Thursday, September 14, 2006

Evolution: Superbugs

Superbugs a growing threat to hospital patients News Staff Updated: Wed. Sep. 13 2006 11:32 PM ET

Superbugs are a growing threat in Canadian hospitals, and better medication and infection controls are needed, a new study suggests.

The number of one powerful bacteria strain's resistance to antibiotics has jumped dramatically: From five-to-15 per cent to 20-to-50 per cent. That's a significant increase from previous estimates, according to the report by the Canadian National Intensive Care Unit.

Researchers examined 4,180 specimens from patients in 19 intensive care units across Canada. The resistance figures pertain to the most common virulent strain of bacteria, methicillin-resistant Staphylococcus aureus (MRSA), which is a major cause of hospital-acquired wound and skin infections. Scientists also found an increase in the resistance of vancomycin-resistant enterococci (VRE) and E. coli, with levels at 6.8 per cent and 4.7 per cent, respectively.
"The stark reality in this country today is the MRSA and other drug-resistant bacteria are posing a serious threat to our ICUs," primary investigator Dr. George Zhanel, a professor at the University of Manitoba, said in a news release. "People infected with these superbugs are more likely to have longer hospital stays and require multiple drug treatments to fight them off.
And even then, it's often too little, too late.” About 8,500 Canadians die each year from complications arising from infections acquired in hospitals, according to the Community and Hospital Infection Control Association. Zhanel says stronger infection control measures are needed to limit the impact of the superbugs. Strict compliance from patients for less complicated infections is also vital, he said.

Another disturbing trend found by researchers is the increase of MRSA acquired in the community, not in the hospital setting. The strains were found among athletes, soldiers and intravenous drug users, the study showed. At least seven cases of the community-acquired strains, usually found in drug users and First Nations communities, are currently being treated across the country, the report said. "In Canada, sporadic cases (of the strains) have started to appear over the last decade," said Dr. Tony Mazzulli, a University of Toronto professor and medical microbiologist and infectious diseases specialist. "They tend to involve different strains and different antibiotic resistance profiles than hospital-acquired infections."

© Copyright 2006 CTV Inc.

Saturday, September 9, 2006

Above all, Gospels tell of God’s love

I really liked this article, and hope the Dispatch doesn't mind that I've saved it...

Above all, Gospels tell of God’s love
Friday, September 08, 2006

I remember once asking a parishioner about his vision of God. "Who or what do you envision God to be?" I asked.
He replied by telling me that he thought of God as the one who keeps track of our rights and wrongs. We are punished for our wrongs by the consequences of our actions, and rewarded for our goodness. And God is always trying to steer us toward the good.
I agreed with his last statement but challenged the rest, saying: "You make God sound like a giant traffic cop in the sky. Where’s the good news in that? "
What happened to the Gospel, which is literally translated "Good News?" I always thought Christianity was meant to be defined by the Gospel. And what is that good news? That God loved the world so much he sent his only Son so that all who trust in him may have eternal life (John 3:16).
I do not remember the New Testament telling me that God sent his Son in order to be sure we always did right, or to keep track of all our deeds. In fact, much of Christian theology assumes that God sent his message of love through his Son because we humans were so often incapable of doing the right and the good.
In recent years, Christianity seems obsessed with right and wrong. As the religion injects itself into the public debate, it does so around hot-button issues like abortion and sexuality, and around party politics.
Increasingly, Christianity seems to be identified with being "right" on the issues or voting for the "right" party. As Christian leaders join the political discourse, they often sound just like politicians: attacking the other side (rather than loving our enemies as Jesus commanded) and giving the spin to a position (rather than speaking the truth in love).
Such public discourse divides people into groups of those who are right and those who are wrong. It also influences the way we envision God, turning the Deity into a bean counter. Where’s the Good News in that?
Early Christianity grew because of its strong message of love. In the dehumanizing world of the Roman Empire, the outcasts heard good news. Slaves heard that God loved them, even if they had no power or standing in society. In the church, slaves became brothers and sisters with those who were not slaves, and were called children of the God of the universe. A woman, living in a maledominated culture, where a husband or boyfriend could legally demand that she have an abortion, found herself treated as an equal to a man. The poor found dignity because they realized they were loved by God just as much as the rich. It was good news.
Christianity was not obsessed in those days with being "right." Rather, it was obsessed with sharing the love of God with all who needed it. And then, the church watched in awe and wonder as that love transformed lives. It was good news.
We live in a modern, dehumanizing world, where we allow ourselves to be defined more and more by our productivity, consumerism and accomplishments. I have found very few people who get up each morning fully aware of Christianity’s great proclamation that God loves them and each and every one us very much. And now the Christian Church fails to proclaim this, its own, most basic message, and instead joins in political bickering. Where’s the love? Whatever happened to the Gospel?
The Rev. Stephen Smith is rector of St. Patrick’s Episcopal Church, Dublin, and a member of We Believe Ohio, a group that unites diverse religious voices for social justice.
Copyright © 2006, The Columbus Dispatch

Monday, September 4, 2006

New Orleans: Who is to Blame?

For purposes of this discussion, I'm going to divide the people of New Orleans into these groups:

Group A: You heard the warnings to get out, and got out. Good for you. You may have lost property, but you exercised good judgement and consequently are not part of the current problem. Thank you.

Group B: You heard the warning, and chose to stay either out of stubborness, or to protect your property, which was lost anyway. Your stubborness has needlessly added to the rescue effort. You're at the end of the help line as far as I'm concerned.

Group C: You wanted to get out, and had the means to get out, but felt you needed to stay to protect loved ones who were unable to get out. Your willingness to sacrifice yourself was noble. Some folks will say that you just added to the number of victims (one of the arguments for NOT jumping into save a drowning victim unless you are trained). I won't be that harsh, because I'm sure I couldn't leave an invalid parent behind if I couldn't get them out.

Group D: You wanted to get out, but didn't have the means. These are the people we failed.

So the specific question: Who should have been taking care of Group D?

US Army Corps of Engineers: I hope the Corps of Engineers gave an adequate appraisal of the risk of the levies failing. It seemed to me that the civilian authorities were most worried about a storm surge coming over the levies. That would have been bad, flooding a great deal of the city. But the presumption would be that once new water stopped coming into the city, the pumps could begin getting it back out immediately. By now (a week later), the water level would be much lower.A complete failure of the levies is clearly much worse. Not only does the water rise to the highest possible level, it's going to stay there until the levies are repaired and a great deal of water is pumped out. It just doesn't seem like anyone considered this possibility...

The Mayor of New Orleans: The Mayor has been making a lot of noise, emphasizing his words with profanity presumably to show the people how mad he is. However, it seems to me that no government official should have been more acutely aware of the potential risks and therefore have taken precautionary steps. It seems like it would have been entirely within his power to commandeer the Superdome before the storm and get it stocked with all the supplies needed to handle a worst-case-scenario, which is pretty much what happened. New Orleans has been threatened with this kind of catastrophic flooding for decades. Why didn't this mayor or any of his predecessors take the initiative to get a disaster plan put together? He could have been on the news a year ago saying: "I want to prepare for a total flood out that traps tens of thousands of people in the city. I can't do it alone -- the state government and FEMA needs to help." I would rather hear him bitch about not getting help in making a plan than point fingers after the disaster takes place.

The Governor of Louisiana: Like the Mayor, she could taken some initiative to prepare for a disaster of this magniture. She has lots more resources than the Mayor, including the Louisiana National Guard. The plan should have been drawn up years ago, and activated in stages as the probability of the storm hitting went up. She could have helped provide resources for the evacuation of the folks in Group D. She could have had Louisiana National Guard bases prepared to be temporary shelters for evacuees. She could have worked deals with governors of other states to lend resources (e.g. National Guard and police units) and evacuation sites.

The Federal Government: Gee, back in the Cold War days, these guys drew up a zillion plans for going to war with the Soviets, and ran enormously expensive war games to try out elements of those plans. Someone, the Corps of Engineers, FEMA, the Pentagon -- someone could have drawn up those plans and mobilized thousands of troops to be ready.

Hopefully we learned some lessons with this disaster. New Orleans is not the only city which can be impacted this way. What about the Big Earthquake on the west coast? Can't say we don't have warning. How about a tornado that finally rips through a big city, like Columbus OH where I live? What if the terrorists had loaded the airliners with nuclear waste before crashing into to the World Trade Center and the Pentagon?

When I was a kid, the entire country had made preparations for a nuclear war with the Soviets. The military had its bunkers in Cheyenne Mountain (and maybe deep under the Pentagon). The Congress was going to bail out to the Greenbriar (those guys are no fools). The President and Cabinet would go to Mount Weather. The rest of us were told to build fallout shelters in our basement and stock them. In the cities, every building had signs posted directing people to the public fallout shelters.

Seems like it is worth it to apply similar effort to preparing for city sized disasters. We know what is needed. Let's not get lazy again.

Mr Mayor: If you want to be a real leader, be a man and admit that you could have done more to prepare your city. Then volunteer to run a federal commission that oversees the development of a plan in cooperation with the state and local governments of our largest cities.

Mayors of other major cities: Use this as a lesson and TAKE RESPONSIBILTY FOR MAKING A PLAN.

FEMA: This is your job, and you blew it. Heads should roll.

Mr President: Put LtGen Honore in charge of FEMA. Make it a 4 star CINC command under the DoD. They're the only guys with the resources, leadership and organization to run something of this magnitude.

Citizens: When the man says "Get Out!" - LISTEN!!

Saturday, September 2, 2006

Funerals and Connections

My Dad, Ted Lambert, passed away on August 20, 2006. He was 83 years old, living independently in his own home (Mom died in 1991), and in full control of his intellect. While he had suffered many years with chronic health problems, and was in the hospital for treatment of an acute episode, his death came suddenly and unexpectedly. You are invited to visit our family website to learn more about Dad and our family.

Certainly there are tragedies in our lives, such as when death comes at a young age. But death is inevitable, and I find that while I mourn the ending of an earthly relationship, I am also able to find joy in the 'gathering of the clan' which happens around a funeral.

Our family has always been a little far-flung. Terry and I have lived in Columbus our entire adult lives, and have raised our kids here, a four hour's drive from our parents. My brother Jeff and Terry's sister Elaine also came to Columbus many years ago. Other siblings are in Charleston WV, Huntington WV, Ripley WV, and Virginia Beach VA. Our collective children are now beginning to spread out: Colorado, North Carolina, Indiana, and Iraq. We have first cousins in Florida, New Jersey, Kentucky, and California.

As our individual families grow, it seems that the horizontal connections in the family tree get a lot less attention than the vertical ones. Our primary focus is on our children, and in time, on their children. We also retain that strong bond to our parents, but the frequency of contact diminishes, especially if they aren't close by. And as we have now experienced, there comes an end to their time on earth, and you never feel you spend enough time with them.

The bond to siblings never diminishes, but again, the frequency of contact goes down as we deal with all the demands on our own time. The contacts beyond that -- with aunts, uncles, and cousins -- become quite rare. Some families are better than others at getting everyone together. Our family, driven by Mom and sister Pat, had some great family gatherings in the 1980s. But after about three of those, we just never got one together again. I really think it's about the logistics. A family gathering is a big deal, and it's simply hard to find a time when everyone can attend, and not be excluded simply because of scheduling conflicts.

When a close family member dies, that trumps everything. The time from death to funeral is a matter of days, and you simply have to drop other commitments and get yourself there.

Terry's Dad died completely unexpectedly, at age 63, when he still had a lot of life to live. His death was tragic because he might well have survived had they lived closer to a emergency medical center. It was a sad time.

Our mothers both died of cancer, with a lot of time to come to grips with the fact that we were experiencing the end of their days. Terry's mom had a beautiful traditional service, and it was an opportunity for me to meet a number of members of Terry's family that I didn't know. For my Mom, we held a gravesite service in the morning, then a memorial service and visitation that evening. People got up and told funny stories about times with Mom, which we all knew she would have loved. The gathering time afterward was wonderful, getting to see many of our family and friends.

A few months ago, Jay White, the younger brother of a very good friend Jim White, passed away suddenly. When Jim and I both worked at CompuServe in the 1970s, we became very close and took part in many activities together. I got to know Jim's family well, including Jay. When Jim married Karen and moved back to his hometown of Pittsburgh to raise their family, our contact became limited to the annual exchange of Christmas newsletters. When Karen called to say Jay had died, there was no question that I would head to Pittsburgh to honor Jay and support Jim. We had the chance to spend the whole following day together, and found that we still shared common interests and enjoyed spending time together. It was a funeral that created the priority to connect once again.

Dad's death was not expected, but then it was. He was in the poorest health of our four parents, but ended up outliving them all. His funeral created that excuse for the gather of the clan, beginning with a wonderful dinner by Rita Shaffer, the granddaughter-in-law who had been taking care of Dad's housekeeping and being his weekly companion (along with her daughter Sarah). For the visitation and funeral, we saw many friends and family, including the last two members of my parents' generation: Dad's sister Betty and Mom's brother Don. Aunt Betty was accompanied by cousin Jane, while Uncle Don came with cousin Donna and her husband Mike. We got to see old neighbors such as Jim and Marg Hively, Chester Flick, and Sada Douglas. Denver Rucker, one of Dad's dearest friends came with his wife. Mrs Whitman, and two of her daughter, Alice and Rebecca were there. While together for dinner at a local restaurant, we ran into Rose Marie, a high school classmate of ours and childhood friend of Terry's. And friend Jim White came down from Pittsburgh to spend the day with us as well.

The following day was one for me and my sibs to get together and begin the tasks of getting Dad's stuff in order. I got to spend a fair amount of time with Sammie and Josh Lambert (Joe and Becky's kids, Ted Lee's grandchildren) and Kristen Casanave (Vikki's daughter, Pat's granddaughter), grand-nieces and nephews that I didn't know very well beforehand. New connections.

I hope that when the day comes, my funeral is a time when lots of people gather to reconnect and celebrate our interwined lives. I wish I could be there!