Science, Technology & Health: April 2014 Archives
Is the Golden Age of antibiotics drawing to a close? Will our children grow up in a world where minor infections that have been easily curable for decades are once again life-threatening? This is a huge public health concern with far greater impact than the availability of health insurance. Developing new antibiotics and preventing a return to bacteria-dominated health environment should be a top priority of the federal government.
The spread of deadly superbugs that evade even the most powerful antibiotics is no longer a prediction but is happening right now across the world, United Nations officials said on Wednesday.Antibiotic resistance has the potential to affect anyone, of any age, in any country, the U.N.'s World Health Organisation (WHO) said in a report. It is now a major threat to public health, of which "the implications will be devastating".
"The world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill," said Keiji Fukuda, the WHO's assistant director-general for health security.
Finally someone has improved on the millennia-old axe for splitting wood by hand! Behold: The Vipukirves, or Leveraxe.
So what makes a lever different than a wedge in this scenario? The Vipukirves still has a sharpened blade at the end, but it has a projection coming off the side that shifts the center of gravity away from the middle. At the point of impact, the edge is driven into the wood and slows down, but the kinetic energy contained in the 1.9 kilogram axe head continues down and to the side (because of the odd center of gravity). The rotational energy actually pushes the wood apart like a lever. A single strike can open an 8 cm gap in a log, which is more than enough to separate it.
Simple and brilliant. Also easy to mechanize.
Three million Californians are newly insured thanks to Obamacare, but they can't find any doctors willing to take them. One of the big philosophical problems with Obamacare is that it makes the assumption that getting someone health insurance will inevitably lead to that person getting health care. That isn't true.
Thinn Ong was thrilled to qualify for a subsidy on the health care exchange. She is paying $200 a month in premiums. But the single mother of two is asking, what for?"Yeah, I sign it. I got it. But where's my doctor? Who's my doctor? I don't know," said a frustrated Ong.
Nguyen said the newly insured patients checked the physicians' lists they were provided and were told they weren't accepting new patients or they did not participate in the plan.
Dr. Kevin Grumbach of UCSF called the phenomenon "medical homelessness," where patients are caught adrift in a system woefully short of primary care doctors.
"Insurance coverage is a necessary but not a sufficient condition to assure that people get access to care when they need it," Grumbach said.
Those who can't find a doctor are supposed to lodge a complaint with state regulators, who have been denying the existence of a doctor shortage for months.
The NYT has a great piece about direct primary care: doctors who have stopped taking insurance and instead work for cash. Like a normal business. Surprise! It works pretty well.
Lee Spangler, vice president of medical economics with the medical association, said Texas was seeing an increase in practices like these because they gave doctors more flexibility to determine the services they provide and to cut costs for their practices."A physician has very little ability to negotiate all policies and procedures that come with insurance contracts," Mr. Spangler said, adding that some insurance companies can even dictate the business hours during which doctors can be paid. "Basically you get rid of all those shackles in terms of having a carrier dictate to the practice how to deliver medical services."
It is the direct primary care business model that proves most attractive, Mr. Spangler said, adding that doctors "want to get out from under what has been stacked up on them."
Bizarrely, "some people" seem to be more worried about health insurance than actual health care. Could it be that these "some people" make their livings as middlemen who don't want patients to go straight to doctors?
Some health care specialists worry that if too many practitioners choose this path, the state could be left struggling to find doctors to accommodate patients with insurance as the federal health care overhaul is making such coverage mandatory for most Texans. So far, efforts to enroll Texans in the federal insurance marketplace -- crucial to the success of the Affordable Care Act -- have made a small dent in the state's uninsured population, which has reached 6 million, according to United States Census Bureau data. The federal Department of Health and Human Services reported that 295,000 Texans had signed up for insurance coverage in the federal marketplace as of March 1."We have to find ways of stretching the current number of primary care doctors to meet that demand," said Dr. Clare Hawkins, president of the Texas Academy of Family Physicians. "Direct primary care goes in the other direction."
What if you passed a law mandating insurance, but no doctors showed up?
Guess what? The penis is not the worst place to be stung by a bee.
"The Schmidt Sting Pain Index rates the painfulness of 78 Hymenoptera species, using the honey bee as a reference point. However, the question of how sting painfulness varies depending on body location remains unanswered. This study rated the painfulness of honey bee stings over 25 body locations in one subject (the author). Pain was rated on a 1-10 scale, relative to an internal standard, the forearm. In the single subject, pain ratings were consistent over three repetitions. Sting location was a significant predictor of the pain rating in a linear model (p < 0.0001, DF = 25, 94, F = 27.4). The three least painful locations were the skull, middle toe tip, and upper arm (all scoring a 2.3). The three most painful locations were the nostril, upper lip, and penis shaft (9.0, 8.7, and 7.3, respectively). This study provides an index of how the painfulness of a honey bee sting varies depending on body location."
Ok, so I'm estimating the number of bee-stings... the actual number could be as few as 75 if the author didn't test all 78 species. But still.
Everyone has heard about BitCoin by now, but did you know that crypto-currencies are just a subset of Distributed Autonomous Corporations?
Distributed Autonomous Corporations (DAC) run without any human involvement under the control of an incorruptible set of business rules. (That's why they must be distributed and autonomous.) These rules are implemented as publicly auditable open source software distributed across the computers of their stakeholders. You become a stakeholder by buying "stock" in the company or being paid in that stock to provide services for the company. This stock may entitle you to a share of its "profits", participation in its growth, and/or a say in how it is run.
