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Imagine what Paula Spurlock must have been going through. Shortly after having a hip replaced in 2011, the trouble started. "I had horrible itching, really bad migraines and intense pain throughout my body," she said. "I couldn't take it. Every single thing in me itched." After many months and several trips to specialists, Spurlock was told it could be anything from food allergies to her medication. But no matter what she changed, the symptoms persisted and Spurlock resigned herself to a life of misery. "I just kind of thought that's what life was going to be like," she said...

Regular marijuana use is associated with favorable indices related to diabetic control, say investigators. They found that current marijuana users had significantly lower fasting insulin and were less likely to be insulin resistant, even after excluding patients with a diagnosis of diabetes mellitus. Their findings are reported in the current issue of The American Journal of Medicine. Marijuana (Cannabis sativa) has been used for centuries to relieve pain, improve mood, and increase appetite...

A co-author of a groundbreaking study documenting reductions in patient length of stay and overall costs from implementation of an antibiotic stewardship program using Bruker's MALDI Biotyper will share her observations at a Bruker symposium to be held during the upcoming American Society for Microbiology (ASM) General Meeting. The study, which is currently available in an online edition1, showed that the average length of stay was reduced by two days for participants in the antibiotic stewardship intervention group and overall costs were reduced by almost $20,000 per patient...

Potatoes and other white vegetables are just as important to a healthy diet as their colorful cousins in the produce aisle, according to the authors of a scientific supplement published in the peer-reviewed journal, Advances in Nutrition. Although green, red and orange veggies are often promoted as top nutrient sources, white vegetables are nutrient powerhouses in their own right and deserve a place on your plate...

UC Irvine Health urologists and health policy experts report in a new study that two written assessments that identify existing comorbidities - the patient-reported Total Illness Burden Index for Prostate Cancer (TIBI-Cap) and the physician-reported Charlson Comorbidity Index - can successfully target prostate patients who would not benefit from biopsy to discover possible cancer. The authors say that by taking comorbidities into consideration, it may not be necessary for men to have prostate biopsy...

Scientists at the University of California, Davis, detected the H1N1 (2009) virus in free-ranging northern elephant seals off the central California coast a year after the human pandemic began, according to a study published in the journal PLOS ONE. It is the first report of that flu strain in any marine mammal. "We thought we might find influenza viruses, which have been found before in marine mammals, but we did not expect to find pandemic H1N1," said lead author Tracey Goldstein, an associate professor with the UC Davis One Health Institute and Wildlife Health Center...

Young women tend to be less healthy and have a poorer quality of life than similar-aged men before suffering a heart attack, according to research presented at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2013. "Compared with young men, women under 55 years are less likely to have heart attacks. But, when they do occur, women are more likely to have medical problems, poorer physical and mental functioning, more chest pain and a poorer quality of life in the month leading up to their heart attack," said Rachel Dreyer, Ph.D...

Middle aged and out of shape? It's not too late to get fit - and reduce your risk for heart failure, according to research presented at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2013. Researchers ranked fitness levels of 9,050 men and women (average age 48) who took two fitness tests - eight years apart - during mid-life. After 18 years of follow-up, they matched the fitness information to Medicare claims for heart failure hospitalizations...

At a time when the U.S. health system is facing both an increasing demand for primary care services and a worsening shortage of primary care physicians, one broadly recommended strategy has been to increase the number and the responsibilities of nurse practitioners...

People diagnosed with cancer are more than two-and-a-half times more likely to declare bankruptcy than those without cancer, according to a new study from Fred Hutchinson Cancer Research Center. Researchers also found that younger cancer patients had two- to five-fold higher bankruptcy rates compared to older patients, and that overall bankruptcy filings increased as time passed following diagnosis. The study, led by corresponding author Scott Ramsey, M.D., Ph.D., an internist and health economist at Fred Hutch, was published online as a Web First in the journal Health Affairs...

Somatic cell nuclear transfer (SCNT) is a technique in which the nucleus of a donor cell is transferred to an egg cell whose nucleus has been removed, generating embryos that are almost an identical genetic match to the donor individual. For the first time, a team of scientists has used SCNT to produce human embryonic stem cells (hESCs). This milestone, published by Cell Press in the journal Cell, opens up new avenues for using stem cells to understand patient-specific causes of disease and for developing personalized therapies...

Continuous infusion of a novel agent not only halted the progression of Ewing sarcoma in rats, while some tumors also regressed to the point that cancer cells could not be detected microscopically, say researchers at Georgetown Lombardi Comprehensive Cancer Center. Their study, which will be presented at the 2013 annual meeting of the American Society of Clinical Oncology*, provides pre-clinical evidence necessary to initiate a clinical trial...

A clinical trial has shown that patients, and their physicians, are eager to jump into next-era cancer care - analysis of an individual's tumor to find and target genetic mutations that drive the cancer. Results of the study, CUSTOM, are being presented at the 2013 annual meeting of the American Society of Clinical Oncology* years before investigators thought they would be ready. CUSTOM is the first completed prospective clinical trial that used genetic analysis alone to assign cancer treatment for patients with one of three different cancers...

Long-term treatment of attention deficit/hyperactivity disorder (ADHD) with certain stimulant medications may alter the density of the dopamine transporter, according to research published in the open access journal PLOS ONE by Gene-Jack Wang and colleagues from Brookhaven National Laboratory and the intramural program at NIH. ADHD is commonly treated using drugs to target dysfunctional dopamine signaling in the brain, such as methylphenidate (commonly known as Ritalin)...

The combination of two different drugs for osteoporosis was found to increase bone mineral density (BMD) more than treatment with either drug alone, according to the results of a small clinical trial published in The Lancet. The combination, which included teriparatide, a bone-building (anabolic) drug, and denosumab, a targeted therapy to stop bone loss, also increased BMD better than previously reported with any available treatment in postmenopausal women with osteoporosis...

Exergaming (active videogaming) may provide an alternative type of exercise to prevent stationary behavior in children, a new study published in The Journal of Pediatrics claims. Obesity and physical inactivity levels in kids are significantly high - with less than 50% of primary school-aged boys and under 28% of girls reaching the minimum levels of exercise necessary to maintain proper health. Exergaming is using active console video games that track player movement to play the game, for example Xbox-Kinect, Wii...

New research conducted by researchers at the University of Vermont reveals that middle-aged men who engage in a lot of cardiovascular exercise are at a reduced risk of suffering from lung and colorectal cancer. In addition, those who exercise are less likely to die from prostate cancer (although their risk of contracting the disease remained the same)...

A long-term study of men with stage I seminoma, a common form of testicular cancer, suggests that surveillance for cancer recurrence, rather than additional chemotherapy or radiation therapy, is sufficient for the vast majority of patients who have undergone successful surgery for their cancer. In a new long-term study conducted in Denmark, researchers analyzed a national clinical database and found that 99.6% of patients who only underwent surveillance (following a successful surgery) were alive after 10 years of being diagnosed with testicular cancer...

A group of villagers is held in thrall by omnipotent rulers, who warn that misfortune will befall the inhabitants if they defy authorities. And then, one day, the emperor is revealed to have no clothes.

On a recent Friday evening in Kazakhstan’s cultural capital, Almaty, a small audience was transfixed by the story unfolding on the stage in Avalanche, a play by Turkish playwright Tuncer Cücenoğlu.

Avalanche is a tale of a village whose inhabitants walk on eggshells because their rulers have convinced them that if they flout strict rules governing their everyday lives, they will spark an avalanche that will engulf them.

A childbirth breaks the spell: as the rulers order a woman buried alive for going into labour without authorisation, the child is born. The commotion fails to bring down a disastrous avalanche, and the leaders are revealed to have lied and manipulated to keep the people in check.

The political parallels with Kazakhstan are unmistakable. A country led by an authoritarian president, Nursultan Nazarbayev, who has retained power for over two decades through methods that his critics say include sham elections, restrictions on political freedoms, and the silencing of dissent.

Airing this tale about the subjugation of personal and political freedoms to the whims of powerful rulers is provocative, and the Aksaray theatre troupe performing the play has left no doubt that it is sending a political message.

This is a play about how “fear does not let people fight for their rights,” Gulnar Amanzhanova, the troupe’s director, told the audience before the performance. “Maybe it’s necessary to get rid of that fear and fight for justice.”

Last spring the theatre performed Avalanche to raise money for the victims of social unrest in the town of Zhanaozen in December 2011, when 15 people died after police opened fire on protestors in violence that shook Kazakhstan to the core.

Last summer the troupe performed Avalanche again to draw attention to the plight of its founder, 61-year-old Bolat Atabayev, then jailed on suspicion of helping to orchestrate the Zhanaozen violence.

Atabayev is now free, absolved of charges soon after Amnesty International declared him a prisoner of conscience – but others, including opposition leader Vladimir Kozlov and dozens of inhabitants of Zhanaozen, are serving prison sentences on what their supporters maintain are politically motivated charges.

Aksaray – which is mainly a musical theatre troupe – did not initially have a political message in mind when it staged Avalanche, which it performs in Kazakh, long before the Zhanaozen turmoil. After the violence, the play assumed a new significance, the performers say.

“Why did the show change after Zhanaozen? We started to perform it differently. The show took on an edge,” actor Asan Kirkabakov told EurasiaNet.org after a recent performance. “I feel that this is my civic position. I have to perform this; I have to get this across to my audience.”

By a quirk of fate, Avalanche was first staged using a state grant allocated to Aksaray. At that time, Amanzhanova said, the troupe’s main source of funding came from the financial patronage of Kazakh oligarch Mukhtar Ablyazov, a political foe of Nazarbayev’s who lives outside Kazakhstan.

That funding has now dried up. Ablyazov is currently on the run from British justice, his whereabouts unknown since he fled the UK last year after a British court ordered him jailed for concealing his assets in a fraud case.

Ablyazov has also become tied up with the real-life drama played out in Kazakhstan over the Zhanaozen turmoil: Astana has accused him of bankrolling the unrest in a bid to overthrow the state, a charge he denies.

Using the arts to send political messages is nothing new, but in Kazakhstan the theatre has more usually been utilised as a platform for promoting messages favourable to Astana than as a forum for airing messages critical of the Nazarbayev administration.

Productions at state-funded theatres, which receive generous arts subsidies, are often lavish affairs that – whether by accident or by design – feed subtly into Astana’s nation-building efforts, such as the popular showpiece opera about national hero Abylay Khan, the 18th-century warrior revered as the founder of Kazakh statehood.

Shows like this use feel-good historical stories to boost patriotic sentiments, but the theatre has also been overtly used to foster loyalty to the modern-day politician who towers over Kazakhstan’s political stage: Two years ago a play called Deep Roots that lionised Nazarbayev in a mythologised version of his life was staged in Astana.

After the recent performance of Avalanche, the Aksaray actors held a question and answer session with the fascinated audience. They explained how they feel driven to perform a play.

“Our job is to have an impact on [public] consciousness,” Almas Azhabayev explained.

In the aftermath of the Zhanaozen rioting, authorities have cracked down on dissent, resulting in the closure of Kazakhstan’s most vocal opposition party, Alga! and the shuttering of independent media outlets.

Are the actors not afraid of suffering retribution from the authorities, one member of the audience asked – a pertinent question given that many who voiced solidarity with the protestors in Zhanaozen later faced unpleasant consequences.

“We have nothing to fear,” Kirkabakov replied. “We’ve done nothing illegal. We’ve done nothing against our authorities.”

*Editor’s note: Joanna Lillis is a freelance writer who specialises in Central Asia.

This story originally appeared on EurasiaNet.org.

As officials in Kyrgyzstan prepare to negotiate with their country’s largest investor in Bishkek this week, new details are emerging about how the Kyrgyz government wants to restructure the agreement covering operations at the country’s flagship gold mine.

Bishkek and Toronto-listed Centerra Gold are engaged in a protracted legal dispute over Kumtor, the largest gold mine operated by a Western company in Central Asia.

Earlier this year, a Kyrgyz state commission claimed Centerra owes approximately 467 million dollars for environmental damages. Then, in February, parliament gave Kyrgyz officials three months to negotiate a new operating agreement, which would be the third in 10 years.

Kyrgyz officials say the current agreement, negotiated under former president Kurmanbek Bakiyev in 2009, shortly before he was ousted amid violent street riots, was unfair. The company, which also operates a mine in Mongolia, argues that it negotiated in good faith with what was at the time the legitimate government, and has threatened to seek international arbitration.

It calls the 467-million-dollar claim — which other miners in Bishkek say is a negotiating tactic — “exaggerated or without merit.” Centerra officials also point out that the agreement gave the company confidence to invest almost one billion dollars in the mine since 2009.

Kumtor is critical to Kyrgyzstan’s economy. Last year the mine, which sits above 4,000 metres in the Tien Shan mountains, contributed approximately 5.5 percent of the country’s GDP. In 2011, a good year, the mine accounted for 12 percent of GDP and over 50 percent of industrial output. Earlier this month, Centerra announced its first quarter revenue rose 44 percent.

Negotiations are likely to focus on current operating agreement’s structure, a source close to the Kyrgyz side told EurasiaNet.org. Under the existing agreement, Kyrgyzstan owns close to one-third of the Toronto-listed company. That arrangement places Bishkek in a bind: if the government fines the company, it hurts its own potential dividends.

Bishkek is ready to divest itself of Centerra ownership, the source said, in return for “both a higher income stream and more direct control over operations at the mine.”

The current agreement “doesn’t allow the nation to properly exercise its function as a sovereign. It actually creates an internal conflict. The more they levy tax, the more they assess environmental penalties, the less revenue is available to them in dividends,” the source said, speaking on condition of anonymity due to the sensitivity of the negotiations.

“This structure may be very useful to Centerra, but it is very difficult to understand why, in 2009, the Bakiyev regime pressed for this structure. That reinforces the suspicions of corruption.”

Centerra has repeatedly denied allegations of corruption, and Kyrgyz authorities have not presented convincing evidence the company engaged in corrupt practices. But some believe the venal Bakiyev administration was eager to obtain stock options so it could one day sell them and embezzle the proceeds.

Kyrgyzstan’s shares are held by the state-run gold company, Kyrgyzaltyn. Kyrgyzstan “has every interest in seeing shareholder value maximised and Centerra run as a profitable and successful business,” Kylychbek Shakirov, Kyrgyzaltyn deputy chairman for economics and finance, said in a May 10 speech to shareholders.

Shakirov stressed that Kyrgyzstan is not seeking to nationalise the mine, but said his delegation was acting as a “responsible shareholder” by pushing for Centerra to use a new auditor (it has employed KPMG for a decade) and sideline a senior member of the board while he faces insider-trading allegations in Canada.

Shakirov also expressed “strong reservations” about proposals to offer senior Centerra managers pay raises, noting that in the past few years, compensation packages have risen “sharply as the company’s performance overall was falling.”

Centerra’s top five principals each earned, on average, over 1.6 million Canadian dollars in 2012, 56.7 percent more than they earned in 2010, according to the management information circular distributed at the shareholders’ meeting. Yet, over the past two years – while production has fallen and the company has faced repeated calls for nationalisation by some Kyrgyz politicians – the company’s value has fallen roughly 80 percent.

John Pearson, Centerra’s vice president for investor relations, told EurasiaNet.org that the two sides “are making progress” as they approach negotiations, which parliament has said must be completed by Jun. 1.

“The discussions with the government are ongoing. Most recently in our discussion with the government we recommended that they retain external independent advisors on both the financial and legal fronts and they have done so,” he said.

Bishkek is said to have hired DLA Piper, the law firm, and Price Waterhouse Coopers as advisors.

In recent weeks, increased waste rock movement at Kumtor has highlighted long-standing environmental concerns, some of the thorniest issues in the negotiations. Centerra points to studies – including several commissioned by Bishkek – that absolve it of wrongdoing.

But questions remain about whether an accelerated pace of melting ice at the high-altitude mine is being encouraged by extraction activities there.

As part of its approach, Bishkek is expected to push for a review of environmental compliance standards, while it considers ways of tightening its own legislation related to mining’s environmental impact in general.

*Editor’s note: David Trilling is EurasiaNet’s Central Asia editor.

This story originally appeared on EurasiaNet.org.