

(http://www.bremolanotide.com)
(www.pherlure.com)

Wednesday, August 1, 2007

Trade dilemma on China-Kazakh border

Trade dilemma on China-Kazakh border
Trade is booming on the Kazakh-China border. But Kazakhstan's increasing economic ties with its huge neighbour can sometimes prove negative as well as positive, says the BBC's Central Asia correspondent Natalia Antelava.

Just a few years ago, 19-year-old Alina, a student at the Kazakh state university, would have been learning English.

These days, she spends hours every week perfecting her Mandarin.

The reason is simple. China, she says, is where her future lies.

It's a vision shared by many across Central Asia, and it takes just a three hour drive from Kazakhstan's economic capital Almaty to find out why Chinese is so popular.

The Chinese-Kazakh border is the country's busiest frontier: lorries and cars cue for hours here, empty on the way to China, loaded with merchandise on the way back.

Hundreds of people and millions of dollars worth of goods cross the border every day.

Co-operation is on the rise, and the relationship is about to get even closer.

Free economic zone

"You have to use your imagination," Ibragim Toyshybekov, a local official, warned me as we embarked on a two-hour tour of an empty steppe spread between the two countries.

As we drove along next to the barbed wire, Ibragim described the ambitious project that he, along with his colleagues, is trying to implement.

The project will fill the empty steppe with shopping malls and business centres. It will allow a free flow of people and goods, and give a huge boost to the trade between China and the whole of Central Asia.

Kazakhstan hopes that the creation of the free economic zone with China will turn the country into a trade crossroad of global significance.

Beijing, on the other hand, says the zone will allow China to expand even further into both Asian and European markets.

The idea is backed personally by Kazakh President Nursultan Nazarbaev, and like the president's every other project in Kazakhstan, among the officials at least, it enjoys unquestionable support.

"It's a brilliant idea; there will be everything here," Ibragim said as we drove right up to the Chinese side.

Beyond a line of red flags marking the border, Chinese guards in beige uniforms strolled and chatted away, relaxed and seemingly oblivious to the blistering sun.

"We'll have shopping malls, business centres, restaurants, hotels, anything your heart desires," Ibragim described.

But when asked about the common fear that China's growing economy may overpower its smaller neighbours, Ibragim laughed and said that he was not allowed to comment.

"Official policy here is to say that China is a very good neighbour, but unofficially there are plenty of fears," said Dostym Satpaev, the head of the regional Risk Assessment Group.

There is, Mr Satpaev says, a real worry in the region that China will simply become too much to handle, and that the growing number of goods and people it sends will pose a serious demographic and economic threat.

"When it comes to China, Kazakhstan is in a tricky position. We need to remember that China is our neighbour, a very ambitious neighbour and economically a very strong neighbour. So we need good relations with Beijing.

"But at the same time we should be wary about its increasing activity here and what consequences it may have," Mr Satpaev said.

'Geopolitical force'

The consequences are already apparent. Across Central Asia, markets are flooded with cheap goods, and full of Chinese traders.

There is no official data on how many Chinese are living and working here, but their number is visibly growing.

"Can you imagine what will happen if more of them come here?" Karlagash, a shopper from Almaty, said.

"Look at our vast plains, I am sure they can't wait to lay their hands on our land," she added.


We'll have shopping malls, business centres, restaurants, hotels, anything your heart desires
Ibragim Toyshybekov, local official

Beijing now has trade missions in every Central Asian country: it's investing in local enterprises and donating money to aid projects.

And by filling the markets with plastic fans and cheap DVD players, China is becoming an increasingly powerful player.

The region's growing reliance on Chinese goods is a major source of Beijing's new political leverage in the energy-rich region.

"China went from being a non-player in the 1990s to becoming a major geopolitical force, and its role is still growing," said Dostym Satpaev of the Risk Assessment Group.

"But the problem is that the only thing China is interested in are the region's minerals; oil, gas, natural resources. It does not want to open factories or invest into manufacturing goods here."

But still, for millions across this impoverished region, China is a lifeline.

Whether they like it or not, people rely on Chinese goods here, and where China's economic influence leads, its political might will follow.

Chinese-made toys recalled in US

Chinese-made toys recalled in US
Toymaker Fisher Price is to recall almost one million Chinese-made toys over fears that their paint contains too much lead.

An internal probe found the Chinese manufacturer had used a non-approved paint pigment, violating its safety standards, the company said.

The recall affects 83 types of toy that have been on sale in the US since May.

It is the latest in a series of safety scares involving goods - food, drugs and other products - made in China.

Mattel Inc, which owns Fisher Price, said that the recall affected a total of 967,000 toys, including characters popular with young children such as Sesame Street's Big Bird and Elmo.

The company said that it was removing the products from shops and would intercept incoming shipments.

"We are still concluding the investigation, how it happened," Fisher Price's general manager, David Allmark, told the Associated Press news agency.

"But there will be a dramatic investigation on how this happened. We will learn from this," he said.

Lead is toxic and can pose a health risk to young children if ingested.

The US Consumer Product Safety Commission urged parents to remove the affected toys from their children and contact Fisher Price.

Tainted products


CHINESE PRODUCT SCARES
Pet food - tainted with chemical melamine
Toothpaste - tainted with chemical diethylene glycol and bacteria
Farmed fish - traces of banned drugs and pesticides found
Tyres - fault may cause blow-outs
Toys - contain lead or pose choking hazard
Children's jewellery - contains lead
Ceramic heaters - pose fire safety risk
Source: FDA and US Consumer Product Safety Commission

In recent months there have been a series of scares in the US involving products such as fish, seafood, toothpaste and tyres from China.

In June, toymaker RC2 recalled 1.5 million Chinese-made toy trains after they were found to be coated in paint containing lead.

Earlier this month, US President George W Bush set up a panel to look at the safety of food and other products imported into the US.

The White House denied the move was aimed specifically at China, saying it is important to check all imports.

Beijing has accused foreign media of exaggerating problems with Chinese products, but has admitted that safety standards need to improve.

In recent weeks, it has taken steps to show it is taking the issue of quality control seriously.

Earlier this month it closed down three companies and arrested several people involved in food and drug scandals that have caused alarm both at home and abroad.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/asia-pacific/6927156.stm

Published: 2007/08/02 03:29:26 GMT