Mortgaging your health (Ireland): Ireland is considering the creation of guidelines for financial sector employees on how to deal with customers vulnerable to mental health problems related to debt stress. Minister for Social Protection Joan Burton will soon release a report that indicates physicians in Ireland are concerned about the increase of debt-related mental health issues among their patients. The portion of clients in arrears on their mortgages at Money Advice and Budgeting Service, the national organization that wrote the report, is 47% and growing. Most of these clients are women aged 26–40, 60% of whom have children. The report calls for Ireland to follow the example of the United Kingdom, which has guidelines for creditors on good practices for handling customers with mental health concerns. — Roger Collier, CMAJ
Nuclear lawsuit (United States): A total of 26 US service members have filed a lawsuit seeking US$2 billion from Tokyo Electric Power Co., claiming the Japanese company lied about the dangers posed to them during an aid effort following the 2011 nuclear disaster in Fukushima. Another 100 people are in the process of joining the lawsuit, according to the military newspaper Stars and Stripes. The plaintiffs, who are each seeking US$40 million in compensatory and punitive damages, claim to have suffered health issues, such as headaches, cancer and thyroid problems. But according to the Defense Department, states Stars and Stripes, service members were not exposed to radiation levels high enough to cause serious health problems. — Roger Collier, CMAJ
Population drop (Malawi): The population of Malawi could dwindle to 30 million by 2052, from a projected 70 million, if the nation fails to control HIV/AIDS, according to the country’s Department of Nutrition and HIV and AIDS. Humphrey Mdyetseni, the department’s deputy minister of planning, research and evaluation, said that unless HIV/AIDS is contained, the life expectancy of Malawians could drop below 40 years over the next five decades, according to the Malawi News Agency. The current life expectancy in the country is 47 years, states the World Health Organization. The best approach to reducing deaths caused by HIV/AIDS, said Mdyetseni, is through improving access to antiretroviral treatment and proper nutrition. — Roger Collier, CMAJ
Green minister (Israel): Israel’s new minister of health has demonstrated her concern for the well-being not only of citizens but also the environment. Upon receiving her position, Yael German was offered a new BMW that wasn’t a hybrid. She turned down the offer, however, requesting a hybrid or electric vehicle instead, according to Israel National News. But her request was refused because those vehicles were not approved for ministers. German said she would use her personal hybrid until such time the government can offer her a greener vehicle. — Roger Collier, CMAJ
Refusing HPV vaccine (United States): The percentage of parents in the United States who wouldn’t vaccinate their teenage daughters against the human papilloma virus (HPV) is increasing, according to a new paper in the journal Pediatrics. In 2008, 39.8% of parents said they didn’t intend to vaccinate their teens, states the paper (Pediatrics 2013;131:645–51). By 2010, that percentage had grown to 43.9%. The most common reasons cited for refusing the vaccine include “not needed or not necessary,” “not sexually active” and “safety concerns/side effects.” Some pediatric researchers expressed disappointment with the trend, claiming they hoped the vaccination rate would be going up rather than down, considering that HPV is responsible for most cases of cervical cancer. “The concern about safety of HPV grew with every year,” states the paper, which analyzed the 2008–2010 National Immunization Survey of Teens. “Addressing specific and growing parental concerns about HPV will require different considerations than those for other vaccines.” — Roger Collier, CMAJ
Healthy rebates (South Africa): Shoppers in grocery stores are more likely to purchase healthier foods if offered rebates, according to new research out of South Africa. The country’s HealthyFood program, which offers cash-back rebates of up to 25% for healthy foods (including fruit, vegetables and nonfat dairy products), has altered consumer behaviour for the better, suggests a study in the American Journal of Preventative Medicine (www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE_3774[3]-stamped-031913.pdf). This is seen by some health experts as a positive step toward understanding which types of incentives best encourage healthier diets. According to the study, which examined the purchases of 170 000 households, the rebates increased the percentage of healthy items in total food expenditures by 6%, while decreasing by 5.6% the percentage of less-desirable foods, such as ice cream, chocolates and potato chips. — Roger Collier, CMAJ
Support for Idic15 (Canada): Parents of children suffering from Isodicentric 15q11–13, more commonly known as Idic15, recently launched a Canadian organization that has created a bank of clinical experts and medical clinics for patients with Idic15. It also aims to support and fund microgrants for clinical research. The rare chromosome disorder affects some 40 Canadian families and has a prevalence of 1 in 30 000 births. Patients with the disorder have a partial duplication of the 15th chromosome, which contains extra genetic material in the region responsible for the brain's development. This can lead to developmental delays, autism and sudden unexpected death. The syndrome is passed through the mother's genes, but not much is known about environmental triggers or other possible genetic causes. "I had really exhausted all avenues in British Columbia for treatment," says Idic15 Canada cofounder Therese McKirdy, whose son has the condition. In the absence of Canadian experts, McKirdy took her son to a clinic in the United States that specializes in chromosome-15 duplications. McKirdy and cofounder Lori Eisenhaur are talking with practitioners at existing clinics across Canada to connect families to a network of experts in psychoneurology, genetics, autism and epilepsy. — Juanita Bawagan, CMAJ
Pay what you weigh (Samoa): Somoa Air is claiming to be the first airline in the world to charge passengers according to their weight. “Your weight plus your baggage items, is what you pay for. Simple,” the airline states on its website (www.samoaair.ws/). Chris Langton, Somoa Air’s chief executive, has defended the policy as being the most fair, stating that a “plane can only carry a certain amount of weight and that weight needs to be paid,” reports The Washington Post. Passengers booking tickets online enter an estimate of their weight and luggage weight, and their airfare is calculated based on the total. The weights are later checked at the airport as well. The price per kilogram varies according to the length of the flight. Langton has also suggested the payment policy will promote awareness about obesity. Samoa regularly ranks among the world’s most obese nations. Some have criticized the policy as a “fat tax” that discriminates against people who are obese. Others have suggested that the concept is too contentious to receive widespread adoption. Still, an academic paper on the topic noted that charging according to weight “is a universally accepted principle not only in transportation but also in other services. As space and weight are far more important in air transportation than in other modes of transport, it is important to consider those aspects in pricing air tickets” (Journal of Revenue and Pricing Management 2013;12:103–19). — Roger Collier, CMAJ
HIV-free fee (Mexico): It could take less than US$300 a year to encourage men who have sex with men (MSM) in Mexico City to reduce behaviours that put them at high risk of acquiring HIV or other sexually transmitted infections, according to new research in The European Journal of Health Economics. A survey of 1745 MSM, including male sex workers, showed that more than 70% would pledge to attend monthly safe-sex talks and undergo regular testing in return for an annual per-person fee of $US288 (http://link.springer.com/article/10.1007/s10198-012-0447-y). Male sex workers would accept an even lower payment, $US156, to make the same commitment. The researchers suggest that financial incentives that encourage men to avoid infection are a bargain considering the high costs of treating HIV. — Roger Collier, CMAJ
Dye out (United States): Two food bloggers gathered about 270 000 signatures on a petition urging Kraft Foods to remove artificial dyes from its iconic macaroni and cheese. They claim the dyes used in the product — tartrazine (or Yellow #5) and sunset yellow (or Yellow #6) — have been linked to hyperactivity and loss of concentration in children. The dyes are used by Kraft in the United States and Canada but not in the United Kingdom. Kraft claims the dyes are legal and safe, reports the Chicago Tribune. Furthermore, the company notes, it offers a variety of macaroni and cheese products with natural colouring or no colouring at all. In Canada, a food product can contain a maximum of 300 parts per million of tartrazine, according to government regulations (http://laws-lois.justice.gc.ca/eng/regulations/C.R.C.,_c._870/page-161.html#s-B.16.100). Health Canada told the Toronto Star that tartrazine poses no risk to health when used according to the specifications in its list of permitted food additives. — Roger Collier, CMAJ
Rare finds (Denmark): Researchers in Denmark have released a free search engine dedicated to retrieving information about rare diseases. The website, called FindZebra, was created to cut through the clutter of questionable information so often returned when doctors punch unusual symptoms into mainstream search engines, according to The Telegraph. FindZebra returns useful results quicker than generic search engines because it goes straight to a selection of databases of rare diseases to satisfy each query. The creators of the search engine claim it names the correct rare disease 67% of the time when symptoms are entered, compared to 32% for Google, reports The Telegraph. The search engine has indexed more than 31 000 documents referencing about 7000 rare diseases (defined as affecting fewer than 1 in 2000 people). The website was not designed for the public, though, and displays, above the search box, the following message: “WARNING! This is a research project to be used only by medical professionals.” — Roger Collier, CMAJ
Exporting obesity (Mexico): Men in Mexico have gained an average of 6.8 kg since the country first opened a US-based fast-food restaurant in 1985, topping global averages listed in the Bloomberg Waistline Index. Women in the country gained even more weight, an average of 8.6 kg. The index correlates average weight gains in various countries with the introduction of US fast-food outlets. The global averages are 5 kg for men and 4.5 kg for women. Like Mexico, Chile has exceeded those averages. The country, which opened its first US fast-food chain in 1989, has seen men gain an average of 6.3 kg and women an average of 8.2 kg, reports Bloomberg. Rates of cardiovascular disease and diabetes are also on the rise in these countries. Some health experts suggest that other factors, in addition to greater access to fast food, are also to blame for weight gains, reports Bloomberg, including an increase in processed and packaged foods, population shifts to urban areas where people tend to be less active and a growing middle class with a sedentary lifestyle. — Roger Collier, CMAJ
Open data (European Union): Bowing to pressure from critics of multinational pharmaceutical companies, the European Medicines Agency is developing a policy to share some of the clinical trial data companies submit when seeking licences to sell their drugs in the European Union. The Agency aims to have its policy in place by January 2014. Currently, it is consulting industry, academic researchers and donors about how the publication process would work and how detailed the information should be, as well as who would be able to access data that could reveal the identities of participants in clinical trials. The European Ombudsman ruled in 2010 that detailed data should not be viewed as proprietary. Industry often argues that proprietary information merits protection from publication. — Laura Eggertson, CMAJ
Data dump (Switzerland): Roche Holding AG, the Swiss pharmaceutical company, has agreed to release data from all 74 of the clinical trials it sponsored for its flu-fighting drug oseltamivir (Tamiflu). Regulators around the world have approved and stockpiled Tamiflu to fight pandemic influenza, but some researchers claim there is little evidence the drug really works. Roche will send the trial data to the Cochrane Collaboration, which is among the groups pushing for its release in order to assess efficacy. Roche will send the studies gradually, after having blacked out anything it deems proprietary or that could identify trial participants. — Laura Eggertson, CMAJ
HIV Self-test (Canada): Introducing home-based HIV test kits around the world could remove the barriers of stigma, discrimination and lack of privacy that prevent people from knowing their HIV status, says a systematic review led by Dr. Nitika Pant Pai. Pant Pai, a clinical researcher at the Research Institute of the McGill University Health Centre in Montréal, Quebec, and the lead author, examined 21 studies from different countries (PLoS Med 10:e1001414). The review concludes that people preferred taking oral tests at home to going to a clinic or to remaining untested, and most people given the tests used them. Increased testing could find infected patients sooner, perhaps preventing them from unknowingly infecting partners, though the authors note that the accuracy of self-testing is variable. Oral HIV tests are available for under US$20 in the United States, but not yet in Canada. — Laura Eggertson, CMAJ