Gambia Study Showed No Significant Reduction in Malaria Vectors from Indoor Residual Spraying

In my ongoing series on the efficacy of DDT as a public health measure, check out a recent study published in The Lancet. I’ve excerpted portions of the abstract:

Although many malaria control programmes in sub-Saharan Africa use indoor residual spraying with long-lasting insecticidal nets (LLINs), the two studies assessing the benefit of the combination of these two interventions gave conflicting results. We aimed to assess whether the addition of indoor residual spraying to LLINs provided a significantly different level of protection against clinical malaria in children or against house entry by vector mosquitoes.

We identified no significant difference in clinical malaria or vector density between study groups. In this area with high LLIN coverage, moderate seasonal transmission, and susceptible vectors, indoor residual spraying did not provide additional benefit.

When you read the study, you observe the care with which effective public environmental health research must be planned and the narrow conclusions which can then be drawn. People who believe that DDT could eliminate malaria are not following scientific research.

Preventing Pandemic Influenza and Moral Responsibility for Good Government

I’ve been listening to The Fatal Strain by Alan Sipress. He claims that public health professionals believe that an outbreak of influenza will become a pandemic unless very specific measures are implemented. These include (my layman’s summary) effective isolation of the sick, quarantine of those with whom they have come into contact, delivery of TAMIFLU doses to everyone in the area of the outbreak, strict control of entry and exit from the region, provision of public health workers, lab personnel and equipment to process the samples necessary to plan and calibrate these interventions and building a reservoir of trust among the general population which would engender cooperation. You can read scientific articles on this subject.[1][2] Continue reading

Nursing Home Association Seeks to Repel #Union Organizing #Labor #Ohio

Nursing-Home-Union

Carol Simpson, 2008

My business sells software to nursing homes. So I participate in trade associations to help my company market to nursing homes and to receive the education programs the associations offer.

The anti-union position of most of these associations disturbs me greatly.

On August 31, the Ohio Health Care Association will hold the Staying Union Free in 2011 webinar.

Ohio S.B. 5 will likely increase union organizing in private sector workplaces. Supervisors in long-term care facilities will need to be prepared. Health care environments are perfect targets: large numbers of employees capable of paying monthly dues; performing demanding work that can create tension with management; in jobs that cannot be ‘off-shored.’ Once a union works itself in, it is virtually impossible to extract. The best strategy for healthcare employers and their supervisors is to focus on prevention: create and maintain a workplace environment that repels union organizing.

As the unions’ resources are not unlimited, they must allocate their efforts to the workplaces that show the most promise of becoming organized. In this presentation, participants will learn effective strategies to assess vulnerability to organizing, detect union activity, and to deter union organizers from becoming interested in their facilities. Case studies are used to introduce and work with the best practices to remain union-free.

In 1999 or so, I did time studies in nursing homes in Indiana. As part of those studies, my company collected wage data. In rural areas, certified nursing assistants (CNAs) were making $5.50 / hr. In Indianapolis, that might increase to $9.00 / hr. Licensed practical nurses were making around $17-20 / hr, and registered nurses were making $28-30 / hr.

Whenever I’d meet one of these nurses, I’d say, “Learn to program. It’s much less stressful, and you’d make the same amount of money.” Programmers aren’t lifting and bathing 200 lb people with behavior problems in a work environment characterized by rigorous professional standards, incredibly difficult medical situations such as wounds and advanced dementia and, frequently, ownership which focused more on the bottom line than the welfare of the residents and employees.

In this context, would not a union be a counterweight to poor management? Should not CNAs make more than employees at Taco Bell a living wage?

Updated May 4, 2019: Persons as Producers: Why bioethics should be concerned with work culture and the structure of labor by Alison Reiheld, May 1, 2018

Feminist bioethics—heck, bioethics writ large—should be deeply concerned with this nation’s culture and structure of labor. And while have focused on the US, we can look for the same features and issues in other nations to see how they do better or worse*. May 1 gives us an important opportunity to bring these issues back to the forefront.

Bioethics, as much as social justice movements more generally, need to be asking an inter-related set of questions of each nation. Do we value humans primarily as producers? Is the economy and work culture structured for human flourishing or for narrowly measured economic gain? What kinds of labor are valued? And of most direct interest, is health care only accessible to those who perform particular kinds of culturally valuable labor?

Updated May 4, 2019: Zero-Sum Game? A Consideration Of Dependency Workers and Dependent Persons by Alison Reiheld, August 10, 2013

And the work of caring for dependent persons—whether young or old, temporarily or permanently—is critically important work to our society which we nonetheless reward badly if at all (I have not even touched on the toll of unpaid dependency work). Doing better by dependency workers may lead to doing better by dependent persons, as well as being a simple matter of fairness to all concerned. And yet, rising wages and benefits for the former will mean rising costs for the latter at a stage when many are on a fixed income, at best. Ought society to take on this burden of justice? If so, how? Regulation alone—say, through revision of the Fair Labor Standards Act (FLSA)—will not cut the cake: it does nothing to make better, more fair provision of care affordable.

If you know how I should properly credit the cartoonist Carole Simpson for using her work, let me know.