In each of the four major pandemics since 1889, a spring wave of relatively mild illness was followed by a second wave, a few months later, of a much more virulent disease. This was true in 1889, 1957, 1968 and in the catastrophic flu outbreak of 1918, which sickened an estimated third of the world’s population and killed, conservatively, 50 million people.

Lone Simonson, an epidemiologist at the National Institutes of Health, who has studied the course of prior pandemics in both the United States and her native Denmark, says, “The good news from past pandemics, in several experiences, is that the majority of deaths have happened not in the first wave, but later.” Based on this, Simonson suggests there may be time to develop an effective vaccine before a second, more virulent strain, begins to circulate.

As swine flu — also known as the 2009 version of the H1N1 flu strain — spreads, Simonson and other health experts are diving into the history books for clues about how the outbreak might unfold — and, more importantly, how it might be contained. In fact, the official Pandemic Influenza Operation Plan, or O-Plan, of the U.S. Centers for Disease Control and Prevention, is based in large part on a history lesson — research organized by pediatrician and medical historian Dr. Howard Markel of the University of Michigan.

A cheerful man with thick-rimmed black glasses and a professor’s manner, Markel was tapped by the CDC to study what worked and what didn’t during the 1918 flu disaster. Markel and colleagues examined 43 cities and found that so-called nonpharmaceutical interventions — steps such as quarantines and school closings — were remarkably successful in tamping down the outbreak. “They don’t make the population immune, but they buy you time, either by preventing influenza from getting into the community or slowing down the spread,” Markel told CNN.

Markel describes a dramatic example in the mining town of Gunnison, Colorado. In 1918, town leaders built a veritable barricade, closing down the railroad station and blocking all roads into town. Four thousand townspeople lived on stockpiled supplies and food from hunting or fishing. For three and a half months, while influenza raged in nearly every city in America, Gunnison saw not a single case of flu — not until the spring, when roads were reopened and a handful of residents fell sick.

Nonpharmaceutical interventions, or NPIs, also proved effective in big cities such as New York, according to Markel. In fact, the sooner cities moved to limit public gatherings or isolate patients, the less severe their experience tended to be — as much as an eight- or ninefold difference in case and death rates, he says. Based on this guidance, the CDC preparedness plan devotes dozens of pages to potential NPIs, from voluntary isolation to reorganizing company work schedules to reduce the density of people sitting next to each other in the office or while riding trains and buses.

If it seems odd to base medical strategy on 90-year-old newspapers, the approach is increasingly popular. “There’s a big case for looking at history,” says Simonson. “We call it archaeo-epidemiology. You go to libraries and places like that, dig around, collaborate with people like John Barry and try to quantify what really worked.”

Barry is the author of “The Great Influenza,” perhaps the signature history of the devastating 1918 pandemic. He says the historical record shows that isolating patients worked to slow the spread of flu in 1918, but that attempted quarantines — preventing movement in and out of cities — was “worthless.”

While Barry supports the CDC’s general containment strategy, in the past he has charged that Markel’s findings rest on flimsy historical research. After the findings were published in the Journal of the American Medical Association, Barry wrote a letter in response, saying it wasn’t swift action but rather an earlier wave of mild flu, acting like a vaccination, that was probably responsible for New York’s relatively low caseload. In the letter, he noted, “New York City health commissioner Royal Copeland did tell reporters…that he would isolate and quarantine cases,” but based on his own articles in the New York Medical Journal, he “apparently never imposed those measures.”

It looks superficially like an academic feud, but in this field, different conclusions can suggest radically different approaches to quashing a pandemic. Nowhere is this more true than in research that builds computer models to predict the spread of outbreaks, based on previous ones. Markel, along with most analysts, says that in prior pandemics, the so-called R-naught number — the number of new infections caused by each infected person — has been approximately 2.0. The current U.S. pandemic control strategy is based on computer simulations that assume a flu virus with an R-naught between 1.6 and 2.4.

Last year, however, Simonson and Viggo Andreasen concluded that the true R-naught of the 1918 flu virus was probably somewhere between 3 and 4. Since an epidemic grows exponentially — each person sickens three others, each of whom infects three more, and so on — this is a tremendous difference. “It says it’s going to be harder than we thought” to control a pandemic,” Simonson says with grim understatement.

Barry agrees. “I do think that some of these things, like isolating [sick people], will take off some of the edge. We hope they’ll do more than that. But to think they’ll stop a pandemic, that is just not going to happen.”

Simonson says control measures such as the steps taken by Mexico in recent days — closing schools and restaurants, for example — are still worth the effort. “It doesn’t mean we should give up, because we don’t know the R-naught [for swine flu]. We don’t know how easily this spreads.” But she adds, NPIs are at best a way to buy time. “We just badly need a vaccine. That’s the most important thing.”

To date, the CDC has emphasized personal protective steps such as washing hands and using hand gels, as opposed to tightening border controls or issuing formal directives to close schools or limit public gatherings. Such steps have been left to state and local officials, who have responded in a variety of ways.

One reason for the delay in stronger guidelines is that swine flu caught planners off guard; they had anticipated being able to recognize a pandemic overseas, weeks or at least days before it hit the United States. At the same time, CDC acting director Dr. Richard Besser said Thursday that it’s important to let officials tailor their response to local conditions. “They can take the recommendations we’re providing and apply them locally. [By doing that] we hope to learn and see what are the most effective control strategies.”

Markel agrees that the best response depends on the particular situation. “History is not predictive science. And the powers of public health officials [in 1918] were much greater. Another difference is that people’s trust of doctors and government in 1918 was probably remarkably different…. But what I have found, studying epidemics, is that good planning and good relationships between local state and federal authorities, goes a long way.”

Today’s Quote is:

“覆水盆に帰らず。” - Japanese Proverb

Literal Translation: “Spilt water will not return to the tray”

Common Translation: “It’s no use crying over spilt milk”

The meaning of the quote is that what is done is done. You can not change the past so any mistakes you make you must live with the consequences in the present. You should waste the time dwelling over it, bu move on and continue with your life trying to better the situation.

Thank you for reading the third quote of the day be sure to read tomorrow’s “Quick Quotes”.

P.S. Anyone have a better name for my column please comment on anyone of the quotes

Today’s Quote is:

“Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing.” - Helen Keller

The meaning of the quote is that in life in general, we are and never will be of complete and total safety. And if by some rare chance we do come to this we give up living, for life is nothing without chance. Helen Keller before her second birthday was both Blind and Deaf. She was then able to overcome this with the help of Annie Sullivan, who took her out of total isolation from the outside world and let her experience things threw touch. She said this quote in later years reflecting on her youth and how her life came to be.

Thank you for reading the second quote of the day be sure to read tomorrow’s “Quick Quotes”.

P.S. Anyone have a better name for my column please comment on anyone of the quotes.

]]> http://metsacramento.org/herald/archives/102/feed http://metsacramento.org/herald/archives/99 http://metsacramento.org/herald/archives/99#comments Fri, 24 Apr 2009 18:30:55 +0000 brian-santiago http://metsacramento.org/herald/?p=99 Welcome to the Brand New “Quick Quotes” Column by Avery Billings. Basically it’s a Quote of the Day column. So everyday their will be a quote a small amount of Background information and the meaning.

So Today’s Quote is:

“Un bon croquis vaut mieux qu’un long discours.” - Napoleon Bonaparte I

Literal Translation: “A good sketch is better than a long speech”

Common Translation: “A picture is worth a thousand words.”

The meaning of the quote is That the longest description in words is never as good as seeing it with your own eyes. This quote is used in everyday language but there are few people that know where this quote comes from or any quotes many people do not know the origin of these everyday parts of our conversation. Emperor Napoleon Bonaparte I of France was probably more well known from his conquering of most of Europe and his fall at Waterloo, but for quotations he is not well-known at all. The reason I started this column is to expose the school to a quote for them to use integrate it into everyday language and teach us a little history along with it. Thank you for reading the first quote of the day be sure to read tomorrow’s “Quick Quotes”.

P.S. Anyone have a better name for my column please comment on anyone of the quotes.

His second post, 20 minutes later, was a little more unusual: “SPELLING WITH MY BRAIN.”

Wilson, a doctoral student in biomedical engineering, was confirming an announcement he had made two weeks earlier — his lab had developed a way to post messages on Twitter using electrical impulses generated by thought.

That’s right, no keyboards, just a red cap fitted with electrodes that monitor brain activity, hooked up to a computer flashing letters on a screen. Wilson sent the messages by concentrating on the letters he wanted to “type,” then focusing on the word “twit” at the bottom of the screen to post the message.

The development could be a lifeline for people with “locked-in syndrome” — whose brains function normally but who cannot speak or move because of injury or disease.

Wilson and his supervisor, Justin Williams, made the breakthrough last month after hearing a question posed on the radio.

“Wouldn’t it be great if you could Twitter just by thinking about it?”

That query sparked what Williams called the “a-ha moment.”

We can do that,” said Williams, an assistant professor and the principal investigator at the lab in Madison, Wisconsin. “We can do that tomorrow.”

In the end, it wasn’t quite “tomorrow,” Williams said, but Wilson had written the software to link existing technology with Twitter “within a couple of days” of starting on the project in March.

He sent Williams his first “tweet” — or message — from the brain-computer interface on March 31.

“I had set up my phone to get Twitter updates, and I walked in my door and got this message, and I knew it was really possible,” he told CNN by phone. “My wife was sitting there, and I showed her the message and she immediately got excited about it — and it’s rare that I come home from work and she gets excited about what I have been doing.”

That’s because using the brain to post Twitter messages is potentially much more than an academic exercise or a party trick — it could help paralyzed people communicate.

“These are people who have ALS, like Stephen Hawking, or they have a brainstem stroke, or a high spinal-cord injury,” Williams explained. “There is nothing wrong with these people’s brains. It’s a normal person, locked into a lifeless, useless body.” (The British physicist Hawking has ALS, amyotrophic lateral sclerosis, which is also known as Lou Gehrig’s disease.)

Hundreds of thousands of people suffer from locked-in syndrome, Williams estimated.

Many of them want just the kind of ability the brain-Twitter project seems to offer, said Kevin Otto, an assistant professor of biomedical engineering at Purdue University in Indiana.

“The interesting thing about this project is they are directly addressing some of the patient desires,” he said. “A lot of people think [locked-in patients] want to walk and want fancy prosthetics, but a lot of times what they want are bladder control and basic communication skills.”

Otto, who was not involved in the University of Wisconsin project, called it “a very important incremental step to take two existing technologies and marry them together like this.”

Williams had been working on brain-computer interface technology “for many years,” he told CNN, before the idea to use Twitter.

“The technology we were developing was 10 or more years down the line, so we started wondering, ‘Is there something we can do now?’ ”

His lab at the University of Wisconsin — like those at Brown University, Purdue and the Wadsworth Center in Albany, New York, among others — is developing ways for locked-in people to communicate. Projects range from manipulating a cursor on a computer screen to operating a robotic arm, and they can include devices physically implanted into a brain.

But the Twitter project has a lot of advantages, Williams said.

“Twitter fits so many of our needs and patients’ capabilities,” he said. “Their first interest is in being able to communicate in a normal fashion, and at a distance.”

Twitter is simpler than e-mail, he said.

“If I am locked in and I want to e-mail someone, the format is all wrong. You have to be able to select recipients and group them, copy, paste, send. … We don’t think about that much as normal people, but it can become unmanageable.

“Twitter takes care of all those things. They just have to get [the message] to a location where people can come and find it,” he said.

Locked-in people communicating by tweet might have followers who don’t even realize they are disabled, Williams said.

“Nobody’s going to notice that the person at the other end is disabled. They might not have any idea. And that might be very empowering for people,” he said.

The interface is not unlike the method the French journalist Jean-Dominique Bauby used to dictate his novel “The Diving Bell and the Butterfly” — later turned into a movie — after a massive stroke left him paralyzed except for his left eyelid. Bauby’s caregivers recited letters of the alphabet; he blinked when he heard the one he wanted and they wrote them down.

The brain-Twitter application flashes letters on a screen while the user, wearing a cap fitted with electrodes, concentrates on a letter.

“When the letter that you are concentrating on flashes, we can pick that up,” Williams said.

Williams declined to say how soon the interface could be available commercially, noting it has not yet been used by anyone with locked-in syndrome.

“I’d hate to speculate about things being on the market,” he said. “Adam [Wilson] is going to graduate in May, and his next role is to start preclinical trials with subjects in New York and Germany.”

But Williams said he is excited about the development.

“We were interested in seeing what we could do right now to help people,” he said. “The field has come far enough that we need to start getting to people in their homes.”

It is fairly simple to do, the first time it took me the full 2 hour class, but it took me 15 minutes this time. He provided the dead elderberry wood (the plant is protected as well as the beetle) which as a soft piff (inner wood). Using a screw driver we drilled the piff out, once the majority of it was gone we then used a file meant for the inside of pipes to shave away and smooth out the flute. After your drill a few holes make it look the way you want, and there you have it a flute. The hard part is playing it though, no mouth peice, so you have to find the sweet spot playing it at different angles.

Because of restrictions in Japan’s constitution, the nation’s military is limited to a “self-defense” role.

The Japanese Cabinet approved the mission Friday. The MSDF’s major overseas missions have focused on background support, such as transport and refueling, Japan’s Kyodo news agency said.

MSDF members aboard the destroyers may fire warning shots if they encounter pirates. However, under Japanese law they are not allowed to harm the pirates except in self-defense, Kyodo reported.

The Japanese government submitted an anti-piracy bill to the Diet, Japan’s parliament, on Friday which would provide the MSDF more latitude against pirates. It would allow the MSDF to fire on boats that close in on commercial ships after repeated warnings, Kyodo reported.

The bill would also enable the MSDF to protect any ship, including those without a Japanese connection — a provision government officials say is needed to fulfill Japan’s international obligations, Kyodo said.

Japan Coast Guard officers are aboard the destroyers to process judicial matters, including collecting evidence and handling suspects, in the event that the vessels encounter pirates, Kyodo reported.

The move comes after Somali pirates released a Japanese-owned vessel that was hijacked in the pirate-infested Gulf of Aden in November, according to a nongovernmental group that monitors piracy. The ship was released last month.

Roughly 400 MSDF personnel and eight coast guard officers are aboard the two destroyers, each of which carry two SH-60K patrol helicopters and two speedboats, officials told Kyodo.

The 4,650-ton Sazanami and 4,550-ton Samidare destroyers left their base in the southern port city of Kure after a ceremony attended by Prime Minister Taro Aso and Defense Minister Yasukazu Hamada, Kyodo reported.

Once the destroyers reach the Gulf of Aden in two to three weeks, they will escort vessels linked to Japan, such as Japanese-registered ships, vessels with Japanese nationals or cargo on board, or ships operated by Japanese shipping firms, Kyodo said.

The waters off Somalia have become a pirate hotspot in recent years, with more than 40 vessels hijacked in 2008 alone, according to the International Maritime Bureau. This has prompted a number of countries to send warships to the region in an effort to combat the problem.

For nearly 30 years, Redding has been an ordained minister in the Episcopal Church. Her priesthood ended Wednesday when she was defrocked.

The reason? For the past three years Redding has been both a practicing Christian and a Muslim.

“Had anyone told me in February 2006 that I would be a Muslim before April rolled around, I would have shaken my head in concern for the person’s mental health,” Redding recently told a crowd at a signing for a book she co-authored on religion.

Redding said her conversion to Islam was sparked by an interfaith gathering she attended three years ago. During the meeting, an imam demonstrated Muslim chants and meditation to the group. Redding said the beauty of the moment and the imam’s humbleness before God stuck with her.

“It was much more this overwhelming conviction that I needed to surrender to God and this was the form that my surrender needed to take,” she recalled. “It wasn’t just an episode but …. was a step that I wasn’t going to step back from.”

Ten days later Redding was saying the shahada — the Muslim declaration of belief in the oneness of God and acceptance of Mohammad as his prophet.

But Redding said she felt her new Muslim faith did not pose a contradiction to her staying a Christian and minister.

“Both religions say there’s only one God,” Redding said, “and that God is the same God. It’s very clear we are talking about the same God! So I haven’t shifted my allegiance.”

The imam at the Islamic Center in Seattle, Washington, where Redding prays said she brings the best of both traditions to her beliefs.

“Coming from an example of wanting to be Christ-like and coming from the perspective of wanting to follow the best example — the example of our prophet Mohammed — it all makes sense then,” Benjamin Shabazz said.

There are many contradictions between the two religions. While Islam recognizes Jesus as a prophet, Christianity worships him as the son of God.

James Wellman, who chairs the department of comparative religion at the University of Washington, said that while it is not unusual for people to “mix and match” beliefs, it is almost unheard of for a minister to claim two religions.

“When you take ordination as a Christian minister, you take an explicit vow of loyalty to Jesus. It’s hard for me to understand how a Christian minister could have dual loyalties,” Wellman said.

Redding said she sees the theological conflicts but that the two religions, at their core, “illuminate” each other.

“When I took my shahada, I said there’s no God but God and that Mohammed is God’s prophet or messenger. Neither of those statements, neither part of that confession or profession denies anything about Christianity,” she said.

To her parishioners and family, though, Redding has turned her back on her faith and office. There was, she said, “universal puzzlement” at her decision to convert to Islam but still remain an Episcopal minister.

“I have people who love me very much who really don’t want me to do this, and I love them very much. And I would love to be able to say, ‘Because I love you I will renounce my orders’ or ‘I will renounce Islam’ … I hate causing pain to people who love me, that’s not my intention,” Redding said.

The Episcopal Church also rejected Redding’s religious choice.

“The church interprets my being a Muslim as ‘abandoning the church,’ ” she said. “And that [there] comes an understanding that you have to be one or the other, and most people would say that. It simply hasn’t been my experience that I have to make a choice between the two.”

The Diocese of Rhode Island, where Redding was ordained, told her to leave either her new Muslim faith or the ministry. A diocese statement said Bishop Geralyn Wolf found Redding to be “a woman of utmost integrity. However, the Bishop believes that a priest of the Church cannot be both a Christian and a Muslim.”

Even though she has been defrocked, Redding said she is not capable of turning her back on either faith. She said she wants to continue speaking about and teaching religion and perhaps even travel to the Hajj, a journey to Mecca that every Muslim is supposed to make in their lifetime.

Redding said she does not want her belief in two religions to diminish the value she holds for both Christianity and Islam. Each faith by itself is enough to fulfill a person spiritually, she said.

“It’s all there. I am not saying you have to go somewhere else to be complete. Some people don’t need glasses, some people need single lenses. I need bifocals.”

Link to Orginal http://www.cnn.com/2009/US/04/02/muslim.minister.defrocked/index.html

Forde ran hard, his ragged breaths hanging in the frigid night air. Every step caused a new explosion of pain in his sides, but he dare not stop, not until his pursuers had lost much ground. He ran into the night, frozen branches slapping at his arms and face, beating him mercilessly as he ran on in the forest. Suddenly, he darted to his right, and continued that way for a while, until he heard voices ahead of him. He jumped into a ditch under a tree, and listened.

“The boss’s gonna be really mad.” A rough voice quivered.

“Well, you’re the one who decided to try to ambush him!” a second voice snarled.

“Both of you shut up! I think I heard something over here” a third, commanding voice ordered. There was a rustling of bushes, and Forde stopped breathing. The bandits were right outside his hideout. If they catch me… no, it doesn’t bear thinking about. He thought, beginning to panic.

The bandits were very close now, searching, listening for anything out of the ordinary. Then one of them bent down to inspect the ground for tracks.

“Boys, I got us something!” he bellowed, waving his arm in the direction of the others. They saw Forde’s tracks, and followed them towards the tree. It’s now or never, Forde thought, tensing for the charge. As they neared the dugout, he sprang up; screaming in a tone that he hoped was barbaric. It wasn’t. As two of the bandits fell down laughing, the third picked Forde up by the ankle, and smiled gruesomely as he brought his axe to Forde’s head. What happened to today? It was so good, he thought, as pain flared up behind his eyes.

People talk, mug, even punk others just to be “cool” but its not “cool” its mean, rude and it hurts. You think just because you are prettier, bigger, even stronger you are better than the people you pick on? The people you pick on are way cooler than you will ever be. They have a heart that beats and a brain that transmit what they say. The “cool” people probably do not even know half of what they say.

You call them losers, throw them in the trash you probably even make fun of them when they were right there. When they go home they probably are scared to come to school just because your there. They cry themselves to sleep remembering the mean words you tell them, wither false or true, it does not matter.

You may not think it hurts them, but it does. Mean to me means a nobody, someone whose sad about how they live and feel; who wants to take it out on others since they do not have anything to do. Call “losers” what you want and do what you please, but just remember who is it really hurting and who has a future?

Let them wear their glasses without saying four eyes. Let them laugh even when it’s loud. Let them even joke when it’s not even funny. Let them be themselves instead of competing in this world for popularity points.

It really does not matter if you are popular or not, hang out one day with the “losers” help them improve their looks here and their… Give those tips and positive comments instead of negativity; a loser to me is a person who has dignity and is inspirable, and does not care what you think of them.