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Maps and Figures

"Hitler or Coulter?" Quiz
Map1 - Teen Pregnancy
Map2 - Incarceration
Map3 - Homicide Rates
Map4 - Drop-out Rates
Map5 - Bankruptcy Rates
Map6 - Driving Distances
Map7 - Energy Use
Map8 - Gonorrhea!
Map9 - Tax Burden
Map10 - State GDP
Map11 - DHS funding
Map12 - Adult Illiteracy.
Map13 - Abortion Bans:
Map14 - ER Quality
Map15 - Hospital Quality
Map16 - Coal Burners
Map 17 - Infant Mortality
Map 18 - Toxic Waste
Map 19 - Obesity
Map 20 - Poverty
Map 21 - Occupational safety
Map 22 - Traffic deaths
Map 23 - Divorce
Figure 1 - Wages vs Right to work
Figure 2 - Unemployment vs Right to work
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Wednesday, February 28, 2007

Hey you, stop trying to improve on nature
One of the funny things about Buck's post on the latest homenoschooling on Wife Swap is the discussion of the raw food types. One thing to remember when dealing with any type of woo, as Orac would call it, is that the purpose of most people's crazy beliefs about diet, medicine whatever, are attempts to create control in their life. People like alternative medicine, not because it respects the body and is natural, these are rationalizations. People like it because there is always an alternative medicine you can take, every day, for any reason. Largely because they're harmless, this is ok. If you did this with real medications you would probably end up dead or sick. Same with the raw food guy in this show. When confronted by the other parent who challenged the wackiness of a world view that includes eating raw chicken, what did he do? He ran to the kitchen and started eating. It's about a feeling of control, that's all, and to some degree that's ok, people need coping mechanisms to deal with stress, and if they end up being a little wacky, that's fine (eating raw chicken might not be).

If a system of "alternative" medicine were legitimately interested in preserving health rather than just selling worthless supplements, one of the first elements of its practice would be to do nothing if nothing is wrong. This new paper in JAMA makes this point nicely. It is entitled "Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention" and is a meta-analysis of nearly 400 studies on antioxidants like selenium, beta-carotene and vitamins A, C, and E. Their findings? Dosing yourself with beta carotene, vitamin A, and vitamin E may increase your mortality, while selenium and vitamin C are at best harmless.

For the most part your body knows what it's doing and can and should be left alone. A normal diet will provide you with all the nutrition you need, and it's very unlikely you need to supplement with some exceptions like folic acid in women of childbearing age, B12 in vegans and old people or if one has an underlying condition like anemia which requires supplementation. So, a simple way to determine if something is quackery is if you're healthy, do they still suggest treatment?

Again, most of these interventions are mostly harmless and merely relieve the sucker of money they soon would have parted with anyway. But it's a sure sign of a bad medical practitioner if they want to do anything to a helthy person to "make them better".

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Wednesday, January 17, 2007

Adverse reactions from altie meds
An interesting Essay is in the NYT from Dan Hurley, author of Natural Causes: Death, Lies and Politics in America's Vitamin and Herbal Supplement Industry (already being freeped by the alties in his ratings).

It's an interesting subject, as monitoring of statistics from poison control centers and other monitors of adverse drug reactions has seen rapidly increasing hospitalizations and deaths from altie/homeopathic/BS remedies since the Dietary Supplement Health and Education Act of 1994. Which, at the time, was defended by Orrin Hatch (does Mormonism make you generally gullible?) on the basis that old things are safe.

Senator Orrin G. Hatch, Republican of Utah, spoke up in their defense. Herbal remedies "have been on the market for centuries," he said, adding: "In fact, most of these have been on the market for 4,000 years, and the real issue is risk. And there is not much risk in any of these products."

Well, the data seems to suggest otherwise, and while common over-the-counter (OTC) drugs are responsible for more overall adverse drug effects, their incidents tend to happen from overdoses and abuse, not on-label use.

Since 1983, the American Association of Poison Control Centers has kept statistics on reports of poisonings for every type of substance, including dietary supplements. That first year, there were 14,006 reports related to the use of vitamins, minerals, essential oils — which are not classified as a dietary supplement but are widely sold in supplement stores for a variety of uses — and homeopathic remedies. Herbs were not categorized that year, because they were rarely used then.

By 2005, the number had grown ninefold: 125,595 incidents were reported related to vitamins, minerals, essential oils, herbs and other supplements. In all, over the 23-year span, the association — a national organization of state and local poison centers — has received more than 1.6 million reports of adverse reactions to such products, including 251,799 that were serious enough to require hospitalization. From 1983 to 2004 there were 230 reported deaths from supplements, with the yearly numbers rising from 4 in 1994, the year the supplement bill passed, to a record 27 in 2005.

The number of deaths may be far higher. In April 2004, the Food and Drug Administration said it had received 260 reports of deaths associated with herbs and other nonvitamin, nonmineral supplements since 1989. But an unpublished study prepared in 2000 for the agency by Dr. Alexander M. Walker, then the chairman of epidemiology at the Harvard School of Public Health, concluded: "A best estimate is that less than 1 percent of serious adverse events caused by dietary supplements is reported to the F.D.A. The true proportion may well be smaller by an order of magnitude or more."


Advocates of the products correctly point out that the poison centers’ figures do not prove a causal link between a product and a reaction and that, in any case, far more people are injured and killed by drugs. Painkillers alone were associated with 283,253 adverse reactions in 2005, according to the poison centers, more than twice as many as with supplements. But only 3.5 percent of those reactions occurred when people took the prescribed amount of painkiller; most were from overdoses, either accidental or intentional. The same was true of asthma drugs (3.6 percent of reactions were associated with the prescribed dose) and cough and cold drugs (3.1 percent).

While reactions to vitamins, minerals and essential oils occurred at similarly low levels when people took the recommended amounts, adverse reactions linked to the recommended levels of herbs, homeopathic products and other dietary supplements accounted for 10.3 percent of all reactions to those products reported to the poison centers — about three times the level seen for most drugs.

Very interesting, not surprising, but certainly interesting. I would add, in defense of prescription and OTC drugs, that in addition to be safer when used as prescribed, they also work for what they are prescribed for.

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