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This September sees doctors entering the debate on First Amendment rights. The American Academy of Pediatricians has published a policy statement attacking the current practices of the television, internet and print media on “explicit” content. Put simply, the AAP lists all the main problem areas from lyrics in music and the accompanying videos, the pornography easily accessed on the internet, to all the ads we see for erectile dysfunction drugs. It notes this is triggering early questions about sex and sexuality without any balancing content on sexual responsibility in relationships and birth control. Taking just two examples, there are now a host of reality TV shows which are supposedly just for “dating”, but the real interest lies in seeing who pairs off. Equally, it’s now routine for advertisers to use sex to sell even the most unsexy products and services. These are images of women wearing only a few clothes posing suggestively. Children gather information from all sources available to them. As peers, they exchange web addresses and swap the latest downloads of music videos. They encourage each other to upload photographs of themselves partially or completely nude to Facebook and other slightly less obvious sites. If life is boring, there are now a host of sites following in the footsteps of chatroulette where you can make random video chat connections. In many instances, this is an excuse for sexually bizarre behavior among many participants, but it can be more mainstream, e.g. the Reddit community asked for a service that would allow them to see more than each other’s faces and Popjam links to Facebook. The underlying question is what message all this sends to our young. First, it’s reinforcing the stereotype of men as wanting hard erections and being prepared to take pills to get them. With images of semi-naked women everywhere it continues the trend of portraying women as sexual “things” and potentially starts the use of pornography at an earlier age. Yet the regulators see nothing wrong. The television stations routinely accept erectile dysfunction ads and refuse ads for oral and emergency contraception pills. The internet continues to be the Wild West with everything available if you know how to use google. Apart from a few “family” and religious organizations prepared to speak out, there has been little pressure to moderate behavior. Perhaps the intervention of the AAP will provoke more discussion and a cultural shift. Until then, we’re all free to enjoy all the ads where the sultry, if not flirtatious, woman wants her man to “do this more often”, referring to the smile both wear as a result of using the pills. Read the rest of this entry »

It’s always interesting to compare how other countries approach the question of treatment. The Brits have the National Institute for Health and Clinical Excellence (shortened to NICE). There were no national standards for treatment so there was a ZIP code lottery, people receiving the care thought best by their neighborhood hospitals. Some did very well. Many did not. But, from 1999, NICE has been responsible for the evaluation of all treatments. It balances patient outcomes against the financial cost, always looking for the best value-for-money. If NICE finds a drug, device or treatment strategy to give poor value, it refuses certification and no public money can be spent on it. This leaves it to those with the cash in hand or an insurance policy to decide whether they will pay for the given treatment privately. In the US, we have no national body to offer clinical guidelines. In theory, this leaves everything to the individual doctors but, in reality, doctors are influenced by the drug companies and device manufacturers. So many hospitals are set up to deliver treatments where there is no evidence they are effective. For example, the Brits believe in pain management centers. These are multidisciplinary teams of specialist doctors, therapists, counselors, and nursing professionals. When a patient continues to experience pain after treatment by a specialized hospital department, the local center takes over. The strategy is to review the patient’s medical records looking for anything not done or not done well. If this rediagnosis finds possible remedial work, it is done first. Only when all physical avenues have been exhausted does the center treat the pain itself by a mixture of counseling and drug therapy. The idea is to get the best quality of life possible with the lowest long-term costs. This means pain management without depending on drugs wherever possible. In the US, the individual hospital departments are too powerful. No one is allowed to take over patients and look for faults in their treatment to date. If a patient is still in pain, the original specialist simply gives more painkillers. That way, their reputations are protected and they keep all the money flowing from the insurance companies. This means patients come out second best and, for the most part, dependent on painkillers to get through the day. You will only find pain management centers in a few hospitals and, for the most part, they are underfunded and understaffed. The pharmaceutical industry has too much to lose if doctors treat patients with less drugs. The hospitals make less money if people are treated at home or in the community. So it’s going to take a revolution to change hospital culture and focus on the actual patients’ needs rather than the financial interests of the doctors and the hospitals. As it stands, there’s little sign of enthusiasm for this change. Read the rest of this entry »

1975, in Lyme, Connecticut, USA, the world realized a new threat to human health. The eponymous Lyme Disease entered human language. Since then, researchers have ferreted out the cause and means of transmission of the disease, but we are still struggling to understand and fight it, even as it spreads around the US and Canada, wreaking havoc. Lyme Disease is caused by several bacteria. We currently know of three strains – Borrelia burgdorferi sensu lato, Borrelia afzelii, and Borrelia garinii, the first infecting the US and the latter two infecting Europe – but new strains may still be discovered. These bacteria are carried by small rodents and other animals, such as mice and squirrels, and then transmitted through ticks to humans. Ticks – parasitic arachnids found on most continents – may bite a small animal with one of these bacteria then may then bite a human, giving them the bacteria from which they contract Lyme Disease. The disease is potentially fatal if untreated. However, certain antibiotics are somewhat effective at treating the illness and eliminating symptoms. The disease usually causes a skin rash known as erythema migrans from one day to one month after a bite. This rash is an infection that is identified by circles of discoloration around the bite. Other early symptoms may be fever, headache, depression, and fatigue. Later symptoms are joint pain and stiffness, heart trouble, and problems with the central nervous system. Left untreated, the disease almost certainly causes debilitating symptoms of bodily dysfunction. The Spreading Threat Lyme Disease has been showing up all over the United States lately. It is becoming a significant problem as far south as Florida and as far west as Indiana. However, looking at the trend, the disease may soon spread across the continent. In fact, the disease has already been identified in California and along the West Coast, though it is not as big a problem as other parts of the United States. Part of the reason it is spreading so quickly is the boom in the tick population, the migration of small animals due to destruction of habitat for human building projects, and especially the increased contact between humans and ticks. As humans move into more forests and brushy areas, they are encountering more ticks and the incident of infection continues to rise. There is also a threat that other tick species might carry the disease. Currently, only the black-legged tick or deer tick is spreading the disease, that we know of. Because certain other ticks prefer non-human hosts, we have not yet confirmed if they can spread it. Treatment New treatments are being explored by scientists and doctors today, but there are only two known successful treatments as of yet: * Prevention * Antibiotics Basically, stay out of the woods and brush and you should be safe from ticks. But as it is unlikely humans will stop cutting into forests, hiking in the woods, living near trees, and feeding squirrels, Doxycycline seems the best option. Read the rest of this entry »

Forurening er bestemt et af de globale problemer, som giver folk over hele kloden hovedpine. Talrige organisationer, hære af videnskabsfolk og miljøaktivister gør alt for at begrænse forureningens årsager og konsekvenser, som har påvirket vor planet stærkt i det sidste århundrede. Hvad enten der er tale om vand, land eller luft, så findes der intet i denne verden, som ikke er påvirket af forureningspesten. Det er et meget alvorligt problem, som udgør en trussel for menneskets eksistens og livet i det hele taget på denne planet. Det største problem er, at flertallet af mennesker i hele verden undervurderer stadigvæk forureningens virkninger. Forurening er et emne, som vil blive diskuteret i det endeløse, og tonsvis af papir vil blive spildt på analysen af dens virkning, men der vil stadigvæk ikke ske væsentlige ændringer. Der er nogle aspekter ved forureningen, som kræver særlig opmærksomhed. Dette problem er den størst bidragende faktor til et andet problem af planetformat – global opvarmning. Du har bestemt hørt begrebet, eftersom det diskuteres bredt i medierne og er blevet det i det seneste tiår. For det første påvirker global opvarmning vor planets islag, idet den smelter dem og frigiver for meget vand ud i havet, hvilket i sidste ende fører til klimaændringer, oversvømmelser og tørke. For det andet gør den globale opvarmning ozonlaget tyndere, hvilket gør os mindre beskyttede over for den skadelige del af sollyset.Begge disse problemer er af global format, og der gøres stadigvæk ikke noget for at vende udviklingen eller i det mindske tempoet, i hvilket dette altsammen sker. Både udviklede lande og udviklingslande gør ikke meget for at bekæmpe forureningsproblemet. De førstnævnte har travlt med at bekæmpe virkningerne af den økonomiske krise, og skønt nogle lande forsøger at blive helt grønne, er det blot en lille dråbe i havet af forurenende substanser, som resten af verden producerer. De sidstnævnte har simpelthen langt mere akutte problemer som fattigdomsbekæmpelse eller forsøget på at føde deres befolkning, og det har bestemt en højere prioritet end at forsøge på at begrænse virkningen af indutriens forurening. Som du således ser, er forurening et alvorligt problem, som vi alle må tage os af. Dens påvirkning af vort helbred kan ikke undervurderes. Flere og flere babier fødes med svagt helbred eller endog mangler ved fødslen, og selv det at få en baby er blevet et alvorligt problem. Hastigheden, med hvilken antallet af mænd med seksuelle problemer vokser, er forfærdelig. Read the rest of this entry »