health-care

"There is little disagreement about what constitutes a healthy state of the organism. But there is much less agreement when one uses the notion of pathology analogically, to describe kinds of behavior that are regarded as deviant. For people do not agree on what constitutes healthy behavior... The medical metaphor limits what we can see much as the statistical view does. It accepts the lay judgment of something as deviant and, by use of analogy, locates its source within the individual, thus preventing us from seeing the judgment itself as a crucial part of the phenomenon."

"To overcome such meddling from India’s prying medical community, in 2005 Gates funded, through GAVI, a four-year, $37 million study of mass vaccination with Hib jabs in Bangladesh intending to showcase the vaccine’s benefits. GAVI’s Bangladesh study backfired, showing no advantage from Hib vaccination. In response, a formidable coterie of superstar international health experts—all of them, coincidentally, from Gates-funded organizations WHO, GAVI, UNICEF, USAID, Johns Hopkins Bloomberg School of Public Health, the London School of Hygiene and Tropical Medicine, and CDC—issued a deceitful proclamation that fraudulently claimed that the Bangladesh study proved a Hib jab protects children from “significant burden of life-threatening pneumonia and meningitis.” … Based on Gates’s orchestrated guile, WHO in 2006 took the official position that the “Hib vaccine should be included in all routine immunization programmes.” Once again, the Indian government caved in to Gates and mandated Hib vaccines in India, where Hib invasive disease was nearly nonexistent. In self-congratulatory articles, GAVI boasted triumphantly of its role in rescuing the Hib vaccine project in India after the Bangladesh study proved the vaccine a worthless waste of money. GAVI’s article notes that, since there was little burden from Hib disease in India, it had been a great challenge to gin up support for WHO’s recommendation. GAVI bragged—in technocratic argot—that it twisted WHO’s arm to revise WHO’s Hib vaccine policy from a weak permissive statement to a firm recommendation calling for universal vaccine introduction in all countries. WHO’s volte-face dragooned reticent Indian health officials to recommend the useless vaccine."

"Notwithstanding such concerns about the high costs and meager benefits of the vaccine, Gates, through his surrogates at GAVI, PATH, and WHO successfully arm-twisted the Indian government in 2007–8 into introducing the hepatitis B vaccines. GAVI pushed WHO to change the official policy to a universal recommendation, meaning that even countries with low disease burdens would be required to vaccinate. GAVI hoped this would reopen the Indian markets. WHO obligingly changed its recommendation to include universal immunization with hepatitis B vaccine for all countries, even those where HCC was not a problem. The Indian government obediently adopted WHO’s recommendation."

"In 2009 and 2012, the Gates Foundation funded tests of experimental HPV vaccines, developed by Gates’s partners GSK and Merck, on 23,000 girls 11–14 years old in remote provinces of India. ... At least 1,200 of the girls in Gates’s study—1 in 20—suffered severe side effects, including autoimmune and fertility disorders. Seven died—about 10x the US death rates for cervical cancer, which almost never kills the young. India’s Federal Ministry of Health suspended the trials and appointed an expert parliamentary committee to investigate the scandal. Indian government investigators found that Gates-funded researchers at PATH committed pervasive ethical violations: pressuring vulnerable village girls into the trial, bullying illiterate parents, and forging consent forms. Gates provided health insurance for his PATH staff but not to any participants in the trials, and refused medical care to the hundreds of injured girls. The PATH researchers targeted girls at ashram paathshalas (boarding schools for tribal children), to dodge the need to seek parental consent for the shots. They gave the girls “HPV Immunization Cards” that were printed in English, which the girls couldn’t read. They did not tell the girls that they were part of a clinical trial and instead hoodwinked them with the lie that these were “wellness shots” that would guarantee “lifelong protection” against cancer. That was not true. PATH conducted the trials in impoverished rural areas that lacked mechanisms for tracking the adverse effects and had no system for recording major adverse reactions to the vaccines, something legally mandated for large-scale clinical trials...."

"In 2011, there were an extra 47,500 new cases of non-polio acute flaccid paralysis. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of non-polio acute flaccid paralysis was directly proportional to doses of oral polio received. In regions where children are vaccinated multiple times, the non-polio acute flaccid paralysis rate is up to 35 times higher than international norms. The non-polio acute flaccid paralysis rate in a given year correlates to the cumulative doses of oral polio vaccine received in the previous 3 years."

"The NTAGI secretariat has been moved out of the ministry to the office of Public Health Foundation of India and the 32 staff members in that secretariat draw their salaries from the BMGF (Bill and Melinda Gates Foundation). There is a clear conflict of interest — on one hand, the BMGF funds the secretariat that is the highest decision making body in vaccines and, on the other, it partners the pharma industry in GAVI (Global Alliance for Vaccines and Immunization). This is unacceptable."

"Perhaps most alarming of all, PATH did not implement any system for recording major adverse reactions to the vaccines, known technically as Adverse Events Following Immunization, or AEFIs, something legally mandated for large-scale clinical trials... In 2010, the Indian Council of Medical Ethics admitted that its own ethical protocols had been flouted in permitting the trials."

"Since 2005, the number of clinical trials in India has ballooned to 1,600 studies involving over 150,000 research subjects. Health campaigners in India have mounted a vigorous campaign calling for stricter regulation of an industry that has seen over 2,000 research participants die between 2007 and 2013. ... India’s health minister recently reported to the Indian parliament that to date, less than twenty-five family members have received compensation from foreign drug companies for loss of life. Families received an average of about $3,000 per individual – a pittance."

"What India really needs is an investigation into the flow of money from the pharma companies to the CROs [clinical research outsourcing companies] to the doctors."

"India is an example of a country where there's plenty of things that are difficult there -- the health, education, nutrition is improving and they are stable enough and generating their own government revenue enough that it's very likely that 20 years from now people will be dramatically better off and it's kind of a laboratory to try things that then when you prove them out in India, you can take to other places."

"I have no doubt in my mind that vaccination is a filthy process, that it is harmful in the end and that it is little short of taking beef."

"I cannot also help feeling that vaccination is a violation of the dictates of religion and morality. [Pg 108]The drinking of the blood of even dead animals is looked upon with horror even by habitual meat-eaters. Yet, what is vaccination but the taking in of the poisoned blood of an innocent living animal? Better far were it for God-fearing men that they should a thousand times become the victims of small-pox and even die a terrible death than that they should be guilty of such an act of sacrilege. (Part II, Chapter VI Contageous Diseases: Small-Pox)"

"The process of vaccination consists in injecting into the skin the liquid that is obtained by applying the discharge from the body of a small-pox patient to the udder of a cow… Vaccination is a barbarous practice, and it is one of the most fatal of all the delusions current in our time, not to be found even among the so-called savage races of the world. Its supporters are not content with its adoption by those who have no objection to it, but seek to impose it with the aid of penal laws and rigorous punishments on all people alike. ... (Part II, Chapter VI Contageous Diseases: Small-Pox)"

"Puliyel protests that the Gates Foundation has privatized and monetized international public health policy, transforming WHO recommendations into effective mandates and compelling poor countries to pay annual tribute to foreign Pharma overlords. Puliyel told me that India and other Asian nations are now effectively compelled to administer the vaccine and to increase Hib uptake targets, “irrespective of an individual country’s disease burden, notwithstanding of natural immunity attained within the country against the disease, and not taking into account the rights of sovereign States to decide how they use their limited resources.” He adds that “The mandate and wisdom of issuing such a directive, for a disease that has little potential of becoming a pandemic, needs to be questioned.” Dr. Puliyel’s commentary in the BMJ denounced Gates and GAVI for pushing Hib vaccine in developing countries and for falsifying the characterization of the research data in their press release: “The directive has come after a number of failed attempts to convince the scientific community of the need for this vaccine in Asia.” Puliyel described the HiB saga as “a case study on the visible and invisible pressures brought to bear on governments to deploy expensive new vaccines.”"

"In 2010, the Indian Council of Medical Ethics found that the Gates group had violated India’s ethical protocols. In August 2013, a special parliamentary committee excoriated PATH, stating that the NGO’s “sole aim has been to promote the commercial interests of HPV vaccine manufacturers who would have reaped windfall profits had PATH been successful in getting the HPV vaccine included in the UIP [universal immunization program] of the Country.” According to Dr. Colin Gonsalves, senior counsel of the Supreme Court of India, The Indian Parliament formed a committee, and it was to be a rather surprising move, because you generally don’t often have such a high level inquiry into matters affecting poor people. And that was such an extraordinary report. I don’t think the Indian Parliament has ever come out with such a scathing report. And the government officials came out and said, “We shouldn’t have authorized this, were sorry, and we’re not going to allow them again”—and now they are back, doing their same old tricks again."

"In 2012, the British Medical Journal wryly noted that polio eradication in India “has been achieved by renaming the disease.” That year, the disillusioned Indian government dialed back Gates’s vaccine regimen and evicted Gates’s cronies and PIs from the NAB. Polio paralysis rates dropped precipitously. After squandering half of its total budget on the polio epidemic—at Gates’s direction—the WHO reluctantly admitted that the global polio explosion is predominantly vaccine strain, meaning it is happening because of Gates’s vaccine program. The most frightening epidemics in Congo, the Philippines, and Afghanistan are all linked to the vaccines he promoted. Polio had disappeared altogether from each of those nations until Gates reintroduced the dreaded disease with his vaccine... As the British Medical Journal reported in 2012, “the most recent mass polio vaccination programs [in India], fueled by the Bill and Melinda Gates Foundation, resulted in increased cases [of polio].”"

"... The results of the European Cooperative Acute Stroke Study III (ECASS III) ... (ClinicalTrials.gov number, NCT00153036), reported in this issue of the Journal, teach us many lessons, some medical and some political, and clearly provide powerful, persuasive evidence that is safe and effective for patients with acute stroke. … The rationale for ECASS III arose from a pooled analysis of several previous studies that had differing time windows for enrollment. ... Analyses from the resulting pooled sample suggested that thrombolytic therapy could be beneficial even when given more than 3 hours after the onset of symptoms, and ECASS III was designed to confirm this hypothesis. As the authors of this article point out, however, neither their results nor those of the previous pooled analysis suggest that the ideal window for acute thrombolytic therapy is 4.5 hours after the onset of a stroke, because we know that the potential for neurologic rescue declines monotonically with every passing minute. ... I like to pose this scenario to my trainees: a patient presents to you 30 minutes after the onset of a left hemispheric stroke; how long do you have to initiate thrombolytic therapy? The correct answer is 1 minute, not 2.5 hours, and ECASS III does not now justify an answer of 4 hours. From the moment the patient arrives at the door, every minute counts ..."

"(AF) is associated with an increase in mortality and morbidity, with a substantial increase in stroke and systemic . Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home than strokes unrelated to AF."

"Our stroke expert, Sarah Song, MD, MPH, assistant professor of neurology at in Chicago, offers this valuable advice. Act FAST. Being able to recognize the signs of stroke will help you respond faster and get help sooner and may result in less disability, says Dr. Song. "Remember the acronym FAST: Face, Arm, Speech, Time," she says. "The face can droop on one side. The arm can be weak or numb. Speech can be garbled, slurred, or nonsensical. Time is of the essence." If you notice any of these symptoms in yourself or anyone else, call 911 and get to the hospital as quickly as possible. "Treatment for stroke is most effective for patients who arrive at the hospital within four and a half hours of the start of symptoms," says Dr. Song. Always call 911. "Some people think they should drive to the emergency department," says Dr. Song. But stroke units in hospitals across the country now work closely with first responders, she says. EMTs are trained to spot the signs of stroke and can connect patients with stroke doctors quickly to prevent long waits in waiting rooms and emergency triage. "Calling 911 is the single best way to get yourself or someone you love evaluated and treated for stroke," she says."

"Stroke versus TIA? s (TIA) occur in approximately 15% of patients before an eventual stroke, with the highest risk in the first days following an event ... While TIAs do not always come to medical attention, their presentation in the acute stroke setting ostensibly complicates the treatment decision in patients who may be exhibiting improvement. The majority of TIAs resolve in less than 60 minutes whereas the majority of true strokes reach peak deficit in the same time frame. A 2009 scientific statement from the / discourages the use of traditional time-based definitions of TIA in favor of a tissue-based definition (i.e. the presence or absence of lesions on diffusion-weighted ) ..."

"... 's part in the has drawn fire as a quixotic quest after the mirage of collective security through the , an allegedly utopian, or "Wilsonian," endeavor that traded vague dreams for harsh realities and derailed a more realistic settlement, which might have lasted. Worst of all, arguments about the political fight at home over the treaty and membership in the League have cast him as a stubborn, self-righteous spoiler who blocked reasonable compromise. That view of him has often overlooked or minimized one glaring fact: in the middle of this fight, he suffered a stroke that left him an invalid for his last year and a half in office. Wilson's stroke caused the worst crisis of presidential disability in American history, and it had a effect on him. Out of a dynamic, resourceful leader emerged an emotionally unstable, delusional creature."

"What is a stroke? ... how common is it? It is the leading cause of serious disability of adults in the United States. It is the fifth leading cause of deaths in the United States. Moreover, it is the second leading cause of deaths worldwide ... it is characterized by injury to the brain from or rupture of a . There are two broad types of stroke. The first is blockage of a blood vessel — that accounts for eighty percent of strokes ... And there's , which accounts for twenty percent ... due to rupture of a blood vessel."

"’s (AC) method is a pharmacotherapy-free approach to quit smoking that is delivered through seminars, online courses, or in the form of a book. It has gained popularity, but its effectiveness remains controversial due to a lack of scientific evidence."

"There is high‐certainty evidence that can aid long‐term smoking cessation. However, bupropion also increases the number of adverse events, including psychiatric , and there is high‐certainty evidence that people taking bupropion are more likely to discontinue treatment compared with placebo. However, there is no clear evidence to suggest whether people taking bupropion experience more or fewer than those taking placebo (moderate certainty). also appears to have a beneficial effect on smoking quit rates relative to placebo. Evidence suggests that bupropion may be as successful as and nortriptyline in helping people to quit smoking, but that it is less effective than varenicline. There is insufficient evidence to determine whether the other antidepressants tested, such as s, aid smoking cessation, and when looking at safety and tolerance outcomes, in most cases, paucity of data made it difficult to draw conclusions."

"If I mention , I am sure most people in this room understandably think of cocaine — but freebasing was invented by the . You add and to the tobacco leaf mixture — the smoke that's produced is more basic, more alkaline. And, as a consequence, nicotine is delivered across the {[w|Pulmonary alveolus|alveolar membrane}} even more rapidly than would otherwise be the case. And we know that the rapidity — with which a drug is delivered and sating a need for a drug — is an important determinant of its propensity to induce and maintain addiction, et cetera, et cetera, et cetera. And we could take the entire hour talking about the elements of cigarette design. … It is important that we understand that we have the most addictive substance in our community — whose use is facilitated by a perversely engineered drug delivery device."

"This variant plays essentially no role in whether an individual initiates smoking or not, which is strongly driven by environmental factors. However, if a person with the high-risk does begin smoking, they will smoke a higher number of s per day, have a higher intensity of smoking, and have a higher age of smoking cessation than those with the low-risk variant, increasing their risk for . The problem with smoking cessation pharmacotherapy using is that it works modestly, at best, and the vast majority of smoking cessation is done without any medication. However, data suggest that people with the high-risk variant rs16969968 have the greatest difficulty quitting and stand to benefit the most from medication, although the evidence is still controversial. This makes sense since this variant affects function. Improved implementation of pharmacotherapy, using patients’ genetics as a guide, could have a huge impact."

"Cigarette smoking is the primary cause of , and smoking cessation is the most effective means of stopping the progression of chronic obstructive pulmonary disease. Worldwide, approximately a billion people smoke cigarettes and 80% reside in low-income and middle-income countries. Though in the United States there has been a substantial decline in cigarette smoking since 1964, when the Surgeon General's report first reviewed smoking, smoking remains widespread in the United States today (about 23% of the population in 2001). Nicotine is addictive, but there are now effective drugs and behavioral interventions to assist people to overcome the addiction. Available evidence shows that smoking cessation can be helped with counseling, nicotine replacement, and bupropion. Less-studied interventions, including hypnosis, acupuncture, aversive therapy, exercise, , s, , s, and , have assisted some people in smoking cessation, but none of those interventions has strong research evidence of efficacy. To promote smoking cessation, physicians should discuss with their smoking patients “relevance, risk, rewards, roadblocks, and repetition,” and with patients who are willing to attempt to quit, physicians should use the 5-step system of “ask, advise, assess, assist, and arrange.”"

"Smoking increases mortality from all causes and has a crucial role in . Active smoking and exposure determine more than 30% of mortality. The exact mechanisms of cardiovascular damages are not well known, but the detrimental effect of smoking on endothelial function has long been recognized. Smoking elicits oxidative processes, negatively affects platelet function, , inflammation and vasomotor function; all these proatherogenic effects double the 10-year risk of fatal events in smokers compared to non smokers. An intriguing issue about smoking is the vulnerability of female gender. The mortality from cardiovascular diseases (CVDs) is higher in female than male smokers and female smokers show a 25% higher risk of developing CHD than men with the same exposure to tobacco smoke. This female vulnerability seems to be related to genes involved in thrombin signaling. The effects of smoking cessation have also been extensively studied. Cessation at an early age (40 years) has an impressive 90% reduction in the excess risk of death."

"The development of antibiotics is considered among the most important advances of modern science. Antibiotics have saved millions of lives. However, antimicrobial resistance (AMR) threatens this progress and presents significant risks to human health. ... The increase in AMR has been driven by a diverse set of factors, including inappropriate antibiotic prescribing and sales, use of antibiotics outside of the health care sector, and genetic factors intrinsic to bacteria. The problem has been exacerbated by inadequate economic incentives for pharmaceutical development of new antimicrobial agents. A range of specific AMR concerns, including carbapenem- and colistin-resistant gram-negative organisms, pose a clinical challenge. Alternative approaches to address the AMR threat include new methods of antibacterial drug identification and strategies that neutralize virulence factors."

"Antimicrobial resistance (AMR) has developed as one of the major urgent threats to public health causing serious issues to successful prevention and treatment of persistent diseases. In spite of different actions taken in recent decades to tackle this issue, the trends of global AMR demonstrate no signs of slowing down. Misusing and overusing different antibacterial agents in the health care setting as well as in the agricultural industry are considered the major reasons behind the emergence of antimicrobial resistance. In addition, the spontaneous evolution, mutation of bacteria, and passing the resistant genes through horizontal gene transfer are significant contributors to antimicrobial resistance. Many studies have demonstrated the disastrous financial consequences of AMR including extremely high healthcare costs due to an increase in hospital admissions and drug usage."

"Let's avoid those unnecessary antibiotics. Let's not feed the antimicrobial-resistance demon."

"The cost of antimicrobial resistance is immense, both economically as well as for human health and lives. The Organisation for Economic Co-operation and Development (OECD) has released a new report (Stemming the superbug tide, 7 Nov 2018), which predicts that 2.4 million people in Europe, North America and Australia will die from infections with resistant microorganisms in the next 30 years and could cost up to US$3.5 billion per year. Southern European countries are predicted to have the highest mortality rate due to resistant infections among countries included in the study. Furthermore, many low and middle-income countries already have high resistance rates, which are predicted to increase disproportionately. For example, in Brazil, Indonesia and Russia 40–60% of infections are already caused by resistant microorganisms, and resistance is predicted to rise 4–7 times faster in these countries than in other OECD countries."

"L'art de la médecine consiste à distraire le malade pendant que la nature guérit la maladie. translation: The art of medicine consists of distracting the patient while nature cures the disease."

"Patient expectations have changed. Many patients are active consumers of health care, comparing quality, service, and cost. They expect the highest technical quality of care, excellent customer service, and good value for the money they pay. They are interested in alternative treatments, and they ask more questions. They spend hours researching on the Internet. They do this for themselves, for their children, and for their aging parents. They judge the quality of the care and service they receive from their perspective."

"... In some cases there is a clear so-called patient zero to a fresh outbreak, perhaps the most well-known of whom is ... But the truth is we don't know the majority of patient zeroes for a given disease, because the disease has been with us since time immemorial, or it erupted and spread too fast for us to pin down its origins, or other factors like politics or wars got in the way."

"Patient empowerment is defined as helping people to discover and use their own innate ability to gain mastery over their diabetes (Funnell MM, Anderson RM. Diabetes Educ. 1991;17:37–41). While you cannot empower a patient, nurses can use strategies that will assist patients in this process. These include providing education for informed decision-making, assisting patients to weigh costs and benefits of various treatment options, setting self-selected behavioral goals, and providing information about the importance of their role in self-management (Funnell et al. Diabetes Educ. 2003;29:454–464). The skills needed by nurses include asking questions in order to understand the patients' fears, concerns, and priorities, listening to responses, and educating and supporting patients for on-going self-management"

"Physicians outside Germany before the war, in the United States in particular, were well aware of the evolving racist thrust of the health care system. They chose to remain silent."

"After Clinton's failure to reform our health care system, we ended up with a cumbersome, profit-driven, consumer-unfriendly, inefficient health care delivery system dominated by insurance companies. And I mean dominated."

"How can we tolerate a situation where the children or parents of the rich get the medical attention they need in order to stay alive, while members of working-class families, who lack health insurance, have to die or needlessly suffer—or go hopelessly into debt to get the care they need? This is an outrageous injustice and it cannot be rationally defended."

"Je le pansai, Dieu le guérit."

"Importantly, socialized medicine is not about health care, it is about control. Are you going to oppose the government or defy bureaucrats when they have the power of veto over your spouse’s or children’s health care?"

"Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane."

"Part of what a doctor can give a patient is consolation and reassurance. This is not to be dismissed out of hand. My doctor doesn't literally practise faith-healing by laying on of hands. But many's the time I've been instantly 'cured' of some minor ailment by a reassuring voice from an intelligent face surmounting a stethoscope."

"America's health care system is second only to Japan … Canada, Sweden, Great Britain … well, all of Europe. But you can thank your lucky stars we don't live in Paraguay!"

"A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society."

"A free Health Service is a triumphant example of the superiority of collective action and public initiative applied to a segment of society where commercial principles are seen at their worst."

"Every GP practice must provide face-to-face as well as telephone and online appointments, as part of making primary care as accessible as possible"

"The ruthless sell-off of Britain's National Health Service during Covid by the Boris Johnson govt is a crime against humanity."

"I suggest in The Dirty War on the NHS we look beyond this virus and ask how our current state of fear and its mass obedience will be exploit­ed in future. Will the workers ‘stood down’ ever see their jobs again?"

"The National Health Service is the closest thing the English have to a religion, with those who practice in it regarding themselves as a priesthood. This made it quite extraordinarily difficult to reform."