Columns
HEADLINES [click on headline to view story]:

Your Health & Happiness

The Doctor's Consultation 

Agony Column

Camera Class by Snapshot

Dogs - Man’s best friend

Money Matters

Life in the Laugh Lane

Your Health & Happiness: WHO: “Learning by Doing” is key to achieving universal access to HIV/AIDS prevention and treatment

Rio de Janeiro – To achieve universal access to HIV prevention and treatment, the scientific and public health community must respond quickly to developments on the ground to narrow the gap between discovery and intervention.

Dr Charlie Gilks, head of treatment, prevention and scale up at the World Health Organization’s (WHO) HIV/AIDS Department, stressed the need to “learn by doing” at the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, a biennial scientific meeting, in Rio de Janeiro, Brazil. Gilks stressed that the scientific community must be committed to applying the results of scientific studies quickly to AIDS programmes while they are being implemented.

The goal of achieving as close as possible to universal access to HIV treatment by 2010 was recently endorsed by G8 leaders in Gleneagles, Scotland at their annual meeting. Achieving this goal will require a significant new investment of resources and effort in research, says Gilks, who cited new formulations of HIV drugs for children and simpler tests to diagnose and monitor patients as major research priorities for scaling up treatment in resource-limited settings.

“The list of research questions is long,” said Gilks. “But if we are going to achieve universal access, we will need to invest in applied research and move new products and approaches quickly into the field.”

Gilks remains confident that the scientific community can meet this challenge, and that prospects for rewarding scientific work in the field of HIV/AIDS have never been better. “We have the knowledge to answer many of these questions,” he said. “In fact, I would argue that in no other field are the opportunities to translate evidence into action so great as they currently are in HIV/AIDS. Not only can researchers have direct impact on policy and practice, they can reduce inequities by helping to make scientific advances available more quickly to the millions of people who need treatment.”

The Rio conference brings together leading AIDS researchers, activists and policy makers to discuss recent advances in HIV/AIDS research and ways of translating research findings into practice.

The WHO and UNAIDS strategy to ensure treatment for three million people living with HIV/AIDS in low- and middle-income countries by the end of 2005 (the “3 by 5”) has been a major catalyst for mobilizing support and action and was an important first step towards the goal of universal access. Access to antiretroviral treatment (ART) in developing countries has expanded significantly. Since the initiative started in 2003, the number of countries establishing national treatment targets has risen from four to 40, and the number of countries that have developed national plans to scale up antiretroviral treatment now numbers 34, up from only three. In the last 12 months, more than 50 countries have doubled the number of people who are on treatment. The recent G8 endorsement of achieving as close as possible to universal access to treatment by 2010 is seen as a major boost to continuing this effort.

Gilks emphasized the importance of research on HIV prevention in addition to more effective ways to deliver treatment. “While we work to keep people alive and healthy with the tools we have now, we also need to ensure that future generations will have access to better prevention technologies,” said Gilks, referring to the importance of vaccine and microbicide research.

For more information about WHO, please visit www. who.int/hiv


The Doctor's Consultation: DIY Monitoring - Is it a good idea?

by Dr. Iain Corness

The correct answer, in my book, to the question of DIY monitoring of chronic conditions is a qualified ‘Yes’ but with the proviso that it should be done in conjunction with the medical attendant who is looking after you for that condition.

I am not backing all the horses in the race with the above statement, but since your doctor has been trained in the treatment of chronic ailments, and is treating your particular one, it makes good sense to monitor, but with the doctor’s assistance and directives.

A good example of where the patient can assist in their own treatment by self-monitoring, is in Diabetes. Blood sugar (glucose) levels can vary enormously over the span of one day, and sometimes it is very difficult for the doctor to gage just “how much” medication to give, to keep the blood sugar within acceptable limits for the entire 24 hours. A few readings, before and after meals can certainly make life easier for the prescribing doctor, and make life better for the person suffering from diabetes.

With electronic everythings these days, electronic blood glucose monitors are fairly common on the shelves of the better pharmacies, so it is quite simple to become your own blood technician.

First: Keep a Log Book. Keep a record of your blood sugar values in a log book or diary, which should show dates, times, sugar levels and relationship to meals.

To get an accurate blood sugar result, you need to make sure that the meter is clean; the meter has the correct code that matches the strip you are using; you have a clean finger and you have collected a good- sized drop of blood.

To get a good blood sample, before pricking your finger, wash your hands with warm water, shake your hands below your waist, use the lancet to the sides of the tip of the finger, then gently squeeze or milk your finger a few times.

Generally, the best times to check are before breakfast, before lunch, before dinner and before bedtime snack. Sometimes it is useful to check blood sugar two hours after a meal to see the effect of the food on your blood sugar levels.

Remember that the routine that you select may have to be changed during periods of stress, illness, or surgery, if you become pregnant, if low blood sugar is suspected or when there are changes made to your treatment program, such as a change in medication, dosage, meal plan or activity.

At those times it is also of value to carry out testing your urinary ketones, which is done by the old dipstick method in freshly passed urine. Ketoacidosis, which can occur with high sugar levels should be dealt with promptly.

The other important blood sugar test is Glycated Haemoglobin (HbA1c). While your home monitoring gives a reasonable indication of how you are doing at that moment, the HbA1c, gives your doctor a picture of how well controlled you have been over the past three months, but this is a lab test, not a home monitor.

Each individual has his/her own target range. This depends upon many factors, including your age, your type of Diabetes and how long you have been a diabetic. This is where your doctor will guide you as to what levels you should be attempting to maintain.

A rough guide would be: HbA1c(%) between 4.5-6.5, and blood sugars (fasting or pre-breakfast) of around 80-120 mg/dL, but it is something about which your doctor will give you a much better indication.


Agony Column

Dear Hillary,

I am trying to buy a second-hand car. I don’t have much to spend, but I want a good one. I have trudged in and out of so many car sales outlets, I am starting to get depressed. The sales people don’t want to talk to me and none of them seem to be able to speak English. Don’t they want to shift the vehicles in their forecourts? Have you any foolproof way to make sure I don’t buy a lemon?
Lemonade

Dear Lemonade,
What you need is obviously some “lemon aid”, my Petal, but what do you think I am running here, girl? A used car lot? A car buying service, or what? In your defense, I must admit that when reading the outpourings from the hearts of many of my letter writers, they have definitely been ‘used’, so I will excuse you. So you want the sales people to speak English to you - would you please repeat after me, “The Country I Live In Is Called Thailand”. Amazingly, the locals speak Thai as well. Now, to avoid the lemons, buy oranges. More expensive, but leave a sweeter taste in the mouth afterwards. There’s plenty at the local markets. To be honest, the best way is to save up the deposit and buy a new one if you must have a car. With interest rates around three percent, anyone can afford one (other than me, as I spend my allowance on champagne and chocolates).
Dear Hillary,
There has been a crackdown recently over copy goods - CD’s, golf shirts and watches and the like. Why is this? Everyone knows that you go to Asia and buy real bargains. I always bring back with me three or four watches for the girl friends and a couple of footy shirts for the blokes down the pub. What’s wrong with this. If I can’t get the stuff in Thailand, do you know where I can get them? I’m coming over in a couple of weeks, so if you can let me know early that would be good.
Copy Kid

Dear Copy Kid,
Put the boot on the other foot. Imagine you are the manufacturer of a high quality “name brand” item. How would you feel if you found that cheap copies were being marketed at half the price you sell them for? They look like yours, but the quality is not the same. Mind you, I think that many of these overseas goods are highly over-priced too, especially when they are made in low-cost manufacturing countries like China, for example. Having said all that, copy goods are still available at the local markets, but don’t tell the police where. Unless the officers are running the market!
Dear Hillary,
How do you work out what size shirts you are supposed to buy in this country? In the UK I am a Medium (M) but over here the shop girls all say I am XL. So I believed her and got three shirts at the markets, all with XL tickets, but only two of them fitted, the third was miles too big. When I went back the little shop wasn’t there any longer, so I am left with this big shirt. What’s your suggestion, Hillary?
Medium

Dear Medium,
Just a crazy thought, but have you ever tried just holding the shirts up against your body, before parting with the cash? Seems fairly obvious to me, Petal. So the shop’s done a midnight flit, give the large one to a large friend, or wait till you grow into it yourself. Most farang males seem to get bigger as they get older. It’s something to do with the refreshment they drink. By the way, it wasn’t copy shirts you were buying, was it?
Dear Hillary,
This is what happens to single males in this town. I was sitting on my own in the bar and I didn’t want to listen to the usual inane chatter that the bar girls think is inviting, “Hello sexy man. Where you come from?” that kind of stuff. Giving the girls the cold shoulder, I started to talk to the service lady and she seemed a nice enough woman, so I bought her a couple of drinks, but then went home (alone). The next day I was so embarrassed because she arrived at the office with a container of food for my lunch, as I had told her that I had to get my own food because I haven’t got a maid or a steady or anything like that. What do I do now ? The last thing I need is unwanted visits at work and polystyrene boxes of food.
Office Johnny

Dear Office Johnny,
How did this girl know where you worked? If she is clairvoyant, then I think you should keep her, my Petal, and cash up on all the winning lottery tickets she will predict for you. But if, on the other had, it was because you gave her your business card, then you have nobody to blame but yourself. If you don’t want to be followed up, don’t hand out your business cards. Of course you can always use someone else’s card (like everyone else)!


Camera Class: How to give your portraits a knock-out punch

by Harry Flashman

This week’s column is designed to make you look critically at your photos and see how to get some ‘punch’ into your portraits, in particular. Remember that the most common subjects in front of camera lenses are people, and yet for many photographers, the results of picture taking of loved ones, pretty girls or even one’s own family members can be disappointingly ‘flat’.

Take a look at the four pictures of people I have included this week and you will immediately see a common theme that runs through them all - these portraits fill the frame. There is no doubting who is the ‘hero’ in these shots.

Now let’s look at them and dissect what gives them that punch. It certainly is not eye contact, with the women, one does have eye contact, the other has her eyes closed. With these two photos, the common factor is that their faces fill the frame to almost overflowing. There is nothing else in shot. You are looking at a close-up portrait.

With the two photos of the men, you are again left in no doubt as to who is the hero. One shot has the frame filled with the sitter, the other shot, which has more dynamism, captures the man having filled his plate at the buffet, and his anticipation of eating it was caught on film. While there is another person in shot, she is very much a background item and that is all. Once more you are looking at a close-up portrait.

To immediately improve your shots, firstly walk up closer to the subject, but use a portrait lens (about 135 mm) if you have one, or use the ‘telephoto’ position if you are using a compact point and shooter.

The best technique is to look through the viewfinder (or at the digital screen) and physically walk in closer until the portrait begins to fill the frame to overflowing, if it is a straight glamour shot. Mentioning ‘straight’ reminds me, try to get the subject to stand at an angle to the camera, and not straight on. You are making a pleasing portrait, not a head shot for a passport!

The other factor to make sure you get that satisfying shot is to take a few frames. Not just one or two, but several. With flash photography, many people will close their eyes at the wrong moment, but you should get one that is usable out of every 12 shots. Remember to try a few portraits in the ‘landscape’ (horizontal) format too. Sometimes the different framing adds interest to the shot. This is something you should get used to doing with all shots, not just portraits.

Note that I did not mention lighting in this article. You can use shadow to emphasize shape and form, but three of these shots were taken with a simple on-camera flash.

However, you will find that your people shots will improve as soon as you move in closer and fill the frame to overflowing. Try it this weekend.


Dogs - Man’s best friend: Companion and Toy breeds (group 9)

Nienke Parma

All around the world dogs are kept for entertainment, their warmth and especially their companionship, something that is central to our relationship with them in present times. It is as if they can understand our emotions.

Cavalier King Charles Spaniel, famous for its friendliness.

Companion dogs consist generally of the smaller breeds, of which all have their ancestors in the other breed groups, although most were never used as working dogs. Well-known examples in Thailand are: Miniature and Toy Poodle, Maltese, Pekingese, Chihuahua, (Cavalier) King Charles Spaniel, Shih Tzu, French Bulldog and the Pug.

Their sizes became so small as a result of dwarfism, through selective breeding or both. Dwarfism occurred naturally in primitive dogs. And probably for their odd looks, such as their relatively big domed heads with big eyes and short-legs, they were kept as pets.

Companion dogs date back over 2,000 years on old Chinese paintings. Some of these breeds assumed an elite role such as the Pekingese in the Chinese Royal Court, the Japanese Chin of the Japanese Aristocrats and the King Charles and Cavalier King Charles Spaniels of the English Royal Court.

As most were solely bred for their companionship with humans, their characters should be easy-going and friendly. They should get along with adults and children as well as with other animals. And generally they do. They are soft little playful creatures. Nevertheless, very sensitive and sometimes fearful characters also exist. This together with often a lack of proper education, also something these little animals need, and misunderstanding of dog language on the part of their owners (many are treated more as children than as dogs), these little dogs can quickly turn into shaky, fearful, snappy creatures. Also over attachment occurs regularly, which can lead to anxiety problems when left alone. Many of the breeds are quite alert in their environment, barking at visitors and suspected danger.

For more information on dog issues, dog and cat boarding, training or behavior please contact LuckyDogs: 09 99 78 146 or www.luckydogs.info


Money Matters: False profits?

Part 2

Alan Hall
MBMG International Ltd.

From last week: Cobus realized that one of 4 situations can happen:
- Dividend Yields can be above the net mean and can actually still be increasing
- They can be above the mean, but be falling
- They can be below the mean but rising
- They can be below the mean but falling

Grouped this way performance data for these periods is very consistent: as you’d probably expect below average and rising or above average and falling are the most common scenarios (just under 60% of the time since 1946 and just over that since 1972). Also, as you’d expect, when the yield starts to fall (whether from above average or below average) returns are negative, volatility is high and the Sharpe ratio (risk/reward co-efficient) turns very ugly.

Is this coincidence? Dividend yields are driven by the expectations of the people running the businesses as to the future performances of those businesses in relation to the amount of capital employed (the stock price multiplied by the number of stocks). If the business prospects can’t keep pace with the stock price, the yield will fall. If there is a lot of fat in the business it will fall from a higher level. If it falls from a low level, then we’re in a nightmare scenario, indicating that the stocks might be overpriced, the future performance of the business might be none too clever and confidence may be turning increasingly negative. We’ve just moved into that pattern now and could be expected to remain there for up to 3 years.

The fact that we have just entered this phase should be seen as extremely negative and a cause for real concern -

“Distribution IV generates a consistently negative Sharpe ratio, suggesting that risk taken in this conditional distribution has historically been uncompensated by return in excess of the risk-free rate.”

Another indication is stock activity by business owners and SEC filings by connected persons show that those in the know are dumping stock at the fastest rate for 4 years, although that is more of a short term and less of a structural indicator than the one above.

Finally, technical analysts looking at the 200 day moving average trends are seeing indications that stocks are looking ugly and bonds are looking set for a reversal. Again technical indicators are notoriously unreliable in certain conditions but technicals, fundamentals and strong co-incidentals all point towards a big stock move down and a bond market rally. However you look at it, this does not look like an ideal time to be in the S&P 500.

We currently face an extremely dangerous juncture in world economic events as evidenced by the release of the US Federal Reserve’s last policy meeting and news of the record trade deficit in February. The minutes cited the Central Bank’s growing concerns about inflation, but downplayed the need for a faster pace of monetary tightening.

The minutes also revealed that several members had become less certain about their previous benign outlook for US inflation; while some said that the Fed’s pledge of a “measured pace” of rate increases should be dropped.

What is our view of the Fed minutes? Most mainstream economists have been fretting about the word “measured” for months. The minutes clearly state that they were considering dropping the word, yet there was no real reaction. These economists must have forgotten about last months’ issues? Our fundamental view remains that the worsening of the structural imbalances in the world’s largest economy and its growing need for daily capital will erupt at some point.

As we recently touched on in our criticisms of the Fed’s plans to allow the US$ to drift further down (copying an economic blueprint from Ireland, Israel and Greece), a weaker US$ is only part of the problem and the bigger issue is that domestic consumer spending/debt needs to be addressed.

The interest rate increases by the Fed are a step in right direction in this regard, but the extent of the leverage within the system means that using higher rates to control the supply of new money will merely cause major problems with imbalances elsewhere in the system. The danger is that the dam will spring leaks and every time one gets covered, 2 more will appear.

You can’t simply turn on and turn off inflation like a switch; over time the pressures build up, inventories become habitual, usage patterns become established so even a recession doesn’t necessarily dampen prices immediately, especially in a high risk environment when paper currencies and intangible assets are locked in a depressionary spiral.

Commodity prices can carry on rising long after the onset of a recession and this stagflation has been evidenced many times over the years and spiralling tangible assets and collapsing paper ones should be familiar to any students of the Great Recession.

We’re advisors and planners, not economists - we take the view that you don’t have to be right; just take the right investment action for whatever actually transpires - the scenarios could play out in a whole host of different ways right now (Heck, Saul could even be right, though we’re sceptical about Goldilocks) but the balance of probabilities is so unclear that making a call one way or another is very dangerous right now. We don’t see an economic happy ending to all of this, but we’re keeping our options open. An optimal portfolio now is one predicated around a very big ‘what if’ factor.

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Alan Hall on [email protected]


Life in the Laugh Lane: Match dot comedy (Chapter Three)

by Scott Jones

Okay, the final chapter of Great Expectations and Match dot com, an international online dating website. You can read the first two chapters at www.chiangmai-mail.com or I’ll trade you the back issues for a few good leads.

Match dot Don’tGiveUp Numbers Four, Five and Six bring their girlfriends to our meetings since they can’t or won’t speak English. I am immediately more interested in the girlfriends who I talk with and about my Match dot date, gesturing in her general direction while we all smile vacantly. Being addicted to oral communication, it’s incomprehensible to me how these couples I watch in Thailand can exist in silence. They eat together in stillness like two shadows in a library but without books. No conversation. No contact. Nothing. Methuselah sits stoically with his great-granddaughter who gazes off wishing she were on a swing set back at the playground thinking, “At least he has a wallet and may actually bite the dust before finishing dinner.” I love silence, but not as the only entr้e on the menu.

Match dot OkayOneMoreTime introduces me to my personal concept of Hell on Earth. She owns a tiny karaoke bar/restaurant right in the middle of a large cluster of tiny karaoke bar/restaurants on both sides of the street. Riding down the block is like slogging through bad radio stations with the volume stuck on Shrill. Being a performer/album producer, my music standards are rather high, though it’s fun to watch people joyfully destroy songs with their whooping and honking.

I sit at one of the four tables, in front of a video screen and a desk. Just to make sure the entire neighborhood can hear that her singers are the worst in Chiang Mai, she has speakers The Rolling Stones would be proud to own, normally used in soccer stadiums or to project messages to other planets. My ear drums are melting. My chest vibrates rhythmically as my ribs begin to separate. I love good loud sounds, but these are penultrasonic, the ones heard just before death, but death doesn’t come to save you.

She speaks to me every fifteen minutes like clockwork to determine if I need another Coke. I can see her lips move. (I imagine we’d soon be the same when her drums become lumps of callous and she can’t hear me, either.) This is how I now imagine Hell but without the flames. I scrape my ear drums off the table as she says goodnight. I can see her hand wave. Later that week, I can finally hear tuk-tuks again.

These days I’m done with Match dot com and still SINGLE, which stands for So I Never Get Lucky, Ever.

If you have a credit card, it’s a snap to join Match dot com, but after a couple of matchless dot com years, it’s a challenge to quit. I was required to resign in person at their home office in Plano on the plains of Texas between 2 to 3 p.m. on the first Tuesday of the month with a note from my mother. They finally accepted my resignation from the other side of the world after 2,379 progressively vehement, unanswered emails to any @ sign on their website, pressure from the credit card company and my mention of a burly Mexican visiting their office with a flame-thrower.