CENTRAL LUZON
JUNE 19-25, 2014
AMY OTR OPHIC AMYO TROPHIC LA TERAL LATERAL SCLER OSIS SCLEROSIS Volume XVI
(ALS) STORY ON P.3
MANALANG, CITY OFFICIALS ATTEND 2014 GLOBAL TOURISM CONFERENCE IN SABAH STORY ON P.3
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EDITORYAL ANO BA ANG ALS NA KARAMDAMAN Binigyan natin ng daan ang pagtalakay sa sakit na ito na isa sa binibigyan ng pansin ng Netizens. May mga kilalang personalidad na nga ang nagbuhos ng tubig na may yelo o kumasa sa Ice Bucket Challenge. Ano ba ang significant sa pagbubuhos na ito ng tubig? Ito raw kasi ang nararamdaman ng isang may karamdamang ALS o AMYOTROPHIC LATERAL SCLEROSIS. Ang may ALS ay kahalintulad ng nararamdaman habang binubuhusan ng malamig na tubig na puno ng yelo, manhid ang katawan at temporarily hindi ka agad makagalaw. Ang pagbuhos ng yelo ay binigyan lamang ng pansin ng Netizens o Media dahil masaya at medyo kontrobersyal. Makakahila ng atensiyon sa madla. Pero ang layunin nito ay mangalap ng donasyon ang ALS Asociation upang magamit sa pagsasaliksik kung ano ang gamot sa karamdamang ito. Daan milyon na ang nakalap ayon sa report ng website nito, ngunit patuloy pa rin ang marami at mga kilalang tao sa buong mundo maging sa Pilipinas na nagbubuhos ng malamig na tubig na may yelo upang kumasa sa challenge ng humamon, subalit ito ay may kalakip na donasyon. Kung ikaw ay gagaya lamang at hindi ka magbibigay ng donasyon, maaari bang huwag mo nang sayangin ang mga yelo at tubig na ibubuhos sa ‘yo. Para sa kabatiran ng lahat ang ALS ay binigyan natin ng espasyo upang matalakay ito at nang mabatid kung ano nga ba ito. Ano ang simula, ang pagpapatuloy at ang huling mga yugto sa buhay ng isang may sakit na AMYOTROPHIC LATERAL SCLEROSIS (ALS). Ang magastos at puno ng hirap at sakit sa nalalabing buhay ng isang ALS Victim.
CENTRAL LUZON
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AMYOTROPHIC LATERAL SCLEROSIS (ALS) Amyotrophic lateral sclerosis (ALS)—also referred to as motor neurone disorder (MND), Lou Gehrig’s disease in the United States, and rarely Charcot disease—is a neurodegenerative disorder with various causes. ALS is characterised by muscle spasticity, rapidly progressive weakness due to muscle atrophy, and difficulty in speaking (dysarthria), swallowing (dysphagia), and breathing (dyspnea). ALS is the most common of the five motor neuron diseases. In the U.S., more than 5,600 are diagnosed every year, and up to 30,000 Americans are currently affected. ALS is responsible for 2 deaths per 100,000 people per year.[1] Median survival time from onset to death is 39 months, and only 4% survive longer than 10 years, although rare cases survive 50 years or more. Most die from respiratory failure, usually within three to five years from onset of symptoms.[2]
SIGNS AND SYMPTOMS The disorder causes muscle weakness and atrophy throughout the body due to the degeneration of the upper and lower motor neurons. Individuals affected by the disorder may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel function and the muscles responsible for eye movement are usually spared until the final stages of the disorder. Cognitive function is generally spared for most patients, although some (about 5%) also develop frontotemporal dementia. A higher proportion of patients (30–50%) also have more subtle cognitive changes which may go unnoticed, but are revealed by detailed neuropsychological testing. Infrequently ALS coexists in individuals who also experience dementia, degenerative muscle disorder, and degenerative bone disorder as part of a syndrome called multisystem proteinopathy. Sensory nerves and the autonomic nervous system are generally unaffected, meaning the majority of people with ALS will maintain hearing, sight, touch, smell, and taste.
INITIAL SYMPTOMS The earliest symptoms of ALS are typically obvious weakness and/or muscle atrophy. Other presenting symptoms include trouble swallowing, cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. About 75% of people contracting the disorder experience “limb onset” ALS, i.e., first symptoms in the arms or legs. Patients with the leg onset form may experience awkwardness when walking or running or notice that they are tripping or stumbling, often with a “dropped foot” which drags gently along the ground. Arm-onset patients may experience difficulty with tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock. Occasionally, the symptoms remain confined to one limb for a long period of time or for the whole length of the illness; this is known as monomelic amyotrophy. About 25% of cases are “bulbar onset” ALS. These patients first notice difficulty speaking clearly or swallowing. Speech may become slurred, nasal in character, or quieter. Other symptoms include difficulty swallowing and loss of tongue mobility. A smaller proportion of patients experience “respiratory onset” ALS, where the intercostal muscles that support breathing are affected first. A small proportion of patients may also present with what appears to be frontotemporal dementia, but later progresses to include more typical ALS symptoms. Over time, patients experience increasing difficulty moving, swallowing SEE ALS ON PAGE 7
MANALANG, CITY OFFICIALS ATTEND 2014 GLOBAL TOURISM CONFERENCE IN SABAH TARLAC CITY (CIO) – To be informed with the new developments in urban tourism promotion, Mayor Gelacio Ace Manalang together with other city government officials attended the 2014 Global Tourism Cities Conference (GTCC) organized by the Kuala Lumpur Tourism Association and Confexhub in Nexus Karambunai, Sabah, Malaysia from June 24 to 25, 2014. With a theme, “Tourism City Profiling – A Key Driver for and others which was also attended by around 500 government Sustainable Growth,” GTCC became a venue for discussions and officials, planning and development specialists, tourism and exchanges on experiences, success stories, new industry trends, hospitality service providers, decision and policy makers; and and in developing the product, market and even networks in the individuals engaged in the industry from across the region Other local government units which attended the conference promotion and development of the urban tourism industry and in were the City of Davao and Municipality of Samal. creating a sustainable Global Tourism City. Meanwhile, Manalang said that he is determined to develop Together with Mayor Ace were City Councilors Glen Troy Caritativo, Frank Dayao, Jojo Briones, Anne Belmonte and Senior the tourism sector of the city which is one of the vital factors in boosting the city’s economy. He said that improving the tourism Tourism Operations Officer Wilfredo Toldanes. Topics discussed were creating and managing heritage cities of the city as well as governance, infrastructure, peace and order for economic development, supporting social and economic and quality of services the city government provides will lure more growth of modern cities through strategic tourism products; investors to establish their businesses here and encourage tourists parks, landscapes, recreation as urban tourism products; to come over and explore the city or even to stay for good, incorporating mega events infrastructure into community consonant to its constant mission of achieving civic excellence. He said further that the knowledge and strategies they were infrastructure planning; waterfront infrastructure and urban tourism and the potential of secondary cities as a global tourism able to acquire from the conference will be applied in the improvement of the tourism of the city. city. The city is also giving incentives to businesses to boost The conference was supported by the Sabah Tourism Board, Sabah Ministry of Tourism, Culture and Environment, Isocarp tourism and investments.
2,030 jobseekers hired-on-the-spot in Labor Day, Independence Day job fairs in CL CITY OF SAN FERNANDO, Pampanga, June 25 (PIA) — A total of 2,030 applicants were hired-on-the-spot during the Labor Day and Independence Day job fairs in Central Luzon this year. “This represent a placement rate of 23.31 percent of the 8,707 in Cabanatuan City; Camp Servillano Aquino in Tarlac; capitol qualified applicants which is beyond the 15 percent target,” grounds in Baler, Aurora; and Candelaria, Zambales. Department of Labor and Employment Regional Director Ana Dione Moreover, 3,453 applicants participated in the Independence disclosed during the recent Mid-Year Planning and Assessment of Day employments fests held at the provincial capitol gym in Malolos Public Employment Service Offices (PESO). City, Bulacan; Rizal Triangle Multipurpose Court in Olongapo City; Among the positions filled up include customer service and municipal covered court in Castillejos, Zambales. representatives, sales clerks, waiters, production workers and factory “The PESOs, through private recruitment placement agencies, workers. were instrumental in facilitating the placement of 85,581 jobseekers Around 12,100 jobseekers trooped the Labor Day fairs which in the first half of 2014, representing an astonishing 80 percent were held in SM malls in Baliuag, Marilao, Pampanga, Clark, San placement rate out of 107,447 referred applicants,” Dione added. Fernando downtown, Tarlac and Olongapo; Megacenter The Mall (CLJD-PIA 3)
DTI to open two shared service facilities in Tarlac TARLAC CITY, June 11 (PIA) — Department of Trade and Industry (DTI) is set to open this week two shared service facilities (SSFs) in Tarlac in a bid to stimulate further economic growth in President Aquino’s home province. “The SSFs, which has the Association of Tarlac Organic Trading common production centers in order for Small and Medium Post Inc. as cooperator, are meant to improve instant ginger tea Enterprises (SMEs) in priority industry clusters gain access to better processing and organic herbs and spices processing. These are technology and more sophisticated equipment thereby increasing located in barangay Dolores and Carangian, both in the capital city, their competitiveness, consequently affecting their contribution to respectively,” DTI Provincial Director Agnes Ramirez said. the national economy,” Ramirez explained. “SSF is a strategy adopted to achieve the goal of the National In Region 3, majority of the equipment that have been identified Industry Cluster Capacity Enhancement Project which is to set up SEE DTI ON P.7 CENTRAL LUZON BANAT / JUNE 19-25, 2014
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Mga estudyante sa Paniqui, tumanggap ng school supplies mula sa NGCP PANIQUI, Tarlac, Hunyo 10 (PIA) — May 180 mag-a-aral ng Acocolao Elementary School sa bayan ng Paniqui ang tumanggap nitong Biyernes ng mga school supplies mula sa National Grid Corporation of the Philippines (NGCP). Ayon kay NGCP Central Luzon Corporate Communication Matatagpuan sa barangay Acocolao ang Concepcionand Public Affairs Officer Ernest Lorenz Vidal, bahagi ang Camiling 69kV transmission line. distribusyon ng kanilang Balik Eskwela project na naglalayong Bukod sa Tarlac, may kahalintulad na aktibidad ang isinagawa magbigay tulong sa mga host communities o yung may mga sa mga host communities sa Pampanga, Nueva Ecija, at Aurora. transmission facilities. (CLJD/LGCC-PIA 3)
Bagong kumander ng NOLCOM, nais ang patuloy na kolaborasyon sa iba’t ibang sektor upang matamo ang makatarungan, pangmatagalang kapayapaan CAMP AQUINO, Lungsod ng Tarlac, Hunyo 10 (PIA) — Hinimok ng bagong upong kumander ng Northern Luzon Command (NOLCOM) na si Major General Felicito Virgilio Trinidad Jr. ang iba’t ibang sektor- mula pambansa at lokal na pamahalaan hanggang civil society organizations at pribadong sektor na patuloy na suportahan ang Armed Forces of the Philippines (AFP) sa pagtamo ng makatarungan at pangmatagalang kapayapaan sa Rehiyon Uno, Dos, Tres, at Cordillera. Sa kanyang mensahe sa idinaos na turn of command rites nitong na iwan na ang kultura ng karahasan at yakapin ang kulutura ng Lunes, sinabi ni Trinidad na magiging katuwang nila ang mga kapayapaan at kaunlaran. stakeholders sa pagbibigay ng mga pangunahing serbisyo at iba Miyembro ng Philippine Military Academy Class of 1982, si pang mga programa’t proyektong pangkaunlaran sa mga malalayong Trinidad ay nagsilbing kumander ng Army 1st Infantry Division. komunidad upang gumanda ang buhay ng mga kababayan roon at Siya ang overall ground commander noong makipagbakbakan hindi maimpluwensyahan ng mga nalalabing miyembro ng New ang mga sundalo at pulis sa breakaway group ng Moro National People’s Army (NPA). Liberation Front sa lungsod ng Zamboanga nitong 2013. Sa pamamagitan aniya ng kanilang mga partner kanilang Kanyang pinalitan si Lieutenant General Gregorio Pio Catapang uudyukin ang mga natitirang NPA at iba pang armed groups sa lugar Jr. na napromote bilang Vice Chief of Staff. (CLJD/LGCC-PIA 3)
PhilHealth, DOH with City gov’t to hold simultaneous launching of ALAGA KA Program Tarlac City (CIO) - In order to provide the registered sector greater access to primary health care services, the Philippine Health Insurance Corporation and the Department of Health with the City government is set to hold simultaneous launching of a multisectoral advocacy campaign dubbed as “Alaga Ka Para sa Maayos na Buhay” or simply “Alaga Ka”. Program. ALAGA KA is a collaboration between PhilHealth, DOH, Local modification; screening services to detect breast and cervical Government Units and other stakeholders in the health sector to cancers; and digital rectal exam. make sure that indigent members and those from the near poor Mayor Gelacio “Ace” Manalang said during the launching at segment of the population are properly instructed on how to avail Tarlac State University on June 10 that before the end of his term, of these basic health services at the rural health units and health he plans to establish a City Hospital and to revive the ACE CARD centers where they reside. program. The move a is clear manifestation of the city governnment’s With the City Health Office led by City Health Officer Dr. Ma. continuous caring for the less privileged by making primary health Carmela Go all 76 barangays in the city will be ensured that they care effectively reach the poor through the various services of could reach Tarlaqueños especially those who live in remote areas. DOH, LGUs and PhilHealth through its TSeKaP or Tamang Serbisyo PhilHealth believes that through TSeKaP, poor families will be para sa Kalusugan ng Pamilya. more empowered to see a doctor and seek medical attention even TSeKaP provides consultations with a primary care doctor without an illness. and entitles them to a package of preventive services designed to They will also receive their updated member data record and be able to learn more of their PhilHealth benefits and entitlements keep them healthy and to detect as well any illnesses early on. Services include regular blood pressure monitoring; and how to avail of these through various seminars and counseling on breastfeeding, smoking cessation and lifestyle presentations.
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Retail group conducts store ops training in CL
CITY OF SAN FERNANDO, Pampanga, June 23 (PIA) — Around 120 individuals from 70 companies across Central Luzon recently took part in the store operations training of the Philippine Retailers Association (PRA) in Pampanga. Entitled “Store Operations: Modern Retail Approaches in Balmeo Salire stressed. Managing your Store towards Profitability,” the one-day activity PRA first came into being as the Chamber of Philippine was done in partnership with Department of Trade and Industry Department Stores and Retailers, Inc. in 1976. (DTI) with Independent Retail and Human Resource trainer Francisco In 1991, after winning the bid to host the 6th Asian Retailers Dela Cruz Jr. as speaker and facilitator. Conference and Expo, the bi-annual event of the Federation of Asian “We also hold retailer seminars but more on the fair-trade laws Retail Associations, the Chamber changed its name into PRA and like price tags and labeling but not on how to operate a store. So I, adopted the now famous shopping bag logo. Today, PRA has matured into a dynamic association with over myself is very interested to know more about the seminar brought by PRA that focuses on the operational side of the business,” DTI 300 member companies, covering the gamut of the distribution chain, in its fold —from retailers, mall and shopping center operators to Provincial Director Elenita Ordonio said. “There are lots of retailers in the provinces and most of them do traders/suppliers, manufacturers, distributors, and wholesalers, not have access to information and training programs. One of the among others. Recognized as a paragon of a genuine partner in nation building, things that we realized to upgrade the competitiveness of the provincial retailers is they need to be trained. There is no organization the PRA enjoys the distinction as the “Pulse and Voice of the that provides trainings aside from us,” PRA Secretary General Evelyn Philippine Retail Industry.” (CLJD/RBRP-PIA 3)
CG conducts clearing operations in Uptown Market TARLAC CITY (CIO) – The City Government of Tarlac conducted a clearing operation in the Uptown Public Market by the removal of structures occupied by illegal vendors situated in front of the market vicinity last June 30, 2014. The activity was conducted by authorities composed of the spaces around the Uptown Public Market were transferred to Public Order and Safety Office, City Economic Enterprise designated areas in the facilities of the market. Management Office, City Mayor’s Office - Construction, Maintenance and Electrical Section, City Environment and Natural Resources Office, with the assistance of the Tarlac City police. The operation came from a directive of Mayor Ace Manalang to clear and clean the market area occupied by illegal vendors insisting to illegally do business and situate themselves wherever they want that causes traffic and disorder. Manalang said: “Malaki ang tulong ng pagnenegosyo sa pagpapaunlad ng ekonomiya ng ating lungsod mas lalo na ng pamumuhay ng ating mga mamamayan, pero ilagay natin sa tama ang lahat, magiging mabagal ang pagusad natin kung magpapatuloy ang kawalan ng disiplina, at wala tayong pakialam sa ating mga batas, sa ating kapwa at sa ating kapaligiran.” “Disiplina at kaayusan ang susi sa kaunlaran,” Manalang concluded. Meanwhile, legitimate vendors who were placed in temporary
Anti-Rabies Vaccination TARLAC CITY (CIO) – The City Government of Tarlac thru the City Veterinary Office is giving free vaccination to prevent death and other risks caused by dog bites in the city. REPUBLIC ACT NO. 9482 or the Anti-Rabies Act of 2007 Section 4 of Anti-Rabies Act of 2007 which is the National declares the policy of the State to protect and promote the right Rabies Prevention and Control Program hereby mandate that there to health of the people. shall be a National Rabies Prevention and Control Program to be A system for the control, prevention of the spread, and implemented by a multi-agency/multi-sectoral committee chaired eventual eradication of human and animal Rabies shall be by the Bureau of Animal Industry of the Department of Agriculture. provided and the need for responsible pet ownership. SEE ANTI ON P.7 CENTRAL LUZON BANAT / JUNE 19-25, 2014
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ALS from P.3
other causes.
(dysphagia), and speaking or forming words (dysarthria). Symptoms of upper motor neuron involvement include tight and stiff muscles (spasticity) and exaggerated reflexes (hyperreflexia) including an overactive gag reflex. An abnormal reflex commonly called Babinski’s sign also indicates upper motor neuron damage. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin (fasciculations). Around 15– 45% of patients experience pseudobulbar affect, a neurological disorder also known as “emotional lability”, which consists of uncontrollable laughter, crying or smiling, attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion. To be diagnosed with ALS, patients must have signs and symptoms of both upper and lower motor neuron damage that cannot be attributed to
Although the order and rate of symptoms varies from person to person, eventually most patients are not able to walk or use their hands and arms. They also lose the ability to speak and swallow food, while most end up on a portableventilator, called a BiPAP. The rate of progression can be measured using an outcome measure called the “ALS Functional Rating Scale Revised (ALSFRS-R)”, a 12-item instrument administered as a clinical interview or patient-reported questionnaire that produces a score between 48 (normal function) and 0 (severe disability). Though there is a high degree of variability and a small percentage of patients have much slower disorder, on average, patients lose about 0.9 FRS point per month. A survey-based study amongst clinicians showed that they rated a 20% change in the slope of the ALSFRS-R would be clinically meaningful.[7] Regardless of the part of the body first affected by the disorder, muscle weakness and
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atrophy spread to other parts of the body as the disorder progresses. In limb-onset ALS, symptoms usually spread from the affected limb to the opposite limb before affecting a new body region, whereas in bulbar-onset ALS symptoms typically spread to the arms before the legs. Disorder progression tends to be slower in patients who are younger than 40 at onset, are mildly obese, have disorder restricted primarily to one limb, and those with primarily upper motor neuron symptoms. Conversely, progression is faster and prognosis poorer in patients with bulbar-onset disorder, respiratory-onset disorder, and frontot e m p o r a l dementia.CX3CR1 allelic variants have also been shown to modify the survival time and the progression of patients.
LATE STAGES
Although respiratory support can ease problems with breathing and prolong survival, it does not affect the progression of ALS. Most people with ALS die from respiratory failure,
usually within three to five years from the onset of symptoms. The median survival time from onset to death is around 39 months, and only 4% survive longer than 10 years. Guitarist Jason Becker has lived since 1989 with the disorder, while physicist Stephen Hawking has survived for more than 50 years, but they’re considered unusual cases. Difficulty in chewing and swallowing makes eating very difficult and increases the risk of choking or of aspirating food into the lungs. In later stages of the disorder, aspiration pneumonia can develop, and maintaining a healthy weight can become a significant problem that may require the insertion of a feeding tube. As the diaphragm and intercostal muscles of the rib cage that support breathing weaken, measures of lung function such as vital capacity and inspiratory pressure diminish. In respiratory onset ALS, this may occur before significant limb weakness is apparent. External ventilation machines that use the ventilation mode of bilevel positive airway ALS CONTINUATON ON P.7
DTI from P.3 and supplied are for processing. This include packaging machines, mechanical driers, industrial weighing scales, noodle making machineries,
ANTI from P.5 The program shall be a multi-agency effort in controlling and eliminating rabies in the country including the mass vaccination of dogs. Meantime, the CVO recently conducted free vaccination at barangay Balingcanaway where a case of death caused by dog bite was reported. Barangays Ligtasan and San Miguel were also given free vaccination. A barangay can avail of the said free vaccination by filing a request addressed to ABC President Allan “Manchoy”Manalang, and once
vegetable and meat slicers, metal craft machineries, milk extraction equipment, deep fat friers, stainless industrial tables, chillers, and freezers. “To ensure the
sustainability of the program, it is just fitting that it is adopted by a counterpart cooperator belonging to the private sector. The cooperator provides the location and means of managing
the use of these facilities and its maintenance and opens this facility for the use of fellow SMEs in the community,” Ramirez added. (CLJD/LGCCPIA 3)
the notice of vaccination is served to the requesting party, theCVO headed by Dr. Gabriel Tabamo Sr.with his staff will go to the barangay to conduct
vaccination. According to NidaBacsa of CVO, there were 40 walk-in clients being served while more than 200 on 3 barangays who first
requested for vaccination were injected. This activity will continue on a first-come-first-served basis until supplies last.
ALS from P.6 pressure (BiPAP) are frequently used to support breathing, initially at night, and later during the daytime as well. The use of BPAP (more often referred to as non-invasive ventilation, NIV) is only a temporary remedy, however, and it is recommended that long before BPAP stops being effective, patients should decide whether to have a tracheotomy and long term mechanical ventilation. At this point, some patients choose palliative hospice care. Most people with ALS die of respiratory failure or pneumonia. In late stages the oculomotor nerve that controls the movements of the eye, can be affected as can the extraocular muscles. The eye movements remain unaffected largely until the later stages due to differences in the extraocular muscles compared to the skeletal muscles that are initially and readily affected.
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CG conducts clearing operations in Uptown Market STORY ON P.5