Yukon Kuskokwim Nushagak science

Here is the original article.

• http://www.thelancet.com/webfiles/images/journals/lancet/s0140673606694919.pdf

Here is how one newspaper headlined it—
Survey says 600,000 have died in Iraq war
By Clive Cookson, Science Editor, and Steve Negus, Iraq Correspondent

• http://tinyurl.com/jrmcf

Financial Times
Published: October 11 2006 17:37 | Last updated: October 11 2006 17:37

or

Disputed study claims 655,000 Iraqi deaths
POSTED: 2:57 a.m. EDT, October 11, 2006 CNN

• http://tinyurl.com/kyw37

or

Enormous death toll of Iraq invasion revealed
11 October 2006, NewScientist.com news service, Debora MacKenzie

• http://tinyurl.com/tq7dl

or

One in 40 Iraqis ‘killed since invasion’
US and Britain reject journal’s finding that death toll has topped 650,000
Sarah Boseley, health editor, Thursday October 12, 2006, The Guardian

• http://www.guardian.co.uk/international/story/0,,1920132,00.html

or

Iraq casualty figures open up new battleground
By Dan Murphy | Staff writer of The Christian Science Monitor

• http://www.csmonitor.com/2006/1013/p01s04-woiq.html

“The possibility of introducing bias in any kind of survey is real, and you spend more time designing the survey to eliminate the sources of bias then actually carrying it out,” he says. “One of the real risks in this is that people report deaths that don’t occur, so we did ask for death certificates. And in 92 percent of cases, they were provided.”

To be sure, the researchers of the Lancet study says possible errors leave a range between a low of 392,979 additional deaths and a high of 942,636. The 601,000 figure is the median.

The commonly accepted numbers until now have been much lower than Lancet surveys. The Iraq Body Count, a website that tracks civilian deaths in the war by compiling data from news reports, estimates 48,000 deaths have been reported in the media, while the Iraq Index sponsored by the Brookings Institution in Washington has counted 61,000 civilian deaths. President Bush estimated 30,000 civilian deaths late last year.

Fortunately,

• The Lancet paper on the Iraq War toll - http://scienceblogs.com/effectmeasure/2006/10/ the_lancet_paper_on_the_iraq_w.php

presents some the background to the current study.

The purpose in presenting this here is to examine the science, the evidence.

What about the science? It doesn’t take much reflection to see that estimating mortality from an invasion with a disastrous and chaotic aftermath is no simple matter.

The Reveres are pretty good at asking the questions you should be asking of medical or health studies. What else could account for the results? If the alternatives are not feasible, then the study has greater validity, whether or not we “like” the results.

powered by performancing firefox

Technorati Tags: Iraq, epidemiology, critical+thinking, statistics, Lancet, newsmedia
Site Search Tags: Iraq, epidemiology, critical+thinking, statistics, Lancet, newsmedia

I found this at the excellent source of health information, BHIC blog, Bringing Health Information to the Community

“Medical Reference for Non-Medical Librarians”

• http://denison.uchsc.edu/outreach/medbib3.htm

Be sure to check out the page on

• Evaluating Medical Web Sites - http://denison.uchsc.edu/education/eval.html

An acronym to help with evaluation

* Use the acronym DOCTOr to remember the key categories to evaluate:
o Design - the aesthetics and ease of movement around the site.
o Other - cost of use, is the site rated or reviewed?
o Content - the depth and quality of the information, its purpose and audience.
o Technical - the technology requirements of the site, the effectiveness of the technology used.
o Origin - the author and sponsor of the site, their qualifications for presenting the information, the date of the information.

The DOCTOr acronym should also remind patients to consult a health professional before following the advice dispensed on a web page, in a news group message, or any other source.

Site Search Tags: BHIC, reference, library, dictionary

2006-07-27 I moved this up from a comment on Local alcohol prohibition, police presence and serious injury in isolated Alaska Native villages so I could better characterize the entry. mpb

I have been assembling references about alcohol control points and whether increasing prohibition (which the City Council of Bethel wishes to do) has any effect on the rate (prevalence) or incidence of crime, chronic alcoholism, or addiction. The references have been assembled in

http://www.connotea.org/user/Hlthenvt

or use your own tags (search terms) to find similar articles cited in the collection as a whole

http://www.Connotea.org

This issue [further alcohol control through a city-run office] needs careful examination which the City of Bethel Council hasn’t yet done, before changing community policy.** Public involvement procedures should provide at least three proposed alternatives–

no action

action 1

action 2

with the pros and cons (positive and negative impacts) of each alternative. (Or, multiple working hypotheses with procedures to falsify them.)

[**the proposal was removed from City Council action by a special election which now requires any establishment of a city-run alcohol dispensing center to be put to a vote of all Bethel voters.]

Site Search Tags: prohibition, Bethel, CoB, connotea, policy

As students of this site are aware, avian influenza already exists in the waterfowl and domestic fowl of North America (contrary to the many public services announcements in May and June 2006). It is a natural phenomenon.

http://tinyurl.com/fok3n
Archive Number 20060704.1834, Published Date 04-JUL-2006
Subject PRO/AH/EDR> Avian influenza, ostriches - South Africa, H5N2: OIE

“[First of all, this is _not_ the Avian Influenza virus that has infected humans. We have previously seen this virus — Highly Pathogenic Avian Influenza H5N2 (HPAI H5N2) — in North America and Europe. In 1983, a now historic outbreak in Pennsylvania in the USA was attributed to H5N2. Mexico (1994) and Texas, USA (2004) also had North American HPAI H5N2 outbreaks. Italy had HPAI H5N2 in 1997 (Italy also had HPAI H7N1 in turkeys in 1999- 2000). A complete table of Highly Pathogenic Avian Influenza outbreaks in poultry by subtype until the end of 2003 is available at

http://www.who.int/csr/don/2004_03_02/en/

Read the rest of this entry »

printed in the Anchorage Daily News which I don’t think intended this to be satire.

http://www.adn.com/life/health/birdflu/story/7939198p-7832627c.html

By MARY PEMBERTON, The Associated Press
Published: July 7, 2006

Alaska is taking an aggressive stance against a possible outbreak of deadly bird flu in humans by placing its order early for medicines intended to slow the spread of a pandemic.

State officials will eventually order enough antiviral doses to cover about a fourth of Alaska residents.

Officials are being bold because the state is a crossroads for migratory birds, which could be carrying the virus here from other parts of the world….

“If we get to 2007, we will be on our road of having a reasonable supply,” Mandsager said….

State health officials this summer will come up with a map for distributing the drugs quickly if there is an outbreak. The plan calls for moving some of the antivirals from Anchorage to cities and towns such as Bethel, Nome and Kotzebue, and eventually to the villages.

“It won’t do any good to have the medicine if we don’t have a distribution plan,” Mandsager said…. emphasis added

With regard to antivirals as effective agents against an H5N1 human pandemic—see discussions here:

from EffectMeasure [It’s not the plan, it’s the planning. - http://ykalaska.uniblogs.org/2006/04/14/ its-not-the-plan-its-the-planning/]
“But an important issue raised by the IAFF (echoed by health care workers) is policy around prophylaxis of essential workers.”
http://effectmeasure.blogspot.com/ 2006/04/firefighters-and-bird-flu.html

Bird Flu: Communicating the Risk, Sandman & Lanard - http://ykalaska.uniblogs.org/2006/03/21/h5n1-risk-sandman/

Even without the transloading ability, Anchorage is a Great Circle airport between the major continents of Asia, Europe, and North America. [see also http://ykalaska.uniblogs.org/2006/04/29/where-is-nearest-us-capitol/] Anchorage is also the only (air)port connecting most of Alaska (most of us off the road system) with the rest of the world and even with the rest of western Alaska. The world-wide microbe mixing bowl is Anchorage; the Delta Regional Hospital (YKHC) is a mini-mixer. If we end up with the highly pathogenic avian influenza, it seems likely to come from the big birds in Anchorage.

Alaska’s unique air cargo rules entice business
TRANSLOADING: Air Canada to join others using transfer capabilities in Anchorage.

By ROB STAPLETON
Alaska Journal of Commerce
http://www.adn.com/money/industries/aviation/ story/7699681p-7610713c.html
Published: May 6, 2006

Read the rest of this entry »

April 30, 2006
from the Detroit Free Press editors
http://www.freep.com/apps/pbcs.dll/ article?AID=/20060430/OPINION01/604300306/1069

…
Don’t panic. But do pay attention. Bird flu may never transform into a human-borne illness, let alone a worldwide pandemic — but if it does, knowledge and preparation will make the difference between hard times and outright catastrophe.

…But bird flu has the world’s attention, because it has had a 55% mortality rate. It is “a very impressive disease,” Eden Wells, Michigan’s influenza epidemiologist, said last week.

The toll on birds has been phenomenal — 200 million killed, the United Nations estimates. Since the start of the year, the virus has spread to birds in 30 more countries, from a count of 15 at the end of 2005. It is a question of when, not if, migrating birds will carry it to North America.

So this is a threat well worth preparing for. Even if this strain of bird flu, H5N1, never transforms so it can spread from human to human, someday some virus will. Many health experts suggest a global pandemic is overdue. Just imagine coping with:

# 40% absenteeism rates. This is based on 25% of workers getting sick — comparable to the rate in the 1918 flu pandemic — and another 15% staying home to care for ill family members or just too scared to leave the house….

The state needs to get more insistent that local health and safety officials pull their plans together, with broad networking among businesses, schools and community organizations as well. People should know so much about bird flu plans that they’re bored with all the talk, but ready for the changes a pandemic would entail. Better to be sick of preparing than unprepared for sickness.

A commentary about Katrina’s “planning” but which is relevant for anyone’s preparedness.

—re: dee Martinez (Submitted: 09/04/2005 10:51 am

• http://www.freenewmexican.com/news/32089.html

and evacuation “plans” and no one could know the levees would break etc.—

Last week I lost a Santa Fé friend. In the 1980s, the Republicans were planning evacuation strategies in case of nuclear attacks. I was at Los Alamos National Lab trying to get the off-site academics, i.e., anthropologists, who were most able to answer the holistic question “what would Nuclear Winter mean to humans” [not people as “patients” or as “soldiers” buit as real people] interested in answering that question. ( Anthropology of Human Survival)

My friend took a detailed look closer to home. According to FEMA (or whatever it was then) the idea was that the folks from Albuquerque would drive up to SFé. Once here (there) they would stay at St Kat’s Indian School, in the room with all the plate glass windows. Three times a day everyone would walk down and back through the fallout to McDonald’s for feeding.

Pete Dyke mapped out each inch and square inch of this “plan” and brought it to everyone’s attention. Among other things, it turns out the evacuation plan allowed a total space smaller than a single bed for each person.

The city ended up not approving the so-called evacuation plan. This is not to say that there shouldn’t be evacuation and emergency plans; but that every one of these plans needs detailed scrutiny from citizens like Pete. There aren’t many like Pete, and now there is one fewer.

This is an interesting news article which discusses how the avian flu may or may not become human H5N1, and the latest scientific discussion about what is known.

March 28, 2006
Making a Ferret Sneeze for Hints to the Transmission of Bird Flu
By DENISE GRADY” Read article.
http://www.nytimes.com/2006/03/28/science/28viru.html

Bird Flu: Communicating the Risk by Peter M. Sandman and Jody Lanard
2005 Perspectives in Health (Panamerican Health Organization), vol 10, No. 2, retrieved 18 March 2006.

Many experts believe that avian influenza is a time bomb for human health. But how to deal with the many uncertainties surrounding the issue? Two leading risk communication experts give their best advice on sounding the alarm about what might be the next great flu pandemic—or not.

http://www.scottberkun.com/essays/essay40.htm

Why smart people defend bad ideas - scottberkun.com:

“Instead I’m saying that short term bits of data are neither reliable nor a wise way to go about making important long term decisions. Intelligent people do this all the time, and since it’s so commonly accepted as a rule of thumb (last time + the time before that), it’s often accepted in place of actual thinking. Always remember that humans, given our evolution, are very bad at seeing the cumulative effects of behavior, and underestimate how things like compound interest or that one cigarette a day, can in the long term, have surprisingly large impacts despite clearly low short term effects.”

Read the rest of this entry »

from the March 21, 2006 edition
http://www.csmonitor.com/2006/0321/p09s01-coop.html

Selling ‘pandemic flu’ through a language of fear
Traditional skepticism is missing in discussions of pandemic flu.
By Peter Doshi
Read the rest of this entry »