Friday, January 05, 2007

Make mine a happy meal, thanks

I pointed out the positive role of McDonalds in hospitals on Dec. 20th., 2006 here so I was pleased to see the realistic Australian article below. Referring to campaigns to get McDonalds out of hospitals, I said: "The fact that for many people the McDonalds is the most comforting and reassuring part of a hospital does not matter, of course. The do-gooders must have a demon to attack"

I CAN'T say I ever pictured myself as a fervent spokesman for McDonald's, but I can say anyone jumping on the bandwagon to save us from Maccas at the Royal Children's Hospital has never had a child who needs treatment there.

There is an old saying that there is good in everything and that one only has to look hard enough to find it. Unfortunately, for us, it is staring us right in the face. My daughter has been an outpatient at the RCH nearly all of her life for a seemingly endless stream of EEGs, ECGs and MRIs. On the morning of our regular visits the conversation usually goes like this:

Can I take dolly to kinder today for show and tell?

Sorry darling, but you have to go to the hospital today.


Can I have a Happy Meal?

Of course, darling.

Yay! What a difference the promise of three nuggets, a small chips, a bottle of water and two bobs worth of a toy promoting the latest kids' movie can make. It's the chasm between having a terrified child in the car who is crying that they don't want to go and one who can't wait to get there. To a parent this is absolute priceless gold.

On the occasions I have to work and our daughter requires a protracted procedure, it also provides a place where my wife can sit and have a coffee while our little bloke has a swing on the monkey bars. So he's happy to go, too. Job done all around.

To write off Ronald McDonald House as merely a clever marketing tool does not give any credit to the contribution that has been made, or the hope given to the people who have had to avail themselves of this centre. Our hearts go out to them.

Yes, obesity is a problem. But there are many ways to tackle it. This current posturing only serves to remove a tiny oasis of joy for people who are in a desert of misery. Most of whom are far worse off than our personal situation. So on behalf of those parents that have had, have now, or will have children that need to attend the RCH, we ask the nobly intentioned to turn their focus to issues that do not involve wiping the smiles from the faces of sick kiddies.


All pregnant women should get Down syndrome test?

Sounds reasonable

There's a big change coming for pregnant women: Down syndrome testing no longer hinges on whether they're older or younger than 35. This week, the American College of Obstetricians and Gynecologists begins recommending that every pregnant woman, regardless of age, be offered a choice of tests for this common birth defect. The main reason: Tests far less invasive than the long-used amniocentesis are now widely available, some that can tell in the first trimester the risk of a fetus having Down syndrome or other chromosomal defects. It's a change that promises to decrease unnecessary amnios - giving mothers-to-be peace of mind without the ordeal - while also detecting Down syndrome in moms who otherwise would have gone unchecked. The new guideline is published in the January issue of the journal Obstetrics & Gynecology.

About one in 800 babies has Down syndrome, a condition where having an extra chromosome causes mental retardation, a characteristic broad, flat face and small head and, often, serious heart defects. Age 35 was always a somewhat arbitrary threshhold for urging mothers-to-be to seek testing. Yes, the older women are, the higher their risk of having a baby with Down syndrome. But it's a gradual increase in risk - from one in 1,200 at age 25 to about one in 300 at age 35. Nothing suddenly changes at the 35th birthday. Indeed, because more babies are born to younger women than older ones, women under 35 actually give birth to most of the nation's children with Down syndrome.

"It's clear there's no magic jump at 35," said Dr. James Goldberg of San Francisco Perinatal Associates, a member of the ACOG committee that developed the guideline. "We've done away with age 35 because the screening tests have gotten much better."

It's not just a question of whether to continue the pregnancy. Prenatal diagnosis also is important for those who wouldn't consider abortion, because babies with Down syndrome can need specialized care at delivery that affects hospital selection, he added.

The original age-35 trigger was chosen years ago when doctors had less information about the risk of Down syndrome, and the only choice for prenatal detection was an amnio, using a needle to draw fluid from the amniotic sac, he said. Amnios are highly accurate but were reserved for women at higher risk of an affected pregnancy because they occasionally cause miscarriage. A study this fall put the miscarriage risk at one in 1,600 pregnancies, far lower than previous estimates.

Also today, women have more options. Doctors already frequently offer younger women blood tests that don't definitively diagnose Down syndrome like an amnio or a similar invasive test called chorionic villus sampling - but that can signal who's at higher risk. The newest method, topping ACOG's recommendation for everyone, is a first-trimester screening that combines blood tests with a simple ultrasound exam, called a "nuchal translucency test" to measure the thickness of the back of the fetal neck. Studies from England, where the nuchal translucency combo has been used for about a decade, and the U.S. conclude that screening method is more than 80% accurate, with a very small risk of falsely indicating Down syndrome in a healthy fetus. It is performed between 11 and 13 weeks into pregnancy, and women are usually given numerical odds of carrying an affected fetus. A woman determined to be high risk then still has time for an invasive test to tell for sure.

Women who don't seek prenatal care until the second trimester can still undergo blood tests known as the triple or quadruple screens. The guideline also says women of any age can choose to skip the screening and go straight for invasive testing, an approach that might appeal to those with chromosomal defects in the family. "This new recommendation makes a lot of sense," said Dr. Nancy Green of the March of Dimes. "Maternal age no longer plays such an important role because the screening is better."

Each test comes with pros and cons, and the new guideline advises doctors to check what's available in their communities - nuchal translucency testing isn't easy to get everywhere - and discuss the best options with each patient.


Bioengineered cows 'resist mad cow disease'

The Greenies and their ilk will have a knee-jerk hatred of this

US and Japanese scientists say they have used genetic engineering to produce cattle that resist mad cow disease. They hope the cattle can be the source of herds that can provide dairy products, gelatin and other products free of the brain-destroying disease, also known as bovine spongiform encephalopathy or BSE. Writing in the journal Nature Biotechnology, the researchers said their cattle were healthy at the age of 20 months, and sperm from the males made normal embryos that were used to impregnate cows, although it is not certain yet that they could breed normally.

The cattle lack the nervous system prions, a type of protein, that cause BSE and other related diseases such as scrapie in sheep and Creutzfeldt-Jakob disease, known as CJD, in humans, the researchers said. "(Prion-protein-negative) cattle could be a preferred source of a wide variety of bovine-derived products that have been extensively used in biotechnology, such as milk, gelatin, collagen, serum and plasma," they wrote in their report.

Yoshimi Kuroiwa of Kirin Brewery Co in Tokyo, Japan and colleagues made the cattle, known as knockouts because a specific gene has been "knocked" out of them, using a method they call gene targeting. "By knocking out the prion protein gene and producing healthy calves, our team has successfully demonstrated that normal cellular prion protein is not necessary for the normal development and survival of cattle. The cows are now nearly 2 years old and are completely healthy," said James Robl of Hematech, a South Dakota subsidiary of Kirin. "We anticipate that prion protein-free cows will be useful models to study prion disease processes in both animals and humans," Robl, an expert in cloning technology, said in a statement.

Misfolded prion proteins are blamed for BSE and other, similar brain diseases. It is known that certain genetic variations make animals more susceptible to the diseases.

BSE swept through British herds in the 1980s and people began developing an odd, early-onset form of CJD called variant CJD or vCJD a few years later. CJD normally affects one in a million people globally, usually the elderly, as it has a long incubation period. There is no cure and it is always fatal.

As of November 2006, 200 vCJD patients were reported worldwide, including 164 patients in Britain, 21 in France, 4 in the Republic of Ireland, 3 in the United States, 2 in the Netherlands and 1 each in Canada, Italy, Japan, Portugal, Saudi Arabia and Spain. The disease may have first started to infect cattle when they were fed improperly processed remains of sheep, possibly sheep infected with scrapie. Although people are not known to have ever caught scrapie from eating sheep, BSE can be transmitted to humans. BSE occasionally occurs in cattle outside Britain although it is now rare.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter? It is just about pure fat. Surely it should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.

The use of extreme quintiles (fifths) to examine effects is in fact so common as to be almost universal but suggests to the experienced observer that the differences between the mean scores of the experimental and control groups were not statistically significant -- thus making the article concerned little more than an exercise in deception


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