Wednesday, April 6, 2016

Quiz April 7

1. What "cultural obsession of the moment" do some mothers consider a viable substitute for vaccination? OR, what problematic implication of their obsession do some fail to consider? 

2. Whose errant article "Deadly Immunity" was retracted, but only in its corrected version?

3. Who said "a scientist is never certain"? OR, Who advocated "negative capability"? 

4. What was the bioethicist who said "it's not a matter of if, but when" referring to? 

5. Immunologist Polly Matzinger's  _____ Model says the immune system is more responsive to entities that do damage than with those that are merely foreign. 

6. Who said "we must cultivate our garden," which for Biss implies recognizing immunity as "a garden we tend together"?  

DQ:
  • "Some prefer to assume health as an identity" 135 and not a fortunate but transient and vulnerable condition. Do you think this attitude leads those who hold it to feel less compassionate towards the sick, or less responsible for participating in behaviors that enhance the health of the whole community? Does it encourage a new and pernicious "social Darwinism"?  137
  • What's your response to those who say that AIDS is a punishment for homosexuality, promiscuity, and addiction? 138
  • Do you ever feel, when doing research - especially online research - that you've fallen down a rabbit hole? 139 How do you climb out? Is science a wonderland mostly in a good way?
  • What's the best way to deal with prevalent misinformation and "sensationalist" misleading headlines that distort science: confront, correct, or ignore? 141 Do you agree that "most published research findings are false"? 142
  • Are you optimistic about our "technologies for reproducing information" and our prospects for conquering the "mysterious unknown" of disease?
  • Are we still in the same predicament as Defoe's narrator, "left to reckon with improbable theories and pure speculation" and fears of mysterious plague? 148  Was San Francisco c.1989 not that different from London c.1665?
  • Can we defuse the "bomb" of antibiotic-resistant bacteria?
  • Is Offit's respect for fear of vaccines but not for decisions not to vaccinate coherent? 150
  • Does Stoicism seem right for our times? Is "apocalypse" an overstatement? 151 If we're too stoic, will we be vigorous enough in challenging those who do not acknowledge a civic responsibility to participate in measures to secure the entire community's health and safety?
  • Is there any rationale for banning gays from giving blood? 157
  • Are there "reasons to vaccinate that transcend medicine"? 158
  • What does "cultivating our garden" mean to you, in either medical or broader contexts? 162
My sister Kim thanks you all for your thoughtful attention and questions Tuesday. She also sends along a photo someone posted on her ER Facebook site, of a tee-shirt with the message: "Too much emergency medicine prevents natural selection." Hmmm. My comment: Nothing prevents natural selection, but humane healthcare enables the selection of decency and compassion. (Will that fit on a tee-shirt?)

Deborah Blum (@deborahblum)
No possible acceptable defense: De Niro Defends Screening of Andrew Wakefield Anti-Vaccine Film at Tribeca Festival nyti.ms/1RErxol
Joe Hanson (@jtotheizzoe)
Hey @Tribeca, I fixed some errors in Andrew Wakefield’s bio for you pic.twitter.com/JOMg7SRCuZ
Michael Shermer (@michaelshermer)
There is an Intelligent Designer & his name is J. Craig Venter: "Design and synthesis of a minimal bacterial genome"science.sciencemag.org/content/351/62…
==
NYT Health (@NYTHealth)
A doctor's memoir is all the more powerful for its frequent uncertainty nyti.ms/1N4XhM0 pic.twitter.com/K1qo4Rj0qt
Saving The Doctor-Patient Relationship
Lifetime M.D. Dr. Nortin Hadler joins us to look at what’s happened to the doctor-patient relationship, and how to save it.
In this photo taken Thursday, Feb. 18, 2016, Doctor Leonid Basovich, left, examines Medi-Cal patient Michael Epps, at the WellSpace Clinic in Sacramento, Calif. (AP Photo/Rich Pedroncelli)
In this photo taken Thursday, Feb. 18, 2016, Doctor Leonid Basovich, left, examines Medi-Cal patient Michael Epps, at the WellSpace Clinic in Sacramento, Calif. (AP Photo/Rich Pedroncelli)
Nortin Hadler, MD, has been doctoring for a long time. He’s old school. Loves a rich doctor-patient relationship, where the whole person – patient – is seen and comprehended. Treated in full. But these days, he says, doctors who care are burning out, retiring early, pulling their hair out. “Today,” he writes, “health is a commodity, disease is a product line and physicians are a sales force in the employ of a predatory enterprise.” Ok! This hour On Point, Dr. Nortin Hadler on how to heal American health care... On Point (listen, read an excerpt of "By the Bedside of the Patient" by Dr. Hadler)

37 comments:

  1. Quiz question: "It isn't really inurrectionary— it's just a ____________" pg. 161

    -Matzinger

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  2. DQ: What's your response to those who say that AIDS is a punishment for homosexuality, promiscuity, and addiction?

    Answer: While I will do not agree with the idea of homosexuality, promiscuity, or addictions of any sort, I do not necessarily agree that AIDs is any more of a punishment for those actions compared to people who contract the disease without indulging in such actions. Diseases such HIV can occur through other means such as needle injections, rapes, and heterosexual relationships, among the least. Lack of proper medical care in third world countries can also result in increased transmittance among the population due to misinformation and misguidance.

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  3. Attached to this post is a link about the FDA's recent one-year abstinence from same sex relationships between men:

    http://www.advocate.com/health/2015/12/21/fda-formalizes-one-year-abstinence-update-gay-blood-ban

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  4. Do you ever feel, when doing research - especially online research - that you've fallen down a rabbit hole? 139 How do you climb out? Is science a wonderland mostly in a good way?

    I do at times feel this way, but when I do, I take a step back and breathe. I then gather my information, verify sources and then move forward ensuring that I am getting good information. I give myself time to really digest what I'm reading and often, look to what other scientists have to say to calm my rising fears. I think that science really is a wonderland in a mostly good way. I learn a lot more than I panic.

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  5. Is there any rationale for banning gays from giving blood? 157

    I see no rationale for banning gays from giving blood. They are no more disease ridden or free than the rest of us and you cannot pass on "being gay". I think that very idea of considering someone dirty or more risky based on sexual attraction is ridiculous and speaks volumes about our society.

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  6. What's your response to those who say that AIDS is a punishment for homosexuality, promiscuity, and addiction? 138

    If this were true, then one might say that the Bible Belt is being punished with tornados and such natural disasters that can destroy your home and all you built, perhaps it is being constantly hit by the hand of God for not believing enough, for judging others in his place or for some other thing they've done. Disease is something rather natural and the spread of disease comes from people living in close quarters in large numbers, not from what we believe or who we are attracted to. I often think that we are just desperately searching for a scapegoat, any scapegoat, as it's awful hard to yell at or punish a disease.

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  7. Quiz question: "San Francisco in 1989... was not unlike London in 1665" pertains to what two epidemics?

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  8. Can we defuse the "bomb" of antibiotic-resistant bacteria?

    As a biologist actively researching for methods of treatment for a pathogen, I believe the answer to this question is yes but with an asterisk. The root of the "Super Bug" pandemic that is developing is our human error. Many doctors will prescribe antibiotics for colds when any one with a basic understanding of biology (or Latin and Greek root words) knows that this is a waste of antibiotics. This is from the pressure that patients irresponsibly exert on doctors and the exasperated irresponsibility of doctors. When exposed to the correct antibiotic, bacteria will die; however, a small percentage of bacteria will thrive and this small percentage is the mother of a generation of immune bacteria. Individuals with colds do not have pathogenic bacteria in their bodies, they have some strain of rhinoVIRUS, meaning the only "cure" for this ailment is a vaccine before being exposed. Currently there is no effective vaccine for the common cold because (1) the disease mutates often and (2) the disease is not life threatening, yet we still see people demanding treatment for a disease that will go away with time and rest. Our race is far too dependent on "cold and flu" accessories that mostly do nothing but hurt us. Reports show that using cooling pads on your forehead when you have a fever, using antihistamines when you have an inflamed area, etc actually slows the healing process because for the most part, your body knows the best way to heal.

    So back to the question at hand, can we diffuse this bomb? Theoretically YES but practically NO. We don't see much activism for this issue that will surely be taking over the world come time.

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  9. DQ: What's your response to those who say that AIDS is a punishment for homosexuality, promiscuity, and addiction?

    Answer: As a practicing Christian and an interested individual on this topic, I find this question to be one of much debate and concern. This question poses several controversies that can, and do, arise within our direct culture and beyond. Nonetheless, most people may agree that this question can be answered in multiple ways. For the sake of conciseness, I will address my response on this topic through religious and medical means. While I do not agree with the idea of homosexuality, promiscuity, or addictions of any sort, I do not necessarily agree that AIDS is any more of a punishment for those actions compared to people who contract the disease without indulging in such. Diseases such HIV can occur through other means including: non-sterilized needle injections, rapes, and heterosexual relationships, among the least. What makes these modes of contraction much different from the aforementioned three? To put into analogous perspectives, a man who jumps from a 15-story building is surely to die once his body crashes into the ground. As a Christian blogger stated, “God did not design gravity as a means to punish human foolishness.” However, due to the great extent that this man took by leaping from such a height, he succumbed to death by way of gravitational assistance. Simply put, I believe that it is the lack of self-control and protection that ultimately results in the development of AIDS among these actions.
    When it comes to tattoos, tattoo artists generally assure their clients that their needles and additional equipment are sterilized and safe. Every time clients step into a tattoo parlor in prep for getting inked, they risk the possibility of becoming infected with AIDS by entrusting that the artists are being truthful and careful with their possessions. Even still, however, tattoo artist are not perfect.
    When it comes to rape victims who contract AIDS through such promiscuous actions, are they to blame for becoming infected by force? How about married couples—heterosexual involvement—in which one or both parties contract the disease? Is it just to say that these individuals deserve AIDS as a “punishment”? These changes negatively impact their lives and scar their minds with such pain.
    Aside from incidents of rape, non-sterilized needle injections, and heterosexual relationships, overpopulation in various countries can greatly facilitate the rate at which the disease is contracted among individuals. An example of this would be the lack of proper medical care and effective treatment in third world and developing countries resulting in failures to treat these individuals. Additionally, while misinformation and misguidance on the part of the general public is dangerous, is it appropriate to say that being born in countries where ignorance is all that people know is a way of punishment when it comes to AIDS contraction? The truth is that many people face these situations everyday unknowing of how serious the disease is. By the time these individuals understand the extent of their case—if they ever do—the disease will have progressed to a worsened state.

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  10. Video of Bobby Kennedy, Jr.'s Deadly immunity:
    http://youtu.be/Ycx9KKppePQ

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  11. Interesting paper on the "Danger Theory":
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443751/

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  12. DQ: What do you believe will cause the next "major pandemic?"

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  13. "Some prefer to assume health as an identity" 135 and not a fortunate but transient and vulnerable condition. Do you think this attitude leads those who hold it to feel less compassionate towards the sick, or less responsible for participating in behaviors that enhance the health of the whole community? Does it encourage a new and pernicious "social Darwinism"?

    In our capitalist, individualistic society, I do believe this is an attitude rapidly taking hold. Those wealthy enough to eat organic, purchase gym memberships, and acquire the leisure time to care for their bodies look down on those who do not have these luxuries. They see their status as something that has been earned and those who "don't make health a priority" deserve the illnesses and physical unease they experience. And it's an easy hole to fall into. As I jog down the street or wake up at 6am to do yoga, it's difficult for me to understand those who don't make time for it. But that doesn't mean that their diseases are their faults. Health is not earned; it can only be cared for. And as is the case in caring for anything, it requires the proper resources to do so.

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  14. Quiz Question

    What is essential to the health of any ecosystem?

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  15. What does "cultivating our garden" mean to you, in either medical or broader contexts?

    In my opinion, I think that "cultivating our garden" means that being able to take in the resources that are presented to an individual and being able to utilize those to expand the amount of benefit(s) received from whatever circumstance may be in question (I.E: "Increasing Crop Yield"). Anyways, that how I depict the phrase "cultivating our garden."

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  16. According to Daniel Defoe, what do physicians call the term for the spread of an infection by a stench of fume?

    (pg. 147)

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  17. Does Stoicism seem right for our times? Is "apocalypse" an overstatement? 151 If we're too stoic, will we be vigorous enough in challenging those who do not acknowledge a civic responsibility to participate in measures to secure the entire community's health and safety?

    Stoicism is understandable under particular mindset. If you believe in an apocalypse where everything will burst into flames or be over-run by zombies I can understand having a deflated/I dont care outlook on life. However, even if we believe that there is some impending doom there is plenty reason to improve the lives of those around us. Therefore, I believe this degree of stoicism should be avoided.

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  18. Here is an article link by CNN that explains the regulations involved with blood donations and homosexuality through the FDA.

    http://www.cnn.com/2015/12/21/health/fda-gay-men-blood-donation-changes/

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  19. Here's a link from the perspective of a gay man on the old ban on blood from homosexual men. Interesting for sure

    https://youtu.be/PSHJ0AVKH2s

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  20. Quiz Question: what did bish give her son on his 4th birthday. pg 139

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    Replies
    1. “lavishly illustrated edition of Alice’s Adventures in Wonderland ”

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    2. “lavishly illustrated edition of Alice’s Adventures in Wonderland ”

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  21. Quiz Question: Evolutionary psychologists describe a "____ immune system" that causes us to be highly sensitive to physical differences or unusual behavior in other people.(pp. 157)

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  22. Below is a link of a documentary that speaks about the rise of superbugs from antibiotic use. I thought it was very interesting and pertained to the topic of "it's not a matter of if, but when" - referring to epidemics and pandemics.

    https://www.youtube.com/watch?v=JW1T_RP-1rQ

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  23. Discussion Question: Do you think it will be the world's lack or knowledge or lack of caring that will lead to a devastating epidemic/pandemic?

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  24. Super Immune Systems – (Make up for 3/31/16)
    For unseen reasons individuals have different strengths of immune systems. Even though diets, lifestyles, and regions of living play a part is this the majority of it occurs naturally. Children who are breast fed have stronger immune systems due to their mother’s natural antibodies. Children who are allowed to “play in the dirt” have stronger immune systems because they were exposed to the germs in their environment and gained immunity. That does not mean that they did not get sickly the first time they “played in the dirt” but it means that their immune system benefitted form in the long run. Even those the children have strong immune systems does not mean that they cannot carry the virus or bacteria inside of them though. The different strengths of immunity are where this comes into play. The example I am about to use is not necessarily about children but it still displays the point I am trying to make. My father has Multiple Sclerosis (MS) which is an autoimmune disorder. He is predisposed to getting sicker much easier just because his immune system is weakened by the disease. He is also a teacher which makes the likelihood of catching and illness going around even worse. Growing up it was always very important to keep our home clean because that put him at much less of a risk of catching a virus. We washed our hands constantly and dusted, swept, and mopped often. It was also very important that we did this while he was not at home that way the dust in the air would not get to him. We took up this technique because once he developed pneumonia after sweeping and it was attribute to the dust in the air. It is for individuals like this, who cannot protect themselves, why people should take it upon themselves (the majority) to protect the few (the minority). My father has received all of the vaccination he can. Some he cannot receive because his immune system cannot not combat it and produce antibodies or the vaccine. One of the biggest examples if the flu shot. So it is very important that the hundreds of students he interacts with on a daily basis receive all of the vaccinations they can and take the proper hygienic procedures to stay healthy. My father works I the public education system so the children that come through must be vaccinated to attend the school. Luckily this requirement is in place because if not my father would either have to find a new profession due to fear for his health. Or he would most likely contract a common, not so serious, virus for individuals who have average or strong immune systems and end up in the hospital… or even dead. That is how easy it is for a person with a strong immune system to infect or possibly kill another individual with a weak immune system. This fact is what anti-vaccination and extremists need to realize. This debate it not just about your child and the rumored, unproven, effects of vaccines but it is about society as whole for both of those who can and cannot protect themselves.

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  25. Scientists Are Never Certain – (Make up for 4/7/16)
    Scientists can never be certain. Evidence can lead to a hypothesis begin accepted but that does not mean that the results are 100% certain. Something can always change and errors can always occur. The best certainty we can achieve is 99.99999%. We can put faith in the 99.9% that results will always be the same and as a society we do. For some people that 0.000001% is enough to deny any of the studies and experiments that aim to prove a theory. People so this is many circumstances and this idea does not only pertain to science but also a plethora of other topics, one particularly is religion. No one can be sure that their faith, or lack thereof, is 100% certain but that is exactly what faith is about. Faith means to have undeniable trust, loyalty, obligation, and belief without stone cold or tangible evidence. That statement can be used to debate religion but that is not the point I am trying to make. I mean to point about that people have faith in many things much less proven than science but for some reason that 0.00001% of uncertainty in science destroys the 99.9999% of certainty. I personally am a Christian and put faith in that there is a God who created life and is watching over me and protecting me. Just like I put faith in God I put faith in science. Some people (from both sides) would refute that religion and science cannot coexist because they disprove each other. I personally do not have that view point. I do not think that one disproves the other and I think is commonly perceived because people are always looking for a hole or mistake or problem to point out. How I perceive the two is that they back each other up. I think God put people with the intellect to be scientist and doctors on earth for a reason and I utilize them for their abilities. I trust the science that is developed and discovered every day because to me that 99.9999& is more valuable than the 0.00001%. I do not think that vaccines cause autism but can I be sure? – no. However, I do think that the numbers prove that pros to vaccinations much more outweigh the cons. I have received vaccination and as far as I know everyone in my family and all of my friends have and no one has had adverse side effects from them. Because of this I will not be afraid of vaccinating my children. I have faith in the science that vaccinations. Am I certain that nothing will go wrong? – no, but I will take that “risk.” If my child receives a vaccination and then “become” autistic I cannot say that I will not blame vaccinations is some part but I do not think I can blame it solely on the vaccination. Just like we cannot 100% prove that vaccinations do not cause autism we cannot 100% that they do either.

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  26. Here's a cool paper that analyzes the disease metaphor of Dracula as discussed in the book.

    https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwjTxOf6t4nMAhUDjz4KHWelA6oQFggcMAA&url=http%3A%2F%2Fxulanexus.xula.edu%2Ftextpattern%2Findex.php%3Fs%3Dfile_download%26id%3D84&usg=AFQjCNH2vRqS0M2fXVaL89qxQ4KvY-8Ywg&bvm=bv.119028448,d.cWw

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  27. DQ: Can we defuse the "bomb" of antibiotic-resistant bacteria?

    Answer: I do not believe we can defuse this "bomb". I believe we can slow the process by avoiding over-treating or providing unnecessary treatments and antibiotics as much as possible. Bacteria will usually become resistant to antibiotics over time, but by limiting the use of antibiotics we can slow down the process. This in turn would give researchers and scientists more time to develop new antibiotics.

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  28. Here is a short article on antibiotic-resistant bacteria, specifically gonorrhea.

    http://evolution.berkeley.edu/evolibrary/article/medicine_03

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  29. DQ: Is Offit's respect for fear of vaccines but not for decisions not to vaccinate coherent? 150

    Dr. Offit says that it is okay for us to be afraid of the risks of vaccines (in the same way that it is okay for us to be afraid of riding motorcycles). But whereas we can avoid riding motorcycles because there are alternatives, there are little substitutes for vaccinations that are effective to that extent toward immunity and therefore not vaccinating has tremendous negative side effects for the individual as well as for public health.

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  30. Quiz Question:
    What method of disease prevention has proven to be effective throughout history but has negative social effects in the present?

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  31. What's your response to those who say that AIDS is a punishment for homosexuality, promiscuity, and addiction? 138

    By no means is this a punishment for anything. Yes the use of needles and promiscuity allows for higher chances of developing aids and contracting HIV, however to think this is a punishment is completely mislead. Under this assumption, sports injuries are a punishment for playing sports.

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  32. Can we defuse the "bomb" of antibiotic-resistant bacteria?

    The best way to solve this issue is to literally follow the doctors orders. It is important to follow through all antibiotics, as well as not overuse it. The incorrect use of said antibiotics is the main contributor to the endemic resistance by the diseases they treat.

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