Doctor and activist


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Category: Public Health

Health Effects of Coal

14 February 2021

Here is Dr Peter Sainsbury, Prof of Public Health. writing about the health effects of coal. Many of the deaths related to the polluting effects are not in Australia, which is not a very reason for us not to be concerned about it.

Some years ago, as we tried to stop the subsidy to Tobacco Growers in Australia, the number of deaths of tobacco-caused disease was compared to the number of jobs in the tobacco industry, which was orders of magnitude lower.

Sainsbury says it will be about 6 deaths per year per job in the coal industry, which is yet another good reason to transfer to renewable energy.

The practice of looking at the number of deaths caused versus the number of jobs created seems a sound basis for looking at the cost benefit of industries. The ‘defence’ industry needs to be looked at in a similar way.

The other interesting fact in this article is that he estimates that Electric Vehicles will be the same price as petrol ones in about 3 years because of the falling price of batteries. Presumably the Morrison government cannot retard progress forever.

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Are Google Algorithms Reinforcing Anti-Science positions? 3 Feb. 2021

As the anti-science movement seems to gain strength and undermines the campaign for COVID vaccination, there has been increased interest in the origin, strength and tactics of this.

It is blamed on the Russians, who presumably are trying to weaken and divide the West, and on civil libertarians, who want to politicise medical common sense.  But when it helped by people like Trump in the White House and Kelly in Australia the conspiracy theories are put into perspective, as the anti-science views are given legitimacy.

But in the fuss about Google withdrawing from Australia, or not covering Australian politics, I wondered what effect this might have and tried a different search engine, duckduckgo.  The difference is that google gives me a personalised feed, but duckduckgo gives everyone the same information for the same key words. 

Search engines at a basic level give a ‘top pops’ of popularity of a topic in that those with the greatest number of clicks go to the top.  This may be fine if you are looking for a movie review, but if you want older material it will be a long way down. Scientific articles are a lot further down than mainstream ones, and the algorithm is influenced by the viewer’s previous viewing habits.  If a person has viewed a lot of conspiracy articles, it is presumably then likely that these are more likely to come up again and reinforce the existing views of the viewer.    If the feed is continually biased to a point of view, the viewer is likely to come into contact with more of this view and people who share t, so that they are eventually in a bubble or subculture of people with this belief, and are unaware that their reality has been changed. 

As an example my son went to school with a boy in NZ whose father controlled feral pests for a living, which meant shooting rabbits, ferrets, deer, pigs, cats and possums which are predators on various farms in NZ.  He kept in touch with his friend and they played video games online.  But his friend went shooting quite a lot with his father, joined a gun club and started to receive the literature of this subculture.  His previously non-political, mainstream views are now hugely influenced by the American gun lobby and rabidly right wing.  This is quite unusual in rural NZ.  My son commented, ‘In the end, you think what you get in your feed’.

The algorithms exist to make you happy and to keep you clicking in order to get you to buy things.  But the result might be quite different- a creation of a bubble environment where everyone’s opinion tends to be magnified, sometimes going in a bad direction.

How this can be controlled is a question- if we all got the same feeds, would the sensible people make sensible articles come up first?  Presumably; if most people were well educated.  We had better go there also.  Which Big Brother will tell google how to do its algorithms?

(The longer version of this attached article is available via a link at its end).

https://www.huffingtonpost.com.au/entry/peter-hotez-anti-science-movement-killing-hundreds-of-thousands_n_6014b39ac5b622df90f382ee?ri18n=true&fbclid=IwAR19_qqWuNe9t8ySSTdNU5OjL6jKkxPCT3cDbAP0EhAKXoXrLPod_xVfdKM

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Marketing Obesity to Children 11/10/20

About 37 years ago BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) identified the problem of advertisers marketing to children and produced a guide, ‘AdExpo- A Self-Defence Course for Children’.  It was in black and white as BUGA UP had no money and the ads are a bit dated now, but the text us still relevant.  www.bugaup.org/publications/Ad_Expo.pdf

Advertisers market to children, and are successful with it.  Now there is the internet, which has made things a lot worse.  Kids can be targeted with the parents only dimly aware of what is going on, and before the kids have actually been formally ‘taught’ anything.  The ads are part of the exciting environment that their little heroes show them.  At last attention is being drawn to this.  This article is from the NY Times, with a cut-down version in the SMH of 7-8/11/20.

Are ‘Kidfluencers’ Making Our Kids Fat?

By Anahad O’Connor, NY Times 30/10/20

Popular YouTube channels often bombard young children with thinly veiled ads for junk food, a new study finds.

One of the most popular YouTube videos from Ryan’s World shows its star, Ryan Kaji, pretending to be a cashier at McDonald’s.  “It’s a stealthy and powerful way of getting these unhealthy products in front of kids’ eyeballs,” a public health expert says.Credit…via YouTube

That is the conclusion of a new study published on Monday in the journal Pediatrics. The authors of the study analyzed over 400 YouTube videos featuring so-called kid influencers — children with large social media followings who star in videos that show them excitedly reviewing toys, unwrapping presents and playing games. The study found that videos in this genre, which attract millions of young followers and rack up billions of views, were awash in endorsements and product placements for brands like McDonald’s, Carl’s Jr., Hershey’s, Chuck E. Cheese and Taco Bell.

About 90 percent of the foods featured in the YouTube videos were unhealthy items like milkshakes, French fries, soft drinks and cheeseburgers emblazoned with fast food logos. The researchers said their findings were concerning because YouTube is a popular destination for toddlers and adolescents. Roughly 80 percent of parents with children 11 years old or younger say they let their children watch YouTube, and 35 percent say their children watch it regularly.

A spokeswoman for YouTube, citing the age requirement on its terms of service, said the company has “invested significantly in the creation of the YouTube Kids app, a destination made specifically for kids to explore their imagination and curiosity on a range of topics, such as healthy habits.”  She added, “We don’t allow paid promotional content on YouTube Kids and have clear guidelines which restrict categories like food and beverage from advertising on the app.”

Young children are particularly susceptible to marketing.  Studies show that children are unable to distinguish between commercials and cartoons until they are 8 or 9 years old, and they are more likely to prefer unhealthy foods and beverages after seeing advertisements for them.

Experts say it is not just an advertising issue but a public health concern.  Childhood obesity rates have skyrocketed in recent years: Nearly 20 percent of American children between the ages of 2 and 19 are obese, up from 5.5 percent in the mid 1970s.  Studies have found strong links between junk food marketing and childhood obesity, and experts say that children are now at even greater risk during a pandemic that has led to school closures, lockdowns and increased screen time and sedentary behavior.  The new findings suggest that parents should be especially wary of how children are being targeted by food companies on social media.

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“The way these branded products are integrated in everyday life in these videos is pretty creative and unbelievable,” said Marie Bragg, an author of the study and an assistant professor of public health and nutrition at the New York University School of Global Public Health.  “It’s a stealthy and powerful way of getting these unhealthy products in front of kids’ eyeballs.”

Dr. Bragg was prompted to study the phenomenon after one of her co-authors, Amaal Alruwaily, noticed her young nieces and nephews obsessively watching YouTube videos of “kidfluencers” like Ryan Kaji, the 9-year-old star of Ryan’s World, a YouTube channel with 27 million subscribers, formerly named Ryan ToysReview.

The channel, run by Ryan’s parents, features thousands of videos of him excitedly reviewing new toys and games, doing science experiments and going on fun trips to stores and arcades.

Children’s channels like Ryan’s World — which are frequently paid to promote a wide range of products, including toys, video games and food — are among the highest grossing channels on YouTube, raking in millions of dollars from ads, sponsored content, endorsements and more.   According to Forbes, Ryan earned $26 million last year, making him the top YouTube earner of 2019.  Among the brands he has been paid to promote are Chuck E. Cheese, Walmart, Hasbro, Lunchables and Hardee’s and Carl’s Jr., the fast food chains.  One of his most popular videos shows him pretending to be a cashier at McDonald’s.  In it, he wears a hat with the McDonald’s logo, serves plastic Chicken McNuggets, cheeseburgers and French fries to one of his toys, and then eats a McDonald’s Happy Meal.  The video has been viewed about 95 million times.

“It looks like a normal child playing with their normal games, but as a researcher who studies childhood obesity, the branded products really stood out to me,” Dr. Bragg said.  “When you watch these videos and the kids are pretending to bake things in the kitchen or unwrapping presents, it looks relatable.  But really it’s just an incredibly diverse landscape of promotion for these unhealthy products

In a statement, Sunlight Entertainment, the production company for Ryan’s World, said the channel “cares deeply about the well-being of our viewers and their health and safety is a top priority for us.  As such, we strictly follow all platforms terms of service, as well as any guidelines set forth by the FTC and laws and regulations at the federal, state, and local levels.”

The statement said that Ryan’s World welcomed the findings of the new study, adding: “As we continue to evolve our content we look forward to ways we might work together in the future to benefit the health and safety of our audience.”

Other popular children’s channels on YouTube show child influencers doing taste tests with Oreo cookies, Pop Tarts and Ben & Jerry’s ice cream or sitting in toy cars and ordering fast food at drive-throughs for Taco Bell, McDonald’s, Burger King, KFC and other chains.  “This is basically a dream for advertisers,” said Dr. Bragg.  “These kids are celebrities, and we know from other rigorous studies that younger kids prefer products that are endorsed by celebrities.”

To document the extent of the phenomenon, Dr. Bragg and her colleagues identified five of the top kid influencers on YouTube, including Ryan, and analyzed 418 of their most popular videos.  They found that food or beverages were featured in those videos 271 times, and 90 percent of them were “unhealthy branded items.”  Some of the brands featured most frequently were McDonald’s, Hershey’s, Skittles, Oreo, Coca-Cola, Kinder and Dairy Queen.  The videos featuring junk food have collectively been viewed more than a billion times.

The researchers could not always tell which products the influencers were paid to promote, in part because sponsorships are not always clearly disclosed.  The Federal Trade Commission has said that influencers should “clearly and conspicuously” disclose their financial relationships with brands whose products they endorse on social media.  But critics say the policy is rarely enforced, and that influencers often ignore it.

McDonald’s USA said in a statement that it “does not partner with kid influencers under the age of 12 for paid content across any social media channels, including YouTube, and we did not pay or partner with any of the influencers identified in this study.  We are committed to responsibly marketing to children.”

Last year, several senators called on the F.T.C. to investigate Ryan’s World and accused the channel of running commercials for Carl’s Jr. without disclosing that they were ads.  The Council of Better Business Bureaus, an industry regulatory group, also found that Ryan’s World featured sponsored content from advertisers without proper disclosures.  And a year ago the watchdog group Truth in Advertising filed a complaint with the F.T.C. accusing the channel of deceiving children through “sponsored videos that often have the look and feel of organic content.”

In March, Senators Edward J. Markey of Massachusetts and Richard Blumenthal of Connecticut introduced legislation to protect children from potentially harmful content online.  Among other things, the bill would limit what they called “manipulative” advertising, such as influencer marketing aimed at children, and prohibit websites from recommending content that involves nicotine, tobacco or alcohol to children and teenagers.

The F.T.C. has long forbidden certain advertising tactics on children’s television, such as “host selling,” in which characters or hosts sell products in commercials that air during their programs.  Critics say the agency could apply the same rules to children’s programs on the internet but so far has chosen not to.

“It’s beyond absurd that you couldn’t do this on Nickelodeon or ABC but you can do this on YouTube just because the laws were written before we had an internet,” said Josh Golin, the executive director of the Campaign for a Commercial-Free Childhood, an advocacy group.

“These videos are incredibly powerful,” he said.  “Very busy parents may take a look at them and think that it’s just a cute kid talking enthusiastically about some product and not realize that it’s often part of a deliberate strategy to get their children excited about toys, or in the case of this study, unhealthy food.”

Anahad O’Connor is a staff reporter covering health, science, nutrition and other topics. He is also a bestselling author of consumer health books such as “Never Shower in a Thunderstorm” and “The 10 Things You Need to Eat.” 

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Limits of Medicine- another COVID-19 Study, and future actions

30 April 2020

People are asking why people getting sick with COVID-19 in aged care homes are not on ventilators.  The reason is probably that the ventilators are unlikely to save them.  One also needs to ask what is the Key Performance Indicator of an ICU.  When I worked in them, it was leaving the unit alive.  The statistics of this have always been improving, because as the units get bigger they take less sick patients.  It the unit has 4 beds as they used to, and have the 4 sickest patients in the hospital, they will have much worse survival statistics than if they take 40 patients including a lot who are scheduled to go there for a few days after elective heart or other surgery.  But the question still remains for the ones that did not get there in a planned way, what level of life-functioning will they have after discharge?  Is no one allowed to die without some time on a ventilator, however hopeless the quest and whatever their quality of life after discharge?

A new survival study of COVID-19 has been published in JAMA (Journal of the American Medical Association) from a number of hospital in New York.  It is an incomplete study in that its final results are not available, published presumably in haste to get some results out.  It looked at 5,700 patients, but only had results for 2634 who had reached an end-point, they had either been discharged or died.  (The other 3066 are still in hospital).  14% of the 2634 needed to go to ICU and 12% needed to be intubated (i.e. on a ventilator with a tube down to the lungs).  Of those who needed intubation in the 18-65 year age group 76% died and in the over 65s 97% died.  3% needed kidney replacement therapy (dialysis).  Overall 21% (553/2634) died. 

It might be noted, however that no one under the age of 20 died, and the 5700 were not entirely typical citizens in that their median age was 63, and they had co-morbidities; 57% were hypertensive, 41% were obese and 34% had diabetes. 

At the time of triage (assessment for admission) 31% had fever, 17% had a respiratory rate greater than 24/min and 28% needed extra oxygen.  This is relevant as there is a lot of discussion as to what are the most important signs and symptoms.  (Cough was not mentioned in the article).

The New York JAMA results are not dissimilar to an earlier Wuhan Study from The Lancet (24/2/20 Xiaobo Yang et al) studying the outcome of 710 hospital patients.  Of these 52/710 were classified as critical (7%).  Of the 52, 29 needed ICU for ventilator support (= 56% of the hospital admission and 4% of the total).  Of the 29 who needed ventilatory support, 22 needed intubation and of these 19 died and 3 survived. (i.e. 86% of those who needed to go on ventilators died).  Of the 29 who needed ventilatory support, 23 died (76%). 

To compare the survival; in the US study, 14% of hospital admissions went to ICU  and 21% of these died, which is roughly 3% of the number admitted. In the Wuhan study 4% of the total patients needed ICU and 76% of these died, giving a mortality of about 3% also.

There is a lot of difference between countries in terms of the number of cases and the fatality rate. Looking at the numbers on worldometerinfo/covid today the UK leads the fatality rate with 15.8%, followed by Belgium 15.7%, France 14.5%, Italy 13.6%, Sweden 12.3%, Netherlands 12.1%, and Spain on 10.3%.  Next there is quite a drop to the next group with Switzerland on 5.8%, the USA on 5.8%, Denmark on 4.4%, Germany and Portugal on 4.0%, Austria on 3.2% and Norway on 2.6%. The USA is earlier in the epidemic, which may make its numbers lower, but the question is why Germany and Denmark can do so much better than adjacent France and the Netherlands.  Perhaps it is because they have managed to stop it getting into their old people’s facilities where the fatality rate is much higher.  Australia and New Zealand are looking very good at 1.3%, which may be for the same reason- many of our cases were contacts from cruise ships, and two nursing homes here have had conspicuously high death rates, but one might reflect that there are only two of them.  The lesson from this is that it is very important to isolate certain areas, and of course if its gets into vulnerable populations where isolation is difficult, such as Aboriginal communities with many transient members, it will not be able to be traced and controlled and there will be ongoing infections forever.

The nursing home managers resisting the government’s more open policy have very sound reasons, and the danger of opening up society when ‘community acquired’ infections are still occurring is high.  Undiagnosed cases have a high chance of infecting vulnerable populations which will either result in a lot of deaths or an ongoing source of infections or both.

Australia’s figures today from the health.gov.au COVID website are that there have been 6753 cases in Australia, of which 5714 have recovered and 91 have died.  This leaves 948 cases of which 34 are in ICU and 89 are in hospital. (It is not clear whether the 34 are included in the 89).  This means that there are either 859 or 825 still active cases that are not in hospitals.  There were 8 new cases yesterday, so the other question is whether they came from quarantined people, who hopefully will not spread the infection, or ‘community acquired’ cases, still popping up at random and in danger of infecting a new group.

https://jamanetwork.com/journals/jama/fullarticle/2765184?guestAccessKey=906e474e-0b94-4e0e-8eaa-606ddf0224f5&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042220

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VALI- Vaping-Associated Lung Illness- a New Disease is born.

20 September 2019 VALI is the name the Centre for Disease Control has given to the new epidemic of lung disease that is putting young people in hospital on ventilators and has killed a few people. It is not clear what the problem is as there does not seem to be a common feature in […]

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Truth v Money in Academia

15 November 2019 The battle continues. Here is an article telling how some academics run a little sideline in testifying that smokers understood the risks of tobacco as they smoked themselves to death.  Needless to say the academics do not say much about their work. Years ago, Dr Ann Woolcock, founder of the Woolcock Institute […]

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Load-Based Pollution 24/12/16

Dr Ben Ewald from the Hunter, who has been working with Doctors for the Environment has been lobbying for a Federal EPA and wrote a submission on the load-based licensing system, which is another name for polluters paying a levy per tonne of pollutant that they produce.  There is some charge for each type of […]

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CT Scans Increase Cancer Risk 11/10/19

CT Scans increase the risk of cancer by 24% for one scan and 15% for each subsequent scan. This is based on a 2013 Melbourne study published in the British Medical Journal, which looked at people who had had CT scans at least a year before they developed any type of cancer. The method used […]

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Contamination on 4 Corners tonight is just part of the tale 9/10/17.

Tonight’s 4 Corners is about the Royal Australian Air Force contaminating the groundwater around its bases with a fire fighting foam containing PFAS (Per- and Polyfluoro Alkyl Substances, aka Perfluorinated chemicals, PFCs).  It made me think of my experience with pollution. I started off in treatment medicine, and saw all the harm tobacco did, so […]

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Is 5G Safe?

24 March 2020 I am bombarded by posts warning of the dangers of 5G transmission towers.  There were similar dire warnings when microwave ovens came out, so I was inclined to dismiss this, but decided that I should read up.  This is the result. We need to put all this into its theoretical framework.  Electromagnetic […]

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