Kristof on Cancer in the Kitchen

NY Times Nicholas Kristof makes a point worthy of notice to those in the public health:

"As long as we’re examining our medical system, the public health system should stop ignoring common chemicals linked to fatal diseases."

His Sunday column looks at links between chemicals, such as those in plastic water bottles and food storage containers, and other things in 0ur kitchen --- and breast cancer and other ailments. Read it and leave your thoughts.

Swine Flu is not a Hoax

Here's a link to a piece I wrote that was in this weekend's Houston Chronicle. Although it is more from a public health perspective than a bioethics one, there's an aspect to disaster planning that I think should be of interest to us--which is the burden that falls to women because of the absolute lack of public health infra-structure. Who do you think has to take off of work when a school is closed or a family member is sick? How would any of us care for ourselves, our families, and our pets if we could not leave the house?
Although any infra-structure can be overwhelmed given a sufficient burden, we in the United States start in the postion: we have nothing to be overwhelmed.

Stop that Bug!

Colleague and WBP supporter Art Caplan explains that the 1918 offers some lessons for us today and that all of us have a responsibility to keep swine flu from spreading:

When faced with the threat of disease, the impulse of most Americans is to think about medical technology and miracle drugs. These are not likely to be much help in the battle against swine flu — but the history books might.

As history has proven, the best way to halt a deadly virus is to keep infected people away from others. In 1918, an influenza pandemic caused by a strain of flu similar to the one identified in Mexico killed more people than died in all of World War I. Up to 50 million people died worldwide. The greatest number of deaths occurred among young adults between the ages of 15 and 35.

At the time, young American men were being mustered into military camps from all corners of the country to prepare for the war. A few brought to those cramped quarters a new strain of flu. They quickly infected one another at an astonishing rate. As they were ordered to ship out, the epidemic spread along the train lines they used, with the flu jumping into the civilian population at every stop, right up to the harbors and port cities where they departed. Many experts think the flu followed these troops on their convoys into Europe, causing millions more to die.

We risk making that same fatal mistake this time around.

The Obama administration has developed plans to send National Guard troops from all over the U.S. to the Mexican border to help contain the violence from the bloody drug war raging there. I hope that by now the White House has realized this is a really, really bad idea. Sending the Guard right now to battle drug war lords could accelerate the spread of the swine flu among a high-risk group while giving the virus a free pass to travel all over the United States as the troops rotate home.

The 1918 pandemic offers additional stark lessons. While an effective vaccine may be found against this rare strain of swine flu, it will take many months to produce in large amounts. The best weapons we have right now are not glamorous and have little to do with doctors, drugs and hospitals: They are isolation, hygiene and controlling large gatherings of people.

New Zealand just quarantined a group of students who had flown back from Mexico. We may need to do the same thing.

Americans are not used to giving up individual liberty in the name of the common good. But that attitude is exactly what diseases such as the swine flu virus thrive on.

Heading out to church, the movies, restaurants, subways, supermarkets, day care centers, schools and other places where large numbers of people gather is a recipe for spreading the virus. What if infected people and those who have close contact with them won’t stay home? What if people with symptoms slog in to work anyway? Will we intrude on their basic rights and make them stay home? Are we willing to cancel public events and close schools, museums and churches until the infection passes, no matter how loud the protests?

Good hygiene — washing your hands frequently; wearing a filtering mask; keeping doorknobs and surfaces clean; being careful about sneezing, spitting and coughing — is helpful in controlling the spread of nearly all infectious diseases, swine flu included.

Each of us needs to take responsibility for stopping the spread of the flu.

What the nation needs is not to send an army to sit in the path of a deadly virus. Instead, we need to prepare for a short period of time when individual rights to go where we want, spend time with who we want and assemble as we want yield to the necessity of protecting the common good.

Reprinted from MSNBC website, original article can be found here.

Obese because your grandparents were in a famine?

Epigenetics, a very hot topic in bioethics and public health, may provide an explanation for the current obesity epidemic. Epigenetics deals with how gene activity is regulated within a cell - which genes are switched on or off, which are dimmed and how, and the transgenerational effect -- the implications for public health could be huge.

In this clip from the NOVA special, the Ghost in Your Genes, researcher Marcus Pembrey of the Institute of Child Health at University College London and his colleagues analyzed records from an isolated community in northern Sweden and found that men whose paternal grandfathers had suffered a famine between the ages of 9 and 12 lived longer than their peers; they also found that the mother's nutrition might affect a child's risk of obesity, too -- women in the Netherlands who were in the first two trimesters of pregnancy during a famine in 1944 and 1945 gave birth to boys who, at 19, were much more likely to be obese. The implication is that extended periods of feast or famine might trigger a switch to a pattern of gene expression that results in different metabolic states for future generations.



The realization that individuals can acquire characteristics through interaction with their environment and then pass these on to future generations of offspring will likely forcue us to rethink evolutionary theories such as Dawkins' selfish gene theory.

All Those Bugs at the Gym, Oh My!

By: Jenny Walters

A recent article on Cnn.com entitled Germ warfare moves to the gym by Linda Saether dealt with the ever increases germs that are present at gyms around the U.S.

According to Dr. Brian Adams, director of University of Cincinnati Sports Dermatology Clinic, “Gyms are great for fitness, but like fun in the sun, you just have to be careful.”[1]

The main microorganisms present at gyms include bacteria, fungi, and viruses. Germs are able to travel to and from many gym –goers’ due to the number of people who share equipment, exercise mats, lockers, and showers. In addition, the activities that gym-goers’ take part in also put them at risk.

Dr. Adams stated: “The first several layers of skin are like a castle wall protecting the athlete from outside marauders. Abrasions from mats and weigh equipment, blisters from constant rubbing while running or using weight equipment both help to break down the castle wall and allow microorganisms to enter the skin.”

Sweating is also another way that germs can enter the body at a gym. According to Dr. Adams: “Sweating super-hydrates the skin and makes the athletes more likely to develop blisters. Sweating by itself may alter the castle and allow penetration of the bugs.”

Bugs that can cause problems include fungi, which can cause athlete’s foot, to viruses that can cause herpes or potentially deadly infections known as MRSA, or methicillin-resistant staphylococcus aureus.

A first line of defense for the gym-goer is disinfectant. Before an individual uses any piece of equipment, he/she needs to wipe down the equipment with disinfectant wipes. The disinfectant wipes will kill any germs that were present on the gym equipment.

One gym-goer has her germ-fighting weapons all contained in her “ultrabreathable, pink, Nike backpack.” Her backpack contains a clean water bottle, plastic bags, workout gear, a clean towel, flip-flops for the shower, a fresh bag of wipes and “everyone’s weapon of choice, the don’t-leave-home-without-it pocket hand sanitizer.”

Due to news of MRSA spreading in gyms, germ fighting has been taken “up a notch.” Gyms today are offering hand sanitizers located throughout the gym and many other germ fighting products.

This article brings light to the age of being vigilant about germs. For me, a nurse a mother, I have the word vigilant about germs embedded into my brain. My husband thinks I go a little overboard, but I would rather be safe than worry about the germs my daughter has been exposed to throughout the day. However, as my pediatrician says, germs are everywhere and it’s good to be exposed to some now and than.

[1] Saether L. Germ warfare moves to the gym. July 2008. Available at: http://www.cnn.com/2008/HEALTH/07/10/hfh.fighting.germs/index.html. Accessed on July 18, 2008.

More on Malaria -- It really is a preventable disease.

One of the places I teach is at the University of Sciences in Philadelphia, in the Department of Biomedical Writing. The Chair of Biomedical Writing is Susanna Dodgson and she is an amazing woman -- you can see her talking about her program at Pharmed Out, an independent, publicly funded project that empowers physicians to identify and counter inappropriate pharmaceutical promotion practices, and who we just added to our blogroll.

In addition to teaching and being the department chair, she is the Editor-in-Chief of the Medical Journal of Therapeutics Africa, and she has recently taken on the cause of eradicating malaria. She went on location in Lagos, Nigeria and produced, with the help of faculty and students of the Biomedical Writing program, this great video why malaria should be and continue to be a major world health concern and just how malaria can be prevented:



We had posted earlier about World Malaria Day and Blackout for Malaria on Facebook, but Susanna's video is a reminder that one day isn't enough. Go, Susanna!

Today is World Malaria Day

Today is the first-ever World Malaria Day, which organizers hope will raise our collective awareness about this disease. The mosquito-borne illness kills more than a million people a year, mostly infants, children, and pregnant women in sub-Saharan Africa. According to the World Health Organization, that's one child every 30 seconds. These deaths occur despite the fact that malaria is a preventable and treatable condition.

Insecticide-treated bed nets keep the skeeters off sleepers and reduce the rate of infection. You can donate one--heck, they cost a paltry 10 bucks apiece! Donate a few!--at Malaria No More, here.

[Editor's note: And if you are on Facebook, please join in Project Blackout: One Million Faces Against Malaria today.]

Blue Cross Proposes Their Own Fix For Uninsured Americans

Earlier this week, Blue Cross released a proposal called "Pathway to Covering America", their own plan to cover 30-35 million of the estimated 47 million uninsured Americans. Blue Cross CEO Scott Serota told reporters that "We believe it's time to act, [and] [w]e're not going to wait for the government to move."

The plan combines ideas to improve general population health, with a focus on shifting to preventive medicine, and tax credits to encourage people to buy coverage.

Blue Cross did not name specific levels for its proposed tax credits but said they would go to low-wage workers in small businesses, people whose health premiums represent a large share of their income, people without access to employer coverage and those who have lost a job.

The association also proposed helping states find and enroll people who are eligible for existing public health insurance programs but are not using them.

The Blue Cross and Blue Shield Association said the tax credits envisioned would cost the U.S. government $50 to $100 billion per year, but the overall proposal also would yield other savings as uninsured people get coverage and cut down, for example, on hospital emergency room costs.

Of significant interest, given recent conversations and posts regarding the FDA and Big Pharma here on the Women's Bioethics Blog, is the Blue Cross proposal to create "an independent institute to back research comparing the effectiveness of new and existing drugs, devices and medical procedures."

I haven't had a chance to read more than the media coverage of the proposal itself, but if you're interested, the BBC has a link to the proposal pdf for download.
-Kelly