People With Chronic Hepatitis B Often Do Not Know It

This is the VOA Special English Health Report.

Today we answer a question. Vu Quang Hien from Vietnam wants to know more about hepatitis B. Hepatitis is the name for a group of viral infections that attack the liver. These are called A, B, C and so on.

An estimated two billion people are infected with hepatitis B. The rates are highest in China and other parts of Asia. The World Health Organization says most of these infections happen during childhood.

Hepatitis B is spread through contact with infected blood or other body fluids. Mothers can infect babies at birth. Unsafe injections and sexual contact can also spread the virus. Experts say it can survive outside the body for at least a week.

There are two forms of hepatitis B -- acute and chronic. Acute cases last for several weeks, although recovery can take months. Chronic cases can lead to death from cirrhosis or scarring of the liver and liver cancer.

Yet people with long-term liver infections can live for years and not even know they are infected. The ones most likely to develop chronic hepatitis B are young children.

In the United States, experts at the Centers for Disease Control and Prevention urge medical providers to test Asian-American patients.

DR. JOHN WARD: "The bottom line -- since most people of Asian heritage came to the US from endemic countries or were born to parents from these countries, they should be screened for chronic hepatitis B."

For acute hepatitis B, patients may receive care to replace lost fluids, but there are no treatments. Doctors can treat chronic cases with interferon and antiviral drugs. But these medicines cost too much for most of the world's poor.

A vaccine to prevent hepatitis B has been available for thirty years. The researcher who discovered this vaccine -- and hepatitis B itself -- was an American named Baruch Blumberg. Dr. Blumberg also showed that the virus could cause liver cancer.

NASA

Dr. Baruch Blumberg

He and another researcher at the Fox Chase Cancer Center in Philadelphia, Irving Millman, invented the vaccine in nineteen sixty-nine. But Dr. Blumberg said it took some time to find a drug company willing to produce it.

He first became interested in studying infectious disease when he volunteered in Surinam during his medical training.

His discoveries with hepatitis B saved many lives and earned him a Nobel Prize in medicine. But he also had other interests -- including the search for life in outer space.

In the late nineties, he helped launch the Astrobiology Institute at NASA. He was at a space agency conference in California in April when he died, apparently of a heart attack. Baruch Blumberg was eighty-five years old.

And that’s the VOA Special English Health Report, written by Caty Weaver.  I’m Steve Ember.

From the VOA

Words and their meaning/s - Water

Now, the VOA Special English program WORDS AND THEIR STORIES.
Expressions about water are almost as common as water itself. But many of the expressions using water have unpleasant meanings.
The expression "to be in hot water" is one of them. It is a very old expression. “Hot water” was used five-hundred years ago to mean being in trouble. One story says it got that meaning from the custom of throwing extremely hot water down on enemies attacking a castle.
That no longer happens.  But we still get in “hot water.”  When we are in “hot water,” we are in trouble. It can be any kind of trouble -- serious or not so serious. A person who breaks a law can be in hot water with the police. A young boy can be in hot water with his mother, if he walks in the house with dirty shoes.
Being in “deep water” is almost the same as being in hot water. When you are in deep water, you are in a difficult position. Imagine a person who cannot swim being thrown in water over his head.
You are in deep water when you are facing a problem that you do not have the ability to solve. The problem is too deep. You can be in deep water, for example, if you invest in stocks without knowing anything about the stock market.
“To keep your head above water” is a colorful expression that means staying out of debt. A company seeks to keep its head above water during economic hard times. A man who loses his job tries to keep his head above water until he finds a new job.
“Water over the dam” is another expression about a past event. It is something that is finished. It cannot be changed. The expression comes from the idea that water that has flowed over a dam cannot be brought back again.
When a friend is troubled by a mistake she has made, you might tell her to forget about it. You say it is water over the dam.
Another common expression, “to hold water,” is about the strength or weakness of an idea or opinion that you may be arguing about. It probably comes from a way of testing the condition of a container. If it can hold water, it is strong and has no holes in it.
If your argument can hold water, it is strong and does not have any holes. If it does not hold water, then it is weak and not worth debating.
“Throwing cold water” also is an expression that deals with ideas or proposals. It means to not like an idea. For example, you want to buy a new car because the old one has some problems. But your wife “throws cold water” on the idea because she says a new car costs too much.
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This VOA Special English program, WORDS AND THEIR STORIES, was written by Marilyn Christiano. I’m Rich Kleinfeldt.


From the VOA
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How Early Treatment Can Limit the Spread of HIV

This is the VOA Special English Health Report.

For people infected with HIV, the earlier they start treatment, the better -- and better not just for them. A new study shows that early treatment greatly reduces the risk that the partner of an infected person will also get infected. HIV is the virus that causes AIDS.

Dr. Anthony Fauci is with the United States National Institutes of Health which paid for the study.

ANTHONY FAUCI: "Many studies have been showing that the earlier you start, the better it is for the person who is infected. This study shows that not only is it better for the person who is infected, but it helps that person from transmitting to the person that's their sexual partner, heterosexual partner."

Researchers cannot say if the results would be the same in men who have sex with men. Most of the couples in the study were heterosexual.

The study took place in Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe. It involved almost two thousand couples divided into two groups.

In one group, the infected man or woman began to take a combination of three antiretroviral drugs immediately after being found to have HIV. In the other group, the infected partners began drug treatment only when they started to show signs of getting AIDS.

The researchers say both groups received equal amounts of HIV-related care and counseling. That included information about safe sex practices, free condoms and regular HIV testing.

The study began in two thousand five. It was supposed to last until twenty-fifteen. But researchers stopped it early because the results were so clear. Only one case of infection was reported in couples where the infected partner began immediate treatment.

Dr. Fauci says earlier treatment led to a ninety-six percent reduction in the spread of HIV to uninfected partners.

ANTHONY FAUCI: "This is a powerful bit of evidence that will go into the thinking and formulation of guidelines and of global policy, policy by WHO, by UNAIDS, by the international organizations that help to provide drugs in the developing world."

The study shows the value in testing and treating HIV before a person even feels sick enough to see a doctor. But in many countries, public health budgets are already stretched thin. In sub-Saharan Africa, the area hardest hit by AIDS, for every person who gets treated, two others go untreated.

Antiretroviral drugs suppress the virus. Once people start treatment, they have to continue it daily for the rest of their life.

And that's the VOA Special English Health Report. To read and listen to our reports, go to voaspecialenglish.com. I'm Jim Tedder.


 From the VOA.

Treating a Bad Headache - Migraine

FAITH LAPIDUS: I'm Faith Lapidus.
BOB DOUGHTY: And I'm Bob Doughty. Today we tell about headaches, the pain that strikes almost everyone at some time.
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FAITH LAPIDUS: Have you had a headache recently? If your answer is yes, you are like many millions of people worldwide who experience pain in the head. The pain can be temporary, mild and cured by a simple painkiller like aspirin, or it can be severe.
The National Headache Foundation says more than forty-five million people in the United States suffer chronic headaches. Such a headache causes severe pain that goes away but returns later.
Some headaches may prove difficult and require time to treat. But many experts today are working toward cures or major help for chronic headaches.
BOB DOUGHTY: The US Headache Consortium is a group with seven member organizations. They are attempting to improve treatment of one kind of headache -- the migraine. Some people experience this kind of pain as often as two weeks every month. The National Headache Foundation says about seventy percent of migraine sufferers are women.
Some people describe the pain as throbbing, causing pressure in the head. Others compare it to someone driving a sharp object into the head. Migraine headaches cause Americans to miss at least one hundred fifty million workdays each year. A migraine can be mild. But it also can be so severe that a person cannot live a normal life.
FAITH LAPIDUS: One migraine sufferer is Curtis Croley of Ellicott City, Maryland. Mr. Croley had head pain as a child. He says he does not know what kind of headaches they were. But when he suffered severe headaches as an adult, doctors identified the problem as migraine.
Today, Mr. Croley produces and directs films and videos. He says months can pass without a headache. But then he will have three migraines within a month. If he takes the medicine his doctor ordered early in his headache, it controls the pain in his head. If not, the pain becomes extremely bad. Sometimes he has had to be treated with a combination of drugs in a hospital.
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BOB DOUGHTY: Some people take medicine every day to prevent or ease migraine headaches. Others use medicine to control pain already developed. Doctors treating migraine sufferers often order medicines from a group of drugs known as triptans.
Most migraines react at least partly to existing medicine. And most people can use existing medicine without experiencing bad effects. Doctors sometimes use caffeine to treat migraine headaches. Interestingly, caffeine also can cause some migraines.
FAITH LAPIDUS: Medical experts have long recognized the work of the Mayo Clinic in Rochester, Minnesota. The Mayo Clinic says several foods are suspected of being “triggers” that start migraines. They include cheese and alcoholic drinks. Food additives like salt and monosodium glutamate also may be triggers.
The Mayo Clinic tells patients to avoid strong smells that have seemingly started migraines in the past. Some people react badly to products like perfume, even if they have a pleasant smell.
The clinic's experts say aerobic exercise can help migraine sufferers. Aerobic exercise increases a person's heart rate. It can include walking, swimming or riding a bicycle. But a sudden start to hard exercise can cause headaches. So it is a good idea to perform some mild exercises before beginning activities that require more energy.
The experts advise that people should plan to exercise, eat and sleep at the same times each day.
Swimmers in a water aerobics class in Sioux Falls, South Dakota. Experts say aerobic exercise can help people with headaches.
BOB DOUGHTY: The Mayo Clinic has advice about estrogen for women who suffer from migraines. The female body makes estrogen. Drugs like birth control pills contain a version of this chemical.
Such drugs may produce headaches or cause them to worsen, the Clinic warns. The same is true for estrogen replacement drugs for women. Doctors sometimes order estrogen replacement for women who are no longer able to have children.
FAITH LAPIDUS: The Mayo Clinic also says hypnosis might help suppress headaches in children and young people. It says the method might reduce the number and severity of a patient’s headaches.
In hypnosis, a patient must first be willing to seek this form of treatment. Patients are placed in a condition that lets them receive suggestions. They look like they are sleeping. The suggestions they receive may be able to direct their whole mental energy against pain.
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BOB DOUGHTY: More people suffer tension headaches than migraines. But most tension headaches are not as powerful.
Events that start tension headaches may include emotional pressure and the deeper than normal sadness called depression. Other tension headaches can start from something as simple as feeling tired. Common changes in atmospheric conditions also can be responsible.
The Mayo Clinic says you may feel a tension headache as tightness in the skin around your eyes. Or, you may feel pressure around your head. Episodic tension headaches strike from time to time. Chronic tension headaches happen more often. A tension headache can last from a half hour to a whole week.
FAITH LAPIDUS: The Mayo Clinic says the pain may come very early in the day. Other signs can include pain in the neck or the lower part of the head. Scientists are not sure what causes tension headaches. For years, researchers blamed muscle tension from tightening in the face, neck and the skin on top of the head. They believed emotional tension caused these movements.
But that belief has been disputed. A test called an electromyogram shows that muscle tension does not increase in people with a tension headache. The test records electrical currents caused by muscle activity. Such research caused the International Headache Society to rename the tension headache. The group now calls it a tension-type headache.
BOB DOUGHTY: Some scientists now believe that tension headaches may result from changes among brain chemicals such as serotonin. The changes may start sending pain messages to the brain. These changes may interfere with brain activity that suppresses pain.
Medicines for tension headaches can be as simple as aspirin or other painkillers. But if your pain is too severe, you will need a doctor's advice.
FAITH LAPIDUS: A website called FamilyDoctor.org provides information from the American Academy of Family Physicians. The group suggests steps to ease or end a tension headache.
For example, it says putting heat or ice on your head or neck can help. So can standing under hot water while you are getting washed. The group also advises exercising often. Another idea is taking a holiday from work. But you had better ask your employer first.
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BOB DOUGHTY: Ask anyone with a cluster headache, and they will tell you that the pain is terrible. The Cleveland Clinic in Ohio says the cluster headache can be many times more intense than a migraine.
Cluster headaches usually strike young people. Smokers and persons who drink alcohol often get these headaches. Men are about six times more likely than women to have them. The Cleveland Clinic says this is especially true of younger men. Doctors say cluster headaches often strike during changes of season.
Cluster headache patients describe the pain as burning. The pain is almost always felt on one side of the face. It can last for up to ninety minutes. Then it stops. But it often starts again later the same day. Eighty to ninety percent of cluster headache patients have pain over a number of days to a whole year. Pain-free periods separate these periods.
FAITH LAPIDUS: The Cleveland Clinic says the cause of cluster headaches is in a brain area known as a trigeminal-autonomic reflex pathway. When the nerve is made active, it starts pain linked to cluster headaches. The nerve starts a process that makes one eye watery and red.
Studies have shown that activation of the trigeminal nerve may come from a part of the brain called the hypothalamus. The Cleveland Clinic says injections of the drug sumatriptan can help. Many other drugs could be used. For example, doctors say breathing oxygen also can help.
Thankfully, modern medicine has ways to treat almost all of our headaches.
(MUSIC)
BOB DOUGHTY: This program was written by Jerilyn Watson. June Simms was our producer. I'm ­­­­­­­­­­­­­­­­­Bob Doughty.
FAITH LAPIDUS: And I'm Faith Lapidus. 

Anti-retroviral drugs 'help reduce' HIV transmission

An HIV-positive person who takes anti-retroviral drugs after diagnosis, rather than when their health declines, can cut the risk of spreading the virus to uninfected partners by 96%, according to astudy.

The United States National Institutes of Health sampled 1,763 couples in which one partner was infected by HIV.

It was abandoned four years early as the trial was so successful.

The World Health Organization said it was a "crucial development".

The study began in 2005 at 13 sites across across Africa, Asia and the Americas.

HIV-positive patients were split into two groups. In one, individuals were immediately given a course of anti-retroviral drugs.

The other group only received the treatment when their white blood cell count fell.

Both were given counselling on safe sex practices, free condoms and treatment for sexually transmitted infections.

Among those immediately starting anti-retroviral therapy there was only one case of transmission between partners.

In the other group there were 27 HIV transmissions.

'Renewed commitment'

"This breakthrough is a serious game changer and will drive the prevention revolution forward. It makes HIV treatment a new priority prevention option," said Michel Sidibe, executive director of the Joint United Nations Programme on HIV/Aids (UNAIDS).

But he warned that it would cost more than ten billion dollars to provide drugs to the ten million people worldwide who are currently not receiving medication for HIV.

The World Health Organization says sexual transmission accounts for 80% of all new HIV infections. Its director general, Dr Margaret Chan, described the announcement as a "crucial development"

She added: "The findings from this study will further strengthen and support the new guidance that WHO is releasing in July to help people living with HIV protect their partners."

The value of anti-retrovirals, in preventing transmission, had been speculated for some time after observational studies, but researchers say this is the first time it has been proven in clinical trials.

Keith Alcorn, from the NAM, an HIV/AIDS charity, said: "This study resoundingly confirms what lots of smaller studies have been telling us for several years.

"International donors cannot ignore the evidence any longer: HIV treatment is a very powerful form of HIV prevention, and could have a major effect on the HIV epidemic in the worst-affected countries.

"What we need now is a renewed commitment to HIV treatment, and studies to show how to get the maximum benefit out of this breakthrough at country level."

From the BBC website.

Apartheid victims to receive TRC pay-outs

Government will pay out millions of rands to compensate victims of apartheid-era atrocities. 

Those who qualify for financial assistance include victims and their children, even if they were born in or out of wedlock or were adopted.

People with parental responsibilities over victims and their children will also be eligible for compensation.

The regulations have come about from the work of a joint committee, established to consider the recommendations of the Truth and Reconciliation Commission (TRC), on reparation for victims.

The committee's decisions were approved by Parliament and now have to be implemented by President Jacob Zuma, the report said.

The Justice and Constitutional Affairs Department has gazetted proposed regulations paving the way for assistance to victims and their children, at the start of their schooling careers to the completion of their tertiary studies.

The gazette indicates that compensation to victims must be paid from the President's Fund, established to provide reparations to those who suffered gross human rights violations during apartheid.

The TRC is said to have collected statements from about 21 000 people.
From the Sunday Times

You Are Your Brand - Be careful of the way you market yourself.

Today we share some ideas for job hunters about presenting yourself online.

Ben Kirshner is chief executive of a New York company he started in two thousand four. Elite SEM, or search engine marketing, has about twenty-five employees. Many companies use headhunters -- recruiting services that find workers for high-paying positions. But Mr. Kirshner says that can be costly.

BEN KIRSHNER: "Probably, for a one-hundred-fifty-thousand-dollar-a-year employee it would cost me in the range of ten to fifteen thousand dollars."

He saves money by advertising jobs online and using social media. Sometimes finding the right person this way can take time. But recently Mr. Kirshner posted a job on the advertising site Craigslist. He says he had one hundred fifty good candidates within four hours.

He says his company does not use sites that offer to search the Web for information about job candidates. His company does that itself. Social networks and other websites can provide a lot of details about people's lives. As Ben Kirshner points out, that may even include personal information that employment laws prevent employers from asking.

BEN KIRSHNER: "Things we are not legally allowed to ask in an interview, we can find because they're publicly displaying it on the social networks."

Leslie Stevenson directs the Career Development Center at the University of Richmond in Virginia. For young job-seekers, she says, the barrier between public and private is changing.

LESLIE STEVENSON: "In the past two years, candidates are not seeing social media as a place that we have to keep private from prospective employers but as a tool that will assist in my search."

To do that, job-seekers need to carefully develop their online image. Ben Kirshner says an important part of that is managing public and private details on social media.

BEN KIRSHNER: "You are your brand. So everything you do online reflects who you are personally and professionally."

He thinks a willingness to share experiences and skills will lead to a more open workplace.

BEN KIRSHNER: "I think there will be sites and services coming out that will make people even more transparent about what they do at their job."

Even the kinds of links you share with other people on Facebook or other sites are part of your image.

Image is one thing. But you also need skills. And career specialist Leslie Stevenson says that includes "soft skills."

LESLIE STEVENSON: "Soft skills are the skills that help people communicate in the workplace. They're all of the things you bring to the table, such as your communication, how you interact both with your teammates, with potential clients."

I'm Mario Ritter.

From the VOA

A Social Network Aims to Speed Up Progress in Science

This is the VOA Special English Education Report.

A few years ago, a university researcher was having problems with an experiment that involved medical imaging. His adviser and his friends had no solutions. The researcher was Ijad Madisch at Harvard in Massachusetts.

IJAD MADISCH: "I was so frustrated. I said, you know, there has to be something online where I go, where people can, you know, present themselves as a scientist, and where they put their information about their research and their publications and you can search for it."

The solution was to start a scientific network to connect researchers and share information. ResearchGate is similar to another social network developed at Harvard -- Facebook. But Mr. Madisch says the purpose of his site is to make scientists more productive.

IJAD MADISCH: "My goal: to win the Nobel Prize. And I really believe in that. Like, if we think that ResearchGate will accelerate research in all the different fields, it will change the speed of science significantly in the future. So i definitely do believe that ResearchGate could win the Nobel Prize for that one day."

Investors liked the idea, including a former Facebook executive and the same investment group that put money into Twitter. So far, nine hundred thousand people have signed up as members of ResearchGate.

CAROLINE MOORE-KOCHLACS: "Logging in ... "

One of those users is Caroline Moore-Kochlacs at Boston University. Her profile page shows her picture and her specialty -- neuroscience. It also lists her doctoral adviser and the work she has published. She can follow other researchers and click onto group pages that discuss different subjects.

CAROLINE MOORE-KOCHLACS: "Let’s see what’s going on in the computational neuroscience group today."

She also uses Facebook but says people almost never discuss science there. She says on ResearchGate she can ask questions and learn about what other researchers are working on before they publish their results. She can also learn about recently published science.

CAROLINE MOORE-KOCHLACS: "The scientific literature is so huge at this point, that it’s really impossible to get through everything in your topic area. People really rely on hearing it from other people."

ResearchGate developer Ijad Madisch says he knows his site will only prove valuable if scientists use it to help each other. But not every user is pleased with it.

Kim Bertrand at the Harvard School of Public Health is an epidemiologist -- someone who studies the spread and control of diseases. Ms. Bertrand says she finds more value in her own offline network of researchers and advisers than in this online network.

KIM BERTRAND: "Sometimes I get these e-mails that are like: 'Dear Sirs: I’m writing a dissertation on public health. Any suggestions? Please advise.' I don’t need that."

And that's the VOA Special English Education Report. Do you use a social network for work or just for fun? Post your comments on the VOA Learning English page on Facebook or at voaspecialenglish.com. There, you can also download program transcripts and MP3s and get podcasts. I'm Steve Ember.

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Contributing: Curt Nickisch

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