The Observer reports:
Backache sufferers will receive spinal manipulation or acupuncture on the NHS as a result of official guidance being issued this week on how to treat the debilitating condition.
The move will be welcomed by many of the millions of patients with the ailment, which brings widespread misery and costs the country billions of pounds in sick leave, welfare bills and medical treatment.
The new approach will be unveiled on Wednesday by the National Institute for Health and Clinical Excellence (Nice), which tells the NHS which treatments are worth spending money on. Nice is expected to say that exhaustive research has shown that manipulation of a patient's spine can be effective in relieving the symptoms of low back pain and recommend that GPs refer sufferers for up to nine sessions with an osteopath, chiropractor or physiotherapist who is trained in manipulation, or an acupuncturist.
It may be timely to look at the Canadian view.
Canadian Neurologists Warn against Neck Manipulation
March 13, 2002
Brad Stewart, MD, FRCPC
Sixty-two clinical neurologists from across Canada, all certified members of the Royal College of Physicians and Surgeons, have issued a warning to the Canadian public and provincial governments about the dangers of neck manipulation. The signers include private neurologists as well as chiefs of neurology departments of major teaching hospitals. Calling their concerns significant, they warn that stroke and death due to neck manipulation has been reported in the scientific literature for over 50 years and that manipulation is one of the leading causes of stroke in the under 45-age group. The neurologists express six basic concerns and you can read them here.
You may argue that with low back pain you should not have your neck manipulated. The problem is that there is a near cult belief in neck manipulation that I feel compelled to warn readers.
See: Paralyzed Alberta woman sues chiropractors, province for $500M
Web: NHS Blog Doctor Quackwatch
Other Posts:
Chiropractic: Strokes and Class Action
Wednesday, May 27, 2009
Tuesday, May 26, 2009
Harvard: BPA and Nalgene Bottles
Globe and MailHarvard is in the news again, this time good news.
Some very brave students at Harvard risked their health for science! Although they were really doing what they have all been doing for sometime: drinking from Nalgene bottles, a sight not uncommon in gyms and sports events; these are unbreakable containers that has been a convenient alternative to metal and glass.
In The Boston Globe on May 22, 2009
Harvard study backs bottle concern
By Beth Daley
A Harvard study released on May 21 supports what many public health specialists have long assumed: Hard plastic drinking bottles containing bisphenol A are leaching notable amounts of the controversial chemical into people's bodies.
Researchers from the Harvard School of Public Health found that people who drank for a week from the clear plastic polycarbonate bottles increased concentrations of bisphenol A - or BPA - in their urine by 69 percent.
The study is the first to definitively show that drinking from BPA bottles increases the levels of the chemical in urine, researchers said. It was published on the website of the journal Environmental Health Perspectives.
BPA is used in hundreds of everyday products. It is used to make reusable, hard plastic bottles more durable and to help prevent corrosion in canned goods such as soup and infant formula.
"If you heat those bottles, as is the case with baby bottles, we would expect the levels to be considerably higher," said Karin B. Michels, senior author of the report and associate professor at the School of Public Health and Harvard Medical School. "This would be of concern since infants may be particularly susceptible to BPA's endocrine-disrupting potential," she said.
Canada banned the use of BPA in baby bottles in 2008, and Massachusetts health officials are now weighing whether to warn pregnant women and young children to avoid food, drinks, and other items containing the chemical.
Numerous animal studies in recent years suggest that low levels of BPA might cause developmental problems in fetuses and young children and other ill effects. The health effects on adults are not well understood although a recent large human study linked BPA concentrations in people's urine to an increased prevalence of diabetes, heart disease, and liver toxicity.
See also:Undergrads volunteer for Nalgene bottle BPA study
UK: BBC
Other Posts: To Ban Or Not To Ban: BPA
Harvard related posts:
Harvard: Sleep Apnoea and Faking
Bipolar Disorder in Children
Bipolar and ADHD: Boys and Breasts
Statins-Harvard-Roosevelt
Bipolar Disorder: Biederman Einstein God.
Popular Posts:
Teratoma: One Patient One Disease?
Teratoma: An Extract,
A Brief History of Time: CPR (Cardiopulmonary Resuscitation)
House M.D.: Modern Tyranny
House M.D. : 95% vs 5%
Some very brave students at Harvard risked their health for science! Although they were really doing what they have all been doing for sometime: drinking from Nalgene bottles, a sight not uncommon in gyms and sports events; these are unbreakable containers that has been a convenient alternative to metal and glass.
In The Boston Globe on May 22, 2009
Harvard study backs bottle concern
By Beth Daley
A Harvard study released on May 21 supports what many public health specialists have long assumed: Hard plastic drinking bottles containing bisphenol A are leaching notable amounts of the controversial chemical into people's bodies.
Researchers from the Harvard School of Public Health found that people who drank for a week from the clear plastic polycarbonate bottles increased concentrations of bisphenol A - or BPA - in their urine by 69 percent.
The study is the first to definitively show that drinking from BPA bottles increases the levels of the chemical in urine, researchers said. It was published on the website of the journal Environmental Health Perspectives.
BPA is used in hundreds of everyday products. It is used to make reusable, hard plastic bottles more durable and to help prevent corrosion in canned goods such as soup and infant formula.
"If you heat those bottles, as is the case with baby bottles, we would expect the levels to be considerably higher," said Karin B. Michels, senior author of the report and associate professor at the School of Public Health and Harvard Medical School. "This would be of concern since infants may be particularly susceptible to BPA's endocrine-disrupting potential," she said.
Canada banned the use of BPA in baby bottles in 2008, and Massachusetts health officials are now weighing whether to warn pregnant women and young children to avoid food, drinks, and other items containing the chemical.
Numerous animal studies in recent years suggest that low levels of BPA might cause developmental problems in fetuses and young children and other ill effects. The health effects on adults are not well understood although a recent large human study linked BPA concentrations in people's urine to an increased prevalence of diabetes, heart disease, and liver toxicity.
See also:Undergrads volunteer for Nalgene bottle BPA study
UK: BBC
Other Posts: To Ban Or Not To Ban: BPA
Harvard related posts:
Harvard: Sleep Apnoea and Faking
Bipolar Disorder in Children
Bipolar and ADHD: Boys and Breasts
Statins-Harvard-Roosevelt
Bipolar Disorder: Biederman Einstein God.
Popular Posts:
Teratoma: One Patient One Disease?
Teratoma: An Extract,
A Brief History of Time: CPR (Cardiopulmonary Resuscitation)
House M.D.: Modern Tyranny
House M.D. : 95% vs 5%
Friday, May 22, 2009
The Ring: Child Psychiatry & Human Behaviour
Ring Cycle Mariinsky Theatre /ROHI really cannot better the essay written by Alan Wagner in one of the Metropolitan Opera’s Playbill in 2004.
The Ring of the Nibelung and The Ten Commandments
By Alan Wagner 01 Apr 2004
Alan Wagner delves into the moral and spiritual core of Richard Wagner's colossal masterwork.
Little in art created by a single mind compares to the sheer size and scope of Richard Wagner's Der Ring des Nibelungen. Only a genius with a hint of madness could have conceived anything this colossal, let alone willed it into completion over twenty-six years of gestation and creation.
Furthermore, its 18 hours comprising a single music-drama have gripped every generation since its 1876 premiere with incredible power, unleashing a torrent of commentary. In order to so possess both artist and audiences, Wagner's Ring clearly must be more than a simple sword-and-sorcery epic about giants, dwarfs, gods, and heroes.
And it is. Within that immense journey from the dawn of consciousness to the obliteration of an entire cosmic order there is a compelling moral core. However, even though the composer and his audience were unavoidably enmeshed within a Christian European milieu, it is far from your mama's Sunday-school lesson, a long way from the Ten Commandments, those pillars of Western ethics.
Wagner's philosophical convictions underwent similarly significant refashioning. When he began the Ring, he was influenced by Ludwig Feuerbach, whose principal tenet, explicated in The Essence of Christianity, was that man created God, not the other way around. Religion merely reveals truths about mankind's needs, and its most meaningful revelation is that God is love. Therefore, the pathway to salvation, personal and societal, is love.
In early drafts of the Ring, the liaison between Siegfried and Brünnhilde brought about a triumphant ending for Wotan's sovereignty. However, by 1854, when Wagner first read the masterpiece that impacted his thinking ever after,
Arthur Schopenhauer's The World as Will and Representation, he was already disillusioned about the perfectibility of either mankind or civilization. The Buddhist-like pessimism of Schopenhauer set the seal for Wagner, and he slid the metaphysical center of the Ring from Siegfried's death to where, as he wrote to his friend August Röckel, "Wotan rises to the tragic height of willing his own destruction."
I will try and look at it from the Child Psychiatrist’s perspective.
The dark side of the gods: (it is sometimes easier if one take GODS in the Ring to mean those in POWER. For the characters read here.) In fact, the gods need not work at all, the Nibelungs work almost all the time.
Disrespectful Wotan is hardly revered unanimously, and even he acknowledges higher authorities. Erda knows things he doesn't; his almost bureaucratic dominance derives solely from treaties engraved in runes on his spear, treaties to which he is subservient.
Born liars
Characters lie as it suits them. Events are initiated by Wotan's spurious promise to the Giants to pay them by giving them Freia in exchange for building Valhalla, a promise he knows he cannot keep, as she is the indispensable symbol of love whose golden apples keep the gods alive. His shady ally, Loge, is defined as a double-dealing trickster. Brünnhilde breaks her promise to her father to allow Siegmund to be killed in combat. Mime makes dissembling a veritable life's work, ably carried forward by his nephew, Hagen, in Götterdämmerung.
Characters lie as it suits them. Events are initiated by Wotan's spurious promise to the Giants to pay them by giving them Freia in exchange for building Valhalla, a promise he knows he cannot keep, as she is the indispensable symbol of love whose golden apples keep the gods alive. His shady ally, Loge, is defined as a double-dealing trickster. Brünnhilde breaks her promise to her father to allow Siegmund to be killed in combat. Mime makes dissembling a veritable life's work, ably carried forward by his nephew, Hagen, in Götterdämmerung.
Contemptuous
Brünnhilde disobeys Wotan, and his grandson Siegfried destroys his power. Mime, who raises Siegfried from infancy and even makes him toys, is treated with disturbingly cruel contempt by the bumptious hero. Hagen, whom Alberich sired via gold-empowered lust as a tool to retrieve the Ring for him, mutters that if he succeeds he will keep it, not hand it over to his Nibelung father.
Thieving & Misappropriation
……. misappropriation, of persons or of things, provides much of the plot machinery. First, Alberich plunders the Rhinegold, and afterward, theft of others' possessions, including the Ring, motivates action upon action.
……. misappropriation, of persons or of things, provides much of the plot machinery. First, Alberich plunders the Rhinegold, and afterward, theft of others' possessions, including the Ring, motivates action upon action.
Incest and other illicit sex
The teasing of Alberich by the Rhinemaidens which leads to his abjuring love--love, not lust. The definitive heroine, Brünnhilde, and her Valkyrie sisters are the offspring of an adulterous liaison between Wotan and Erda; Wotan also illegitimately fathers the Wälsung twins by a mortal. Sieglinde's infidelity is excoriated by marriage-goddess Fricka, as is her violation with Siegmund of an even more basic taboo, incest. But Wotan defends the twins ("…those two are in love") and, like most audience members moved by the ardent love music, views both transgressions kindly.
The teasing of Alberich by the Rhinemaidens which leads to his abjuring love--love, not lust. The definitive heroine, Brünnhilde, and her Valkyrie sisters are the offspring of an adulterous liaison between Wotan and Erda; Wotan also illegitimately fathers the Wälsung twins by a mortal. Sieglinde's infidelity is excoriated by marriage-goddess Fricka, as is her violation with Siegmund of an even more basic taboo, incest. But Wotan defends the twins ("…those two are in love") and, like most audience members moved by the ardent love music, views both transgressions kindly.
Homicidal
Fafner kills his brother Fasolt, the first victim of Alberich's curse, and we are off to the homicide races. Hunding slays Siegmund, only to be destroyed by Wotan's contempt. Siegfried kills Fafner, the Giant-turned-dragon, and then, after realizing that Mime is trying to poison him, kills him as well. By the time the gods' destiny climaxes, Hagen has murdered both Siegfried and Gunther and is himself drowned by the Rhinemaidens. Eventually Brünnhilde sets Valhalla ablaze as part of her self-immolation upon Siegfried's funeral pyre ("Thus do I hurl the torch into Valhalla's proud-standing stronghold") and all the gods die.
Greed, greed, greed!
Finally, "coveting that which is your neighbor's" is pretty much the whole raison d'être for the Ring story, starting with Alberich's desire for the Rhinemaidens, then for the gold they guard. Thereafter everybody seems to want what doesn't belong to him or her: the Ring, a sword, a treasure, someone else's wife, sheer power.
Finally, "coveting that which is your neighbor's" is pretty much the whole raison d'être for the Ring story, starting with Alberich's desire for the Rhinemaidens, then for the gold they guard. Thereafter everybody seems to want what doesn't belong to him or her: the Ring, a sword, a treasure, someone else's wife, sheer power.
Yet in spite of Wagner's wholesale abandonment of the Decalogue, the bastion of Western morality, Der Ring des Nibelungen generates explosive ethical and metaphysical impact. He started with the absorption, fusion and reinvention of myriad legendary sources, and layered Schopenhauer's philosophy upon Feuerbach's. In Art and Climate Wagner wrote, "there is no true freedom except that which is common to all mankind... The redeemer is therefore love… starting with sexual love, [it] strides forward through love of children, brothers and friends, to universal love of humanity." The emphasis is his. Yet, some years later he wrote to Mathilde Wesendonck, "I can conceive of only one salvation. It is Rest! ...The stilling of every desire!"
Wagner once wrote to Röckel, "I have come now to realize how much there is, owing to the whole weight of my poetic aim, that only becomes clear through the music." He later described the discontinuity between his "rationally formed ideas" and "the exquisite unconsciousness of artistic creation… guided by wholly different, infinitely more profound intuition."
Music alone would now convey the message. The last moments of Der Ring des Nibelungen are given entirely to the orchestra: there is too much weight for words. Something greater than the story, richer than all the sources, probably better than Wagner himself knew, is brought to a healing close with a tender statement of a motif heard only once before in the Ring, when Sieglinde learns she is bearing her child of love, Siegfried. It is the motif of Redemption Through Love.
How wonderful it is to wait this long for the protein to be activated.
In the end, Wagner fashioned a masterwork of such extraordinary strength that it transcends analyses, personalities, philosophers, his own prejudices, and even his total disregard for Judeo-Christian society's standards of ethical behaviour.
Out of the highest art came a truth beyond even his explanation.
Out of the highest art came a truth beyond even his explanation.
Ring Synopsis: Das Rheingold Die Walküre Siegfried Götterdämmerung
Stop Press: Lohengrin Review: FT
"Sunday’s audience, which had grumbled and tittered its way through the performance, was stunned into silence. Suddenly, Lohengrin had become a more troubling, more ambivalent work than we all imagined it to be. In place of utopias, it spoke of false dreams, taboos, uncertainty. The rats’ herd-like belief in a better life had been smashed, just as Lohengrin’s quest for unconditional love had failed. No wonder Wagner called Lohengrin his saddest opera."
Wagner website.
Ring Synopsis: Das Rheingold Die Walküre Siegfried Götterdämmerung
Independent: Mariinsky Ring
Other Opera Posts:
Other arts posts:
Wednesday, May 20, 2009
House M.D. : Australia
Dr Crippen alerted us to the wonderful story in The Telegraph
A man and his Black & Decker
"Natasha Richardson and Medical Technology we looked at the tragic and premature death of Natasha Richardson on a ski-slope in North America. No one was brave enough to treat her on site. To put it in simple terms, no one was brave enough to drill. The delay turned out to be fatal.
"I believe the delay was due to medical technology. CT scanners, MRI scanners and helicopters. That sounds counter intuitive, but think about it. These days, and particularly in the medico-legal climate prevalent in North America, it would be a brave doctor indeed who did not wait for the CT scan before drilling the burr holes. It would be a career making or career breaking decision. Few American doctors are brave. Defensive medicine is the order of the day. You cannot have a migraine in the USA without someone ordering an MRI scan."
Compare Natasha Richardson's story with this:
Nicholas Rossi ABC
A man and his Black & Decker
Others:
A simple bump on the head can kill you
Natasha Richardson’s Brain Injury
The wussification of the American medical profession
Related:
House M.D. : 95% vs 5%
House M.D.: Modern Tyranny
A man and his Black & Decker
"Natasha Richardson and Medical Technology we looked at the tragic and premature death of Natasha Richardson on a ski-slope in North America. No one was brave enough to treat her on site. To put it in simple terms, no one was brave enough to drill. The delay turned out to be fatal.
"I believe the delay was due to medical technology. CT scanners, MRI scanners and helicopters. That sounds counter intuitive, but think about it. These days, and particularly in the medico-legal climate prevalent in North America, it would be a brave doctor indeed who did not wait for the CT scan before drilling the burr holes. It would be a career making or career breaking decision. Few American doctors are brave. Defensive medicine is the order of the day. You cannot have a migraine in the USA without someone ordering an MRI scan."
Compare Natasha Richardson's story with this:
Nicholas Rossi ABC"Nicholas Rossi, 13, fell off his bike in the small rural town of Maryborough in Victoria and hit his head. He was not wearing a helmet, and the impact knocked him momentarily unconscious. He recovered enough to go home, but complained to his mother Karen, a trained nurse, of a bad headache. Mrs Rossi took her son to district hospital where Dr Rob Carson, a local GP, was on duty, his family told The Australian newspaper. The boy was kept under observation, but one hour later, he started drifting in and out of consciousness. Dr Carson recognised the problem as internal bleeding in the skull and noticed that one of Nicholas's pupils was larger than the other, another sign of bleeding that was placing pressure on the brain. The injury was the same that recently led to the death of actress Natasha Richardson after a skiing accident. Dr Carson believed Nicholas had torn an artery just above his ear between his skull and his brain, creating a large and life-threatening blood clot. In scenes reminiscent of a television medical drama.
"Dr Carson realised he had minutes to save the boy's life and there was no time to transfer his patient to a hospital with a dedicated brain surgery unit. Instead, he telephoned Dr David Wallace, a neurosurgeon 105 miles away in Melbourne, to help talk him through the operation - which he had never attempted before.But there was one problem. The hospital was not equipped with a surgical drill. Instead, Dr Carson had to use the next best thing - a household drill found in the hospital's maintenance cupboard. He disinfected the drill and, under Dr Wallace's guidance, used it to bore into Nicholas's skull to release the blood clot."
The story has been picked up now by the main stream media across the world: BBC ABC.
Let us remind ourselves:
There are three medical procedures that can be dramatically live-saving.
1. Relieving a tension pneumothorax
2. Performing a tracheotomy
3. Drilling burr holes into a skull.
Looks like House M. D. is back. This time in Australia! Is that why so many doctors are migrating to there? It is a good day for doctors anywhere.
Links:A man and his Black & Decker
Others:
A simple bump on the head can kill you
Natasha Richardson’s Brain Injury
The wussification of the American medical profession
Related:
House M.D. : 95% vs 5%
House M.D.: Modern Tyranny
Tuesday, May 19, 2009
Bipolar Disorder: Divalproex ER vs Placebo
Just before I retired, it has become fashionable to use anticonvulsants as a mood stabiliser. Being a traditionalist, I felt then that the evidence was not clear and I tended to stick with the trusted lithium.
Well my doubts were confirmed:
Journal of the American Academy of Child & Adolescent Psychiatry:
May 2009 - Volume 48 - Issue 5 - pp 519-532
doi: 10.1097/CHI.0b013e31819c55ec
New Research
A Double-Blind, Randomized, Placebo-Controlled Trial of Divalproex Extended-Release in the Treatment of Bipolar Disorder in Children and Adolescents
WAGNER, KAREN DINEEN M.D. et al.
Abstract
Objective: To compare the efficacy and safety of divalproex extended-release (ER) to placebo in a 28-day double-blind study of bipolar disorder in children and adolescents and evaluate the safety of divalproex ER in a 6-month open-label extension study.
Method: In the double-blind study, 150 patients (manic or mixed episode, aged 10-17 years) with baseline Young Mania Rating Scale (YMRS) score of 20 or higher were randomized to once-daily placebo or divalproex ER, which was titrated to clinical response or serum valproate concentration of 80 to 125 μg/mL. Sixty-six patients enrolled in the extension study.
Results: In the double-blind study, a treatment effect was not observed with divalproex ER based on change in mean YMRS score (divalproex ER -8.8 [n = 74]; placebo -7.9 [n = 70]) or secondary measures. Divalproex was similar to placebo based on incidence of adverse events. Four subjects treated with divalproex ER and three treated with placebo discontinued because of adverse events. Mean ammonia levels increased in the divalproex ER group, but only one patient was symptomatic. In the long-term study, YMRS scores decreased modestly (2.2 points from baseline). The most common adverse events were headache and vomiting.
Conclusions: The results of the study do not provide support for the use of divalproex ER in the treatment of youths with bipolar I disorder, mixed or manic state. Further controlled trials are required to confirm or refute the findings from this study. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(5):519-532.
An earlier Harvard study showed that Lithium reduced suicide risks by as much as 9 fold.
Related Posts:
Bipolar Disorder: Lithium-The Aspirin of Psychiatry?
Lithium Bipolar and Nanking
Bipolar Disorder in Children
Bipolar and ADHD: Boys and Breasts
Statins-Harvard-Roosevelt
Bipolar Disorder: Biederman Einstein God.
Antipsychotics: Really?
Well my doubts were confirmed:
Journal of the American Academy of Child & Adolescent Psychiatry:
May 2009 - Volume 48 - Issue 5 - pp 519-532
doi: 10.1097/CHI.0b013e31819c55ec
New Research
A Double-Blind, Randomized, Placebo-Controlled Trial of Divalproex Extended-Release in the Treatment of Bipolar Disorder in Children and Adolescents
WAGNER, KAREN DINEEN M.D. et al.
Abstract
Objective: To compare the efficacy and safety of divalproex extended-release (ER) to placebo in a 28-day double-blind study of bipolar disorder in children and adolescents and evaluate the safety of divalproex ER in a 6-month open-label extension study.
Method: In the double-blind study, 150 patients (manic or mixed episode, aged 10-17 years) with baseline Young Mania Rating Scale (YMRS) score of 20 or higher were randomized to once-daily placebo or divalproex ER, which was titrated to clinical response or serum valproate concentration of 80 to 125 μg/mL. Sixty-six patients enrolled in the extension study.
Results: In the double-blind study, a treatment effect was not observed with divalproex ER based on change in mean YMRS score (divalproex ER -8.8 [n = 74]; placebo -7.9 [n = 70]) or secondary measures. Divalproex was similar to placebo based on incidence of adverse events. Four subjects treated with divalproex ER and three treated with placebo discontinued because of adverse events. Mean ammonia levels increased in the divalproex ER group, but only one patient was symptomatic. In the long-term study, YMRS scores decreased modestly (2.2 points from baseline). The most common adverse events were headache and vomiting.
Conclusions: The results of the study do not provide support for the use of divalproex ER in the treatment of youths with bipolar I disorder, mixed or manic state. Further controlled trials are required to confirm or refute the findings from this study. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(5):519-532.
An earlier Harvard study showed that Lithium reduced suicide risks by as much as 9 fold.
Related Posts:
Bipolar Disorder: Lithium-The Aspirin of Psychiatry?
Lithium Bipolar and Nanking
Bipolar Disorder in Children
Bipolar and ADHD: Boys and Breasts
Statins-Harvard-Roosevelt
Bipolar Disorder: Biederman Einstein God.
Antipsychotics: Really?
Sunday, May 17, 2009
Learning From History: SARS, Canada, Masks and Inluenza A (H1N1)
In The Globe and Mail, Canada Link: ttps://www.theglobeandmail.com/life/sars-how-the-quest-for-a-quick-victory-led-to-costly-error/article22394326/
WHO H1N1 UPDATES
SARS ACCOUNTS: Dr Yannie Soo, Tom Buckley.
Other Posts:
EBM: Masks, Cathay Pacific Airline, SARS and Influenza A(H1N1)
Swine Flu: WHO Level 5 & The 1976 Vaccine Disaster.
Hong Kong: SARS and Swine Flu
SARS and Quorum Sensing
Hospital Infection: Quorum Sensing
May23, 2003
“Faced with the World Health Organization's costly declaration on April 23, that Toronto was too dangerous to visit, politicians, health officials and even the news media quickly banded together against a common enemy — and it was not the virus but WHO, the United Nations agency, that had effectively put Canada's largest city under quarantine. ‘That week, that advisory definitely changed our psychology and the way we looked at this outbreak, ’Dr. Low said. ‘I remember . . . we were putting such a positive spin on things, including myself — everybody wanted to be clean of this.’”
"Now Toronto is holding its collective breath through a crucial weekend once again, as health officials cling to hopes of containment even as the numbers of cases and people in quarantine climb. The WHO lifted its travel advisory on April 30. Two weeks later, after the agency removed Toronto from its list of SARS-affected areas, Ontario lifted the provincial emergency status. Behind the scenes, the province disbanded members of its epidemiology team and scaled back its emergency-operations centre to a routine monitoring function. With no known new cases after 20 days, the city had laid down its gloves. On May 16, health staff in area hospitals were instructed that they no longer needed to wear full protective gear. May 16 is emblazoned with regret in Dr. Low's mind: "As soon as the masks and the gloves came off, you can see this dramatic spike in the cases.”
"Now Toronto is holding its collective breath through a crucial weekend once again, as health officials cling to hopes of containment even as the numbers of cases and people in quarantine climb. The WHO lifted its travel advisory on April 30. Two weeks later, after the agency removed Toronto from its list of SARS-affected areas, Ontario lifted the provincial emergency status. Behind the scenes, the province disbanded members of its epidemiology team and scaled back its emergency-operations centre to a routine monitoring function. With no known new cases after 20 days, the city had laid down its gloves. On May 16, health staff in area hospitals were instructed that they no longer needed to wear full protective gear. May 16 is emblazoned with regret in Dr. Low's mind: "As soon as the masks and the gloves came off, you can see this dramatic spike in the cases.”
“……There was a new cluster, they told him, centering on patients who had spent time at St. John's Rehabilitation Centre in the city's north end before being transferred to four other Toronto area hospitals. Contact tracing had turned up no epidemiological link to the first outbreak. But a lab test confirmed that one of the four known patients carried the SARS coronavirus deep in his bronchial tract. It was back.”
You really cannot spin the public’s health, or can you? However there was some other form of spinning.
“Dr. Low's head spun with disbelief. ‘You're hearing it all and you're trying to minimize it. You're thinking, No this can't be right, this can't be.'
I know that Influenza A(H1N1) is not SARS, but why should we not learn from it.
The evidence of masks is here. CDC on SARS.
Bus in Hong Kong AFP
In the meantime we are donning masks whatever anyone else may say.WHO H1N1 UPDATES
SARS ACCOUNTS: Dr Yannie Soo, Tom Buckley.
Other Posts:
SARS, Freedom & Knowledge
Learning from History: Swine Flu & Antibiotics
Learning From History: 1918 Flu Pandemic, Hong Kong SARS, Swine Flu & Influenza A(H1N1)EBM: Masks, Cathay Pacific Airline, SARS and Influenza A(H1N1)
Swine Flu: WHO Level 5 & The 1976 Vaccine Disaster.
Hong Kong: SARS and Swine Flu
SARS and Quorum Sensing
Hospital Infection: Quorum Sensing
Friday, May 15, 2009
Nobel: Kandel and Lohengrin
Eric Kandel, M.D.:
"We are what we are through what we have experienced and what we have remembered."
In 2001 I was fortunate enough to be in New Orleans for the American Psychiatric Association Annual Conference. One of the lectures attracted a long queue and it turned out that the Nobel Laureate Eric Kandel was giving his lecture. I was fortunate enough to be able to secure a seat."What learning does is to change the strength of the synaptic connections in the brain," Kandel explained, "and this has held true for every form of learning so far analyzed. So, what genetic and developmental processes do is specify the cells that connect to each other, but what they do not specify is the exact strength of those connections. Environmental contingencies, such as learning, play a significant part in the strength of those connections."
"Different forms of learning result in memories by changing that strength in different ways. Short-term memory results from transient changes that last minutes and does not require any new synthesis of proteins, Kandel said. However, long-term memories are based in more lasting changes of days to weeks that do require new brain protein to be synthesized. And this synthesis requires the input of the neuron’s genes."
Lohengrin Royal Opera HouseI have always maintained that there is something fundamentally enjoyable about a piece of music that you are familiar with. It is of course the case with many pop songs. But they were only a few minutes long. Lohengrin runs to nearly four hours.
Yet to me it is one of Wagner’s most wonderful piece of music. On the 8th of May the musical performance was amazing. You can feel the brain re-activating the proteins.
The set was of course from 1977 and bits of it smack of a school play. The costume was extraordinary even after 32 years. Adherence to the classical Grail story is deceptive especially with the unexpected kissing of Elsa and her brother on the lips. I know incest is covered in the Ring cycle but sex seems to be the new black now in opera. Or was Wagner dropping hints on Nietzsche’s relationship with his sister? I did not think it helped the opera Lohengrin.
There is no question though: Lohengrin has one of the best music of all the Wagners including Götterdämmerung.
Autobiography: Eric Kandel
Wagner website.
Synopsis: Lohengrin
Other Opera Posts:Lohengrin: Speech Disability, Design & Hypertension
The Dark Side: Il TrovatoreDoctor Atomic
Illness and Morality
Lunar Eclipse
Other arts posts:
Can They Draw: From Picasso to Matisse
Picasso, Medicine and Lloyds
Picasso and Tradition
Thursday, May 14, 2009
Paraguay: Technology Meets Ecology
Loofah drying ----Rolex AwardElsa Zaldívar takes leftover pieces of a vegetable sponge loofah and mixes them with other vegetable matter and recycled plastic to form strong, lightweight panels that can easily be assembled into simple structures, including houses.
Her technological, eco-friendly solution to her nation’s housing shortage will help save what remains of Paraguay’s rapidly diminishing forests.
Loofah growing--- Rolex Award
She won the Rolex Award for 2008
"In the poverty-stricken countryside of Paraguay, a landlocked country in the heart of South America, an innovative social activist has found a new use for an old vegetable. Elsa Zaldívar, whose longstanding commitment to helping the poor while protecting the environment has won her deep respect in her native land, has found a way to mix loofah – a cucumber-like vegetable that is dried to yield a scratchy sponge for use as abrasive skin scrubber – with other vegetable matter like husks from corn and caranday palm trees, along with recycled plastic, to form strong, lightweight panels. These can be used to create furniture and construct houses, insulating them from temperature and noise. About 300,000 Paraguayan families do not have adequate housing.
"In the poverty-stricken countryside of Paraguay, a landlocked country in the heart of South America, an innovative social activist has found a new use for an old vegetable. Elsa Zaldívar, whose longstanding commitment to helping the poor while protecting the environment has won her deep respect in her native land, has found a way to mix loofah – a cucumber-like vegetable that is dried to yield a scratchy sponge for use as abrasive skin scrubber – with other vegetable matter like husks from corn and caranday palm trees, along with recycled plastic, to form strong, lightweight panels. These can be used to create furniture and construct houses, insulating them from temperature and noise. About 300,000 Paraguayan families do not have adequate housing.
"The area’s economy had declined with the collapse of cotton and increasing cultivation of soya, an environmentally disastrous crop that had left soils contaminated and forced families off the land, leaving them without employment. Zaldívar took an interest in loofah, a plant that grows easily in the region, but which had fallen out of favour. She persuaded local women in Caaguazú to consider it as a means of generating income.
"The Rolex Award will finance a promotion centre near Asunción and the construction of three model houses where the panels’ versatility will be displayed for both urban and rural audiences, as well as funding the production of a video that will be used to describe the project to people interested in using similar techniques in other countries.
"Zaldívar’s initial focus for providing low-cost housing remains Paraguay’s deforested countryside. 'We want to find sustainable housing alternatives for the poor, while also discovering new markets for their agricultural products, particularly the loofah. This is a perfect combination,' she says."
You can listen to her here.
Nature Posts:
ECOLOGY: First Bees, Now Bats.
Honey Money Money
Hong Kong: Humpback Whale
Tasmania: Whales & Dolphins-Mother & Baby
It’s a Bird, a Reptile, a Mammal: It’s Platypus
"The Rolex Award will finance a promotion centre near Asunción and the construction of three model houses where the panels’ versatility will be displayed for both urban and rural audiences, as well as funding the production of a video that will be used to describe the project to people interested in using similar techniques in other countries.
"Zaldívar’s initial focus for providing low-cost housing remains Paraguay’s deforested countryside. 'We want to find sustainable housing alternatives for the poor, while also discovering new markets for their agricultural products, particularly the loofah. This is a perfect combination,' she says."
You can listen to her here.
Nature Posts:
ECOLOGY: First Bees, Now Bats.
Honey Money Money
Hong Kong: Humpback Whale
Tasmania: Whales & Dolphins-Mother & Baby
It’s a Bird, a Reptile, a Mammal: It’s Platypus
Wednesday, May 13, 2009
EBM: Masks, Cathay Pacific Airline, SARS and Influenza A(H1N1)
Cathay Pacific at Hong Kong International Airport Wikimedia CommonsHong Kong's main airline, Cathay Pacific, on Saturday backed down on its refusal to allow its flight attendants to wear face masks to protect themselves against swine flu. The change of policy came after the confirmation of East Asia's first swine-flu case in Hong Kong on Friday night and an appeal from the city's health secretary, York Chow. AFP/Standard
It is claimed that there is no evidence that the wearing of face mask is useful. So I tried to search for the evidence.
New Scientist
Face masks are best protection against SARS
02 May 2003 by Shaoni Bhattacharya
"Face masks offer the best protection in the fight against SARS, reveals a new hospital-based study from Hong Kong.
It is claimed that there is no evidence that the wearing of face mask is useful. So I tried to search for the evidence.
New Scientist
Face masks are best protection against SARS
02 May 2003 by Shaoni Bhattacharya
"Face masks offer the best protection in the fight against SARS, reveals a new hospital-based study from Hong Kong.
SARS HK 2003 Medical Staff in Hospital Virgin Media "Wearing a mask can give a person dealing with SARS patients in hospital up to 13 times more protection compared with not wearing one, says Wing Hong Seto, study lead and chief microbiologist at the Queen Mary Hospital in Hong Kong.
"However only surgical masks and N95 masks - designed to block airborne particles - will work. These masks protect the face from droplets coughed out by infected people, which the team believes is the primary mode of spread. Seto says droplets are probably the main mode of transmission of SARS outside hospitals as well. He says the findings confirmed SARS is not spread through the air - if so only the N95 masks would have been protective.
"Face masks have become a morbid symbol of the impact of SARS in the worst-hit parts of the world. The virus has now killed 416 people across the globe, with over 6000 infections in 29 countries.
"Wearing masks in public places has become commonplace in the Hong Kong and the Chinese mainland, where the disease first emerged. But their effectiveness has been controversial and some commentators say their use has helped stoke an atmosphere of panic.
"But Seto told New Scientist: "Masks seem essential for protection. This finding fits well with droplet transmission, because droplets are generated at the face level."
Statistically significant
"Seto and colleagues from five Hong Kong hospitals and the University of Hong Kong, surveyed over 250 hospital staff exposed to 11 SARS patients between 15 March and 24 March.
"Most of the 13 staff who became infected did wash their hands, and a handful also wore gloves or a paper mask, but none had used a surgical or N95 mask. Analysis of the data showed that the use of surgical or N95 masks was the only measure to give statistically significant protection.
"Paper masks offered little protection, says Seto. 'Such masks, being easily wet with saliva, are never recommended as a precaution against droplets.'
"However, not one of the 69 staff who had used all four recommended protection measures - wearing a mask, gloves, gowns and washing their hands - contracted the virus."
"Seto believes the risk of contracting SARS in public places is 'very low' and so does not wear a mask himself. 'However, I have it ready if I am in a crowded place,' he says. 'I see someone consistently coughing, then I put it on. If I see he is febrile, I strongly advise him to go home and see a doctor. Then I wash my hands and take a good shower on coming home.'
Journal reference: The Lancet (vol 361, p 1520)
It has to be accepted that there is virtually no rubbish collecting facility in public places in the UK due to worries about bombs and there are no hand washing facilities on buses and other public transports. See NHS Direct Advert.
In any case, Hong Kong has now a second case of of Influenza A (H1N1); a passenger on Cathay Pacific flying in from the US. There has been no local spread so far.
SARS ACCOUNTS: Dr Yannie Soo, Tom Buckley.
Other Posts:
Monday, May 11, 2009
Corruption: Three Doctors and a Professor.
I woke up to three doctors all writing about a Professor. No, she is not corrupt.
She un-covered what has been going on in the NHS that is corrupt.
Corruption, dishonesty, fraud and cover-up.
Dr Crippen
“IN the BMJ this week, Professor Pollock, discusses the information she has been able to gather by using the Freedom of Information legislation. It was like getting blood out of a stone. It reveals a tale of duplicity, incompetence, fraud and secrecy as, once again, the government tries to cover up the way in which billions of pounds of taxpayers’ money has been squandered.”
Secrets
Dr Grumble
“But what has really goaded Grumble into this tirade on secrecy? It wasn't the MPs' expenses. It wasn't even the drug licensing issue. It was frustration that we do not know how much the parts of the NHS that have been privatised are costing. Except that is for one ISTC. You can read about that in an article written by Allyson Pollock.It's long article. Here's a key bullet point:
The Scottish Regional Treatment Centre treated only 32% of annual contract referrals in the first 13 months of operation at 18% of the annual contract value. If the same patterns apply in England, up to £927m of the £1.5bn may have been paid to ISTCs for patients who did not receive treatment under the wave one ISTC contracts.
Allyson tells it as it is. She can't be much loved in some quarters. She will never be Dame Allyson. Probably she doesn't want to be a dame.She must have difficulty getting funded - except, that is, for one-way trips to Outer Mongolia.”Say goodbye to your money.
Jobbing Doctor
“So my reading is we paid 5 times as much as we needed to for these operations. Much of the data is kept secret because of 'commercial confidentiality'. I'm sorry but this doesn't wash with the Jobbing Doctor. Professor Pollock has started to unpick the monumental squandering of millions of pounds on work that is either substandard or often not done!”
Links: BMJ Article.
Jobbing Doctor: Say goodbye to your money.
Dr Grumble: Secrets
NHS Blog Doctors: Corruption, dishonesty, fraud and cover-up.
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