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by revere, cross-posted from Effect Measure

We are now almost through the period considered to be the traditional flu season (to the end of March in the temperate northern hemisphere) and so far the amount of documented influenza infection is at a relatively low normal level and pneumonia and influenza deaths are about usual for this time of year. Said another way, there so far has been no big “third wave” of pandemic swine flu. Most flu experts didn’t know what would happen but if they had to bet, probably would have bet on a resurgence. I suppose it could still happen, since the original transmission in the community occurred “out of season” (April to June of last year). But now the odds look to be against it. So what lesson do we draw from this? I hope it’s not the wrong one:

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by revere, cross-posted from Effect Measure

The latest study on flu vaccine effectiveness in children has been well discussed in the MSM and the flu blogs, so I’ll point you to those excellent pieces (Branswell, crof, Mike Coston at Avian Flu Diary) and just add some things not covered elsewhere. The full text of the article is available for free at JAMA and it’s a pretty good read, so if you want to see for yourself what is involved I urge you to read it, too. First, let me back up a bit and connect this to the controversy about observational and randomized clinical trials we’ve been discussing here of late (before my grant writing interfered, anyway).

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by revere, cross-posted from Effect Measure

It really gives me heartburn to see an otherwise sensible article in AOLNews by Katie Drummond with a headline: “Hyping H1N1: Did It Create a Dangerous Flu Fatigue?” I don’t know if that was her title or not. Newspapers have headline writers who often seem never to have read the piece they are headlining, but online authors often title their own pieces. In any event, the word in the headline I object to is “Hyping.” It implies deliberate exaggeration for ulterior motives.

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by revere, cross-posted from Effect Measure

The National Health Interview Survey (NHIS) has been conducted since 1957 and is one of the main instruments to get a glimpse at the health of the US population. The NHIS is a “multistage area probability design,” or what many call cluster sampling. The idea is to first sample geographic areas in all 50 sates and the District of Columbia, where the area might be a county, a small adjoining group of counties in sparsely populated places or a metropolitan area where population is dense. The list of areas to be sampled has about 1900 entries and 428 are drawn at random, although all states are sampled. So that’s the first stage. Within these primary sampling units subsamples of either 8, 12 or 16 addresses are then drawn or a sample of 4 housing units built after the year 2000. The sample isn’t a straight random sample of the population as Blacks, Hispanics and Asians are oversampled via a screening procedure or by including areas known by the previous census to have higher numbers of these demographic groups. You can read more details at the NHIS site. Interviewing of sampled households goes on throughout the year to get a representative sample of adult, non-institutionalized resident of the US. Participation is voluntary, but response rates exceed 90%, which is pretty amazing.

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by revere, cross-posted from Effect Measure

Congratulations, North Carolina. You are getting brand new $52 million facility for your State Public Health Laboratory and Office of the Chief Medical Examiner, each in separate wings of a 220,000 square foot facility in Raleigh. Sounds great. But if you work there you might want to shower at home and bring bottled water. And better check your benefits. Because the company that got the contract is non other than Kellogg Brown & Root (KBR), until recently a Halliburton subsidiary and notorious Iraq contractor under investigation for shoddy electrical work resulting in the electrocution deaths of 18 US soldiers while showering (the company’s defense? it wasn’t required to follow US electrical codes in Iraq); and exposing workers in a water injection plant to carcinogenic agents. Oh, and the benefits?

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by revere, cross-posted from Effect Measure

Being over 65 I’m an older adult, according to the author’s definition (as reported in the press release, at least), and like everyone else I frequently take elevators. Maybe not as frequently as some. My office is on the 4th floor and I almost always take the stairs, but in taller buildings I take elevators. My rule for the parking garage (top floor is 7) is that I always walk down but I take the elevator up if I’m above the 4th floor on the way back to may car at the end of the day. It’s not a health or exercise issue. I’m too impatient to wait for the elevator. Type A all the way. Enough about me. Back to the elevator and my geezer age group:

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by revere, cross-posted from Effect Measure

Most people feel safe at home, but statistically it’s not the safest place to be, at least in terms of being injured (here injury includes not only trauma but poisoning, but if we restrict it to trauma probably little is changed). Here’s one of CDC’s “Quickstat” looks at the percentage distribution of injuries by place of occurrence, as reported in a cluster sample of the US population (the National Health Interview Survey). The years covered are 2004 to 2007:

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by revere, cross-posted from Effect Measure

We still don’t know if we are experiencing a lull in flu or the virus has burned itself out for the season, but it’s as good a time as any to reflect a bit on where we’ve been and where we still need to go. Being otherwise occupied (I’m sure you are sick of hearing about my grant writing obsession but not half as sick as I am about having it!), I’ll start with something relatively straightforward: how CDC did on the epidemiology and surveillance front. Historically this is the agency’s strong suit and so it is expected they would have acquitted themselves well. And pretty much, they did. A lot of good epidemiology got done and the surveillance system more or less worked to provide important information. But this doesn’t mean there isn’t room for improvement.

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by revere, cross-posted from Effect Measure

The Nature blog, The Great Beyond, has an interesting although not surprising report of accusations on BBC that a cabal of researchers has been impeding publication of important stem cell research to help themselves or help their friends:

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by revere, cross-posted from Effect Measure

It used to be my job to teach the environmental health survey course for public health students and air pollution was a topic I spent a lot of time on because it interested me and intersected some of my research work. One of the things I taught my students was that some air pollutants were very local — carbon monoxide (CO) being a good example; levels of CO on one side of the street could vary significantly from those on the other side by virtue of traffic patterns or street canyon effects — while others were considered regional pollutants. Ozone (O3) was my example of choice. It isn’t emitted by sources by formed as a secondary pollutant via chemical reactions in the atmosphere from chemical precursors like volatile organics and nitrogen oxides (juiced with sunlight) which were emitted by sources (primary pollutants). Thus ozone was an area-wide pollutant with not as much spatial variation, although there was a paradoxical suburban-rural high ozone effect caused by additional reactions of high precursors in the city “eating up” some of the ozone they had produced, leaving a relatively lower ozone level. It turns out my former teaching didn’t go far enough in its areal reach. A new paper in Nature suggests that a significant proportion of background ozone in the lower levels of the atmosphere may be a result of long range transport from East Asia, especially China:

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