U.K Hospitals – Get that filthy tie out of here!

Byoliveridley

It may be no surprise to some that doctors frequently transmit diseases amongst patients in hospitals. And bugs in hospitals, raised on a steady diet of antibiotics, tend to be hardy, drug resistant and deadly. Among the many sensible things doctors need to do (ahem, wash your hands doc!), turns out that the clothes you wear make a difference. So, in the U.K, where they worry about these things, doctors are being issued a dress code. Read on for some biting criticism of that most pointless of neck appendages.

U.K. hospitals issue doctors’ dress code – Yahoo! News

“British hospitals are banning neckties, long sleeves and jewelry for doctors — and their traditional white coats — in an effort to stop the spread of deadly hospital-borne infections, according to new rules published Monday.

Hospital dress codes typically urge doctors to look professional, which, for male practitioners, has usually meant wearing a tie. But as concern over hospital-borne infections has intensified, doctors are taking a closer look at their clothing.

‘Ties are rarely laundered but worn daily,’ the Department of Health said in a statement. ‘They perform no beneficial function in patient care and have been shown to be colonized by pathogens.’

Please frame that statement, ties are pointless, ties perform no beneficial functions, down with ties!

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Autism epidemic not caused by shifts in diagnoses; environmental factors likely

Byoliveridley

California’s sevenfold increase in autism cannot be explained by changes in doctors’ diagnoses and most likely is due to environmental exposures, University of California scientists reported. The scientists who authored the new study advocate a nationwide shift in autism research to focus on an array of potential factors in the environment that babies and fetuses are exposed to, including pesticides, viruses and chemicals in household products.

Autism epidemic not caused by shifts in diagnoses; environmental factors likely — Environmental Health News

One of the most common arguments you will see about a lot of mental health diagnoses is that doctors have changed their diagnostic practices significantly. While there is evidence of this occurring in diagnoses of childhood depression, anxiety, or even bipolar disorder due to the millions of dollars involved in medication and the attendant corruption, autism is different.

This population study used 17 year data in California and concluded that diagnostic changes were only responsible for a 2 fold increase, not the seven fold increase seen. The rest is unexplained, and the authors attribute it to a confluence of environmental and genetic factors.

And no, for the last time, VACCINES DO NOT CAUSE AUTISM!

Industry Funding may Bias Nutritional Health Research

Byoliveridley

Not a truly surprising finding, given the enormous profits at stake for the Nestle’s of the world.

PLoS Medicine – Relationship between Funding Source and Conclusion among Nutrition-Related Scientific Articles

Funding source was significantly related to conclusions when considering all article types (p = 0.037). For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding (p = 0.009). The odds ratio of a favorable versus unfavorable conclusion was 7.61 (95% confidence interval 1.27 to 45.73), comparing articles with all industry funding to no industry funding. Conclusions: Industry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors’ products, with potentially significant implications for public health.

Note the zero, as in, the number of unfavorable conclusions in wholly industry funded interventional studies.

interventional study—if humans consumed, or if human tissue was exposed to, a food or food component with the intention of measuring a biological response

Well, not surprising. You can exert much tighter control on an interventional study where you control most of the variables. Seems like there’s some predestination going on here!

What do the authors think is going on here?

(1) Industrial sponsors may fund only those studies that they believe will present their products in a favorable light, or their competitors’ products in an unfavorable light. In support of this possibility, all studies funded entirely by industry were characterized as “benefit” or “antagonism” with regard to the product under study (none were characterized as “no relationship”). That is, industrial organizations do not seem to sponsor articles about products in which they have no financial interest. (2) Investigators might formulate hypotheses, design studies, or analyze data in ways that are consistent with the financial interests of their industrial sponsors. (3) Industrial sponsors or investigators may choose to delay or not publish findings that have negative implications to the sponsor’s product. (4) Authors of scientific reviews may search and interpret the literature selectively, in ways consistent with the sponsor’s interests. (5) Scientific reviews arising from industry-supported scientific symposia, often published as journal supplements, may over- or under-represent certain viewpoints, if presenters whose opinions conflict with the sponsor’s financial interests are not invited to participate.

All good points. Remember next time you read an article in the paper about how exercise is much more important in determining obesity compared to your average sugary drink. Remember that a 12 Oz can of coke contains 39 grams of sugar, or 8 teaspoons worth!

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Small California Study Finds Correlational Link Between Organochlorine Pesticides and Autism

Byoliveridley

That would have been my headline! It was a study of 29 women, and the results show a six-fold increase in the incidence of autism in children whose mothers were close to fields being sprayed with organochlorine pesticides. A factor of 6 is a big number, which is why they found statistical significance at such a low sample size.

Most organochlorine pesticides (the most famous being DDT) are already banned in the first world. The ones suspected here, endosulfan and dicofol are banned in quite a few countries including Belize, Singapore. Cambodia and Germany. The Stockholm convention (international treaty to identify and restrict the use of persistent organic pollutants) has identified endosulfan as a possible addition to its list of POPs.

Of course, the US has not even ratified the Stockholm convention thanks to the pesticide lobbies. So, nothing the Stockholm convention decides about endosulfan will  carry any legal weight. In this country, pesticides and most other chemicals in current use are “innocent until proven guilty”, meaning harm must be conclusively proven in a manner that will withstand court challenge. With industry sponsored research and lobbying, such a burden of proof is often insurmountable and therefore, hazardous pollutants are used in the US well beyond their sell-by dates.

Pesticide link to autism suspected – Los Angeles Times

Women who live near California farm fields sprayed with organochlorine pesticides may be more likely to give birth to children with autism, according to a study by state health officials to be published today. The rate of autism among the children of 29 women who lived near the fields was extremely high, suggesting that exposure to the insecticides in the womb might have played a role. The study is the first to report a link between pesticides and the neurological disorder, which affects one in every 150 children. But the state scientists cautioned that their finding is highly preliminary because of the small number of women and children involved and lack of evidence from other studies.

Clearly, the increase in autism incidence has many more factors linked to it than environmental chemical exposure, but this is interesting and good work. This study will doubtless be severely criticized by the pesticide lobby. After all, it’s only a correlation, no mechanism has been proposed, and the sample size is very small. But, as I mentioned before, you don’t normally see six-fold increases in disease incidences with ambient environmental exposure, so there is definitely something going on here.

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NC smoking bill extinguished?

Byoliveridley

Laura Leslie has the scoop…

Monday: Snuffed Out? — North Carolina Public Radio WUNC

Looks like House Maj. Leader Hugh Holliman’s smoking ban may be in trouble. The first sign of trouble was that it didn’t come up for a floor vote in the few days following its 9-4 approval in J1 committee. Today, Holliman told NCNN’s Matt Willoughby he’s planning to pull the bill off the calendar when it comes up tomorrow.

It’s only a matter of time, they can fight it all they want, the smoking bans will pass throughout the country in a a decade or less, that’s a bold prediction!

Most critics say the legislation goes against private property rights in banning all workplace smoking, regardless of the context. But supporters point out the government has been regulating workplace safety on issues like asbestos for a long time, even on private property. Since secondhand smoke is an environmental toxin, they say, it should be regulated, too.

As I mentioned in comments on an earlier post, property rights is a catchall rhetorical tool that can defend just about anything, good bad or neutral. So, I am not surprised it is being used here. The obvious counter argument that property rights do not give you the right to pollute is apparently lost on this debate. But this is not really about property rights, is it? It is about protecting the tobacco industry, good old plut-prot-principle!

Lasers shooting into irises
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Lasers shooting into irises

Byoliveridley

I did not think my first minor surgery would involve someone shooting lasers to make holes in my iris. It sounds like more fun than it actually was, but was mostly painless and here I am, looking at a computer screen 3 hours later. My eyes feel like they’ve had about 5 hours of sleep, which is good considering they’re now sporting two brand new drain holes.

Laser iridotomy is also performed prophylactically(preventively) on asymptomatic individuals with narrow angles and those with pigment dispersion. Individuals with a narrow angle are at higher risk of an acute angle closure, especially upon dilation of the eye

http://www.surgeryencyclopedia.com/La-Pa/Laser-Iridotomy.html

I also just started reading Bad Science by Ben Goldacre, which is about the use and misuse of the banner of science by a large group of people including nutritionists, pharmaceutical companies and “alternative” treatment specialists. It has a great chapter on the “placebo” effect, how much of it is culturally mediated, and how much doctor demeanour and confidence in their skills and outcome affects results. The doctor shooting holes in my eye was extremely confident in their skills and their results, and normally, my brain would be sending off all kinds of hubris warnings. In this case, their confidence reassured me a bit, and Bad Science definitely helped. It was also interesting to see a large section on homeopathy in the book, since I’ve written about my contact with homeopathy and felt that the cultural practices of a good homeopath can be of some use to people as long as they don’t go too far. The book confirmed some of that.

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Shaming People into Pooping Indoors

Byoliveridley

Meanwhile, in the other India, people still poop outdoors…

Using shame to change sanitary habits – Los Angeles Times

Every morning before sunrise, Ravi Shankar Singh, a cheerful man known to his neighbors as “Luv” Singh, sets out to patrol the potholed roads and rice fields of this north Indian village. He carries a whistle and a flashlight. He sings while he walks. The village’s self-appointed sanitation guardian, Singh is on the lookout for anyone squatting in the fields or alleys, using the cover of darkness to do what millions of people have always done across India: defecate outdoors. After years of programs to increase the number of latrines in villages, the government still has not managed to eradicate a practice that is cited in the spread of water-borne illnesses and parasites, such as diarrhea and hookworms. Critics say the obstacle is not so much the shortage of latrines, though that, too, remains a problem for nearly half of India’s rural population. The main challenge is getting people to use the facilities they have. Singh says he’s found a way. When he spots someone squatting, he lets loose with a blast on his whistle. Or shines his light on the offender. Or both.

This is clearly a serious public health issue and one that is linked to many avoidable deaths from disease. I am not sure if blowing whistles at people is an ethical way to do it. In a country where actual toilet facilities are still rare, and the people who grew up in this scarcity have internalized the fact that they have to “externalize” their poop, just providing facilities and shaming them is not enough.

Just as with most things in India, no easy answers, I guess the right combination of education (especially targeting the young), enforcement through fines, and most importantly, saturation coverage of clean and easily available toilets would eventually work.  But it will take time, and of course, public urination is a completely  different beast!