April 14, 2006
Iowa City tornado
The alarm clock radio came on this morning at 7 a.m. as usual and I was only half awake when I heard NPR announcing that "...Iowa City, Iowa, was hit by a tornado last evening...". Okay, now I was wide awake. I have close friends in Iowa City -- I grew up about an hour from there -- and this was the first I'd heard about the tornado. While there was a lot of damage, it sounds like the tornado wasn't a deadly one.
You can read a first-hand account on my friend's blog and click the main picture to see all the pictures she took. As she said, you grow up in Iowa and hear about tornados all the time, but until now she'd never seen one...
March 27, 2006
Unseen. Unforgotten.: Newly-published photos of Birmingham civil rights movement
This week's InternetTourbus mentioned an amazing discovery of old negatives dating from 1950 to 1965 in a closet at the Birmingham News newspaper office. That discovery has been published in a special report by the newspaper: Unseen. Unforgotten. It's an amazing journey through the civil rights movement of the 50's and 60's in Alabama, split into four photo galleries. [Note, before you are allowed access to the site, you are asked for your ZIP code, birth year, and gender. The InternetTourbus suggested using the ZIP of the University of Alabama, which is 35487, if you don't want to divulge your own.]
There is also a companion piece available for download as an Adobe Acrobat PDF file:
March 24, 2006
Surprising Lead Poisoning Danger
I was reading a new MMWR Dispatch this morning about a lead poisoning death in a 4-year-old Minneapolis boy. What I found quite shocking about this tragic story (see the Strib's "Jewelry Recalled for Lead Poisoning Danger") was the source of the lead: a small charm bracelet that was included with a pair of Reebok shoes. The Minnesota Public Health Laboratory tested the bracelet and found that it was 99.1% lead! This was basically a chunk of lead given away with your shoe purchase! Health departments and consumer groups have worked hard to get lead out of gasoline, paint, crayons, candy wrappers, and dish ware. And still it shows up in products we'd consider safe.
The Minnesota Department of Health has some good lead prevention information on their web site.
Category "Public Health"
Category "Science and Policy"
January 25, 2006
Buying organic; BSE in the news
Consumer Reports recently produced a review of organic foods: Organic products: When buying organic pays (and doesn't). The investigators group foods according to how likely it is that a fruit, vegetable, or meat product contains pesticides and other additives. They also consider the price difference between organically- and conventionally-grown foods.
For example, CR suggests purchasing organic varieties of what the Environmental Working Group calls the "dirty dozen": apples, bell peppers, celery, cherries, imported grapes, nectarines, peaches, pears, potatoes, red raspberries, spinach, and strawberries. This is because these foods "consistently carry much higher levels of pesticide residue than others," based on USDA testing.
On the other hand, CR determined that purchasing organic seafood isn't worth it. The USDA has not established organic certification standards for seafood. And organically-produced fish can still contain mercury and PCBs.
It is important to point out that these evaluations are based solely on a comparison of certain contaminants -- what is typically seen on organic foods versus what is typically seen on non-organic foods. There is no consideration of environmental impact, animal production and handling practices, or other conditions that characterize organic farming. But CR does a good job of explaining why a certain organic food is deemed 'worth it' or not in their opinion. It's a good starting point for consumers to assess their own beliefs and value judgements in deciding whether to buy organic or not.
There was one part of the report that popped out at me as especially intriguing. For the most part, all the comparisons were an assessment of chemicals: pesticides, heavy metals, etc. There was no assessment of risks from infectious agents save one: BSE. CR suggests buying organic meat in part because of the reduced "risk of exposure to the agent believed to cause mad cow disease." They also mention that buying organic meat, poultry, and eggs is a good idea because of the antibiotics used in conventional farming and the greater potential for toxins in non-organic feed. I must say that worrying about contracting the human form of BSE, variant CJD, doesn't keep me up at night. But BSE and other prion diseases are definate health concerns.
The BSE point is especially interesting in light of Japan's recent re-instatement of U.S. beef ban just a month after it lifted its initial ban; and the continuing discovery of BSE in Canada, and suspected BSE in UK cattle born after the 1996 feed regulations.
There is interesting debate between Japan and the U.S. over what is considered risky for BSE. The risk of a cow getting BSE increases with age. This is because the BSE infectious agent, the prions, need time to become established in the brain and nervous system tissues and time to replicate and cause damage. (Find out more about BSE here.)
The U.S. argues that there is little or no risk of BSE in very young cows (less than 30 months old). Furthermore, the very small levels that would exist in these young cows would be too small to detect using the clinical tests that are presently available. These beliefs have resulted in two U.S. policy decisions: first, it is not useful to test any cows younger than 30 months old, and second, brain and other risky tissues pose no risk for transmitting BSE. Japan, on the other hand, tests all ages of cattle and prohibits risky tissues (also called specified risk materials or SRMs) from cows of any age to be included in any food product. This last difference is what prompted the ban reinstatement, and the difference is summarized nicely in this posting to ProMed-mail.
Personally, I tend to agree that testing of symptom-less cows less than 30 months old is futile with current technology. But I also think that the current feed bans for cattle in the U.S. are too permissive. I think they should read as the USDA organic standards do: "The producer of an organic operation must not feed mammalian or poultry slaughter by-products to mammals or poultry" (see National Organic Program regulation Â§ 205.237 Livestock feed). I just don't want to eat meat from a herbivore animal that has been fed animal products. The organic rules aren't perfect, but they are a step in the right direction.
October 25, 2005
Forest conservation was on my mind today as a result of two stories that have crossed my path. First, Greenpeace will be launching a nationwide demonstration and educational event on November 3, dubbed Kleercut, against Kimberley-Clark's use of virgin (non-recycled) product in its paper products.
Second, I came across this article in a Scientific American news digest: Selective Logging Fails to Sustain Rainforest. A group of researchers studying the Brazilian Amazon rainforest developed a new method for measuring the impact of selective logging, which could not be measured by traditional analysis of satellite data. They estimate that "for every tree removed [by selective logging], 30 more will become severely damaged." The research, led by Gregory Asner at Stanford University, appears in this month's (October 2005) issue of the journal Science.
September 2, 2005
Giving aid to Katrina victims
The people of Louisiana, Mississippi, and Alabama are foremost in my mind today. Lots of thoughts and fears and critical opinions that I'll keep off of this page. If you have the means, please donate. FEMA has a list of reputable organizations accepting donations on its web site.
We heard on our local NPR station this morning from the Twin Cities Second Harvest chapter, Second Harvest Heartland. They've been able to load up 68,000 pounds of food from their storehouses because local need has been lower lately, but they will need to replenish their stocks as Autumn comes, so giving locally will be a big help, too.
July 8, 2005
TerraPass: clean up after your car...
I came across a short news item in this month's Wired magazine about a way to offset the carbon dioxide your car emits by funding projects that reduce industrial carbon dioxide emissions.
The project is called TerraPass. They create a way for individuals to help finance projects that reduce carbon dioxide by having members pay for the greenhouse gases they are producing by driving around in their car. In essence, TerraPass is allowing individuals to get in on the carbon emissions free market trading that was part of the Kyoto Protocol.
On their web site there is a calculator for estimating the amount of carbon dioxide generated per year for a given make and model of car and the average annual mileage. Our manual transmission Honda Civic emits about 5800 pounds of carbon dioxide per year. TerraPass estimates it can fund programs that prevent the equivalent amount of carbon dioxide from being emitted for about $30 a year.
They have four classes of memberships based on fuel efficiency: Hybrid, Efficient, Standard, and Performance (SUV). The Performance pass is the most expensive $80 a year and is off-setting about 20,000 pounds of carbon dioxide a year. Members receive a bumper sticker and a window decal, presumably alerting the crazed person that is about to key your SUV (or bash it with a baseball bat) that "Yes, I am emitting greenhouse gases, but I'm paying for them!" (Of course, there's still the carbon monoxide, particulate matter, and nitrogen compounds to worry about, among other things, that all petroleum-fueled cars emit...) All cynicism aside, I think it's a cool idea. And since my family still relies on the car quite a bit, I'm considering becoming a member.
TerraPass has made some interesting investments. They're divided into three categories:
· Clean energy -- including a wind farm in Dodge Center, Minnesota
· Industrial efficiency -- trading on the Chicago Climate Exchange
· Greenhouse gas -- bacterial digestion of manure on a California dairy farm to prevent methane emissions
Or they could just start paying bicycle commuters directly!
May 15, 2005
Class in America
Interesting article in the NYT today, Class in America: Shadowy Lines That Still Divide. It's long, but very good, especially around the ideas and ideals of "meritocracy":
A paradox lies at the heart of this new American meritocracy. Merit has replaced the old system of inherited privilege, in which parents to the manner born handed down the manor to their children. But merit, it turns out, is at least partly class-based. Parents with money, education and connections cultivate in their children the habits that the meritocracy rewards. When their children then succeed, their success is seen as earned.
Check out how class rankings work and see where you fit in using their interacitve tool.
April 26, 2005
New twist to TV-turnoff week
This is TV-Turnoff Week, from April 25 to May 1, sponsored by the TV Turnoff Network. The idea is to promote a more active and engaged public by turning off the television and finding other things to do. I think it's a great idea and something I have wrestled with, especially since there are so many programs - and baseball! - I like to watch.
But there's a bit of a twist to this year's effort. According to an interview in Salon.com, TV-Turnoff Week is affiliated with Adbusters magazine. And Adbusters is trying a new tack this year: turning off other people's televisions. They are promoting TV-B-Gone, a little gizmo about the size of an eraser that is a big TV remote OFF button. The idea, according to Adbusters' Editor in Chief, is to take back public space by turning off all of those televisions that drone on in the background.
I've gotta say I kind of like the idea. I really do feel the encroachment of televisions in many of the places I go. Although I generally draw the line at turning off sports programs at the local bar, there is a bar on a very popular corner in town that has a ginormous television that takes up almost an entire wall (it's a group of televisions, really, that are linked together to show one big picture). And the bar has an all-glass street front, so you can't help but see this monster TV as you walk by the place. I would love to hit the OFF switch on that thing just once...
Category "Scientific interpretation"
April 25, 2005
More of Merck's murky waters
Another article about Merck pharmaceutical company and trouble over how it handled clinical trials of its painkiller, Vioxx. This one was in yesterday's New York Times: "Evidence in Vioxx Suits Shows Intervention by Merck Officials".
Two disturbing points jump out at me:
|(1)||A Merck scientist urged one of the clinical trial researchers to list the cause of death for a patient as "unknown" rather than heart-related. And the researcher seemed to be a willing participant, since he said in an e-mail communication, "If it is easier to call this an unknown cause of death, I could be persuaded to say that as well." It seems to me that "unknown" should no be acceptable as a cause of death for a patient participating in a clinical trial since it may be connected to the drug or procedure exposure. At the very least a contributing cause should be indicated and by an impartial doctor.|
|(2)||The doctor listed as first author for the published trial results, Dr. Jeffrey Lisse, didn't write the paper. Merck wrote the paper and he edited it. And it doesn't sound like he was overly questioning of the data because he accepted it at face value, telling the Times reporter, "Basically, I went with the cardiovascular data that was presented to me."|
Clinical trials are a great asset to public health and medicine. When conducted correctly, we are able to make some reasonably good assumptions like random assignment of the exposure (drug, procedure) among the groups, exchangeability of the groups--outcomes in each group is a good substitute for the outcomes of the other, etc. that make interpretation of the data more robust. I guess it never occurred to Dr. Lisse to question the assumption that the data were accurate and not deliberately skewed.
Putting obvious duplicity aside, this reminds me of a more general point. You've probably heard the line about "letting the data speak for themselves." This is totally wrong--data don't speak, we speak! We look at the data and make assumptions about what it represents, what we think it is telling us. Everyone understands that art is all about interpretation; it's about time that we realize it is similar for science, as well. And no, I don't think this will horribly muddle the waters. In fact, I think we scientists will be better able to reach consensus once we make it common practice to state our assumptions along with our data and conclusions. Then all the cards will be on the table, and we can call a spade a spade.
Category "Around town"
April 1, 2005
Enjoying a new St. Paul jazz venue sans smoke
The Twin Cities went smoke free in restaurants and bars yesterday! Actually, it's a bit more patchwork than that since Minneapolis and Hennepin county went smoke free indoors with no exceptions, while St. Paul and Ramsey county allow for some bars to be exempt. There's been a lot of talk about these ordinances, but as a non-smoker I really do think I'll be going out more often. It's been in the press a lot, but my favorite piece so far is the humorous "Smoker's Guide to the Twin Cities" presented by Hackey the Cigarette in this week's City Pages.
To celebrate, we went out to check out the scene at a new smoke free bar in downtown St. Paul. The French Press Jazz Café just opened in March in the Lowertown district. According to a write-up at JazzPolice.com, the owner, Kevin O'Neill, is a police officer in West St. Paul and is looking to provide another venue downtown for local musicians.
This jazz venue is a nice space with the lofty ceilings, hardwood floors, and exposed brick that makes this old warehouse district so great. The café part of it comes not only from the coffee and pastries it has to offer, but also the layout. The tables, chairs, and couch make it feel a lot like a coffee house. But make no mistake, it is primarily a bar - with a fairly good selection of wine and beer and an offering of appetizers. There is also a small lofted dining area over the bar and kitchen. The performance space is in one of the front corners by the windows, and the openness of the café allows the music to fill the space quite nicely. The atmosphere is very casual (in fact, I was a bit overdressed) and it was nice to see a mix of ages in the crowd.
I got the feeling that the French Press is still working out some kinks and wrinkles that come with a new place (like only having one wine bottle opener), but the staff were very friendly and welcoming, if not always organized. That's not a big deal to me in a bar, where I like to be left to converse and enjoy the music. The music was good, but a tad loud, and it was nice to come in on a night without a cover charge (usually $5) to check out the scene for the first time. To be honest, last night's performers, Cinco Latino, were a guitar-based jazz group, which really isn't our thing. It would be nice to go back to hear a more acoustic group or a piano-based group, which is more along where our tastes lie. As for the libation offerings, I liked that you could order 2 oz. "tastes" of wine, along with the regular glass or bottle. And they offered "flights" - 3 tastes from any of their 5 or 6 groupings, which are fun. All-in-all we liked the French Press and will be back again to check out other acts. And we really like the smoke free atmosphere! (As if you couldn't tell... )
March 31, 2005
Did Merck decide to "see no evil" in Vioxx?
Developing pharmaceuticals is a tough job. And designing and conducting tests for a drug's safety and efficacy is quite complicated. You must carefully identify the study questions you want to answer, because everything from the type of people you enroll, to the study length, the analysis, and how you interpret the results depends upon a careful framing of the question. With all of these complexities, it's natural to expect some mistakes and missteps. But an excellent article by Robert Burton at Salon.com calls into question whether Merck's failure to recognize deadly heart-related side effects of its pain drug, Vioxx, were simple mistakes or a calculated decision not to directly investigate.
The story, "How Merck stacked the Vioxx deck" lays out how Dr. Burton sees it: that Merck knew there were heart risks with Vioxx but conducted studies "designed to avoid finding out how serious they were."
To check out the article, Salon offers non-members a 'Free Site Pass' that allows you access to their site after watching a short ad from their sponsors. For those of you don't want to bother, no worries, I've excerpted some key parts for you:
Given the enormous intellectual investment in the design of a drug like Vioxx, it is reasonable to presume that all potential outcomes were seriously entertained. I must presume that Merck would factor in what might happen to Vioxx sales with each study result. And so it's hard to escape the sadly cynical conclusion that the company consciously crafted its tests to avoid exposing the risks of Vioxx to the public.
As far back as 1984, Garret FitzGerald and his colleagues at the University of Pennsylvania, writing in the New England Journal of Medicine, showed that the COX enzyme might prevent arterial blood clot formation. FitzGerald suggested that this side effect might mean little in healthy persons but could be dangerous to patients with severe atherosclerosis.
Merck responded to FitzGerald's research by re-analyzing all of its Vioxx clinical data, and included FitzGerald's potentially worrisome lab data in its FDA application. (This data was published in 1999 in the Journal of Pharmacology and Experimental Therapeutics.) Merck also declared that it had adopted the standard procedure for "facilitating rigorous scientific analysis, on an ongoing basis, of all competing hypotheses about potential CV [cardiovascular, or heart-realted] risks or benefits from Vioxx."
Was this a sufficient evaluation of a potentially serious side effect of Vioxx? Or should more have been done? Given that it is standard practice to assess all serious potential risks of new drugs, FitzGerald's concern should have been directly addressed.
But rather than design a study focused on the C.V. risks of Vioxx, Merck created the VIGOR (Vioxx Gastrointestinal Outcomes Research) study in 2000. It compared the incidence of G.I. complications of Vioxx to naproxen, another conventional NSAID, whose most popular brand is Aleve. The goal was to prove that Vioxx was an equally effective but safer drug than an over-the-counter NSAID. Unfortunately, the study, published in the New England Journal of Medicine, revealed a twofold increase in C.V. risk for patients who took Vioxx. Of course, Merck acted surprised. What Merck didn't tell us is that it had stripped the deck of patients at high risk for heart disease.
Burton goes on to explain that the VIGOR study... (By the way, isn't that a great name for an efficacy trial? I don't need to see the results, I can just tell that Vioxx must work from that great name.) ...sorry, that the VIGOR study's participants were predominantly women, the mean age was 58, and the study duration was a little less than a year. Given that women tend to develop heart disease an average of 10 years later than men, it would be hard to draw conclusions about heart side-effects from this study group over the study time period. Meanwhile, other studies continued to raise questions about the heart risks of COX-2 inhibitor drugs, the class of drugs that includes Vioxx. And Merck looked like it was going to investigate...
According to an article in the New York Times earlier this year, the company planned to initiate a major C.V. risk study called VALOR [another great name!] in 2002. But just days before company researchers were to submit the study's protocol to the FDA, the project was abruptly halted. Merck did not explain why. It issued a general statement, saying that as it was designing the study, "we continued to ask ourselves and our consultants whether this was the right way to definitely answer" the question of whether Vioxx posed C.V. risks. "We ultimately decided not to conduct that particular study."
To further distance Merck from any responsibility for those who had recently begun taking Vioxx, Kim added, "While the cause of these results is uncertain at this time, they suggest an increased risk of confirmed CV events beginning after 18 months of continuous therapy."
No, the risk didn't begin after 18 months. This would be analogous to saying that daily sunbathing for 18 months poses no risk for melanoma if no melanomas are detected during that time, and that the risk doesn't begin until the melanomas are first discovered. The risk is present from the beginning but only evident at 18 months.
Finally, Merck is asking us to believe that it didn't suspect from the outset that Vioxx might increase the risk of heart attacks and strokes. It's telling us that its studies were adequately designed to detect both the incidence and possible underlying mechanisms of cardiovascular risks. It wants us to accept that a nine-month study, abruptly concluded, was insufficient evidence for the withdrawal of Vioxx because it was reasonable to presume that naproxen had a cardio-protective effect.
For me, the sad but inescapable conclusion is that Merck made an informed decision to avoid knowing the full extent of Vioxx's potential risks for heart attacks and strokes.
There's lots more good stuff in the story, but I've probably excerpted too much already, so go check it out. At the end of the article, Burton calls for transparency of the data so independent doctors and scientists can review it for themselves. Finally, Burton acknowledges that decisions to take drugs must involve a personal risk-benefit analysis between us and our physicians. But we can't have drug companies playing a shell game with us and revealing only those results it wants us to see.
March 28, 2005
Best places to work in fed gov't
One of the largest employers in the public health field is the federal government. Even though, with my current situation, I probably won't be working for the feds anytime soon, it's always good to know what the current fed employees think of their jobs. That's why this site,
The Best Places to Work in the Federal Government, caught my eye.
Brought to you by Partnership for Public Service and the American University's School of Public Affairs, Best Places is a ranking of federal agencies and subagencies by the employees who work there. According to their web site, the rankings "use the opinions of over 100,000 federal employees to rate 28 federal agencies and nearly 200 subagencies in the executive branch."
So who's #1?...NASA. Followed by the National Science Foundation and the Office of Management and Budget.
Here are more results:
• EPA ranks fairly high as 5th overall
• Health and Human Services ranks 11th overall
→ CDC (part of HHS) ranks 68th over all the subagencies
• Department of Agriculture ranks 13th overall
• DoE, Defense Agencies, and FEMA round out the bottom of the list
It should be noted that these rankings were compiled as a way of promoting the federal government as a good place to work and showcasing some of the bright spots. And contrary to what some might think, I don't think showcasing is a hard thing to do for some departments. As I've said before, there are some professions where the best cutting-edge work is done at the federal level, and I think that is reflected in those agencies towards the top. In the same vein, it may be that the agencies with the least cutting-edge, less unique work have come out on the bottom...
March 3, 2005
Tonight - Rob Corddry reports on "New Forms of Journalism"
On Monday, a fake reporter infiltrated the press corps at a question-and-answer session in front of New York's City Hall. Disguised in a fake mustache and hair piece in an obvious spoof of discredited White House reporter "Jeff Gannon," the intruder identified himself as "Dino Ironbody." He got City Council Speaker Gifford Miller's attention and asked: "How do you feel about the president's awesome plan to privatize Social Security?"
Miller caught on right away. "I'm not such a big fan of the president's plan to private Social Security," he answered. "I think Social Security has worked pretty well for generations and we outta stick with something that works."
The reporter was Daily Show correspondent Rob Corddry, shooting a segment that will air on Thursday night's show.
February 27, 2005
World Jump Day
Scientific research has proven that this change of planetary positioning would very likely stop global warming, extend daytime hours and create a more homogeneous climate.
This reminds me of a mathematics professor, Dr. Alexander Abian, who was at Iowa State when I was attending undergrad there in the early 1990s. He proposed blowing up part of the moon in order to stabilize weather here on Earth. When I Googled "ISU professor blow up moon", the first two hits were:
Hey, if that ain't prestige, I don't know what is.
February 26, 2005
Epi makes top 25 list
The job of Epidemiologist has been ranked by Fast Company as one of the top 25 jobs in 2005! This feels like Sally Field moment - "you like me, you really like me!"
One of the four categories they used to rank jobs was Room for Innovation. That really hits the nail on the head for me. Epidemiology is a different way of looking at things. It studies cause and effect, exposures and diseases. But the big challenge is separating the mere spurious associations from the truly causal associations, separating the chaff from the wheat. It's a lot of Sherlock Holmes-like deductive reasoning. And it's a relatively new field with all sorts of new methods and avenues opening up all the time.
On the other hand, the job of epidemiologist scored low on Salary Range Index because so much of the work is done at the local, state, and federal government agency level. Much of the funding is at the whim of representatives of the public for whom we serve. And when epidemiologists are doing their job well, there are fewer outbreaks, exposures, and illnesses. So when things are going well, there are fewer problems, and no problems mean no funding.
But money isn't everything. Just as long as I make enough to pay off these student loans before I reach retirement age!