Smallholders represent a significant portion (38%) of oil palm cultivation in Indonesia, and represent a critical component of the palm oil industry, as well as constitute a significant opportunity to improve livelihoods in resource-poor settings. Smallholders’ engagement in oil palm cultivation began as part of Indonesian government to promote tree plantation crops in the late 1970s. The initial programme consisted basically of direct state investments through state-owned companies (PTPN) and was integrated with government-sponsored transmigration programmes to provide a labor force for the new plantations. This integration was embryonic for smallholder engagement in state-led agribusiness. The emergence of smallholder oil palm planters constituted a spread effect of plantation development led by the government. The state agribusiness-driven policy has transformed rural areas and settlement development was started in the surrounding of large-scale oil palm plantation.
Smallholders represent a significant portion (38%) of oil palm cultivation in Indonesia, and represent a critical component of the palm oil industry, as well as constitute a significant opportunity to improve livelihoods in resource-poor settings. Smallholders’ engagement in oil palm cultivation began as part of Indonesian government to promote tree plantation crops in the late 1970s. The initial programme consisted basically of direct state investments through state-owned companies (PTPN) and was integrated with government-sponsored transmigration programmes to provide a labor force for the new plantations. This integration was embryonic for smallholder engagement in state-led agribusiness. The emergence of smallholder oil palm planters constituted a spread effect of plantation development led by the government. The state agribusiness-driven policy has transformed rural areas and settlement development was started in the surrounding of large-scale oil palm plantation.
Objective Capital Precious Metals, Diamonds and Gemstones Investment Summit
Panel Discussion: Outlook for the Precious Metals Markets
20 May 2010
by David Wilson - Societe Generale
Bill Fisher - RX Exploration
David Hargreaves - Fair Trade Gemstones
Objective Capital Precious Metals, Diamonds and Gemstones Investment Summit
Focus on Gold: Challenges of gold mining in the US – reopening the Drumlummon Mine in Montana
20 May 2010
by David Wilson - Societe Generale
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, for the Australiasian college for Emergency Medicine 27th Annual Scientific Meeting - Canberra
Objective Capital Precious Metals, Diamonds and Gemstones Investment Summit
Panel Discussion: Outlook for the Precious Metals Markets
20 May 2010
by David Wilson - Societe Generale
Bill Fisher - RX Exploration
David Hargreaves - Fair Trade Gemstones
Objective Capital Precious Metals, Diamonds and Gemstones Investment Summit
Focus on Gold: Challenges of gold mining in the US – reopening the Drumlummon Mine in Montana
20 May 2010
by David Wilson - Societe Generale
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, for the Australiasian college for Emergency Medicine 27th Annual Scientific Meeting - Canberra
Alan B. Kruegar, Chairman of the President's Council of Economic Advisers, spoke on reversing the middle class jobs deficit on April 26, 2012 at Columbia University
Pandemics: Dealing with the Unexpected "Scientific Theory and Practical Reality"Department of Health
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO. Options for the control of Influenza VII Conference - Hong Kong 6 Sept 2010
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO,to the PHAA 12th National Immunisation Conference in Adelaide 17 August 2010
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, on Cancer Control in Australia - Institute of Cancer Research 12 July 2010
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Are There Any Natural Remedies To Treat Syphilis.pdf
Australia's Future Health
1. AUSTRALIA’S
FUTURE HEALTH
University of Melbourne Medical Alumni 2010
Melbourne – 19 November 2010
Professor Jim Bishop AO
Chief Medical Officer
Australian Government Department of Health and Ageing
2. OECD HEALTH DATA 2010
How Does AUSTRALIA Compare
Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
8,000
7538
7,000
6,000
5004
5,000 4627
4210
4079 4063
3970
4,000 3793 3737
3696 3677
3540 3470
3359 3353
3129 3060
3008
2902 2870
3,000 2729 2687 2683
2151
2,000 1801 1781 1737
1437
1213
999
852
1,000 767
0
1 Refers to insured po pulatio n rather than resident po pulatio n. 2. Current expenditure. 3. 2006. 4. 2007. So urce: OECD, OECD Health Data, June 201
. 0
Public expenditure on health Private expenditure on health
8. AGED ADJUSTED DEATH RATES
From CVD, 1907 - 2006
Source: AIHW Australia’s Health 2010
9. Mortality-to-incidence ratio
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Ke
ny
a
Ni
Source: IARC 2010.
ge
ria
Eg
yp
Vi t
et
Na
m
Tu
rk
ey
In
di
a
Ch
in
a
Ru
So ss
ut ia
h
Af
ric
a
G
re
ec
e
Br
az
il
Cz Ja
ec pa
h n
Re
pu
bl
ic
Un
ite Ita
d ly
Ki
ng
do
m
Ca
na
da
G
er
m
an
Sw y
Ne ed
w en
Ze
al
an
d
US
Au A
st
ratios for selected countries - 2008
ra
lia
Males
Females
ALL CANCER – MORTALITY/INCIDENCE
10. CHANGES IN DEATH RATES IN
MALES - using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
11. CHANGES IN DEATH RATES IN
FEMALES - Using Joinpoint
Analysis
Source: Tracey et al – Cancer Institute NSW
12. 5 year Survival Rates
2004
NSW SEER
Non small cell lung 13% 14%
Colon 65% 67%
Rectum 66% 69%
Breast Cancer 89% 90%
Lymphoma (DL) 53% 53%
Source: Tracey et al – Cancer Institute NSW
13. TOTAL CANCER CASES & DEATHS
per year (1972 to 2036)
Source: Cancer Institute NSW
14. TRENDS IN LEADING CAUSES
OF DISEASE BURDEN 2003-2023
Source: AIHW Australia’s Health 2010
16. THE KEYS TO PREVENTION
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol
Alcohol
Fruit/vegetables
Illicit drugs
Air pollution Total of 32%
Unsafe sex
0.0 2.0 4.0 6.0 8.0
% DALYs
Source: Table 4.1 AIHW Australia’s Health 2008
20. Budget 2010-11
Anti-smoking campaigns ($27.8m)
COAG agreed
• Increased tobacco excise
• Plain packaging
• Restricting internet advertising of tobacco products
• Further funding for National Binge Drinking Strategy
($50m)
• Survey of Australia’s Health ($54m)
National Preventative Health Agency (Spring Session)
21. NATIONAL PREVENTATIVE
HEALTH AGENCY
• Builds on the National Partnership Agreement on
Preventative Health ($872.1m over 6 years)
• Establishment and operational by early 2011 ($17.6m)
• Specific responsibilities:
- National Social Marketing ($102m over 4 years)
- Preventative Health Research fund ($13.1m
over 4 years)
- Preventative Health Workforce audits and
strategy ($0.5m over 2 years)
22. AUSTRALIAN HEALTH SURVEY
Four components run by ABS 2011-13
- Health Survey
- ATSI Health Survey
- Nutrition and Physical Activity Survey
- Health measurement Survey
Around 50,000 participants
De-identified data available as summary statistics,
tables
23. Commonwealth Government Health and
Hospital expenditure under the NHHN
Source: Commonwealth Budget Papers, DOHA and PMC Analysis
24. HEALTH REFORM
Increasing expenditure to $15 billion 2010/11
Additional $7.3 billion over 4 years
Local Hospital Networks (LHN) 60% Federal
Funds (60% of research and teaching)
Medicare locals (100% Federal funds)
GP Superclinics – multi disciplinary teams
(100% Federal Funds)
25. BUDGET 2010-11
e-Health – connecting patients, providers and information
systems
The Government will establish a personally controlled
electronic health record system ($466.7m)
The system will:
• Enable people – and their chosen health provider - to
access online their key health information when and where
it is needed, for their care across the health system.
• Allow people to register online to establish a personally
controlled electronic health record from 2012-13
• Rigorous governance
• Privacy maintained
26. HEALTH REFORM
KEY NEW STRUCTURES
National Performance Authority
Independent Hospital Pricing Authority
Expanded Australian Commission of
Safety and Quality in Health Care
(ACSQHC)
27. CLINICAL GUIDELINES
SUPPORTS FOR CLINICAL
DECISION MAKING
Evidence Base
Highest Impact
Range of best practice tools
Successful implementation methods
Monitor and report
28. CLINICAL GUIDELINES
Highest Impact
Greatest Burden of disease
Greatest harm from poor practice
Greatest demonstrated need:
- New Standard of Care
- Proven variation in practice
Greatest time spent/cost to health system
29. REVIEW OF CLINICAL GUIDELINES
N – 313
N %
CANCER 17 5%
CARDIOVASCULAR 18 6%
RENAL 22 7%
MENTAL ILLNESS 22 7%
NEUROLOGICAL 0 0%
INJURIES 13 14%
CHRONIC RESPIRATORY 0 0%
DIABETES 11 4%
OTHER 173 67%
TOTAL 313 100%
Buchan et al 2006
30. MILESTONES IN
CANCER CONTROL
Public health measures in smoking reduction,
screening breast, cervix, bowel, health literacy
Adjuvant treatment of breast, lung and bowel
cancer
New anti-cancer drugs and symptom control drugs
Cancer research translated into practice
Cancer registries, data linkage and analysis
31. BREAST CANCER
MORTALITY
NEJM 2005
Source: New Engl.Journ. Med: 353:17
32. PROJECTED YLLs – Three
scenarios, Australia – 1980 to 2016
Source: Bishop et al – Cancer Institute NSW
35. Project Grants - Success Rates
3600
3200
Number of applications
2800
19% Not recommended for
funding (score < 4)
2400 37%
24%
25%
2000
39% 3344
1600 58%
42% Fundable, but
44%
41% 43% not funded
48% 49%
33%
1200 42%
40%
800 37% 36%
36% 34% 34%
400 27% 27% 23%
21%
30% 23% 23% 22% 22% 21% Funded
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Year of Application
36. NHMRC Supported
Research Workforce
10000
NHMRC Supported Workforce
8000
6000
4000
2000
0
2003 2004 2005 2006 2007 2008 2009 2010
F u ll Tim e P a rt Tim e
39. NHMRC Support for
Translational Research
Translational funding mechanisms
Partnership Projects for Better Health
Partnership Centres for Better Health
Centres of Clinical Research Excellence
Centres of Research Excellence in Population Health
Research, & Health Services Research
National Health Research Enabling Capabilities Scheme
Industry Development awards
40. NHMRC Project Grants
Clinical Trials Expenditure
$70 300
Millions
$60
250
$50
200
$40
150
$30
100
$20
50
$10
$0 0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Total Expenditure Number of Grants
41. Harmonization of Multi-centred
Ethical Review (HoMER)
National Statement for Ethical Conduct of Human
Research (2007)
Process supported by AHMAC conducted by
NHMRC
Certification of ethical review processes – first round
Roles, responsibilities, templates published
NHMRC working with States and Territories
42. CONCLUSIONS
Australia faces substantial challenges in Chronic diseases
with longer life and life style diseases
The overall burden of disease is reducing with the
exceptions of cancer, dementia and diabetes with ongoing
mental health needs
Health reform offers opportunities for prevention, new
models of care and translational research
New structures, guidelines and indicators need a solid
research and evidence base to improve patient outcomes