Harm Reduction

We want our diagnostic tests to accurately identify patients, and not falsely identify one as positive or negative for a condition. But there is no test available with that kind of accuracy.
PM2.5 designates a near-ubiquitous air-polluting particle that frequently appears in the scientific literature as well as popular press news items. But few of us really know what they are talking about, mainly because it is just one characteristic of a complex category.
I have been concerned that face masks for non-first-responders would shift vital protective resources away from first-responders and that would give some people a false sense of security. As a physician, I think the time has come to put those concerns aside.
As we get used to sheltering in place, speculation turns to an exit strategy, especially impatient are those most concerned with the economy. If you follow Covid-19 coverage, there are any number of possible approaches coming forward.
"You never let a serious crisis go to waste. And what I mean by that it's an opportunity to do things you think you could not do before." -- Rahm Emmanuel [1]
A blood alcohol concentration (BAC) of 0.08% while driving is considered impaired, and it's associated with an increase in motor vehicle accidents. But what about a “quick pop”? You know, being buzzed? How does that figure into the thinking? A new study sifts through the data.
How do you measure the number of lives lost from air pollutants? As is often the case, it depends. In the United States, by and large, these studies have been designed to support regulatory interests under the Clean Air Act rather than scientific inquiry. The EPA selects the pollutants of concern, the outdoor locations to be monitored and the timeframes of interest. But what, if anything, is really being measured?
At one point, nuclear power provided 25% of Germany's electricity. But the fallout from Chernobyl, both political and real, led to a moratorium on construction and an initial planned phaseout of all nuclear reactors by 2022. That deadline subsequently was extended to 2032, but after the events at Fukushima in Japan, the phaseout policy deadline reverted back to two years from now. Today, Germany gets 11% of its electricity from nuclear sources. A study from the National Bureau of Economic Research measures the fallout.
We are holobionts, those who thrive in a saline environment, crafting of at least two species living in close proximity with one another. The other species is our gut microbiome, those microbial communities residing in our bowels and providing us with nutrients and signals. There's no denying their importance. But not as much can be said for probiotics –- the live microorganisms marketed to us with claims to better our health.
Patients who experience life-altering hospitalizations -- in this case, strokes -- are often discharged not to home, but to either inpatient rehabilitation facilities (IRF) or skilled nursing facilities (SNF). A new study shows that patients sent to IRFs do better than those assigned to SNFs. But as always, the story is more complicated.
Like ACSH itself, ACSH advisor Dr. Jeffrey Singer is a proponent of harm reduction. Here's his take on a report, issued by the health and medicine panel of the National Academy of Sciences, Engineering and Medicine (NASEM), titled "Opportunities to Improve Opioid Use Disorder and Infectious Disease Services." Not surprisingly, Dr. Singer calls for needle exchange, methadone use, and the use of prescribing pre‐​exposure HIV prophylaxis (PrEP) and post‐​exposure prophylaxis (PEP).
It’s been 50 years since cleaning up the air in the United States began in earnest. Skies are much clearer now than in the mid-20th century. Leaded gasoline is gone, power plants have been abandoning coal and sulfur dioxide has dropped by 91%. Despite these growing improvements, why have epidemiologists been unable to show the demonstrable public health benefits that their computer models predict?