“Early detection, early response” is central to infectious disease control, and thus a high priority of TED Prize winner and executive director of Google.org Larry Brilliant.
Google.org has now made an innovative example of early-detection publicly accessible with Flu Trends. Take a close look at the associated animation — which illustrates the early warning potential of the Flu Trends data. Compared to traditional CDC alerts, detection two weeks earlier is a very big deal w/r/t containing a future influenza pandemic.
…So why bother with estimates from aggregated search queries? It turns out that traditional flu surveillance systems take 1-2 weeks to collect and release surveillance data, but Google search queries can be automatically counted very quickly. By making our flu estimates available each day, Google Flu Trends may provide an early-warning system for outbreaks of influenza.
It will be interesting to see if the media framing of this innovation centers around “privacy invasion“. Here’s some of the real-world stuff going on to ensure privacy is NOT an issue:
…Since we launched yesterday, the response from the medical community has been positive. “The earlier the warning, the earlier prevention and control measures can be put in place,” said Dr. Lyn Finelli of the influenza division at the Centers for Disease Control and Prevention, to The New York Times. “[T]his could prevent cases of influenza.” You can check out the tool for yourself.
We couldn’t have built this flu detection system without analyzing historical patterns. Because flu season is different every year, just a few months of data wouldn’t have done the trick. For example, the 2003-2004 flu season was unusually severe in many regions. The data from that season was especially robust and allowed us to discover a more accurate, reliable set of flu-related terms. To learn more about how we built the system, see this page on how Flu Trends works.
Because we’re committed to protecting your privacy, we made sure that the searches that we analyze for Google Flu Trends are not drawn from personally-identifiable search histories but rather from an aggregated set of hundreds of billions of searches.
In order to provide a rough geographic breakdown of potential flu outbreaks, we use IP address information from our server logs to make a best guess about where queries originate. To protect your privacy, we anonymize those IP addresses at nine months. And we don’t provide this aggregated, anonymized data to third parties. For more information about the privacy protections for Flu Trends check out our FAQs and privacy policy.
This is just the first launch in what we hope will be several public service applications of Google Trends in the future. And as we continue to think of ways to use aggregated and anonymized search data in helpful ways, we’re also committed to safeguarding our users’ privacy.
Here is a very interesting research summary on the omega-7 fatty acid called C16:ln7-palmitoleate — in the Oct 11th Science News by Tina Hesman Saey:
Some fats are just better than others. Omega-3 fatty acids, including fats that make up fish oil, have been recognized for their health-promoting benefits.
Well, move over, omega-3s; now there’s a fat that’s even phatter. Researchers at Harvard University and Lipomics Technologies in West Sacramento, Calif., have discovered that a fatty acid, a type of lipid, can make mice super healthy.
An omega-7 fatty acid called C16:ln7-palmitoleate works as a health-promoting hormone, the researchers report September 19 in Cell. Palmitoleate is made by fat and liver cells, the team discovered. The fatty acid signals muscles to respond to insulin, prevents the buildup of fats in the liver and reduces levels of inflammatory chemicals made in fat cells.
The new study “really suggests that lipids–fatty acids–could have a signaling effect,” says Clay Semenkovich of Washington University in St. Louis. “This is something people have postulated for a while, but has been difficult to get a handle on.”
Palmitoleate is the first lipid demonstrated to work as a hormone, a job usually done by proteins, such as insulin, or by small molecules, such as adrenaline. If the lipid works the same way in people as in mice, it could someday be added to foods or given as a supplement to ward off heart disease and diabetes.
Researchers led by geneticist Gokhan Hotamisligil of Harvard had previously created extraordinarily healthy mice by preventing the mice from making two proteins that normally bind to fatty acids. Previous research had shown that blocking the proteins could improve health. But mice lacking both proteins had health “beyond the normal range,” Hotamisligil says. “Almost indestructible. No heart disease, fatty liver disease, diabetes. No asthma, nothing.” And their health held up even when they ate a high-fat diet.
But it wasn’t obvious why the mice were so healthy. “The general dogma in the field is the more fatty acids you have in the blood, the sicker you are,” Hotamisligil says. But the mutant mice had slightly higher levels of fatty acids in their blood than normal mice.
When examining which fats were present in the fiber-healthy mice, the scientists found that palmitoleate, normally rare, was the third most abundant fatty acid in the healthy mice’s blood. The lipid improves muscle responses to insulin and prevents liver cells from accumulating other harmful fats, the researchers found. Because the mice were missing the two proteins, their fat cells were not able to store fat. The fat cells instead made lipids, primarily palmitoleate.
Liver cells also make the lipid hormone, the team found. In normal mice, the lipid is produced at low levels. When these mice eat a high-fat diet, their cells cut palmitoleate production in half. But the super-healthy mice continue making lots of the lipid, even when they eat diets rich in fat.
People probably also respond to high-fat diets by producing less palmitoleate, Hotamisligil says. “A caveman chasing a deer probably had active production of this material, but not us constantly stuffing ourselves with calories.”
Rather than supplementing the diet, Hotamisligil thinks it would be healthier to persuade people’s fat cells to produce more of the lipid. “What you make yourself is always the best,” he says. “It’s like homemade cooking.”
People whose bodies make an unusually active form of a certain protein tend to have dangerously high levels of cholesterol. Those with an inactive form of the protein have low cholesterol and a low risk of heart attacks.
Needless to say, pharmaceutical companies would love to find a drug that can attach itself to the protein and block its activity. That might be difficult for this protein, which is called PCSK9.
But a powerful new approach, called RNA interference, may surmount that obstacle. Instead of mopping up a protein after it has been produced, as a conventional drug would do, RNA interference turns off the faucet, halting production of a protein by silencing the gene that contains its recipe.
In monkeys, a single injection of a drug to induce RNA interference against PCSK9 lowered levels of bad cholesterol by about 60 percent, an effect that lasted up to three weeks. Alnylam Pharmaceuticals, the biotechnology company that developed the drug, hopes to begin testing it in people next year.
More… This is a good survey article on a topic that is likely to turn out to be important.
according to this NYT article Stretching: The Truth
WHEN DUANE KNUDSON, a professor of kinesiology at California State University, Chico, looks around campus at athletes warming up before practice, he sees one dangerous mistake after another. “They’re stretching, touching their toes. . . . ” He sighs. “It’s discouraging.”
If you’re like most of us, you were taught the importance of warm-up exercises back in grade school, and you’ve likely continued with pretty much the same routine ever since. Science, however, has moved on. Researchers now believe that some of the more entrenched elements of many athletes’ warm-up regimens are not only a waste of time but actually bad for you. The old presumption that holding a stretch for 20 to 30 seconds — known as static stretching — primes muscles for a workout is dead wrong. It actually weakens them. In a recent study conducted at the University of Nevada, Las Vegas, athletes generated less force from their leg muscles after static stretching than they did after not stretching at all. Other studies have found that this stretching decreases muscle strength by as much as 30 percent. Also, stretching one leg’s muscles can reduce strength in the other leg as well, probably because the central nervous system rebels against the movements.
“There is a neuromuscular inhibitory response to static stretching,” says Malachy McHugh, the director of research at the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital in New York City. The straining muscle becomes less responsive and stays weakened for up to 30 minutes after stretching, which is not how an athlete wants to begin a workout.
THE RIGHT WARM-UP should do two things: loosen muscles and tendons to increase the range of motion of various joints, and literally warm up the body. When you’re at rest, there’s less blood flow to muscles and tendons, and they stiffen. “You need to make tissues and tendons compliant before beginning exercise,” Knudson says.
One underreported story of this election is how heavily John McCain has been damaged by Barack Obama’s television ad assault on his health-care plan. A lot of voters seem to believe the Democrat when he says that Mr. McCain wants to deny them coverage or bankrupt them with crushing hospital bills.
Mr. McCain has himself to blame for not defending his own reform ideas, during the debates and in TV ads, against attacks that have been misleading when not flat-out false. Even so, Mr. Obama’s tactics are especially cynical because his own health-care advisers support plans much like Mr. McCain’s. Or at least they did before joining up with Mr. Obama.
Put simply, the McCain plan seeks to remedy a distortion in the health-care market that economists have spent decades begging politicians to fix: The tax code subsidizes insurance only if it is provided through employers. Individuals can’t take the same tax deduction for buying insurance that businesses can. So Mr. McCain wants to “spread the wealth” of these tax breaks to individuals of any income through a refundable tax credit, no matter where they get coverage.
“The fact that the tax subsidy, which supports the employer-sponsored system, is better than nothing is a feeble excuse for resisting any changes to the status quo.” That’s not John McCain’s judgment. It’s a quote from Jason Furman, who happens to be Mr. Obama’s economic policy director. In a cri de coeur published in the journal Democracy in 2006, Mr. Furman implored fellow Democrats and other progressives to confront “a critical missing link” in their health ideology — the same link his boss now spends most of his time demagoguing.
Mr. Furman used to portray the current system as regressive, inequitable and a subsidy for health plans that insulate consumers from the cost of their care, thus inflating health spending. When he was director of the Brooking Institution’s Hamilton Project, Mr. Furman outlined a health reform — again using tax credits — that took the “sensible approach” of “exposing individuals to the price of health care through greater cost sharing.”
When President Bush unveiled a health reform similar to Mr. McCain’s in 2007, Mr. Furman co-authored a Tax Policy Center paper that called it “innovative and a step in the right direction.” As recently as May, he published a long article in Health Affairs on the possibilities of health-care tax reform.
What a difference an election makes. “The choice you’ll have,” Mr. Obama warned of the McCain plan during one of the debates, “is having your employer no longer provide you health care.” Sounds terrible. But wait, let’s consult another one of Mr. Obama’s advisers. David Cutler, the Otto Eckstein Professor of Applied Economics at Harvard, put it this way: “Health insurance is not something that is made better by tying it to employment. As a result, essentially all economists believe that universal coverage should be done outside of employment.”
More…
I’ve commented several times on the quality of Obama’s economics advisers, starting with Jason Furman. However, Obama policy is run from a very different office — one where there are no ethics, and certainly no intellectual honesty.
For more analysis see Almost Everyone Would Do Better Under the McCain Health Plan — His tax credit is larger than the current tax subsidy for insurance.
The McCain health-care insurance tax credit may well be one of the most misunderstood proposals of this presidential election. Barack Obama has been ruthless in his attacks. But the tax credit is highly progressive and will provide a powerful incentive for people to purchase health insurance. These features under normal circumstances should endear Democrats to the proposal.
Say what?
For all of America’s cherished belief in choice and freedom, it remains an astonishing fact that the U.S. government forces citizens over the age of 65 into a subpar health plan of its choosing. And so it is with some hope that we greet a new federal lawsuit that aims to allow senior citizens to flee Medicare.
The suit comes courtesy of Kent Masterson Brown, a lawyer who has previously tangled with the government over Medicare benefits. Mr. Brown represents three plaintiffs who are suing the federal government to be allowed to opt out of Medicare without losing their Social Security benefits.
Amazingly, this is not currently allowed. While the Social Security law does not require participants to accept Medicare, and the Medicare law does not require participants to accept Social Security, the Clinton Administration in 1993 tied the programs together. Under that policy, any senior who withdraws from Medicare also loses Social Security benefits.
Mr. Brown’s plaintiffs are three men who do not want to be in Medicare, even though they paid Medicare taxes throughout their income-earning years and though they are not asking for that money back. The three instead saved privately to cover their health care expenses. They now prefer to contract with private doctors and health facilities that they believe are superior to those offered by Medicare.
Read the whole thing - it’s short.
Dozens of incentive schemes have been uncovered which allow GPs to profit by slashing the number of patients they refer for hospital care.
Under one scheme, GPs stand to gain £59 for every patient not referred to hospital, if they cut an average referral rate by between two and eight per cent.
Torbay care trust in Devon will pay up to £15,000 to the average-sized GP practice if it hits a swathe of targets, including reducing hospital referrals.
NHS managers say referral rates, which rose 16 per cent nationwide during the first quarter of this year, have to be cut to save money. They claim many patients can receive equally good care from community NHS staff, such as physiotherapists and nurses.
But critics fear that patients could suffer if GPs’ decisions are swayed by the prospect of a cash bonus.
A leading surgeon said that patients’ cancers had already gone undiagnosed after they were denied specialist care under two such “referral management” schemes.
Orthopaedic surgeon Stephen Cannon, former president of the British Orthopaedic Association and a consultant surgeon at the Royal National Orthopaedic Hospital, described the cases as an “absolutely terrible” warning that decisions by non-specialist doctors could have devastating consequences.
Looking forward to your single payer British quality health care?
Mr. Obama’s policies on drug access and his party’s plans to control pricing will distort the financial incentives that inspire innovations. This will shortchange the contributions innovations provide.
The most powerful tool we have for reducing health care costs is drugs instead of procedures. All of Obama’s medical policies are dead wrong — Americans can now look forward to British-quality health care. But all nations will suffer from Obama’s policies because America has been funding most of the drug development.
Pfizer recently said it’s exiting the development of drugs for common conditions like heart disease. This is part of a shift underway in the pharmaceutical industry to give up on routine medical problems in favor of discovering “specialty” drugs for rare diseases and unmet medical needs like cancer.
The shift is driven in part by the industry’s critics in Washington, who have long maligned drug companies for targeting too many routine medical problems with drugs that were “merely” tweaks on existing medicines. Now these same detractors, led by House Democrats, are proposing controls on access to and eventually pricing of the specialty drugs as well. Under a Barack Obama presidency, this is one way they’ll pay for the candidate’s plan to create a Medicare-like program for the under-65 crowd. These new controls — based on a view of medical care as a commodity to be purchased at the lowest price, with little allowance for innovation — could push drug development over a tipping point.
Specialty drugs offer significant health benefits but for a high price, reflecting the difficulty of developing them. The regulatory process for getting them approved is more uncertain, since the diseases are poorly understood or haven’t been tackled before in clinical trials. Enrolling patients with rare conditions is also expensive; they are harder to recruit and often need to undergo more extensive testing to monitor the progress in trials. It can cost less than $5,000 to enroll a single patient in a trial for a primary care drug such as a blood pressure pill, but up to $70,000 for a big cancer study and more than $100,000 for some very rare diseases. Specialty drugs that were once tested on hundreds of patients are now often required by the Food and Drug Administration (FDA) to be tested on thousands.
Success rates are low. On average, a drug stands an 11% chance of making it through clinical trials and reaching patients. Cancer drugs only have a 5% chance of clearing these hurdles. Specialty drugs are also harder to distribute and by definition have a much smaller market for sales.
The big drug makers’ shift into these markets isn’t a measure of their strength, but a symptom of their decline, as they grope for a profitable niche amid increasing regulation. Mobilizing capital to take on these medical problems requires the promise of big returns for the few drugs that succeed. When a new drug mitigates — and sometimes cures — a previously untreatable problem, innovators can often “re-price” the initial treatment of a disease, charging very high prices for the administration of a drug. The initial intervention becomes more costly — but the new benefits should reduce long-term costs, extend life, or ease suffering.
… The last time policy makers waged a concerted effort to control the price of and the access to the most innovative, but expensive new drugs as part of broader health-care reform in the mid 1990s, the percent of venture capital going into biotech fell by almost half in a single year. A lot of that money shifted into Internet companies.
More analysis from AEI fellow Dr. Scott Gottlieb. Do read the whole thing…
If you like top-down, centralized government, then the Obama health plan is for you. If you prefer decentralized government –where citizens have choice, then the McCain health plan is for you. Bob Moffit examines the polar opposite proposals:
Presidential candidates John McCain and Barack Obama are offering ambitious, comprehensive and expensive health care reform plans. Both would greatly expand health insurance coverage for millions of Americans.
Examining the key elements of these two competing plans, one can discern clearly two very different visions of America’s health care future. They are polar opposites. The Obama health plan would centralize power over health care financing and delivery in Washington. The McCain health plan would decentralize control over health care financing and decision-making among individuals and families, while retaining authority in the states. This is not a judgment; it is a fact.
The Obama plan is comprehensive in scope, but sparse in detail. He proposes four major steps to expand coverage:
The creation of a new national health plan (a government health plan) that would enroll those who do not have employer based coverage or who are ineligible for existing government health programs, such as Medicaid and SCHIP
The creation of a national health insurance exchange, which would serve as a regulatory “watchdog” to enforce federal rules and standards on both the new federal health plan and those private health plans permitted to compete with the new government health plan.
An employer mandate, whereby employers either offer a government-approved health benefits package of unspecified value or pay a new federal tax of an unspecified amount, which would finance coverage in the new government plan.
An expansion, again unspecified, of existing government health programs, particularly Medicaid and SCHIP, along with new regulatory initiatives governing the delivery of medical care by physicians and other medical professionals.
Independent analysts expect that Obama’s creation of a new national health plan within a federally run “health insurance exchange” would lead to a rapid erosion of private coverage in general and employer-based coverage in particular. The Lewin Group, a prominent econometrics firm based in Virginia, estimates that the Obama plan would result in a net reduction of the uninsured by 26.6 million. But the composition of American insurance coverage would change. 22.5 million Americans would lose their employer based coverage, according to the Lewin analysis, and an estimated 48.3 million more Americans, including those who lost employer-based coverage, would be enrolled in government health care programs.
The McCain plan is also comprehensive in scope, and likewise lacks some critical details. He proposes three major steps to expand coverage:
The replacement of existing federal tax breaks for employment-based health insurance (specifically, the employees’ tax exclusion, not the employer’s deduction) with a universal health care tax credit worth $5,000 for a family and $2,500 for an individual, annually indexed for inflation.
The creation of a national market for health insurance (quite unlike Obama’s national health insurance exchange), where individuals and families could buy state-regulated health insurance plans anywhere in the country, not just in the state where they happen to live.
A “guaranteed assistance program,” whereby federal authorities would financially assist state officials in providing affordable insurance coverage for the estimated 2 million to 5 million Americans who are “uninsurable” or hard to insure because of medical conditions. This would be accomplished through state-based high risk pools or similar mechanisms. Like Obama, McCain would also promote changes in the delivery of medical care to secure greater value for health care dollars.
Independent analysts generally see McCain’s proposal as a bold and innovative change in health care financing. Powered by a universal health care tax credit, the tax policy change would result in a rapid expansion in private health insurance coverage and a decrease in dependency on government programs. While some critics imply that McCain’s proposal to tax health benefits to finance the tax credit amounts to a tax increase, the indisputable truth is that it is a major tax cut, particularly for the middle class. Urban Institute analysts, for example, estimate that the typical family would come out roughly $1,200 ahead annually. The Lewin Group estimates that the McCain plan would result in a net reduction of the uninsured by 21.1 million. Likewise, the composition of American insurance coverage would change. An estimated 26.5 million persons would gain private insurance coverage, according to the Lewin Group, and 5.4 million Americans currently on Medicaid would secure private health insurance coverage.
Latest Comments
RSS