Quotulatiousness

September 8, 2009

John Snow and the start of modern epidemiology

Filed under: Britain, Health — Tags: , , — Nicholas @ 08:52

Another “on this date” entry for you: in 1854, John Snow persuaded the local authorities in a London borough to remove the handle from a water pump at the centre of a cholera outbreak. The move was successful, and the death rate dropped immediately. Randy Alfred has the story:

BroadSt_cholera_map

Physician John Snow convinces a London local council to remove the handle from a pump in Soho. A deadly cholera epidemic in the neighborhood comes to an end immediately, though perhaps serendipitously. Snow maps the outbreak to prove his point . . . and launches modern epidemiology.

The Soho neighborhood was not then filled with galleries, clubs, restaurants and other fine urban diversions. Some of it was an unsanitary slum where centuries-old cesspits sat chockablock with the wells that provided drinking water to a crowded populace.

Asiatic cholera had stricken Britain in successive waves since 1831. Snow, an obstetrician who pioneered the use of anesthesia in Britain, published On the Mode of Communication of Cholera in 1849. His hypothesis (and supporting data) held that the scourge was caused by sewage pollution in drinking water and “always commences with disturbances of the functions of the alimentary canal.”

September 7, 2009

QotD: Environmentalism as religion-replacement

Filed under: Environment, Quotations, Religion — Tags: — Nicholas @ 00:17

It never ceases to amaze me that people who say we can “save the planet” by wearing a jumper or growing our own veg are treated with the utmost seriousness, while those who argue that tackling climate change might require some larger-scale projects — such as geo-engineering the Earth — are treated as sci-fi freaks who should stick to reading Philip K Dick novels and stop polluting public debate with their insane ideas.

When it comes to climate change, the only acceptable debate, it seems, is how we can encourage ordinary people to do less, consume less and fly less. Bigger and more far-reaching ideas about how we might offset the impact of climate change are elbowed off the agenda.

This reveals something profound about environmentalism: it is not really a campaign to find solutions to the practical problem of climate change, but rather has become a semi-religious, almost medieval demonisation of human behaviour as dirty and destructive. This is really a priestly, ideological effort to lower people’s horizons and expectations, rather than a focused attempt to create a less polluted planet.

Brendan O’Neill, “Wearing thermals won’t save the planet: Why is the 10:10 campaign, with its pledges to turn off lights and grow more veg, taken more seriously than geo-engineering?”, The Guardian, 2009-09-02

September 5, 2009

Chicken chicken chicken

Filed under: Science — Tags: — Nicholas @ 18:23

H/T to Susan Fox for the link.

(more…)

Scientific head-scratchers

Filed under: Environment, Science, Space — Tags: , — Nicholas @ 10:30

Courtesy of Roger Henry, a list of oddities from New Scientist:

2. Dark Flow: Something unseeable and far bigger than anything in the known universe is hauling a group of galaxies towards it at inexplicable speed.

3. Eocene Hothouse: Tens of millions of years ago, the average temperature at the poles was 15 or 20 °C. Now let’s talk about climate change.

4. Fly-by Anomalies: Space probes using Earth’s gravity to get a slingshot speed boost are moving faster than they should. Call in dark matter.

September 3, 2009

QotD: “The red-headed step-child of the environmental movement”

Filed under: Environment, Quotations, Railways, Technology — Tags: — Nicholas @ 16:48

As a practical matter, we’d probably get more environmental benefit (and save more wear-and-tear on our roads) from improving our freight rail system, like the abysmal mess in Chicago, than from high speed passenger rail that is very unlikely to carry more than a handful of Americans on any regular basis. . . But this does not attract one eightieth of the interest that you see in HS(P)R. As I understand it, there is finally some actual progress on Chicago, but it’s still bogged down in process, and it’s not clear to me whether it’s really enough. It seems clear to me that switching freight to rail whenever possible should be a policy priority, but it’s the red-headed stepchild of the environmental movement. We need freight cars that look more like pandas.

Megan McArdle, “Rail: It’s Not Just for Passengers”, Asymmetrical Information, 2009-09-03

September 2, 2009

NHS better than Canadian health system, says Jeremy Clarkson

Filed under: Bureaucracy, Cancon, Health — Tags: , — Nicholas @ 00:03

It’s always surprising to find a British author willing to call their massive National Health Service (NHS) “a monster that we can barely afford”, but that’s exactly what Jeremy Clarkson says in his latest Times column. But that’s merely an aside. The venom in this article is reserved for Canadian healthcare, specifically in Quebec:

Some say America should follow Canada’s lead, where private care is effectively banned. But having experienced their procedures while on holiday in Quebec, I really don’t think that’s a good idea at all.

[. . .]

Now, we are all used to a bit of a wait at the hospital. God knows, I’ve spent enough time in accident and emergency at Oxford’s John Radcliffe over the years, sitting with my sobbing children in a room full of people with swords in their eyes and their feet on back to front. But nothing can prepare you for the yawning chasm of time that passes in Canada before the healthcare system actually does any healthcare.

[. . .]

After a couple of hours, I asked the receptionist how long it might be before a doctor came. In a Wal-Mart, it’s quite quaint to be served by a fat, gum-chewing teenager who claims not to understand what you’re saying, but in a hospital it’s annoying. Resisting the temptation to explain that the Marquis de Montcalm lost and that it’s time to get over it, I went back to the boy’s cubicle

[. . .]

And they also had the cash to employ an army of people to slam the door in your face if you poked your head into the inner sanctum to ask how much longer the wait might be. Sixteen hours is apparently the norm. Unless you want a scan. Then it’s 22 months.

At about 1.30am a doctor arrived. Boy, he was a piece of work. He couldn’t have been more rude if I’d been General Wolfe. He removed the bandages like they were the packaging on a disposable razor, looked at the wound, which was horrific, and said to my friend: “Is it cash or credit card?”

August 24, 2009

The trend to violence has actually been a trend away from violence

Filed under: Science — Tags: , , — Nicholas @ 11:56

Radley Balko links to this interesting article by Steven Pinker, which shows something that on the surface appears to fly in the face of the facts: we’re not becoming more violent, we’re becoming more peaceful:

Our seemingly troubled times are routinely contrasted with idyllic images of hunter-gatherer societies, which allegedly lived in a state of harmony with nature and each other. The doctrine of the noble savage — the idea that humans are peaceable by nature and corrupted by modern institutions — pops up frequently in the writing of public intellectuals like, for example, Spanish philosopher José Ortega y Gasset, who argued that “war is not an instinct but an invention.”

But now that social scientists have started to count bodies in different historical periods, they have discovered that the romantic theory gets it backward: Far from causing us to become more violent, something in modernity and its cultural institutions has made us nobler. In fact, our ancestors were far more violent than we are today. Indeed, violence has been in decline over long stretches of history, and today we are probably living in the most peaceful moment of our species’ time on earth.

Infant mortality rates in the US

Filed under: Health, USA — Tags: — Nicholas @ 07:54

Steve Chapman looks at one of the bigger question marks in the debate over health care in the United States: why such a high infant mortality rate?

The American medical system has the latest technology, the greatest variety of new drugs, and unparalleled resources. But anyone who thinks we’re getting something great for our dollars inevitably encounters a two-word rebuke: infant mortality.

The United States is the richest nation on Earth, but it comes in 29th in the world in survival rates among babies. This mediocre ranking is supposed to make an irrefutable case for health care reform. If we cared enough to insure everyone, we are told, we would soon rise to the health standards of other modern nations. It’s just a matter of getting over our weird resistance to a bigger government role in medical care.

[. . .]

No one denies the problem. Our infant mortality rate is double that of Japan or Sweden. But we live different lives, on average, than people in those places. We suffer more obesity (about 10 times as much as the Japanese), and we have more births to teenagers (seven times more than the Swedes). Nearly 40 percent of American babies are born to unwed mothers.

Factors like these are linked to low birth weight in babies, which is a dangerous thing. In a 2007 study for the National Bureau of Economic Research, economists June O’Neill and Dave O’Neill noted that “a multitude of behaviors unrelated to the health care system such as substance abuse, smoking and obesity” are connected “to the low birth weight and preterm births that underlie the infant death syndrome.”

August 23, 2009

Toronto’s recent brush with tornado weather

Filed under: Cancon, Environment — Tags: , , — Nicholas @ 17:29

I was deep in downtown Toronto when the storm started to move in, and listening to the professional pants-wetters at 680PanicNews was initially disturbing, but eventually hilarious. Not to minimize the genuine damage caused in Vaughan and the town of Durham. This is how I summarized the weather-related experience in an email to Jon:

I barely made it home before the storm hit . . . it chased me all the way, with the ProfessionalPantsWetters at 680Panic Radio getting more and more excited as the time went on.

I got out of the truck, picked up my laptop, walked to the door, and less than a minute later the storm hit. The power went out about five minutes after that (and didn’t come back on until about 3:30 in the morning).

No obvious damage around the house, thank goodness, although the gazebo tried to go walkies around the yard. It wrapped itself around the patio set, which will take several pairs of hands to disentangle and find out if it’s still usable.

From a follow-up email, specifically about the radio coverage:

At first, they didn’t seem too bad. I turned on the radio just as traffic came to a stop on the DVP just south of the Bloor Viaduct. By the time I got as far as Lawrence, the woman reporter who got all verklempt over the TORNADO ON JARVIS!!!!! wasn’t able to draw a breath without sounding like she was panting or gasping. I was starting to laugh at them by that point.

The meteorpanickologist who started to repeat (several times) that everyone should get into the basement — or lower — or into a closet (aren’t most people’s closets on the upper floor if they’re in a house?) or cower in a bathtub (aren’t they usually upstairs too?) . . .

I also found amusement in the repeated definition of the terms “tornado watch” and “tornado warning”, where almost every time, the description of “tornado warning” was to “_watch_ out for imminent tornado formation”. They just don’t listen to themselves, do they?

I thought it quite telling that one of the better reports was from their entertainment editor, who reported from her car on the way up Victoria Park Avenue. She, at least, sounded calm and reported only what she could see for herself.

Chris Taylor brings some actual data to the discussion of tornado frequency and writes “It can be tempting for Torontonians — who generally think of themselves as an island of tranquillity free of severe weather — to overreact a little.”

August 22, 2009

Right wing nutbars, observed

Filed under: Health, History, Liberty, USA — Tags: , , , — Nicholas @ 08:23

P.J. O’Rourke tries to save readers the effort of reading the Washington Post coverage of recent town hall protests:

So there was Rick Perlstein calling everyone to the right of Nikita Khrushchev a candidate for the state psychiatric ward with Alec MacGillis playing his KGB Bozo sidekick, firing blanks and honking his “End-of-life care eats up a huge slice of spending” airhorn. Then, to add idiocy to insult, the Post sent Robin Givhan to observe the Americans who are taking exception to various expansions of government powers and prerogatives and to make fun of their clothes.

Givhan writes a column called “On Culture,” and this is what passes for culture at the Post: “Of the hundreds of thousands of style guides currently for sale on Amazon, not one . . . was prescient enough to outline the appropriate attire for those public occasions when good citizens decided to behave like raving lunatics and turn lawmakers into punching bags.” Meeting with Givhan’s scorn were “T-shirts, baseball caps, promotional polo shirts and sundresses with bra straps sliding down their arm.”

I’ve never seen Robin Givhan. For all I know she dolls herself up like Jackie O. But I have seen other employees of the Washington Post and — with the exception of the elegant and, I dare say, cultured, Roxanne Roberts — they look as if they got dressed in the unlit confines of a Planet Aid clothing-donation bin.

Perlstein, for all the highness of his dudgeon, doesn’t catch the nuts saying anything very nutty. The closest he gets to a lunatic quote is from a “libertarian” wearing a holstered pistol who declares that the “tree of liberty must be refreshed from time to time by the blood of tyrants and patriots.” And those are the words of lefty icon Thomas Jefferson. I myself could point out the absurdity of protestors’ concerns about government euthanasia committees. Federal bureaucracy has never moved fast enough to get to the ill and elderly before natural causes do. And what’s with those “birthers”? Why their obsession with a nonentity like Obama? How about John Adams with his Alien and Sedition Acts choke-hold on the First Amendment? Or Jefferson? He could tell his Monica Lewinsky, “I own you,” and he wasn’t kidding. Or John Quincy Adams, pulling the original Blagojevich, buying the presidency from Henry Clay? Or that backwoods Bolshevik Andrew Jackson? Or William Henry Harrison, too dumb to come in out of the rain? Not one of these scallywags was born in the United States of America — look it up.

August 21, 2009

QotD: Heroin as a treatment for addiction

Filed under: Health, Quotations — Tags: , , — Nicholas @ 11:53

Stripped of the medicalese, what the researchers found is that if you give heroin addicts heroin, they will keep coming back for more. They will also be less likely to buy heroin on the street or commit crimes to support their habit. These findings, similar to the results of European studies, are not exactly surprising. The puzzling thing is that we’re asked to pretend that heroin is a “treatment” for heroin addiction. “Study Backs Heroin to Treat Addiction,” says the headline over a New York Times story that begins, “The safest and most effective treatment for hard-core heroin addicts who fail to control their habit using methadone or other treatments may be their drug of choice, in prescription form.”

What the study actually shows is that the problems associated with heroin addiction are largely caused by prohibition, which creates a black market in which prices are artificially high, quality is unreliable, and obtaining the drug means risking arrest and associating with possibly violent criminals. The drug laws also encourage injection by making heroin much more expensive that it would otherwise be and foster unsanitary, disease-spreading injection practices by treating syringes and needles as illegal drug paraphernalia. When you take these dangers out of the equation, regular use of heroin is safe enough that it can qualify as a “treatment” dispensed by men in white coats. That rather startling fact should cause people to question not just current addiction treatment practices but the morality of trying to save people from themselves by making their lives miserable.

Jacob Sullum, “This Just In: Heroin Addicts Like Heroin”, Hit and Run, 2009-08-21

August 15, 2009

The high cost of coping with Celiac Disease

Filed under: Health — Tags: — Nicholas @ 12:33

An article in the New York Times discusses something near and not-particularly-dear to our hearts — Celiac Disease:

Seven years after receiving his diagnosis, Mr. Oram, who is married and has one daughter, is symptom-free, but the cost of staying that way is high. That’s because the treatment for celiac does not come in the form of a pill that will be reimbursed or subsidized by an insurer. The treatment is to avoid eating products containing gluten. And gluten-free versions of products like bread, pizza and crackers are nearly three times as expensive as regular products, according to a study conducted by the Celiac Disease Center at Columbia University.

Unfortunately for celiac patients, the extra cost of a special diet is not reimbursed by health care plans. Nor do most policies pay for trips to a dietitian to receive nutritional guidance.

In Britain, by contrast, patients found to have celiac disease are prescribed gluten-free products. In Italy, sufferers are given a stipend to spend on gluten-free food.

Some doctors blame drug makers, in part, for the lack of awareness and the lack of support. “The drug makers have not been interested in celiac because, until very recently, there have been no medications to treat it,” said Dr. Peter Green, director of the Celiac Disease Center at Columbia University. “And since drug makers are responsible for so much of the education that doctors receive, the medical community is largely unaware of the disease.”

Elizabeth has suffered from gluten intolerance for most of her life, so we’re very aware of the difficulty (and added cost) of finding food that doesn’t contain wheat gluten. Wheat is a very cheap way of adding bulk and body to foods that traditionally do not contain it . . . it’s distressing the number of times we’ve discovered that a packaged food that used to be gluten-free has been “improved” . . . and the extent of the improvement has been to add wheat in place of more expensive non-gluten ingredients.

QotD: The biggest risk in moving to a single-payer system

Filed under: Health, Quotations — Tags: , , — Nicholas @ 11:05

My objection is primarily, as I’ve said numerous times, that the government will destroy innovation. It will do this by deciding what constitutes an acceptable standard of care, and refusing to fund treatment above that. It will also start controlling prices.

Now, at this point in the discussion, some interlocutor starts chanting what I’ve come to think of as “the mantra”: othercountriesspendlessandhavelongerlifespans. Then they ask me how I can ignore the overwhelming evidence that national health care is superior to our terrible system. Now, what’s odd about this is that all of those countries do precisely what I am concerned about: slap price controls on the inputs, particularly pharmaceuticals. Their overwhelming evidence indicates that I am 100% correct that a government run system in the US will destroy the last really profitable market for drugs and medical technology, and thereby cause the rate of medical innovation to slow to a crawl.

[. . .]

The things that make markets innovate — profit potential — have been mostly squeezed out of the system. The things that hasten market discover — prices — have also been increasingly relegated to central authority. Having something like that in the United States would produce exactly the outcome I’m worried about. So if Matt is right, and this is where the slippery slope ends up, my nightmare will have been realized.

Megan McArdle, “What Does It Mean To Have a Private Health Care System?”, Asymmetrical Information, 2009-08-13

August 14, 2009

If it isn’t Astroturf . . .

Filed under: Health, Politics — Tags: , — Nicholas @ 12:34

. . . maybe it really is grassroots? Jesse Walker decodes some of the hysteria around both the protests and the official responses:

Clashes keep breaking out at the “town hall” meetings devoted to discussing health care reform. Usually the excitement amounts to some angry questions and heckling, but sometimes there’s more. Six people were arrested at a demonstration outside a meeting in St. Louis. Violence erupted at a town hall in Tampa after opponents of ObamaCare were locked out of the building. A North Carolina congressman cancelled a meeting after receiving a death threat; the pro-market group FreedomWorks, which was involved in some of the protests, fielded a death threat of its own. Supporters of the president’s health care reforms, who used to tout the support he’d received from the pharmaceutical and insurance industries, are now accusing the very same companies of riling up “mob violence” to stop the plan.

As the charges and countercharges fly, here are three maxims to keep in mind:

1. It isn’t Astroturf after the grassroots show up.

[. . .]

2. It isn’t unprecedented if there are obvious precedents. When someone like New York Times columnist Paul Krugman claims that the “mob aspects” at the meetings are “something new and ugly,” all he’s demonstrating is that he’s an economist, not a historian. When it comes to bands of angry citizens being disruptive, it isn’t hard to find earlier examples in American history. It isn’t even hard to find earlier examples in 21st century American history. Just go to Google and punch in phrases like “guerrilla theater,” “antiwar protest,” and “Code Pink.”

[. . .]

3. It isn’t fascism if…actually, you can stop there. IT ISN’T FASCISM, you numbskulls.

August 12, 2009

QotD: “an abject failure for the Obama administration”

Filed under: Health, Politics, Quotations, USA — Tags: , , , — Nicholas @ 12:34

But who would have thought that the sober, deliberative Barack Obama would have nothing to propose but vague and slippery promises — or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.

There is plenty of blame to go around. Obama’s aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.

You can keep your doctor; you can keep your insurance, if you’re happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.

I just don’t get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy.

Camille Paglia, “Obama’s healthcare horror: Heads should roll — beginning with Nancy Pelosi’s!”, Salon.com, 2009-08-12

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