Should we encourage Swine Flu parties?

Infectious-disease specialists say they understand the logic: surviving the current, apparently mild strain of the virus may be protective if a more virulent strain emerges next fall. But they are generally against it.

Dr. Anne Moscona, a flu specialist at Weill Medical College of Cornell University, said she had been called by a reporter for a women’s magazine “asking if mothers should hold swine flu parties, like chickenpox parties.”

(Chickenpox parties, at which children gather so they can all be infected by a child who has the pox, are often held by parents who distrust chickenpox vaccine or want their children to have the stronger immunity that surviving a full-blown infection affords and are willing to take the risk that their child will not get serious complications.)

“I think it’s totally nuts,” Dr. Moscona said. “I can’t believe people are really thinking of doing it. I understand the thinking, but I just fear we don’t know enough about how this virus would react in every individual. This is like the Middle Ages, when people deliberately infected themselves with smallpox. It’s vigilante vaccination — you know, taking immunity into your own hands.”

The idea has arisen from the history of the 1918 Spanish flu. A mild spring outbreak was followed by two deadly waves in the early and late winter of 1918-1919. Some believe, although there is little evidence beyond anecdotal reports in old newspapers, that those who got sick in the first wave were less likely to get sick in the second and third.

Many cite as the source of their thinking the book “The Great Influenza,” a history of the 1918 pandemic by John M. Barry.

Mr. Barry, in a telephone interview, said he had never publicly suggested deliberate self-infection, “but I used to joke with my wife, and I may have jokingly said it in speeches, that if a virus emerged and looked mild, I’d be on an airplane to Indonesia.”

-Debating the Wisdom of ‘Swine Flu Parties’

Quitting Smoking is not easy

Today, 21 percent of Americans smoke, down from 28 percent in 1988. Off-again-on-again smoking and serial quitting are common, as is the long-term use of nicotine gum and patches.

“It takes the average smoker 8 to 10 times before he is able to quit successfully,” said Dr. Steven A. Schroeder, director of the Smoking Cessation Leadership Center at the University of California, San Francisco.

-Lessons for Other Smokers in Obama’s Efforts to Quit

Washing-machine model of addiction treatment

Every year, state and federal governments spend more than $15 billion, and insurers at least $5 billion more, on substance-abuse treatment services for some four million people. That amount may soon increase sharply: last year, Congress passed the mental health parity law, which for the first time includes addiction treatment under a federal law requiring that insurers cover mental and physical ailments at equal levels...

“What we have in this country is a washing-machine model of addiction treatment,” said A. Thomas McClellan, chief executive of the nonprofit Treatment Research Institute, based in Philadelphia. “You go to Shady Acres for 30 days, or to someclinic for 60 visits or 60 doses, whatever it is. And then you’re discharged and everyone’s crying and hugging and feeling proud — and you’re supposed to be cured.”

He added: “It doesn’t really matter if you’re a movie star going to some resort by the sea or a homeless person. The system doesn’t work well for what for many people is a chronic, recurring problem.”

-Drug Rehabilitation or Revolving Door?

The Best of New York Times

Investors Buy U.S. Debt at Zero Yield ;

In the market equivalent of shoveling cash under the mattress, hordes of buyers were so eager on Tuesday to park money in the world’s safest investment, United States government debt, that they agreed to accept a zero percent rate of return.

Weak Oversight Lets Bad Hospitals Stay Open;

Mistakes happen even at good hospitals, of course. But evidence shows that University, which is owned by the State University of New York system, is not a good hospital. In fact, in late 2006 a state commission recommended that it be scaled back and merged with another hospital.

$73 an Hour: Adding It Up





The Pain May Be Real, but the Scan Is Deceiving

Primal, Acute and Easily Duped: Our Sense of Touch;

Touch also turns out to be easy to fool. Among the sensory tricks now being investigated is something called the Pinocchio illusion. Researchers have found that if they vibrate the tendon of the biceps, many people report feeling that their forearm is getting longer, their hand drifting ever further from their elbow. And if they are told to touch the forefinger of the vibrated arm to the tip of their nose, they feel as though their nose was lengthening, too.

Some tactile illusions require the collusion of other senses. People who watch a rubber hand being stroked while the same treatment is applied to one of their own hands kept out of view quickly come to believe that the rubber prosthesis is the real thing, and will wince with pain at the sight of a hammer slamming into it. Other researchers have reported what they call the parchment-skin illusion. Subjects who rubbed their hands together while listening to high-frequency sounds described their palms as feeling exceptionally dry and papery, as though their hands must be responsible for the rasping noise they heard. Look up, little Pinocchio! Somebody’s pulling your strings.

In Defense of Teasing

Scorpios Get More Asthma, but Astrology Isn’t to Blame

What price is life?

If the Hardys lived in the United States or just about any European country other than Britain, Mr. Hardy would most likely get the drug, although he might have to pay part of the cost. A clinical trial showed that the pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000.

But at that price, Mr. Hardy’s life is not worth prolonging, according to a British government agency, the National Institute for Health and Clinical Excellence. The institute, known as NICE, has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen’s life....

The institute has analyzed the cost-effectiveness of surgical operations, cancer screening tests and medical devices. For example, it found that drug-coated cardiac stents were worth only $450 more than bare-metal ones. In the United States, stent price differences are often far wider....

After consulting a citizens group, the institute decided that the nation should spend the same amount saving or improving the life of a 75-year-old smoker as it would a 5-year-old....

The institute’s decision-making process involves a series of independent assessments, consultations with manufacturers, committee meetings, comment periods for outsiders and appeals that, taken together, Dr. Rawlins described as “procedural justice,” or “muddling through elegantly.” While the institute provides advice, decisions are made by one of three committees made up of doctors, nurses and economists from outside the government.

-British Balance Gain Versus Cost of Latest Drugs