Washington DC Just Got Capped!
June 26, 2008 at 5:52 pm | In Firearms and Explosives, Supreme Court, health care, shootings | Leave a CommentHandgun related violence epidemic will begin today in Washington DC
A split Supreme Court today declared that the Second Amendment protects an individual’s right to own guns for self-defense, striking down the District of Columbia’s ban on handgun ownership as unconstitutional. Be prepared for an increase in gun violence in DC.
District of Columbia officials argued they had the responsibility to impose “reasonable” weapons restrictions to reduce violent crime. Intrestingly Justice Breyer argued in his dissent that the framers of the Constitution did not present self-defense as their main reason for the Second Amendment. “The self-defense interest in maintaining loaded handguns in the home to shoot intruders is not the primary interest, but at most a subsidiary interest,” he wrote. “The Second Amendment’s language, while speaking of a ‘militia,’ says nothing of ’self-defense.’ “
Addiction has to start from somewhere…
June 21, 2008 at 11:16 pm | In Health care politics, Public Health, Tobacco, VCU, Virginia, smoking | Leave a Comment
Virginia Commonwealth University (VCU), signed a secret contract in 2006 to do research for Philip Morris Altria Group, the nation’s largest tobacco company. The VCU scientists were given money to study how to identify early warning signs of pulmonary disease, and how to reduce nitrogen and phosphorus drained into rivers from processing tobacco leaves. What is shocking is the extremely restrictive terms that the university must follow. Some were:
A. Professors are not allowed to publish the results of the studies with out tobacco company’s permission
B. Professors are not allowed to talk about the results without the tobacco companies permission
C. All patent and other intellectual property rights go to the tobacco company, not the university or its professors
D. The contract also includes a longer than usual time (180 days) for Philip Morris Altria Group to review and grant/deny permission to VCU for any possible publications by the researchers. VCU’s own guidelines state that any industry reviews take no more than 90 days.
More shocking is that the VCU even admits that it knew that many of the provisions violated the university’s guidelines for industry-sponsored research. About 15 public health and medical schools no longer accept donations from the tobacco industry, and many major research universities continue to do so only if guaranteed independence to carry out the research and publish the results. Universities should not take money from tobacco companies because of the public health impact of smoking and the tobacco industry’s past misuse of scientific research.
Approximately 100% Smokefree
October 23, 2007 at 12:15 pm | In Cigar Aficionado, Marriott, Non-smoking hotels, second hand smoke, smoking | Leave a CommentMarriott Hotels are about to violate its no-smoking policy–which went into effect in September 2006–when its New York Marriott Marquis property hosts an event for Cigar Aficionado magazine next month.
There are two issues involved first, New York City law prohibits smoking anywhere in a hotel though it does exempt smoking in rooms that are “used exclusively for functions where the public is invited for the primary purpose of promoting and sampling tobacco products, and the service of food and drink is incidental to such purpose.” The event is being promoted, food and drink are not incidental, but an integral part of the event. This is an issue in that non-smoking Marriott hotel staff will be forced to be exposed to harmful second hand smoke. It is unclear if staff that refuse to work the event will lose their job.
The second issue is that Marriott’s own stated policy to be 100 percent smoke free, which includes all guest rooms, restaurants, lounges, meeting rooms, public space and employee work areas. Once a corporation makes a public promise, they’re bound by it unless they publicly announce that they’re changing it. For example, a recent case where McDonald’s paid an $8 million settlement for not publicizing a delay in implementing its publicly announced promise to remove trans fat from its food. Marriott simply cannot grasp the honorable title of 100% Non-smoking hotels and all of the press and other good things that come from that declaration…and then not honor that policy.
Kathleen Duffy, public relations at Marriott Hotels, says that while it is true that Marriott International announced last year that its hotels in North America would be smoke-free, Marriott has a contractual obligation to hold the event. Duffy adds that the hotel plans to do major commercial cleaning, filtering, and venting of the Marquis ballroom, where the Big Smoke will be held. She also says, “I can confirm that we have a contract [for the Big Smoke event] for this year and at least next year at the Marriott Marquis.”
This year the American Public Health Association will be holding it annual meeting in Washington DC. Some participants will be staying at the Marriott at Metro Center the week of November 5. If the Marriott continues I would suggest that all APHA members Boycott all Marriott hotels during the 2008 October 25-29 annual meeting in San Diego.
Is Epidemiology a liberal art?
September 28, 2007 at 12:30 am | In Epidemiology, liberal art | Leave a CommentEpidemiology has features that resemble those of the traditional liberal arts. This makes it fit both for inclusion in an undergraduate curriculum and as an example in medical school of the continuing value of a liberal education. As a “low-technology” science, epidemiology is readily accessible to nonspecialists. Because it is useful for taking a first look at a new problem, it is applicable to a broad range of interesting phenomena. Furthermore, it emphasizes method rather than arcane knowledge and illustrates the approaches to problems and the kinds of thinking that a liberal education should cultivate: the scientific method, analogic thinking, deductive reasoning, problem solving within constraints, and concern for aesthetic values.
Read more: N Engl J Med 1987; 316:309-14.
Cliff Notes for Understanding Presidential Healthcare Politics
September 18, 2007 at 3:42 pm | In Clinton, Edwards, Giuliani, Health care politics, Health insurance, Obama, Romney, health care | Leave a Comment
Is the University of Iowa for sale to the highest bidder?
August 17, 2007 at 1:25 am | In Branding, Public Health, University of Iowa | Leave a CommentThe University of Iowa was considering whether to rename its College of Public Health after Wellmark Blue Cross and Blue Shield’s foundation in exchange for a $15 million gift from the company’s philanthropic arm. Thus, Iowa would have been the first public university to name a college after a corporation. Although the U of I officials were so close to accepting the gift that they wrote up a draft news release, the Dean called the $15 million naming gift offer from the Wellmark Foundation “embarrassingly small,” and stated that that naming the college after the insurance giant was not acceptable because it would ultimately hurt the college’s research funding and academic freedom. The Public health faculty then overwhelmingly approved a resolution July 5 rejecting the Blue Cross/Blue Shield name.
The offer has ignited a debate over where universities should draw the line when accepting corporate gifts.
Unfortunately, a corporate name on a school could undermine the independence of their researchers and create other conflicts. For example, often when a publishing a paper in an academic journal, professors are required print their employer and affiliations. If readers see that a major publication is coming out of the Wellmark Blue Cross and Blue Shield’s School of Public Health, they may naturally think that Blue Cross and Blue Shield sponsored the paper. Thus diluting University of Iowa’s own contribution to the creation of the paper (mainly the ability to identify highly qualified professors and provide them the academic environment that fosters the creation of new research ideas).
If this plan would have gone through, Blue Cross and Blue Shield would have established an advertising foothold in a new media…peer reviewed journals. Every time a study is published, Blue Cross and Blue Shield gets it’s name in ink. This is a very subtle but calculated attempt by Blue Cross and Blue Shield to increase it’s “brand recognition”.
Since most public health practitioners do not have a degree in Business, here is a quick lesson in Branding 101…
Marketers (in this case Blue Cross and Blue Shield marketers) engaged in branding seek to develop or align the expectations behind the brand experience, creating the impression that the brand associated with a product or service has certain qualities or characteristics that make it special or unique. A brand image may be developed by attributing a “personality” to or associating an “image” with a product or service, whereby the personality or image is “branded” into the consciousness of consumers. A brand is therefore one of the most valuable elements in an advertising theme. The art of creating and maintaining a brand is called brand management.
A brand which is widely known in the marketplace acquires brand recognition. When brand recognition builds up to a point where a brand enjoys a critical mass of positive sentiment in the marketplace, it is said to have achieved brand franchise. Brand energy is a concept that links together the ideas that it is not just about the experiences of customers/potential customers but all stakeholders; and that businesses are essentially more about creating value through creating meaningful experiences than generating profit. Economic value comes from businesses’ transactions between people whether they are customers, employees, suppliers or other stakeholders. For such value to be created people first have to have positive associations with the business and/or its products and services and be energized to behave positively towards them – hence brand energy. In this case, economic value comes back to Blue Cross and Blue Shield by maximizing profit to its shareholders via increased visibility. In non-commercial contexts, the marketing of entities which supply ideas or promises rather than product and services (e.g. political parties or religious organizations) may also be known as “branding”. You can learn more about branding on Wikiopedia.
To decrease this impact of corporate infultration into journals, the University of Iowa can gracefully accept the donation and name a library or building after the corporate entity and editors of peer reviewed journals can stop publishing the affiliations/employers of authors if more corporations begin “sponsoring” schools of public health.
Shooting down the data
July 11, 2007 at 11:28 am | In Adrian Fenty, Data, Firearms and Explosives, Michael Bloomberg, Tiahrt rider | Leave a Comment
In the past, the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) publicly released the results of the analyses of data gained by tracing the history of guns used in crimes. Some of the results were startling: For example, 57% of crime guns came from 1.2 percent of licensed dealers. In other words, the guns the bad guys use don’t come from the black market they come from a handful of gun vendors.In 2003, Rep. Todd Tiahrt (Republican-Kan.) added a rider to the Justice Department’s budget that prohibited ATF from sharing such gun-trace information with law enforcement officials, researchers and the public. Every year since, the so-called Tiahrt Amendment has gotten more restrictive, narrowing the ability of local police to gain access to or apply gun-trace information.
The worst iteration yet came last month, when the Senate Appropriations Committee approved a version from Sen. Richard C. Shelby (Republican-Ala.) that threatens to put police officers in prison if they use federal gun-trace data for any purpose other than to advance specific, “bona fide criminal investigations” — for proactively tracking and interdicting illicit guns, for example, or identifying problem gun sellers.In reaction tothis, Washington DC Mayor Adrian M. Fenty (Democrate) and New York Mayor Michael R. Bloomberg (Independent) called for repeal at a joint news conference, a cause is backed by 200 other mayors and law enforcement organizations and police chiefs.
Eliminating the Tiahrt rider is not about weakening the perceived Second Amendment rights but rather it is about transparence with public health data that keeps the public safe by identifying unscrupulous gun vendors. Read more
Washinton Post Editorial, Wednesday, July 11, 2007; Page A14.
Are CMEs becoming infomercials?
June 28, 2007 at 12:10 am | In Accreditation Council for Continuing Medical Education, CME, pharmaceutical | 2 CommentsCME is an acronym for Continuing medical education. It is a type of continuing education that serves to maintain, develop, or increase the knowledge, skills, and professional performance of a physician after they leave medical school. CME activities are usually educational interventions that rely on evidence based medicine to provide unbiased direction to medical practitioners to meet educational needs and ultimately improve patient care. In April, a Senate Finance Committee study found that the Accreditation Council for Continuing Medical Education, the main accrediting body for education providers, does not scrutinize course materials for accuracy or evidence of bias toward sponsors’ products. At times, sponsors have been able to select topics, and presenters have discussed off-label uses for drugs, the report found.
Recently, pharmaceutical companies have become the biggest sponsors of CME courses, even at the nation’s top medical schools, a development that critics say raises health-care costs, skews doctors’ treatment decisions and allows the industry to skirt laws against advertising “off-label” uses for its products. The trend toward pharmaceutical industry sponsorship accelerated after the government backed off a plan to limit commercial sponsorships in 2002 at the urging of the industry.
Now, nearly two-thirds of the cost of continuing education courses sponsored by medical schools, popular for their prestige, are paid for by drug and medical device companies and other commercial interests, figures show. Overall, commercial sponsors pick up about half of the $2.25 billion annual cost of the courses doctors must attend to keep their licenses.
Scott Lassman of the Pharmaceutical Research and Manufacturers of America state the following for the practice of pharma funding:
• a way to educate physicians about the latest medical and scientific research.
• are viewed as running independently of the pharmaceutical company. The company may be providing the funding for it, but they are not directing the content.”
• Allows for physicians to learn about “off-label” uses of drugs since “A lot of times, the regulatory process lags behind the science,” Thus “[he] think it’s a benefit for physicians, as long as it’s independent and as long as the scientific information is solid.”
J. Gregory Rosenthal, of Physicians for Clinical Responsibility For doctors and others states the following against the practice:
• “[Pharma] makes it very difficult [for a physician] to know what research to believe”
• “[a physician] can’t go onto a CME Web site without being confronted by sponsorship logos.”
• the drug industry does hold some sway over which topics are covered in the courses.
• “[CME] are promotional activities disguised as education.”
Read more: Conflict Alleged in Drug Firms’ Education Role, Elizabeth Williamson and Christopher Lee, Washington Post Wednesday, June 27, 2007; Page A03 .
SiCKO Primer #3: ” Patient Dumping “
June 8, 2007 at 1:10 pm | In Emergency room, Michael Moore, SiCKO, health care, patient dumping | 2 CommentsOnly since 1986 was Emergency room physicians mandated to provide care to all patients – regardless of their medical condition, age, or ability to pay. Before 1986, some hospitals participated in a practice called “patient dumping” as a solution to address emergency department overcrowding. Patient dumping is the denial of care by hospital emergency departments despite being capable of providing the needed medical care. Patient dumping is defined as the transfer of patients from one hospital to another based on the patient’s inability to pay for care. Schiff (1986) reported that 250,000 inappropriate transfers of medically unstable patients occurred, resulting in increased patient morbidity and mortality. The reason this is import behavior to critique, is that it was the founding action of a federal law that eventually became a contributor to the emergency department overcrowding situation.
Congress created and passed the Emergency Medical Treatment and Active Labor Act (“EMTALA”) as a response to “patient dumping”, EMTALA was written so that federally funded hospitals were required to give emergency aid in order to “stabilize” a patient suffering from an “emergency medical condition” or “active labor” before discharging or transferring that patient to another facility (Fosmire, 2003). An “emergency medical condition” is defined by Section (e)(1) of EMTALA as a condition with “acute symptoms” of a “sufficient severity” such that the absence of “immediate medical attention” could reasonably be expected to result in serious health risks and/or disability. The courts have interpreted the phrase “emergency medical condition” to mean a condition which puts the patient in imminent danger of death or serious disability. Unfortunally hospitals still do practice patient dumping.
In order to combat “patient dumping” hospital must fulfill six duties. They include providing a medical screening examination to all patients that present themselves ED premises regardless of ability to pay; providing stabilizing care; not transferring patients who are potentially unstable if the hospital has the capabilities to treat the patient (Patients may only be transferred under EMTALA for medical necessity such as burn patients who need a Burn Unit); providing medically appropriate transfers where the patient is transferred for medically necessity; maintaining an on-call system for physicians to provide coverage to be available to assist stabilizing patients; and accepting requests for in-coming transfer if the hospital has the specialized capabilities needed by the patient, and the transferring hospital is relatively less able to care for the patient (Fosmire, 2003).
Federal government penalties under EMTALA may be against hospitals and or individual physicians if they negligently dump a patient. They may face civil penalties up to $50,000/violation and or exclusion from participation in the Medicare and Medicaid reimbursement programs. In addition, EMTALA allows for civil actions for individual who experience personal harm. Interestingly, enforcement of EMTALA remains a patient complaint-driven process. In other words, the investigation of a hospital’s practices, are initiated only by a patient or public complaint. Thus, there is no federal “EMTALA Police” performing undercover hospital inspections. However, as patients become more consumer-oriented and informed about their patient rights, it is probable that dissenting hospitals and physicians will be identified and curtailed.
It’s all about me and my TB!
June 3, 2007 at 1:03 am | In Andrew Speaker, CDC, Generation Me, Public Health, TB | Leave a CommentI nominate Andrew Speaker as the poster boy for the “Me Generation”. Generation Me is a term that describes people that don’t know how to put duty before self; people that believe that the needs of the individual should come first; people who take it for granted that the self comes first and feel no responsibility for their actions; people who feel entitled. Here are my arguments for your consideration.
Tuberculosis is caused by germs that are spread from person to person through the air. It affects the lungs and can lead to symptoms such as chest pain and coughing up blood. It kills nearly 2 million people each year worldwide. Multidrug-resistant” TB can withstand the mainline antibiotics isoniazid and rifampin. The man at the center of the current case was infected with something even worse — “extensively drug-resistant” TB, also called XDR-TB, which resists many drugs used to treat the infection.
A few points to ponder after listening to Andrew Speaker interview. If Speaker truly believed that he was harmless then why was his father compelled to secretly tape record the conversation? I think there are two reasons for this (a) if the CDC quarantined him, the tape would have been used to sue the CDC and health officials for denying his civil liberties by detaining and confining him against his will, or (b) suing the CDC and health officials for not properly warning him if he had actually infected someone else. Either way, it does show that he or at least the father knew that he was in a high risk situation and that he was more concerned about his own wedding happiness and any potential legal fallout then with the actual fact that he might actually cause pain and suffering in another human being.
Point 2. Somewhere around the time when Speaker was notified that he had XDR-TB he found out that he was put on the no-fly list and that he was asked to check himself into a hospital. By his actions I can only assume his only thoughts were “How can I get the best treatment for myself regardless of who I come in contact with”. Once again this shows his utter disregard for his fellow man.
Point 3. In Atlanta on May 10th Speaker admitted that “They said I was multi-drug resistant. I wanted to stay in Atlanta for treatment but they convinced me that with all the toxicity of the drugs and since there weren’t that many drugs left for me I should go to Denver, that it was my best chance of living through this.” Why wasn’t he in fear for his life at this time? Then in Europe on May 18th, Speaker said officials wanted him to check into a treatment center in Rome indefinitely. But he feared that if he did, he might not make it to Denver. “It is a very real threat that I could have died” in
Italy, he said.
Speaker’s attorneys will likely paint him as a “victim” despite the fact that he himself created hundreds of potential victims when he exposed them to one of the deadliest strains of TB via his reckless globe-trotting. So why should he be a victim? And one more thing, who is going to pay for testing all these people?
SiCKO Primer #2 : “ Prescriber Profiling ”
May 28, 2007 at 4:12 pm | In Michael Moore, Prescriber, Profiling, Public Health, SiCKO, health care, pharmaceutical | Leave a CommentFor the next 4 to 5 weeks, I am going to put together an educational primer for people interested in the Movie SiCKO, a political documentary film about pharmaceutical companies and of Food and Drug Administration by Michael Moore, scheduled for release in the United States on June 29, 2007. What is interesting is that Mr. Moore isn’t bringing up anything new….pharmaceutical and health insurance companies have been behaving like this for years. In any case, by reading this blog the next few weeks, I hope that you will educate yourself about several concepts before seeing the movie.
The concept: “Prescriber Profiling”
The players: Pharmaceutical Companies, American Medical Association (AMA), data mining companies.
How it works:The American Medical Association license access to it’s AMA Physician Masterfile, a database containing names, birth dates, educational background, specialties and addresses for more than 800,000 doctors to data-mining companies. The data mining companies, known as health information organizations (HIOs), then links this individual physician data to their demographic data and their prescription record. They then sell this linked database to sell them to pharmaceutical companies.
The pharmaceutical industry then employs approximately one sales representative for every 5 office-based physicians. A representative can quickly access a breakdown of pharmaceuticals prescribed by any physician on a handheld computer, enabling that representative to deliver a tailored marketing pitch to physicians selected for their current prescribing habits. Within weeks, the sales representative can monitor each physician’s response to the pitch—as well as to inducements, such as meals, gifts, and drug samples—and can make repeated visits to achieve sales goals. They can also identify physicians who prescribe a competitors’ drug and target them with campaigns touting their own products. Salespeople chart the changes in a doctor’s prescribing patterns to see whether their visits and offers of free meals and gifts are having the desired effect.
Critics claim that Prescriber Profiling biases the doctor-patient relationship, and it’s driving up costs. The pharmaceutical industry defends the practice as a way of better educating physicians about NEW drugs. Critics reply that this type of drug marketing serves mainly to influence physicians to prescribe more expensive NEW medicines, not necessarily to provide the best treatment.
After complaints from some members, the AMA last year began allowing doctors to “opt out” and shield their individual prescribing information from salespeople, although drug companies can still get it. So far, 7,476 doctors have opted out, AMA officials said. Some critics, however, contend that the AMA’s opt-out is not well publicized or tough enough, noting that doctors must renew it every three years. Furthermore critics claim that the AMA is reluctant to change it’s behavior because of it’s $44.5 million in revenue from the sale of database products (in 2005)—16% of the AMA’s total revenue for that year. They stress that patient names are encrypted early in the process and cannot be accessed, even by the data-mining companies.
Read more
Doctors, Legislators Resist Drugmakers’ Prying Eyes By Christopher Lee. Washington Post, Tuesday, May 22, 2007; Page A01.
Prescriber Profiling: Time to Call It Quits. David Grande. Annals of Internal Medicine. 15 May 2007. Volume 146 Issue 10. Pages 751-752.
SiCKO Primer #1: “ Me too drugs ”
May 24, 2007 at 1:58 am | In Food and Drug Administration, Me too drugs, Michael Moore, SiCKO, health care, pharmaceutical | Leave a CommentFor the next 4 to 5 weeks, I am going to put together an educational primer for people interested in the Movie SiCKO, a political documentary film by Michael Moore, scheduled for release in the
United States on June 29, 2007. It will investigate health care with a focus on large American pharmaceutical companies and the Food and Drug Administration. I haven’t seen the movie yet however I intend to. What’s interesting is that Mr. Moore isn’t bring up anything new….pharmaceutical and health insurance companies have been behaving badlyfor years. In any case, by reading this blog the next few weeks, I hope that you will educate yourself about several concepts before seeing the movie.
The concept: “Me-too drugs”
The players: Pharmaceutical Companies
The Scoop: The pharmaceutical industry is not especially innovative or inventive. The great majority of “new” drugs are not new at all but merely variations of older drugs already on the market. These are called “me-too” drugs. The idea is to grab a share of an established, lucrative market by producing something very similar to a top-selling drug. For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first. As Dr. Sharon Levine, associate executive director of the Kaiser Permanente Medical Group, put it,
“If I’m a manufacturer and I can change one molecule and get another twenty years of patent rights, and convince physicians to prescribe and consumers to demand the next form of Prilosec, or weekly Prozac instead of daily Prozac, just as my patent expires, then why would I be spending money on a lot less certain endeavor, which is looking for brand-new drugs?”
Of the 78 drugs approved by the FDA in 2002, only 17 contained new active ingredients, of which seven of these were classified by the FDA as improvements over older drugs. The other seventy-one drugs approved that year were variations of old drugs or deemed no better than drugs already on the market. Only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH). Of the 7 drugs discussed above, not one came from a major US drug company.
Case in Point: Nexium, a “me-too” drug for stomach acid, has earned approximately $5 billion for its maker, AstraZeneca, since it went on the market in 2001. Nexium illustrates the drug makers’ strategy. Many chemicals come in two versions, each a mirror image of the other: an L-isomer and an R-isomer. (The “L” is for left, the “R” is for right.) Nexium’s predecessor Prilosec is a mixture of both isomers. When Prilosec’s patent expired in 2001, the drug maker was ready with Nexium, which contains only the L-isomer.
Is Nexium better? So far, there’s no convincing evidence that it is, says Stanford drug industry watcher Randall Stafford, MD, PhD.
The problem with Me-Too drugs is that they are always marketed as BETTER than what’s already available. However, the FDA approves drugs on the basis of their superiority to placebo, not their superiority to existing drugs,” Stafford says. “I think people misunderstand the nature of FDA approval and the criteria used to allow drugs to enter the market. So consumers feel compelled to leave their current regime–even if it’s working–for these drugs. Me-Too drugs also COST SUBSTANTIALLY more–forget about lowering prices.
Read more:
1. The Truth About the Drug Companies ByMarcia Angell
2. “Me-too drugs, Sometimes they’re just the same old, same old” By Rosanne Spector.
Public Health History
May 20, 2007 at 5:28 pm | In Education, History, National Institutes of Health, Public Health, Thomas D. Dublin, polio, vaccine | 1 CommentThis is a synopsis of an article printed in the Washington Post about Thomas D. Dublin who died recently. He was a true public health leader who passed away recently. I hope that this posting will serve as a history lesson for public health professionals.
Thomas D. Dublin, 95; Epidemiologist, Health-Care Advocate
(By Matt Schudel, Washington Post, Sunday, May 20, 2007; Page C07)
Thomas David Dublin, 95, an epidemiologist who helped design early field trials of Jonas Salk’s polio vaccine and who became a medical director of the U.S. Public Health Service, died May 3 of congestive heart failure at Walter Reed Army Medical Center.
During his long career, Dr. Dublin was an advocate for expanding health care for poor and underprivileged people across the country. In the 1940s and ’50s, he spoke of the need for health clinics in rural America and for minorities. Later, with the Public Health Service, he coordinated many studies with the National Institutes of Health to improve access to medical care.
While working as a consultant to the National Foundation for Infantile Paralysis from 1953 to 1955, Dr. Dublin was enlisted as the medical field director to help test Salk’s experimental polio vaccine. Dr. Dublin designed and directed “double-blind” field trials to measure the efficacy of the vaccine against a placebo. The trials were conducted in a way that allowed polio patients who received placebos to be treated with the vaccine at the conclusion of the study.
Dr. Dublin came to Washington in 1955, when he was named medical director of the Public Health Service. A specialist in epidemiology, he was particularly concerned about controlling contagious diseases and broadening the nation’s health-care system.
In addition to his Public Health Service duties, he held several joint appointments as a senior scientist with the National Institutes of Health, including chief of the epidemiology and biometry branch of the National Institute of Arthritis and Metabolic Diseases from 1960 to 1966. He also spent two years in Israel working on studies of risk factors associated with cardiovascular disease.
He was director of the Office of Health Manpower of the old Department of Health, Education and Welfare from 1968 to 1970 and consulted with other federal agencies and the American Medical Association before and after his retirement in 1976.
Dr. Dublin was born in New York on Jan. 18, 1912, and received his undergraduate degree from Dartmouth College. He graduated from Harvard University medical school in 1936 and received master’s and doctoral degrees in public health from Johns Hopkins University, in 1940 and 1941, respectively.
He held a succession of teaching and research positions at Boston City Hospital, Johns Hopkins University, Columbia University, New York’s Albany Medical College and the Long Island College of Medicine. He joined the Kingston Avenue Hospital in Brooklyn, N.Y., as an epidemiologist in 1943.
In 1948, Dr. Dublin was named executive director of National Health Council in New York. He used that platform to speak out against inequitable health care, noting that almost a third of U.S. communities lacked proper health departments. He urged both the federal government and local communities to develop plans to provide services for maternal and child care, sanitation, disease control and education.
“This situation is particularly regrettable,” he said in 1950, “because the importance of increasing the number of local full-time health departments in the nation’s medical care program is one thing on which everyone is in agreement.”
Dr. Dublin was a fellow of the American Public Health Association and a member of its governing council. He was a director of the American Board of Preventive Medicine’s National Board of Medical Examiners from 1961 to 1971 and was chairman of the certification committee of the American Board of Medical Specialists from 1972 to 1977. He also served on a public health advisory panel for the World Health Organization from 1954 to 1980.
Another of Dr. Dublin’s interests was the smooth integration of international physicians and specialists into the U.S. medical profession. He conducted an important study on the subject and helped shape policies to permit foreign medical specialists to work and study in the United States.
Dr. Dublin lived in Bethesda for many years and later in Washington. He contributed articles on international health and other issues to professional journals and kept up with developments in medicine until his death. Throughout his life, he was a mentor to younger medical professionals, including Nobel Prize-winner Baruch S. Blumberg.
His wife of 58 years, Christina Carlyle Dublin, died in 1997.
Survivors include two daughters, Sarah Dublin Slenczka of Nuremberg, Germany, and Barbara Dublin Van Cleve of Greensboro, N.C.; seven grandchildren; and two great-grandchildren.
The facts that pro-gun advocates don’t want you to know the day after the Virginia Tech shootings
April 18, 2007 at 3:31 am | In Blacksburg, Public Health, Virginia, Virginia Tech, shootings | 7 CommentsDon’t be fooled by the weak stories of the pro-gun groups are insensitively pushing the day after the Virginia Tech shootings. The pro-gun advocates, such as Larry Pratt, state: “The shootings at Virginia Tech highlight the need to allow weapons on campus and at businesses because gun carriers will protect themselves and other students by shooting the perpetrators of gun violence.”
Pro-gun argument #1: As evidence for their claim pro-gun advocates states that a killer was stopped at the Appalachian School of Law when two students were able to go off campus to their vehicles and get their guns which they used to subdue the killer.
Cold hard truth #1: In the Appalachian School of Law incident, the killer stopped shooting because he ran out of ammo, not because he was shot by other gun toting students. Also the students that finally did subdue the killer were trained off-duty policemen who grabbed not only their guns, but bulletproof vests and handcuffs from their cars.
Pro-gun argument #2: Another argument the pro gun advocates are pushing is “All the school shootings that have ended abruptly in the last ten years were stopped because a law-abiding citizen — a potential victim — had a gun.”
Cold hard truth #2: Let’s review the cold hard facts (as stated by David Hemenway Director of the Harvard Injury Control Research Center):
1. Moses Lake [Washington], a 14-year-old honors student, opens fire in algebra class. He stopped when he was tackled by a teacher.
2. West Paducah, Ky., a 14-year-old kills three students and wounds five others at a prayer group. He drops the pistol when he’s approached by a principal and another student. No gun involved with the principal or the other student.
3. The 1999 Columbine High School killers took their own lives with the guns they’d used to kill 25 others, hours before a SWAT team stormed the building.
Hemenway said statistics show that in general, firearms don’t mix well with colleges, known for combustible elements like heavy drinking and romantic complications. “People get drunk, people get angry, they’re going to use their guns.” He concluds that “We do know that where there’s more guns, there’s lots more death. There’s more homicides, more suicides, more gun death.”
Pro-gun argument #3: What about examples where allowing guns on campus seems to work? “Isn’t it interesting that Utah and Oregon are the only two states that allows faculty to carry guns on campus,” Pratt said in his statement, “[and] you haven’t read about any school or university shootings in Utah or Oregon?”
Cold hard truth #3: School shootings are rare occurrences to begin with, thus, the probability of seeing an event in these states is naturally reduced. Second the population of Utah and Oregon are relatively low, so the probability of seeing an event in these states is naturally low (less people in a state, less chance an event will occur). Another rebuttal, just because an event has not occurred in the past does not guarantee it will not happen in the future. One final rebuttal to pro-gun argument #3: Massachusetts, has strict gun control laws and like Utah and Oregon there are no known school shootings.
Pro-gun argument #4: The shootings at Virginia Tech highlights the need to allow weapons on campus and at businesses because gun carriers will protect themselves and other students by shooting the perpetrators of gun violence.
Cold hard truth #4: The probability of innocent students getting caught in the crossfire of the killer and the armed untrained student may actually increase fatalities. Simply put, the more flying bullets (regardless of who pulled the trigger) the higher the probability of someone getting hit. In conclusion, when you boil the arguments down the pro-gun advocates are saying the answer to gun violence is more guns….the cold hard truth is that if noone had guns, there would be no gun fatalities!
Short term financial impact of the Virginia Tech Massacre on gun manufactures
April 18, 2007 at 2:24 am | In Blacksburg, Public Health, Virginia, Virginia Tech, shootings | Leave a CommentThe following chart displays a comparison of price percentage changes for the five day time period from April 11 to April 17, 2007. The VT shootings occurred on April 16th. Please click to enlarge.
Please note that the blue line is Smith & Wesson gun manufacture, the red line is Sturm, Ruger & Company gun manufacture, the yellow line is the S&P500 index.
The following chart displays a comparison of price percentage changes for the approximately seven year time period from Aug 2006 to April 17, 2007. Please click to enlarge.
In the short term (1.5 days after the VT shootings) gun manufactures experienced a decreasing trend. Over the long run, Smith & Wesson, the gun company, has fared extremely well in the stock market with an 1254.34% increase. The stock of Sturm, Ruger & Co., Inc.the only other publicly listed U.S. gun manufacturer, has more closely mirrored the ups and downs of the market. However, it too ended this time period with an overall 33.03% increase. Interestingly, I could not find the stock information for gun manufactures during the The Columbine High School massacre which occurred on April 20 1999. Anyone have this information?
Why the NRA is celebrating on the day of the Virginia Tech shootings at Blacksburg, Virginia
April 17, 2007 at 12:56 am | In Blacksburg, Virginia, Virginia Tech, shootings | 1 CommentThe National Rifle Association (NRA) had a website that (regardless of when it was originally posted) insensitively stated on April 16th 2007 (the day of the VT shooting) “Today is one of the most important days of the year for gun owners. The start of the NRA Annual Meetings is both a celebration of freedom and a rally for the Second Amendment, but it’s also a show of force by gun owners to the enemies of freedom everywhere.” The NRA should have taken down those comments shortly after the event occurred.
I am not sure why the NRA would be so inconsiderate and callous to have that statement on the front page of their website while the nation is grieving the death of over 30 students. I wonder what the 30+ American families think about the NRA’s insensitive celebration tonight?
Click the thumbnail for a large snapshot of today’s (April 16th 2007 at 8pm) NRA website below (I added the red text, arrow and circle above and below for emphasis):
When you click on the LaPierre link you come to these interesting comments (Click the thumbnail for a large snapshot):
In any case, today’s events reminded me of the title of Stanley Gallon’s new book… ”Darkest Days” (http://www.stanleygallon.com/) or (http://www.myspace.com/stanley_gallon).
In light of the shootings at a dorm and a classroom building at Virginia Tech in Blacksburg, Virginia this post will also review a Harvard School of Public Health Injury Control Research Center published in 2002 appropriately titled “Guns and gun threats at college”. (please email mmiller@hsph.harvard.edu for a copy). The authors surveyed more then 10,000 undergraduate students attending 119 4-year colleges about gun possession and gun threats. Approximately 4.3% reported having a working firearm at college. Of the respondents, 1.6% reported being threatened with a gun while at school. The authors state “Students are more likely to have a firearm at college and to be threatened with a gun while at college if they are male, live off campus, binge drink, engage in risky and aggressive behavior after drinking, and attend institutions in regions of the United States where household firearm prevalence is high.” The authors also report that carrying firearms for protection is associated with being threatened with a gun.
Good luck and take care,
JGG
Top 10 Most Read Articles on Medscape March 2007
April 10, 2007 at 8:15 pm | In Litrature, Medscape | Leave a CommentTop 10 Most Read Articles on Medscape Last Month (you’ll need to register with Medscape for these free articles):
1. CDC Issues Guidelines for Preconception Care of Women CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTc0GX
2. New Management Recommendations Issued for Kidney Stones CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTd0GY
3. Imaging X-rays Cause Cancer: A Call to Action for Caregivers and
Patients CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0ICla0Gb
4. Making Sense of the Gadolinium Safety Issue: Report From the MRI
Front CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTe0GZ
5. Current Diagnosis of Venous Thromboembolism in Primary Care: A
Clinical Practice Guideline from the American Academy of Family
Physicians and the American College of Physicians
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTf0Ga
6. Low-Carb Diets Safe and Effective for Weight Loss CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTg0Gb
7. Antioxidant Vitamins May Increase Mortality CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTh0Gc
8. Management of Venous Thromboembolism: A Clinical Practice Guideline
from the American College of Physicians and the American Academy of
Family Physicians
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTi0Gd
9. Helping Patients Who Drink Too Much: A Clinician’s Guide From NIAAA
CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTj0Ge
10. Postmenopausal Osteoporosis: Putting the Risk for Osteonecrosis of
the Jaw Into Perspective CME/CE
http://mp.medscape.com/cgi-bin1/DM/y/eBMnx0TLfDz0SqN0IUTk0Gf
Biostatisticians: Know your worth
April 4, 2007 at 3:15 am | In Biostatistics, Career, Salary | Leave a CommentFor the first time, recent graduates and employees have access to the equivalent of a Kelley Blue Book for jobs. The availability of online compensation information has leveled the playing field between employer and employee when it comes to negotiation and job offers. Employers who are confident in their pay practices should welcome these new data sources, as they provide external validation that their compensation is competitive with the market.
For recently graduated biostatisticians one authoritative source for salary information is the Annual Survey Reports from the American Mathematical Society. In 2006 they reported that 18 Doctoral degree-granting departments of biostatistics and biometrics out of the 32 departments nationwide responded to the 2006–07 Faculty Salary Survey. They reported on the salary of 206 Biostats faculty.
Assistant Professor (n=93) Q1=67,810 Median=74,420 Q3=88,870 Avg. =77,800
Associate Professor (n=70) Q1=82,630 Median=92,500 Q3=103,370 Avg. =96,395
Full Professor (n=103) Q1=116,140 Median=141,250 Q3=181,780 Avg. =145,205
The full report can be found at:
http://www.ams.org/employment/2006Survey-First-Reports.pdf
Another excellent source for Academic biostatistician salary information is American Statistical Association’s 2006–2007 Salary Report of Academic Statisticians found at:
http://www.amstat.org/profession/salaryreport_acad2006-7.pdf
Keep in mind that the previously mentioned salaries pertain only to academic biostatisticians. In another report by the American Statistical Association salary statistics were categorized by organization type (e.g., Federal. Government., Pharma, Consulting, Other), managerial status, highest academic degree attained (e.g., BS, MS, PhD), and total years of experience. Median pay for Federal Government Statisticians ranged from $82,000 to 132,000 and the median pay for Pharmaceutical/Medical Devices/Diagnostic Statisticians ranged from $73,000 to $178,000. The report for Federal Government, Pharmaceutical/Medical Devices/Diagnostic, and other statisticians can be found at:
http://www.amstat.org/publications/amsn/2005/highlights10-1.pdf
Don’t hesitate to print out the above reports and take them with you on your next job interview.
Good luck and take care,
JGG
About this social experiment
April 4, 2007 at 1:22 am | In Background | Leave a Comment
Blogging has been a major new phenomenon transversing social, political, and economic boundaries at unimaginable speeds and connecting complex sets of relationships between members of social systems at all scales. As Nobel-prize-winning economist Gary Becker and federal circuit judge Richard Posner stated in their initial blog (Dec 5, 2004) “It is a fresh and striking exemplification of Friedrich Hayek’s thesis that knowledge is widely distributed among people and that the challenge to society is to create mechanisms for pooling that knowledge”. The Internet has enabled the instantaneous pooling (and hence correction, refinement, and amplification) of ideas and opinions, facts and images, reportage and scholarship, generated by bloggers, lay persons, and professionals. Unfortunately, public health practitioners have not taken full advantage of this powerful tool. The few blog that have been started are usually specific to a public health topic such as epidemiology or international health. This blog will focus more on the global concept of what is public health and how to become savvy practitioners.
I have decided to restart a blog that has explored current issues of epidemiology, biostatistics, and public health policy in a dialogic format. Initially I will be posting just once a month. In time I may post more frequently. I wish in closing this brief introduction to my blog to thank Dr. Jim Johnson at the University of North Carolina for his valuable inspiration in setting up this blog.
Public Health Crunch- Public Health Crunch
- Washington DC Just Got Capped!
- Addiction has to start from somewhere…
- Approximately 100% Smokefree
- Is Epidemiology a liberal art?
- Cliff Notes for Understanding Presidential Healthcare Politics
- Is the University of Iowa for sale to the highest bidder?
- Shooting down the data
- Are CMEs becoming infomercials?
- SiCKO Primer #3: ” Patient Dumping “
- It’s all about me and my TB!
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