Tag Archives: illness

Shinzo Abe, Japan’s longest-serving leader, leaves office a diminished figure with an unfulfilled legacy

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ROBERT GILHOOLY/EPA

Craig Mark, Kyoritsu Women’s University

Japanese Prime Minister Shinzo Abe ended weeks of speculation about the state of his health by announcing his surprise resignation today.

The 65-year-old Abe was finally forced to concede to the ulcerative colitis intestinal disease that had brought his first brief term in office to an end in 2007.

After being treated with a new course of medication, Abe made a remarkable political comeback in 2012. He regained the leadership of the conservative Liberal Democratic Party (LDP), and led it back into government, three years after it was knocked out of power.

Abe easily defeated the weak and disorganised opposition parties in the 2014 and 2017 elections, and in 2018 secured an unprecedented third three-year term as LDP president, with his supporters speculating he could lead for yet another.

Abe was re-elected as LDP president in a landslide victory in 2018.
Takehiko Suzuki/AP

Partial successes in the economy, defence

Abe kept up this political success based around his core economic policy, prominently marketed as “Abenomics”. This comprised the three “arrows” of record stimulus spending, quantitative easing (printing money to buy assets), and attempts at deregulation.

Abenomics was partially successful at restoring mild economic growth, but this started to wane after consumption tax hikes last October. The country then slipped into recession with the coronavirus pandemic.

In foreign policy, the nationalistic Abe reinterpreted Japan’s pacifist constitution, passing bills in the Diet in 2015 to allow collective self-defence with its US ally — despite a lack of public support and large student-led demonstrations.

Accompanied by a sharp increase in defence spending, Abe’s long-held desire to change the constitution to allow even more assertive use of the Japanese Self-Defence Forces was left unfulfilled. In 2019 Upper House elections, the LDP and its coalition partners lost the two-thirds majority required to allow any constitutional referendum.

Despite this setback, the lack of a strong challenger within the LDP — as well as the failure of the opposition parties to pose any credible threat — allowed Abe eventually to become the longest-serving prime minister in Japanese history.

Deeper relations with regional states

Abe energetically pursued foreign affairs throughout his tenure, maintaining the key US alliance through presidents Barack Obama to Donald Trump.

He sought greater Japanese participation in regional security by promoting a “free and open Indo-Pacific” region, and in doing so, deepened Japan’s strategic relations with India, ASEAN and Australia.

Japan’s Self-Defence Force brought recovery equipment and personnel to help in Australia’s response to bushfires this year.
DAN HIMBRECHTS/AAP

Abe managed largely stable relations with China, Japan’s largest trading partner, but territorial disputes with Beijing, as well as with Russia and South Korea, also went unresolved. Relations with South Korea, in particular, reached a low point over their wartime and colonial history.

Abe nevertheless built on his image as a senior world leader, culminating in hosting the G20 summit in Osaka last year.



Read more:
Shinzo Abe’s latest cabinet reshuffle could transform Japan

A bungled response to coronavirus

Abe’s erratic response to the coronavirus caused a sharp decline in his authority this year. A massive stimulus spending program sought to limit the damage to the economy, but the overall public response by Abe’s government lacked clear direction.

Regional leaders such as Tokyo Governor Yuriko Koike pushed early for a national state of emergency, but Abe only reluctantly declared one in April — and it only lasted around a month. Abe also delayed making a decision to postpone the Tokyo Olympics until foreign delegations announced they wouldn’t attend.

Abe’s leadership was damaged by the government’s initial missteps in its coronavirus response.
Masanori Genko/AP

While Japan has fared relatively well dealing with COVID-19, there have been other ill-considered responses by the government. These included the widely ridiculed “Abenomasks” and the “GoTo Travel” domestic tourism campaign, which entrenched the public’s impression Abe was failing to respond energetically enough to the crisis.

Persistent political scandals also continued to erode Abe’s legitimacy.

From mid-June, Abe held no press conferences for nearly 50 days, and made few public appearances until the commemorations around the 75th anniversary of the end of the second world war in mid-August.

As his approval ratings dropped to their lowest levels since 2012, Abe made a series of hospital visits in recent weeks. This sparked media speculation over his health, which LDP officials vainly tried to downplay.



Read more:
How Shinzo Abe has fumbled Japan’s coronavirus response

Who will be the next prime minister?

Abe will stay on as caretaker until the LDP’s Diet members elect a new president sometime over the next two or three weeks. This person will then be confirmed as prime minister by a vote in the Diet.

Speculation about his successor was already building in anticipation of the end of his term in September 2021, but this has now been rushed forward.

Prime candidates include his main old rival, former Defence Minister Shigeru Ishiba, who enjoys the highest public approval ratings as an alternative leader. Fumio Kishida, the LDP policy council chief and former foreign minister, is widely considered to be favoured by Abe as his replacement.

Shigeru Ishiba is seen as a potential successor to Abe.
KYDPL KYODO/AP

Another long-standing ally, Chief Cabinet Secretary Yoshihide Suga may also be in contention, as could Defence Minister Taro Kono or Economic Revitalisation Minister Yasutoshi Nishimura.

Whoever is chosen by the LDP is unlikely to greatly change the direction of Japan’s economic and foreign policy. The new leader will have the ongoing responsibility of dealing with the persistent “second wave” of the COVID-19 pandemic and trying to engineer a post-pandemic recovery, while still burdened with record public debt and an ageing population.

Japan’s next prime minister will also soon face the judgement of the electorate, as the next national election is due by October 2021. The end of this patrician era of conservative politics has dramatically brought Japanese politics into an suddenly uncertain future.



Read more:
Why the fall-out from postponing the Olympics may not be as bad as we think


The Conversation

Craig Mark, Professor, Faculty of International Studies, Kyoritsu Women’s University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How does the Wuhan coronavirus cause severe illness?

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Allen Cheng, Monash University

We usually think of viral respiratory infections, like the common cold, as mild nuisances that pass in a few days. But the Wuhan coronavirus has proven to be different. Of those infected, around 2% are reported to have died but the true mortality is unknown.

There’s much we’re yet to learn about this new virus, but we know it often causes pneumonia, an infection of the lungs which produces pus and fluid and reduces the lungs’ ability to absorb oxygen.

Of the first 99 people with severe infection, three-quarters had pneumonia involving both lungs. Around 14% appeared to have lung damage caused by the immune system, while 11% suffered from multi-organ system failure, or sepsis.

Others are at risk of complications from being treated in hospitals, such as acquiring other infections.



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How contagious is the Wuhan coronavirus and can you spread it before symptoms start?

At this stage, we know some people develop only a mild infection, while others become critically ill, but the exact proportion of each is not yet clear.

Overall, there are four key ways the Wuhan coronavirus can cause severe disease – and some can occur at the same time.

1. Direct viral damage

For the SARS (severe acute respiratory syndrome) coronavirus, direct viral damage was probably the most common way the infection caused disease. This is likely the case with the Wuhan coronavirus.

Early studies have found the Wuhan coronavirus attaches to a particular receptor found in lung tissue. This is like a lock and key mechanism allowing the virus to enter the cell, and is the same receptor the SARS coronavirus used.

Viruses “hijack” the host cell’s mechanisms to make more copies of itself. Damage results from either viruses taking over the cell completely and causing it to die, or immune cells recognising the viral infection and mounting a defence, triggering cell death.

If large numbers of cells die, then the affected organ can’t function effectively.

Studies from patients who died from SARS coronavirus showed the virus caused damage to not only the lungs, but also other organs in the body. Early research suggests the Wuhan coronavirus can also damage other organs, including the kidneys.

2. Pneumonia

While we’re still piecing together the relationship between the Wuhan coronavirus and pneumonia, there’s much we can learn from influenza.

Influenza is a virus but it commonly leads to bacterial pneumonia – this is what’s known as a secondary infection.

It’s thought the influenza virus weakens the usual protective mechanisms of the lung, allowing bacteria to establish and multiply. This is especially true in children, older people and those with compromised immune systems.

Secondary bacterial pneumonia is more severe than influenza alone – in hospitalised patients, around 10% of those with influenza and pneumonia die, compared to around 2% of those who don’t have pneumonia.

The Wuhan coronavirus appears to cause pneumonia in two ways: when the virus takes hold in the lungs, and through secondary bacterial infections, however, the first way appears to be more common.

3. Sepsis

Sepsis is a serious condition that can be caused by many infections.

When we get an infection, we need to mount an immune response to fight off the pathogen. But an excessive immune response can cause damage and organ failure. This is what happens in the case of sepsis.



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What is sepsis and how can it be treated?

Although it can be difficult to determine whether organ damage from the Wuhan coronavirus is a result of direct viral infection or indirect “collateral damage” from the immune system, initial reports suggested around 11% of people severely ill with the Wuhan coronavirus experienced sepsis with multi-organ failure.

So far no drugs or interventions have been able to dampen this immune response. Although several treatments have been proposed for Wuhan coronavirus, none have yet been shown to work.

4. Complications of hospital care

Finally, patients who require hospital care may have complications. These include infections from intravenous lines (for drips/medication) or urinary catheters (flexible tubes inserted into the bladder to empty it of urine), pneumonia, or non-infectious complications such as falls or pressure sores.

Studies have found 10% of patients in hospital have some sort of health care-acquired infection, and around 5% have a pressure sore.

Hospitals work hard to try to prevent these complications, by making sure health care workers disinfect their hands and other equipment. However, complications still occur, particularly in patients who are debilitated from long hospital stays.



Read more:
1 in 10 patients are infected in hospital, and it’s not always with what you think

While most respiratory viral infections are mild, some can trigger serious complications, either directly or indirectly. It’s too early to tell how often this occurs with the Wuhan coronavirus. While we have initial data on those who were severely affected, many others may not have required medical care.The Conversation

Allen Cheng, Professor in Infectious Diseases Epidemiology, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What are parasites and how do they make us sick?

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Giardia is an example of a parasite you don’t want to catch. Symptoms can include diarrhoea, abdominal cramps, fatigue, weakness and weight loss.
From shutterstock.com

Vincent Ho, Western Sydney University

A parasite is an organism that lives in or on an organism of another species.

Three main classes of parasites can cause disease in humans: protozoa, helminths, and ectoparasites. Protozoa and helminths largely affect the gut, while ectoparasites include lice and mites that can attach to or burrow into the skin, staying there for long periods of time.

The majority of protozoa and helminths tend to be non-pathogenic (meaning they don’t cause disease) or result in very mild illness. Some, however, can cause severe disease in humans.



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Health check: the low-down on ‘worms’ and how to get rid of them

Faecal-oral transmission, where parasites found in the stool of one person end up being swallowed by another person, is the most common mode of transmission of parasitic protozoa and helminths.

The initial symptoms tend to be gastrointestinal symptoms like diarrhoea. When parasites invade the red blood cells or organs, the consequences can become more serious.

Protozoa

Protozoa are tiny single-celled organisms that multiply inside the human body.

The protozoa giardia, for example, has a classic two-stage life cycle. In the first stage, called trophozoite, the parasite swims around and consumes nutrients from the small bowel. In the second stage it develops into a non-moving cyst.

Cysts excreted in faeces can contaminate the water supply, and ingesting contaminated food or water results in transmission. Close human to human contact and unsanitary living conditions can promote transmission.

Symptoms of giardia can include severe or chronic diarrhoea, abdominal cramps, fatigue, weakness and weight loss.

Once the parasite has been diagnosed, it can usually be treated effectively.
From shutterstock.com

Other important protozoa are the plasmodium species. Plasmodium develop in mosquitoes, and infected mosquitoes transmit the parasite to humans by biting them. Plasmodium destroys red blood cells which impacts organ function and causes a disease in humans known as malaria.

Malaria causes the most deaths of all parasitic diseases. In 2017 it was estimated malaria resulted in 435,000 deaths globally, most of them young children in sub-Saharan Africa.



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How our red blood cells keep evolving to fight malaria

Helminths

Helminths, often called worms, are large multicellular organisms usually visible to the naked eye in their adult stages. As a general rule, helminths cannot multiply inside the human body.

One major group of helminths are flatworms. Flatworms literally have flattened soft bodies. Their digestive cavity has only one opening for both the ingestion and removal of food. It’s thought 80% of flatworms are parasitic.

Tapeworms are one type of flatworm. The most common human tapeworm in Australia is the dwarf tapeworm. The prevalence of dwarf tapeworm in isolated communities in northwest Australia is estimated to be around 55%.

Infestation in humans comes from ingesting dwarf tapeworm eggs. Transmission from person to person occurs via the faecal-oral route. As with other parasites, the major risk factors are poor sanitation and shared living quarters. Symptoms include diarrhoea, abdominal pain, weight loss and weakness.

Some parasites, like plasmodium, which causes malaria, are transmitted to humans via mosquito bites.
From shutterstock.com

Another major group of helminths are nematodes, commonly known as roundworms. Nematodes are the most numerous multicellular animals on earth and can be found in almost every environment. Unlike flatworms, they do have a digestive system that extends from the mouth to the anus.

More than 50% of the world’s population are thought to be affected at one point during their life by at least one of six main classes of nematodes.

The eggs or larvae of these nematodes usually develop in soil before being transmitted to the human host. For this reason these nematodes are often called soil-transmitted helminths. A good example are hookworms which infest humans by penetrating the skin from contaminated soil. So wearing appropriate footwear is an important way to prevent hookworm transmission.



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The pinworm Enterobius vermicularis has a different life cycle to the other nematodes. Pinworm larvae develop in eggs on the skin near the anus or under the fingernails.

Pinworm, also known as threadworm, is the most common helminth parasite in Australia. Itching around the anus is a major symptom of pinworm. Pinworms are easily passed from one person to another and it’s common for entire families to be infested.

Ectoparasites

The term ectoparasites generally refers to organisms such as ticks, fleas, lice and mites that can attach or burrow into the skin and remain there for long periods of time.

Scabies, for example, a contagious skin disease marked by itching and small raised red spots, is caused by the human itch mite. Scabies usually is spread by direct, prolonged, skin-to-skin contact.

Head lice are small, wingless insects that live and breed in human hair and feed by sucking blood from the scalp.

Head lice, a type of ectoparasite, are common in children.
From shutterstock.com

Prevention and treatment

Some parasites can lie dormant for extended periods of time. This can make the diagnosis of parasitic infestation challenging as there may be no symptoms, or symptoms can be vague and non-specific.

The good news is we have very good medications to treat many different kinds of parasites once they’ve been diagnosed. These medications do have side effects but on the whole are very effective.



Read more:
Six human parasites you definitely don’t want to host

Treatment of parasites should be accompanied by preventative strategies such as improving sanitation and ensuring the availability of appropriate clothing and footwear in affected areas.

The World Health Organisation has recommended periodic medical treatment (deworming) to all at-risk people living in endemic areas, but widespread implementation remains challenging.The Conversation

Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Does your mental state affect recovery from illness and disease? We asked five experts

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A positive mindset can affect some aspects of disease, but grief is normal and to be expected.
from http://www.shutterstock.com

Alexandra Hansen, The Conversation

Many of those who’ve suffered from illness or disease would have received the advice to “stay positive”. Is this sage advice that can truly have a positive effect on health, or an added burden for someone who is already suffering – the need to also feel good about it?

We asked five experts in various fields whether a positive mindset can affect outcomes for those suffering from illness and disease.

Five out of five experts said yes

However, they had some important caveats. It depends on the disease – for example, one expert said studies in cancer have not found positive thinking affects disease progression or the likelihood of early death.

And while our mental health can have powerful effects on our physical health, the perceived need to “stay positive” can be an added burden during a difficult time. So it’s also important to remember grief is normal.

Here are the experts’ detailed responses:

If you have a “yes or no” health question you’d like posed to Five Experts, email your suggestion to: alexandra.hansen@theconversation.edu.au

Erica Sloan is a member of the Scientific Advisory Board of Cygnal Therapeutics. Jayashri Kulkarni receives funding from the NHMRC.The Conversation

Alexandra Hansen, Chief of Staff, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Recuperation

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This is a post I’m putting up at all my Blogs, even though that particular Blog may be unaffected due to scheduled posting, etc. Blog posts may be down a little at the moment and that for the last week or so. I have been ill with various illnesses and complaints for the last several weeks, so I have now decided to take the next week off from most Blogging activities in an attempt to rest and recover – if I can while still actually doing my very physically demanding actual job in the real world. I hope to return to Blogging full time in about a week’s time.