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Diagnosis is Not Enough, Measuring Medical Outcomes is Critical
Paul Nurse, Ph.D, is a British biochemist. He was awarded the 2001 Nobel Prize in Physiology or Medicine with Leland H. Hartwell and R. Timothy Hunt for their discoveries regarding cell cycle regulation by cyclin and cyclin dependent kinases. He became Rockefeller University's ninth president in 2003.
Question: How important is measuring outcomes?
Paul Nurse: Measuring outcomes, particularly in cancer, is actually crucial because if you make incorrect assumptions in the way you're doing analysis, things go bad rather quickly actually because you get statistics that show certain cancers, or certain diseases, are dramatically increasing, when it may be only that we are diagnosing them better, and then everything goes wrong in trying to think about it.
What I think about this public health issue is that by having better diagnosis, I have talked a little bit about how you can use molecular tools to get better diagnosis, which I think will classify disease better, by using more modern techniques and applying them in sensible ways, I believe we are likely to get better information upon which public health statistics can be acquired. I do think it's important because that public health information is going to be important for the population-based studies that are necessary to understand prevention better, the genetic effects and environmental effects. If we have imprecise information there, we're going to get deeply misled. And, once again, will give rise to quackery because people will read, maybe allergies have increased tenfold or something, and then they say this is due to pollution or whatever, because this is how the way people think when in fact it may have nothing to do with that, and we get campaigns in favor of certain approaches which is simply totally misplaced.
One example, which was really close to a tragedy, was the so-called "triple jab" for immunization of young children against several diseases. There was very flawed research which suggested that giving the three vaccines together would cause autism. This was barely taken seriously by the clinical community because the data was not very good. But because it got such public support, this changed the way immunizations were being carried out, and then led to a rise of the very diseases that you're trying to eliminate. That's a consequence of not reporting properly the data that you have, because autism was seen to be on the rise, in particular circumstances, when in fact it was simply being diagnosed better and it appeared at a certain time in life when these inoculations were given.
Accurate information about disease and disease onset is crucial for good prevention and good heath care delivery.
Recorded on: May 20, 2009
Biochemist Paul Nurse says that if you make incorrect assumptions in analysis, things can go bad quickly for public health.
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Health officials in China reported that a man was infected with bubonic plague, the infectious disease that caused the Black Death.
- The case was reported in the city of Bayannur, which has issued a level-three plague prevention warning.
- Modern antibiotics can effectively treat bubonic plague, which spreads mainly by fleas.
- Chinese health officials are also monitoring a newly discovered type of swine flu that has the potential to develop into a pandemic virus.
Bacteria under microscope
needpix.com<p>Today, bubonic plague can be treated effectively with antibiotics.</p><p style="margin-left: 20px;">"Unlike in the 14th century, we now have an understanding of how this disease is transmitted," Dr. Shanthi Kappagoda, an infectious disease physician at Stanford Health Care, told <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">Healthline</a>. "We know how to prevent it — avoid handling sick or dead animals in areas where there is transmission. We are also able to treat patients who are infected with effective antibiotics, and can give antibiotics to people who may have been exposed to the bacteria [and] prevent them [from] getting sick."</p>
This plague patient is displaying a swollen, ruptured inguinal lymph node, or buboe.
Centers for Disease Control and Prevention<p>Still, hundreds of people develop bubonic plague every year. In the U.S., a handful of cases occur annually, particularly in New Mexico, Arizona and Colorado, <a href="https://www.cdc.gov/plague/faq/index.html" target="_blank">where habitats allow the bacteria to spread more easily among wild rodent populations</a>. But these cases are very rare, mainly because you need to be in close contact with rodents in order to get infected. And though plague can spread from human to human, this <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">only occurs with pneumonic plague</a>, and transmission is also rare.</p>
A new swine flu in China<p>Last week, researchers in China also reported another public health concern: a new virus that has "all the essential hallmarks" of a pandemic virus.<br></p><p>In a paper published in the <a href="https://www.pnas.org/content/early/2020/06/23/1921186117" target="_blank">Proceedings of the National Academy of Sciences</a>, researchers say the virus was discovered in pigs in China, and it descended from the H1N1 virus, commonly called "swine flu." That virus was able to transmit from human to human, and it killed an estimated 151,700 to 575,400 people worldwide from 2009 to 2010, according to the Centers for Disease Control and Prevention.</p>There's no evidence showing that the new virus can spread from person to person. But the researchers did find that 10 percent of swine workers had been infected by the virus, called G4 reassortant EA H1N1. This level of infectivity raises concerns, because it "greatly enhances the opportunity for virus adaptation in humans and raises concerns for the possible generation of pandemic viruses," the researchers wrote.
The word "learning" opens up space for more people, places, and ideas.
- The terms 'education' and 'learning' are often used interchangeably, but there is a cultural connotation to the former that can be limiting. Education naturally links to schooling, which is only one form of learning.
- Gregg Behr, founder and co-chair of Remake Learning, believes that this small word shift opens up the possibilities in terms of how and where learning can happen. It also becomes a more inclusive practice, welcoming in a larger, more diverse group of thinkers.
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- Selfish behavior has been analyzed by philosophers and psychologists for centuries.
- New research shows people may be wired for altruistic behavior and get more benefits from it.
- Times of crisis tend to increase self-centered acts.