AIDS, on the road to pande(mic)monium

22 Jun 2011, Posted by Ashley Mooney in Health & Science, News, 0 Comments

Using antiretroviral drugs has been shown to decrease risk of transmission, according to a recent study at the University of North Carolina at Chapel Hill.

HIV/AIDS has been the 21^st century’s version of the Black Plague. However, unlike the plague, it takes a lot more than a few antibiotics to kill this bugger.

A landmark new study has shown that the use of anti-retroviral drugs can actually prevent HIV transmission. Myron Cohen, director of the Institute of Global Health and Infectious Diseases UNC, led the project.

Over the course of six years, Cohen studied transmission rates among discordant couples—couples in which one partner is HIV positive and the other is not. Half of the infected partners were provided with anti-retroviral drugs. To maintain the standard of research ethics, all were provided with safe-sex counseling, free condoms, and regular check-ups.

The study found that only 28 out of over 1,700 previously HIV-free partners were infected.

While these results are monumental, it is important to note that Cohen’s study focused on preventing transmission only in discordant couples. So yes, the study was wildly successful, but only for a specific risk group. The HIV/AIDS epidemic targets many walks of life, often those that are weakest and least able to care for themselves or partake in one of these experimental studies.

Even though the study holds many implications for the future of treatment and prevention of HIV/AIDS, the battle is far from over. As Cohen stated in an email, “policy follows science.”

HIV/AIDS policy has been controversial to say the least. In a debate as notorious as the chicken-egg dilemma, politicians have been arguing for decades over whether to focus on prevention or treatment.

“In a world where we have limited funds, new opportunities mean more funding,” said Michael Miller, adjunct associate professor of global health and former deputy assistant administrator for global health at USAID. “You have to be very careful about what new things you fund versus what you already fund.”

According to The Economist, it would take about $25 billion a year to more effectively combat HIV/AIDS.  Currently, only $17 billion is being spent.

So if we were to implement a prevention program based off of Cohen’s study, what would it cost? Cohen placed patients on ARV’s much earlier in the progress of the disease than usual, and ARV drugs are notorious for being spendy. Earlier treatment means more ARV’s, more ARV’s mean more money – and money, as we all know, does not grow on trees.

“Once you put somebody on treatment, if there’s no cure for AIDS, you’re obligated to keep that person on treatment forever,” Miller said.

So if we choose to fund such at treatment, we have to fully commit. We can’t pay for people’s drugs and then say ‘just kidding, we need the money for something else now.’

“There are many challenges in broadly implementing [ARV] for all HIV-infected persons,” John Bartlett, director of the AIDS Research and Treatment Center at Duke, wrote in an email. “But even success in reaching a portion of them will result in decreased transmission and aversion of new cases.”

Despite innumerable setbacks and issues, progress is being made. New infection rates have decreased over the past decade – from 3.1 million infections annually to 2.6 million, according to The Economist.

Hopefully, with the help of more successful studies like Cohen’s, the trend will continue and we will finally someday eradicate this plague.

PHOTOS: Obama in Durham 6/13/11

15 Jun 2011, Posted by Ted Knudsen in News, 0 Comments

Obama Visits Cree Factory on 6/13/11 – Images by Duke Student Publishing Co. Duke Chronicle

President Obama spoke about jobs and technology at Cree Inc. in Durham, NC on Monday, June 13th, 2011. Check out Chronicle photographer Ted Knudsen’s photos of the event.

The first Republican debate: winners and losers

14 Jun 2011, Posted by Michael Shammas in News, 0 Comments

Seven Republican candidates faced off Monday in the first presidential debate of the year in New Hampshire, which—as usual—will be holding the first primary of the Republican nomination process.

Mitt Romney, Rick Santorum, Newt Gingrich, Ron Paul, Michelle Bachmann and Herman Cain spoke for two hours in the CNN-hosted debate moderated by John King. The Republicans notably did not attack one another but instead were united in their criticism of President Barack Obama. This is significant because Romney, the media-proclaimed front-runner, was expected to be the main target of the others. So who “won” the debate? Read on.

The Winners

1^st place, Mitt Romney: I have to give the crown to Romney, mainly because he did exactly what a front-runner is supposed to do in a debate—not mess up. Add that to the fact that none of his opponents laid a hand on him, and Romney looks formidable indeed, emerging from this debate with unmatched fundraising potential, a lead in the polls and an unstated consensus by many that Romney—more than any other candidate—can appeal to the general electorate enough to snatch the presidency away from Obama.

And why didn’t anyone battle Romney head-on? After all, they had ample opportunity to make Republicans question him by bringing up his former liberal stance on abortion and the Obama-esque health care plan he instituted as governor in Massachusetts. Maybe they’re coveting the vice presidency. Whatever the case, onto number two…

2^nd place, Newt Gingrich: Despite his campaign falling apart at its seams, the former Speaker of the House appeared surprisingly articulate, and his answers—unlike those of some of his opponents—actually had some substance behind them. Like Romney, Gingrich seems able to appeal both to the Tea Party crowd and to moderates. If he can get his campaign back together before the primary season, he might be a competitive candidate.

Although that is a big “if”…

3^rd place, Michelle Bachmann: Bachmann comes in 3^rd for a couple key reasons: her answers were clear and concise; unlike some other candidates (Herman Cain comes to mind), she avoided hateful speech; and she finally emerged from Sarah Palin’s massive shadow to begin creating a brand of her own. If Palin doesn’t run, Bachmann certainly has a chance to win over Tea Party voters.

Bachmann also wins for finally making her campaign official at the debate. This comes to no one’s surprise, but by making the move Bachmann was able to direct post-debate coverage to a greater degree than her opponents.

4^th place/wild card, Ron Paul: Once again, Paul seems to be the odd ball of the race. He agreed on some issues with his fellow Republicans, but his stance on drugs (wants to make them legal), foreign policy (wants to pull all American troops out of foreign bases and wars and to bring them back to the United States), and the Federal Reserve (no income tax) may be too much for even the most ardent Libertarian. Still, you’ve got to give the man props for bringing issues to light that would otherwise remain dormant.

And—more importantly for my fellow Dukies—Paul attended Duke Medical School.

The Losers

5^th place, Rick Santorum: Santorum was rather unremarkable. Not much to say here.

6^th place, Tim Pawlenty: Pawlenty caused Republicans everywhere to scratch their heads at his refusal to criticize Romney’s Massachusetts health care bill even though he called it “Obamneycare” (a pun of “Obamacare”) the previous day on Fox News Sunday. By doing so, he distinguished himself even less from Romney and disappointed his supporters who were largely counting on him to tear Romney away from his front-runner position. Whether or not Pawlenty ever goes on the offensive in the future remains unpredictable.

7^th place, Herman Cain: While the first Republican African-American candidate may have appealed to some Republicans with his appalling anti-Muslim sentiments, his words are likely to come back and bite him if he wins the primary and makes it to the general election.

Background: When King asked Cain about a his previous statement saying that he would never appoint a Muslim to his Cabinet, Cain replied that the media was taking his words out of context. What he meant to say, he assured us, was that he would not be “comfortable” having a Muslim in his Cabinet.

Interestingly, Cain is still rising in the polls.

I don’t think this debate changes much. Romney is still the favorite to win the nomination. His fundraising means that he has raised more money than any other candidate, while his name recognition makes him instantly recognizable to most of the electorate. Barring a huge defeat in the New Hampshire primary or an entrance by Sarah Palin into the race, this election is still Romney’s to lose.

Unemployment may lead to lower test scores

08 Jun 2011, Posted by Melissa Dalis in News, 0 Comments

Blame the economy for that bad grade on your math test.

According to a recent study by the Sanford School of Public Policy called “Children Left Behind: The Effects of Statewide Job Loss on Student Achievement,” higher unemployment rates cause significantly lower test scores across the state, regardless of whether or not a child’s own parents are unemployed.

“We found pretty big effects for eighth grade math test scores, and we believe they are large enough that they can’t just be coming from the kids with parents who lost jobs,” said Elizabeth Ananat, assistant professor of public policy and economics at Sanford. “An entire community of children is affected when there’s a serious job loss.”

The results of this analysis show that high unemployment rates affect not only students in individual families where the parents are unemployed, but also entire communities.

The economy’s impact on test scores can have severe effects on schools—especially under the No Child Left Behind Act, which requires schools to set goals for students to be proficient in reading and math—said Anna Gassman-Pines, assistant professor of public policy, psychology and neuroscience at Sanford. There can be serious consequences for schools that fail to reach these goals or show yearly progress.

Most states with 2% change in unemployment over the course of one year have shown to have a 16% of their schools fail to meet the guidelines for Adequate Yearly Progress under the No Child Left Behind Act, Gassman-Pines said.

“It struck us that there was a lot of attention being paid to the workers themselves…but we realized that no one was really asking what the consequences were for children both in these families and also in communities where there have been serious job losses,” Gassman-Pines said.

The 1996 through 2009 national data from reading and math standardized tests for fourth and eighth graders consistently showed lower test scores in states with higher unemployment rates. Only the effects on eighth grade math test scores, however, were statistically significant. Ananat speculated that, while a student’s reading success is very much cumulative, the math scores can fluctuate from year to year, depending on the student’s grasp of the math topic that is taught and then tested at the end of the year.

What about the effects of aggregate changes in the economy and unemployment rates like in the current recession—would higher unemployment across the board hurt everyone’s scores? Although test scores generally improve from year to year, Ananat speculated that schools in the recession might be improving less than they would have had it not been for the suffering economy.

As a college student, I also wonder if high unemployment rates in students’ hometowns would carry with them when they move to college or into the real world. And what about tests for getting into college in the first place, like the ACT or SAT? Are students in states with high unemployment at a disadvantage?

Future research by these authors might answer these types of questions.

“On the one hand, you can imagine that…as things improve, [students’] test scores kind of go back up—that’s certainly one scenario that seems plausible,” Gassman-Pines said. “[Or it] could also create a snowball effect where test scores go down and cascade—we just don’t know about longer-term.”

2012 election may be nastier than 2008

06 Jun 2011, Posted by Michael Shammas in News, 0 Comments

The next presidential election is more than a year away, but potential candidates are already attacking one another for political gain. Whether one looks at Sarah Palin’s public critique of “Romneycare” or Congresswoman Michelle Bachmann’s questioning of our President’s citizenship, the 2012 election is shaping up to be even nastier than the 2008 election. So is there any hope for civil discourse? New data from the Fuqua School of Business suggests we shouldn’t hold our breath.

“Our study implies that campaigns with lots of money tend to be more negative,” said Ron Shachar, visiting professor at Fuqua, who led the research. “Given that experts expect the 2012 election to attract a lot of money, one can expect—given our findings—that 2012 will be quite negative.”

Initially, Shachar wished to understand a more common political phenomenon: why campaigns tend to grow more negative as election day approaches. In this process, however, he undermined a common assumption. He discovered that, contrary to previous belief, it’s not the intensity of the competition that helps predict if candidates go on the attack, but instead the money and attention a tight race draws. As both increase, so too does a candidate’s negative advertising.

Importantly, though candidates with deeper pockets or media saturation often turn to attack advertisements, lesser known candidates tend to focus on positive advertising. The reason for this is simple: a candidate who is not as well-known as others must spend time getting voters to know who he or she is, Shachar said.

Whatever the case, the upcoming Republican primaries should provide ample opportunity to see Shachar’s research in practice. I’m excited.