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Tech Helproom
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Slow Firefox Problems
Likes # 0
Posted January 30, 2012 at 10:36PM
Lately these past few days I've been having slow firefox problems I'm using the latest version of firefox (9.0.1)
The issue I think is to do with the New Tab Page Addon I have
I also have Adblock Plus addon
I have tried disabling the addons and trying again no difference is noticed.
Has anyone else had this problem?
Likes # 0
Posted January 30, 2012 at 11:06PM
Works ok for me except for one site that I cannot get into tonight.Apart from that it's Ok.
Likes # 0
Posted January 30, 2012 at 11:08PM
Maybe remove the New Tab Page Add-on and see if things go back to normal.
Likes # 0
Posted January 31, 2012 at 4:25PM
thanks Buteman
Ile see how things go.
Likes # 0
Posted January 31, 2012 at 4:50PM
It would seem as though Firefox 10 was released about 2/3 hours ago.
Likes # 0
Posted February 6, 2012 at 8:06PM
Everything is seem to running fine and I'm on FF 10.0 ile monitor this for a few more days.
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Entries in 'Hardware' (226)
Xbox hardware supplies have overtaken demand, Microsoft says
Microsoft CFO Amy Hood has told investors that there will be a "channel inventory drawdown for Xbox consoles".
Nintendo reveals exclusive Team Mario and Team Luigi Mario Kart 8 Wii U bundles
Two additional Mario Kart 8 Wii U bundles have been announced.
An Xbox Live Gold subscription can win you prizes worth $5,000
Microsoft has just kicked off a massive Xbox Live promotion in India, where any Xbox Live Gold subscriber can stand to win a Gold Rush suitcase with goodies worth $5,000.
Vita back on top as Titanfall makes Famitsu's Japanese Top Ten
Sony's PlayStation Vita was the best selling console in Japan last week according to the latest sales data from Famitsu.
No PS4 restock in India till May
The PlayStation 4 has been out of stock in India since shortly after its launch in January, and any hopes of it becoming available this month are now gone.
Borderlands 2 Vita bundle launches in May
Sony has dated the Borderlands 2 Limited Edition PlayStation Vita Bundle for next month, with the standalone release of the game coming one week after.
Xbox One: Five things Microsoft needs to do in India
The Xbox One's September launch for India is still quite a way off, but Microsoft is set to announce India-specific details this month. It's the perfect time, then, to take ...
Vita Football Manager Classic 2014 bundle incoming
Sega's Football Manager Classic 2014 for Vita will also be available in a hardware bundle.
3DS regains lead as PS4 sales slip in Japan
Nintendo's 3DS is back in front in Japan.
Pink 2DS arriving in UK next month
A pink version of Nintendo's 2DS handheld will be released in the UK in May.
Nvidia, Asus partner to release Battle Box gaming PCs
PC hardware giants Nvidia and Asus have joined forces to launch five specialised gaming PCs in the Indian market.
PS4 hardware sales jump 106% on InFamous: Second Son launch
The release of InFamous: Second Son has given PS4 hardware sales a big jump in the UK.
Dark Souls II debuts at No.1 in Japan as PS4 retains hardware lead
Cult RPG game Dark Souls II has debuted at the top of the Japanese charts, the latest Famitsu sales data has revealed.
Official: Xbox One India launch in September
The Xbox One will go on sale in India, Microsoft has announced.
No PS4 restock in India before April
If you were holding off on buying the PS4 till Infamous: Second Son or Metal Gear Solid 5: Ground Zeroes came around, there's some bad news.
PICTURES: Amazon console controller images leaked
The first images of Amazon's dedicated under-the-TV gaming hardware have seemingly arrived online.
PS4 outsold Xbox One in US in February as Wii U hardware sales climb
Sony continues to dominate the next-gen hardware market in America, NPD numbers show.
Apple shortens iPhone returns policy period
Apple has shortened its return policy for the iPhone from 30 to just 14 days.
New Nvidia GeForce bundles offer free Daylight or F2P currency
There's a host of new gaming bundles available to customers who splash out on Nvidia's top hardware.
PS4 and PS3 Watch Dogs hardware bundles confirmed
Sony and Ubisoft have confirmed both PS4 and PS3 hardware bundles to accompany the launch of Watch Dogs on May 27th in the UK.
Japanese hardware market up 179.1% as PS4 arrives
The games console hardware market enjoyed a sharp year-on-year increase in Japan thanks to the launch of PS4, Famitsu has revealed.
Iwata reaffirms Nintendo's commitment to dedicated hardware
Dedicated video games hardware will remain Nintendo's core focus, the company has pledged.
Sony reveals Lego The Hobbit PS3 bundle for North America
A new PlayStation 3 bundle featuring Lego The Hobbit is heading stateside this spring, Sony has announced.
Free supply of PS4 expected by April
PS4 will remain in short supply until around April, predicts Sony.
Sony reveals Metal Gear Solid: Ground Zeroes PS4 hardware bundle
The Japanese arm of Sony has confirmed a Metal Gear themed PS4 console.

subset: commoncrawl


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New Event: Crazy Person has greeted you
Yo, my name's Anna and I'm currently the least girly teenage girl you're going to meet. When I'm not drawing or generally being lazy, I'm playing videogames, as I have been ever since I've been able to pick up a videogame controller.I don't do girly stuff, chatspeak, dating, romance in general or little kids, which you should probably keep a large distance away from me.
I like watching television, too. I like anime but I'm not into Naruto or some other stuff like that.
Death Note's awesome and I like others, of course, but that's just my favorite.
I'd like to be a videogame designer but that's obviously gonna be a while, I might try writing some reviews for some videogames just for the fun of it.
I'm pretty much a n00b to 1up at this point and probably will stay so, as I'm not a people person. I am extremely sarcastic and have a morbid sense of humor.
Other than that it's downright dandy to meet you. C:
Oh, also, you may friend me if you want; I'll accept but I'm not going to talk very much unless I'm responding to comments or something, no offense to you. I'm just not very good with socializing.


text:
Big Government: We almost never agree with President Obama's favorite economist Paul Krugman, but he recently spoke the truth about where Obama's policies are taking the country. It should scare anyone with a pulse.
Krugman, after speaking at the Sixth & I Historic Synagogue in Washington, D.C., was asked about the debt crisis. After arguing it's no big deal in the near term, Krugman admitted that "Eventually we do have a problem. The population is getting older, health care costs are rising ... . Something is going to have to give."
What's that something? According to Krugman, it's middle-class pocketbooks.
"We won't be able to pay for the kind of society we want without some increases in taxes," he said, "and surely in the end it will require some middle-class taxes as well, maybe a value added tax."
That's not all. We're also "going to have to ... really make decisions about health care, (and) not pay for health care that has no demonstrated medical benefits."
In case anyone failed to get what he was talking about, Krugman made it clear, saying the snarky version is:
"Death panels and sales taxes is how we do this."
This wasn't the first time Krugman has used this line — a couple years ago he said pretty much the same thing on NBC's "This Week." And to his credit, Krugman is at least being honest about the miserable end to which liberalism leads. If the government continues on its current course, the nation's debt will climb inexorably higher.
But Krugman's bleak future is hardly set in stone.
Remember, Krugman says that it's the inevitable future that results from creating "the kind of society we want," meaning the kind of society Krugman and his fellow liberal elitists want.
There is a far better alternative.
We just need to get control of entitlement programs such as Medicare, Medicaid and Social Security, for which Republicans have offered numerous workable cost-saving reforms. We need to kill ObamaCare, which if allowed to take effect will turbocharge federal spending.
And we need to boost economic growth by unleashing the private sector through a sustained campaign of deregulation and tax reform.
Do those things, and we can easily close the budget gap without ever resorting to death panels or a VAT tax.
That might not be the kind of society Krugman or Obama wants, but it certainly leads to a far better place than theirs.
For investors in technology start-ups, things are about to get much more complex and dangerous. Friends of inventors, family, angels, venture capitalists and private equity managers: Listen up. The "Innovation Act," also known as H.R. 9, will reenter the House Judiciary Committee in the next two ...
Health Reform: Voters who handed Republicans control of the Senate, largely on the promise of killing ObamaCare, must be wondering why they bothered. Senate leaders now want to protect the law for the next two years. In June, the Supreme Court is expected to rule in a case that could eliminate ...
The discussion of Hillary Clinton's candidacy has, so far, thoroughly explored her video announcement, restaurant choices, clothes, health, ethics and, of course, husband. Relatively little attention has been devoted to her ideas — or the ones that should animate her campaign. The easiest way ...
Betrayal: Another Obama amnesty program is well underway — at Guantanamo, where three dangerous al-Qaida operatives have quietly been OK'd for release in three months. And now a close aide to the 9/11 mastermind is also on tap for release. After already freeing an al-Qaida bomb maker last ...
Regulation: To understand how far Dodd-Frank set back the financial industry, look at the first bank to open in the country since that legislation became law in 2010. It is literally a horse-and-buggy operation. Dodd-Frank was sold as the salvation of America's wayward financial system. President ...


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US 5619775 A Abstract A safety latch for a clip that is conventionally used to sealably close the opening in an ostomy or colostomy bag. The purpose of the safety latch is to prevent the accidental disengagement of the clip arms when engaged to the colostomy bag opening, forming a seal therein. The safety latch includes a resilient latch that, when engaged between the arms of the clip, is in a stretched condition, putting the clip arms in tension. The safety latch can be removed manually by additional stretching of the resilient member that holds the arms together.
Claims(6) 1. A safety latch for an ostomy pouch clip to prevent accidental disengagement of the clip, comprising:
an ostomy bag clip body, unitarily formed, having a first branch and a second branch; a flexible hinge member connecting said first branch to said second branch, allowing said first branch to move pivotally relative to said second branch; said clip body first branch having a free end and an opposite end connected to said hinge member, said second branch of said clip body having a free end and an opposite end connected to said hinge member, said first branch having a recessed area near its free end and said second branch having a recessed area near its free end; and a resilient fastener, said resilient fastener having a first state of a given size and a second, stretched state of a second size, said resilient fastener connected to said first branch recessed area and within said second branch recessed area in a stretched state, locking said first branch against said second branch when they are together; said clip body second branch recessed area including a retaining aperture, said second branch recessed area retaining aperture having a circumference less than a complete circle (360 degrees), but greater than a semicircle (180 degrees), said resilient fastener having an exterior circumference with a diameter that approximates the diameter of said second branch retaining aperture; whereby said resilient fastener can be manually removed from said first branch recessed portion, allowing said first branch to be separated from said second branch, said resilient fastener is held and connected to said second branch member. 2. A safety latch as in claim 1, wherein:
said resilient fastener is a resilient O-ring having a predetermined inside diameter that at rest, in an unstretched or deformed state, is smaller than the distance between said first branch recessed area and said second branch recessed area. 3. A safety latch as in claim 1, wherein:
said first branch includes a channel sized to receive said second branch when said clip is in an engaged position. 4. A safety latch as in claim 3, wherein:
said first branch includes a resilient catch for engaging said second branch. 5. A safety latch for an ostomy or colostomy bag opening clip that sealably engages and closes the bag opening when engaged thereto, said safety latch for said clip comprising:
a clip body having a first arm and a second arm integrally formed and hinged together by a flexible hinge, having a first open position and a second position where said first arm and second arm are engaged together, forming a seal across a colostomy or ostomy bag opening in the engaged position; said first arm and said second arm each including a retaining aperture, each of said first arm and said second arm retaining apertures having a circumference less than a complete circle of 360 degrees, but greater than a semicircle of 180 degrees; and a resilient latch member connectable to said first arm and said second arm at said first arm and said second arm retaining apertures in a stretched condition under tension to prevent the disengagement of said first arm from said second arm when engaged across a colostomy bag opening, and manually removable by additional stretching from said first arm and said second arm to allow the disengagement of said first arm from said second arm. 6. A safety latch as in claim 5, wherein:
said resilient latch member is an O-ring having a predetermined inside diameter that, when engaged between said first arm and said second arm, the inside diameter is in a non-circular, stretched length. Description This application is a Continuation-In-Part of U.S. application Ser. No. 29/026,488 filed on Jul. 29, 1994 abandoned. 1. Field of the Invention This invention relates generally to ostomy and colostomy bag clips which are removable and that form seals on openings in a colostomy bag and specifically, to a safety latch for the ostomy bag closure clip to prevent accidental disengagement of the clip from the bag. 2. Description of the Prior Art Colostomy and ostomy bags are used with patients to allow for disposal of bodily waste which collects in the ostomy bag. The bag typically has a lower opening end which has traditionally been sealed by a clip. When the bag is to be emptied, the clip is manually removed, allowing the bag contents to be disposed of. Because of the physical demands on such clips to only be released when required, it is imperative that the clip remain firmly in place, regardless of the movements of the user, at all times, until manually disengaged by the user. The prior art shows a plethora of plastic clips, typically having two or more arms or branches hinged together by a unitary plastic connection. Typically, the devices are hinged in a flexible manner which allows them to be bent and joined together with a protuberance that overrides a projecting surface for locking the clip in place. U.S. Pat. No. 5,125,133, issued Jun. 30, 1992 to Morrison, shows an ostomy pouch clamp with a hinge supplementing guide blade which allows for the pouch opening to be sealed by the guide blade action and which allows the clamp to be resiliently locked in place. U.S. Pat. No. 3,523,534, issued Aug. 11, 1970 to Nolan, shows a closure for a drainage pouch. U.S. Pat. No. 5,379,489, issued Jan. 10, 1995 to Delk et al., shows a bag closure clamp with a hinge supplementing complementary cam surface. This also provides for a resiliently disengageable latch or lock to keep the hinge engaged except when the locking pin is pressed physically and flexed. U.S. Pat. No. 4,887,335, issued Dec. 19, 1989 to Folkmur, shows a closure which is a plastic clamp or clip for closing plastic bags and the like. U.S. Pat. No. 5,428,871, issued Jul. 4, 1995 to Iosif, shows a clamp for elastomeric bags which has a locking pin that engages a resilient opening. U.S. Pat. No. 4,983,172, issued Jan. 8, 1991 to Steer et al., shows a clip for a drainable ostomy pouch. As described herein, ostomy pouch and colostomy bag are used interchangeably. The clip for a drainable ostomy pouch in Steer et al., U.S. Pat. No. 4,983,172 shows a single, unitary clip made of a plastic that can be bent with a pair of branches engaged together by a resilient catch. The drawback for the clip shown in Steer et al. is that it can be accidentally opened by certain movements of the user. Such accidental opening obviously can be extremely embarrassing for the user. While the clip itself functions adequately and does maintain a seal of the bag's lower opening when engaged, accidental disengagement is unacceptable. The purpose of the present invention is to provide a safety latch or safety lock for a clip, such as that shown in Steer et al., to absolutely prevent any type of accidental disengagement of the clip arms, while still making the deliberate disengagement of the clip relatively simple manually in order to empty the bag. With the safety latch in place, it is physically impossible for the clip to become accidentally disengaged. The safety latch, in accordance with the present invention, is non-complex in design and economical in the overall manufacture. Present day ostomy and colostomy bag clips are sadly deficient in their holding power. Because these clips are unitarily formed often of plastic or plastic-like materials with a flexible hinge connecting the clip arms most clips have one or more protrusions which act to fit into a slot plastic to plastic that is manually overridden when the clip is disengaged. Clip separation and accidental release and opening of the clips is quite a common event. Users of the ostomy and colostomy bags often have to empty the bags several times a day increasing the probability of accidental disengagement. Most often, however, the problem is that the catch integrally formed in the conventional clip does not have the type of holding power necessary to insure and guarantee a secure lock. This is because if it was made that tight it would be impossible manually to override the catch. The present invention overcomes these problems by providing a foolproof safety latch that cannot come apart accidentally. A safety latch for preventing the accidental disengagement of an ostomy bag clip, comprising a resilient ring, said ring having a predetermined internal diameter and being constructed of a resilient material that allows it to return after stretching to its original diameter. The ostomy bag clip includes first and second branches which are unitarily formed together through the use of a unitary flexible hinge and includes a locking channel in one branch that engages the ostomy bag opening to form a closure when the clip branches are engaged together. One of the branch hinges disposed on its outer surface away from the hinge portion includes an arcuate recess angularly disposed with a tapered wall in the direction of the branch free end. The other branch of the clip includes a retaining circular aperture that engages one portion of the latching ring, providing for a permanent mount or attachment of the ring to the branch arm. The branch arm that retains the ring permanently extends in length beyond the opposing branch arm which contains a channel to receive the blade-like effect of the other branch in the engaged position. The ring receiving, tapered recess on the branch channel arm is strategically located near the end of the branch arm and the ring is sized such that in the engaged position, one can manually move the ring portion into the tapered recess, which firmly locks the clip branches together in the sealing position for the ostomy bag. Because the recess is tapered upwardly, pointing towards the free end of the clip's branches, in order to remove the ring manually to disengage the clip, the ring must be stretched upward over center and over the recessed arm that is angled in order to remove the ring to allow the clip to be disengaged. Thus, the ring inside diameter is strategically sized to fit snugly and totally between its permanent mounting annular opening and the tapered recess to insure that the clip branch arms are held firmly in place in the natural position. To operate the clip with the safety latch when the clip is in the disengaged or open position, both branch arms are rotated in hinge-like fashion so that the blade of one branch arm engages the channel of the other branch arm with the bag end opening therebetween, thereby sealing the bag. The clip may include its conventional resilient fastener which merely requires that the channel opening along one portion be spread apart, allowing the other blade arm to be released. With the safety latch of the present invention, however, the resilient ring is manually disposed into the locking recess in the channel arm, firmly locking the clip in place. The only way that the clip can now be disengaged so that the branch arms can be separated, allowing the bag to be opened, is for the resilient ring to be manually forced and stretched about one wall of the recess, and due to the recess angle, a deliberate, manual engagement is required. In the open position, the retaining annular opening in the blade arm will keep the ring attached to the blade arm when the clip has been disengaged and the bag opening used to empty the bag. The manual dexterity required to either engage or disengage the safety latch through manipulation of the ring is quite simple and does not require any extra dexterity or strength. In the preferred embodiment, the safety latch is a small, rubber O-ring, wherein the tubular diameter is selected for proper adaptation to the clip size and the inside diameter of the O-ring itself (not the body tubular portion) is selected to fit snugly between each recessed portion on each arm when the pin is firmly engaged in the locking position. The resiliency of the O-ring is selected so that it can stretch to a distance greater than its internal diameter to allow it to be manipulated manually over and around the wall of the recess in the blade arm. The resiliency of the O-ring allows it to return snugly in the locked position so that the clip will not be allowed to open. The branch arm body having the channel that receives the latching recess with the recess being angled such that the safety latch has to be resiliently pulled in its own plane in order to get around the upper portion of the safety latch receiving recess, such that the upper portion of the safety latch recess extends beyond the end portion of the resilient O-ring when it is in place, locking the branches together. The plane of the safety latch O-ring is at a distinctive angle when in the latched or safety lock position relative to the longitudinal axis of the clip branches when they are engaged together. Although the safety latch could work if the plane of the resilient ring were perpendicular to the longitudinal axis of the arms or branches of the clip when they are engaged in the locked position, it is believed that the angle requires that the resilient latch be moved in such a way that it enhances the distance required and counteracts the tendency of the hinge to move in an arcuate direction or tangential direction. It is an object of this invention to provide an improved clip for an ostomy or colostomy bag opening that is removable, that prevents any accidental disengagement of the sealing clip of the bag. It is another object of this invention to provide an improved safety latch for an ostomy bag clip that prevents accidental disengagement of the clip, but can be easily manually removed when required. And yet another object of this invention is to provide an improved ostomy bag clip having a safety latch or safety lock that can only be disengaged by deliberate manual intervention of the user, and that is non-complex in operation and economical to manufacture. In accordance with these and other objects which will become apparent hereinafter, the instant invention will now be described with particular reference to the accompanying drawings. FIG. 1 is a perspective view of the invention in the clipped mode and showing a segment of an ostomy pouch in phantom. FIG. 2 is a perspective view of the invention in the unclipped mode showing an O-ring latch in engaged with an arcuate recess on an upper branch of the invention and the ostomy pouch in phantom. FIG. 3 is a front elevational view of the invention in the unclipped mode showing the O-ring latch attached within a second arcuate recess on a lower side of the invention as shown in FIG. 1. FIG. 4 is a left-end elevational view of the invention in the unclipped status as shown in FIG. 2. FIG. 5 is a right-end elevational view of the invention in the unclipped status as shown in FIG. 2. FIG. 6 is a top plan view of the invention in the unclipped status as shown in FIG. 2. FIG. 7 is a bottom plan view of the invention in the unclipped status as shown in FIG. 2. FIG. 8 is a side elevational view of the invention in the clipped status showing the O-ring latch engaging the first arcuate recess on the upper side of the invention as shown in FIG. 2. FIG. 9 is a left-end elevational view of the invention in the clipped status as shown in FIG. 1. FIG. 10 is a right-end elevational view of the invention in the clipped status as shown in FIG. 1. FIG. 11 is a top plan view of the invention in the clipped status as shown in FIG. 1. FIG. 12 is a bottom plan view of the invention in the clipped status as shown in FIG. 1. FIG. 13 shows a cut away partial side elevational view and cross section of the keyhole aperture that retains the O-ring within branch 18 so that it is very difficult to be removed. FIG. 14 shows a partial cut away side elevational view and cross section of a portion of the branch arm and the recessed area for retaining the O-ring latch. Referring now to the drawings and in particular FIGS. 1 and 2, the present invention is shown generally at 10, and includes an ostomy bag portion 20 (shown dotted) and an ostomy bag closure clip 14 shown in the fastened position, including resilient O-ring 12 which locks the clip branch members 16 and 18 firmly together. The position shown in FIG. 1 is with the safety latch in position to keep the clip closed. FIG. 2 shows the same clip 14 in the unlocked position, again with 20 representing a portion of an ostomy bag, or colostomy bag, or any other resilient bag that has an opening that can be sealed by clip 14. Clip 14 includes a first branch 16 that has a channel 16a, an O-ring receiving recess 16b near the free end of branch 16, and a flexible hinge 22 that connects branch 16 to branch blade 18. The blade portion 18a fits along channel 16a to seal and lock the material of the colostomy bag between the branches firmly to prevent any leakage of moisture or materials from the bag in the closed position, as shown in FIG. 1. The blade or branch 18 includes a circular recess 18c that is greater than a half-circle that permanently retains a resilient rubber O-ring 12 connecting it permanently to branch 18. O-ring 12 can rotate, but a substantial portion of the aperture 18c surrounds the outer circumference of the O-ring in one location to retain the O-ring attachably to branch 18. Branch 18 also has a small recess 18b that coincides longitudinally with the recess in branch 16, designated as 16b, so that when branch 18 is engaged with branch 16, the O-ring can be stretched into recess 16b and 18b, as described below. FIG. 2 shows the O-ring which is circular, having a circular internal diameter and a circular outside diameter, along with its own circular body. As shown in FIG. 1, the distance from the bottom of recess 18c to the bottom of recess 16b is such that it is greater than the internal diameter of O-ring 12 in a relaxed state, as shown in FIG. 2. This allows, because of the elastic and resilient nature of the rubber or artificial rubber used in the construction of O-ring 12, in the stretched position O-ring 12 maintains a resilient force holding branch 16 against branch 18. The angular relationship with respect to the longitudinal axis of branch 16 and branch 18 in the locked position shown in FIG. 1 is such to resist further the hinge motion of the clip 14, that is the plane form between recess 16b and recess 18c relative to the longitudinal axis of branch 16 and branch 18 in the locked position shown in FIG. 1. FIG. 3 shows branch 16 unitarily formed and connected to branch 18 by a flexible hinge 22. This is the conventional construction of the clip. Applicant's invention includes the addition of a resilient O-ring receiving arcuate recess 16a disposed adjacent the free end of branch 16 and resilient O-ring receiving recess 18b which aligns and coincides with recess 16a of branch 16 when branch arm 16 is locked and receives blade 18a and branch 18 in the channel within branch 16. The O-ring 12 is shown attached to branch 18 in a circular recess 18c, the perimeter of which is greater than the semicircular distance around the O-ring body itself. Thus, a small opening, much smaller than the circular diameter of recess 18, is presented where the O-ring 12 is firmly positioned within when the device is made at the factory, when the O-ring is joined to the clip 14. FIG. 4 shows a left-hand view of the position of the clip 14 as shown in FIG. 3. FIG. 5 shows a right-hand view of the position of the clip shown in FIG. 3, which shows the O-ring receiving recess 16b near the end of branch 16. FIG. 6 shows that the clip 14, and in particular branch 16 near the free end, has a pair of raised protrusions 16d on the inside of the channel which act as a catch against the outside back of branch 18 in the locked position (as shown in FIG. 1) so that the channel formed in 16 is resilient enough so that the protrusions 16d are spread apart when the clip branch 16 is disengaged manually from catch formed by 16d protrusions. However, Applicant has found that that catch, which is conventional, is not sufficient to prevent accidental release of branch 16 from branch 18. The O-ring 12, in conjunction with recess 16b and recess 18b, firmly holds branch 16 against branch 18 unless the O-ring is stretched manually to disengage it from the branch recesses 16b and 18b. FIG. 7 shows the O-ring 12 firmly engaged in circular recess 18c, the opening of which is smaller than the diameter of the O-ring body (the tubular body of the O-ring). FIG. 8 shows the safety latch for clip 14 formed by the resilient O-ring 12, which in the position shown in FIG. 8 is stretched beyond its normal, relaxed inside diameter between recess 16b and recess 18c, safely locking together branch 16 into branch 18. In order to disengage the clip, the resilient O-ring, any radial movement of branch 18 away from branch 16 is clearly resisted and prevented by the stretched O-ring 12, and enhanced by the angle of the O-ring relative to the longitudinal axis of arm 18 and branch 16. FIG. 9 shows the catch formed by protrusions 16d in the flexible channel in branch 16 when it engages branch 18 that resists opening. However, because of the resilient nature of channel 16a in branch 16, the conventional catch is very easy to disengage with very little force required to overcome the catch 16d making the clips easier to operate for the user but much more likely to separate or accidently open. If catch 16d were made to require extreme force to open, manual use would be difficult. FIG. 10 shows the opposite end of the device in elevation shown in FIG. 8. FIG. 11 shows the top view with the O-ring 12 engaged in recess 16b with branch 16 firmly engaged and locked to branch 18 by O-ring 12. FIG. 12 shows the O-ring as it is retained by recess 18c in branch 18, where the opening 18c outside of the branch arm is greatly smaller than the tubular diameter of the O-ring body itself, thereby firmly holding and attaching the O-ring 12 to branch 18 at all times. To operate the present invention, referring to FIG. 8, the safety latch is shown engaged by O-ring 12 being in a stretched, fixed position, having a portion in recess 16b and another portion where it is permanently attached to branch 18 in aperture 18c. To disengage the safety latch, the O-ring 12 is manually grasped and pushed upwardly over the top of branch end 16, freeing branch 16 and allowing the O-ring to be removed from recess 16b. The different positions of locked and unlocked clip are shown also in FIGS. 1 and 2. It is clearly seen that unless the O-ring is stretched manually out of the recess 16b, the clip itself is firmly locked in place so that it cannot become accidentally dislodged from the ostomy bag or any other bag opening. Although a rubber or artificial rubber, resilient or elastic O-ring has been disclosed, a suitable resilient plastic O-ring could also be utilized. It is important that the recessed branch 16b be of sufficient arcuate size to receive the entire cross section portion of the O-ring. It is likewise important that the distance between the perimeter of the recess 16b as it faces the perimeter of recess 18c exceed the natural inside diameter of the O-ring in its resting position when not stretched, so that the O-ring is in a stretched tension in the locked position shown in FIG. 8. It is also important to keep the O-ring permanently attached to branch 18 by insuring that the aperture holding the O-ring has a circumference that is almost equal to the circumference of the tubular body of the O-ring, but still with sufficient opening to allow the O-ring to be installed initially. FIG. 13 shows the arcuate aperture 18c with a passage 18d that is much smaller than the diameter of arcuate aperture 18c and much smaller than the diameter of the O-ring 12 to insure that at all times the O-ring 12 remains attached or fixed to the clip and in particular to branch 18. This insures that the user, when opening or closing the clip and the contents of the ostomy bag, does not accidently lose the O-ring or have it spring off of the device at the worse possible time. In summary, present day clips which are usually solid piece plastics having a flexible joint have been used for ostomy and colostomy bag sealable closures allowing the bags to be periodically emptied which can be up to several times a day. The great deficiency in these clips is that the catches which are provided which are typically integral protrusions which overlap the opposing arm of the clip are very easily accidentally opened by the slightest pressure that might try to separate the arms of the clip. To have the clip which is located at the bottom of the bag which has an opening come off is a disastrous result but not uncommon with clips found in conventional ostomy and colostomy bags. The purpose of this invention is to insure with nothing left to chance that the clip body cannot separate with the safety latch in place avoiding extremely embarrassing situations for the user. Thus, in addition to the catch found in conventional clips, with the addition of the safety latch, the user can feel comfortable and secure in the day to day use of the bag clips. In addition, with the present invention, the O-ring cannot become dislodged from the body of the clip, another important feature for users. The present invention thus solves the safety latch problem and insures that the safety latch is always available and does not separate from the clip body. Referring now to FIG. 14, the recessed slot 16b is shown in body 16 that receives the O-ring latch 12 which is in tension or stretched into position. Note the arrow showing the direction of stretch in the preferred embodiment which requires that in order to release branch 16 the O-ring must be additionally stretched up and over the upper part of the recessed 16b. This configuration where the recess itself overlaps a portion of the O-ring vertically especially away from the direction of tension or stretch of the O-ring completely insures the security of the safety latch. Only manual intervention as stretching in a direction parallel to the arrow overriding the top portion of recess 16b will release the O-ring latch. The instant invention has been shown and described herein in what is considered to be the most practical and preferred embodiment. It is recognized, however, that departures may be made therefrom within the scope of the invention and that obvious modifications will occur to a person skilled in the art. Patent Citations
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Nigeria's Answer To Amazon: Jumia
Description:Jumia is based in Nigeria and is a comprehensive one stop online shop for all your needs. The company was inspired by Amazon to provide a convenient shopping experience at the comfort of your own home. IBT Senior Reporter Connor Sheets had a chance to meet with Tunde Kehinde, the co-founder of the retail website, and take a tour of their facilities in Nigeria. Sheets sat down with IBTimesTV to discuss his impressions of the company. From what he saw the business model as, their biggest obsta (4:46)
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What do you look forward to?
What do you look forward to during the holiday season?
Is it the gifts? The coming together of family and friends? The general feeling of happiness? The food? The music? The TV programming?
What do you look forward to?
I live in New York and my boyfriend is from Australia. After nine long months of being apart he's headed here for a month for the Holidays. I cannot wait. I'm so happy! So aside from the usual excitement I have around the Holidays this just completes the picture for me. :)
I look forward to it being over. I am not a holiday fan.
Quoting atlmom2:
Spending time with family. It sucks. FIL died last year a week before Christmas. SIL passed away last night. Tainted the holidays forever now.


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Le Devoir, April 26, 1920, p. 5 FINAL TESTIMONY THE GAGNON TRIAL WILL CONCLUDE TOMORROW — MONSIEUR ARMAND LAVERGNE WILL DELIVER HIS CLOSING ADDRESS IN ENGLISH – WITNESSES REPEAT THEIR DEPOSITIONS — "PEOPLE WILL START TALKING SOON ENOUGH." Quebec City, 6 (D. N. C.). – Attorneys for Télesphore Gagnon, accused of the murder of his young daughter Aurore, have brought in Maître Armand Lavergne as their English-language counsel, who will deliver the closing address in English for the mixed jury. One of the jurors neither understands nor speaks French; consequently, all proceedings are being conducted in French and English. When the trial resumed on Saturday, the witnesses heard included Constable Laurent Couture, Madame Arcadius Lemay, Madame Octave Hamel and Monsieur Adjutor Gagnon. All of the witnesses, with the exception of Adjutor Gagnon, had been heard at the trial of the Gagnon woman and merely repeated their previous testimony as to the condition in which they found the victim. The witnesses stated that the child's injuries were quite visible to whomever took the trouble to look at them. Madame Lemay stated that, when the accused noticed that the victim was unconscious, he asked if she had been in that state for a long time and if she had made a confession. The witness asked that the child's grandmother be brought in but Gagnon answered: "People will start talking soon enough." To this Madame Lemay replied: "People will talk with good reason. I warned you and you did nothing." The accused told her that he had stopped beating Aurore as it was useless, and that he had decided to place her in a Reform School. When Madame Lemay replied that it was no place for a child of her age and that he should send her to a convent, he answered that he did not have the means to do so. To Madame Hamel, who drew his attention to the marks on the child's body, Gagnon answered that he did not know what had caused them. She herself washed the child, who was very dirty. The child was limping. Gagnon was there. He appeared to be discouraged and he said he thought that this would all drive him crazy. Adjutor Gagnon, the only new witness in the affair, spent 15 days at the home of the accused. He saw him beat the child with a small switch, but not in a brutal way. It is believed that the trial will conclude tomorrow. Source: Correspondant Le Devoir, "Les derniers témoignages," Le Devoir (Montréal), April 26, 1920.
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Hells Angels Sue Alexander McQueen For Liking Skulls
- The Hells Angels is suing Alexander McQueen and Saks Fifth Avenue for selling clothing and accessories featuring skulls. Apparently the Hells Angels believe they own skulls? We guess we wouldn't want to be the ones to tell them otherwise. [NYPost]
Karl Lagerfeld Will Let Only Nobu's Creations Touch His Rarefied Lips
- Fashion diva Karl Lagerfeld held up a luncheon given in his honor because he refused to eat any food not made by Nobu. [Telegraph]
- Breaking: Anna Wintour briefly removed her sunglasses before the Derek Lam show. [NYObs]


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Hanson ("MMMBop") Brings World Tour to House of Blues
House of Blues Chicago,
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Isaac, Jordan and Zac Hanson were all under 18 years old when their song "MMMBop" topped the charts in 12 countries, becoming one of the biggest hits of the '90s. But these brothers are much more than a one-hit wonder. Over the band's career, Hanson has sold more than 16 million albums. The boys are now celebrating their 21st anniversary as a band with the release of their latest studio album Anthem. Filled with trademark soulful pop songs like "Get the Girl Back," Anthem shows the band's increasing maturity and skilled musicianship. Nickelodeon star Drake Bell (Drake and Josh) opens the show with Beatles and Beach Boys-influenced pop-rock.
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Who's Bad: Ultimate Michael Jackson Tribute Band at Chicago's House of Blues
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view more less of this reviewMy fifth time seeing the band... and they always put on an awesome show! This space is great for the boys, although it's always a little overpriced and overrated once you get in the door ($6 budlight cans and $120 stools)
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Amir Perets
Amir Perets אמיר פרץ |
Born | Tiberias, Israel |
20 September 1974
Native name | אמיר פרץ |
Residence | Los Angeles, CA |
Nationality | ISRAEL US |
Height | 1.82 m (5 ft 11 1⁄2 in) |
Weight | 103 kg (227 lb; 16.2 st) |
Style | Krav Maga |
Rank | 4th dan black belt in Krav Maga |
Years active | 1985-present |
Website | http://www.amirperets.com |
Amir Perets (born September 20, 1974) is an Israeli-born mixed martial artist, an entrepreneur, and an active participant in Fight Science featured on the National Geographic Channel.[1] He is an instrumental figure in popularizing the self-defense system of the Israeli Defense Forces known as Krav Maga.
At age 18, Amir Perets became Israel's heavyweight full-contact martial arts champion and he joined the IDF. Perets later on became the IDF Krav Maga/hand-to-hand combat instructor of the Israeli infantry and Special Forces units.[2]
Excelling as an instructor, Perets was assigned to the top level of Krav Maga instruction in the IDF, certifying the hand-to-hand combat instructor course; Having taught some of the IDF top instructors, Perets then was selected for the elite IDF Naval Commando Unit where he built the unit's hand-to-hand combat program.[1]
After completing his military service, Perets traveled to Thailand to continue to pursue his interest in mixed martial arts by training in "Muay Thai," (Thai boxing),[3]
Perets then immigrated to the United States and pursued teaching defensive tactics and life saving methods to military counter-terror units, law enforcement agencies and civilians worldwide.[4] Simultaneously, he became a lead instructor at the newly formed "Krav Maga National Training Center", in Los Angeles California, where he holds a fourth degree black belt.[5]
Perets completed his High School education mastering in Psychology/Sociology at Amal Institute in Israel. He then joined the Israeli Defense Force (IDF) - Excelling as an instructor for Krav Maga and Combat Fitness, Perets was assigned to the top level of Krav Maga instruction in the IDF, certifying the hand-to-hand combat instructor course, Having taught some of the IDF top instructors, Perets then was selected for the Elite IDF Naval Commando Unit.[6]
Motion Capture[edit]
Perets was used as Niko Bellic for the video game "Grand Theft Auto IV"[7] and did motion capture for the main character's fighting moves along with Bas Rutten.
Hall of Fame[edit]
In 2009 Amir Perets was inducted into the Martial Arts Masters Hall of Fame for his outstanding contributions to law enforcement, military and the world of martial arts.[8]
The Masters Hall of Fame is an association of Martial Artists and other interested parties that works to recognize, develop, enhance and improve the Martial Arts Leaders and Businesses by "Developing and Recognizing Excellence" in the Martial Arts Communities.[9]
- Warrior .... Yosi
- Drillbit Taylor (2008) .... "Mossad" Agent aka "Drillbit Taylor: Budget Bodyguard" - USA (poster title)
- Never Back Down (2008) (Technical Advisor)
- Psychotic (2002) .... Juice
TV / Miscellaneous[edit]
- Car Science (2011)
- "Bust a Move" (2011) TV episode .... Himself
- Inside MMA (2007–2010)
- Episode dated 5 March 2010 (2010) TV episode .... Himself
- Episode #1.14 (2007) TV episode .... Himself
- Fight Science (2008–2010)
- "Human Weapon" (2010) TV episode .... Himself
- "Fighting Back" (2008) TV episode .... Himself
- Fight Science (2007) (TV) .... Himself
- ^ a b "Fight Science | Profile: Amir Perets | National Geographic Channel". Channel.nationalgeographic.com. 2009-12-22. Retrieved 2010-08-27.[dead link]
- ^ "Amir Perets – Martial Arts Champion, Fitness Guru, Israeli Self-Defense Expert". TheMartialArtsReporter.com. 2009-12-12. Retrieved 2010-08-27.
- ^ "Hollywood's Defense Minister". ynet.co.il. Retrieved 2010-06-01.
- ^ "Foreign defense | News". South Philly Review. 2003-03-06. Retrieved 2010-08-27.
- ^ "Winter Workshop with Amir Perets (4th degree BB KM) in Los Angeles — Krav Maga Worldwide Israeli Self Defense Forums". Kravmaga.com. 2008-03-26. Retrieved 2010-08-27.
- ^ "Deadliest Warrior: U.S. Navy SEAL vs. Israeli Commando". Kmwtrainingcenters.com. 2010-07-27. Retrieved 2010-08-27.[dead link]
- ^ "Grand Theft Auto IV". Archived from the original on 15 October 2010. Retrieved 2010-10-12.
- ^ "MHOF Inductee List 2009". Masters Hall of Fame. Retrieved 2010-08-27.
- ^ "KMW Instructors Inducted into the Masters Hall of Fame". Kravmagaeu.com. 2009-08-21. Retrieved 2010-08-27.[dead link]
External links[edit]
- Fight Science featuring Amir Perets on KravMaga.com[dead link]
- MA Success Magazine Article about Amir Perets[dead link]
- Black Belt magazine featuring Amir Perets[dead link]
- Amir Perets – Martial Arts Champion, Fitness Guru, Israeli Self-Defense Expert
- Inside MMA 410: Cain Velasquez, Vladimir Matyushenko and Amir Perets
- Martial Arts Masters Hall of Fame


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"West and Central Africa in particular requires a special focus for child survival, as it is lagging behind all other regions, including Eastern and Southern Africa, and has seen virtually no reduction in its annual number of child deaths since 1990."
But as Ebola has overwhelmed some countries and threatened many others, questions are being asked about the role of international agencies in undermining health systems in West Africa. Specifically, fingers have been pointed at the 1980s structural adjustment policies of the World Bank and IMF for forcing poor African countries to cut public spending on health[2]. These policies also shifted the financing burden of health services onto poor populations by charging them user fees. Interestingly at the time one of the leading critics of this policy was none other than the current President of the World Bank[3].
Other health policies promoted at the same time were also damaging to poor people's access to health care. The Bamako Initiative (BI) launched in 1987, was prompted by UNICEF and WHO as community management of "revolving drug funds". However, BI institutionalized user fees for essential medicines in some of the poorest countries in the world. Not surprisingly, with most households unable to pay these fees, utilization of health services in the countries concerned slumped, with the poor most likely not to seek care. In West Africa where the BI became established, typical utilization of curative services at the start of the millennium was around one visit per person every three years![4]
Thankfully a huge volume of research evidence over the last 20 years has conclusively proved the folly of this approach. User fees have been shown to be ineffective in raising health revenues, inefficient in incurring high administration costs and inequitable in excluding the poor[5]. They have also resulted in outrageous human rights abuses where poor people (often women and babies) have been detained in hospitals because they can't pay their bills[6]. Sadly this practice continues to this day[7].
As a result of these findings many prominent aid agencies have radically changed their health financing policies, including the World Bank whose President has referred to user fees as "unnecessary and unjust"[8]. Even one of the architects of the World Bank's previous pro-user fees policy has publicly stated his change of position on user fees although he did not admit that it was a mistake then[9].
However, not all agencies have been so clear in making a break with the past. As recently as 2008 in its State of the World's Children Report[10], UNICEF was still championing the Bamako Initiative and openly criticizing NGOs that were advocating the removal of user fees Indeed one of the countries singled out for praise in implementing the BI was Guinea, from where the current Ebola epidemic has spread
It is true that the international agencies involved in promoting the BI have gradually shifted their positions on health financing and are now rallying behind the goal of universal health coverage. However, the agencies that promoted the BI need to acknowledge their past mistakes rather than assuming that the Bamako Initiative never happened.
This is problematic because whereas other development agencies are aware of the changing consensus on health financing, this may not be the case in many countries. Some governments are still laboring under the illusion that the BI is working and thus user fees policies are still implemented. Thankfully, some countries in the region are now replacing user fees with public financing, for at least some of the population, most notably in Liberia, Ghana, Senegal, Niger and Sierra Leone. The latter's free health services initiative for pregnant women and children under 5 has been a particularly good example of the impact of removing user fees.
However in West and Central Africa, out-of-pocket payments including user fees remain by far the biggest health financing mechanism. With the Ebola virus not beaten yet in the region, the lack of effective healthcare coverage doesn't only threaten the health of the population in the region but also poses a threat to global health too.
Therefore, as the international community begins to support countries in West Africa to develop more resilient health systems, there is one immediate action they should take as a top priority. This action would cost practically nothing but its impact could be profound in helping put countries on a path towards equitable universal health coverage. After a twenty-eight year failed experiment, it's time that agencies including UNICEF and WHO formally and publicly end the Bamako Initiative.
[1] UNICEF 2013 Committing to Child Survival, a Promise Renewed, Progress Report 2013 Available at: http://www.unicef.org/publications/files/APR_Progress_Report_2013_9_Sept_2013.pdf
[2] IDS Practice Paper in Brief 2015 Ebola and Lessons for Development Available at: http://opendocs.ids.ac.uk/opendocs/bitstream/handle/123456789/5849/ID557%20Online.pdf
[3] Kim JY et al editors 2000 Dying for Growth Global Inequality and the Health of the Poor. Common Courage Pres
[4] UNICEF 2009 Maternal and Child Health the Social Protection Dividend: West and Central Africa
[5] Yates R 2009 Universal Health Care and the Removal of User Fees The Lancet 373: 2078–81 Available at http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(09)60258-0.pdf
[6] Kippenberg J Burundi A High Price to Pay Detention of Poor Patients in Hospitals 2006 Human Rights Watch Volume 18 No 8(A) New York, USA
[7] See https://www.youtube.com/watch?v=RNfzXh4I-Pw
[8] Kim JK Poverty Health and the Human Future [Speech] World Health Assembly, Geneva, Switzerland 21 May 2013 Available from: http://www.worldbank.org/en/news/speech/2013/05/21/world-bank-group-president-jim-yong-kim-speech-at-world-health-assembly
[9] Boseley S (2012) From user fees to universal healthcare – a 30-year journey. The Guardian
[10] UNICEF 2008 State of the World's Children: Child Survival available at: http://www.unicef.org/sowc08/docs/sowc08.pdf
Medicine: A hugely profitable business: Medicines, so critical for saving lives and protecting public health, can also deliver eye-watering profits. In 2013 the 10 leading pharmaceutical companies had combined revenue of US $440 billion. The biggest pharmaceutical company in the world, Pfizer, generated US $50 billion of revenue and US $22 billion profit in 2014. Such profits flow from the prices set for some of the newer medicines. In 2014 Gilead Sciences set the US price of its new drug to treat Hepatitis C at US $1000 per pill, or US$ 84,000-110,000 per treatment, a price that generated sales worth US $10 billion in 2014 for this medicine alone. It is worth remembering that approximately 150 million people are infected with hepatitis C, 75% of whom live in Low- and Middle-Income Countries (LMICs), and that about 350,000 of these die each year.
New cancer medicines allow big pharma to charge more than US $100,000 per treatment. These astronomical prices have become unaffordable even in rich countries. The UK has refused to reimburse several cancer medicines due to exorbitant prices. An op-ed co-signed by 100 leading oncologists in the prestigious journal Blood in 2012 called for a reduction of cancer medicine prices, which they deemed economically unsustainable. These unprecedented prices turn life-saving medicines into a highly profitable business.
The collective wealth of billionaires with interests in the pharmaceutical and health sectors increased from US $170bn in 2013 to US $250bn in 2014, a 47% increase and the largest percentage increase in wealth of the different sectors on the Forbes list. The World Bank estimated that the economic costs of the Ebola outbreak to Guinea, Liberia and Sierra Leone was US $356m in lost output in 2014, and that this will increase to US $815m in 2015 if the epidemic cannot be quickly contained. The greatest increase in wealth by a single pharma-related billionaire between 2013 and 2014 could pay the entire US $1.17bn cost for 2014–15 three times over. With such huge amounts of money at stake, the pharma sector does everything in its power to ensure that rules and policies are in place to maintain the status quo.
When company lobbyists hijack the decision-making process: Large sums are spent by the pharmaceutical industry in lobbying health-related decision-makers. In 2013, the pharmaceutical and healthcare sector spent more than US $487 million on lobbying in the US alone, more than was spent by any other sector in the US. The same sector spent US $260 million on campaign contributions during the election cycle of 2012. In Europe, the pharmaceutical industry employs around 220 lobbyists and an army of lobbyists covers Capitol Hill. They aim to maintain monopoly controls that allow high prices for as long as possible.
The pharmaceutical sector also lobbies the governments of the US and the EU to expand companies' intellectual property (IP) monopoly power through the negotiation of Free Trade Agreements (FTA)[1]. These FTAs seek to restrict governments' ability to use policy tools that promote access to affordable medicines, which has been condemned by the World Health Organization's (WHO) Director Margaret Chan.
Countries are also put under pressure to strengthen their IP rules outside trade negotiations.
This is the case with the US pressure to reform India's balanced IP law, threatening to shut down the "pharmacy of the developing world"[2]. The "Pharma Gate" scandal in South Africa in 2014 revealed leaked emails showing that Pharmaceutical Associations based in South Africa and the US (PhRMA) hired a powerful US lobby firm to derail South African IP law reform that facilitated access to generic medicines.
Big pharma should focus on what it's supposed to do: create useful new medicines to support public health at affordable prices: Pharmaceutical companies play a critical role in public health through creating medicines that save and improve the quality of life. But increasingly the industry has lost its way, concentrating on 'blockbuster' products, and spending money on marketing and lobbying for ever stronger monopoly rights. The current system, which is supposed to incentivize R&D by granting 20-year patents on innovative medicines, fails to meet the public health need for affordable medicines. R&D is invested where large profits can be made – often products are priced so that only a small proportion of the needs are met – while diseases that affect primarily poor countries are sidelined. Only 10% of the world R&D is spent on diseases that affect 90% of the world population. It is estimated that more than one billion people affected by neglected tropical diseases fail to get the treatment they need.
Three pharmaceutical companies (GSK, Johnson and Johnson, Novartis) made the greatest financial contribution to the Ebola relief effort, donating more than $3 million in cash and medical products. Although laudable, these same three companies together spent more than US $18 million on lobbying activities in the US in 2013. The non-existence of a treatment or vaccine for Ebola resulted from lack of R&D investment and the absence of a financially profitable market. The industry employs great scientists and researchers whose creativity is channeled to products for highly profitable markets instead of services for the vast numbers of people worldwide who are still denied the benefits of new technologies. Their plight should be the number 1 priority of all actors who have a part to play, including the pharmaceutical companies.
Winnie Byanyima, the head of Oxfam International, rightly put it in Davos: "Let the companies stop lobbying, and put the money into medicine!". The Oxfam Even It Up campaign seeks to consign to the history books the statistic that 1 person out of 3 does not have access to needed medicines.
[1]The following trade negotiations are currently undergoing: EU-Thailand FTA, EU-India FTA, the Transatlantic Trade and Investment Partnership (TTIP), the Trans-Pacific Partnership (TPP).
[2]India's balanced IP law allowed its generic industry to lower the price of Antiretroviral treatments by 99 % since 2000, bringing the cost of treatment to below $100 per person per year
According to the 2013 representative population survey, Russians think that the two forms of inequality most strongly affecting the well-being of the country's population are:
• Income inequality (72 per cent of respondents)
• Inequality in access to healthcare (47 per cent)
The income inequality percentage may not surprise outside observers, as Russia has witnessed one of the most radical increases in economic inequality in the last two decades following the collapse of the Soviet Union, and is now on par with other high inequality G20 peers like Turkey and Mexico. Inequality in access to healthcare may come as a bit more of a surprise, taking into account that Russia formally has universal health coverage and the right to free healthcare is enshrined in its constitution. Moreover, BRICS are now being looked at as important players in the global health arena.
So, what does inequality in access to healthcare actually look like in Russia? What are the main causes of inequality in access to healthcare? And how does economic inequality, ravaging the country is related to the inequality in access to healthcare?
Inequality in access to healthcare Russia has three key dimensions:
Key drivers of inequality in access to healthcare:
Clearly the lack of publicly funded health service makes people' income the decisive factor in a person's chances of getting healthcare in Russia. Private expenditure on healthcare of the richest 10 per cent of the Russian population is now eleven times greater than that of the poorest 10 per cent. The combination of lack of investment in health service and rising economic inequality will continue to exacerbate inequality in access to healthcare, which, in turn, will lead to further perpetuation of income inequality at the country enters into this vicious circle.
Jim O'Neill of Goldman Sachs turned the spotlight on the four emerging economies when he dubbed them the"BRIC" countries in 2001. The acronym was extended later — to BRICS — to include South Africa. Although such a grouping may be useful from economic point of view, it sounds awkward and artificial when it comes to global health policy.
While health economists see strong potential roles for the BRICS in the development of universal health coverage, these countries vary greatly in terms of their patterns of disease, healthcare systems, financial interest in the pharmaceutical trade, and engagement in the global arena for healthcare. Although many might be looking to the BRICS for leadership, it is still not clear if these countries have sufficient shared interests or the coordinating mechanisms and processes needed to collectively and cohesively influence or promote global health policy.
The BRICS are also nowhere near economic parity. Russia and Brazil are far ahead in per capita income, outdistancing both India and China by significant margins – nearly $14,000 compared with China's $6,629 and India's $1,592; data and figures which were released in 2013 by the IMF. Notwithstanding, the countries in question have for the most part fallen short of successfully addressing inequalities in healthcare. Inequality in the BRICS has come under scrutiny of late, particularly due to their falling behind on Millennium Development Goals.
Despite diversity, the BRICS countries face a number of similar public health challenges, including inequitable access to healthcare and affordable medicines, soaring health costs, rising non communicable and infectious diseases such as AIDS and tuberculosis.
These factors were illustrated by recent findings of a study conducted by Oleg Kucheryavenko, which noted that limited access to healthcare for a significant number of people in Russia is an issue of concern to all social groups, non-governmental organizations and political parties. Inequality has not been given much attention by policy makers.
The Russian healthcare system is characterized by significant differences in demand from the various socioeconomic classes. Social groups with a higher incomes request healthcare more frequently than those with lower incomes. This inequality is reflected by a widespread health service based on cash payments: high-income persons pay 2.5 times more for a visit to a healthcare institution than those with a low income. However, poor people spend 1.5 times more of their household budget on medical care than well-off people.
Since 1990, the material and human resources of the health sector have been reduced. Beds have decreased by 12%, the number of doctors has dropped by 46%, and nursing staff by 10%. Yet, Russia is still among the top countries of the world in terms of the number of doctors and hospital beds per 1000 persons.
While global growth in expenditures for health care is rising, Russian spending continues to decline, which hinders government' ability to subsidize the most in need. Russian state healthcare expenditures are several-fold lower than the ones in the countries of the European Union; in Hungary, the Czech Republic, and Poland – 6% of GDP, in Germany – 11%.
Russian spending on the health and social sector has slipped as EU and US economic sanctions have taken hold. Cutting public expenditures meant less spending for social services. Moreover, the Russian parliament approved a fragile budget that includes a reduction in healthcare spending by 25% in 2015. These decisions have put the country's relative position of strength among the BRICS in serious jeopardy.
Between 1995 and 2011, private spending by Russians on health surpassed state spending by 2.1 times. Over half of this private spending is for retail purchases of medicines and healthcare products. Expenditures for paid health care services and unofficial payments amount in total to 87.9% of personal expenditures.
Given the current trends in healthcare financing and the structure of informal payments for health care services, expenditures for prescription drugs are likely to increase. Our study, estimated that the private expenditures will rise from 331.9 billion RUB in 2013 to 1305.5 billion RUB in 2020, considerably outperforming state expenditures on health.
Increasing funding alone will not solve all the problems in the health care system. Current spending is both insufficient and ineffective. Without effective policy changes, additional funding is likely to have a negligible effect. A key change is to adopt a social policy based on recognizing health as a human right and not a commercial product. Adopting universal health coverage as a basis for health policy means that quality health services are publicly financed and publicly delivered to all who need it.
It is evident that the prospects for health care in Russia are directly interwoven with the nation's future socioeconomic development. What happens in the future depends on the extent to which the government recognizes the inequality that is skyrocketing in society.
]]>A report on the pricing of medicines for cancer treatment by Ellen't Hoen discusses the unsustainability of the high prices of newer medicines. The report also provides evidence of a problem that is looming large not only in low- and middle-income countries (LMICs) but also in wealthy countries.
The report points out that while numbers of cancer deaths are reducing in wealthy countries because of access to early diagnosis and treatment, the incidence and prevalence is increasing in developing countries. In India it is projected that the number of patients with cancer will reach 1.1 million by 2020. When cancer medicines are priced out of the reach of most people living in developing countries, it compounds the challenges of accessing treatment, exacerbating illness and contributing to preventable suffering.
Even in rich countries the prices of newer cancer medicines are being questioned against a backdrop of escalating health care costs. For example, the recent decision to delist 16 medicines from the UK's Cancer Drug Fund has elicited furious debate about the high price tag of treatments that deliver limited clinical benefits and equity in providing access to all patients under the NHS.
Access to anticancer medicines is aggravated the world over by intellectual property rights held by pharmaceutical companies and by companies' pricing strategies. Multinational pharmaceutical companies holding the intellectual rights to new medicines justify high and often exorbitant prices as a necessary means to recover research and development (R&D) costs. However, this explanation is not possible to verify since transparency about costs is lacking. In addition, public funding contributes significantly to the development of new cancer medicines. The report contrasts the best estimates of Novartis' R&D expenditure on imatinib (Glivec), $38-96 million, with the sales of the drug in 2012 which came to $4.7 billion. Pricing to maximise profits has proven to be very lucrative for pharmaceutical companies. The industry's global oncology sales were worth $61.45 billion in 2012 and are expected to increase to $81.3 billion by 2018.
There is now a global consensus that the current R&D model that maintains monopolies and leads to high prices of medicines is broken. New ways of financing biomedical innovation that de-link the cost of R&D from the price of the product are being debated and piloted at the WHO.
Yet there is intense pressure on governments that are taking measures to increase affordability and access to medicines from the pharmaceutical industry and the governments protecting its interests. The current pressures on India are a prime example.
The US government, on behalf of the commercial interests of its pharmaceutical companies, is engaged in an intense effort to undermine India's use of public health safeguards enshrined in India's intellectual property regime. The industry seeks to force the introduction of TRIPS-plus provisions (such as data exclusivity and patent linkage) that will prolong monopolies on medicines and delay generic entry into the market. India has now been stopped from advancing a compulsory license for an anti-leukaemia medicine, dasatinib.
Experiences from the global fight for HIV treatment over the last decade have taught us that generic competition is the most robust and effective way of bringing down the price of medicines. If the US government is successful in imposing its demands on India, the generic supply of life saving medicines and the health of people living in India and other developing countries will be seriously threatened.
The Access to Cancer Treatment report presents evidence of the scale of the problem of access to cancer medicines and recommends how it may be tackled. What is clear is that we are at a tipping point where high prices for cancer medicines and the resulting lack of access to treatment are neither justified nor acceptable. The stage is set for the governments to act in favour of patients and to find workable solutions to what has become one the greatest challenges to equity and access to medicines in our time. Will we act?
Universal Health Coverage (UHC): Senegal example
Two years ago, the United Nations General Assembly unanimously adopted a Resolution urging Governments, civil society and international organizations to promote UHC, in order for people to use the health services they need without suffering financial hardship. More than 70 countries worldwide, including 30 of the poorest, have passed laws for UHC and have already started to reap the benefits of healthier communities with potential for stronger economies.
Health care coverage is low in developing countries. In Africa only 10% of the population has health coverage. In Senegal, 60% of the population lives with less than 2 dollars per day and only 20% has health coverage. In 2013 the government of Senegal set a target of covering 75% of its population by 2017.
UHC is an ambitious society project which, first and foremost requires a strong political will for building equitable societies. Political will must be translated into concrete action by building an equitable health system that covers the most vulnerable populations, mobilizing adequate financial resources from both domestic funding and donors' assistance.
Civil society plays a key role in informing citizens about their health rights and ensuring that the principles of equity, including gender equity, and universality are fully respected. For example, supporting government's efforts in Senegal means advocating to expand free services beyond the current groups (children under 5 years of age and the elderly) and beyond the current covered diseases. That is why the Pan-African Institute for Citizenship, consumers and Development (CICODEV) has launched the "Access to Health and the Universal Health Coverage" campaign.
Financing UHC: The responsibility of states and donors:
Far from reaching the 15% Abuja Commitment (2001), health expenditure accounted for only 5% of the Senegalese national budget in 2012 according to WHO Global Health Observatory. CICODEV is concerned that the 2015 Senegalese budget plan allocates only 5 billion CFA francs (€7, 6 million) to health whereas more than 25 billion CFA francs (€38 million) are needed to achieve the government goal on UHC. Discussions are underway in Senegal to mobilize additional resources, through innovative funding.
Meanwhile, official development assistance (ODA) represents 19% of Senegal's health expenditure and hence it plays a significant role in financing health services. However, establishing a progressive taxation system for both individuals and corporations is an essential strategy to mobilize domestic resources to finance UHC in a sustainable way.
UHC post Ebola
The current Ebola crisis in West Africa highlighted the importance of sustainable investment in UHC. Today, the European Union Ministers in charge of Development Cooperation are meeting in Brussels to discuss the short and medium-term EU's response to Ebola outbreak. They will also review the ongoing process to define the next 15 years global Sustainable Development Goals. They must seize this opportunity to defend the public re-distributive policies such as using ODA to finance UHC in order to support countries committed to making the right to health a reality for their population.
The ability of a country to contain an outbreak of an infectious disease like Ebola is largely dependent on the strength of its healthcare system and on having enough staff working within it to cope with the crisis. Clearly the healthcare systems in the affected countries were too weak to control the outbreak. For example, Sierra Leone had 119 doctors serving a population of nearly six million people. This meant that for every 50,000 people in Sierra Leone, there was one doctor compared to a 100 in the UK. That ratio in Sierra Leone falls well below the WHO's recommended minimum of at least 23 doctors, nurses and midwives per 10,000 of the population.
In Liberia and Guinea, the shortage of healthcare workers is even worse. In these countries, there is only one doctor for every 100,000 people. In addition to the severe shortage of health workers, there are also problems in terms of the number of health facilities accessible to citizens and insufficient medical supplies. For example, in Liberia, there are only 3,352 hospital beds for a population of nearly 4.5 million. Guinea has a similar number of beds (3,435) for a population of nearly 11.5 million. It is hardly surprising then that these countries have struggled to contain the Ebola virus.
Inequality and the rich country drain on health workers
The health worker shortage in Africa is a stark example of global inequality. According to WHO research, Africa has the highest burden of disease of any continent, but has only 3% of the world's health workers, and less than 1% of the world's financial resources. While the continent continues to grapple with infectious diseases, such as HIV, malaria, cholera, tuberculosis and child pneumonia, as well as problems with maternal health, there has also been a rise in noncommunicable diseases. But the number of health workers to respond to these challenges remains remarkably few.
In order to address the unequal distribution of healthcare workers, we need to understand the labour market dynamics that affect the training, recruitment, deployment and performance of global and local health workforces. There is a global shortage of healthcare workers, affecting high-, middle-, and low-income countries, from the USA and Germany to India and Uganda. The difference between high-income countries and low- and middle-income countries lies in their ability to address these health workforce shortages, and to invest in the recruitment and training of medical staff and managers. Too often, richer countries simply recruit staff from poorer ones. It is estimated that 10% of Sierra Leone's trained nurses are working in the UK health system.
There are many issues that lead health workers to seek employment outside their country of origin, including low salaries, inadequate health facilities and a lack of training and career development. Serious investment in these areas is needed in order to avoid the damage to local health services that is caused through the loss of healthcare workers. When significant numbers of doctors and nurses leave the countries that financed their education, there is a huge loss of public investment which makes it more difficult to deliver services and to offer education and training to people who wish to enter the health profession in the future. While workers should enjoy freedom of movement, mechanisms should be in place to support their retention, such as improving working conditions, and remuneration and career development. In Zambia, for example, healthcare workers receive an extra 25% recruitment and retention allowance on top of their basic salary, which has been effective in decreasing the migration of nurses.
Ensuring countries have the human resources tackle health crises
Wealthier nations are more able to make these kinds of investments, not only within their own borders, but internationally through providing aid and sharing expertise. A recent Global Forum on Human Resources for Health recommended that each country with severe healthcare personnel shortages should be supported to develop and implement a budgeted plan to strengthen its health workforce, as part of a broader national health strategy. This should include a special focus on the most poor and marginalised sections of society, as well as strategies to train skilled health workers and maximise their performance.
The Ebola crisis has undermined the economic progress that Sierra Leone, Liberia and Guinea were making, thereby limiting the ability of these governments to make much-needed investments in their public services. It has, however, also succeeded in focusing attention on the shockingly unequal distribution of healthcare workers, which stands in the way of achieving key public health priorities, such as reducing child mortality, improving maternal health, increasing vaccine coverage, and combating HIV/AIDS, malaria and other diseases.
The international community must invest in human resources for health for all. Health workers are the basis of a functioning healthcare system, which in turn helps to drive economic growth, save lives and improve the quality of life for millions of people around the world.
It was largely thanks to a huge global mobilisation of civil society led by people living with HIV that leaders and pharmaceutical companies started to feel embarrassed about denying access to life-saving medicines to millions of people. But it was only after generic competition kicked in that access to medicines became something policymakers talked about. An offer by an Indian company to sell a cocktail of the three basic medicines for one dollar a day slashed the prices of antiretrovirals, meaning that today over 9 million people are on treatment,, including over 7 million in Africa.
Generic competition was possible because India had not at that time implemented the Trade Related Aspects on Intellectual Property Rights (TRIPS) and thus was able to manufacture the medicines. Since adopting TRIPS, India's ability to produce medicines has been limited. Yet the country has been under immense pressure from multinational pharmaceutical companies, the US and the EU to tighten its IP rules even further and thus to limit access to medicines to those who need them.
It seems that the world is obsessed by granting more and more monopoly power to pharmaceutical companies rather than by investment in research and development (R&D) for medicines and vaccines that are needed for public health.
For this reason Ebola is the other side of the coin to HIV as the intellectual property rights system allows the market to shape R&D priorities, rather than public health needs. That same system allows companies to charge high prices that are unaffordable in developing countries as the HIV crisis taught us.
The fear of Ebola crossing borders and affecting people in the US and Europe has changed the situation – clearly there is now a market for travelers, but more importantly the threat of a global epidemic means that donors may be willing to pay for products that contain the spread of Ebola and other hemorrhagic fevers.
The most promising vaccines that are now being rushed through clinical trials have been developed with public money, mainly from the governments of the US, Canada and the UK.
It is not ethical, sustainable nor safe to leave commercial interests decisions and financing for R&D for products, capable of modifying global health threats, to be dictated by the commercial interests of pharmaceutical companies.
Governments, under pressure from multinational companies, have agreed to a profit -based system (TRIPS) instead of looking for more innovative ways of financing R&D.
Throughout the history of medicine's development, public funding has played an essential role in developing breakthrough medicines, including for the treatment of HIV and now prevention of Ebola. We need to change the present monopoly ownership system to allow public funds their proper place in stimulating accessible and affordable technologies that make our world a safer and more humane place.
So it was not much to ask that the world's most powerful leaders would seize the opportunity of the G20 Summit in Australia (15-16 November) to address the acute global health and humanitarian crisis of Ebola.
Some governments have already made generous pledges of finance and medical staff since the WHO declared this Ebola outbreak a 'Public Health Emergency of Global Concern' in August this year. Yet instead of ambitious new commitments to help implement the UN plan, the G20 issued a statement on Ebola that was more talk than action.
Yes, G20 countries want to 'extinguish' the outbreak, and will 'do the necessary,' but no new cash or human resources were pledged. Their statement seemed to back away from specific commitments from governments; it could only 'invite' other governments to respond, whereas it 'urges' the pharmaceutical sector, the World Bank and IMF to do so.
There is one apparently new commitment in the statement: a further $300m from the IMF, with an unspecified split between concessional loans, debt relief, and grants. This is in the context, however, of the combined debt of Sierra Leone, Liberia and Guinea being $3.6bn, which is already costing them $100m in debt service in 2014, and will be more next year. Considering the devastating impact of Ebola, these countries need grants and debt cancellation, not new debt.
To be fair, the G20 statement is a little better on solutions for the longer-term. The G20 recommitted to implementing the WHO's International Health Regulations (which they are legally obliged to have already completed by 2012), that focus on disease surveillance and response capacities. The statement flagged that some G20 countries have initiatives to support countries in West Africa and elsewhere to implement the regulations too.
The World Bank re-announced its idea to develop a contingency fund for health crises, which would provide ready cash in the event of a future outbreak. The fund is supposed to provide a financial incentive for pharmaceutical companies to invest in vaccines and treatments for diseases afflicting developing countries, by assuring them that any vaccine or drug that they produce be paid for (out of this fund) if another epidemic hits. Clearly global financing for rapid response to outbreaks could be a useful vehicle for global actions. However, such solutions must also enhance local capacity to respond to outbreaks, and rapidly mobilise sufficient human and financial resources to help the countries in need.
The Ebola crisis highlights the failure of the current research and development (R&D) system which relies on market incentives for developing vaccines and medicines for public health needs. Financing R&D for vaccines and medicines for Ebola and similar outbreaks needs to happen now. R&D cannot wait till an outbreak is declared a global emergency. Instead the vaccines and medicines must be developed, and be ready for production and distribution at that time.
We will await the details of those proposals. The immediate priority must be focusing on the current outbreak, where there is still a need for greater international response. The UN has set itself a target to get a hold on the epidemic by 1 December – which would require treating 70 per cent of patients, and ensuring that 70 per cent of all burials are done safely. We are now 13 days away from this deadline, and the G20 had an opportunity to push the international response towards this goal. Unfortunately, it didn't take it.
There is still a long way to go to turn this epidemic around, to reduce suffering and to save lives. This crisis cannot be summarised by numbers of cases and deaths – it is reaching into the heart of these countries, spreading fear and social breakdown. Oxfam is working with people who have lost five members of their family in a single week to Ebola. This kind of devastation is not easily overcome.
The impact also goes far beyond Ebola cases. A major collapse of health services means that deaths and illnesses from other diseases are going unchecked. It is difficult to imagine what can happen to women who have difficult labours when no health service is available for them, or for children that can't get treated for malaria or pneumonia.
We urge G20 countries to rapidly deliver the promised financial and medical support to the affected countries in order to help bring an end to the suffering of their citizens.
The G20 has missed an important opportunity in the fight against Ebola. Now they have 13 days to prove they can still be world leaders.
On September 1, 2011, the Lancet featured Japan's 50th anniversary of Universal Health Coverage (UHC). In 1961, Japan formally kick-started its national health insurance system. The system comprised two main components; an employee-based insurance 'Shaho' and a community-based insurance 'Kokuho'.
Now Japan is lauded by WHO and OECD as one of the best countries in the world when it comes to healthy longevity of its population with relatively low medical expenditures. How was this possible? One key factor is the Japanese 'Peace Constitution' which underpinned universality and accessibility in health care services. Article 25 of the constitution stipulates that:
"All people shall have the right to maintain the minimum standards of wholesome and cultured living. In all spheres of life, the State shall use its endeavors for the promotion and extension of social welfare and security, and of public health".
The Lancet articles presented fair analyses and lessons learnt from the Japanese experiences, especially regarding public policy and health system formation. However there is one important factor that was missed in the Lancet articles- namely the Primary Health Care (PHC) approaches. Japanese forerunners struggled to supplement the health system's failures and shortcomings at the community levels by PHC.
This bottom-up approach has been tremendously important and instrumental than the mention in the Lancet articles. For the war-battered Japanese society, especially in rural areas where doctors have always been a rare commodity, PHC played a critical role.
I will describe the example of two persons who were role models for PHC:
Dr. Toshikazu Wakatsuki, a medical doctor and Mr. Masako Fukazawa, the mayor of Sawaguchi-mura village, who were great pioneers in setting up Community-health and UHC in Post-war Japan.
Dr. Wakatsuki was dispatched to the remote Saku region in Nagano prefecture to work in a forlorn hospital in March 1945 – just a few months before the surrender of Japanese Imperial Army to the Allied Forces. Although he was a gifted surgeon, he got deeply involved from the start in health promotion and preventive activities in the poor and mountainous communities. Since late 1940s, he had helped organize outreach health teams and community health volunteers and jointly started health counseling sessions for poor villagers using role plays pertinent to their everyday health issues and tried to raise health awareness among rural population. By 1980s, thanks to Wakatsuki and local people's joint efforts, Nagano prefecture saw the incidence of stroke and TB, the two major killer diseases at that time, drastically lowered and medical cost to the population considerably reduced. Even to this day, Nagano stays at the top level among the 47 prefectures and city governments in terms of both male and female longevity.
In 1957, Mr. Fukazawa of Sawauchi-mura village, in the Iwate prefecture, was elected as mayor. The village is in northern Japan and is mostly immersed in snow with bad roads and no doctors. He first introduced state-of-the-art bulldozers into the village to remove deep snow from the roads and thus facilitated the transportation of the villagers to clinics, schools and shops during winter. He also started prenatal counseling and toddlers' regular health checkups free of charge. In early 1960s Fukazawa introduced free medical consultation for infants under 1 year old and elderly persons above 60. His do-it-alone measure was severely criticized by the then central and prefectural governments because the national health insurance law did not allow such a policy. But Fukazawa proudly declared "Although I know what I did for the infants and the elderly was against the health law, I know it is in accordance with our Constitution, article 25."
In five years' time, villagers as well as policy makers were astonished to know that the infant mortality rate in Sawauchi was brought down from 69.6 per thousand to zero!. This marvelous achievement was accompanied by less medical costs compared to neighboring villages in the same prefecture. Eventually the Central Government adopted the same policy. Like Dr. Wakatsuki in Saku, Mr. Fukazawa was also eager to strengthen health promotion and preventive activities. He set up a village health committee and asked the villagers for active participation. For him, UHC was not only about making medical services free but also creating a sustainable and participatory mechanism in the community.
As physician and public health researcher, Julian Hart correctly pointed out in his famous article:
"The availability of good medical care tends to vary inversely with the need for it in the population served. This law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced."
This law is still valid to remind us of the fundamental factors that undermine the availability of health service. It emphasise that optimistic reliance on market forces must be challenged when establishing UHC both in the community, national and global contexts.
As a member of global society we must contribute to realizing better health for peoples in the developing nations. Our past experiences in UHC could offer important lesson for other countries and UN agencies that governments role in shaping the national health policies is without a doubt of paramount importance. Yet our experiences also shows that grass-roots level initiatives can also make a huge difference to improving the quality of UHC.


text:
Jordan T Van Orman
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