WHO calls for universal coverage

(CNN) -- In a Nairobi slum, more than one in four children under 5 will die, but in a wealthier part of the Kenyan capital, the mortality rate is one in almost 67, according to a World Health Organization http://www.who.int/en/ report released Tuesday.

The World Health Report 2008 aims to spotlight disparities in health care across the globe, and as the Nairobi example illustrates, the differences exist not only between the First and Third Worlds -- they can occur just across town.

WHO roundly criticizes the organization, finance and delivery of health care and calls advances in the field "deeply and unacceptably unequal, with many disadvantaged populations increasingly lagging behind or even losing ground."

The report says that a citizen of a wealthy nation can live up to 40 years longer than someone in a poor country, and of the 136 million women who will give birth this year, about 58 million (43 percent) will receive no medical assistance during childbirth or the postpartum period.

UNICEF Executive Director Ann Veneman said the sharp inequities in the cost and access to health care often speak to larger societal ills.

"High maternal, infant and under-five mortality often indicates lack of access to basic services such as clean water and sanitation, immunizations and proper nutrition," she said in a statement.

WHO Director-General Margaret Chan insists the dilemma is not just a matter of haves versus have-nots.

"A world that is greatly out of balance in matters of health is neither stable nor secure," she said in a statement from Almaty, Kazakhstan, where the report was released.

The difference in annual government expenditures on health care is more canyon than gap, according to the report. While the wealthiest nations dole out as much as $6,000 per person each year, some countries are unable or unwilling to spend more than $20 per person.

However, while calling for wide-ranging reforms in the delivery of primary health care, the report notes that it isn't always a matter of government expenditures.

Tajikistan and Sierra Leone both spend less than $100 per person on health care. But while the health-adjusted life expectancy in Sierra Leone is under 30 years of age, Tajikistan's is almost 70 -- a figure comparable to the United States, which spends more than $2,500 a person on health care.

"When countries at the same level of economic development are compared, those where health care is organized around the tenets of primary health care produce a higher level of health for the same investment," the report says.

WHO defines primary health care as being "universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost that the community and country can afford."

The organization's report -- titled "Primary Health Care -- Now More Than Ever" -- calls for a move toward universal coverage to reverse a trend over the last 30 years in which disparities in the levels of health care have actually widened.

Universal coverage, the report says, would lower the risks of disease outbreaks for everyone, not just the impoverished.

Currently, the most common means of paying for health care is out of pocket, which WHO says is the "most inequitable method for financing health care services." The report says more than 100 million people fall into poverty in a given year because of health care bills.

Another problem, the report says, is that doctors tend not to focus on prevention.

"Rather than improving their response capacity and anticipating new challenges, health systems seem to be drifting from one short-term priority to another, increasingly fragmented and without a clear sense of direction," according to the report.

But the report also handed out accolades, most notably to Iran and Cuba.

WHO applauded the Islamic Republic's 17,000 "health houses," which serve about 1,500 people each. The report credited the centers with boosting Iranians' life expectancy from 63 to 71 years between 1990 and 2006.

And in Cuba, the nation's "polyclinics" have yielded one of the longest life expectancies (78 years) of any developing country, the report says.

The report called for all sectors of society to help determine how health care is allocated, and it singled out the United States for spending just 0.1 percent of its health budget on health systems research -- the kind of research that policymakers use to decide how money is spent.

The report also points to the pharmaceutical industry's impact on health care in the United States, where the average expenditure on prescription drugs in 2005 was $1,141 per person -- twice the average in Canada, Germany and Britain, and 10 times the average in Mexico.

To combat the problems facing global health care, WHO says in its report that nations must improve coverage and delivery, as well as policy and leadership. It acknowledges that primary health care isn't cheap, but asserts that the "investment provides better value for money than its alternatives."

"The legitimacy of health authorities increasingly depends on how well they assume responsibility to develop and reform the health sector according to what people value -- in terms of health and of what is expected of health systems in society," the report says.

SAN FRANCISCO -- The Golden Gate District Board of Directors voted 14-to-1 Friday to approve the installation of a controversial net below the famed structure to prevent suicides, bridge officials said.

Details of the bridge's next steps in the installation project were to be disclosed at a Friday afternoon news conference, bridge district spokeswoman Mary Currie said.

The vote by the 16-member board was certain to spark a controversy after an online poll conducted by the bridge district found that half of 4,147 Bay Area residents who responded preferred that no suicide barrier in any form be built.

About 32 percent were nearly evenly divided in favor of adding another eight feet to the existing 4-foot railing on the bridge or installing a horizontal net system below the span to catch jumpers as their first choice.

Among the options the bridge district considered were not erecting a barrier at all, installing a net beneath the bridge to catch those who jump, and four other proposals that would increase the height of the existing 4-foot railing along the bridge by another 4-8 feet.

It will cost $78,016 a year to maintain a net beneath the bridge and would have cost between $429,000 and $466,000 to maintain the rail extension options, according to the report revealed earlier this month.

Nine state agencies also submitted public comments about the project.
The California Highway Patrol expressed "significant concerns" with the net system and the safety of rescuers who try to recover bridge jumpers in the net, according to the report.

"The CHP also is concerned about impacts to the flow of traffic on the bridge resulting from incidents in the net and prefers other build alternatives to the net," the report stated.

The Marin Mental Health Board supported a sidewalk toll to offset the cost of suicide prevention but said the net alternative is the most promising of the alternatives in the draft environmental impact report.

The San Francisco Mental Health Board supported building a suicide deterrent on the bridge and the National Park Service, Golden Gate National Recreation Area supported the net system for scenic, biological and cultural reasons.

The Marin County coroner's office released a report last year stating more than 1,250 people have jumped from the bridge since it opened 1937. Other estimates say 1,300 people have jumped to their deaths.

This is the true joy in life, the being used for a purpose recognized by yourself as a mighty one; the being a force of nature instead of a feverish, selfish little clod of ailments and grievances, complaining that the world will not devote itself to making you happy.

I am of the opinion that my life belongs to the whole community, and as long as I live it is my privilege to do for it whatever I can.

I want to be thoroughly used up when I die, for the harder I work, the more I live. I rejoice in life for its own sake. Life is no brief candle to me; it is sort of splendid torch which I have got hold of for the moment, and I want to make it burn as brightly as possible before handing it on to the future generations.

- George Bernard Shaw

A house divided: Estranged couple's home cut in half

(CNN) -- A Cambodian couple who separated after 40 years of marriage may have taken things too literally when it came to splitting their assets:

The husband cut the house in two.

"It is the strangest thing I've ever seen," said May Titthara, who wrote about the case for The Phnom Penh Post, an English-language newspaper in the Cambodian capital. "People there never saw this happen in a divorce. It is very interesting for them."

The husband and wife had been living together in the house in a village in the Prey Veng province of southern Cambodia, roughly 50 miles (80 km) from the capital.

The couple would not talk to the newspaper, but the village chief told May Titthara that the husband was angry because his wife wouldn't tend to him when he was ill.

Last week, the husband and his friends moved his belongings to one side of the house -- and sawed and chiseled it off, said the reporter, who interviewed the village chief and neighbors.

The couple also divided their property into four sections: for themselves and their two children.

Because the couple side-stepped the provincial courts when they parted ways, their unusual resolution could pose a problem later, said Prak Phin, a lawyer for Legal Support for Child and Women in the province.

"This was a not a legal divorce. It never went to the court," he said. "If they have disagreements in the future, they will not have a legal (recourse)."

The man moved his part of the house to his parent's property, May Titthara said. He lives with his parents, while the wife continues to reside in her precariously perched, upright half.

NEW YORK (AP) -- In a sign of the times, the National Debt Clock in New York City has run out of digits to record the growing figure. As a short-term fix, the digital dollar sign on the billboard-style clock near Times Square has been switched to a figure — the "1" in $10 trillion. It's marking the federal government's current debt at about $10.2 trillion. The Durst Organization says it plans to update the sign next year by adding two digits. That will make it capable of tracking debt up to a quadrillion dollars. The late Manhattan real estate developer Seymour Durst put the sign up in 1989 to call attention to what was then a $2.7 trillion debt. NYC National Debt Clock runs out of digits Wed Oct 8, 10:03 PM ET

Rainy Day Women # 12 & 35

Well, they'll stone ya when you're trying to be so good,
They'll stone ya just a-like they said they would.
They'll stone ya when you're tryin' to go home.
Then they'll stone ya when you're there all alone.
But I would not feel so all alone,
Everybody must get stoned.

Well, they'll stone ya when you're walkin' 'long the street.
They'll stone ya when you're tryin' to keep your seat.
They'll stone ya when you're walkin' on the floor.
They'll stone ya when you're walkin' to the door.
But I would not feel so all alone,
Everybody must get stoned.

They'll stone ya when you're at the breakfast table.
They'll stone ya when you are young and able.
They'll stone ya when you're tryin' to make a buck.
They'll stone ya and then they'll say, "good luck."
Tell ya what, I would not feel so all alone,
Everybody must get stoned.

Well, they'll stone you and say that it's the end.
Then they'll stone you and then they'll come back again.
They'll stone you when you're riding in your car.
They'll stone you when you're playing your guitar.
Yes, but I would not feel so all alone,
Everybody must get stoned.

Well, they'll stone you when you walk all alone.
They'll stone you when you are walking home.
They'll stone you and then say you are brave.
They'll stone you when you are set down in your grave.
But I would not feel so all alone,
Everybody must get stoned.

1966

Narcissists like to be in charge, so it stands to reason that a new study shows individuals who are overconfident about their abilities are most likely to step in as leaders, be they politicians or power brokers.

However, their initiative doesn't mean they are the best leaders. The study also found narcissists don't outperform others in leadership roles.

Narcissists tend to be egotistical types who exaggerate their talents and abilities, and lack empathy for others. The researchers stress that narcissism is not the same as high self-esteem.

"A person with high self-esteem is confident and charming, but they also have a caring component and they want to develop intimacy with others," said lead researcher Amy Brunell, a psychologist at Ohio State University at Newark. "Narcissists have an inflated view of their talents and abilities and are all about themselves. They don't care as much about others."

She added, "It's not surprising that narcissists become leaders. They like power, they are egotistical, and they are usually charming and extraverted. But the problem is, they don't necessarily make better leaders."

Born leaders?

The results, which will be detailed in an upcoming issue of the journal Personality and Social Psychology Bulletin, come from three studies, two with students and the other with business managers.

In one study, 432 undergraduate students completed surveys that measured various personality traits, including aspects of narcissism. Then, the students were put in groups of four and told to assume they were a committee of senior officers of the student union. Their task was to elect next year's director.

Results showed that students who scored higher on one dimension of narcissism - the desire for power - were more likely to say they wanted to lead the group. The narcissists were also more likely to say they did lead the group discussion and more likely to be viewed as leaders by the other group members.

Another dimension of narcissism - the desire for attention - was not as strongly linked with leadership roles in the groups.

Shipwrecked island experiment

In a similar study, more than 400 students, placed into groups of four, were told to imagine they were shipwrecked on an uninhabited island. They had to choose 15 items from the ship that would best help them survive on the island.

Individuals who scored highest on the power dimension of narcissism again showed the most desire to lead the group discussion, rated themselves as leaders, and were viewed by other group members as the leaders.

To rate leadership abilities, the researchers compared the 15-item lists with one prepared by an expert who has taught survival skills to the U.S. military. Turned out, narcissists did no better than their less self-centered counterparts at choosing survival items.

A third study involved more than 150 business managers enrolled in an executive MBA program at a large southeastern university. The managers were grouped in fours and told to assume the role of a school board deciding how to allocate a large financial contribution from a fictional company.

Two trained observers monitored the group discussions, finding that the MBA students who rated highest in narcissism were most likely to emerge as group leaders. The results held even when other personality traits, such as self-esteem and extraversion, were taken into account.

Narcissists in society

Brunell said she believes the results apply to many parts of life, from the politics of presidential races to Wall Street.

"Many people have observed that it takes a narcissistic person to run for president of the United States," Brunell said. "I would be surprised if any of the candidates who have run weren't higher than average in narcissism."

Wall Street traders could also have a high dose of narcissism, she suggested. "There have been a lot of studies that have found narcissistic leaders tend to have volatile and risky decision-making performance and can be ineffective and potentially destructive leaders."

Brunell does hedge though, saying that not all troubles in Washington and Wall Street can be blamed on narcissists, and of course, you can't boil everything down to personalities.

LiveScience.com

Artist Laura Gilberts' print 'The Zero Dollar' protesting the breakdown of the American economy. Gilbert distributed 10,000 of the fake greenbacks in front of the New York Stock Exchange on Tuesday, Oct. 7, 2008 to call attention to the economic crisis gripping the nation.

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