Parademic Notes Ending Week 170205

1. Foucault, 2. Cancer Conspiracy, 3. Unstable Medical Situation, ↕4. Zika, 5. Public Health Trust, 6. Learning style, 7. Cascade Disaster, 8. Moving FEMA, 9. Medical Surge, 10. Fire Smoke and Health, 11. Vaccination Poll, 12. Invasive Pigs,↕T. Trumpism ↔ Parademic, ↕C. Communications.

-1. Michel Foucault is a major influence of social science thought on modern medicine. Often times some author’s are unaware of the roots of concepts that they use. Foucault and Modern Medicine. Modernity as a concept or ideal, resulting from the age of Enlightenment and the French Revolution gave hope of a better future and new possibilities. To be modern means an 'enlightened' individual and society, welcoming change and development. In this paper, I will discuss Foucault's analysis of problematics in medicine in eighteenth century France. Three themes prominent in the text are: 'the birth of the clinic', 'the clinical gaze'* and the power/ knowledge relationship. Three problematics identified in modern medicine by Foucault and which are particularly relevant to twentieth century medicine are: (i) the extension of the clinical gaze from the individual body to the wider population; (ii) the increasing medical intervention and use of technology in fundamental life processes; and (iii) the relationship between society and medicine. Foucault's analysis is fraught with ambiguities. It is useful, however, for establishing an explanation for medicine today and for presenting a particular interpretation ofmodernity. Michel Foucault and the Birth of Modern Medicine. Japan’s Public Health Paradigm: Governmentality and the Containment of Harmful Behavior. Technologies of the Self and Ethnographic Praxis.

-*. This may be related to the phenomena that one cannot perceive what one does not know what to look for. This happens in biodisaster during its slow hidden phase as the signals for it are geographically and temporally so separate that the pattern is not apparent. When it accelerates then one know what to look for that was missed, while others still have not seen the pattern and continue not to perceive what they have no image for. This is one reason why problems are defined incorrectly, with the result of solving the wrong problem.

-2. This conspiracy theory has been revived again, probably to marketing another quack cure. The original form of the title alone tells one it is a conspiracy theory, ALL CAPS, ?, !, font style. This particular one uses a click bait [Meme] posted as an advertisement on legitimate medical sites. Did the Nazis Bury a True Cure for Cancer, Found. A Priceless War Relic Covered up. In 1944, a German scientist performing cancer research for Hitler made an incredible discovery. The Nazi War on Cancer (1999), Nuremburg Records Indicate Nazis may have Found Cure for Cancer (1999), A Jew, a Führer and a Cancer Breakthrough….Hitler’s Gift to the World (2014), The Nazis' Forgotten Anti-Smoking Campaign (2014), “The Truth about Cancer” Series Is Untruthful about Cancer (2015).

-Quote: I told you yesterday that the shock has backfired on them. Indeed, they are shocked because of what they have seen. No one received them with roses. They were received with bombs, shoes and bullets. Now, the game has been exposed. Awe will backfire on them. This is the boa snake. We will extend it further and cut it in the appropriate way. – Mohammed Saeed al-Sahar. 160821-6.1Quote, T↓.

-3. #Book Biomedicine in an Unstable Place: Infrastructure and Personhood in a Papua New Guinean Hospital [Cover]. Social anthropologist Alice Street’s first book is an ambitious ethnography of personhood and recognition in Madang Hospital, an under resourced provincial hospital in Papua New Guinea. The book shows how doctors, nurses, and patients endeavor to make themselves “visible” to others in order to initiate relations of care at multiple scales, while also emphasizing the uncertainties of diagnosis and treatment within an institution subject to perennial shortages of staff and supplies. Good source to look at if one is seeing the possibility that one’s medical facility may face a surge of needs that makes one short of personnel and resources, or a funding shortfall that will likewise create a shortage or staff and supplies.

↕4. Framing by Political Advocacy Groups May Jeopardize Public Understanding of Zika. The public's ability to understand the dangers posed by Zika virus may be jeopardized by advocacy groups linking the virus with culturally charged issues such as illegal immigration and global warming. Culturally Antagonistic Memes and the Zika Virus: an Experimental Test: 1. The strange world of public risk controversy, 2. Two dynamics and a missing link [Chart], 3. Study: Zika and culturally antagonistic memes [Memes], 3.2.3. Cultural worldviews [Chart], 3.4.1. ZAFFECT [Chart, Chart], 3.4.2. ZLIT and misfearing [Chart], 4.1.1. Antagonistic Meme (AM) vulnerability vs. AM immunity, 4.1.2. Miserly processing: an alternative explanation, 5. Conclusion: antagonistic memes in the ‘Liberal Republic of Science’. Top Zika Memes on the Internet [Meme, Cartoon recycle of Cartoon, Meme].

-4.1. A Clue to the Mystery of Colombia’s Missing Zika Cases. In December of 2015 the Zika virus that had hit Brazil less than a year before. Alarming reports of microcephaly were beginning to come out of Colombia’s neighbor to the east. Monitoring began of pregnancies to see if a similar wave would hit Colombia. It never did. In Brazil, more than 2,300 Zika infected babies have been born with microcephaly. In Colombia, the world’s second largest outbreak has produced far fewer: only 82. Taking total population into account, that’s still more than an order of magnitude less. The disparity has bewildered public health officials, and caused many to question the link between the birth defect and Zika. The US CDC formally declared a causal link between microcephaly and the virus in April of 2016, citing a compelling accumulation of data from Brazil. But Colombia’s microcephaly cases never materialized. They now think there is something close to an explanation: Microcephaly wasn’t appearing in just a few cases, it was appearing in just the worst cases. Zika was still causing significant brain damage even in babies without below average sized skulls. Microcephaly is just the end of the spectrum, but the brain tissue stops growing well before that. Simple head measurements are not enough to make a diagnosis for the suite of developmental defects caused by the virus, congenital Zika syndrome. These results haven’t yet been peer reviewed, but do match up with another recent study from a group of researchers in Seattle and Brazil who reported on 13 Zika infected infants born withnormal sized heads. As they got older, these children began to develop new complications. Their heads didn’t grow as fast as the rest of their bodies; they had strange muscle weaknesses and spasms. MRIs showed that inside their skulls they had decreased brain volume, too much fluid in certain brain tissues. That means there may be a lot of babies out there who have yet to show signs of congenital Zika defects. If brain scans don’t expose them, time will. Zika Virus: B.C. Cases Rise to 47 Including 3 Pregnant Women. This is a clinical study but if proven correct it will mitigate (but not prevent completely) doubt about the cause of Ziki neurological symptoms. More importantly fewer resources will be diverted disproving conspiracy theory and fewer people avoiding medical assistance for pseudo cures.

-4.2. Gov. Scott's "Fighting for Florida's Future" Budget Makes Key Investments in Zika Preparedness investing $2.9 billion to protect the health and well-being of Florida families and visitors. The budget focuses on enhancing epidemiological resources, boosting existing programs focused on children and continued technological improvements. Too bad that he slashed the same budget before Zika. 170129-T.1*, 161113-4.1H, 161023-4↓+.

-4.3. Brazil on High Alert as Yellow Fever Threatens Major Cities. The uptick comes exactly a year after the Zika virus – another mosquito borne disease – was declared a global health emergency, and as during the previous epidemic Brazilian authorities are struggling to calibrate an appropriate response. Because there is a vaccine, yellow fever should, in theory, not cause as much of a panic but global vaccine stocks are dwindling, and the disease is far more deadly than Zika. Brazil is already unstable and this is another biodisaster punch. Brazil Is Suffering an Almost Biblical Tidal Wave of Plagues Right Now. Why More than 200 New Dams Will Be a Disaster for the Amazon. Brazil: Deforestation in the Amazon Increased 29% over Last Year.

-4.4. Trump's Budget Director Pick: “Do We Really Need Government Funded Research at All”*, suggesting Zika science is uncertain, so we shouldn’t bother to fund it. This is a reasonable position for an accountant. There purpose is to assure that any action will pay for itself. Money will be wasted on dead ends with the uncertainties of research. Only absolute certainties should be funded such as meeting the life long health, education and other care of neurologically damaged children. These people will never contribute to the economy directly (or be voters) but the need for facilities, equipment, mortuary services, care takers will indirectly provide jobs. Even if a solution is found to prevent future neurological damage, or provide the basis for controlling similar disease and vectors in the future it will still mean money spent now, as opposed to important spending such as deportation of mosquitos, mosquito proof borders, investigations that all mosquitos are here legally, and preventing mosquito voter fraud. The money not spent now can provide about 25% of the costs later when there is greater political benefit to finding a solution. Appropriation Negation. Though it has since been deleted, Mick Mulvaney did pose this question in a Facebook post in response to a scientific study casting doubts on the role of the Zika virus in causing infant microcephaly. [Quote, Meme]. Search Zika + Congress + Funding.

-*. New Zika Vaccine Candidate Protects Mice and Monkeys with a Single Dose is from research that was government funded, albeit the funding was delayed and may have been found earlier if funds had been available earlier. This does not mean that this will become a vaccine for humans, but such is the nature of looking for something unknown in an unknown area.

-A. A better line of attack for anti-science is about the risks of some research. Though this already have government oversight there is still the possibility of an accident or intentional release, and those that would oppose blocking funding for science, might be supportive of not funding science because of these risks. Dual Use Science, Technological Innovation. Debunking the “Mistakes Science Made” Tropes. Defining Dual Use Research: When Scientific Advances Can Both Help and Hurt Humanity.

-4.5. Congress Needs to Act Now to Prevent Another Biodisaster like Anthrax, Zika. Besides the pertinence to this stub this is a different definition of bio(logical) disaster than parademic bio(sphere)disaster (oft time due to human behavior), and the official Biological Disaster Law and Legal Definition. This usage in the article combines both natural (not due to man) and man made (terror, lab accident, creating habitats for toxin producing life forms) bioagents, a liminal between biological and biosphere. Expert Views on Climate Finance in the Age of Trump. Is Donald Trump an Ebola Level Global Health Threat. Science Curiosity and Political Information Processing. T.B, T.2↓.

-5. Public Health and Public Trust: Survey Evidence from the Ebola Virus Disease Epidemic in Liberia. Trust in government has long been viewed as an important determinant of citizens' compliance with public health policies, especially in times of crisis. Yet evidence on this relationship remains scarce, particularly in the developing world. We use results from a representative survey conducted during the 2014–15 Ebola Virus Disease (EVD) epidemic in Monrovia, Liberia to assess the relationship between trust in government and compliance with EVD control interventions. We find that respondents who expressed low trust in government were much less likely to take precautions against EVD in their homes, or to abide by government mandated social distancing mechanisms designed to contain the spread of the virus. They were also much less likely to support potentially contentious control policies, such as “safe burial” of EVD infected bodies. Contrary to stereotypes, we find no evidence that respondents who distrusted government were any more or less likely to understand EVD's symptoms and transmission pathways. While only correlational, these results suggest that respondents who refused to comply may have done so not because they failed to understand how EVD is transmitted, but rather because they did not trust the capacity or integrity of government institutions to recommend precautions and implement policies to slow EVD's spread. We also find that respondents who experienced hardships during the epidemic expressed less trust in government than those who did not, suggesting the possibility of a vicious cycle between distrust, non-compliance, hardships and further distrust. Finally, we find that respondents who trusted international non-governmental organizations (INGOs) were no more or less likely to support or comply with EVD control policies, suggesting that while INGOs can contribute in indispensable ways to crisis response, they cannot substitute for government institutions in the eyes of citizens. T.1, C.3↓.

-5.1. Closer Look at What Caused the Flint Water Crisis. Flint, Michigan, continues to grapple with the public health crisis that unfolded as lead levels in its tap water spiked to alarming levels. Now the scientists who helped uncover the crisis have tested galvanized iron pipes extracted from the 'ground zero' house. They confirm that the lead that had accumulated on the interior surface of the pipes was the most likely source of the lead contamination. This is the clinical description of identifying the causative agent and source of the problem, but in now way describes what caused the crisis, the parademic description. The decisions of switching water without accounting for old pipes, the inability for the community to warn of a problem, why it was ignored, the fact that this could have all been prevented or at least caught early. Scientists Now Know Exactly How Lead Got Into Flint's Water. New report points blames corrosion and warns that fixing lead poisoning nationwide will require more work than we hoped. Fortunately this need is already part of the current plans, Why Trump’s Infrastructure Spending Plan Will Be a Boon for the Water Industry, or maybe not, Trump's Infrastructure Plans Will Hamper Access to Clean Water. In the meantime Science Is Falling Woefully Behind in Testing New Chemicals in water. Giardia: Coming to a Faucet Near You.

-5.2. Comparison of Social Resistance to Ebola Response in Sierra Leone and Guinea Suggests Explanations Lie in Political Configurations Not Culture C.3↓. Sierra Leone and Guinea share broadly similar cultural worlds, straddling the societies of the Upper Guinea Coast with Islamic West Africa. There was, however, a notable difference in their reactions to the Ebola epidemic. As the epidemic spread in Guinea, acts of violent or everyday resistance to outbreak control measures repeatedly followed, undermining public health attempts to contain the crisis. In Sierra Leone, defiant resistance was rarer. Instead of looking to ‘culture’ to explain patterns of social resistance (as was common in the media and in the discourse of responding public health authorities) a comparison between Sierra Leone and Guinea suggests that explanations lie in divergent political practice and lived experiences of the state. In particular the structures of state authority through which the national epidemic response were organised integrated very differently with trusted institutions in each country. Predicting and addressing social responses to epidemic control measures should assess such political-trust configurations when planning interventions. C.3↓. I have some qualms about separating culture and politics, but this appears to be using different definitions than I am familiar with, and the point being made is a valid one.

-5.3. From ‘Trial Community’ to ‘Experimental Publics’: How Clinical Research Shapes Public Participation. In relation to clinical trials, it is far more usual to speak of the community (singular, static) than of publics (multiple, emergent). Rarely defined, the community is commonly taken to be the existing people in a given area, which the trial will engage, mobilise or sensitise to facilitate successful recruitment and retention. Communities are assumed to pre-exist the research, to be timeless, and to be a whole (sometimes consisting of different parts, referred to as stakeholder groups). In this paper, we suggest a conceptual shift from ‘trial community’ to ‘experimental publics’. Using an empirical case study of an HIV prevention trial in Zambia, we draw out the following key points: firstly, publics do not pre-exist research activities but are enacted in concert with them. Secondly, publics are dynamic and transient. And thirdly, experimental publics are situated at the intersection of various forms of inclusion and exclusion, both locally and globally. Our findings emphasise the need to create long-term forms of participation in science, which transcend both the instrumental goals and the individual timelines of specific trials. The recent conflict in Florida over GMO mosquito testing touched the same topic, the worry of a community that they were an experimental guinea pigs. [Photo, Photo, Meme] 161113-4.1A, 161009-4.3↓.

-6. If this is something that can be generalized more widely it could give clues to how to communicate public health knowledge to this generation of the population. Millennial Generation's Learning Preferences in Medical Education Examined. The classroom can reflect its students' learning preferences, and a study demonstrates evidence of this in medical education. The study focuses on competency based medical education, which consists of milestones and entrustable professional activities. The study notes that this change in attitude about competency based education coincided with the increased presence of millennial medical students in the classroom. Defined as individuals born between 1982 and 2000, the millennial generation is described by the study as displaying more needs for perfectionism, transparency, rules and emotional stability, and less self reliance*, while setting high expectations. The step based approach of competency based medical education is formed on a continuum beginning at the novice level and provides milestones where specific feedback is offered to learners. The milestone based assessment provides a sense of mentorship to students by continuously following them down a spectrum and evaluating their performance. This assessment allows the individuals providing feedback to be very specific and tailor that feedback to millennial learners in a way that is pertinent to the skill set they'll need in their medical profession. C et al↓.

-*. The self reliance issue is what I think is the most difficult to overcome. It can be documented that childhood has been increasingly pushed from ending about age 12 to now about age 25, with legal adulthood around 18. The lack of independence at older ages is frustrating for those in instructional roles who see younger people asking for help for things that they remember they were doing independently at a younger age, while at the same time refusing to ask for help or blaming failure on not being given help, for what they should have asked for help on.

-7. ∩ Example of a cascade where each of the little disasters that, though disruptive, are correctable if encountered one at a time, and there is time to recover between each. However if there is a domino effect or near simultaneous occurrence of different small disasters, these can cumulate into a big disaster, a combination knockout series of punches thrown in sequence [Sound Bubbles], or being attacked by a pack of small predators [Photo]. Chipotle Might Have a Whole New Guacamole Problem. A year after the CDC declared Chipotle's business crushing ¹E. coli outbreak over, the company is ²still trying to win back customers. ¶ Now the chain has had ³trouble keeping avocados in stock, which in 2014 caused a panic among its customers, which many news outlets dubbed the "Guacapocalypse". ¶ Before its E. coli issues, Chipotle marketed its brand around the idea that paying more for higher quality food actually counts as value. That concept became harder to push after the food safety scandal made ⁴consumers doubt the pricier equals better formula. The chain has also been hurt by fast ⁴food rivals returning to offering heavier discounts after a period where they had turned away from that. ¶ A tax on goods from Mexico could hurt numerous chains, but Chipotle's ⁶need for avocados gives it greater exposure than its rivals. If this border tariff passes, ⁷the company will almost certainly have to raise prices or stop selling guacamole because it's unlikely it will be able to source avocados from other countries or domestically in the amounts it needs. ⁸The Return of the Avocado as a Luxury Item. Throttled by climate change and wild demand, the now ubiquitous fruit is about to become even more expensive [Photo]. Except for a few mass extinction events, such as when the atmosphere was contaminated with oxygen, few biodisasters have been globally catastrophic to the point of not being recoverable from. However biodiasters have been a contributing cause to social collapse, either starting the process of making a society unstable, lacking in resilience, or further destabilizing societies that are already unstable.

-8. What Would a Reformed FEMA Look Like. Should it divorce itself from the Department of Homeland Security. My vote is yes. The conflict between law enforcement/security and humanitarian aid is an unneeded complication of top of having the conflict of Continuity of Government versus All Hazard and whole community approaches What Do We Mean by ‘Community Resilience’ A Systematic Literature Review of How It Is Defined in the Literature, not to mention a bunker mentality and a tendency toward security that hinders operations. For example giving protective markings (For Official Use Only FOUO) to disaster planning documents that tout being collaborative. It is impossible to call something a plan when not everyone who is a stakeholder implementing it knows what the plan is. There is also the tendency for security to become more and more restrictive over time because there is no such thing as perfect security, so each breach of security in solved by more restrictive measures until the organization can no longer operate to perform its mission and becomes vulnerable Eight Steps to Determine If Hyperconverged Is the Right Solution for Your Organization to an unanticipated attack because increased security causes an information bubble where new information and views cannot enter. Lie Detectors Don’t Work as Advertised and They Never Did.

-9. Flu Epidemic and Living on the Edge. People don't realize how close we are today, Jan. 28 – the day I'm writing this blog post – to being overwhelmed with flu cases in Washington state. We are in the middle (hopefully) of a significant flu outbreak and our medical system, especially hospitals, are at or near the breaking point in being able to cope with the number of sick people needing hospitalization. ¶ We walk this dance all the time with our critical infrastructure. It is a just in time delivery system that works until there is a need for a surge capacity and none exists. The breaking point is not understood to be much sooner than anyone expects. For reasons of profitability most hospitals try to keep all beds filled with the minimum staff to keep those beds functional. That could be between 4 to 25 patients would overwhelm a hospital. For a highly infectious disease that requires isolation that would be 1-4 beds, assuming the ability to create an isolation room and that the whole hospital is not loss due to having permitted infected person without safeguards. Respirators likewise are 0-4. Just in Time (JIT) has the problem that if a hospital is cut off, or suppliers can’t or won’t deliver, most hospitals only have enough supply for 2 to 3 days, and in a surge probably less of critical items. Critical Resources for Hospital Surge Capacity. Hospital Medical Surge Planning for Mass Casualty Incidents. Strengthening the Links in Disaster Supply Chain Management. Flu Season Nearing its Peak, CDC Says.

-10. Chile's Worst Wildfires Reduce An Entire Town to Ashes. Interestingly the health hazard has not so far been noted as with the 2014 Chili fires, Chile Forest Fires Spark Health Alert as Smoke Spreads and this year is a much larger and number of fires producing more smoke. My guess is that the last fires were not interesting in and of themselves so the health problem was added to give it news value. This time the fire itself is more impressive, though likely there will be an obscure report later about the smoke health affects, 170129-12↓. Chile Battles Devastating Wildfires: 'We Have Never Seen Anything on this Scale' [Photo, Photo]. No information if programs like U.S. Increases Firefighting Aid to Chile as More than 70 Blazes Rage will be stopped, or if forest fire fighteres from Latin America will be barred from entering the US. USFS Having Difficulty Hiring Firefighters to Suppress Wildfires in Area Contaminated with Asbestos.

-11. Majority of Americans Say Benefits of Childhood Vaccines Outweigh Risks, but parents of young children are among several groups that see higher risk and lower benefits of the MMR vaccine. Despite debate about the safety of childhood vaccines among some groups in the public, an overwhelming majority of Americans (82%) support requiring children attending public school to be vaccinated for measles, mumps and rubella (MMR), according to a new Pew Research Center survey. Some 73% of Americans see high preventive health benefits from the MMR vaccine and 66% believe there is a low risk of side effects from the vaccine. Overall, 88% believe that the benefits of the MMR inoculation outweigh the risks. ¶ Yet, several groups express more concern about the safety of the MMR vaccine, including parents of young children. About half (52%) of parents with children ages 4 or younger say the risk of side effects from the MMR vaccine is low, while 43% say the risk of side effects is medium or high. By comparison, 70% of those with no minor-age children say the risk of side effects is low, while 29% say the risk is medium or high. As far as potential benefits, 60% of parents with children 4 or younger say the preventive health benefits of the MMR vaccine are high, compared with 75% of parents with school age children (ages 5-17) and 76% of people with no children younger than 18. The groupings in the poll are demographic. Did not see any geographic information that would indicate if there are clusters that cross demographics that are geographic. It also did not give information that may led to understand why this minority view has influence well beyond itsnumbers. Pew Report. Vaccination Funding May Be Cut If Obamacare Ends, Public Health Experts Warn, but on the bright side this would provide a natural experiment if a large urban area does not vaccinate, as opposed to small clusters that are anti-vax, are exposed to a vaccine preventable disease. However I don’t believe this is necessary as we have pre vaccine historical records of what happens, and see what happens when a large urban area is hit with as disease that there is no vaccine for. Probably cheaper to keep funding vaccination or sending in the feds to stop the carnage. Contrary to Impressions (And Donald Trump’s Antivaccine Views) Most Americans Support Vaccine Mandates. I Love it When an Antivax “Study” Meant to Show How “Dirty” Vaccines Are Backfires So Spectacularly. Trump’s Vaccine Views Are at Odds with Those of Most Americans. Battles over Non-Medical Exemptions to Vaccination Festering in State Legislatures, which may correlated with Anti-Evolution Bills Continue to Evolve. Pew Vaccine Survey – Some Good and Bad News.

-11.1. The Strange Mental Quirk That’s Endangering the Public’s Health. “Actions have consequences”, as the saying goes. Inaction, by contrast, is a mostly neutral state of being – or so it often seems in our mind’s eye. We are, in fact, predisposed to think that harms that result from our actions are worse than those that arise from our inaction. Sins of the first variety can whisk us into “Thou shall not” territory. Sins of the second, we tend to think, are crimes of mere idleness, laziness, or thoughtlessness at worst. That bifurcation is deeply ingrained in the human psyche – and it can get us into big trouble. Such “omission bias” – the instinctive belief that doing something is inherently riskier than doing nothing – can often lead to the far greater harm. ¶ Such doubt over vaccine safety and even over the necessity of these inoculations has become endemic in America. I won’t belabor the old fact-based arguments when it comes to vaccine safety and, importantly, public safety. The bottom line is that failing to vaccinate our kids against serious and preventable illnesses is itself a serious and preventable mistake. Inaction has consequences too. Vaccine Advocates Scramble to Mobilize Against Threats to Public Health.

-12. Invasive Wild Pigs Leave a Growing Swath of Destruction Across U.S. [Map]. This invasive species has been an increasing problem for decades Can Wild Pigs Ravaging the U.S. Be Stopped (2014), A Plague of Pigs in Texas (2011), Wild Pigs in U.S. Spreading Disease, Ruining Property (2006), Feral Swine Impacts on Agriculture and the Environment (2004), History of Wild Pigs.

-13. #Book. Bubonic Panic: When Plague Invaded America by G. Jarrow. The third pandemic began in the mid 1800s when China became ground zero for this next wave, which spread to Hong Kong by 1894. Hong Kong was a busy port town and trade and travel on steamships allowed for rapid dispersion of the disease. Researchers from a number of countries sought feverishly to identify the source of the epidemic and learn how it was spread. By the late 1890s two of them had proven it was rat fleas. Unfortunately almost nobody believed them, which became problematic when in 1900 San Francisco saw its first deaths in Chinatown. ¶ Jarrow provides a fascinating look at the political and social climate of this period in relation to the attitudes of Americans towards Chinese immigrants and the impact quarantining San Francisco’s Chinatown would have on businesses reliant on trade and tourism. It became a complicated and fraught tug o war between politicians, businessmen, doctors and public health officials, fighting about whether to recognize and publicize the deaths and quarantine when the evidence seemed inconclusive as to their cause. Even after proof was offered action was surprisingly slow to follow and the disease was able to spread, although the number of deaths was comparatively low, being in the low hundreds. [Cover]. This appears to be a school textbook.

↕T. Trump Says ‘All Is Going Well’ on Immigration Order amid Questions and Confusion. This statement is consistent with previous comments made during Ebola, Trump Wanted to Keep Americans Critically Ill with Ebola out of the U.S. [Tweet, Video], and worldview that immigrants bring disease Do Mexican Immigrants Bring Disease into the US. Donald Trump Says There’s a Health Scare, but Statistics Say Otherwise, and Islam is a threat Trump: 'I Want Surveillance of Certain Mosques' [Tweet]. This is also in concert with the Wall [Meme, Poem, Meme, Meme], and continued decline in trust, increase is mistrust (the two don’t necessarily correlate or have a causal relation) The US Has Been Downgraded to a “Flawed Democracy,” but Not Just Because of Trump. The Deep Denialism of Donald Trump. 7 Lessons from Psychology That Explain the Irrational Fear of Outsiders. How Executive Orders Work.

-A. Unless there is something very different that happens this entry will be limited to Monday, Jan 30, reports. Otherwise this will become too long and not provide anything that is not a repeat of what happened in previous Trumpism/Parademic Social Disruptions. Pattern is well established with push back, intransigence, social adjustments to situations that were not prepared for and codified, denouement and escalation. Not dissimilar to Freeze responses before there is sufficient familiarity with behavior that is outside of social and legal norms Fear of Retaliation - Why We Tend Not to Enforce Social Norms to decide to chose a response of ignore/avoid, wait and see/delay (believe that point is now past), fight or flight 161023-8, 160918-1, 160904-4.4, 150201-4↓+. ¶ This is an illustration why parademic uses a Monday to Sunday for weekly collection periods, that seems to correspond to newscycles. Suspect in this case that it was though that this newscycle could be taken advantage of by making an announcement before the weekend so the story would not spread, possibly die, thus avoiding resistance. There was apparently a lack of understanding about social media that spread the news sufficiently for there to be outrage while official channels were unable to answer questions to allow smooth implementation, or avoid implementation.

-B. There are unintended consequences, most of which can be put under the umbrella term “outrage” ones that I have come to be expected in parademic:

¶ As is normal in parademic, the above categories for behavior from the ban blends and blurs categories that in stable situations are clear cut. This is not unusual in disaster where mental templates [Map] The 2017 Political Risk Map, definitions of words and what were certainties become disrupted.

-Quote: If the views the president wants to execute are unlawful, should the attorney general or the deputy attorney general say 'no. – Senator Jeff Sessions to Sally Yates during 2015 Senate confirmation hearing for deputy attorney general.

-*B. There are indicators that causing fear of refugees was the goal of ISIS. This not only causes dissension in countries that were willing to take refugees but also creates a pool of future recruits who will be desperate, easily swayed, disenfranchised, stigmatized, and have suffered from broken promises and harm by “the West”. This also creates an impoverished population that is susceptible to disease, will damage the environment in the form of slums and refugee camps, both of which can lead to biodisaster Low Socioeconomic Status Reduces Life Expectancy and Should Be Counted as a Major Risk Factor in Health Policy. This could be as extreme as someone willing to be infected and become a suicide vector, or simple as reservoirs to hide toxins and pathogens as they grow toward acceleration. The intent of Terror is to create strategic terror, not a successful limited tactical victory, but leveraging limited resources and events into impact far beyond the real impact. Five Reasons Refugees Are Good for U.S. Security, UN Report Finds No Evidence Migration Causes Terror Attacks and Warns Anti-Refugee Laws Could Worsen Risk, Do Syrian Refugees Pose a Terrorism Threat, Migrant Crisis and Euro Tensions Threaten to Trigger Catastrophic Conflict Claim Experts, Paris Attacks Stoke Fears of Refugees, and That’s What ISIS Wants, Can Terrorists Really Infiltrate the Syrian Refugee Program, You Should Fear Racism and Xenophobia, Not Syrian Refugees or Muslims, The Intense Backlash to Syrian Refugees 'Plays Right Into' ISIS’ Hand. These all predate the Jan 20 Inauguration, and likely Intelligence agencies have more definitive evidence, if it was heard. This selection of articles was biased, but the assumption is that there is sufficient counter arguments circulating that paint refugees as Terrorists, or that will be invented as justification New Yorkers Hold Vigil for Victims of 'Bowling Green Massacre', Remember Bowling Green, Now You Can Donate to the “Victims” of the Nonexistent Bowling Green Massacre, not unlike rumor and propaganda against public health and medicine. Again a lesson not learned. The U.S. Government Turned Away Thousands of Jewish Refugees, Fearing That They Were Nazi Spies.

-C. There is however the advantage of greater entrenchment of supporters, similar to anti-science beliefs becoming more intransigent when presented evidence against their beliefs, Trump Voters Shrug Off Global Uproar Over Immigration Ban, In Ban on Migrants, Trump Supporters See a Promise Kept, (Throwing Science at Anti-Vaxxers Just Makes Them More Hardline). In fact there will undoubtedly be reactions by others to this action that then can be proof that the action was the correct one to take Iran Tests Ballistic Missile in Defiance of UN Resolution (Don’t Call Them Dumb: Experts on Fighting the Anti-Vaccine Movement), and continued justification of erroneous beliefs It’s Naive To Think Illegal Aliens Aren’t Voting – By The Millions\fs24plain (Why Anti-Vaxxers Just 'Know' They're Right). 2.1Quote↑ [Quote].

-T.1. Another new political term related to T↑, Fake Tears. Schumer Gets Emotional Discussing Trump's Immigration Ban. Trump Accuses Top Democrat of 'Fake Tears' over Executive Order. Trump’s Joke about Schumer’s ‘Fake Tears’ Sours an Already Complicated Relationship. [Tweet]. Trump Accuses Schumer of Shedding 'Fake Tears' over Refugees. Possibly a continuation of a previous [Meme]. Good example of how easy it is to reframe something as something else, changing a debate of an issue into debate if something is real or not Why Don't West Africans Believe Ebola Is Real, Distrust of the Health Care System and Self Reported Health in the United States. From this and non parademic Trumpism a pattern is emerging. The aim seems to create an inner core that is in concert, and to create disharmony outside this core. This is associated with autocratic management/leadership styles. Donald Trump's Leadership Style in 5 Words, How to Deal with Autocratic Leadership, Debating Donald Trump's Radical Leadership Style: Innovator or Narcissist. This is a complete opposite of the cooperation, collaboration of one health that is required to effectively deal with biodisaster and turn parademic into support and facilitators of solutions rather than hindrances and barriers.

-Quote: One of the little celebrated powers of Presidents is to listen to their critics with just enough sympathy to ensure their silence. – John Galbraith

-T.2. Trump Pushes Drugmakers for Lower Prices, More U.S. Production. We’re going to streamline the FDA Trump said. The meeting between Trump and the pharmaceutical executives signaled a defusing of tensions that have kept drug stock prices in check since the presidential election. Shares rallied following the meeting, even as the broader stock market slid. Trump is a populist above all else, and having these (drug) prices skyrocket, he’s commented that under his administration, this is not going to happen. Trump is playing a balancing act between controlling prices and loosening regulations. Trump’s Health Care Agenda. Evolving U.S. Workforce Is Central to Quality of Care. U.S. House Panel to Take up Bill to Spur Generic Drug Development. House Lawmaker Pushes Bill to Rein in Drug Prices, Bill Would Aim to Curb High Drug Prices by Triggering Competition Through Generics. This will probably have the opposite result. Ittakes years, money and lots of research that leads nowhere to develop drugs in the first place. Taking away profit motive will likely result in fewer drugs being developed. Why spend the time and money when there is no profit to do so. This would make the government the sole producer and new research for drugs. Probably not a good idea with antibiotic resistence, emerging diseases, novel diseases, toxins in the environment, vectors increasing their ranges. This is especially the case if the idea that it is a waste for taxpayers money to do so 4.5↑. Trump vows to ease rule for Drug Makers, but Again Zeros in on Prices. If Trump Wants to Lower Drug Prices, He’s Going about it All Wrong. Dangerous Infectious Diseases – Good News for Wall Street.

-A. Popularism and healthcare is a risky combination. One is juggling mainlining popularity by decreasing costs, speeding the process of medicine production which is risking iatrogenic mistakes and is expensive, without a means to sustain. Potential result could be something as is currently being observed in Venezuela. Great at first, except for unintended death and increasing instability as the system limps along, and then falls apart. That was taking an incomplete health system that was not working and artificially improving and sustaining it. What is being proposed is dismantling an all service of a dynamic functional system (recognizing there are flaws) that is self sustaining, and recreating the system with the goal of functioning as well as the previous one without flaws and makes a select segment of the population happy. A Look at the Venezuelan Healthcare System. Are Venezuelans Better off under Chavez. The Legacy of Hugo Chávez. The Collapse of Chávezcare. In Post Chavez Venezuela, Health Care Ails, Food Is Scarce and Crime Is Everywhere. In Venezuela, We Couldn’t Stop Chávez. Don’t Make the Same Mistakes We Did. 5↑, 161002-6, 160814-11, 160529-4.2, 160228-4.2↓. [Journal]. How to Build an Autocracy. ¶ A potential stemming from this to watch for is medical personnel being kicked out of health insurance networks, or losing hospital privileges due to their country of origin, or patients losing health care because of religion or country of origin. This goes against the medical ethic of providing care without declining to treat due to gender, country of origin, sexual orientation, ethnicity, religion, politics. Medical insurers and administrations however are not constrained by medical ethics.

T.2.1. This story already has legs, but this action will guarantee it will continue for awhile, State Dept. Reverses Ban, Allowing Travelers with Visas into U.S, Homeland Security Suspends Implentation of President Trump’s Travel Ban [Tweet, Tweet, Tweet replays of Tweet, Tweet, Tweet]. However. this continued story will probably be outside the purview of parademic into pure politics and ranting with limited biodisaster implications. The damage of these implications are already done and may take years to recover from, to include social media, fake news and fear/hate mongering panic Social Media Reports of Deportation Checkpoints False [Social Media]. Iranian Baby Will Be Allowed into US for Life Saving Surgery. Sometimes though social media rumor has a good result Defendant Duped by Ebola Meth Hoax on Plea Docket.

-T.2.2. Trumpism has already received iconic images of the deadly sins [Meme, Meme] and the 4 horsemen of the apocalypse [Meme, Cartoon]. The one to watch for is the Grim Reaper [Photo], especially if it depicting one of the Trumpism associated figures, to include Trump, Pruitt and Price, as the Grim Reaper in the context of a current accelerated biodisaster. [Art]. Bizarre Email from Trump’s HHS Spokesperson.

-T.3. All of the above T are indicative of a lack of long term thinking and An Impulsive Cognitive Style Comes with Implications. Know anyone who would rather have $40 right now than $80 next month. Psychology researchers have just published a sprawling study about such folks. It shows them to have a mild but consistent set of tendencies – the scientists call it a "surprisingly broad cognitive phenotype" – to take the quicker and simpler path when thinking about logical challenges, the people around them, the societies they live in and even spiritual matters.

-T.4. The EPA Has Started to Remove Obama Era Information. A group of researchers have found what are likely the first steps in a major overhaul of a site that’s been closely watched since President Trump’s inauguration on Jan. 20. Federal climate plans created under former President Obama, tribal assistance programs, and references to international cooperation have been stricken from the site. ¶ A mention of carbon pollution as a cause of climate change has also been removed and adaptation has been emphasized, indicating an attempt to separate the cause of climate change from the response. Some of the changes are housekeeping, according to an agency statement. This action was anticipated and in comparison to other action that impact parademic is relatively restrained. Unknown at this time if this is simply a changing of tone to be more palatable to current policy, or if the beginning of incremental but dramatically different reframing of climate change. The saving of data now seems to have been a wise step rather than paranoia, Rogue Scientists Race to Save Climate Data from Trump, Scientists Are Copying U.S. Climate Data, Fearing it Might Vanish under Trump, WikiLeaks Offers to Save Climate Data from Trump, 170129-T.1, -T.4↓. How Hitler Perverted the Course of Science, Was Nazi Science Good Science, Hitler’s World May Not Be So Far away, The Disgraceful Episode of Lysenkoism Brings Us Global Warming Theory, Stalin and the Soviet Science Wars. Comparisons to other regimes and historical figures are not to indicate that Trumpism is of the same beliefs. The intent is to only draw from the use of similar techniques and processes to reframe, justify policy that is contradicted by science based evidence, and forward agendas that are ultimately harmful. Fearful Americans Stockpiling Facts Before Federal Government Comes to Take Them Away.

↕C. Crisis and Emergency Risk Communication (CERC) Corner [Logo]. Why Listening is Crucial to Communicating 6↑. While it’s important to share information as quickly as possible during an emergency, it’s important to get information affecting your target audience as well. Understanding a community’s specific needs can help you tailor public health recommendations to make them easier to access, understand, and follow. ¶ Time is precious during a disaster, but taking the time to listen to people affected by a crisis is crucial for effective communication. The right message at the right time from the right person can save lives. However, that message may need to come in different formats through different channels to reach everyone affected by a public health emergency. ¶ Listening to communities in crisis can tell you: • What concerns are most upsetting, • What questions need to be answered, • Which messages need more explanation, • Which public health recommendations are not working. ¶ Changing your messages based on community input may increase the number of people who are able to take your suggestions, change their behaviors, and avoid future risks to their health and well being. ¶ During a disaster, the public often tells you—directly or indirectly—exactly what information they want to hear from you. Below are a few ways you can hear what they’re saying. • Media monitoring: Both traditional and social media may indicate what the public is thinking. Media monitoring can reveal rumors and public reactions worth addressing. • Helplines: Helplines can expose information patterns and gaps. This awareness can help you improve messaging and outreach efforts. • Town Hall Meetings: Meeting with community members in person can be extremely informative. These forums can uncover how messages are being received and interpreted. They can also support open channels of communication. ¶ The best time to start understanding what a community needs is before a crisis ever occurs. Building relationships with community representatives will allow you to assess and meet people’s needs quickly. Listening to early input from communities can help you manage information before rumors become anissue. This issue did not provide a link. One may have to go to the Newsletter Archive to find the January 2017 that this and C.1 are in.

-C.1. Communication Tips Use CDC's Clear Communication Corner and CERC Corner tips to improve the clarity of your public health messages. ¶ Why is Clear Communication Important: Clear communication is essential when addressing public health emergencies. According to CDC's health literacy facts, nine out of ten adults struggle to understand and use health information when it is unfamiliar, complex, or jargon filled. Limited health literacy is a public health issue because people cannot act on messages if they do not understand them. Using plain language and easy-to-follow layouts helps the public better understand the steps they need to take to protect themselves. ¶ What is the Clear Communication Index: CDC’s Clear Communication Index is a tool that helps writers ensure their public health messages are clear. It uses a scoring system to rate the quality of the message’s language and presentation. It can be used to assess any type of communication, from emails to podcasts. It is available to everyone. The Index scores 20 items and provides numerical scores for four main parts: 1. Part A: Core (Main Message, Call to Action, Language, Information Design, State of the Science) 2. Part B: Behavior 3. Part C: Numbers 4. Part D: Risk. ¶ The scores for each section are combined into an average score; 90 or higher is considered passing. For more information use the Clear Communication Index User Guide. The Index is easy to use and takes only 15 minutes to score material once you are comfortable with the process. Without using the index I can guarantee it will receive a low score. It is not intended to inform the public. It is intended as a resource of raw information for the health literate who will have to go through informing the public, designing the messages, and interpreting what the community is like before (build relations) and then the massive amount of direct and indirect feedback if the message is achieving the desired result. That is not achieved by superficial being fed the answers in small already digested bites. To this requires higher cognitive skills, and sort through masses of information that does not come in a consistent format, in the proper sequence, contains misinformation, and is not broken into predetermined categories.

-C.3. Communitarian Societies and Public Engagement in Public Health. For effective public health interventions in communitarian societies, public engagement must reflect cultural values that focus on preserving collectives, rather than individuals. The case of the Ebola epidemic in West Africa is used to reflect on the drivers and consequences of failure to incorporate local knowledge, local leaders and local ethical values in the adaption of programmes from elsewhere. 5, 5.2↑. ‘$100 Is Not Much to You’: Open Science and Neglected Accessibilities for Scientific Research in Africa. ‘We Can’t Do That Here’: Negotiating Evidence in HIV Prevention Campaigns in Southwest China.

-C.4. Stories Are Better than Lectures at Teaching Us about Health. Humans having been using stories or narratives to transmit crucial information for thousands of years. Despite that, Western medicine largely ignores the use of narrative and instead continues to rely on lists of dos and don’t’s, facts and figures to compel behavior change. We Have a Vaccine for Six Cancers; Why Are less than Half of Kids Getting it, Low HPV Vaccination Rates Are a 'Significant Threat to Public Health', All Those HPV Vaccine Deaths Aren't After All, Anti-Vaccination Blog Revives Debunked HPV Story. India’s Measles Elimination Campaign Rocked by Rumours, Fake Alerts Before Launch, Fake Anti-Vaccination Messages Circulated Widely on WhatsApp and Facebook, Fuelling Fears That Polio Might Return, MR Vaccine Is Safe; Ignore Claims of Side Effects.

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Parademic

Parademic is the complex, complicated, confusing, contradictory and chaotic human behaviors that occurs in the contexts of existential biosphere calamities.

02/06/2017