public health
mikethemadbiologist | November 18, 2009Friday, the NY Times described the relatively paltry efforts in cancer prevention, compared to those for heart disease. Not that researchers haven't been busy figuring out how to prevent various cancers:
Then, in 1999, he had a chance to do another breast cancer prevention trial, this time of an osteoporosis drug, raloxifene, or Evista, which did not have the cancer drug taint. It was to be compared with tamoxifen.
The $110 million study, involving 19,000 women, ended in 2006. The two drugs were found to be equally effective in preventing breast cancer, but with raloxifene there was no…
mikethemadbiologist | November 9, 2009You might think that a bill winding its way through Congress which would lift the ban on organizations using federal funding for needle exchange programs would be a good thing. And it would be a good thing, except for this little provision:
A bill working its way through Congress would lift a ban of more than 20 years on using federal money for needle exchange programs. But the bill would also ban federally financed exchanges from being within 1,000 feet of a school, park, library, college, video arcade or any place children might gather -- a provision that would apply to a majority of the…
mikethemadbiologist | November 9, 2009No, not that stuff (well, actually, yes, that stuff too, but I definitely don't want to know about it). One of the important tools in fighting infectious disease is disinfecting surfaces. Which brings me to a recent paper about cruise ships and cleanliness. In June 2006, 43 norovirus outbreaks occurred on thirteen vessels. Noroviruses can cause severe vomitting and diarrhea, and in children, particularly infants, can be deadly (also see Aetiology). In the paper, the authors decided to examine how often bathroom surfaces on cruise ships are cleaned:
Methods. Trained health care…
mikethemadbiologist | October 31, 2009"If the president's [budget] proposal is enacted similar to what he recommended, it will have a chilling effect on abstinence education across the country...We're in a race against time to keep these people in business"
So says Leslie Unruh, rightwing nutjob extraordinaire (and a driving force behind this). I'm not sure why anyone in the Coalition of the Sane should care, in light of these results of abstinence-only misinformation (italics mine):
In the beginning, the public-health community was open to the programs. The United States did, after all, have the highest teen pregnancy rate in…
terrasig | October 29, 2009No, this is not the same old beaten horse.
Revere at Effect Measure, one/some of the best public health writers on the web, has written a splendid piece on the difference between the two types of blogging in response to the denial of his registration at the Knight Science Journalism Tracker. Revere has intended to comment on their coverage of the Brownlee and Lenzer cover article on swine flu at The Atlantic.
I was going to pick out some excerpts but the whole post is so clearly written and important in its entire context that I refer you to read it in its entirety.
I don't believe that I…
ejohnson | October 27, 2009President Obama declared the swine flu epidemic a national emergency on Saturday, after more than 1,000 US deaths--over 100 of them children--were confirmed as linked to the virus. The Centers for Disease Control report that this is purely a step towards preparedness, but many are wondering how effective this measure will be in preventing the spread of H1N1 in light of recent vaccine shortages. David Dobbs of Neuron Culture points out why the current chicken egg-based system of engineering vaccines is "too slow, too glitchy--and apparently, not terribly accountable." The White Coat…
ddobbs | October 27, 2009A bit early yet, but as I'm traveling the rest of the month, here's my top 5 over the last month.
1. The Weird History of Adjuvants, in which we ponder the inclusion of eye of newt and such in vaccines, and the strangeness of the fact that dirty is good.
2. Why is the swine flu vaccine so late? Who are you to ask such a question? was a close runner-up despite appearing only yesterday. Includes bonus trash-talk from a Canadian.
3. Embargo? Embargo? The case of the missing swine flu paper In which rumor runs not just amok, but quite a bit of policy as well. A particularly interesting…
ddobbs | October 26, 2009In a disturbing post at ScienceInsider, Jon Cohen and Martin Enserink explain why the swine flu vaccine is running so late. Or at least they try to explain why it's so late. For while all the suppliers are running into problems, we're not allowed to know what they are.
The delays are substantial and critical. They leave us naked as the flu spreads through the country. The flu has now killed 1000 people, over 100 of them children. Even as this happens, the delivery dates keep moving back and the delivery amounts keep shrinking. As recently as a month ago, the CDC was telling us that we'd…
mikethemadbiologist | October 25, 2009For anything? Excluding very rare norovirus outbreaks, I can't remember ever reading about school absentee rates like these from Grafton, MA:
Grafton High School closed early today after more than a third of its students and more than a quarter of its staff stayed home sick. It is the only school in the state to close, according to public health and education departments, but absenteeism has been elevated some communities across the state. At the beginning of the school year, state officials urged schools to close only as a last resort during flu season and instead focus on keeping sick…
tsmith | October 22, 2009I've written previously about "chicken pox parties". These types of events are coming back into vogue (they were common in the days before the vaccine, when the only way to provide immunity was to be infected), as parents mistakenly believe that "natural exposures" to these pathogens are somehow superior--and safer--than vaccinations. Though the latest rage are "H1N1 parties", chicken pox parties are still around, and potentially being held at your local McDonald's by families connecting on the internet:
I am trying to put together a chicken pox party and am looking for someone to donate…
tsmith | October 21, 2009I realize that, despite the scientific evidence to the contrary, there is still a lot of fear and misunderstanding about vaccine safety. Two recent articles discuss this "epidemic of fear" and why it affects us all, the first here at Wired magazine, and the second here at the Gotham Skeptic. I especially like the second, which has some excellent points:
My pediatric practice is situated at the nexus of three Manhattan neighborhoods (the West Village, Chelsea, and the Meat Packing District) that seem to comprise just the right balance of wealth, edginess, and socio-cultural awareness that…
ddobbs | October 21, 2009
Nurses and doctors have won a victory in their battle for their "right" to infect patients with easily prevented pandemic influenza.
Judge Halts Flu Vaccine Mandate For Health Workers
via pandemicchronicle.com
Posted via web from David Dobbs's Somatic Marker
ddobbs | October 14, 2009 "The Brite Nightgown," from Donald Fagen's First And Only Solo Tour (2006) -
Dana Blankenhorn, who brings a distinctive mix of skepticism, intelligence, and gruff impatience to his flu coverage, digests some unsettling stats from the JAMA articles. Some of his highlights:
* Health care workers get little protection from fancy masks. Workers given ordinary medical masks had a nearly 1 in 4 chance of getting the disease. The same for those given fancy N95 fitted masks. Many medical workers have been resisting getting the shot.
* Hospitals must be prepared for extraordinary burdens in…
ddobbs | October 13, 2009
Mount Pisgah, diving into Lake Willoughby, way up noth
Vermont, my chosen and beloved place of residence, took the top spot last week in the Commonwealth's "State Scorecard" for healthcare, which ranks states based on access, quality, costs, and health outcomes.
For people who live elsewhere, this report adds one more thing to add to the list of Things That Make Vermont Cool. (This is a jump up from second place in the 2007 scorecard.) For people who live here, this report raises amazement -- and the feeling that it must be very bad indeed everywhere else.
Vermont's health system is a mess…
scientificactivist | October 12, 2009I recently had the pleasure of writing an op-ed piece about health care reform for my hometown newspaper, the Fort Worth Star-Telegram, and it ran in the paper today. You can check it out online here. I grew up reading the Star-Telegram, so this was an exciting opportunity.
My article discusses the need for robust health care reform in the form of a strong public option, comparing and contrasting my health care experiences in the US and the UK to build my case. For regular readers of my blog, you will note that this is a theme I have often explored.
I would have preferred that the Star-…
j7uy5 | October 12, 2009This is about chronic fatigue syndrome and the association with
XMRV. I apologize in advance for the provocative title, and the
subsequent gratuitous references to the Nobel Prize, but there is a
point to this.
Take a look at this summary of the "old-fashioned disease":
During the nineteenth century general paresis of the insane
emerged as a new psychiatric disorder which was extremely common and
completely devastating. While retrospective studies have found earlier
instances of what may have been the same disorder, the first clearly
identified examples of paresis among the insane were…
ddobbs | October 8, 2009Probably dreaming.
But these the rise of the public option and the fade of the flu sometimes seem so real.
swine flu, public option, healthcare reform
ejohnson | October 8, 2009In the use of immunopharmacotherapy to treat drug abuse, antigenic molecules are hitched to molecules of the drug to stimulate a future immune response against the drug itself; as DrugMonkey reported this week, a recently published paper offers hopeful evidence that it could be a potentially effective treatment against cocaine addiction, though he cautioned, "It is quite obviously not a silver bullet solution at present. And when you think about it a bit, it never will be." Later on, DrugMonkey looked at another study that tracked the contents of street ecstasy to determine how much actual…
mikethemadbiologist | October 8, 2009In the midst of all of the discussion about improving healthcare, one issue that has been neglected is the role of poverty in poor healthcare outcomes. One group that is hit particularly hard is the homeless. The Toronto Invasive Bacterial Diseases Network reports that the homeless are thirty times more likely to be diagnosed with pneumonia caused by Streptococcus pneumoniae than the population at large:
We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of…
ddobbs | October 5, 2009I've wondered many times, including out loud in Slate, why it's not common in the U.S. to give flu vaccinations at schools, so they could efficiently be given to the population (children) whose inoculation most effectively prevents epidemics or pandemics, as well as to anyone else who wanted one. Same place, procedure, and personnel every year. It would simply and speed things immensely, and save scads of money?
This story in the Times has me asking the question anew. Instead of a single date (or a few dates) in which people can line up and get their shots in an orderly, efficient process,…