Category Archives: Public Health

Jenny McCarthy: “Playmate,” Co-Host on “The View,” & “Medical Expert”. Well, 2 Out of 3 Ain’t Bad.

Jenny McCarthy, courtesy Playboy Enterprises

Jenny McCarthy, pictured above, is not a medical expert. After she became convinced that her son’s autism was triggered by vaccines, the actress, model, and “Playmate” associated herself with Generation Rescue, which promotes the unfounded anti-scientific belief that autism is caused by vaccines. McCarthy has appeared on Larry King Live, in 2008, Youtube here, Oprah and currently co-hosts “The View,” a talk show on daytime television on the ABC network. ABC’s decision to hire her in this role was criticized in NJ.com, PLOS, the LA Times.

The problem is one needs nothing more than notoriety to become a pundit, and “pundits” who speak convincingly while they utter nonsense can cause real harm.

Continue reading →

DebateGraph.org: visualization and collaboration tools

Debategraph is a software tool with applications for addressing, defining and attacking many types of problems in many ways. Here’s one of their interactive maps on epidemiology:

Who’s using it? Apparently the White House, CNN, the Prime Minister and the Foreign Office in the United Kingdom. A concept map explaining DebateGraph itself appears below.

Continue reading →

Dr. Irwin Redlener on President Obama’s State of the Union Address:

“The president made a strong case for universal early education in America, along with raising the minimum wage. But his commitment to eliminate extreme poverty and save children from preventable deaths was focused on children of the world. All of this is, of course, laudable. But we hoped to hear a commitment to eliminate child poverty in America, where more than 16 million children are facing grim challenges right now that undermine their futures – and the future economy of the nation. Poor kids are not a voting block and they don’t have the capacity to influence public policy. The sooner the president engages the full power of his office in the battle to eliminate child poverty, the better the prospects of every child reaching his or her potential.”

Statement by Irwin Redlener, MD on President Obama’s State of the Union Address

Via Dr. Irwin Redlener’s blog. Dr. Redlener is the co-founder and president of The Children’s Health Fund.

Researchers posit new disease vector: trans-oceanic airbone pathogens: NPR

Cleaning Up In Hospitals

Germs on the Hand. Courtesy Talk is Cheap

5% of hospital patients develop an infection. And the majority of those infections are acquired from the hands of Health Care Providers.

Medicare pays 40% of the nation’s hospital bills. (This, in and of itself, is an argument for a single payer system – one single payer already pays 40% of hospital bills. And it’s the Government.) However, Medicare does not reimburse hospitals for their mistakes. It shouldn’t. If I borrow your car, and run out of gas, it’s my fault, not yours. Note that this is an example of the government doing something right.

Because of this policy decision, medical accidents went from being a source of hospital revenue to a massive financial drain. Medical institutions were forced into the business of disease prevention, at least once people were in their care.

According to the Committee to Reduce Infection Deaths statistics, (PDF) hospital acquired infections kill more people in America than AIDS, Breast Cancer and Auto Accidents combined. What is worse is that 5% of the patients in hospitals acquire infections in the hospital, and the vast majority of the patients that acquire such infections in hospitals get them from the hands of health care providers.

More details after the click.

Continue reading →

Don’t wealthy Americans need emergency rooms, too?

httpv://www.youtube.com/watch?v=9H4u-trTvNk

New York City politics is often about real estate value, and distance is often measured in travel time. A hospital three miles away in suburban or rural Arizona might be reachable, on a flat straight road with no traffic, in an ambulance with lights and sirens running, in well under three minutes. Not in New York City.

In 2010, in financial trouble after serving the sick and dying for 161 years, a deal was brokered – the details don’t matter – in which the overwhelming majority of the hospital’s grounds would be replaced by luxury housing, plus the fig leaf of an “urgent care center,” which, it was implied, was the functional equivalent of a hospital emergency department. St. Vincent’s did have, while it was in operation, a full-on top tier emergency department, with specialists, operating rooms – like, in fact, a fully accredited emergency department designated as a trauma center in a major American city. The replacement “urgent care center” – to be frank, this phrase as used is more deceptive than illustrative – would not, is not, and will not be able to treat gunshot wounds, heart attacks – those patients will have to be transported to the nearing hospital designated, accredited, equipped and trained as a trauma center.

So the people buying this “luxury” housing will be buying housing without one of the characteristic amenities of modern big cities: outstanding hospitals with emergency departments. Unless, of course, they’re lucky in avoiding traffic, or in good enough shape to withstand a long ride in an ambulance. It is not without some shame that we note that New Yorkers, whatever their other virtues, are inured to the signals of emergency vehicles: we don’t rapidly pull over to make way for ambulances, police vehicles, or fire trucks. Our chronic housing shortage being what it is, people will undoubtedly buy or rent apartments on the former St.Vincent’s site anyway, but we wonder if the lack of a readily available emergency room will affect prices. From http://healthcarevote2013.com:

Few healthcare issues are as urgent in New York City as hospital closures. The Year Of The Healthcare Vote 2013 was created in response to the closure of St. Vincent’s Hospital in 2010. St. Vincent’s had served New York for 161 years, and will be replaced by luxury condominiums. Since that time hospitals have been closing at an alarming rate throughout New York City – in particular those that serve working and middle class New Yorkers.

In 2013 New Yorkers will choose a new Mayor, 51 members of City Council, a Comptroller, a Public Advocate and five Borough Presidents. Access to quality healthcare is a life and death concern for New Yorkers; Healthcare Vote 2013 will bring awareness and accountability to healthcare issues in New York City’s upcoming elections.

Healthcare Vote 2013 will work to advance discussions on all healthcare issues important in our communities and ask candidates to pledge to preserve publicly accessible hospitals and expand public healthcare in the neighborhoods they represent including restoring a hospital to the Lower West Side of Manhattan.

Please get involved.

PFCs, chemicals widespread in children, appears to impair children's immune systems

This is Jon Hamilton‘s excellent explanation of this disturbing risk possibility, reported yesterday in JAMA. From Common Chemicals Could Make Kids’ Vaccines Less Effective

The more exposure children have to chemicals called perfluorinated compounds, the less likely they are to have a good immune response to vaccinations, a study just published in JAMA, the Journal of the American Medical Association shows.

The finding suggests, but doesn’t prove, that these chemicals can affect the immune system enough to make some children more vulnerable to infectious diseases.

For decades now, PFCs have been used in nonstick coatings, stain-resistant fabrics and some food packaging. And because they persist in the environment for years, they have become common around the globe.

“You can find them in polar bears,” says Dr. Philippe Grandjean, the study’s lead author who works at both Harvard and the University of Southern Denmark.

Studies in animals have shown that PFCs can weaken the immune system.

Grandjean wanted to know whether this was happening in children. So he led a team that studied nearly 600 kids in the Faroe Islands, which lie about halfway between Scotland and Iceland.

The Faroese have levels of PFCs similar to those of U.S. residents. Grandjean figured if the chemicals were having an effect, it would show up in the way kids’ bodies responded to vaccinations.

Normally, a vaccine causes the production of lots of antibodies to a specific germ. But Grandjean says the response to tetanus and diphtheria vaccines was much weaker in 5-year-olds whose blood contained relatively high levels of PFCs.

“We found that the higher the exposure, the less capable the kids were in terms of responding appropriately to the vaccine,” Grandjean says. The results raise the possibility that “the immune system is not really developing optimally.”

The health effects of PFCs are still poorly understood. But in the past decade, government scientists have become increasingly concerned about possible links to developmental problems in children.

If this turns out to be coincidental, without causal connection, all well and good. But if there’s something here that, on the precautionary principle, would lead us to ban or limit PFCs – it’s likely we’ll do it first in more affluent countries. This may protect some children – but if the children of entire continents are left unprotected, not only are those children at direct risk, their communities may constitute international disease paths. In a world with routine international travel and shipping, diseases don’t need green cards.

Drug companies to be required to report all payments to physicians

Robert Pear, who has always provided excellent coverage of public health issues for The Times, reports that the administration plans to require drug and medical equipment suppliers to report all payments – down to coffee and bagels – made to physicians and medical personnel – and make them accessible to the public via the web. We can’t imagine that there’s a plausible argument that anyone has a privacy information in this data.

What would your reaction be if your physician prescribed a particular medicine, and then found out that your doctor was taking thousands of dollars from the drug’s manufacturer? By the same token – if you found out that your physician accepted no gifts at all from drug prescribers, might that not enhance your view of that physician’s credibility? From Robert Pear’s U.S. to Force Drug Firms to Report Money Paid to Doctors:

WASHINGTON — To head off medical conflicts of interest, the Obama administration is poised to require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment. Many researchers have found evidence that such payments can influence doctors’ treatment decisions and contribute to higher costs by encouraging the use of more expensive drugs and medical devices.

Consumer advocates and members of Congress say patients may benefit from the new standards, being issued by the government under the new health care law. Officials said the disclosures increased the likelihood that doctors would make decisions in the best interests of patients, without regard to the doctors’ financial interests.

Large numbers of doctors receive payments from drug and device companies every year — sometimes into the hundreds of thousands or millions of dollars — in exchange for providing advice and giving lectures. Analyses by The New York Times and others have found that about a quarter of doctors take cash payments from drug or device makers and that nearly two-thirds accept routine gifts of food, including lunch for staff members and dinner for themselves.

The Times has found that doctors who take money from drug makers often practice medicine differently from those who do not and that they are more willing to prescribe drugs in risky and unapproved ways, such as prescribing powerful antipsychotic medicines for children.

In Upstate NY, Gas Drilling Debate Gets Local

Tweet Maria Scarvalone’s coverage illustrates how rapidly and intensely opposition to “fracking” has spread in communities in Upstate New York. Her coverage suggest that the fracking question

“It’s like playing Russian roulette with your water supply.”

has energized voters – against the “fracking” scheme. Scarvalone’s piece makes the probability of “fracking” coming to pass seem unlikely. Add to that other constituencies who are likely to oppose fracking: banks, property owners, title insurance companies, attorneys and real estate professionals will influence the ongoing debate over “Fracking.” Continue reading →

Impacted Nurse: "Critical Incident Stress Debriefings" Re-Examined

Tweet A look at psychological first aid replacing critical incident debriefs. may tell us a bit more about assuming that all not people respond the same way to a given incident – or to a given therapy. Or maybe they do. From the brilliant blog Impacted Nurse, quoting in turn from Vaughan Bell at Mind Hacks:

“This technique is now not recommended because we know it is at best useless and probably harmful, owing to the fact that it seems to increase trauma in the long-term.

Instead, we use an approach called psychological first aid, which, instead of encouraging people to talk about all their emotions, really just focuses on making sure people feel secure and connected.
Psychological first aid is actually remarkable for the fact that it contains so little psychology, as you can see from the just released psychological first aid manual from the World Health Organisation.
You don’t need to be a mental health professional to use the techniques and they largely consist of looking after the practical needs of the person plus working toward making them feel safe and comfortable.

No processing of emotions, no ‘disaster narratives’, no fancy psychology, its really just being practical, gentle and kind.”

Via Mindhacks – Escaping from the past of disaster psychology. As noted above, via Impacted Nurse.

Cats, Mice, and Sustainable Energy

“Join me in setting a new goal: By 2035, 80 percent of America’s electricity will come from clean energy sources.” – President Barack Obama, State of the Union, January 25, 2011.

When a mouse makes noise, only other mice and local cats take notice. When a lion roars, however, everyone notices; other lions, elephants, zebras, gazelles, smaller cats, mice ….

New Jersey is one of 27 states, which, like the District of Columbia, have a Renewable Portfolio Standard, or RPS, mandating that by a certain date, a specific target of a renewable energy capacity will be deployed. An additional five states have non-binding goals. (This are listed by the U. S. Dept. of Energy at Energy Efficiency and Renewable Energy.)

In New Jersey the RPS is 22.5%, about 1.6 gigawatts (GW), by 2021. New Jersey today, in January, 2011, has about 300 megawatts of renewable energy capacity. I am confident that New Jersey will meet, and possibly exceed its RPS goal. We started with 9.0 kilowatts (KW) of photovoltaic solar in 2001. We were up to 211 megawatts (MW), by the end of September, 2010, and we added an additional 24 MW in December, 2010. Even when you factor in 30 MW of biomass, 8 mw of wind power, and 1.5 mw of fuel cells, this is less than 20% of the goal of 1.6 gw. (This is shown at the NJ Clean Energy Program Renewable Energy Technologies page.) However paradigm shifts are systems phenomena. They occur at exponential rates. We went from 9.0 kw in 2001 to 211 mw in mid-2010, to 360 mw by the end of 2010. In December, 2010, we added an additional 10% – moving from 236 mw to 260 mw. We are hitting the handle of the hockey stick.

California’s RPS is 33% by 2030. In Texas, the RPS calls for 5,880 MW by 2015. California , New Jersey and Texas are the roaring mice in domestic US clean energy policy. And a cat – the lion in the Oval Office – the President of the United States – has listened to the mice in California, New Jersey, and Texas. Last night he roared.

Courtesy of the White House.

In his “State of the Union” address, January 25, 2011, President Obama set a lofty goal: “80% clean electric generation by 2035.” While I think we can do better – 100% clean renewable sustainable energy by 2025 – Obama’s goal is specific, measurable, achievable, realistic, and time-bound. It’s SMART. It’s also wise.

As a President should, Obama is thinking, and thinking long term. We at Popular Logistics wish him success because success for a President means a better future for the nation.

–

Two observations.

There is no such thing as “Clean Coal.” Even if we capture and sequester all the carbon dioxide produced from burning coal, which is expensive, there are still impurities, such as arsenic, lead, mercury, uranium, zinc in coal. And mining and processing coal is a very dirty business.
Nuclear is heavily regulated. We exercise tighter control over the wastes. In practice, nuclear power is arguably cleaner than coal. But in reality, things happen.

One question is “Can we achieve Obama’s Clean Electricity Goal?” But a better question is “How can we achieve this goal? ” My back of the envelope response is:

100 gigawatts offshore wind,
100 gigawatts land based wind,
50 gigagwatts solar,
75 gigawatts stored micro-hydro or biofuel, for when the sun isn’t shining and the wind isn’t blowing.

And as Amory Lovins, of the Rocky Mountain Institute, says, “The cheapest unit of energy is the ‘Negawatt’ – the energy you don’t have to buy.” How much can we reduce our energy requirements? How much can we gain by conservation?

Want Some Mercury With That Slice?

How’s about some arsenic? Whadda ya mean “toxic?” You got a problem wid my pizza pie?

Check out the Slice web-site at Serious Eats. Their Coal-Oven Pizzeria map shows about 20 coal-oven pizzerias in the New York City metropolitan area. While a coal fire may produce a perfect heat for baking pizzas, coal fires also produce mercury, arsenic, uranium, thorium, and other toxic heavy metals.

YUM!

No Thank You.

Does one drink red or white wine with mercury, arsenic, uranium, thorium, cadmium, aluminum, sulfur and all those toxins?

In the Mines

Coal. One of the most impure of fuels. A mixture of carbon, with impurities including uranium, thorium, aluminum, iron mercury, arsenic, sulfur, and methane. Carcinogenic, mutagenic, explosive. But it burns great. A magic rock. Just like Pandora’s mythical box.

Deepwater Horizon – Bombs and Hurricanes

Satellite Photo of Hurricane Alex, courtesy NOAA

Hurricane Alex has temporarily halted cleanup efforts (Reuters). Yet the oil continues to gush unabated. Using the Government’s “Improved Estimate,” 2.8 to 4.8 million barrels have gushed into the Gulf in the MONTHS since the April 20 explosion which killed 11 workers. The explosion and spill have destroyed fisheries, tourism, and profoundly disrupted the ecology of the Gulf. Given that the spill of 35,000 to 60,000 barrels per day continues unabated the extent of the damage is unclear.

movie net i am number four online

In “Blow Up the Well to Save the Gulf,” in the NY Times, 6/22/10, Christopher Brownfield, a former nuclear submarine officer, wrote, “President Obama needs to create a new command structure that places responsibility for plugging the leak with the Navy, the only organization in the world that can muster the necessary team. Then the Navy needs to demolish the well. … At best, a conventional demolition would seal the leaking well completely and permanently without damaging the oil reservoir. At worst, oil might seep through a tortuous flow-path that would complicate long-term cleanup efforts. But given the size and makeup of the geological structures between the seabed and the reservoir, it’s virtually inconceivable that an explosive could blast a bigger hole than already exists and release even more oil.”

President Obama instituted a 6-month moritorium on deepwater drilling. Judge Martin L. C. Feldman of United States District Court, appointed by President Reagan in 1983, stopped the moritorium, writing that the Obama administration had failed to justify the need for such “a blanket … moratorium” on deep-water oil and gas drilling. “The blanket moratorium, with no parameters, seems to assume that because one rig failed and although no one yet fully knows why, all companies and rigs drilling new wells over 500 feet also universally present an imminent danger.” NY Times.

alpha and omega filme

With all due respect to Judge Feldman, the editors at Popular Logistics think that oil, coal, natural gas, mining, drilling, and transport, do present an imminent danger

the fighter full movie

. Look at the evidence in the Gulf of Mexico, Ecuador, Nigeria, Prince Edward Sound, Montcoal, W. V, upriver of Kingston, Tenn, in the coal mines of China, and in the mercury levels in fish, shellfish, dolphins, and whales. The “Precautionary Principle” dictates that we must stop drilling and figure out to move off fossil fuels.

Notes

The “improved estimate of the Flow Rate Technical group, of 35,000 to 60,000 barrels per day, announced by Energy Secretary Chu, Interior Secretary Salazar, and Director of the U. S. Geological Survey and Chair of the National Incident Command’s Flow Rate Technical Group (FRTG) Dr. Marcia McNutt on June 15, 2010, is consistent with a scientific analysis of the 70,000 barrels per day reported one month earlier by NPR May 14, 2010 and a “back-of-the-envelope” estimate of 25,000 to 50,000 barrels per day reported in this blog on May 15, 2010.
The “Precautionary Principle” implies a social responsibility to protect the public and the environment from harm. In general, the burden of proof that an action or policy is not harmful falls on those taking the action. This allows policy makers to take action in the face of limited scientific data.
The series began after Earth Day and includes Fossil Fuels and a Walk on the Moon, Drill Baby Drill or Drill Baby Oops, Magnitude, Part 1, One Month After, The Chernobyl of Fossil Fuel?, Magnitude, Part 2 and The Deepwater Horizon after the Macondo Well Spill. It will continue indefinitely.

Brain Trauma Foundation/BTF Learning Portal

Brain Trauma Foundation logo

The Brain Trauma Foundation, and its BTF Learning Portal, which provides continuing education for medical professionals, are an excellent resource for anyone concerned with preventing and treating head injuries.The BTF Learning Portal’s courses are CME-accredited in most, if not all, states. To their credit, BTF courses seem to be priced so as to permit them to continue their work rather than, as is sometimes the case, a revenue stream which can lead a non profit off-course, we we’ve seen in other cases.The BTF research led to treatment guidelines for TBI. According to the CDC, the CDC analysis

found that that if the BTF guidelines were used more routinely, there would be a 50% decrease in deaths, improved quality of life and a savings of $288 million a year in medical and rehabilitation costs.

According to the study, “Using a Cost-Benefit Analysis to Estimate Outcomes of a Clinical Treatment Guideline: Testing the Brain Trauma Foundation Guidelines for the Treatment of Severe Traumatic Brain Injury,” just published in the December issue of the Journal of Trauma: Injury, Infection, and Critical Care, when the BTF guidelines are followed, the proportion of patients with good outcomes increased substantially from 35% to 66%, and the proportion of patients with poor outcomes decreased from 34% to 19%.

Link to BTF press release. (We’ll update this shortly with a direct link to the CDC statement).

order the next three days film

Obama and Holt on Health Care

President Obama

Washington, DC, Nov. 7, 2009, 11:00 PM. The U. S. House of Representatives passed a health care bill that appears to profoundly change the system.

According to President Obama, (click here or here)

Comprehensive health care reform can no longer wait. Rapidly escalating health care costs are crushing family, business, and government budgets. Employer-sponsored health insurance premiums have doubled in the last 9 years, …. This forces families to sit around the kitchen table to make impossible choices between paying rent or paying health premiums. … The United States spent approximately $2.2 trillion on health care in 2007, or $7,421 per person – nearly twice the average of other developed nations. Americans spend more on health care than on housing or food. If rapid health cost growth persists, the Congressional Budget Office estimates that by 2025, one out of every four dollars in our national economy will be tied up in the health system. This growing burden will limit other investments and priorities that are needed to grow our economy. Rising health care costs also affect our economic competitiveness in the global economy, as American companies compete against companies in other countries that have dramatically lower health care costs.

According to Rush Holt, D, NJ-12, (click here or here)

Rep. Rush Holt, D, NJ-12

This bill would provide secure and stable health coverage regardless of whether you change jobs or are between jobs, ensure Americans will never be denied care if they get sick, and extend coverage to those not well served by the current system.

This is a historic vote and the furthest we have come toward providing affordable and quality health coverage to all Americans.

watching tron: legacy online

Once this bill becomes law, it immediately would eliminate cases where insurance benefits run out because of an expensive illness, would allow young adults to remain on their parents’ insurance through age 26, and would shrink the Medicare prescription doughnut hole.

The bill would strengthen and extend existing programs. For example, those who have health insurance through their employers would benefit from caps on yearly out of pocket costs. Under the legislation, Medicare would be intact, only better – recipients would benefit from free preventive care and better primary care. Clickhere to read more about what the bill would do for you.

Reform would preserve the relationship between families and their doctors and shift to a focus on healthy outcomes and rewarding physicians for treating the whole patient.