Insurance broker Aon launches Ebola liability cover

Medical staff members take part in a Ebola virus preventive drill at Ditan Hospital in Beijing, October 30, 2014.

LONDON (Reuters) - (The story was corrected in the first and fourth paragraphs of Oct. 28 story to show Aon is based in Britain, and not the United States)

British insurance broker Aon has launched Ebola liability cover for hospitals and other health care institutions, the company said on Tuesday.

The Ebola virus has killed nearly 5,000 people worldwide, mainly in West Africa.

Fear of Ebola infections spreading to developed economies has prompted insurance companies to add exclusion clauses to their standard policies or to develop new products.

The broker's Ebola cover is for situations "where existing liability programs may not apply" and provides up to $25 million of liability coverage, Aon said in a statement.

"There are several areas where there has not been certainty about coverage for Ebola," Gigi Norris, managing director of Aon Risk Solutions' Western Region Health Care Practice, said.

"This is something our health care clients are extremely worried about."

The cover will protect hospitals from cases related to their response to Ebola brought by employees, patients, or even potential patients who have been refused admission, Norris said.

It has been designed for U.S. hospitals, but could be adapted for the international market, she said.

The policy has been developed with British insurance company Hiscox, and will be available through other brokers after 60 days, Aon said.

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Ebola death toll rises, fewer cases in Guinea than thought: WHO

A billboard with a message about Ebola is seen on a street in Conakry, Guinea October 26, 2014.

GENEVA (Reuters) - The Ebola epidemic has killed 4,951 people out of 13,567 infected in eight countries, the World Health Organization said on Friday, slightly revising downwards its figures for cases mainly due to "suspected cases in Guinea being discarded".

The toll reflects a rise of 31 deaths since the United Nations agency reported its previous figures on Wednesday, while the number of overall cases fell by 136.

"Of the eight Guinean and Liberian districts that share a border with Cote d'Ivoire (Ivory Coast), only one in Guinea is yet to report a confirmed or probable case of Ebola virus disease," the WHO warned in the statement.

Guinea, Liberia and Sierra Leone account for the bulk of infections of the deadly hemorrhagic fever, but there have been sporadic cases in Nigeria and Senegal, both now declared Ebola-free, as well as Spain, the United States and Mali.

A 2-year-old girl who brought Ebola to Mali may have had contact with up to 141 people, 57 of whom have yet to be traced, according to experts from the WHO and U.S. Centers for Disease Control concerned it could spread in Mali and beyond.

Liberia, the worst-hit country, may be seeing a decline in the spread of the virus, though the battle to contain the outbreak is far from won, the WHO said on Wednesday.

All 83 contacts of a health care worker in Spain infected with Ebola have completed a first 21-day incubation period for the virus, but a second one must follow before the country can be declared free of the disease, the WHO said on Friday. The nurse treated two Spanish priests repatriated from Liberia and Sierra Leone who later died.

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Judge rejects isolation for U.S. nurse who treated Ebola patients

FORT KENT Maine (Reuters) - A Maine judge ruled on Friday that a U.S. nurse who treated victims of Ebola in West Africa does not need to be confined to her home, declaring Ebola fears in the United States "not entirely rational."

Nurse Kaci Hickox's challenge of Maine's 21-day isolation regime became a key battle in the dispute between some U.S. states and the federal government. A handful of states have imposed mandatory quarantines on health workers returning from three Ebola-ravaged West African countries while the federal government is wary of discouraging potential medical volunteers.

While she may travel freely in public, the judge decided that Hickox must continue direct monitoring of her health, coordinate travel plans with health officials and report any symptoms.

"I'm happy with the decision the judge made today," Hickox told reporters via a live video feed from her house in Maine to her lawyer's New York City office. "I think we are on the right track. I think now we're discussing as a nation and individual communities about this disease."

Public concern about the spread of the virus is high in both the United States and Canada. Canada became the second developed nation after Australia to bar entry for citizens from the three West African nations where Ebola is widespread.

Some U.S. politicians have called for a similar travel ban, making Ebola as much of a political issue as a public health question.

The most deadly outbreak of the disease on record has killed nearly 5,000 people, all but a handful of them in Liberia, Guinea and Sierra Leone.

Only one person in the United States is currently being treated for Ebola, a New York doctor, Craig Spencer, who cared for patients in West Africa.

Maine Governor Paul LePage, a Republican in a tough re-election battle that culminates in Tuesday's elections, said he was disappointed that restrictions confining the nurse to her home were lifted. His office did not respond to questions about whether the governor would appeal the ruling.

The issue is not yet legally closed.

A hearing is scheduled for Tuesday that will give lawyers for the state another opportunity to plead their case for more restrictions on Hickox before Charles LaVerdiere, the chief judge of Maine District Court.

In Friday's order, LaVerdiere said, "the court is fully aware of the misconceptions, misinformation, bad science and bad information being spread from shore to shore in our country with respect to Ebola.

"The court is fully aware that people are acting out of fear and that this fear is not entirely rational. However, whether that fear is rational or not, it is present and it is real," the judge added, saying Hickox is "not infectious."

On Thursday, the 33-year-old nurse defied the state's quarantine order and went on a bike ride with her boyfriend. Following the ruling, state troopers who had been stationed outside Hickox's home departed.

Speaking to reporters alongside boyfriend Ted Wilbur outside her two-story clapboard house in the small town of Fort Kent along the Canadian border, Hickox said she would comply.

"It's just a good day," Hickox said. "I am taking things minute by minute. Tonight, I am going to try to convince Ted to make me my favorite Japanese meal. And I think we're going to watch scary movies since it's Halloween."

Hickox tested negative for Ebola after returning from working for Doctors Without Borders in Sierra Leone. She also objected when the state of New Jersey put her into isolation when she arrived at Newark airport.

She said he hoped to be able to return for more work in West Africa. "I love working overseas. It's been a large part of my life since 2006," Hickox said.

"I know that Ebola is a scary disease. I have seen it face-to-face and I know that we are nowhere near winning this battle," she added.

Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and is not transmitted by asymptomatic people. Ebola is not airborne.

An Oregon resident was hospitalized on Friday for a possible Ebola infection after traveling to West Africa, according to state health officials. The woman registered a high temperature and is in isolation and not a danger to the public, Oregon Health Authority said.

The woman had not come into known contact with Ebola patients while in Africa, and had not been quarantined after arriving in Portland because there was no medical need, Dr. Paul Lewis, a public health officer in the Portland area, told a news conference.

Public health experts, the United Nations, federal officials and even President Barack Obama have expressed concern that state quarantines for returning doctors and nurses could discourage potential medical volunteers from fighting the outbreak at its source in West Africa.

In New York on Friday, U.S. Ambassador to the United Nations Samantha Power defended federal guidelines for monitoring healthcare workers returning from the three Ebola-stricken countries.

Power spoke at a Reuters Newsmaker event hours after returning from a four-day trip to Liberia, Guinea and Sierra Leone. She said she believed current federal guidelines for returning healthcare workers balanced "the need to respond to the fears that this has generated" in the United States with the known science on the disease.

The U.S. Department of Defense trod that line carefully on Friday. According to the Pentagon, civilian U.S. defense employees returning from Ebola relief work in West Africa must undergo monitoring to ensure they are free of disease but can choose between following civil health guidelines or the stricter military regimen, which requires troops to be isolated for 21 days after returning to their home station.

Another potential flashpoint was resolved when Louisiana reached an agreement on Friday to prevent Veolia Environmental Services, which is in possession of the incinerated personal items of Ebola victim Thomas Eric Duncan and is holding them in Port Arthur, Texas, from sending them to a Louisiana landfill.

Louisiana Attorney General Buddy Caldwell had sued and obtained a temporary restraining order to block the transfer of the material collected from Duncan and the Dallas apartment where he was staying to a hazardous waste landfill in Louisiana.

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U.S. Medicare sets new hospital, doctor payments for 2015

WASHINGTON (Reuters) - The U.S. Medicare program's payment rate for hospital outpatient services will increase 2.3 percent in calendar year 2015, while the rate for ambulatory surgical services will rise 1.4 percent, the federal government announced on Friday.

The Medicare health insurance program for the elderly and disabled will also begin to pay doctors a monthly fee to coordinate care for patients with multiple chronic conditions in 2015, a government statement said.

The separate monthly payment of $40.39 is aimed at improving care, including outside of regular office visits, for patients suffering from two or more chronic illnesses, said the statement from the U.S. Centers for Medicare and Medicaid Services, the federal agency that oversees Medicare.

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The double burden household in sub-Saharan Africa: maternal overweight and obesity and childhood undernutrition from the year 2000: results from World Health Organization Data (WHO) and Demographic Health Surveys (DHS)

Background

Previous studies have characterized an increasing trend of double burden households, or households with individuals experiencing both undernutrition and obesity, in countries undergoing a nutrition transition. Although most prior studies indicate the prevalence of double burden households is highest in middle-income countries, there is some support for an increase in double burden households in sub-Saharan African countries as well.

Method

Using data from the Demographic Health Surveys (DHS) and the World Health Organization (WHO), the prevalence of double burden households in sub-Saharan African countries was calculated and the associations between prevalence of overweight/obese adults and underweight, stunted and wasted children were evaluated at the country level. Restricted analyses and frequencies were calculated using urban-only datasets. Surveys from 28 African countries were available using WHO data and 26 from the DHS surveys. Only surveys that were conducted after 2000 were included in analyses.

Results

Using the WHO datasets, there were inverse associations between the prevalence of overweight and obesity in adults and underweight, stunting and wasting in children. Correspondingly, there were positive associations between adult underweight and child underweight, stunting and wasting. These associations were not significant in a smaller sample size using urban-only surveys. The prevalence of double burden households in DHS datasets was low: under 5 percent for obese mothers and underweight, stunted or wasted child pairs with a slightly higher percentage for overweight mothers and children with undernutrition. Restricting the analysis to urban only populations did not increase the frequencies of double burden households significantly.

Conclusion

There was a low prevalence of double burden households in recent data from sub-Saharan Africa. Countries that have a high prevalence of child undernutrition correspondingly have a high prevalence of adult underweight and low prevalence of adult overweight and obesity.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

• Correspondence: Janet M Wojcicki wojcickij@peds.ucsf.edu

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The cost of anal cancer in England: retrospective hospital data analysis and Markov model

Background

Anal cancer requires a multidisciplinary approach to treatment with often complex interventions. Little is known regarding the associated costs and resource use.

Methods

Patient records were extracted from a national hospital database to estimate the number of patients treated for anal cancer in England. Identified resource use was linked to published UK cost estimates to quantify the reimbursement of treatment through the Payment by Results system. A mathematical model was developed simultaneously to validate findings and to calculate the average 10-year cost of treating a squamous cell anal carcinoma case from diagnosis. The model utilised data from the Association of Coloproctology of Great Britain and Ireland's anal cancer position statement.

Results

On average, 1,564 patients were admitted to hospital and 389 attended an outpatient facility per year. The average annual cost per inpatient and outpatient ranged from [pound sign]4,562-[pound sign]5,230 and [pound sign]1,146-[pound sign]1,335, respectively. Based on the model estimates, the inflated cost per case was between [pound sign]16,470-[pound sign]16,652. Results were most sensitive to the mode of admission for primary treatment and the costs of staging/diagnosis (inflated range: [pound sign]14,309-[pound sign]23,264).

Conclusions

Despite limitations in the available data, these results indicate that the cost of treating anal cancer is significant. Further observational work is required in order to verify these findings.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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AbbVie sales blow past forecasts, fueled by Humira

A screen displays the share price for pharmaceutical maker AbbVie on the floor of the New York Stock Exchange July 18, 2014.

(Reuters) - AbbVie, which this month walked away from a $55 billion deal to buy Dublin drugmaker Shire, on Friday reported quarterly revenue and earnings well above Wall Street expectations, fueled by soaring sales of its Humira arthritis drug.

The Chicago drugmaker, which significantly boosted its full-year earnings forecast, said it earned $506 million, or 31 cents per share, in the third quarter. That compared with $964 million, or 60 cents per share, in the year-earlier period.

Company sales rose 7.8 percent to $5.02 billion, topping the average analyst estimate of $4.83 billion, according to Thomson Reuters I/B/E/S.

Excluding special items, AbbVie earned 89 cents per share. Analysts, on average, expected 77 cents per share, according to Thomson Reuters I/B/E/S.

Sales of Humira, the world's top-selling drug, jumped almost 18 percent to $3.26 billion. They accounted for 65 percent of total AbbVie sales, underscoring the company's dependence on the medicine and its need for other products to broaden its drug portfolio.

A few other products showed strong growth, including thyroid hormone replacement drug Synthroid, whose sales rose 24 percent to $200 million.

But many others suffered sales declines, including its cholesterol treatments and its AndroGel testosterone gel, whose sales have been hurt by growing concerns that such medicines may increase the risk of prostate cancer.

AbbVie raised its full-year profit forecast to between $3.25 and $3.27 per share, from its prior view of $3.06 to $3.16.

Abbott had hoped to buy Shire and locate the combined company in Britain to take advantage of its lower tax rate relative to the United States.

In its earnings report, AbbVie made no mention of intentions to pursue other mergers but said it had abandoned the deal after changes to tax law announced last month by the U.S. Treasury "introduced an unacceptable level of risk" to the economics of the deal.

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U.S. envoy to report temperature twice daily after West Africa visit

NEW YORK (Reuters) - U.S. Ambassador to the United Nations Samantha Power returned to New York on Thursday after a brief visit to Ebola-stricken West Africa and will report her temperature twice daily to the New York state health department for the next 20 days.

Traveling on a U.S. government plane, Power's delegation did not come in contact with any Ebola patients during a visit to Guinea, Sierra Leone and Liberia, the three countries worst affected by the deadly hemorrhagic fever that has killed some 5,000 people.

Customs and Border Protection officers at New York's John F. Kennedy airport took Power's temperature and she then answered several questions about her health and whether she had come in contact with anyone infected with Ebola.

Ebola is spread through contact with bodily fluids of an infected person or the still-contagious body of someone who has died of the virus. It has a 21-day incubation period. Power left West Africa on Wednesday.

Power was given an information kit that included a thermometer and a card to record her temperature twice daily. She is required to report her temperature and any symptoms twice daily to the New York State health department.

Several U.S. states, including New York where the United Nations is headquartered, have imposed a mandatory quarantine on healthcare workers returning from the region who had contact with Ebola patients.

Speaking in Brussels earlier on Thursday, Power said some countries had yet to shoulder their share of the Ebola response burden and some restrictions on aid workers returning home from West African nations hit hardest by the disease could deter thousands from helping. [ID:nL1N0SP3DK]

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U.S. quarantines 'chilling' Ebola fight in West Africa: MSF

A Doctors Without Borders health worker takes off his protective gear under the surveillance of a colleague at a treatment facility for Ebola victims in Monrovia September 29, 2014.

NEW YORK (Reuters) - Mandatory quarantines ordered by some U.S. states for doctors and nurses returning from West Africa's Ebola outbreak are creating a "chilling effect" on aid work there, the humanitarian aid group Doctors Without Borders said on Thursday.

In response to questions from Reuters, the group said it was discussing whether to shorten some assignments as a result of restrictions imposed by several states since one of its American doctors, Craig Spencer, was hospitalized in New York City last week with the virus.

"There is rising anxiety and confusion among MSF staff members in the field over what they may face when they return home upon completion of their assignments in West Africa," Sophie Delaunay, executive director of Doctors Without Borders in the United States, said in a statement emailed to Reuters.

Doctors Without Borders, also known by its French name, Médecins Sans Frontières, or MSF, is one of the main aid groups working in Guinea, Sierra Leone and Liberia, where the worst Ebola outbreak on record has killed nearly 5,000 people.

Some MSF workers have been delaying their returns to the United States and are staying in Europe for 21 days, Ebola's maximum incubation period, "in order to avoid facing rising stigmatization at home and possible quarantine," Delaunay said.

As a result, MSF is discussing whether to shorten some Ebola assignments from their current duration of four to six weeks. Aid workers typically begin and end their assignments in Brussels, the Belgian capital, a spokesman said.

"Some people are being discouraged by their families from returning to the field," Delaunay said.

The governors of New York and New Jersey announced strict new screening rules at airports last Friday, including mandatory 21-day quarantines for people who have had contact with Ebola patients in West Africa. People may be quarantined in their homes in some cases.

Last weekend, U.S. President Barack Obama's administration criticized the quarantining of healthy people as "not grounded in science," echoing criticisms from public health experts.

Delaunay's comments on Thursday are the most substantive criticism of the rules since they were announced, suggesting they are eroding MSF's manpower and forcing American workers into temporary exile.

MSF says the policies have also created a misperception that healthcare workers are endangering the public, even though a person who does not have symptoms cannot spread the virus.

Delaunay sent her statement in response to questions from Reuters about whether returning MSF workers were rearranging travel plans to avoid U.S. states with mandatory quarantines.

She did not say how many workers were choosing to delay their return or whether MSF was paying to accommodate them. MSF had already made a policy of asking its workers not to return to their regular jobs for 21 days after finishing an Ebola assignment. It pays them wages for that time.

Only one person is known to have been ordered into quarantine as a result of the new rules announced by New York Governor Andrew Cuomo and New Jersey Governor Chris Christie.

Nurse Kaci Hickox, 33, was confined to a tent against her will for several days after arriving at Newark Liberty International Airport in New Jersey last Friday, shortly before the new rules were announced. She had worked for MSF in Sierra Leone.

Hickox, who tested negative for Ebola and says she is completely healthy, has mounted a personal protest against the quarantine policy.

Three other MSF aid workers have returned to the United States since last Friday via one of five airports approved for passengers who have recently been in West Africa. Those workers have not been quarantined, an MSF spokesman said.

He would not say whether they had arrived at Newark, John F. Kennedy International Airport in New York City or at airports in states that have not called for a blanket quarantine.

Press officials for Cuomo and Christie did not respond to a request for comment.

Delaunay, the MSF director, also said there were fears among its non-American workers that other countries may follow the example set by some U.S. states.

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New Zealand's Fonterra says China lifts ban on baby formula ingredients

WELLINGTON (Reuters) - New Zealand's Fonterra Co-Operative Group, the world's biggest dairy exporter, said the Chinese government has lifted a ban on the last two products that were embroiled in last year's contaminated infant formula scare.

It said the ban on New Zealand producers exporting whey powder and base powder containing whey for infant formula to China has ended.

The ban was imposed in August last year in the wake of the scare that whey powder had been contaminated with a bacteria that could cause botulism.

The scare, which prompted precautionary product recalls and import bans in various markets, turned out to be a false alarm.

Fonterra said the two products accounted for about 3 percent of its total exports to China, and it would be able to resume selling the ingredients to Chinese based infant formula manufacturers.

Dairy exports are New Zealand's biggest export earner and China is the country's biggest export customer.

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The impact of numerology over the names

Whenever an infant is born into a family, it’s a norm to first assess him/her with a name. The name of a person is just not a word to be referred to them but actually is the definition, a description of their personality and the briefing of their traits. It should be made very sure that while naming a person all the necessary measures are taken care of. They say that labeling of a product is done properly to define the quality of that product. The same theory can be applied upon assessing names to the young ones too. The better the name the more illustrative would be the definition.

 

While a lot of people who believe in ancestry, name their children on the basis of their legacy or the family trees, while others who believe in Numerology have different opinions. The people who believe in numerology work and practice a lot with numbers before naming their kids. In numerology each letter of your name is said to have an individual corresponding number. Cornerstone is said to be the first letter in your name while capstone is said to be the last one. Under Numerology the first vowel is also given sheer importance, as it is said to fulfill all your urges and dreams in life. Each and every letter in this section has a meaning of its own and preparing a name with all those combine meaningful letters will eventually make out the best desired result. The sum of the numbers in your birth date and the sum of numbers you make out while naming a person displays a great deal in the character, the future, the strengths and the weakness of an individual. Numerology helps in standing and fighting against all these weaknesses and odds. Believers say that numerology make you achieve whatever you want in life, and not just infants, a lot of people change their names in the later stages of their life too after realizing the problems they are suffering in their lives and in order to fight against them. This concept of Numerology was initially brought up by the Babylonians but gradually everyone started practicing it and eventually it became so popular and effective that now it is practiced across almost all over the world. There might be no scientific proofs about the authenticity of these numerology charts, but people still have faith in ample numbers about the relationship of words and numbers.

 

People also believe that in Numerology the on goings and the redemption is based upon three major factors; the date of birth, the name given to you on your birth and the name you use currently. The third factor can well be managed according to the needs and necessary requirements by the Numerology charts. There are ways to work over your names even if you’re a grown up in order to get over the grey shades you are going through in your personal lives. So everyone needs to go through that Numerology chart while assessing their young ones with new names.

 

Browse through name meaning, rankings, other people's comments, ratings, and other statistics in addition to the name meanings.

 

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U.S. quarantines 'chilling' Ebola fight in West Africa: MSF

A Doctors Without Borders health worker takes off his protective gear under the surveillance of a colleague at a treatment facility for Ebola victims in Monrovia September 29, 2014.

NEW YORK (Reuters) - Mandatory quarantines ordered by some U.S. states on doctors and nurses returning from West Africa's Ebola outbreak are creating a "chilling effect" on Doctors Without Borders operations there, the humanitarian group said on Thursday.

In response to questions from Reuters, the group said it is discussing whether to shorten some assignments as a result of restrictions imposed by some states since one of its American doctors, Craig Spencer, was hospitalized in New York City last week with the virus.

"There is rising anxiety and confusion among MSF staff members in the field over what they may face when they return home upon completion of their assignments in West Africa," Sophie Delaunay, executive director of Doctors Without Borders, said in a statement emailed to Reuters. Doctors Without Borders is also known by its French name, Médecins Sans Frontières, or MSF.

Some MSF workers are delaying their return home after their assignments and staying in Europe for 21 days, Ebola's maximum incubation period, "in order to avoid facing rising stigmatization at home and possible quarantine," Delaunay said in her statement.

"Some people are being discouraged by their families from returning to the field," she said.

The governors of New York and New Jersey announced strict new screening rules at airports last Friday, including mandatory 21-day quarantines for any healthcare worker who had been treating Ebola patients in West Africa.

Only one person is known to have been quarantined as a result of the new rules, nurse Kaci Hickox, who was confined to a tent against her will for several days after arriving at Newark Liberty International Airport in New Jersey last Friday. Hickox, 33, was returning from Sierra Leone, where she had cared for Ebola patients as an MSF healthcare worker.

Hickox, who tested negative for Ebola and says she is completely healthy, has strongly criticized the quarantine policy in New Jersey and then in her home state of Maine, where she was taken to finish her 21-day quarantine at home.

She went for a bike ride on Thursday, putting her on a collision course with Maine Governor Paul LePage, whose office said he would exercise his legal authority to keep her quarantined.

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World Bank funding for Ebola fight hits $500 million

People sit near a banner reading ''The Ministry of Agriculture, Dixinn Commune, Together to defeat Ebola,'' in Conakry, Guinea October 26, 2014.

GENEVA (Reuters) - The World Bank pledged $100 million on Thursday to help recruit more foreign health workers in the fight against Ebola, taking its funding for the three worst-hit countries to more than half a billion dollars over the past three months.

The biggest recorded outbreak of the deadly virus has killed almost 5,000 people, according to the World Health Organization, mainly in Liberia, Sierra Leone and Guinea. Some aid groups have criticized the scale of the initial international response.

World Bank Group President Jim Yong Kim said the three states were still struggling to get enough health staff to areas with the highest infection rates.

“We must urgently find ways to break any barriers to the deployment of more health workers. It is our hope that this $100 million can help be a catalyst for a rapid surge of health workers to the communities in dire need,” Kim said in a statement.

The latest tranche will go towards setting up a coordination hub to recruit, train and deploy qualified foreign health workers and support the three countries' efforts to isolate Ebola patients and bury the dead safely, the bank said.

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To stop Ebola's spread in West Africa, target funerals: study

NEW YORK (Reuters) - As the global health community ramps up its efforts to treat Ebola patients and curb its spread in West Africa, a new analysis finds that the greatest impact would come from insuring safe burials for victims, scientists reported on Thursday.

The need for safe burials has been known from the beginning of the epidemic last spring, when people who attended the funeral of a faith healer in Guinea became infected.

U.S. guidelines call for workers wearing full protective gear to wrap the remains of Ebola victims, which have an extremely high concentration of the virus, in a plastic shroud and then place them in two body bags. The body should not be washed or handled in any way, something that has been a common practice in much of West Africa.

The new findings, published in the journal Science, are based on a mathematical model being developed by Ebola researchers at Yale School of Public Health.

It takes into account data from the current outbreak and previous ones, including how long people harbor the virus before becoming ill, how long they are infectious, and what percentage are isolated at home or in a treatment center.

Similar models have already informed public policy. A U.S. projection that there could be 1.4 million cases in Liberia and Sierra Leone by late January spurred some Western countries to commit more funds and personnel to curb the worst Ebola outbreak since the disease was identified in 1976.

The Yale model calculates the spread of Ebola in the community, in hospitals and at funerals, including how many secondary cases are caused by the average case in each setting.

If transmission in the community or in hospitals could be eliminated through better isolation practices, Yale's Alison Galvani and her colleagues found, each Ebola case would still cause 1.4 or 1.5 additional infections.

But if transmission via burial practices were eliminated, the secondary infection rate would drop below one per Ebola case, the sole way epidemics peter out.

"Reducing transmission in hospitals and the community is insufficient to stop the exponentially growing epidemic," the scientists wrote. The most effective intervention is halting burial practices in which mourners handle bodies, which "are effectively serving as superspreader events."

Because making all Ebola burials sanitary might not be feasible, said Yale's Martial Ndeffo-Mbah, the Ebola response must also continue to isolate cases.

Other modelers predicted the study's emphasis on funerals would be "quite controversial," according to biostatistician Ira Longini of the University of Florida.

Longini and colleagues at Northeastern University created a mathematical model that shows that most Ebola transmission occurs in the community and within households, so isolating patients would have the most effect on the epidemic.

Still, "Liberia has concentrated hard on the funeral problems," Longini said, and is now seeing fewer new cases than in recent weeks.

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Bike-riding nurse defies Ebola quarantine, on collision course with governor

CAPE ELIZABETH Maine (Reuters) - A nurse who treated Ebola patients in Sierra Leone but has tested negative for the virus went for a bike ride on Thursday, defying Maine's order that she be quarantined in her home and setting up a legal collision with Governor Paul LePage.

Attorneys for Kaci Hickox, 33, said they had not yet been served with a court order to enforce the 21-day quarantine - matching the virus's maximum incubation period - but remained prepared to fight such an order if necessary.

The quarantine showdown between Hickox and Maine has become the focal point of a struggle between several U.S. states opting for stringent measures to guard against Ebola and a federal government wary of discouraging potential medical volunteers.

Mandatory quarantines ordered by some U.S. states on doctors and nurses returning from West Africa's Ebola outbreak are creating a "chilling effect" on Doctors Without Borders operations there, the humanitarian group said on Thursday.

LePage's office said negotiations with Hickox, who worked with Doctors Without Borders in Sierra Leone, "have failed despite repeated efforts by state officials" and that he would "exercise the full extent of his authority allowable by law."

Hickox left her home in the small Maine town of Fort Kent, along the Canadian border, and television news images showed her taking a morning bicycle ride with her boyfriend, Ted Wilbur. Hickox has given the New England state a deadline of Thursday to lift an order that she remain at home until Nov. 10, or she will go to court.

“It’s a beautiful day for a bike ride,” said Hickox, wearing a helmet and other bike gear as she headed out for her 3-mile (5-km) ride while police stationed outside her house stood by without trying to stop her, according to local media.

LePage's office said he was open to an arrangement in which she could go for walks, runs or bike rides but not go into public places or come within 3 feet (1 meter) of other people.

“I was ready and willing - and remain ready and willing - to reasonably address the needs of healthcare workers meeting guidelines to assure the public health is protected,” said LePage, a Republican locked in a tough three-way re-election battle.

President Barack Obama, who has criticized mandatory quarantine policies imposed by some states for returning medical workers like Hickox, flew to Maine on Thursday to campaign in the town of Cape Elizabeth for Democratic candidates, including Mike Michaud, who is trying to unseat LePage in Tuesday's midterm elections.

Asked for comment on Hickox's situation, White House spokesman Josh Earnest told reporters aboard Air Force One en route to Maine that U.S. Centers for Disease Control and Prevention officials have been in regular touch with the health authorities in the state.

"Ultimately, it is their decision," said Earnest, adding that Obama had no plans to see Hickox while in Maine. Cape Elizabeth is at the opposite end of the state, on its southeastern coast.

One of Hickox's attorneys, Norman Siegel, defended his client's decision to go for a bike ride but noted that she avoided the center of town so as not to “freak people out.”

“Since there’s no court order, she can be out in public,” Siegel said. “Even if people disagree with her position, I would hope they respect the fact that she’s taking into account the fear, which is based on misinformation about the way the disease is transmitted.”

Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and is not transmitted by asymptomatic people. Ebola is not airborne.

U.S. concern about the disease is high even though there is only one person in the country currently being treated for it, a New York doctor, Craig Spencer, who cared for patients in West Africa. Spencer, 33, remains in serious but stable condition, New York's Bellevue Hospital said on Thursday.

Hickox tested negative for Ebola after returning from Sierra Leone, one of the three impoverished countries at the heart of the outbreak that has killed about 5,000 people there.

She previously blasted New Jersey Governor Chris Christie after she was taken from Newark's airport and put in isolation in a tent before being driven to Maine to spend the rest of her 21-day quarantine at home.

Such treatment of returning medics is affecting those still in West Africa, said Sophie Delaunay, executive director of Doctors Without Borders.

"There is rising anxiety and confusion among MSF staff members in the field over what they may face when they return home upon completion of their assignments in West Africa," said Delaunay in a statement emailed to Reuters. Doctors Without Borders is also known by its French name, Médecins Sans Frontières, or MSF.

With elections coming Tuesday, Republicans aiming to take full control of the U.S. Congress have made criticism of Obama's response to Ebola - which they call inept and too weak - a part of their campaign message.

Some U.S. states have imposed automatic, 21-day quarantines on doctors and nurses returning from treating Ebola patients in Liberia, Sierra Leone and Guinea. Obama and other critics say such steps may discourage American doctors and nurses who are desperately needed there from volunteering.

New York City and state officials on Thursday announced a program to encourage healthcare professionals to work in West Africa, an effort to deflect criticism of the state's mandatory quarantine.

The program will provide financial incentives and employment protections similar to the benefits and rights provided to military reservists, New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio said jointly.

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In Guangdong, nervy Chinese ramp up Ebola watch

HONG KONG (Reuters) - Chinese authorities have identified the southern province of Guangdong, home to Asia's biggest African population, as a frontline in their efforts to prevent the deadly Ebola virus from entering mainland China.

The province bordering Hong Kong has proven susceptible to infectious diseases in the past, shouldering a large share of SARS and bird flu cases, prompting local authorities to take no chances with Ebola.

Local authorities say they have expanded testing procedures at provincial entry ports and 27 hospitals have been designated to handle possible Ebola cases. Travelers arriving from Ebola-affected nations must leave their contact details.

"The central government has asked Guangzhou to strengthen preventative measures," Mao Qun'an, a spokesman for the Ministry of Health, told Reuters. "Of course in Guangzhou, there are many people from outside China's borders."

As many as 190 flights connect Guangdong and Africa each month, ferrying thousands of traders, many of whom come from the Ebola-hit nations of Sierra Leone, Liberia and Guinea. More than 60 percent of the passengers arriving on the mainland from West Africa arrive in Guangdong.

China has not reported any confirmed cases of the deadly virus, though several suspected cases have ended up in hospital for observation.

At this week's Canton Fair in the provincial capital Guangzhou, China's biggest trade exhibition, medical workers donned full protection suits and checked visitors for signs of the Ebola virus that has killed nearly 5,000 people, mostly in West Africa.

"Of course we are worried," said a police guard at the fair who identified himself only by the name Sun. "People are coming from all over the world."

The Guangdong Provincial Center for Disease Control and Prevention has conducted tests on about 50 people from West Africa, all returning negative results, the China Daily reported on Thursday.

The center and health officials in Guangdong could not be reached by Reuters for comment.

AFRICAN TRADERS

Authorities' main concern revolves around the large number of African traders, many of whom come from West Africa, in Guangzhou. The city is a booming marketplace for cheap goods that are exported to Africa.

Officially, about 15,000 Africans live in Guangzhou, but there are many illegal immigrants and some reports put the number at 10 times that figure. The official Guangzhou Daily said 438,000 Africans passed through the city from January to October this year.

Frank, 37, a trader from Nigeria who has lived in China for 10 years, said Ebola was a sensitive subject given many Africans were staying in Guangdong illegally, raising concerns that victims would avoid visiting public hospitals.

Nigeria itself was declared Ebola-free by the World Health Organization last week, having contained the spread of the disease after 20 people were infected. Seven of those died.

"It's a very big problem," Frank said. "Without a valid visa, you can do nothing in this country ... We don't talk about it."

Authorities in Guangzhou have launched a campaign warning of the dangers of Ebola, but African immigrants complain they have received little information.

"There's nothing much we can do," said a 30-year-old Kenyan man by the name of Pawsi. "I don't know what the government has done. I can't read Chinese."

State media reported on Wednesday that people returning to Beijing from regions affected by Ebola should quarantine themselves at home for 21 days and undergo twice daily temperature checks if they have had contact with patients.

China's health ministry has identified the main airports in Beijing, Shanghai and Guangzhou as key in terms of risk, and has been focusing its initial health and temperature checks there.

"Beijing has experience with SARS and the H7N9 (bird flu) virus. Once there is a case of Ebola, we have the ability to control its spread," city health official Zhao Tao told the official Xinhua news agency.

There is much scepticism about the government's transparency.

In 2003, Chinese officials covered up the spread of Severe Acute Respiratory Syndrome (SARS) for weeks before a growing death toll and rumors forced the government to reveal the epidemic, apologize and vow full candor in future disease outbreaks.

But in 2013, the government earned praise from the international community for being transparent on an outbreak of a deadly new bird flu in humans.

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Why do some survive Ebola? Sierra Leone study offers clues

Survivors of the Ebola outbreak attend a discharging ceremony at a health clinic in Freetown October 6, 2014.

CHICAGO (Reuters) - An analysis of the first Ebola cases in Sierra Leone helps draw a clearer picture of why some people survive the disease, while others do not, including their age and the pace at which the virus replicates within their body.

The study published Wednesday is based on data gathered from 106 patients diagnosed with Ebola at the Kenema Government Hospital in Sierra Leone from May 25 to July 18. Some of the data on this group was incinerated because of fears that the nurses' station where the records were kept became contaminated.

But the team managed to analyze detailed clinical records from a total of 44 Ebola patients, the biggest trove yet from the outbreak in West Africa that has killed nearly 5,000 people.

"This is the first time anybody has had this much data collected on any Ebola patients," said Dr. John Schieffelin of Tulane University in New Orleans, an author of the study published in the New England Journal of Medicine.

He said the findings help confirm some of the observations seen by doctors treating patients with Ebola.

It shows, for example, that 57 percent of people under age 21 who were treated for Ebola died from their infections, compared with 94 percent of those over the age of 45.

In the cases studied, the virus took six to 12 days to incubate before patients developed symptoms, and 74 percent of the patients in the study died, similar to what has been seen in prior outbreaks.

Fever was the most common symptom, occurring in 89 percent of patients, followed by headache (80 percent), weakness (66 percent), dizziness (60 percent) diarrhea (51 percent), abdominal pain (40 percent) and vomiting (34 percent).

However, there were some big differences in how individual patients responded to the virus, Schieffelin said.

"There were people who had very mild cases, and there are people who have very severe cases and they go downhill quickly," he said.

One surprise was the significant difference in the amount of virus present in patients when they came in for treatment, a factor that affected whether or not they survived.

For example, 33 percent of patients with less than 100,000 copies of the virus per milliliter of blood at diagnosis ultimately died, compared with 94 percent mortality in those whose had more than 10 million copies per milliliter.

Among the various symptoms in this outbreak, Schieffelin said diarrhea is a "really big feature of it," suggesting that doctors treating Ebola patients need to be very aggressive in administering intravenous fluids.

Bleeding, a key feature of Ebola in prior outbreaks, was rare among this population, with only 1 patient having this symptom, the study found.

Some researchers have questioned the value of spending resources on studying Ebola during the outbreak rather than using those funds to help curb the epidemic directly. Schieffelin said the analysis offers important insights for healthcare workers fighting the current outbreak, including data that can be used to determine new treatment and diagnostic approaches.

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Ebola appears to be slowing in Liberia: WHO

World Health Organization (WHO) Assistant Director General Bruce Aylward gestures during a news conference at the organization's headquarters in Geneva October 29, 2014.

GENEVA (Reuters) - Liberia, the country worst-hit by the Ebola epidemic, may be seeing a decline in the spread of the virus, although the battle to contain the outbreak is far from won, the World Health Organization said on Wednesday.

WHO Assistant Director General Bruce Aylward told a news conference the number of burials and new admissions had fallen and there was a plateau in laboratory-confirmed cases.

"All the data point in the same direction," he said. "Do we feel confident that the response is now getting an upper hand on the virus? Yes, we are seeing slowing rate of new cases, very definitely."

Aylward cautioned against overly optimistic conclusions but said: "We're seeing a reversal of that rapid rate of increase to the point that there seems to be a decline right now."

Liberian President Ellen Johnson Sirleaf told Reuters on Oct. 8 there were early signs the outbreak might be "in decline".

Aylward said the fresh information could be attributed to the wrong factors and misunderstood. "Getting a slight decrease in the number of cases on a day-to-day basis, versus getting this thing closed out, is a completely different ball game."

U.S. Ambassador to the United Nations Samantha Power said governments who made commitments to help fight Ebola should deliver on their pledges and those yet to commit should do so.

Power said she was encouraged by progress in the last couple of weeks, and that the two most critical remaining challenges are to fill gaps in the delivery of people and resources and to fight fear, misinformation and stigma.

"There is a need for more beds, more bleach, more cash in order to pay community mobilizers or people who do safe burial," she told a news conference in the capital of Ghana after a visit to Sierra Leone, Guinea and Liberia.

In Liberia, the National Christian Ebola Task Force, a group of different Christian denominations, began three days of prayer and dawn-to-dusk fasting on Wednesday to seek salvation from the "curse" of the epidemic, which has killed 2,705 people and infected 4,665 more in the West African country.

"Ebola is a virus from the devil. It's killing us because we have turned our back to God," said Reverend David G. Benitoe of the Task Force. "We have traded the worship of God with the worship of demons and witchcraft, and evil stuff is now happening in this country."

CALL TO NATO

Aylward said there had been 13,703 Ebola cases in eight countries and the reported death toll, to be published later on Wednesday, was likely to be over 5,000.

A jump of more than 3,000 in the number of cases reported since Saturday was largely due to the data being updated with old cases rather than new cases, he added.

Both Senegal and Nigeria have been declared Ebola-free, after passing two incubation periods of a total of 42 days. Cases have also been confirmed in Spain and the United States.

Aylward said he would be "terrified" if his statement was understood to mean Ebola was under control.

"It's like saying your pet tiger is under control," he said. "This is a very, very dangerous disease ... A couple of burials go wrong, it can start a whole new set of transmission chains and the disease starts trending upward again."

But if current trends continued, Guinea, Liberia and Sierra Leone should be able to "comfortably" meet a target to scale up Ebola-containment measures by Dec. 1, he said.

Last week, Mali became the sixth West African country to report a case of the disease. A two-year-old girl died after traveling by bus from Guinea with her grandmother, with at least one stopover, in the capital Bamako.

Aylward said the Mali government was working hard to track people who had contact with the girl, with 84 people being monitored and none showing symptoms as of early on Wednesday.

The goal is to set up 56 Ebola treatment centers across the three worst-hit countries, a total of 4,700 beds, Aylward said.

Only 15 centers with 1,047 beds are fully functional now, he said. There are commitments to build and staff 22 centers, but foreign staff are still needed to manage the final 19 centers.

In Sierra Leone, the second-worst-hit country, the number of cases was continuing to increase in some areas, including the capital Freetown. "We're still seeing this thing burning quite hot in parts of Sierra Leone right now," Aylward said.

Separately, 40 senior European political, diplomatic and military figures on Wednesday urged the NATO alliance to deploy staff, ships and aircraft to help fight Ebola in West Africa.

Signatories including two former NATO secretaries-general and three ex-prime ministers said in two open letters the WHO and United Nations should ask for help from NATO, whose "unique capabilities ... could make a difference in this situation."

The letters to NATO chief Jens Stoltenberg, UN Secretary-General Ban Ki-moon and WHO Director-General Margaret Chan were drafted by the European Leadership Network think tank in London.

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U.S. attends Ebola meeting in Cuba called by leftist bloc

HAVANA (Reuters) - U.S. government officials joined health experts from throughout the Americas at an Ebola conference in Cuba on Wednesday, the latest show of cooperation between the historic adversaries on fighting the disease.

The meeting organized by ALBA, a bloc of leftist-governed countries, aims to coordinate a regional strategy on the prevention and control of Ebola, which has killed about 5,000 people in West Africa but in the Americas has only reached the United States.

U.S. military personnel and Cuban medical specialists are already posted in West Africa and prepared to work side by side if needed, officials have said, and Washington has expressed appreciation to Cuba for committing hundreds of doctors and nurses to the region to treat Ebola patients.

"This is a world emergency and we all should work together and cooperate in this effort," said Nelson Arboleda, the U.S. Centers for Disease Control and Prevention's (CDC) director for Central America, one of two U.S. officials and among 254 specialists from 32 countries at the Havana meeting.

ALBA, a nine-nation bloc led by socialist allies Venezuela and Cuba, held a summit in Havana last week in which presidents and prime ministers pledged cooperation on Ebola, leading to Wednesday's follow-up meeting.

The Pan American Health Organization (PAHO), a regional arm of the World Health Organization, invited the United States to participate, White House spokesman Edward Price said.

"Consistent with our ongoing engagement in all meetings and events organized by PAHO, the director of the Central American region for the Centers for Disease Control and Prevention will attend this meeting," Price said.

Following one of the agreements from the summit, Cuba is preparing to train health professionals from around the Americas for treating the disease, Cuban Health Minister Roberto Morales said.

"We have offered our training center ... and our experts to prepare professionals who can become facilitators in each country in the region and help elaborate and implement Ebola prevention and control plans," Morales told reporters.

With help from the World Health Organization and the CDC, Cuba has trained 461 of its own doctors and nurses for treating Ebola patients, more than half of whom have already gone to Sierra Leone, Guinea and Liberia for six-month missions.

The United States and Cuba have been adversaries since the 1959 revolution that brought Fidel Castro to power, though in recent years the two countries have cooperated on issues such as immigration, illegal drug interdiction, weather forecasts and oil spill prevention.

On Tuesday, the United Nations General Assembly voted 188 to 2 to condemn the decades-long U.S. economic embargo against Cuba.

A Liberian man died Oct. 8 while visiting Dallas, Texas, the first Ebola case diagnosed in the United States, and two nurses who treated him were infected but later cleared of the virus. In addition a New York doctor was diagnosed last week. Craig Spencer, 33, had worked with the humanitarian group Doctors Without Borders treating Ebola patients in Guinea.

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Saying she will not be bullied, nurse fights Maine Ebola quarantine

WASHINGTON (Reuters) - Saying she will not be bullied by politicians, a Maine nurse is giving the state an ultimatum: lift her Ebola quarantine by Thursday or she will disregard the restrictions and go to court.

The saga of nurse Kaci Hickox illustrates how U.S. states are struggling to protect against the virus without resorting to overzealous and useless precautions or violating civil rights.

Hickox, 33, tested negative for Ebola after returning from treating patients in West Africa. She previously blasted New Jersey Governor Chris Christie after she was taken from Newark's airport and put in quarantine in a tent before being driven to Maine to spend the rest of her 21-day quarantine at her home.

"I truly believe this policy is not scientifically nor constitutionally just, and so I am not going to sit around and be bullied around by politicians and be forced to stay in my home when I am not a risk to the American public," Hickox, speaking from her home in the small Maine town of Fort Kent along the Canadian border, told NBC's "Today" program.

"If the restrictions placed on me by the state of Maine are not lifted by Thursday morning, I will go to court to fight for my freedom," Hickox added.

Hickox's defiance did not sit well with Republican Governor Paul LePage, who said he would seek legal authority to keep her isolated at home until Nov. 10.

"While we certainly respect the rights of one individual, we must be vigilant in protecting 1.3 million Mainers, as well as anyone who visits our great state," LePage said in a statement.

At a White House event, President Barack Obama scolded politicians who have sought quarantines or strict travel bans for caving into fears, although he did not mention anyone by name.

"When I hear people talking about American leadership, and then are promoting policies that would avoid leadership and have us running in the opposite direction and hiding under the covers, it makes me a little frustrated," Obama said.

The president was flanked by three doctors in white lab coats and several other healthcare workers who have served in West Africa or will soon travel there. "When they come home, they deserve to be treated properly. They deserve to be treated like the heroes they are," Obama said.

Even people who did not treat Ebola patients but traveled to West Africa are facing restrictions.

A Connecticut school superintendent defended the decision to keep a 7-year-old girl out of class for three weeks over concerns the girl might have contracted Ebola while at a wedding in Nigeria. The World Health Organization declared Nigeria Ebola-free days after the girl's trip.

Hickox worked with the humanitarian group Doctors Without Borders in Sierra Leone, one of the three nations at the heart of an outbreak that has killed about 5,000 people in West Africa. Liberia, the country worst-hit by the epidemic, may be seeing a decline in the spread of the virus, the World Health Organization said on Wednesday.

In several media interviews, Hickox said she was in good health and had not had any symptoms of the virus that would indicate she had become contagious. Hickox said she had been monitoring her condition and taking her temperature twice a day.

Lawyers for Hickox said Maine officials would have to go to court to get an order to enforce a quarantine and that, if the state does, she would challenge it.

'ILLEGAL AND UNCONSTITUTIONAL'

Her lawyer Steven Hyman told Reuters that Maine has no basis to arrest or detain her. "Such action would be illegal and unconstitutional and we would seek to protect Kaci’s rights as an American citizen under the Constitution. There is no medical risk and we have to deal with fact and not hysteria," he said.

Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and is not transmitted by asymptomatic people. Ebola is not airborne.

Hickox said her last contact with an Ebola patient was on Oct. 21. The maximum incubation period for Ebola is 21 days.

Some U.S. states have imposed automatic 21-day quarantines on doctors and nurses returning from treating Ebola patients in Liberia, Sierra Leone and Guinea. Republicans including Christie have accused Obama's administration of doing too little to protect Americans from Ebola.

California, the most populous U.S. state, announced on Wednesday that people returning from Ebola-affected countries who have had contact with infected patients will be quarantined for 21 days. The policy offers a degree of flexibility, with local health officials allowed to "establish limitations of quarantine on a case-by-case basis."

Public health experts, the United Nations and medical charities - and Obama - oppose such steps as scientifically unjustified. They say such policies may discourage badly needed American doctors and nurses from volunteering to help.

Also on Wednesday, another American nurse who returned home from working with Ebola patients in Sierra Leone agreed to quarantine herself at home in Texas with twice-daily monitoring by state health officials for 21 days, officials said. The nurse, who was not identified, is asymptomatic.

Setting himself apart from his counterparts in Maine and New Jersey, Texas Governor Rick Perry, a possible 2016 Republican U.S. presidential candidate along with Christie, telephoned the nurse, calling her a hero.

Four people have been diagnosed with Ebola in the United States, with one death, a Liberian man who flew to Texas. Two of his nurses were infected, but both have recovered and are virus-free. The only patient now being treated for Ebola in the United States is a New York doctor, Craig Spencer, who was diagnosed last Thursday after treating Ebola patients in Guinea.

Two U.S. health officials attended a meeting in Havana organized by ALBA, a bloc of leftist-governed countries, to coordinate a regional strategy on stopping Ebola. It was the latest show of cooperation between historic adversaries Cuba and the United States on fighting the disease.

U.S. military personnel and Cuban medical specialists are already posted in West Africa and prepared to work side by side. Washington has expressed appreciation to Cuba for committing hundreds of doctors and nurses to the region.

In another sign of alarm over Ebola felt in many U.S. communities, the University of North Carolina on Wednesday banned students from school-related travel to Sierra Leone, Guinea and Liberia. It said faculty and staff must seek prior approval to travel there for humanitarian or scientific reasons.

The Pentagon said Defense Secretary Chuck Hagel approved a strict, 21-day quarantine-like monitoring period for all U.S. troops returning from the Ebola relief mission in West Africa.

Hagel also called for a review of the decision in 45 days. The new policy expands one put in place on Monday for Army soldiers to all branches of the military.

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As debate rages, GMO labeling votes loom in Oregon, Colorado

(Reuters) - With less than a week before voters in two U.S. states weigh measures to require labeling of foods made with genetically modified ingredients, labeling supporters were hoping for victory but planning for defeat.

Fresh polling showed support for the Oregon GMO labeling law waning in the face of a well-funded onslaught of advertising from labeling opponents, and pro-labeling Colorado campaigners still could not muster enough money for television ads to counter thousands of ads by labeling opponents.

In both states, the bid for votes on Nov. 4 is largely coming down to the size of each side's bank account. Those opposing mandatory GMO labeling have contributed more than three times the money contributed by labeling supporters.

"We're not able to compete with these massive contributions,' said Larry Cooper, campaign chair for Right to Know Colorado, which is asking backers to go door to door to drum up support for labeling. "I have not written off the campaign. But it is very much a David and Goliath situation."

The Colorado campaign counts about $900,000 in contributions, mainly from organic groups and scores of individuals, many making $10 or $20 donations. That compares to more than $16 million contributed by food companies and seed and chemical firms for opposition.

In Oregon, labeling supporters have received more than $7 million, compared to the $18.7 million put together by opponents.

The money has fueled heavy advertising. The Oregon and Colorado measures are among the most heavily advertised measures on the Nov. 4 ballot nationwide, with more than 9,600 ads focused on GMO labeling in the two states, according to the Center for Public Integrity.

An Oct. 26-27 poll of 403 likely voters in Oregon showed the labeling measure losing 48 to 42, according to a survey conducted by Elway Research of Seattle. The poll had a margin of error of five percentage points, plus or minus.

David Bronner, whose California-based natural products company Dr. Bronner's Magic Soaps has contributed $2 million to the Oregon labeling campaign and $50,000 to the Colorado campaign, said large donors like himself pegged Oregon as the best chance to pass a labeling law this year.

"I would love it if our money had enough firepower to run two campaigns, but we don't. So we're focusing on Oregon," he said. Even if both measures lose, labeling efforts will continue, Bronner said.

"We aren't going away," he said.

One opponent of GMO labeling is biotech crop company DuPont Pioneer, a unit of DuPont, which on Oct. 17 kicked in $4.5 million to the anti-labeling campaign in Oregon.

"Dupont is part of a broad coalition of people in Oregon that oppose this labeling initiative because it could be costly and confusing for consumers," said DuPont spokeswoman Jane Slusark.

Several states are eying GMO labeling measures. Labeling proponents say GMOs can be harmful for humans and the environment, while labeling opponents say GMOs are proven safe.

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Baby sleep cycles you should understand

Baby sleep cycles are quite different from yours, starting from the amount of time each of you spend sleeping. As you probably already know, your baby needs much more sleep than you do!

 

Here's a guide for a 24 hour period, depending on age:

• Newborns need around 16 hours
• 3 month olds need around 15 hours
• 2 month olds + need around 12 hours

Of course, your baby will not take all this sleep in one long stretch, but in sleep-wake cycles throughout the day. You only need to consider the size of a baby's stomach (hint: tiny!) to know that they will need to wake more often to fill it up. Babies need to eat quite frequently just to keep functioning.

 

To properly compare the sleep cycles of adults and babies,  let's start by taking a look at your own sleep cycles. When adults fall asleep, they go through several sleep stages, such as deep sleep and REM (or active) sleep. The latter stage is actually essential for the healthy life of any adult and is known widely because of its association with dreaming. What's more, even though the skeletal system is temporarily paralysed, brain activity during this stage resembles that of the waking brain - the eyes move quickly beneath the eyelids and breathing often becomes irregular. From beginning to end, an adult’s sleep cycle lasts about 90-100 minutes. At the end of a sleep cycle, an adult either wakes up or begins a new cycle by returning to an earlier stage.

 

What does a baby's sleep cycle consist of?

 

A newborn's sleep cycle is much simpler with only two stages – quiet and active sleep. Your baby’s sleep cycle is also much shorter, with an average of 50-60 minutes for the first nine months, often even shorter. It looks like this:

• When a baby first falls asleep they go into active sleep, which is very similar to REM sleep for adults. During this stage, babies are also more likely to wake up. A newborn will spend about 50% of his or her sleeping cycles in this stage, as opposed to an adult, with only 20%.
• About halfway through a sleep cycle, the baby falls into quiet sleep, which is characterised by slower, rhythmic breathing, less movement and no eyelid fluttering. Quiet sleep is the end of the sleep cycle, which means that the baby will either wake up or return to active sleep.

From six months onwards, babies develop more stages that resemble adults and gradually replace quiet sleep. The duration of their sleep cycles also lengthen and the time spent in active sleep shortens.

 

To recap, babies are not born with the sleep-wake cycles your body works with. They are much lighter sleepers than adults, because they spend so much time in active sleep. This is why it can take anywhere from six months to one year of age for a baby to sleep through the night like you do. From about six months, they can sleep for longer stretches, but it can take a while for them to build to a solid, uninterrupted 8-12 hours sleep with no whimpering or wakefulness whatsoever.

 

Despite all these challenges about the way babies are wired for sleep, sleep remains crucial in the early months and years for brain development, especially forming the vital connections between the brain hemispheres which are important to language, relationships and reasoning. There are lots of ways to help your baby form healthy sleeping habits. A good place to start is by creating and implementing simple bedtime routines.

 

About National Home Doctor Service:

National Home Doctor Service is a bulk-billing, after hours, doctor home visiting service.  We are available for home visits from 6pm weeknights, 12 noon on Saturdays, all day Sundays and public holidays.  Our doctors carry complimentary starter packs of many commonly prescribed medications so patients can start treatment right away. We also provide a report of each visit to your GP immediately after treatment to ensure follow up and continuity of care. 

 

ype your postcode in our suburb locator here

 

 

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Smiles, movies cheer Ebola patients in Liberian bush unit

GBARNGA Liberia (Reuters) - Deep in a Liberian bush, two U.S. nurses are taking a break after spending two hours wearing protective suits in stifling temperatures to care for patients suffering from Ebola, the viral killer that has ravaged three West African countries.

Well behind them in the treatment unit's "red zone" two young boys, Solomon and Joe, who is wearing SpongeBob SquarePants pajama pants, stand at a neon orange fence waving. Solomon is on day 13 of his treatment and Joe is on day 8.

The nurses - Bridget Mulrooney, 36, and Kelly Suter, 29 - said both boys appeared to be getting better, along with other family members being cared for at the Bong County Ebola Treatment Unit about 200 km (120 miles) east of the capital, Monrovia.

"Solomon's little sister, she was really sick but she’s getting better. Today she's sitting up, playing with a little squirt gun in bed," said a beaming Mulrooney, who is originally from Florida. "It's so exciting when they get better."

The treatment unit has been open about six weeks. It was built by the charity Save the Children, staffed by International Medical Corps, a humanitarian organization, with funding from the U.S. Agency for International Development.

It has about 50 beds, including 30 for confirmed cases of Ebola and 20 for suspected cases. On Tuesday, there were 15 confirmed Ebola patients and another five awaiting test results.

"There's hard days; there's also really good days. It's very encouraging to see them get better, to see them happy. We show nightly movies, 'The Lion King' and 'Frozen' and stuff like that," said Suter, who comes from Michigan. "They love it, especially the kids."

If patients are able, they bring chairs outside the treatment unit tents and watch the movies projected on a sheet slung over a piece of rope, said Mulrooney and Suter, who were speaking to Reuters over an outer perimeter fence.

During a brief visit to Liberia, U.S. Ambassador to the United Nations Samantha Power traveled to Bong County on Tuesday, where the United States has also set up a mobile laboratory. Accompanied by U.S. public health experts, Power visited the treatment unit but did not enter the facility.

Seeing some U.S. troops in Power's delegation, young Solomon stood and saluted. In a yard in front of the boys, black boots worn by healthcare workers were hanging on poles to be cleaned.

Mulrooney said many of the patients have moved her.

"One of my favorites is getting better right now, he's a man from Sierra Leone. ... He came in really, really sick," she said. "I was in PPE (personal protective equipment), and he could not believe that I put my hands on him. He said, 'You're touching me. ... You're not afraid of me.'"

Some 5,000 people have been killed by Ebola, predominantly in Sierra Leone, Liberia and Guinea. There have been a handful of cases in Senegal, Nigeria, Mali, Spain and the United States. The disease is spread through contact with bodily fluids of an infected person or someone who has died of the disease.

With several U.S. states imposing mandatory quarantines for healthcare workers returning from West Africa, Mulrooney said people considering traveling to the region to help should not be deterred by rules she characterized as "unfair, unjust."

"I love it, I absolutely love it," she said. "I extended, I'm here until the end of the year."

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Obama sees different Ebola rules for U.S. military than for civilians

U.S. President Barack Obama speaks about the U.S. response to Ebola from the South Lawn of the White House in Washington October 28, 2014.

WASHINGTON (Reuters) - President Barack Obama on Tuesday appeared to back more rigorous procedures for dealing with soldiers returning from missions to Ebola-hit West African countries, even as he criticized moves by some U.S. states to quarantine returning civilian health workers.

Obama said that American military personnel were in a "different situation" compared with healthcare workers. While civilians may be discouraged from volunteering to help fight the Ebola if they are facing quarantine on their return, troops were sent as part of their mission and could expect such inconveniences.

"They are already by definition if they are in the military under more circumscribed conditions," Obama told reporters at the White House. "We don't expect to have similar rules for our military as we do for civilians."

The differences in approach played into a fierce debate in the United States over how best to treat Americans who may have come into contact with the disease when they came home from one of the three West African countries hit by Ebola: Liberia, Sierra Leone or Guinea.

The Pentagon said on Monday that Major General Darryl Williams, commander of U.S. Army Africa, and 11 of his staff were put in isolation for 21 days of monitoring after returning from West Africa to their home base in Vicenza in northeastern Italy.

The Army chief of staff, General Ray Odierno, ordered the isolation not because of medical necessity but to reassure troops and local communities that the Army was taking "all steps necessary to protect their health," an Army statement said.

Odierno's decision went beyond Pentagon policy, which calls for monitoring but not isolation.

The Obama administration has been seeking to dissuade U.S. states from imposing quarantines on doctors, nurses and other health workers returning from West Africa and has resisted political pressure to impose travel bans on people coming from the affected area.

EBOLA ISOLATION PROGRAM

Obama's spokesman, Josh Earnest, said an isolation program was appropriate for the hundreds of military personnel returning to bases across the world while a self-monitoring program was right for the smaller number of returning healthcare workers.

Top U.S. military commanders formally recommended to Defense Secretary Chuck Hagel on Tuesday that the Pentagon impose a "quarantine-like" 21-day monitoring period on all U.S. military personnel returning from Ebola response efforts in West Africa.

Rear Admiral John Kirby, the Pentagon press secretary, said Hagel was considering the proposal, which would extend to all U.S. military personnel the kind of program imposed on Williams and his men when they left Liberia last weekend.

Kirby said Hagel was weighing a number of factors as he considered whether to approve the tougher monitoring, including the effect it could have on other agencies by raising fears about whether the government was acting appropriately.

"The spillover effect (of any decision) on other agencies and the American people certainly are on his mind. But his primary responsibility is to take care of the Defense Department, our troops and our families, and that’s always been foremost in his mind," Kirby said.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, said most returning medical workers should have daily monitoring but did not need to be isolated. He called for voluntary home quarantine for those at greatest risk.

Kirby said Hagel supported the Army's decision to place Major General Williams and his team in isolation but was still deciding what to do about the return of future military personnel.

Unlike civilian medical workers, the U.S. military personnel sent to West Africa are not coming into contact with Ebola patients but are building facilities, including Ebola treatment units.

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In Ebola response, Obama's 'czar' stays behind the curtain

U.S. President Barack Obama holds a meeting with Ebola Response Coordinator Ron Klain (R) and members of his team coordinating the government's Ebola response in the Oval Office of the White House in Washington October 22, 2014.

WASHINGTON (Reuters) - It's not often that a White House official gets mocked on both Saturday Night Live and a major daily newspaper before he makes his first public appearance.

But Ron Klain's low-profile first week as President Barack Obama's behind-the-scenes Ebola "czar" has become another attack point for a White House struggling to show it's on top of the crisis.

Since starting last Wednesday, Klain has been seen only once, in a photo op on his first day, leaving health officials from the Centers for Disease Control and Prevention and National Institutes of Health - and Obama himself - to be the public "face" of the response.

The White House has declined to give details about his activities, especially what role he played as governors Andrew Cuomo of New York and Chris Christie of New Jersey undermined the White House's attempt to keep the nation calm about the risk posed by healthcare workers returning from Ebola-stricken West Africa.

"I recognize that all of you have not had a chance to see him and talk to him every day, but the president certainly has," White House spokesman Josh Earnest told reporters on Tuesday about Klein.

Klain's lack of a public profile has fueled attacks by conservative critics who last week seized upon his lack of medical expertise. Klain, 53, is a lawyer and political insider who previously served as chief of staff to Vice Presidents Joe Biden and Al Gore and left the White House in 2011 to help AOL co-founder Steve Case oversee his holdings.

The White House has tried to temper expectations that Klain will emerge as a regular voice on Ebola. He might do the occasional briefing or interview, "but that is pretty low on his to-do list," Earnest said.

Instead, Klain has briefed Obama on developments on six of seven days since he began work, Earnest said.

He has talked to some state officials, but not others.

Virginia Governor Terry McAuliffe spoke to Klain on Monday to tell him how the state was monitoring people returning from West Africa, a spokesman said.

But the Texas Department of State Health Services hasn't had direct contact with Klain, a spokeswoman there said.

Florida health officials have not been contacted by Klain either, said Nathan Dunn, a spokesman for the state agency collaborative dealing with Ebola preparations.

A 'RAISED TEMPO'

Others have defended the pick and Klain's seven-day track record, saying the job is a behind-the-scenes one that requires a deft political touch to navigate state, federal and military officials.

On Capitol Hill, Democrats have seen a "raised tempo" in communications from the White House and other federal officials since Klain took the reins, said Diana DeGette, a senior Democrat on the House Energy and Commerce committee.

Klain talked to New York officials when Dr. Craig Spencer was diagnosed with Ebola, but the White House will not say what Klain did in the first big public test of his coordination prowess - the Friday night decision by Cuomo and Christie to quarantine doctors and nurses returning from Ebola front lines.

The measures came ahead of and went far beyond what the federal government was considering, and raised questions about whose policies were better.

The situation "accentuates the need" for Klain's role, said Mike Feldman, who worked with Klain in the Clinton White House, and describes him as "one of those guys who can go deep pretty quickly" on policy and is deeply trusted by Obama and his team.

"Give him a couple of days to get grounded and get his feet wet. This is one of those situations that's rapidly unfolding," Feldman said.

COHERENT EXPLANATION NEEDED

People who have seen Klain work on thorny government issues in the past say his talents work best behind the scenes, and he leaves the cameras to other players.

"He wasn't often the face of communications or even policy, but he was always somebody who was behind the scenes, strategizing on both," said Jay Carney, who worked with Klain in Biden's office.

Carney described him as an "unflappable" character who was adept at dealing with governors and lawmakers while addressing legal, political and communication problems during the massive 2009 economic stimulus package that invested $787 billion in projects around the country.

"He was extremely reassuring in this period when we coming in (to office), and the world was falling apart economically, there were a lot of tough fights," Carney said in an interview.

It's highly unlikely Klain will play a similar role to Admiral Thad Allen, who Obama put in charge of the government response to plugging the gushing BP oil well in the Gulf of Mexico in 2010, and became the public face of that disaster.

In an interview, Allen, who does not know Klain, said "one size doesn't fit all" when leading during a complex crisis. But he said it can help, at some point, to have a point person who can explain what the government is doing.

"The country is looking for kind of a coherent explanation about how that comes together," Allen said.

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Independent Kids - When Can You Let Go? When Do Children Become Independent? Should You Let Your Children Exercise Independence? How to Coach Your Child to Be More Independent

It's tough to know when to give your children their independence, as well as how much to give. Here are some tips for parents.

 When can you start leaving your child home alone, letting them go out alone, or play out on the street without supervision? It's a tough question, and one that doesn't have a "one size fits all" answer.

 

The truth is that every child becomes independent at a different age. First and second born children often are forced into independence, as their parents can become busy with the younger children. They are forced to find their own entertainment, and thus they become much more independent.

 

The younger children, on the other hand, usually take longer to want that independence, as they're accustomed to Mum and Dad being with them all the time.

 

You'll find that children will express their desire for independence in different ways:

• Doing activities that isolate them from the rest of the family
• Wanting to spend more time outside and away from the house
• Not wanting to join in on family activities.

 

Most of the time, your children will test their limits. For example, if you say they can play outside your house, they'll go to the very end of the street. It's their way of expressing their desire for independence, and if your kids are doing things like this, it's time to consider letting go.

 

 

Absolutely! Your child will one day leave home, and he/she will need to be prepared to face REAL life. If they start exercising independence from a young age, they will be ready when it comes time for them to leave.

 

Independence is a key quality is successful people, and giving your kids their independence will increase their chances of being successful in their lives.

 

Start slow. Your child is no doubt used to being closely monitored and cared for. Don't throw them in at the deep end, but start with small things, i.e. walking through the mall alone, cycling around your neighborhood without supervision, choosing their own clothes, etc.

 

Give freedom with responsibility. You want to promote responsible independence in your kids, so make sure that every freedom you give them comes with an equal responsibility. For example, allow internet time AFTER homework is done, hanging out with friends AFTER the room is clean, etc.

 

Teach safety. Teach safety when at the park, at school, at the mall, on the street, etc.

 

Set limits. They need to know what they can and can't do, both according to your rules and the laws of the land. Set limits for your children, and don't hesitate to take away their freedoms if they break the rules.

 

Find age-appropriate activities. Your 8-year old isn't going to go to a junior high school party, and you can't expect your teenager to be stuck at home. Find age-appropriate activities to encourage independence in your children.

 

Do this, and you can start promoting independence among your children at a very young age.

 

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