public health
mikethemadbiologist | June 17, 2007There's an excellent article in the NY Times magazine about the problem of opiate addiction. One of the problems when distinguishing between patients and doctors who are trying to manage pain versus those who are dealing opiates is that there is no easy way to regularly track opiate prescribing.
I've discussed before how national databases, when privacy issues are properly addressed, are important for drug safety. One of the serious impediments to national health databases is that our healthcare system is so fragmented that electronic surveillance becomes very difficult (e.g.,…
mikethemadbiologist | June 14, 2007The misuse of cefquinome has been a pet peeve of mine. Well, I have a commentary in ASM's Microbe about this topic: "Cefquinome: when Regulation Collides with Biology."
It might be boring because I don't use, erm, colorful, blogtopian language, but it still might interest you.
tsmith | June 12, 2007 One of the most famous stories in all of epidemiology revolves around the very birth of the science, in the midst of a London cholera outbreak in 1854. At the time, the scientific community was divided over the cause of cholera and other diseases. The majority of them accepted the miasma theory, the idea that disease was due to corrupted air ("all smell is disease," noted sanitation commissioner Edwin Chadwick). This idea dates back to antiquity, and increased in popularity in the Victorian era. It's a great example of something that logically made sense, even though it was wrong.…
tsmith | June 11, 2007It's been awhile since I picked on the real science journalists (as opposed to we Daily Show-esque "fake news" sites). I don't mean to get down on them too much; I know that there are many out there who do an incredible job, but then there are also ones who write up articles like this one on how "...women in northern Europe evolved with light hair and blue eyes at the end of the Ice Age to stand out from the crowd and lure men away from the far more common brunette."
Ugh.
So especially for you infectious disease types, can you spot a glaring omission in this article: "Meningitis A…
mikethemadbiologist | June 10, 2007I'm usually loathe to rip into a top-notch economist like Brad DeLong, especially when he titles his post "An Unrealistic, Impracticle, Utopian Plan for Dealing with the Health Care Opportunity." But several things bothered me about that post.
What I've never understood about the entire healthcare debate is the need to invent completely new plans. My take on this is ultimately pragmatic: find a system that provides universal coverage and good healthcare and institute it. Much of Europe--including the dreaded French--have very good healthcare. Translate the damn documentation, slap a big…
tsmith | June 10, 2007Rwanda abolishes the death penalty:
Rwanda's parliament voted late on Friday to abolish the death penalty, a move that should clear the way for suspects in the 1994 genocide to be extradited back to Rwanda.
You might think that survivors of such a horrible genocide would want to see those who victimized them put to death, but the president of a group of survivors says otherwise:
Survivors of the slaughter welcomed the decision, noting that the death penalty had existed in Rwandan law before the genocide.
"It didn't deter people from picking up machetes to slaughter their fellows - that's…
tsmith | June 8, 2007 I previously mentioned Sierra Leone when discussing the effect of warfare on the emergence of disease. Sierra Leone has long been a country divided, and suffered through more than a decade of civil war (1991-2002) and decades of instability prior to that. Since the end of the war, changes have happened, but slowly. Most recently, the good news is that their Parliament voted to increase the age of marriage from 11 to 18 as part of a new childs' rights bill. However, they stopped short from taking action on another controversial area: female genital mutilation (FGM), otherwise known as "…
tsmith | June 8, 2007Well, this is a new low. I ran across this blog post from a few months back, discussing the Imus situation:
Anytime a person is negatively labeled because of gender or race, this affronts our shared human dignity. And we should be especially careful here, for this has not always been such an obvious evil. It took the civil rights and women's rights movements to raise our awareness, and the work is not yet finished.
Okay, sounds reasonable. So far. However, he continues:
There is another assault on human dignity at work in our midst, only this one based on geography. A whole class of…
mikethemadbiologist | June 7, 2007I like much of Matt Yglesias' writing. But he still doesn't appreciate how science and evolution affect public policy issues. As many of you know, three out of ten Republican presidential candidates stated that they don't believe in evolution at one of the presidential debates. Yglesias comments on Huckabee's response:
I see that Jamie Kirchick didn't care for the reply at all: "Sorry, but if someone believes in fairy tales, I think that's pretty relevant to their qualifications as president." But why? The core of Huckabee's answer is here:
It's interesting that that question would even…
tsmith | June 7, 2007 My office in the epidemiology department is located within the hospital. Therefore, every day when I walk into work, I pass by a sign like the one on the left. Like most states, Iowa has a safe haven law--a law that allows parents to leave a newborn infant at a designated site, no questions asked, without any threat of prosecution. These sorts of laws were developed in response to cases where babies had been left on doorsteps, or thrown in trash dumpsters, etc. Safe Haven laws, in theory, should prevent those kinds of abuses--the parents abdicate responsibility for the infant, who can…
tsmith | June 5, 2007Time journalist (and newly minted Nieman fellow in global health) Christine Gorman recently gave a talk at the Global Health Council's annual meeting. Christine discussed topics that get a lot of press--such as HIV/AIDS--and others that occasionally bubble up to the surface, such as malaria and non-infectious global health issues like female genital mutilation. However, she also noted stories that are rare or missing in mainstream health journalism--more on those after the jump.
First, she notes a dearth of stories that "cut across lines, across diseases, across silos." Much like the…
tsmith | June 5, 2007
Today is the sixth annual Hunger Awareness Day, sponsored by America's Second Harvest. All too often we think of hunger as something affecting other countries (which of course it does) and focus more on obesity than hunger in America, but we have a serious problem with it here in the United States as well. Some of the numbers:
⢠The A2H (America's Second Harvest) system served an estimated 24 to 27 million unduplicated people annually, with a midpoint of 25.3 million. This includes 22 to 25 million pantry users, 1.2 to 1.4 million kitchen users, and 0.8 million shelter users.
⢅
mikethemadbiologist | June 4, 2007Recently, I took pious gasbag Senator Brownback to task for, among other things, arguing that 'faith' plays a role in scientific inquiry. In a NY Times article about 'ethically-challenged' doctors who take part in clinical trials, I found this little gem:
Dr. Ronald Hardrict, a psychiatrist from Minneapolis who pleaded guilty in 2003 to Medicaid fraud. In 2004 and 2005, he collected more than $63,000 in marketing payments from seven drug makers. In an interview, Dr. Hardrict said it was "insulting" and "ridiculous" to suggest that income from drug makers might influence doctors' prescribing…
tsmith | May 31, 2007Just popping in quickly after I saw Klearchos' comment on the updated tuberculosis post. He notes on his website that the CDC has released additional travel information about the XDR-TB infected patient, including shorter flights made within Europe in addition to the intercontinental flights. However, Klearchos notes:
...there is a big "hole" in the information provided by the CDC since, nobody has answered yet the question about how he moved from Santorini to Mykonos. CDC doesn't say anything about that in its report!!
There is no direct flight between the two Greek islands so he must have…
tsmith | May 31, 2007Today is the kids' last day of school, and just happens to be an early dismissal as well, so I'll be busy with them and not tied to the computer this morning/afternoon. However, there are tons of good things to read elsewhere.
First, Orac has a long-awaited update on the Tripoli Six: the group of nurses and doctors accused of killing children in Libya by deliberately infecting them with HIV. The science exonerated them, but that didn't change the court outcome, and I've not seen updates until now.
Next, Revere writes about the H7N2 influenza outbreak in Wales, reminding us (as as I've…
tsmith | May 31, 2007In the comments to the XDR-TB update post, Scott suggested that bloggers were putting too much emphasis on whether the TB patient was stupid/arrogant/self-centered/whatever, and later that "waxing indignant is pointless." I started this as a response to those comments, but thought instead it might be an interesting conversation--is it pointless? Certainly indignation about this guy's behavior won't change what's happened. Indignation about creationists' abuse of science won't make them stop. Does it have a point? My thoughts on it below the fold.
So, my thoughts. I think there…
tsmith | May 30, 2007I blogged earlier about the Georgia man who globe-trotted while infected with XDR-TB. I wrote that post late Tuesday evening, and since then, a number of other details about his case have come to light--and they're not encouraging. In fact, this serves as a nice example of a convergence of a number of areas I've written about before--obviously, the evolution of antibiotic resistance and the terrible position it leaves us in, the politics and policies of quarantine/isolation (and how they'd be enforced), and the global spread of infectious disease, so I figured this would warrant another…
tsmith | May 30, 2007 I blogged back in March about World TB day, the theme of which was "TB anywhere is TB everywhere." We know that someone can simply hop on a plane halfway across the world, and be practically anywhere else on the globe in the span of about a day--and their bacteria and viruses are just along for the ride. This is particularly disconcerting when it comes to respiratory diseases, where fellow airline passengers may be coughing and sneezing all over you, or touching shared objects without washing their hands. This is also a scenario that's known to have spread SARS, and may spread a future…
tsmith | May 29, 2007 Scanning today's New York Times, I ran across this article on designing for the world's poor, which isn't really an issue I'd spent much time considering previously. From the article:
"A billion customers in the world," Dr. Paul Polak told a crowd of inventors recently, "are waiting for a $2 pair of eyeglasses, a $10 solar lantern and a $100 house."
The world's cleverest designers, said Dr. Polak, a former psychiatrist who now runs an organization helping poor farmers become entrepreneurs, cater to the globe's richest 10 percent, creating items like wine labels, couture and Maseratis.
"We…
mikethemadbiologist | May 25, 2007A couple of weeks ago, after I posted about a very serious emerging bacterial threat, KPC, I received an email from a reader with an elderly relative in the hospital with a very serious case of pneumonia caused by KPC. What he* told me is shocking.
The relative, who has had repeated hospital stays and a previous MRSA infection, was in the hospital for a week before any laboratory cultures were performed. That's right, a patient with practically every major risk factor for a multidrug resistant infection wasn't tested for a week. So this patient wasn't isolated, exposing other ICU patients and…