health care
milhayser | December 9, 2009
Last month the US government released new guidelines for breast cancer screening mammography, a revision which Orac writes has "shaken my specialty to the core." For most women, the guidelines now recommend beginning biennial screenings at age fifty, instead of annual screenings at age forty. Around the same time, a study came out which "suggested that low dose radiation from mammography may put young women with breast cancer-predisposing BRCA mutations at a higher risk for breast cancer." Get some perspective on Respectful Insolence before breaking out the snake oil. Then visit Andrew…
terrasig | December 7, 2009
An article by Paul Davidson in this morning's USA Today reminded me of another reason why we need health care reform in the United States, or at least a move away from employment-linked health coverage: temporary employees may soon comprise 25% of the national workforce.
An encouraging jobs report Friday underscored the growing prominence of temporary workers who some experts predict could constitute up to a quarter of the workforce in a few years.
A big reason employers shed a far-less-than-expected 11,000 jobs last month is that temporary staffing agencies found slots for 52,000 additional…
milhayser | December 4, 2009
On Wednesday, the NIH approved thirteen new embryonic stem cell lines for federally-funded research, with ninety-six additional lines still under review. These new approvals come as a direct result of the "Obama administration's new rules on federal funding for stem cell research, which reversed the Bush policy of prohibiting such funding in most cases." Read more about the new rules and a dismissed lawsuit against them on Dispatches From the Culture Wars by Ed Brayton. On Framing Science, Matthew C. Nisbet suggests that public attitudes toward stem cells are changing, and reminds us that…
revere | November 22, 2009Since the way Chinese public health officials traditionally save face is by covering their ass, when I hear things like this I don't automatically believe it:
"With initial efforts of containment, actually we not only reduced the impact of the first wave to China, but we also won time for us to prepare the vaccine" now being given to China's people, [Chen Zhu, China's health minister] said in an interview during the Havana meeting of the Global Forum for Health Research.
After the swine flu first appeared in Mexico last spring, China put Mexican visitors — and people from other countries who…
terrasig | November 19, 2009No matter how early I wake up, it's always five hours later in the UK and I'm overwhelmed by the thought that I'm already behind (I won't even get into the feeling I have when I think of our Australian readers).
So when I start the day reading my Twitter stream, it's usually populated by midday news from England. I follow the NHS - National Health Service - "one of the largest publicly funded health services in the world," and their superb health information site, NHS Choices.
This morning I saw this tweet about the launch of their new sexual health site:
@NHSChoices Our new sexual health…
milhayser | November 18, 2009
We often hear that "you are what you eat," but the relationship between what goes in our bodies and what our bodies make of it is really quite complex. On Respectful Insolence, Orac laments that "diet does not have nearly as large an effect as we had hoped" on the prevention of cancer, and that by the time we reach adulthood, dietary interventions may be too late. Elsewhere, Joseph on Corpus Callosum examines a new study which suggests that drinking coffee lowers the risk of hepatitis C progression in afflicted individuals. Bucking the study's correlative conclusion, he says it's "not…
denialism | November 16, 2009So who here has actually read the health care bill?. I've been devoting a bit of time each week to peruse more and more of it, and while there are endless obstacles to a complete understanding of it (including legalese and the annoying tendency of legislation to contain edits to other bills without including the text of the other bills being edited) it is telling that opponents of the bill are having some difficulty coming up with real criticisms of it. For example, the now infamous death panel fiasco was a willful misunderstanding of a completely wholesome concept, the idea that physicians…
milhayser | November 12, 2009
Sometimes, present circumstances can belie the uncertainty of the future. On Not Exactly Rocket Science, Ed Yong discusses experiments on "restraint bias" which show that many people overestimate their powers of self-control. He notes that "we're generally bad at predicting the future," arguing that those who feel the strongest are the most likely to risk temptation and defeat. On Respectful Insolence, Orac critiques the latest "kerfuffle over screening for cancer," which questions the value of routine screening. While early detection may seem like a no-brainer for an improved prognosis…
revere | November 12, 2009I don't know if the rest of the world laughs at the US, but I feel quite sure they at least shake their collective heads when they hear how we lack one of the most important non-pharmaceutical measures against pandemic flu: paid sick leave. Of course only those countries with a policy of paid sick leave would be shaking their heads. It turns out, though, that's just about everybody:
The United States is one of only five countries in the world without a national policy on paid sick leave, Dodd said.
"We're in the company - and I say this respectfully of these countries - of Lesotho, Liberia,…
milhayser | November 10, 2009
After hours of deliberation late into Saturday night, the US House of Representatives passed the long-awaited health care reform bill. While many Americans are elated at the new bill's passing, others are questioning the controversial amendment added that prohibits insurance coverage for abortions. Ed Brayton from Dispatches from the Culture Wars examines the compromise many Democratic Representatives made with Catholic bishops local to their constituencies in adding this amendment. Later on, Ed also criticizes what he calls "unruly behavior" exhibited by some House Republicans to delay the…
revere | November 10, 2009Nursing homes (Long Term Care Facilities, LTCFs) are a favorite hunting ground for respiratory viruses, including flu. They are open to the general community, where visitors and employees mingle freely with the residents. The residents are usually of an advanced age, have other sicknesses that make them vulnerable and often have less active immune defenses. So when the swine flu pandemic began at the end of April, the Public Health Laboratory at Ontario's Agency for Health Protection and Promotion ramped up their respiratory infection outbreak registration system with the prospect that LCTFs…
revere | November 9, 2009We only just got to the surgical/N95 mask article in the Journal of the American Medical Association (JAMA). We've been traveling and haven't been able to keep up with what others were saying, but we're sure it's been well covered by the usual suspects. So we'll just add our take here, for what it's worth.
As most readers here know, what kind of mask (if any) will best protect a health care worker or anyone else at high risk of exposure to people infected with influenza virus is a difficult question. We still remain unsure whether flu is transmitted mainly by large or small droplets. If most…
revere | November 8, 2009It looks like there's going to be some kind of health care reform bill, but we're not celebrating. It's legislation that could have been important and meaningful and instead is a neutered industry-friendly cup of weak tea with a Draconian anti-choice amendment. That Obama would disappoint us is no surprise. We expected it and predicted it during the presidential campaign. And we said we'd complain. And we are. Expecting it, though, doesn't prevent us from being disappointed and angry he has turned out to be lousy on things that count. He's not George Bush, we'll give him that. But no…
revere | October 25, 2009Al Franken may have made his name as a comedian on Saturday Night Live, but as a Senator (D-MN) he's a force to reckon with. In this clip from hearings this week he nails a witness from the right wing Hudson Institute pimping for the health care industry. Her claim? That health care reform would lead to more bankruptcies. He makes his point and thanks the witness, but she tries to score with a question of her own. Bad move. It turns out Franken knows the answer:
Smart, serious, prepared. Live from Washington, DC. It's not Saturday Night Live!
Addendum, 1 pm EST: Just had to take my son-in-…
awild | October 15, 2009Every year my part-time photography business does a little better than the year before. A few new clients, a few new venues, a few more visitors to my web sites. It's not a meteoric rise by any measure, but considering the current economic situation I am counting my blessings.
Naturally, of course, when business is good I muse about expanding it. What would it take to become a full-time professional photographer?
If I replaced all the time I spent running PCRs with time spent calling up potential clients and marketing my wares, and replaced the time I spent writing papers with time…
revere | October 13, 2009The online publication of three papers and a commentary yesterday in the Journal of the American Medical Association (JAMA; free access, links at bottom of post) provides some further data on what demand for critical care resources might be from the current swine flu pandemic. One paper reports on the Mexican experience, where mortality seemed unusually high but where access to services may have made the outcome worse. The papers from Canada are perhaps most pertinent to what might be experienced in the US and Europe. It appears that in terms of demand for ICU beds, the first wave from last…
revere | October 8, 2009A Catholic hospital system in Arkansas seems to have come up with an innovative solution to encouraging health care workers be vaccinated while allowing them the autonomy to make their own decision. When we last brought up this question one of our commenters said he'd like to see a button on health care workers that said, "I'm not vaccinated." St. Vincent hospital system seems to have figured out a way to do this while still protecting both the worker and the patient. The idea is surprisingly simple:
Given the choice between face masks or the seasonal flu vaccine, nearly all 3,200 employees…
revere | October 5, 2009In an earlier post I said I opposed mandatory vaccination for adults (but not for children), the one exception being for health care workers because they come in contact with people at high risk. My view then was that if you work in a health care institution and won't get vaccinated against flu, then you shouldn't come to work. Now I am re-evaluating my position as a result of some cogent and pragmatic comments from lawyer-bioethicist George Annas, professor of health law, bioethics and human rights at Boston University School of Public Health, and author of "The Rights of Patients." I know…
revere | September 30, 2009For the first time in medical history we may be seeing an influenza pandemic unfold in real time, but that doesn't mean we know what we are seeing. There remains some uncertainty about virulence, both in terms of how often it kills and how it kills when it does kill. You'd think both would be easy to determine, but those who have been following along know the problem of how often infection with this virus kills is made almost impossible by not knowing how many people it is infecting. But what about the question of how it kills? There are mainly three scenarios of interest: primary viral…
revere | September 25, 2009There's hopeful news about the possibility of an effective HIV/AIDS vaccine and a weird story from Canada about "preliminary results" saying that you are more at risk from swine flu if you get the seasonal flu vaccine. With flu, anything is possible, but that is more than a little counterintuitive and strikes me as unlikely. Nowhere else has reported a similar experience. Since we don't know the methods or the data or the limitations or much of anything else that could allow us to consider how much to weigh this as evidence I won't say any more about it.
While we do write about vaccines here…