Natural immunity superior to vaccinated immunity

This is clear indisputable evidence that natural immunity is far more durable than vaccinated immunity: The Covid protection lasted for 650 days with no noticeable decline.

"Prevalence and Durability of SARS-CoV-2 Antibodies Among Unvaccinated US Adults by History of COVID-19" Jennifer L. Alejo, MD1; Jonathan Mitchell, MBBS1; Amy Chang, MD1; et al JAMA Network
https://jamanetwork.com/journals/jama/fullarticle/2788894

In this cross-sectional study of unvaccinated US adults, antibodies were detected in 99% of individuals who reported a positive COVID-19 test result, in 55% who believed they had COVID-19 but were never tested, and in 11% who believed they had never had COVID-19 infection. Anti-RBD levels were observed after a positive COVID-19 test result up to 20 months, extending previous 6-month durability data.5

Study limitations include lack of direct neutralization assays, the fact that antibody levels alone do not directly equate to immunity,4,6 the cross-sectional study design, a convenience sample with an unknown degree of selection bias due to public recruitment, self-reported COVID-19 test results, the study population being largely White and healthy, and lack of information on breakthrough infections. Participants were given only 1 month to complete antibody testing, which may have contributed to the 52% rate among those invited to test.

Although evidence of natural immunity in unvaccinated healthy US adults up to 20 months after confirmed COVID-19 infection is encouraging, it is unclear how these antibody levels correlate with protection against future SARS-CoV-2 infections, particularly with emerging variants. The public health implications and long-term understanding of these findings merit further consideration.

The spirit of revolt--100 years ago

 JAMA (which is the journal of the American Medical Association) has an interesting feature called "JAMA Revisited," reprinting articles from the past.  In the October 12, 2021 issue it reprinted an article titled "The Spirit of Revolt" from October 8, 1921, 100 years ago.

"Psychologists today are more concerned with the changing spirit of mankind than with any other psychologic problem.  The literature on the spirit of revolt, of restlessness, of lawlessness and of radicalism is daily becoming greater.  The subject is engaging the attention of our greatest minds.  Thus James M. Beck, Solicitor-General of the United States, devoted the presidential address before the annual meeting of the American Bar Association, held recently at Cincinnati, to this subject. There is throughout the world today, he pointed out, a revolt against the spirit of authority.  Pending criminal indictments in federal courts have increased from 10,000 in 1912 to more than 70,000 in 1921.  The losses from burglaries repaid by casualty companies have grown in amount from $886,000 in 1914 to over $10,000,000 in 1920. [purchasing power of about $138,974,000 today]"   

After quoting some murder statistics from New York City and Chicago, Mr. Beck goes on to report the problem is worldwide.  He attributes it to the rise of individualism which began in the 18th century and which had steadily grown with the advance of democratic institutions, and also the growth of technology saying that man had become the tender of machines rather than a constructive thinker.  "The increase in potential of human power has not been accompanied by a corresponding increase in the potential of human character."

The article goes on to say that despite the current (following WWI) peace commissions and conferences,  "Radicals are advocating methods of government that are the expressions of primitive emotional and mental processes. . .  Prejudices, fixed ideas, suspiciousness, sentimentality and outbursts of passion are making more difficult the task of establishing law and order. . . The craze for speed dominates everything, speed in transportation, speed in thinking, speed in living and, as revealed in the war, speed in killing. . . mob spirit governs and the urge is uncontrolled." 

Well, that certainly sounds familiar, sort of like the evening news.  Much of the collapse and the coarsening of the general populace that the writer of the JAMA article describes can certainly be blamed on the "Great War" (estimates of 22 million deaths) which had killed so many in Europe and more civilians than military, and the worldwide pandemic of 1918. However, in the U.S. we had the most socialistic president, Woodrow Wilson, until Barack Obama claimed the honor in 2008. The eighteenth century was a period of "enlightenment" and the degrading of a Christian society and disrespect for Biblical authority. Then the nineteenth century gave the world Marx and Nietzsche.  Yes, we were well on the way to the Antifa and BLM riots of 2020, and the acceptance of them has been building for 100 years.

Humanized mice, Covid and bioethics

When I begin to read a medical article, and a phrase introduces a topic with, "Although Florida Governor Ron DeSantis and Texas Governor Greg Abbott have promoted monoclonal antibodies while opposing vaccine and mask mandates, they're not a substitute for Covid-19 vaccines." 

You have to read it carefully, though. They are not against vaccines or masks, only the mandates. Opposing mandates is a political stance. It's about opposing growing totalitarianism, the huge failures of Biden and the lies of Fauci. This journal obviously is political too--JAMA (Journal of the American Medical Association)

But here's my question for medical/scientific folks, because I'm way over my pay grade here: the monoclonal antibodies for Covid preexposure prophylaxis use 'humanized mice" in their development. Is that for testing or is some of that matter passed into our system? Using animals as chimeras is not new, but the bioethics of this seem to only be discussed in some committee locked in a closet in a research institution. Maybe in Wuhan?

'Humanized mice': Chimeras fuel quest to treat chronic diseases, cancer and even COVID-19 - Genetic Literacy Project

Part mouse, Part human - Science in the News (harvard.edu)

JAMA editor not woke enough?

I have no horse in this race--but JAMA is a journal I read often and is frequently quoted in the media.

"Mike Davis, founder and president of Unsilenced Majority, today released the following statement regarding the firing of Dr. Howard Bauchner, the editor-in-chief of the Journal of the American Medical Association (JAMA). 

“You would think that in the middle of a pandemic, the Journal of the American Medical Association would be focused more on its medical reporting and less on woke nonsense, but you’d be wrong. The firing of its top editor speaks to the priorities that have infected so many of our institutions: feelings, not facts; tone, not substance. Unfortunately, while our leaders in government, science, media and technology dedicate their attention to assuaging the woke mob, the advantages we have as a country are deteriorating. Scientists’ only concern should be science. Journalists’ only concern should be journalism. Educators’ only concern should be education. THE MORE WE GIVE INTO THE NOTION THAT IT'S ACCEPTABLE AND EVEN EXPECTED TO CANCEL THOSE WHO DEVIATE FROM WOKE ORTHODOXY, THE MORE WE'RE SETTING OURSELVES UP FOR DIVISION AND FAILURE. JAMA should rescind its unfair and ridiculous politically-motivated firing of its top editor immediately.”

The editorial policies have been pretty liberal for years, but with "structural racism," we're dealing with a religious cult and one of the underlings insulted the most high goddess and denied her awesomeness and truthiness in a podcast. Dr. Bauchner groveled and apologized (my interpretation of reading about it in our unbiased news like CNN and NYT), but that goddess has no mercy in this religion.

The Great Coronavirus Pandemic of 2020--7 Critical Lessons

As of January 28, 2020 there were more than 4500 confirmed cases (98% in China) of a new virus that originated in the City of Wuhan, China and more than 100 deaths according to Lawrence O. Gostin, J.D., global health expert at Georgetown University (and now an advisor to Biden). On January 30, 2020, when the U.S. had not yet reported a single death, President Trump closed travel into the U.S. from China. Powerful Democrats like Biden, Pelosi, and DeBlasio predictably called him racist and xenophobic. Since Trump is not a doctor, lawyer, or experienced in public health, he created a team and listened to advice from well established experts, with credentials just as good as Dr. Gostin. For weeks he was on TV with his advisers, but because he was hopeful and positive, the Democrat run media stomped their feet and insisted on gloom and doom (which we still get with the nightly news).
In JAMA Forum article Nov. 10, 2020 (v. 324, no. 18) Dr. Gostin published "The Great Coronavirus Pandemic of 2020--7 Critical Lessons." He's a lawyer who advises organizations like UN, WHO, and now Biden, and holds multiple international academic professorial appointments. If I were to criticize his lessons, I would be waved away like a gnat.

With distain he refers to "populist political leadership" right after acknowledging the remarkable development of clinical trials for a vaccine within 6 months of the virus being sequenced. He credits personal hygiene, physical distancing and masks to control virus particles so tiny that so far, no mask has been able to stop. Still, lesson 2 is a nation needs great leadership and public trust to beat such a challenge. Imagine public trust when 95% of the media report negatively or lie about dear "leader." Gostin seems to mean, any leader other than Trump could raise the public trust. Like someone who says, "Hey man, I'm here for ya."

And no article could be complete these days without a mea culpa for health inequities. When this article was in a first draft in the fall he knew, we all knew, old age and comorbidities were factors in death rates. Now I think the figure is about 50% elderly and 80% overweight or obese. Blacks and Hispanics have a higher rate of overweight and obesity than whites, who are obese, but less so. Life style strongly influences health--smoking, drinking, drugs, poor nutrition/too many calories, lack of exercise and sexual promiscuity. Dr. Michael Rosen of the Cleveland Clinic says 75% of chronic illnesses can be improved or cured by changing our lifestyles. The medical profession has not yet found a way to control our lifestyles, despite all the articles, TV ads, billboards, organizations and lectures. It's easier to just blame societal inequities.

In lesson 6 he mentions the horrifying disaster of the uneven lockdowns through the sweeping powers of local and state governments. He warns of usurpation of power under the pretext of a health crisis which threatens to erode democratic freedoms. Yet his only solution seems to be "the rule of law," by which I think he means federal, or even global. If you're a hammer, everything looks like a nail, and his area of expertise is global law and institutions. So he really was unhappy when President Trump thought WHO mishandled or mislead other countries.

So his recommendations are choose "science," the rule of law, and equity. That would be transformational, he says.

To mask or not to mask

I keep looking for research on the safety and efficacy of the masks used by the general public. This isn't it, but it's the best we've got. This is observational, not clinical, and it is for health care workers, not you and me. The article even says, "in the absence of data" [for the masks worn by the public] this will have to do. It also is one of the few articles (it's an editorial, not research) that says there are 2 purposes--one is it protects the wearer. Which is why I wear a mask. Why is no one putting together a study on the masks the general public uses? It couldn't be that difficult. There are all sorts of fabrics, thickness, filters, countries of origin (including China!). So far, it is observational, anecdotal, and opinion. Many states are making policy on this issue, and people are having fights. Let's do the research!,

In Ohio, the governor has now mandated masks outside our residences.

https://jamanetwork.com/journals/jama/fullarticle/2768532?

Life expectancy dropping since 2014

Our behavior is showing up in our health statistics as well as our homes.

"Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states."  https://jamanetwork.com/journals/jama/article-abstract/2756187?

Americans can't smoke, over eat, have multiple sex partners, sooth the soul with alcohol and become a zombie with drugs and not have it show up in a study down the road. Although the numbers ticked up 2010-2017, the behavior began much before that--the 1980's-1990s.

And that Ohio Valley information in the study--straight up from Mexico—black tar heroin.  Read “Dreamland; the true tale of America's Opioid Epidemic” by Sam Quinones. He was a speaker at Lakeside, I think in 2018.  The stories of young men in Mexico, independent of the drug cartels, in search of their own American Dream via the fast and enormous profits of trafficking cheap black-tar heroin to America’s rural and suburban addicts combined with Big Pharma.  https://nihrecord.nih.gov/2018/05/18/author-recounts-how-opioids-took-hold-america

Politics and healthcare

At the coffee shop today I was reading the Oct. 9, JAMA and noticed an editorial on "Politics and Healthcare." JAMA's left of center, but I thought I'd take a look. Praise for Lyndon Johnson and Medicare in 1965, praise for Barack Obama and PPACA (Obamacare) in 2010 and then 3-4 paragraphs lambasting President Trump who, but for McCain, would have been able to undo Obama's disastrous grab of the private sector and 1/5 of the economy. It's one of the reasons Trump was elected--the people hated it, especially those who lost good coverage or lost their doctor or were forced to buy coverage for contraception and abortion. Obamacare was the only significant piece of social legislation that got zero support from Republicans, who had supported FDR and social security, and LBJ and Medicare. In fact, it's doubtful those programs would have passed without Republican support. It is the Obama administration that created the extreme partisanship we see today, not President Trump.

Yes indeed. Politics and healthcare in black and white in JAMA. So I looked up the author, Donald M Berwick--he's retired, but has been on just about every government board and committee to give us socialized medicine, was part of the Clinton administration, and even worked with the British National Health Service and was knighted by the Queen! I would not have expected anything else from him.

Moving from No to Go, 2018 guidelines for exercise

“Probably the most important message from the 2018 guidelines is that the greatest health benefits accrue by moving from no, to even small amounts of, physical activity, especially if that activity is of moderate (eg, brisk walking) or vigorous (eg, jogging and running) intensity. Multiple studies demonstrate that the steepest reduction in disease risk, such as for coronary heart disease, occurs at the lowest levels of physical activity.² Patients need to understand that even small amounts of physical activity are beneficial and that reductions in the risk of disease and disability occur by simply getting moving. The evidence demonstrates that adults obtain the maximal benefits of physical activity by regularly performing 150 to 300 minutes per week of moderate-intensity or 75 to 150 minutes per week of vigorous-intensity activity or an equivalent combination of moderate- and vigorous-intensity aerobic activity. These levels of activity are possible for most healthy people.”

https://jamanetwork.com/journals/jama/fullarticle/2712934

Letter to my statistics professor

You are in Cape Town, and I’m in Columbus, Ohio.  Through the miracle of on-line learning and MOOC, I am in week 6 of your Coursera offering on Understanding Medical Research, in which you often stress the importance of statistics, choosing the right tests, and having access to the original data. I'm definitely a statistical outlier among your students--I'm 78 and retired in 2000, and have had no math since 1955. And although this class doesn't demand a heavy background in math, I even had to review fractions, percent, and square root!

So, in the Nov. 28, 2017 JAMA there is an article, "Adherence to Methodological Standards in Research Using the National Inpatient Sample," that caught my eye, and impressed upon me everything you've been teaching us. I was surprised to read that of 120 articles (the sample) of the 1082 (the population) published in a 2 year period using data from 35 million hospitalizations in the U.S., 85% did not adhere to 1 or more required practices of the AHRQ (Agency for Healthcare Research and Quality), and 62% did not adhere to 2 or more required practices. A total of 79 of the 120 in the sample (68.3%) did not account for sampling error, clustering, and stratification; 62 (54.4%) extrapolated non-specific secondary diagnoses to infer in-hospital events, and so forth.
So I began linking the people involved; not only did the researchers get it wrong, the peer reviewers missed the errors, as did the editors of the medical journals (some with a high impact factor). The articles with incorrect statistical information were used to get promotion and tenure at universities.  Possibly policies and regulations for hospitals may result from some of these published articles with careless statistics, or, a "medical journalist" will attempt to translate the results for a layman, and it will be reported in the media.

In the U.S. we have been subjected to a horribly expensive electronic medical records law which all physicians and hospitals had to incorporate (I think it began around 2010).  There was no evidence this would improve medical care, but it was apparently "needed" so researchers had more data to mine.  I still have to ask for my medical visits from Dr. A to Dr. B, two miles apart, to be faxed because these systems don't talk to each other. Now with all this data ready to be mined, someone will mess up the statistics!

So, Dr. Juan Klopper, you are definitely needed, and will never run out of things to talk about.

Low fat and no fat diets may be dangerous to your health

If you want to make a New Year's resolution that should be easy to keep, give up low-fat or no fat food items. For 40 years the U.S. has been on the fast track to obesity problems--diabetes, more cardiovascular problems, and decreased exercise and activity because it's just tough to do it with all those extra pounds that damage knees and hips. Now it turns out the the U.S. government, the professional nutrition organizations, academic researchers and the food processing companies (which followed government guidelines) probably had it wrong.

When I was a child about 40% of our calories came from fat--mostly animal fat. My mother cooked with lard, we drank whole milk (cream would freeze and push up the cap when the delivery was on the porch), we used butter, we ate eggs and bacon, but sugar especially when rationed during WWII and Korea was used frugally. Somewhere along the way my mother was swayed by articles on nutrition published in women's magazines--and in the 60s and 70s she switched to margarine and 2% milk, she was cautious with eggs, and bacon probably wasn't used. Lard became Crisco and then Safflower Oil and Peanut Oil for her fabulous pies.

For 40 years Americans tried to decrease their use of fat--we (at least I) bought low-fat or no-fat salad dressing, skim milk, low-fat sour cream, skinny bread, and added carbs just as the government recommended, and sugar was added to processed food to make them palatable, as the flavor and satiety  was gone. Special chemicals were added to provide texture and thickening. So we just ate more of everything because the food didn't taste or feel right and didn't satisfy. And we all got fatter and less healthy; cardiovascular diseases which had been on the decrease, began to increase; diabetes which had been relatively rare became an epidemic. In studies of low-fat, high carb diets, those studied had higher rates of premature death, not lower as was expected. Industry went along because there was a profit to be made--ordinary products like dairy and cereal were advertised as low fat; diet products proliferated and became a huge industry as did weight reduction surgery and weight clubs and support groups. Exercise products and clubs sprung up.

Researchers know more about the human body in 2016 than they did in 1966--men and women aren't the same (no matter which pronoun is demanded), blacks and Asians aren't the same, teens and elderly aren't the same, children are not just small adults, our grandparents did actually pass along culture as well as genes, and you just can't change thousands of years of evolution of our bodies' response to famine and plenty by having the USDA or HHS mandate food for school lunches and grants for academic research.

So put some butter on that toast, and fry up some bacon and enjoy the New Year while you wait for the next expert to report on why we need to believe them about climate change.

 http://jamanetwork.com/journals/jama/article-abstract/2564564

https://www.hsph.harvard.edu/nutritionsource/2015/12/16/dr-david-ludwig-clears-up-carbohydrate-confusion/

 

 

No reduction in emergency room visits under Obamacare

Don’t expect use of emergency departments to drop after Obamacare is fully implemented.  A recent study of the Massachusetts system show that ER visits increased after insurance reforms.

“Insured white patients younger than 65 years accounted for 62.7% of emergency visits before reforms went into effect and 64.2% afterward. In the same age group, insured black patients accounted for 12% of emergency visits before the reforms and 13.9% afterward. The largest increase was among Medicaid patients younger than 65 years, who accounted for 23.6% of emergency department patients before the reforms went into effect compared with 29.7% afterward.”

http://newsatjama.jama.com/2014/03/20/emergency-visits-up-in-massachusetts-after-reforms-enacted/

Not what I wanted to read the day after Thanksgiving

My daughter’s Thanksgiving Day pies—cherry, apple and pumpkin. She always decorates with little cut outs from the pastry.

I've had A-fib (atrial fibrillation) as long as I can remember, but wasn't diagnosed until 1996. I was on medication for awhile, then had an ablation (the cause turned out to be an extra circuit), then for a decade didn't use meds, then it began kicking in more frequently, and recently I returned to medications to control the rhythm and slow down my heart and a blood thinner in case a clot develops (the biggest risk for A-fib is a stroke). The Nov. 30 JAMA reports that losing weight is important in reducing A-fib, which would account for the increase in symptoms and the 30 lbs I've added in the last 4 years. This is not what I wanted to know the day after Thanksgiving with the frig loaded with left overs, including 3 kinds of pie.

http://jama.jamanetwork.com/article.aspx?articleid=1779533

The War Against Women—more breast cancer

Kill the babies; then make the women vulnerable to breast cancer and suicide.  Good plan, Democrats.

I was reading an article in JAMA (Feb. 27, 2013) about the increase in aggressive breast cancer among young women (15-29). Why the increase? Well, about the only suggestion offered was better imaging technology. No mention of oral contraceptives and abortions, which many studies have shown to create a problem for young women. Oral contraceptives are a class-1 carcinogen. Pregnancy and nursing protects breast tissue. Abortion increases breast cancer risk as reported in numerous studies. But then that would be both political and religious, wouldn't it, if the premier medical journal of an organization that has backed Obama 100% actually reported this?

Didn't AMA cover up tobacco risks and the Tuskegee syphilis study scandal? Isn't the journal packed with ads from pharmaceutical companies? The abortion that hurts the health of women the most is a first pregnancy abortion. I wonder if they are told that at abortion clinics? Clinics that are supported by the same government handing out oral contraceptives like they were lemon drops.

Women exposed to partner violence

There was an interesting study done in Cook County, IL about abused women (these days it's not even called "domestic violence," it's been down/up graded to "partner violence). I think the idea was that if identified as abused through screening by their doctors (aka primary health care setting), and then given the proper tools and resources, the women would do something to stop the abuse and improve their quality of life. Didn't happen. It's the second study that shows universal screening for partner violence does not prevent abuse. Sort of made me think of all the women who voted for Obama in 2008, have all the knowledge and resources to recover their dignity and pride in 2012, but will vote for him anyway. (JAMA, Aug. 15, 2012) The the answer is, more studies, more rigorous methods. I know a sample pool of several million women . . .

Behind every powerful man. . . is a smart woman

                              

Some might call La Malinche a traitor, but if you were a slave, and slaves were destined for sacrifice to the gods when the winners changed in ritual wars, who would you side with?  Pretty it up as much as you want with cultural anthropological chit chat, but the woman may have been ahead of her time.  She is the mother of the mixed races of Mexico. And God only knows what the radical feminists do to this story.

“Before the Spanish conquest, the Aztec civilization controlled trade routes from the Pacific Ocean to the Gulf of Mexico and as far south as Guatemala.  Its rich and populous empire was helld together by marriage alliances and ritualized battles in which large numbers of enemy warriors were captured and sacrificed to honor and sustain the gods.  When Hernan Cortes sailed from Cuba to claim the Mexican mainland for Spain in 1519, he could not have anticipated the odds against him and his small force of 600 foot soldiers and 15 horsemen.

His ultimate success in subduing the Aztecs was in large part due to the help of a Nahua slave woman called La Malinche, who became his chief interpreter, advisor, and the mother of his firstborn child.  She advised Cortes on the weakness of Aztec alliances with other indigenous groups, their respect for ruthlessness, and their preference for capturing rather than killing their enemies in battle.  Cortes used his information to defeat an army that was better supplied and much larger than his own.  After God, he said, La Malinche was his most important ally.” 

Thomas B. Cole, MD, MPH, JAMA March 28, 2012 describing the cover of the journal named for La Malinche.

Fudge phrases—rich, thick, gooey

“Experts agree. . . “

“The new model recognizes that. . .”

“While data are limited. . . “

“The answer probably has to do with. . .”

“While outcomes data on alternatives are limited. . . “

“Consistent with this proposal, . . .”

“It is also possible. . . “

These were all in Dr. Ezekiel J. Emanuel’s (Rahm’s brother and Obama’s house doctor) first third of a paper arguing for shortening medical training by 30%.  I have no opinion on this. However, once he’d warmed up to the topic with vague generalities, he then became very dogmatic and authoritarian about values and ethics.  On that, I do have an opinion.  It’s dishonest.  It should be noted that these are his opinions not based on data or a high power from which ethics flow.

“Efficiency has its own value.”

“Waste, especially wasting the time of some of society’s most highly educated and talented people, is unethical.”

“Changing the structure of training would force medical leaders to eliminate unnecessary and repetitious material and emphasize training physicians to become part of a care team.”

In the first half of his article he lists 3 medical schools, University of Pennsylvania, Duke University, and  Harvard, that have rearranged different parts of medical training, and one, Texas Tech that offers a 3 year program.  Then at the conclusion, he confidently states, “many medical schools and residency and fellowship programs have already shortened their training in various ways. . .” 

You can tell he’s worked in government (for both Obama and Clinton) can’t you? But that isn’t noted in the JAMA, March 21, 2012 “Viewpoint,” only that he’s in the Department of Medical Ethics and Health Policy at University of Pennsylvania.  His NIH web site: “Ezekiel J. Emanuel is Head of the Department of Bioethics at The Clinical Center of the National Institutes of Health and a breast oncologist. He is on extended detail as a special advisor for health policy to the director of the White House Office of Management and Budget. “ According to a quote at Wikipedia, he believes you and I have an obligation to participate in biomedical research as a civic obligation.

Living with an aging parent--JAMA Aug 17, 2011, vol 306.no.7

JAMA has a bimonthly series called, "Care of the Aging Patient; from evidence to action," and the most recent was Living with an aging parent, a well written summary with citations to the medical literature of one family's exerience. In the library field, we used to call these articles, "How I done it good" papers. JAMA solicits these articles from actual experience, assures the authors of "peer review" status to put on their CV, and gives a $500 honorarium.

The three authors tell a story of a healthy couple, 89 and 86, who move across the country in 2006 to live with their daughter and husband after the husband begins showing signs of dementia. The daughter invites them, rather than have them go to a retirement community. The backstory is that for 15 years, the parents lived with this family in the summer to take care of their children while the parents worked. The article describes the health condition and living arrangements and how things changed between 2006 and 2011. There are 3 tables which would help anyone considering this type of living arrangement, and one list of "issues."

I could have written this article myself, and I don't have an MD, PHD or MSPH, but my good frinds Jim and Jackie did a similar move to Colorado a few years back with similar results. Nor would I need 5 grants from the U.S. government, or various awards from foundations, all listed as an appendix to the article.

Now I say this for two reasons: 1) the article is an interview with 46 citations from medical databases to confirm the points made by either the interviewer or the interviewees. There is nothing wrong with this method--it's informative, easy reading, and although it would seem to be common sense, many people don't have that, so it will be very helpful for anyone considering a multigenerational living arrangement; 2) this type of writing isn't rocket science, but for the tax payer it is very expensive.

As near as I can determine, Alabama has received nearly $9,500,000 from the federal government of Title VIII just in 2010. Glancing through the list I think this is all geriatric health issues. That's just one state, one issue. The lead author, Christine S. Ritchie, according to her vita which I looked up, has at the moment, 7 simultaneous positions/titles, and if my experience in academe is to be trusted, she's being paid for each one. I found two different amounts for Dr. Richie, both over $200,000, for grants that supported this research--research that I could have written given a few days off my regular duties. The other two authors also report (disclosure) support from grants.

Physical Activity Levels of High School Students

Healthy People 2020 recommends 60 min. a day 7 days a week of aerobic exercise for teens. What is it now (self reported)?

Nationwide, 15.3% of high school students met the HP 2020 objective for aerobic activity. A higher percentage of male (21.9%) compared with female (8.4%) students? Combined with muscle activity, only about 12% of today's teens meet the HP 2020 objective.

Physical Activity Levels of High School Students—United States, 2010, July 27, 2011, 306 (4): 367 — JAMA

But here's the phrasing you need to look out for--it's where the money is. This will be a cash cow for every city block grant, non-profit community organization and probably even churches. The KEY phrase is "multisector approach." NEPLB. No exercise plan left behind.

These strategies are being included in programs such as the First Lady's Let's Move! campaign, CDC's Communities Putting Prevention to Work program, and the Safe Routes to School program. Additionally, the National Physical Activity Plan identifies the need to use a multisector approach involving schools, communities, families, and the private sector to facilitate integrated approaches to increasing population activity levels. Continued efforts to implement these evidence-based strategies and programs will help to meet the HP 2020 objective target for aerobic activity as well as the targets for muscle-strengthening activity and both aerobic and muscle-strengthening activities (once these targets have been set based on findings from the 2011 national YRBS). Public health efforts to improve participation in aerobic and muscle-strengthening activities among U.S. high school students might be most relevant for female students, students in upper grades, and students with obesity.

JAMA: State Should Seize Fat Children from Parents

I haven't seen the July 13 issue of JAMA yet, but it contains an opinion piece that suggests obese children might need to be removed from their parents' home. Yes, and that's because the state has done such a wonderful job in those areas already assigned to it.

Jonathan Bean, who I believe teaches at Ohio State, writes: "Disclosure: I was a “super-obese” teenager at 320 lbs. My brothers were normal weight. My parents urged me to limit my diet but I ate secretly. Then, on my own, I lost 140 lbs in a single year and have kept if off for 28 years (I’m 10 lb over my 21 year old weight). That was my decision. Imagine if the know-it-alls in DCFS had put me in foster care, supervised by my new rotating parents and caring social workers. Yes, children, this is our Brave New World fast in the making."

JAMA: State Should Seize Fat Children from Parents | The Beacon

I think they are panicking because childhood obesity has leveled off in the last decade, and they fear a funding source might be drying up. Maybe you should write the author and give him a piece of your mind. Sounds like he needs it. David S. Ludwig, MD, PhD, Children's Hospital, 300 Longwood Ave, Boston, MA 02115. (david.ludwig@childrens.harvard.edu).