earlier podcasts about TinyPrincess discussed the problem of caregiving and burnout in the family due to her fragile nature and frequent seizures. They finally got help from some local sisters who do home care for the dying.
Much of this is overtly religious, but as a doc who worked with the poor, I might just say that it reminds one of how parents think and feel about their children: but few are articulate enough to put it into words.
This is the story told by a pious Catholic father, but the idea that a young child who dies, especially one who is "special needs", will await one in haven and even intercede for their parents is found in other religions, such as Islam.
Dale Evans (wife of Roy Rogers) had a child with Down's syndrome who died as a toddler of measles and wrote a book about her. Download it from this MN site, or borrow it (free registration) from internet archive.
compare and contrast to many "opinions" of so called "bioethicists" who see them as useless eaters, better to be aborted or killed at birth.
Sigh.
often these families are helped by local churches (as in the podcast) and/or government programs.
and caring for a loved one, even in the USA, where the meme is that everyone is selfish, is astonishingly common: this site estimates 45 million caregivers who gave up time and work in the past year: often giving up their own outside job to properly care for the child or elder in their care.
Hospice care is often seen as sort of like a nursing home, but actually most hosice cases are also cared for in the home, with the hospice nurse helping advise in getting things to help the person (caregiver to do bathing, a hospital bed, adjusting pain medicine to keep the person free of pain but not oversedated).
but a lot of cases are from chronic disease. And the hardest cases are those with behavior problems: Severe ADHD in children with developmental disabilities, or Alzheimer's disease in the elderly.
Often the behaviors are hard to treat, so these people end up in nursing home or need frequent respite care to stop caregiver burnout.
Here in the Philippines, the extended family is the one who usually cares for the sick: often with outside help. For example, I hired someone to help me with Lolo at night, his cousin with a broken hip and osteoporosis and COPD that made surgical repair inadvisable was cared for by a cousin and her teenaged children, and Joy's pastor's son has family to care for him with a part time caregiver.
In the US, modern trends (to save money) insists people to be cared for at home (also because it is better for the patient) ignores an economy that insists women work full time to support themselves.
One result: A lot of caregivers quit their jobs or work part time to do this care. Adult day care and other activities help.
this one claims that giving opiods post partum is a risk for continued opiod use.
So they suggest not to give the moms pain pills post partum
(usually we give them for Caesarian section or if they have a large episiotomy, not to everyone.) but here the article claims the risk was the same in both groups.
but how big is the risk?
The incidence of persistent opioid use during the year following delivery was low overall -- at less than 1 percent -- and was higher among women with cesarean versus vaginal delivery.
so let the women suffer.
Actually, what might be happening is that women who are depressed find their depression is helped by these pills. the wife of Senator McCain would be a big example.
However the study only included those who hadn't taken narcotics in the past 180 days. Did they check the percentage of women who took other drugs such as marijuana or tranquillizers?
Science magazine says that the new Ebola vaccine seems to be helping fight the outbreak in Central Africa.
40 thousand people have received the vaccine.
So far the outbreak has tallied some 500 cases, about half of whom have died, according to the DRC’s Ministry of Public Health. It spans a region of the DRC’s northeast that abuts four other countries, and Salama and many others worry about the deadly virus jumping a border, which would require separate response teams and boost the potential for wider spread by infecting people with increased transportation options.
Without more financial and personnel support from wealthy countries, the situation could explode into a long-running calamity similar to the Ebola epidemic that devastated three West African countries from 2014 to 2016, warns an editorial published last month in The New England Journal of Medicine (NEJM).
A consensus statement from 25 public health and policy experts published the same week in The Journal of the American Medical Association calls the outbreak “exceptionally” dangerous.
The editorials urge the U.S. government to change a policy that prevents its Centers for Disease Control and Prevention (CDC) from sending staff to the region because of security concerns.
well, unless they send in the Marines (Or hire a bunch of mercs from Blackwater), the CDC personnel would be risking their lives, not from Ebola but from local violence including kidnappers and thieves who attack hospitals and clinics and those driving down roads without guards.
I worked during a war, and several of my friends were killed, so maybe I take this more seriously than those sitting in offices in Chicago (JAMA).
a lot of the work can be done by locals, as I noted in an earlier post.
And yes, they are under threat too...
one only has to look at the health care workers, many local folks, in Afghanistan and Pakistan who have been kidnapped or killed trying to help people. At least they were volunteers.
Stimulants are frequently abused (one big problem here in the Philippines is use of Shabu, i.e. meth, by drivers and farmers to stay awake, but also leading to abuse and violence in some users, especially when used to get high).
StrategyPage has a long article on the use of drugs in the War, including new treatments for post traumatic stress, but also how soldiers cope in stressful combat situations using stimulents so people don't fall asleep in times of battle (and sometimes sleeping pills to counteract these pills to fall asleep).
This is not just by Americans: The ISIS type crazies like it too.
While Islamic terrorists found heroin, cocaine and prescription drugs useful, the most widely used Islamic terrorist chemical enhancer was that old World War II era standby amphetamines ("speed") pills. When shipments of Islamic terrorist weapons and ammo were seized there were often quantities of amphetamines as well guns, ammo and sometimes medical supplies.
this is nothing new: A recent book showed how the Nazis pushed this on not just soldiers in combat (which was also how the Yanks used it) but in civilians.
The book in question is The Total Rush – or, to use its superior English title, Blitzed – which reveals the astonishing and hitherto largely untold story of the Third Reich’s relationship with drugs, including cocaine, heroin, morphine and, above all, methamphetamines (aka crystal meth), and of their effect not only on Hitler’s final days – the Führer, by Ohler’s account, was an absolute junkie with ruined veins by the time he retreated to the last of his bunkers – but on the Wehrmacht’s successful invasion of France in 1940. Published in Germany last year, where it became a bestseller, it has since been translated into 18 language
of course, the traditional drug has always been alcohol.
my take? I agree with StrategyPage: It's the lesser of two evils,
Prolonged use of these drugs is not healthy. But neither is being drowsy during combat. It's better to get some sleep when you can, even if you have to take more medications to help make that happen. Troops exposed to prolonged combat find the stimulants lifesavers and consider them as essential as ammunition. Thus Islamic terrorists consider a weapons and ammo shipment incomplete if some Captagon was not included.
but I do wonder if the drug use in combat contributes to the high rate of suicide.
long discussion here (and note how traumatic brain injury also might be one reason for the high rate of psychiatric problems)
actually people back then knew about this, but it has been airbrushed out of history.
------------------------
the Ebola outbreak in the Congo has spread to a large city of Butembo which has 1,2 million people.
Unlike previous outbreaks, which have been restricted to fairly remote, rural areas, the present epidemic has swept through populated parts of northeastern Congo, a lawless area that is infested with rebel groups, freelance militias and armed criminal gangs.
Already struggling in conditions more challenging than previous outbreaks anywhere in Africa, health workers are now trying to deal with an outbreak that has multiple epicentres.
But nowhere is as worrying as Butembo, where a blend of insecurity, suspicion of aid workers and a large, mobile population have created an ideal landscape for the rapid spread of the disease.
Hmm... almost as high as in some AmerIndian tribes like the Objibwe or Pima tribes. We attributed it to the high fat diet from the free commodities the gov't gave the tribe to combat malnutrition that was behind the high TB rate.
When you read about the epidemic of fat people in the world, just remember the alternative is not think healthy people, but malnourished folks who die of TB or after minor infections.
In both the Objibwe and Pima tribes, obesity is the norm. Yet the Apache, who lived a more active traditional lifestyle, had much lower rates, and the Pima who live across the border in Mexico tend to eat poorly, work hard in the fields, and be thin, do not have much diabetes.
And we are seeing it more and more hree in the Philippines: along with high blood pressure (from the high salt diet) we now see diabetes.
Is the gene for metabolic syndrome behind this? Is having enough to eat causing the diabetic syndreome, or could it be plastics etc in the environment?
and the propaganda about euthanasia is encouraging the disabled and elderly to kill themselves so they are not a burden.... and probably also encouraging medical personnel to kill their patients who they see as useless eaters.
actually, this is not new. 30 Years ago, I took a couple months of psychiatry residency (and dropped out when I needed surgery).
They knew back then that a large percentage of people in jail had positive findings of brain damage, often from poor prenatal care, abuse/ head injuries in the past, and low grade lead poisoning, either from eating paint chips or from pollution before they took lead out of gasoline.
and they were just starting to use PET scans to see the damage in real time.
They also knews that LSD and other drugs caused permanent brain changes, and that Temporal lobe epilepsy caused both visions (St Paul, anyone?) and violent outbursts.
When I recovered from surgery I took a job at an institution for the profoundly retarded, at that time when the intellectually disabled were being discharged to the community. (and don't correct me and tell me that I shouldn't use the word "retarded": I am so old that I remember when we used the word "moron" and "imbicile" instead of moderate and severely mentally retarded).
Many of the mildly retarded had already been discharged by the time I took the job, and the nurses remarked that, alas, many of them ended up in jail, either for petty theft or for temper tantrums/violent outbursts. The problem was so bad that the state made special sections for these prisoners, to protect them from the real criminal predators.
The only treatment in the past was to fill these folks up with anti psychotic medications, which sedated them.
But the powers that be decided we needed to stop these "unneeded" medicines, so we were busy weaning them off of medicines and restraints and even protective equipment such as helmets that protected their heads from falls or head banging behavior.
But one doctor who worked in these institutions put out a newsletter suggesting anti seizure medicines for violent outbursts, and voila, it worked on many (but not all) of our violent patients.
Before I started to work there, most of the "mild" cases had been sent to the community, often with little supervision, and alas many of them ended up in jail.
Being naive many of them were horribly abused by other prisoners.
So will Kanye tell Trumpie maybe we should start treating people with these problems in jail, so they can be released?
Or will the civil rights folks, who were behind the "deinsitutionalization" lawsuits, but who never followed up to make sure community services could keep them safe, complain? They already have pretty well made it impossible to save lives of the depressed via shock treatment, often oppose "forced medicine" for hallucinating schizophrenics, made it almost impossible to hospitalize the mentally ill whose families are in despair over their problems, or have the police remove those who wander the streets talking to themselves in a delusional state, yet if we try to help the mentally ill, point out clockwork orange that we are harming the prisoners?
The abuse of people in psychiatry in the past was real, but one who never worked with the really dangerous mentally ill can appreciate how bad their behavior can be.
One thing that one needs to remember: there is a difference between use and abuse.
A medicine that allows you to cope and work and interact with your family is a medicine.
A medicine that leads you to addictive behavior, neglect of family in order to get high, or to hurt others is abuse.
from StrategyPage. the article is about China's economic and military status but contains this:
The increased censorship and restrictions on what the media can report go beyond the economy. Corruption and fear of embarrassment also play a role. Current examples are how the secret police are handling Chinese victims of yet another “dangerous food and drugs” scandal.
Many of the victims of Changsheng Biotechnology, the second largest supplier of vaccines in China, are seeking compensation from the government for injuries suffered from bad vaccines.
In July Changsheng was accused of selling unsafe medicines and getting away with it by bribing government inspectors to ignore evidence of poor quality control that resulted in ineffective vaccines.
This is the latest of many such scandals involving dangerous food products or medicines. It is why the government has been so energetic in its anti-corruption campaign but also evidence that the “war on corruption” was not going as well as the government was reporting.
This latest incident was so scary that even North Korea refused to buy low cost medicines from China because of the growing popular belief (in China and North Korea) that too many Chinese made drugs were probably ineffective.
The problem of obesity is world wide now. Why?
well, here in the Philippines, whereas in the past kids worked in the fields they now take a tricycle to school.
And their parents now have handplows and threshers that make growing rice less work intensive.
And of course, even if you can't afford the 75 peso hamburger at McD or the 50 peso hamburger at jolibee, you can buy two for 25 pesos at the kiosk at the night market.
And women don't have 6 kids anymore (the fertility rate is down: most women have two or three kids).
And what no one wants to discuss: Estrogens in plastic and phytoestrogen in the envirtonment, and estrogen from birth control pills.
which induces the gene for metabolic syndrome.
Of course, I am superstitious: My Austrian aunt, who is tiny because of the starvation of the WWI era, visited her home village in the 1930s and told everyone there was going to be another war.
This was when Hitler was not being taken seriously, so my mom asked her how she came to that conclusion. And she replied: because all the peasant women were getting fat, because they sensed a war was coming.
,,,The scope of the outbreak is hard to assess because it could take one to two weeks to detect, meaning the full extent of the number of infections is likely unknown at this time.
The outbreak follows a Tuberculosis outbreak in the same area along numerous staph infections reported.
a lot of these people are mentally ill or addicts, and in the past you could arrest them and put them either in jail or in an asylum. But now the ACLU decided it was against their civil rights.
Sigh.
wayback machine: DDT stopped the typhus epidemic in post war Naples.
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I'll have to read about what it actually was about later, but the firstparagraph in the article says:
Since the dawn of life on our planet, 3.7 billion years ago, nature has used the power of evolution to create a vast diversity of molecules with an ever-increasing array of chemical capabilities.
The Royal Swedish Academy of Science awarded the 2018 Nobel Prize in chemistry Wednesday to three scientists who have harnessed that power and sped it up, allowing them to create never-before-seen chemical reactions in a process called directed evolution.
uh, nature is not able to do anything. the "breakthru" of Darwin was that things just happened due to chance, with no plan at all.
the "power" of evolution is a meaningless phrase. It merely suggests that evolution is a force, no just randomness that sort of just happens.
IF you think Nature did these things, you assume something is directing these things: i.e. God.
the forbidden word that Darwin's followers preferred to ignore and censor.
And if Nature did these things, you have to assume there is a plan behind life, and things are not just random.
A PBS documentary reveals the identity -- and an artist's digitally created image -- or the woman whose well-preserved body was found in a metal coffin in Queens seven years ago. (Impossible Factual/Joe Mullins)
When a backhoe unearthed a woman's body, some thought it was a recent crime.
But it turns out that she died in the 1850s but was buried in an iron coffin that slowed her decomposition.
A testament to the coffins’ effectiveness, Peterson’s skin was intact to the point that she appeared to have been deceased for only a week.
Warnasch noted that “smallpox lesions covered her body.” Initially he was concerned by this: “The body was so well preserved that I would not have been shocked if the smallpox virus had survived.”
Researchers from the Centers for Disease Control and Prevention confirmed that the smallpox had degraded to a nonthreatening level. An autopsy revealed that the disease had infected Peterson’s brain and most likely killed her.
so how long could the virus live? This article discusses. Some anecdotes suggest 100 plus years, but it could have been a coincidence since small pox was around back then.
My friend in Zimbabwe lost her college aged niece a couple months ago. She was ready to start college but died unexpectedly of an infection.
Sigh.
but the miracle was that she lived that long, because she was born of an HIV positive mother, in the days before the disease was recognized and easily diagnosed, let alone treated. Most of these children died in childhood of ordinary childhood diseases.
Her father died of HIV about that time, again in the days when there was no treatment available, and what treatment was around in the west was very very expensive, too expensive even for the African middle class.
But things changed when GWB decided to spend money to save these lives. From PJMedia:
WASHINGTON -- The George W. Bush initiative to combat HIV/AIDS in Africa has saved more than 16 million lives so far, according to a new administration report on the President's Emergency Plan for AIDS Relief.
That includes 14 million men, women, and children on lifesaving drugs and 2.2 million babies born HIV-free to HIV-positive mothers.
The program has also helped 6.4 million orphans and caregivers, and provided 15.2 million men and boys with circumcision to lower the risk of HIV transmission.
Additionally, a quarter of a million medical personnel have been trained to improve care for HIV and other outbreaks.
In his 2003 State of the Union address, Bush announced the President's Emergency Plan for AIDS Relief, as "seldom has history offered a greater opportunity to do so much for so many."
"As our nation moves troops and builds alliances to make our world safer, we must also remember our calling, as a blessed country, is to make the world better,"
Bush said then. "Today, on the continent of Africa, nearly 30 million people have the AIDS virus, including 3 million children under the age of 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than 4 million require immediate drug treatment. Yet across that continent, only 50,000 AIDS victims -- only 50,000 -- are receiving the medicine they need."
At the time, the cost for life-saving antiretroviral treatment had dropped from $12,000 a year to under $300 a year, "which places a tremendous possibility within our grasp," Bush said.
Bush had asked Congress for $15 billion over the next five years to treat 2 million HIV patients and prevent 7 million new infections. That was the birth of PEPFAR.
this gets little publicity in the USA because Bush was a Republican, and the press is a Democratic echo box, and never sees anything good about Bush (or Trump).
the docs at the hospital where I used to work were involved in the program, and the public health sister that I worked with ran a clinic outside the capital to monitor the medicine (until Mugabe demolished the clinic and much of the suburb in revenge LINK)
No I didn't work with this: I left my second African stint in the early 1980s. I suspect we had cases, because we had a couple cases of kaposi's sarcoma etc. but it was not recognized then, and people often died of trivial infections that we attributed to the low protein malnutrition that was common.
right now I'm listening to The-Fate-of-Rome-Climate-Disease-and-the-End-of-an-Empire on Scribd.
Scary.
The theory is that various plagues resulted in depopulation in the Roman empire, and the climate variations (volcanic?) caused famines.
Plagues that weakened Rome includes the Antonine plague (? Measles? Smallpox?) and the plague of Cyprian.(measles? Smallpox? a viral Hemorrhagic fever?)
Cyprian's plague was blamed on that diabolic sect the Christians (/s) but one wonders if the custom of Christians for careing for the poor and sick might have resulted in converts too. No data on this: Just wondering.
Wikipedia on the Diseases of Rome. Don't forget Malaria, which was more widespread in "temperate" climates than most moderns realize.
But the really big plague that probably stopped the swift recovery of the western Roman empire was the plauge of Justinian.
Justinian's plague was probably Bubonic plague, and began in Egypt/Ethiopia, although the black death probably started in China.
The germ does hide in various little critters: Gerbils, rats, etc.
So IHS docs would see a couple cases a year in the Navajo reservation, and there are spotted reports about cases in Islamic terrorists catching it probably from living in dirty caves.
and SciAm wonders if this might have encouraged locals to migrate to safer pastures (i.e. to Europe and India). But DNA suggests that this strain was a lot less infectious.
But the analysis revealed that plague might have been less transmissible in the early Bronze Age. The six oldest Bronze Age strains lacked a gene called ymt that helps Y. pestis to colonize the guts of fleas, which serve as an important intermediary. In outbreaks of bubonic plague, infected fleas (often travelling on rodents) transmit the bacteria to humans living nearby. Without fleas as a go-between, Y. pestis spreads much less efficiently through blood (where it is known as septicaemic plague) or saliva droplets (pneumonic plague).
yet one does wonder what was behind a lot of bronze age plagues in the Middle East.
and one wonders if this is what hit the Philistines after they stole the Arc of the Covenant ("Hemorrhoids" is the usual translation.) and if this might have been the plague that devestated the Hittites after they went against Egypt in the Battle of Kadesh and took home some POWs as slave (and the plague followed them).
The method of attack was simple. The Hittites would leave the sheep outside the targeted city. Locals would bring them in and either breed them or eat them, spreading the disease.
and this article suggests it was Tularemia that hit the Philistines too.
Global Security has a history of the use of Tularemia as biowarfare, and mentions the debate if the Tularemia in German troops at Stalingrad was biowarfare or just from normal infections. Discussion here.
More than 820,000 people had AIDS or were HIV-positive at the end of June, up by 100,000 from the year previous,,,.
More than 40,000 new HIV/AIDS cases were reported in the second quarter alone in China, with 93.1 percent having contracted the virus through sex.
China has experienced scandals related to HIV transfusion through blood transfusions in the past, the number of HIV infections by blood transfusions has "essentially been reduced to zero", according to Xinhua.
In the 1990s, rural parts of China - particularly the central province of Henan - endured the country's most debilitating AIDS epidemic.
It stemmed from a tainted government-backed blood donation programme and infected tens of thousands of people, including entire villages.
After nearly three decades of being virtually drug free, use of heroin and other illicit drugs has re-emerged in China as a major public health problem. One result is that drug abuse, particularly heroin injection, has come to play a predominant role in fueling China's AIDS epidemic.
The first outbreak of HIV among China's IDUs was reported in the border area of Yunnan province between China and Myanmar where drug trafficking is heavy. Since then drug-related HIV has spread to all 31 provinces, autonomous regions and municipalities.
via Atlas Obscura: When Infants in Incubators were sideshow attractions:
The premise of the attraction was straightforward enough: pay an entrance fee to see something you wouldn’t usually be able to see.
What set Couney’s sideshow apart was that his subjects were premature babies in incubators, receiving care that hospitals did not provide.
The entrance fees he collected went toward his operating costs, including round-the-clock care and wet nurses. Couney did not charge the parents of his tiny patients.
Couney visited the Pan-American Exposition in Buffalo with his baby incubators, 1901. PUBLIC DOMAIN
Reporting in 1903, The Brooklyn Daily Eagle described the “seriousness and value of the system shown.” A visit to Couney’s showcase revealed rows of warmed, glass-fronted incubators supplied with filtered air, containing “little pitiful pinched looking waifs… the only things that indicate that they are alive are the healthy color of their little faces and the faint flutterings of movement which are perceptible on closer inspection.”
Lucille Horn was one of them. Born in 1920, she, too, ended up in an incubator on Coney Island. "My father said I was so tiny, he could hold me in his hand," she tells her own daughter, Barbara, on a visit with StoryCorps in Long Island, N.Y. "I think I was only about 2 pounds, and I couldn't live on my own. I was too weak to survive." She'd been born a twin, but her twin died at birth. And the hospital didn't show much hope for her, either: The staff said they didn't have a place for her; they told her father that there wasn't a chance in hell that she'd live. "They didn't have any help for me at all," Horn says. "It was just: You die because you didn't belong in the world." But her father refused to accept that for a final answer. He grabbed a blanket to wrap her in, hailed a taxicab and took her to Coney Island — and to Dr. Couney's infant exhibit.Dr. Martin Couney holds Beth Allen, one of his incubator babies, at Luna Park in Coney Island. This photo was taken in 1941.Courtesy of Beth Allen"How do you feel knowing that people paid to see you?" her daughter asks. "It's strange, but as long as they saw me and I was alive, it was all right," Horn says. "I think it was definitely more of a freak show. Something that they ordinarily did not see." Horn's healing was on display for paying customers for quite a while. It was only after six months that she finally left the incubators. Years later, Horn decided to return to see the babies — this time as a visitor. When she stopped in, Couney happened to be there, and she took the opportunity to introduce herself. "And there was a man standing in front of one of the incubators looking at his baby," Horn says, "and Dr. Couney went over to him and he tapped him on the shoulder." "Look at this young lady," Couney told the man then. "She's one of our babies. And that's how your baby's gonna grow up."
The NYTimes is asking people to relate stories of their sexual escapades in high school and colleges.
They will then presumably presume this survey is significant: but it's not, since anecdotes don't give you an idea of what is going on, and of course, people will lie and make up stories.
If you want hard data, check the CDC data: Youth Risk Surveillance survey which I cited below to put the pedophilia crisis into perspective.
Nationwide, 45.3% of students had had sexual contact with only the opposite sex, 1.6% had had sexual contact with only the same sex, 5.3% had had sexual contact with both sexes, and 47.8% had had no sexual contact (Supplementary Table 5).
So yes, there are virgins in high school.
....
and yes, date rape happens
Nationwide, 7.4% of students had ever been physically forced to have sexual intercourse when they did not want to (Supplementary Table 34). The prevalence of having been forced to have sexual intercourse was higher among female (11.3%) than male (3.5%) students; higher among white female (11.2%), black female (11.7%), and Hispanic female (11.2%) than white male (3.3%), black male (3.4%), and Hispanic male (3.6%) students
.................
and date rape rates varies according to your sexual orientation:
Analyses based on the question ascertaining sexual identity indicated that nationwide, 5.4% of heterosexual students; 21.9% of gay, lesbian, and bisexual students; and 13.1% of not sure students had ever been physically forced to have sexual intercourse when they did not want to (Supplementary Table 34). .
.........
rates vary widely in different areas:
Analyses of state and large urban school district data indicated that across 34 states, the overall prevalence of having been forced to have sexual intercourse ranged from 5.7% to 19.2% across state surveys (median: 8.3%) (Supplementary Table 35). Across 20 large urban school districts, the prevalence ranged from 6.8% to 11.9% (median: 9.2%)
............
and a lot of kids are assaulted or forced into sexual situations short of rape. Note that this analyzed only those who were dating, so cut the percentage in half to see the actual percentage of all kids.
Among the 68.3% of students nationwide who dated or went out with someone during the 12 months before the survey,¶ 6.9% had been forced to do “sexual things” (e.g., kissing, touching, or being physically forced to have sexual intercourse) they did not want to do one or more times during the 12 months before the survey by someone they were dating or going out with (i.e., sexual dating violence) (Supplementary Table 38).
and the rate varies according to who you are dating, i.e. heterosexual vs homosexual vs not sure;
Analyses based on the question ascertaining sexual identity indicated that nationwide, among the students who dated or went out with someone during the 12 months before the survey, 5.5% of heterosexual students; 15.8% of gay, lesbian, and bisexual students; and 14.1% of not sure students had experienced sexual dating violence
---------------
so kids are all promiscuous, right? uh, not really:
Nationwide, 9.7% of students had had sexual intercourse with four or more persons during their life (Supplementary Table 137). The prevalence of having had sexual intercourse with four or more persons was higher among male (11.6%) than female (7.9%) students;
-------------
but what about normal intercourse? a lot of statistics ask who has had intercourse at any time, but the actual number who are routinely sexually active is lower than you think
Nationwide, 28.7% of students had had sexual intercourse with at least one person during the 3 months before the survey (i.e., currently sexually active) ,,,,The prevalence of being currently sexually active was higher among 10th-grade (24.9%), 11th-grade (35.3%), and 12th-grade (44.3%) than 9th-grade (12.9%) students;
This pretty well agrees with what I saw in practice: younger teenagers are at great risk for problems, including pregnancy and STDs, and that group continues to have problems:
but a lot of more mature teenagers are having intercourse with regular partners. Since in my day, I have had friends who married at age 16 to 18, I figure this is just the same behavior as their grand parents, except they don't marry nowadays.
In summary:
there is also a subgroup of teenagers at risk for sexual coercion.
You just can't arrest every time this is done, but school and public health authorities need to address this (as do churches).
This behavior to be addressed, but it is not universal.
By the way: The survey also has statistics on bullying, threats of violence, kids carrying guns, using alcohol and tobacco and drugs, were depressed, thought about suicide, and if they ate their veggies.
Nationwide, 26.6% of students had eaten vegetables (green salad, potatoes [not counting French fries, fried potatoes, or potato chips], carrots, or other vegetables) two or more times per day during the 7 days before the survey
About three billion people around the world live in households that regularly burn wood, coal or other solid fuels to cook their food. Solid fuels emit very high levels of pollutants, especially very small particles that can penetrate deep into the lungs. Typically, these households are found in the rural areas of low- and middle-income countries. Although China is rapidly urbanizing, one third of its population still relies on solid fuels.
here, I had to increase the salary of my maid so she could buy LPG gas for cooking because I got tired of treating her son for respiratory infections.
In Africa, they tended to cook outside, but in cold weather, they heated the huts with wood fires, so we saw not only respiratory illness in kids but severe burns from accidents.
"We conducted an experiment with over 5,500 diners in real-world restaurants and found that calorie labels led customers to order 3 percent fewer calories," said study author John Cawley. The drop amounted to about 45 fewer calories consumed per meal.
"This was due to reductions in calories ordered as appetizers and entrees," he added, with little change seen in the calorie count of either drinks or desserts...
uh but don't desserts have a lot of calories? Shouldn't they be cutting these out instead of appetizers?
"In interpreting that, it's important to remember that people will change their behavior when the information is new or surprising," he explained. "People may have already known that desserts are high-calorie and not cut back, but been surprised by the number of calories in appetizers and entrees, and so reduced calories there."
or maybe they cut out the appetizer so they wouldn't feel guilty about eating that calorie filled dessert...
what is not explained: if the 45 calories was in everyone, or if they added up everyone and divided it by the number of people. So a person omitting a high calorie appetizer (say, 1000 calories) but 24 people not doing anthing would amount to an average of 40 calories less per person.
even if this was true for everyone, and everyone cut their calories by 45 calories, how much weight would they lose?
Cawley calculated that over a three-year period, the calorie cut would lead to weight loss in the range of one pound.
assuming they don't go home hungry and then scarf down some potato chips and beer.
a third study was done in real time: with young 30 something white men.
Duh. Hippocrates knew this. The problem? Given the choice between a pill and diet/exercize, most people prefer the pill.
Lolo jogged until he hit age 88, but he wouldn't give up his soy sauce/patis/salty Fiilipino dishes.
and of course, for severe high blood pressure, mere diet and exercize doesn't work.
For some of us, exercize is hell. (arthritis, fear of ridicule). My only exercize is to walk George the cat killing Labrador, but even then, I go with the cook for fear of falling/being pulled down by the dog).
The problem? infrastructure collapse from not repairing it.
The government is saying that it is doing what it can, but say it is hindered by the current economic crisis. The opposition blames the lack of resources on decades of corruption and mismanagement.
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two cases of monkey pox in the UK in people returning from Africa.
not usually fatal and not easily transmitted person to person.
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After every typhoon, we have a minor epidemic of Leptospirosis.
It is easily treated with antibiotics, but often people don't seek help in time.
the flight that was stopped in NYC with a lot of sick people. What caused it? Influenza is what is being told. Then why were so many people (10) hospitalized? Or was it a precaution?
And it appears that the illness might have been spread from pilgrims returning from last week's haj celebration.
The Centers for Disease Control and Prevention is investigating illnesses that sickened dozens of passengers on three separate international flights headed into the US this week.
It looks like many of the sick passengers were traveling from Mecca, where the Hajj was recently underway, and massive crowds of millions of people gathered.
nor was that flight the only one.
First, there was an Emirates flight from Dubai that landed at JFK airport Wednesday morning and had to be quarantined... Nearly a dozen passengers on board that flight were hospitalized and given anti-viral drugs. The Centers for Disease Control and Prevention said "preliminary tests indicate that some patients tested positive for influenza and/or other common respiratory viruses."
But the agency isn't quite sure this was the common flu.
Then, on Thursday, two flights coming in to Philadelphia from Paris and Munich were briefly held upon arrival because of passengers on board with sore throats and coughs. As NBC reported, those sick passengers were all traveling from Mecca, Saudi Arabia where the annual Hajj pilgrimage was underway in late August. It's not too far from where the first plane took off (in the United Arab Emirates).
Infectious disease is always a worry for hij pilgrims, many of whom come from poor countries (poor people often are offered free pilgrimage paid for by richer Muslims).
One problem being, of course, that the seasonal influenza varies from year to year and sometimes the vaccines don't cover that strain of the virus.
In contrast, MERS has similar "flu like" symptoms, but is a different virus, one related to SARS. WHO LINK
Approximately 35% of reported patients with MERS have died.
Although the majority of human cases of MERS have been attributed to human-to-human infections in health care settings, current scientific evidence suggests that dromedary camels are a major reservoir host for MERS-CoV and an animal source of MERS infection in humans.
However, the exact role of dromedaries in transmission of the virus and the exact route(s) of transmission are unknown.
The virus does not seem to pass easily from person to person unless there is close contact, such as occurs when providing unprotected care to a patient. Health care associated outbreaks have occurred in several countries, with the largest outbreaks seen in Saudi Arabia, United Arab Emirates, and the Republic of Korea.
we had at least one scare here: and would be at major risk, not just because of returning Haj pilgrims but because we have so many caregivers in that area.
Influenza spreads quickly in crowded areas which is why during flu season they often stop visitors to nursing homes and even close churches and theatres to stop the spread of the flu.
In contrast, MERS requires close contact and does not spread easily person to person.
Strikes with microwaves, some experts now argue, more plausibly explain reports of painful sounds, ills and traumas than do other possible culprits — sonic attacks, viral infections and contagious anxiety.
In particular, a growing number of analysts cite an eerie phenomenon known as the Frey effect, named after Allan H. Frey, an American scientist. Long ago, he found that microwaves can trick the brain into perceiving what seem to be ordinary sounds.
The false sensations, the experts say, may account for a defining symptom of the diplomatic incidents — the perception of loud noises, including ringing, buzzing and grinding. Initially, experts cited those symptoms as evidence of stealthy attacks with sonic weapons.
Members of Jason, a secretive group of elite scientists that helps the federal government assess new threats to national security, say it has been scrutinizing the diplomatic mystery this summer and weighing possible explanations, including microwaves.
In men, the androgens released at puberty are known to remodel the brain. This is also true in women, where relatively small quantities of testosterone can cause certain areas to shrink and others to grow.
so did anyone bother to check it out?
...One of the first such studies was conducted only eight years ago - after the pill had already been in use for 50 years.
Dr Pletzer recruited a mixture of men and women on and off hormonal contraception, then scanned their brains.
What she found was striking. The scans revealed that several brain areas were larger in the women on the pill, compared to those of women who weren't.
These areas just so happened to be larger in men than women, too.
The study involved a relatively small sample and didn't separate androgenic and anti-androgenic contraception, so Dr Pletzer cautions against reading too much into the results. But other research has hinted that both types of hormones actually may be changing our behaviour.
It turns out that women taking pills with androgenic progestins have lower verbal fluency. They were also better at rotating objects. This makes sense, since men are thought to be slightly less articulate than women in certain situations and have better spatial awareness.
Other studies have found that women on oral contraception remember emotional stories more like men - recalling the gist more than the details. They're also not as good at recognising emotions in others, such as anger, sadness, or disgust - just like men. It looks suspiciously like certain types of pill are "masculinising" women's brains....
As Dr Pletzer wrote in 2014, when athletes take steroids we call it 'doping' - it's considered abuse and strongly condemned by society. But we are happy for millions of women to take these hormones every day, sometimes from puberty to menopause.
Scientists do not yet know if any of the pill's effects on the brain have much of an impact on our behaviour. But perhaps it is time we put it to the test.
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on the other hand, the alternative might be ten kids, or ten abortions, so maybe it's okay.
A lot of headlines are touting the increase in STD diagnoses in the USA. AFP via Manila Bulletin:
In US, sexuallly transmitted infections hit new highs
But, like the Catholic "abuse" crisis, the elephant in the room is "MSM" or homosexual sex in men.
Between 2013 and 2017, syphilis diagnoses spiked 76 percent, going from 17,375 to 30,644 cases.
Men who have sex with men made up almost 70 percent of syphilis cases.'
Over those four years, gonorrhea cases increased 67 percent — from 333,004 to 555,608 cases.
Gonorrhea diagnoses nearly doubled among gay men — going from 169,130 cases in 2013 to 322,169 last year.
translation: about 60 percent are in gay men.
Increases in gonorrhea among women “are also concerning,” said the CDC report, with cases going from 197,499 to 232,587 in a single year from 2016-2017.
they go on to discuss Chlamydia, but you know, with the newfangled idea you don't need yearly pap smears (where we docs routinely did Chlamydia testing) I wonder if some cases are missed.
they go on to lament that gonorrhea now is getting resistant to antibiotics like Zithromax (which also can treat Chlamydia, which often is missed or false negative test).
But not in the article:
It may not be an increase in gay MSM sex, but because of a decrease in the use of protection.
You see, if you take anti HIV retroviral medications, your viral load goes down and the rate of transmission of HIV goes way down too. So the fear of catching HIV is lower, meaning that there is probably less "safe sex" protection being done.
But I can't find the original report at the CDC so this is only an assumption.
guess what? A single pill with two drugs treats blood pressure better than two pills. SciDaily report:
The guidelines recommend starting most patients on two blood pressure lowering drugs, not one. The previous recommendation was for step-wise treatment, which meant starting with one drug then adding a second and third if needed. This suffered from "physician inertia," in which doctors were reluctant to change the initial strategy despite its lack of success. At least 80% of patients should have been upgraded to two drugs, yet most remained on one drug.
well, it's not "lack of success" but that there is partial success, and we figure that was good enough.
so now they think putting two pills together might work better... and this is related to why docs figure one pill was good enough: Because patients object to taking a lot of pills, or forget to take them correctly:
It is now recognised that a major reason for poor rates of blood pressure control is that patients do not take their pills. Non-adherence increases with the number of pills, so administering the two drugs (or three if needed) in a single tablet "could transform blood pressure control rates," state the guidelines.
the problem? We used to have these combinations back in the 1980s, but some "expert" at the FDA outlawed them, saying that it was more scientific to give separate pills so we could individualize the doses. But we docs knew about the patients not taking pills, but never mind: The experts had spoken.
the latest ebola epidemic isn't making a lot of headlines. LINK
The Ebola outbreak in the Democratic Republic of the Congo's (DRC's) North Kivu district continues to grow, amid new healthcare worker infections and concerns that regional violence is making surveillance and detection challenging for international aid workers.
According to an update released late yesterday by the DRC's healthy ministry, Ebola cases now total 96 (5 new cases), with 69 confirmed. In addition, 55 people have died. The 5 new cases and 5 newly recorded deaths are all in Mabalako health zone.
Aristotle, Pliny, and Plutarch recognized the numbing effect of electricity when referring to the application of the torpedo fish to the body. Scribonius Largus advocated the use of piscine electrotherapy for the relief of pain associated with gout, headache, arthritis, and hemorrhoids. Various means of providing electrical current were developed, including the use of the electric ray or great Nile catfish.“
The Egyptians reputedly used the electric shock from them when treating arthritis pain.[9] They would use only smaller fish, as a large fish may generate an electric shock from 300 to 400 volts. The Egyptians have depicted the fish in their mural paintings and elsewhere;[8] the first known depiction of an electric catfish is on a slate palette of the predynastic Egyptian ruler, Narmer, about 3100 BC.[7] It was suitably called "angry catfish" in ancient Egyptian.
An account of its electric properties was given by an Arab physician of the 12th century; then as now, the fish was known by the suggestive name of raad, abo el raash, el raad or raash, which means "thunder"[8] (literally "trembler" or "shaker").
but beware the electric eels, whose shocks are more dangerous.
giving electric stimulation for pain is used in rehabilitation: And arthritis responds to this (probably in the same way that linaments and other irritants help wih the pain).
WAPO article on athlete who uses electric patches for his arthritis.
medical analysis of electrical stimulation for Rheumatoid Arthritis.
The results showed that ES had significant benefit when compared to a control no treatment group in terms of muscle strength and fatigue resistance of the first dorsal interosseous. Most favourable results were obtained by using a patterned stimulation derived from a fatigued motor unit of the first dorsal interosseous in a normal hand rather than a fixed 10 Hz stimulation frequency. Side effects of the ES application were not reported.
The stronger medicine with androgenic properties made me "fat hairy and horny"... luckily I couldn't afford the full dosage or I would have gone manic and started to attack men.
The final medicine I took turned off my hormones and made me severely depressed. I cried all the time.
(So when I had men with prostate cancer who were put on this hormone, I warned them. I wonder how many of them ended up committing suicide? Or drinking for depression etc)
The emotional side effects of birth control pills are rarely discussed, but then as a woman with ovarian problems, I can tell you my own hormones did the same thing. PMS anyone?
I could tell my period was due when I would cry over nothing.
In the good old days, men with prostate cancer often were placed on estrogen: Cheap and efficient. Why did we stop using this? Because a double blind study showed the death rate on estrogen was higher for men: Not from cancer, where the death rate was lower, but from cardiovascular disease.
So this article (Via Virtueonline, an Episcopal webpage) notes the dirty little secret that no one wants to discuss, lest they enrage the twittermob or lose their job:
Hormones for transsexuals have side effects.
The US study compared medical records of over 5,000 transgender people against more than 97,000 others.
It also suggested that men who took hormones for more than six years were ten times more likely to have a stroke caused by a blood clot than the general population.
'Risks'
The study concluded: "These results may indicate the need for increasing vigilance in identifying long-term vascular side effects of oestrogen therapy".
Senior author Michael Goodman of Emory University's Rollins School of Public Health said the findings could be "taken into consideration when planning follow-up and evaluation of patients".
"The confirmation of this risk is good to have so patients can be warned", added fellow author Dr Joshua Safer.
this, presumably, was in adults.
The problem of giving various hormones and puberty blocking hormones to young teens with "gender dysphoria" is a bigger problem, because not only do many if not most of these kids have merely a transient wish to change sexes, and change their mind later, but the long term health problems are not clear.
this is a big problem here: generics are cheaper but you don't know if they work.
Usually, if it is a major infection or something important, I buy brand names or brand name generics at Mercury drug store, which checks on their generics.
The cheaper generics? I use when not so important.
Once Lolo had an infection that didn't get better with generic cephalexin, and our niece said to get the brand name, and the infection promptly resolved. Since he had CLL and a poor immune system, this could have mean a life threatening infection: but the generic was not completely fake, so it merely kept the infection under control with a suboptimal dosage.
We always encouraged our moms to breast feed, and one problem was when milk formula companies peddled their products to poor women.
But as the kids got older, the parents couldn't afford formula, so watered it down and the kids ended up malnourished and often vulnerable to die from infections.
So when I read the headlines claiming Trumpieboy opposed breast feeding, I thought "WTF?"
No, not because I suspected fake news (I am used to nuances being twisted by the MSM against Trumpieboy), but because public health docs have pushed to stop this for years at the local level.
So making it a UN resolution means lots of money for UN bureaucrats to push their weight around, but not much else.
and my other question was: This issue has been around for years (we opposed this in the early 1970s) so why did it come up now, at a time when people in third world countries are a lot richer, and there are a lot more women who need to work outside the home and use formula because they can't breastfeed?
This is what I found back in the 1970s: breastfeeding was universal in rural Zimbabwe, where babies often were not weaned until 2 years old, but in urban Liberia, the patients and nurses pointed out that these women needed to work and so needed formula to feed their babies.
Nowadays, here in the Philippines, they often breast feed for up to a year, but again often supplement the child's feeding with formula.
TV ads here for formula often only are about older kids, and do insist that breast feeding is better.
what has changed in the last 40 years is that people are now richer.
Yes, there are poor people, especially in war torn countries, but as a whole, there is a lot less poverty around.
And insisting on breast feeding until one year of age means women would not be able to hold a job outside the family. Back to the good old days!
Hmmm... this is the real "Handmaiden's tale".
The Federalist has the backstory and indeed it is "fake news".
“The Trump Administration believes it’s a public health priority that women and their families have all the information to decide how to appropriately deliver nutrition to their children, whether it is via breastfeeding or other methods,” an HHS spokesman said.
The agency pointed out that the United States has a long history of supporting breastfeeding and breastfeeding programs, and is the largest bilateral donor of foreign assistance programs in this area. Exclusive breastfeeding rates have doubled across 20 of countries where these programs have focused between 1990 and 2014, they say. The U.S. also supports complementary feeding programs and accurate description of the same as a matter of long-standing policy. The original resolution would have made that policy goal difficult, officials said.
StrategyPage on Central Africa notes that there is a polio epidemic, thanks to BokoHarum, a small Ebola outbreak, and lots of refugees fleeing political infighting. Sigh.
they also note China's investments there in mining for copper and cobalt, but that China is getting shafted and may have second thoughts on the deal.
but there is some good news: Volkswagon is making cars in Rwanda...
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this disease is very infectious person to person: and it can kill, especially those with malnutrition or immune problems.
But more disturbing are diseases that are being spread by mosquitoes: such as Yellow Fever (in Brazil and Nigeria).
Brazil is fighting with vaccine, but there is a vaccine shortage.
But habitat clean up is most needed (as in "drain the swamp" and use insecticides). The article blames people for moving into the jungle. Dang those poor people trying to make a living. But it is spreading to the cities, so maybe it is the lack of sewers to drain the rain and the failure of the gov't to spray high risk areas.
There was an epidemic in Angola back in 2916, that spread to the Congo and even to China, but they did manage to clean up the place and give out enough vaccines to stop it:
that was good news, because the same mosquito that carries dengue fever, which is endemic in East and south Asia, also could spread yellow fever.
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speaking of dengue: The newfangled anti Dengue vaccine that they gave out to stop the local epidemic here was found to make things worse.
Duterte, so far, is keeping his mouth shut, because it's not clear if it was corruption, or merely ignorance (and a coverup by the vaccine manufacturer about possible problems) that encouraged the government to buy and use the vaccine, which was originally tested and found to work in Brazil...
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related item: I put a few drops of medicine on my dogs to keep them free from ticks.
Time notes that this could work in humans, not just for ticks but for mosquitoes. (headup Instapundit.)
"iPad neck," sometimes called "tablet neck," is usually associated with sitting without back support, such as on a bench or on the ground, or slumping over the tablet while it rests in the user's lap.
Other postures significantly associated with pain included using tablets while lying on the side or back.
The condition is more prevalent among young adults than older adults.
Women were 2.059 times more likely to experience musculoskeletal symptoms during iPad use than men.
Those with a history of neck and shoulder pain reported experiencing more neck and shoulder symptoms during tablet computer use.
My last rant might have sounded paranoid, but the problem is that very sick and dying patients can be "offed" if the doc is overworked (as happened with the deliberate Euthanizing of patients during Katrina) or just because.
The "protocol" for "terminal sedation" has been misued to kill people: but the protocol is actually guidelines to relieve severe pain: the problem is the physicians etc. want the patient to be dead.
( I might add: I was once accused of overdosing a dying patient who was moaning in pain and I had ordered doses of narcotics to be given until he was pain free...there is a small line here, but I should note that several patients who were given huge doses of sedation actually got better once the pain was relieved and the cause of their pain or infection was treated).
this would be kept quiet in the USA, but the UK papers have this about the Gosport scandal:
In 1991, Anita Tubbritt, a staff nurse working nights on an elderly ward at the Gosport War Memorial Hospital in Hampshire, asked to have a quiet word with her local union representative.
Mrs Tubbritt, along with a number of her colleagues, had become concerned over the way medical heroin was being administered to patients, who in their opinion did not require it.
On Wednesday, more than 27 years later, those concerns were finally acknowledged, when an independent inquiry concluded that more than 650 patients’ lives could have been prematurely ended by the “institutionalised regime” of prescribing and administering opioids without medical justification.
In arriving at that conclusion, the Right...
that one is behind a pay wall, but here is the UKGuardian article about the scandal.
The independent report found that Dr Jane Barton, a GP working as a clinical assistant at the hospital, routinely overprescribed drugs for her patients in the 1990s.
consultants were aware of her actions but did not intervene. Nurses and pharmacists collaborated in administering high levels of drugs they would have known were not always appropriate.
Some senior nurses in 1991 tried to raise the alarm over using diamorphine – the medical name for heroin – for patients who were not in pain, administered through a syringe-driver pumping out doses that were not adjusted to each patient’s needs.
the whole issue of "assisted suicide" will not only encourage the depressed to think suicide is rational, but it will change the ethics of the medical profession to think that killing is okay, and hey, they will do it to "help" people.
“Handing over a loved one to a hospital, to doctors and nurses, is an act of trust and you take for granted that they will always do that which is best for the one you love,” Jones said in the introduction to the report.
“It represents a major crisis when you begin to doubt that the treatment they are being given is in their best interests. It further shatters your confidence when you summon up the courage to complain and then sense that you are being treated as some sort of ‘troublemaker’.
Right now, there is a level of mistrust by minorities against doctors, and this is going to make it a lot harder to practice medicine .
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Dr. Martin Couney holds Beth Allen, one of his incubator babies, at Luna Park in Coney Island. This photo was taken in 1941.Courtesy of Beth Allen"How do you feel knowing that people paid to see you?" her daughter asks.
