![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
brdgt
First off - local health news:
Norovirus outbreak at UW biggest in 10 years
Bill Novak, The Capital Times, November 12, 2008
University of Wisconsin health officials are cautioning students in dorms to wash their hands after using the bathroom and before preparing food after what's being called the biggest outbreak of the norovirus on campus in the last 10 years.
Up to 40 students were sick last weekend with a norovirus, commonly referred to as stomach flu, with the outbreak basically confined to the sixth floor of Sellery Hall, a large high-rise dormitory that houses over 1,100 students on West Johnson Street.
UW Health Services epidemiologist Craig Roberts told The Capital Times the virus is extremely infectious and tends to be most common in confined living areas such as cruise ships, nursing homes or dormitories.
"It tends to spread easily in a household, and this (dormitory) is a very large household," Roberts said. "We haven't had this big an outbreak at UW in 10 years."
University housing officials sent e-mails to residents of Sellery Hall notifying them of the outbreak, which started to be shown Friday and basically was over within a few days.
"This situation can happen from time to time, especially among large groups of people living together," said John Lucas from UW-Madison University Communications. "It's unpleasant, but something that passes fairly quickly."
The symptoms shown included vomiting and diarrhea, which tends to resolve the stomach flu very quickly, usually within a day or so, Roberts said.
Students were advised in the e-mail to wash their hands after using the bathroom and to stop washing dishes in the bathroom sinks.
Norovirus is spread literally hand to mouth, with the virus possibly carried on a person's hands and spread to food or drink that someone else might consume, such as a food service worker not washing hands properly after using the bathroom and then preparing food at a restaurant or kitchen.
Roberts said the shared restrooms at Sellery Hall are being "deep cleaned" to attempt to rid the facilities of the norovirus.
The outbreak at Sellery has been deemed contained, but Roberts said it's important for students and staff and the public to know of the risks involved if proper sanitary measures aren't taken.
"This norovirus is a general risk for everybody," he said. "We need to hand-wash after using the restroom and before preparing foods."
The Wisconsin Department of Health Services has a norovirus fact sheet online at http://dhs.wisconsin.gov/communicable/factsheets/norovirus.htm.
The e-mail sent to Sellery Hall students noted there is no treatment for the illness, but supportive treatment such as fluid replacement may be needed to prevent dehydration in severe cases.
Students who feel they might be suffering from the virus can contact University Health Services at 265-5600.
Veterans’ Families Seek Aid for Caregiver Role
By LESLIE KAUFMAN, The New York Times, November 12, 2008
Tracy Keil met her husband, Matt, in August 2005 between his first and second tours of duty in Iraq. They married in January 2007. Six weeks later, Staff Sergeant Keil was shot in the neck while on patrol in Ramadi, Iraq, and rendered a quadriplegic.
Because her husband, now 27, could no longer take care of himself, not even to get a drink of water, Mrs. Keil, 31, quit her job as an accountant to take care of him.
She tried to hire others to help her, a service that is paid for by the government, but after going through four workers in nine months she gave up. She said many of the caregivers from contractors on the government-provided list “were awful.” One did not know how to use the lift system that hoists Mr. Keil out of bed; another gossiped about the family’s private business.
But the real problem was that even the good caregivers could not help Mr. Keil live as he wanted. Regulations, for example, do not permit them to take him out of the house. “Matt is back to his old self, and we like to get out and about, go grocery shopping or a see a movie,” Mrs. Keil said. “He doesn’t want just a baby sitter.”
While she has never regretted leaving her job, the financial repercussions have been serious. Although Mr. Keil gets a full disability pension of $6,800 a month and their house in Parker, Colo., was donated to them, they have lost Mrs. Keil’s salary of $58,000 a year, as well as employer contributions to her retirement account, and her dental plan.
Mrs. Keil has joined a growing group of veterans’ families who are asking to be compensated in place of a caregiver. She sees it not only as a battle about income but also about dignity and respect.
“I am here and I take wonderful care of Matt and I enjoy it,” she said. “But he would be institutionalized without me. He is my full-time job now. I just feel like I should be compensated for that. They should value what I do.”
In the last session of Congress, families and veterans groups persuaded lawmakers to introduce legislation that, among other things, would allow families of soldiers with traumatic brain injuries to be paid for their caretaking after training and certification by the Veterans Affairs Department. The Keils think they would benefit because Mr. Keil has minor brain trauma as well. The bill did not come up for a vote but the families think it stands a better chance next year because President-elect Barack Obama has endorsed other supportive legislation and the future first lady, Michelle Obama, has said helping veterans’ families will be a priority to her.
The Veterans Affairs Department opposed the legislation, saying it would create unacceptable liability; if a veteran was injured by a family member trained by the department, it would be liable. But Paul Rieckhoff, executive director and founder of Iraq and Afghanistan Veterans of America, said families of veterans suspected that the government was not compensating them for another reason: because they know they would do the work anyway. “They are kind of being taken advantage of,” Mr. Rieckhoff said.
The question of how to best take care of a service member wounded in war is a well-worn battleground. But broader compensation for family members has become a pressing issue, veterans’ groups say, because better medical technology has allowed so many soldiers to survive with serious injuries.
In 2007, the Dole-Shalala Commission said there were 3,000 service members so severely injured that they required full-time clinical- and care-management services.
Five years into the war, “the impacts of those injuries are first being fully realized by the families today,” said Jeremy Chwat, executive vice president of the Wounded Warrior Project, an organization that is lobbying for this change.
Today’s families are less likely than those of previous generations to just accept the situation, said James B. Peake, the secretary of veterans affairs.
“When Bob Dole came home from World War II wounded,” Mr. Peake said, referring to the former Senate majority leader who lost the use of his right arm after being wounded in Italy at age 21, “his mother in Kansas quit everything she was doing and came to take care of him at the hospital, no questions asked. That’s not the case anymore,” he said. Families still race to veterans’ sides, but they are demanding more from the government.
Programs are already evolving. In the 1990s, the Veterans Affairs Department allowed family members to train with the companies under contract to provide home-health aides. Certain veterans are allowed to go through those companies to hire family members, but for only four hours a day. The department does not keep data on how many families use this program.
Families who think that program does not go far enough object to giving a third party a cut of the money, and say four hours is insignificant when they often spend 24 a day in the job. It also limits compensation to time spent on medical needs like bladder assistance and feeding, leaving out other tasks like chauffeuring and paperwork.
The sense of injustice is particularly acute for families whose loved ones are suffering from brain-related injuries and who tend to get lower levels of disability pay than those with severe visible physical ailments, like blindness or paralysis. That is the case for Ted and Sarah Wade of Chapel Hill, N.C.
Mr. Wade, now 30, was wounded in Iraq in 2004 when someone threw a homemade bomb at what Mrs. Wade describes as his “roofless, doorless, unarmored Humvee.”
He was classified as 100 percent disabled because one arm was amputated, and brain damage gave him problems with speech, memory and interpreting visual signals. When Mrs. Wade took him from the hospital she was told, she said, that he should never be out of her line of sight.
But because Mr. Wade’s needs are not of the physical variety that veterans have traditionally recognized — he can use the bathroom and feed himself, for example — the family received only $3,500 a month in pension, which includes $780 a month for an aide, or four hours of daily assistance. That does not fill all of his needs, Mrs. Wade said. Mr. Wade’s vision is so poor that he cannot cross a street by himself, his short-term memory is such that he is unsafe in a kitchen, his voice is too unclear to use the phone (even the Veterans Affairs Department sometimes hangs up on him because they cannot understand him, Mrs. Wade says), and he cannot drive himself to his numerous therapy appointments.
It also does not address the quality of his life. In February, Mr. Wade plans to attend an adaptive ski program in Colorado, and he requires someone to travel with him. He likes using his adapted bicycle to go on 30-mile rides, but requires someone to keep him safe from traffic that he cannot see.
Recently the stress of caring for Mr. Wade full time became so overwhelming that they both agreed he would temporarily go into respite care, paid for by the Veteran Affairs Department at $857 a day, or about $25,700 a month.
It is a welcome break, but makes Mrs. Wade even more determined to get compensation so she can provide more help for her husband. “What makes me mad is what I see happening to him is institutionalization,” she said, “as opposed to giving him the supports he needs for the real world.”
This article has been revised to reflect the following correction:
Correction: November 13, 2008
A picture caption with Veterans Day coverage on Wednesday misidentified a group of parade-goers wearing military-style uniforms. Although members of the military were among thousands gathered in Manhattan for the Veterans Day parade, as the caption noted, the young people shown lining up at a hot-dog cart were members of the Junior ROTC, a high school leadership program; the young people are not members of the military.
Google Uses Searches to Track Flu’s Spread
By MIGUEL HELFT, The New York Times, November 12, 2008
SAN FRANCISCO — There is a new common symptom of the flu, in addition to the usual aches, coughs, fevers and sore throats. Turns out a lot of ailing Americans enter phrases like “flu symptoms” into Google and other search engines before they call their doctors.
That simple act, multiplied across millions of keyboards in homes around the country, has given rise to a new early warning system for fast-spreading flu outbreaks, called Google Flu Trends.
Tests of the new Web tool from Google.org, the company’s philanthropic unit, suggest that it may be able to detect regional outbreaks of the flu a week to 10 days before they are reported by the Centers for Disease Control and Prevention.
In early February, for example, the C.D.C. reported that the flu cases had recently spiked in the mid-Atlantic states. But Google says its search data show a spike in queries about flu symptoms two weeks before that report was released. Its new service at google.org/flutrends analyzes those searches as they come in, creating graphs and maps of the country that, ideally, will show where the flu is spreading.
The C.D.C. reports are slower because they rely on data collected and compiled from thousands of health care providers, labs and other sources. Some public health experts say the Google data could help accelerate the response of doctors, hospitals and public health officials to a nasty flu season, reducing the spread of the disease and, potentially, saving lives.
“The earlier the warning, the earlier prevention and control measures can be put in place, and this could prevent cases of influenza,” said Dr. Lyn Finelli, lead for surveillance at the influenza division of the C.D.C. From 5 to 20 percent of the nation’s population contracts the flu each year, she said, leading to roughly 36,000 deaths on average.
The service covers only the United States, but Google is hoping to eventually use the same technique to help track influenza and other diseases worldwide.
“From a technological perspective, it is the beginning,” said Eric E. Schmidt, Google’s chief executive.
The premise behind Google Flu Trends — what appears to be a fruitful marriage of mob behavior and medicine — has been validated by an unrelated study indicating that the data collected by Yahoo, Google’s main rival in Internet search, can also help with early detection of the flu.
“In theory, we could use this stream of information to learn about other disease trends as well,” said Dr. Philip M. Polgreen, assistant professor of medicine and epidemiology at the University of Iowa and an author of the study based on Yahoo’s data.
Still, some public health officials note that many health departments already use other approaches, like gathering data from visits to emergency rooms, to keeping daily tabs on disease trends in their communities.
“We don’t have any evidence that this is more timely than our emergency room data,” said Dr. Farzad Mostashari, assistant commissioner of the Department of Health and Mental Hygiene in New York City.
If Google provided health officials with details of the system’s workings so that it could be validated scientifically, the data could serve as an additional, free way to detect influenza, said Dr. Mostashari, who is also chairman of the International Society for Disease Surveillance.
A paper on the methodology of Google Flu Trends is expected to be published in the journal Nature.
Researchers have long said that the material published on the Web amounts to a form of “collective intelligence” that can be used to spot trends and make predictions.
But the data collected by search engines is particularly powerful, because the keywords and phrases that people type into them represent their most immediate intentions. People may search for “Kauai hotel” when they are planning a vacation and for “foreclosure” when they have trouble with their mortgage. Those queries express the world’s collective desires and needs, its wants and likes.
Internal research at Yahoo suggests that increases in searches for certain terms can help forecast what technology products will be hits, for instance. Yahoo has begun using search traffic to help it decide what material to feature on its site.
Two years ago, Google began opening its search data trove through Google Trends, a tool that allows anyone to track the relative popularity of search terms. Google also offers more sophisticated search traffic tools that marketers can use to fine-tune ad campaigns. And internally, the company has tested the use of search data to reach conclusions about economic, marketing and entertainment trends.
“Most forecasting is basically trend extrapolation,” said Hal Varian, Google’s chief economist. “This works remarkably well, but tends to miss turning points, times when the data changes direction. Our hope is that Google data might help with this problem.”
Prabhakar Raghavan, who is in charge of Yahoo Labs and the company’s search strategy, also said search data could be valuable for forecasters and scientists, but privacy concerns had generally stopped it from sharing it with outside academics.
Google Flu Trends avoids privacy pitfalls by relying only on aggregated data that cannot be traced to individual searchers. To develop the service, Google’s engineers devised a basket of keywords and phrases related to the flu, including thermometer, flu symptoms, muscle aches, chest congestion and many others.
Google then dug into its database, extracted five years of data on those queries and mapped it onto the C.D.C.’s reports of influenzalike illness. Google found a strong correlation between its data and the reports from the agency, which advised it on the development of the new service.
“We know it matches very, very well in the way flu developed in the last year,” said Dr. Larry Brilliant, executive director of Google.org. Dr. Finelli of the C.D.C. and Dr. Brilliant both cautioned that the data needed to be monitored to ensure that the correlation with flu activity remained valid.
Google also says it believes the tool may help people take precautions if a disease is in their area.
Others have tried to use information collected from Internet users for public health purposes. A Web site called whoissick.org, for instance, invites people to report what ails them and superimposes the results on a map. But the site has received relatively little traffic.
HealthMap, a project affiliated with the Children’s Hospital Boston, scours the Web for articles, blog posts and newsletters to create a map that tracks emerging infectious diseases around the world. It is backed by Google.org, which counts the detection and prevention of diseases as one of its main philanthropic objectives.
But Google Flu Trends appears to be the first public project that uses the powerful database of a search engine to track a disease.
“This seems like a really clever way of using data that is created unintentionally by the users of Google to see patterns in the world that would otherwise be invisible,” said Thomas W. Malone, a professor at the Sloan School of Management at M.I.T. “I think we are just scratching the surface of what’s possible with collective intelligence.”
Supreme Court Rules for Navy in Sonar Case
By ADAM LIPTAK, The New York Times, November 13, 2008
WASHINGTON — Courts must be wary of second-guessing the military’s considered judgments, the Supreme Court said Wednesday in lifting judicial restrictions on submarine training exercises off the coast of Southern California that may harm marine mammals.
In balancing military preparedness against environmental concerns, the majority came down solidly on the side of national security.
“The lower courts failed properly to defer to senior Navy officers’ specific, predictive judgments,” Chief Justice John G. Roberts Jr., joined by four other justices, wrote for the court in the first decision of the term.
For the environmental groups that sought to limit the exercises, Chief Justice Roberts wrote, “the most serious possible injury would be harm to an unknown number of marine mammals that they study and observe.” By contrast, he continued, “forcing the Navy to deploy an inadequately trained antisubmarine force jeopardizes the safety of the fleet.”
The decision, in Winter v. Natural Resources Defense Council, No. 07-1239, came in the latest of a series of skirmishes between the Navy and environmental groups, which have fought the service’s use of sonar for about a decade. The environmentalists have had some success, using lawsuits, negotiation and persuasion, in limiting that use in training exercises around the world.
The groups say that sonar can be as loud as 2,000 jet engines, causing marine mammals to suffer lasting physical trauma, strandings and changes in breeding and migration patterns. They contend that courts are perfectly capable of weighing the competing security and environmental concerns.
Chief Justice Roberts took a different view. Courts, he said, quoting a 1986 decision of the justices, must “give great deference to the professional judgment of military authorities” in making decisions about personnel, training and priorities.
He cited an observation, made by President Theodore Roosevelt in a 1907 message to Congress, that only “practice at sea, under all the conditions which would have to be met if war existed,” can guarantee a prepared Navy.
In a conference call with reporters, lawyers for the Natural Resources Defense Council sought to minimize the importance of the decision, stressing that the Navy had agreed to abide by other restrictions on the exercises and that the group’s work in monitoring and seeking to modify what it called dangerous testing and training would continue.
Chief Justice Roberts emphasized the importance and difficulty of sonar training exercises. The nation’s adversaries, he said, have at least 300 diesel-electric submarines that “can operate almost silently, making them extremely difficult to detect and track.”
So-called midfrequency active sonar, which emits pulses of sound and receives acoustic echoes back, is effective at finding enemy submarines, the chief justice said, but only if sonar operators have become proficient in its use. He said the extent of harm to marine mammals was sharply disputed, noting that the Navy asserted that there had not been “a single documented sonar-related injury to any marine mammal” in over 40 years of similar exercises off the California coast.
Whatever the correct answer to how many animals could be harmed, Chief Justice Roberts wrote, those injuries are “outweighed by the public interest and the Navy’s interest in effective, realistic training of its sailors.”
Justice Stephen G. Breyer, joined by Justice John Paul Stevens, concurred in the decision lifting two restrictions imposed by lower courts in California, saying those courts had not adequately explained why they had rejected the Navy’s contentions. But Justice Breyer, writing only for himself on this point, said he would have imposed more limited restrictions.
Justice Ruth Bader Ginsburg, joined by Justice David H. Souter, dissented.
“Sonar is linked to mass strandings of marine mammals, hemorrhaging around the brain and ears” and acute effects on the central nervous system as well as “lesions in vital organs,” Justice Ginsburg wrote.
And though the Navy has said it can find no previous documented case of sonar-related injury to a marine mammal in such exercises, Justice Ginsburg said the service had predicted that a current set of exercises off the California coast would cause lasting injuries to hundreds of beaked whales, along with vast behavioral disturbances to whales, dolphins and sea lions.
Justice Ginsburg would have upheld restrictions imposed by a federal judge in Los Angeles and affirmed in February by the United States Court of Appeals for the Ninth Circuit, in San Francisco. The restrictions, which the appeals court stayed while the Supreme Court considered the case, required the Navy to suspend the use of sonar if it detected a marine mammal within 2,200 yards and to reduce sonar levels when water temperatures reached certain levels whether or not animals were present.
Chief Justice Roberts took issue with both restrictions. The Navy had agreed to shut down its sonar if marine mammals were sighted within 200 yards. The appeals court’s requirement that it increase the zone to 2,200 yards, Chief Justice Roberts said, would “expand the surface area of the shutdown zone by a factor of over 100,” given “the exponential relationship between radius length and surface area.”
He also discounted the appeals court’s conclusion that the rarity of the temperature condition, “surface ducting,” made restrictions on sonar use acceptable.
“This reasoning is backwards,” Chief Justice Roberts wrote. “Given that surface ducting is both rare and unpredictable, it is especially important for the Navy to be able to train under these conditions.”
Neither the majority nor Justice Breyer’s opinion directly addressed the merits of the case, reaching only the question of whether a preliminary injunction had been properly entered.
Justice Ginsburg, by contrast, concluded that the Navy had violated the National Environmental Policy Act, which requires the government to prepare environmental impact statements before undertaking major actions that will affect the environment. In this case, Justice Ginsburg wrote, the Navy is scheduled to publish the impact statement only upon completion of the current exercises, which are to end in January.
The larger message of the majority opinion was one of judicial deference to military judgments. Quoting a passage from the majority opinion in last term’s Guantánamo decision, Boumediene v. Bush, Chief Justice Roberts stressed that “neither the members of this court nor most federal judges begin the day with briefings that may describe new and serious threats to our nation and its people.”
He went on to quote from sworn statements in the sonar case submitted by senior Navy officers emphasizing the importance of the exercises.
“Of course,” Chief Justice Roberts added, “military interests do not always trump other considerations, and we have not held that they do. In this case, however, the proper determination of where the public interest lies does not strike us as a close question.”
Norovirus outbreak at UW biggest in 10 years
Bill Novak, The Capital Times, November 12, 2008
University of Wisconsin health officials are cautioning students in dorms to wash their hands after using the bathroom and before preparing food after what's being called the biggest outbreak of the norovirus on campus in the last 10 years.
Up to 40 students were sick last weekend with a norovirus, commonly referred to as stomach flu, with the outbreak basically confined to the sixth floor of Sellery Hall, a large high-rise dormitory that houses over 1,100 students on West Johnson Street.
UW Health Services epidemiologist Craig Roberts told The Capital Times the virus is extremely infectious and tends to be most common in confined living areas such as cruise ships, nursing homes or dormitories.
"It tends to spread easily in a household, and this (dormitory) is a very large household," Roberts said. "We haven't had this big an outbreak at UW in 10 years."
University housing officials sent e-mails to residents of Sellery Hall notifying them of the outbreak, which started to be shown Friday and basically was over within a few days.
"This situation can happen from time to time, especially among large groups of people living together," said John Lucas from UW-Madison University Communications. "It's unpleasant, but something that passes fairly quickly."
The symptoms shown included vomiting and diarrhea, which tends to resolve the stomach flu very quickly, usually within a day or so, Roberts said.
Students were advised in the e-mail to wash their hands after using the bathroom and to stop washing dishes in the bathroom sinks.
Norovirus is spread literally hand to mouth, with the virus possibly carried on a person's hands and spread to food or drink that someone else might consume, such as a food service worker not washing hands properly after using the bathroom and then preparing food at a restaurant or kitchen.
Roberts said the shared restrooms at Sellery Hall are being "deep cleaned" to attempt to rid the facilities of the norovirus.
The outbreak at Sellery has been deemed contained, but Roberts said it's important for students and staff and the public to know of the risks involved if proper sanitary measures aren't taken.
"This norovirus is a general risk for everybody," he said. "We need to hand-wash after using the restroom and before preparing foods."
The Wisconsin Department of Health Services has a norovirus fact sheet online at http://dhs.wisconsin.gov/communicable/factsheets/norovirus.htm.
The e-mail sent to Sellery Hall students noted there is no treatment for the illness, but supportive treatment such as fluid replacement may be needed to prevent dehydration in severe cases.
Students who feel they might be suffering from the virus can contact University Health Services at 265-5600.
Veterans’ Families Seek Aid for Caregiver Role
By LESLIE KAUFMAN, The New York Times, November 12, 2008
Tracy Keil met her husband, Matt, in August 2005 between his first and second tours of duty in Iraq. They married in January 2007. Six weeks later, Staff Sergeant Keil was shot in the neck while on patrol in Ramadi, Iraq, and rendered a quadriplegic.
Because her husband, now 27, could no longer take care of himself, not even to get a drink of water, Mrs. Keil, 31, quit her job as an accountant to take care of him.
She tried to hire others to help her, a service that is paid for by the government, but after going through four workers in nine months she gave up. She said many of the caregivers from contractors on the government-provided list “were awful.” One did not know how to use the lift system that hoists Mr. Keil out of bed; another gossiped about the family’s private business.
But the real problem was that even the good caregivers could not help Mr. Keil live as he wanted. Regulations, for example, do not permit them to take him out of the house. “Matt is back to his old self, and we like to get out and about, go grocery shopping or a see a movie,” Mrs. Keil said. “He doesn’t want just a baby sitter.”
While she has never regretted leaving her job, the financial repercussions have been serious. Although Mr. Keil gets a full disability pension of $6,800 a month and their house in Parker, Colo., was donated to them, they have lost Mrs. Keil’s salary of $58,000 a year, as well as employer contributions to her retirement account, and her dental plan.
Mrs. Keil has joined a growing group of veterans’ families who are asking to be compensated in place of a caregiver. She sees it not only as a battle about income but also about dignity and respect.
“I am here and I take wonderful care of Matt and I enjoy it,” she said. “But he would be institutionalized without me. He is my full-time job now. I just feel like I should be compensated for that. They should value what I do.”
In the last session of Congress, families and veterans groups persuaded lawmakers to introduce legislation that, among other things, would allow families of soldiers with traumatic brain injuries to be paid for their caretaking after training and certification by the Veterans Affairs Department. The Keils think they would benefit because Mr. Keil has minor brain trauma as well. The bill did not come up for a vote but the families think it stands a better chance next year because President-elect Barack Obama has endorsed other supportive legislation and the future first lady, Michelle Obama, has said helping veterans’ families will be a priority to her.
The Veterans Affairs Department opposed the legislation, saying it would create unacceptable liability; if a veteran was injured by a family member trained by the department, it would be liable. But Paul Rieckhoff, executive director and founder of Iraq and Afghanistan Veterans of America, said families of veterans suspected that the government was not compensating them for another reason: because they know they would do the work anyway. “They are kind of being taken advantage of,” Mr. Rieckhoff said.
The question of how to best take care of a service member wounded in war is a well-worn battleground. But broader compensation for family members has become a pressing issue, veterans’ groups say, because better medical technology has allowed so many soldiers to survive with serious injuries.
In 2007, the Dole-Shalala Commission said there were 3,000 service members so severely injured that they required full-time clinical- and care-management services.
Five years into the war, “the impacts of those injuries are first being fully realized by the families today,” said Jeremy Chwat, executive vice president of the Wounded Warrior Project, an organization that is lobbying for this change.
Today’s families are less likely than those of previous generations to just accept the situation, said James B. Peake, the secretary of veterans affairs.
“When Bob Dole came home from World War II wounded,” Mr. Peake said, referring to the former Senate majority leader who lost the use of his right arm after being wounded in Italy at age 21, “his mother in Kansas quit everything she was doing and came to take care of him at the hospital, no questions asked. That’s not the case anymore,” he said. Families still race to veterans’ sides, but they are demanding more from the government.
Programs are already evolving. In the 1990s, the Veterans Affairs Department allowed family members to train with the companies under contract to provide home-health aides. Certain veterans are allowed to go through those companies to hire family members, but for only four hours a day. The department does not keep data on how many families use this program.
Families who think that program does not go far enough object to giving a third party a cut of the money, and say four hours is insignificant when they often spend 24 a day in the job. It also limits compensation to time spent on medical needs like bladder assistance and feeding, leaving out other tasks like chauffeuring and paperwork.
The sense of injustice is particularly acute for families whose loved ones are suffering from brain-related injuries and who tend to get lower levels of disability pay than those with severe visible physical ailments, like blindness or paralysis. That is the case for Ted and Sarah Wade of Chapel Hill, N.C.
Mr. Wade, now 30, was wounded in Iraq in 2004 when someone threw a homemade bomb at what Mrs. Wade describes as his “roofless, doorless, unarmored Humvee.”
He was classified as 100 percent disabled because one arm was amputated, and brain damage gave him problems with speech, memory and interpreting visual signals. When Mrs. Wade took him from the hospital she was told, she said, that he should never be out of her line of sight.
But because Mr. Wade’s needs are not of the physical variety that veterans have traditionally recognized — he can use the bathroom and feed himself, for example — the family received only $3,500 a month in pension, which includes $780 a month for an aide, or four hours of daily assistance. That does not fill all of his needs, Mrs. Wade said. Mr. Wade’s vision is so poor that he cannot cross a street by himself, his short-term memory is such that he is unsafe in a kitchen, his voice is too unclear to use the phone (even the Veterans Affairs Department sometimes hangs up on him because they cannot understand him, Mrs. Wade says), and he cannot drive himself to his numerous therapy appointments.
It also does not address the quality of his life. In February, Mr. Wade plans to attend an adaptive ski program in Colorado, and he requires someone to travel with him. He likes using his adapted bicycle to go on 30-mile rides, but requires someone to keep him safe from traffic that he cannot see.
Recently the stress of caring for Mr. Wade full time became so overwhelming that they both agreed he would temporarily go into respite care, paid for by the Veteran Affairs Department at $857 a day, or about $25,700 a month.
It is a welcome break, but makes Mrs. Wade even more determined to get compensation so she can provide more help for her husband. “What makes me mad is what I see happening to him is institutionalization,” she said, “as opposed to giving him the supports he needs for the real world.”
This article has been revised to reflect the following correction:
Correction: November 13, 2008
A picture caption with Veterans Day coverage on Wednesday misidentified a group of parade-goers wearing military-style uniforms. Although members of the military were among thousands gathered in Manhattan for the Veterans Day parade, as the caption noted, the young people shown lining up at a hot-dog cart were members of the Junior ROTC, a high school leadership program; the young people are not members of the military.
Google Uses Searches to Track Flu’s Spread
By MIGUEL HELFT, The New York Times, November 12, 2008
SAN FRANCISCO — There is a new common symptom of the flu, in addition to the usual aches, coughs, fevers and sore throats. Turns out a lot of ailing Americans enter phrases like “flu symptoms” into Google and other search engines before they call their doctors.
That simple act, multiplied across millions of keyboards in homes around the country, has given rise to a new early warning system for fast-spreading flu outbreaks, called Google Flu Trends.
Tests of the new Web tool from Google.org, the company’s philanthropic unit, suggest that it may be able to detect regional outbreaks of the flu a week to 10 days before they are reported by the Centers for Disease Control and Prevention.
In early February, for example, the C.D.C. reported that the flu cases had recently spiked in the mid-Atlantic states. But Google says its search data show a spike in queries about flu symptoms two weeks before that report was released. Its new service at google.org/flutrends analyzes those searches as they come in, creating graphs and maps of the country that, ideally, will show where the flu is spreading.
The C.D.C. reports are slower because they rely on data collected and compiled from thousands of health care providers, labs and other sources. Some public health experts say the Google data could help accelerate the response of doctors, hospitals and public health officials to a nasty flu season, reducing the spread of the disease and, potentially, saving lives.
“The earlier the warning, the earlier prevention and control measures can be put in place, and this could prevent cases of influenza,” said Dr. Lyn Finelli, lead for surveillance at the influenza division of the C.D.C. From 5 to 20 percent of the nation’s population contracts the flu each year, she said, leading to roughly 36,000 deaths on average.
The service covers only the United States, but Google is hoping to eventually use the same technique to help track influenza and other diseases worldwide.
“From a technological perspective, it is the beginning,” said Eric E. Schmidt, Google’s chief executive.
The premise behind Google Flu Trends — what appears to be a fruitful marriage of mob behavior and medicine — has been validated by an unrelated study indicating that the data collected by Yahoo, Google’s main rival in Internet search, can also help with early detection of the flu.
“In theory, we could use this stream of information to learn about other disease trends as well,” said Dr. Philip M. Polgreen, assistant professor of medicine and epidemiology at the University of Iowa and an author of the study based on Yahoo’s data.
Still, some public health officials note that many health departments already use other approaches, like gathering data from visits to emergency rooms, to keeping daily tabs on disease trends in their communities.
“We don’t have any evidence that this is more timely than our emergency room data,” said Dr. Farzad Mostashari, assistant commissioner of the Department of Health and Mental Hygiene in New York City.
If Google provided health officials with details of the system’s workings so that it could be validated scientifically, the data could serve as an additional, free way to detect influenza, said Dr. Mostashari, who is also chairman of the International Society for Disease Surveillance.
A paper on the methodology of Google Flu Trends is expected to be published in the journal Nature.
Researchers have long said that the material published on the Web amounts to a form of “collective intelligence” that can be used to spot trends and make predictions.
But the data collected by search engines is particularly powerful, because the keywords and phrases that people type into them represent their most immediate intentions. People may search for “Kauai hotel” when they are planning a vacation and for “foreclosure” when they have trouble with their mortgage. Those queries express the world’s collective desires and needs, its wants and likes.
Internal research at Yahoo suggests that increases in searches for certain terms can help forecast what technology products will be hits, for instance. Yahoo has begun using search traffic to help it decide what material to feature on its site.
Two years ago, Google began opening its search data trove through Google Trends, a tool that allows anyone to track the relative popularity of search terms. Google also offers more sophisticated search traffic tools that marketers can use to fine-tune ad campaigns. And internally, the company has tested the use of search data to reach conclusions about economic, marketing and entertainment trends.
“Most forecasting is basically trend extrapolation,” said Hal Varian, Google’s chief economist. “This works remarkably well, but tends to miss turning points, times when the data changes direction. Our hope is that Google data might help with this problem.”
Prabhakar Raghavan, who is in charge of Yahoo Labs and the company’s search strategy, also said search data could be valuable for forecasters and scientists, but privacy concerns had generally stopped it from sharing it with outside academics.
Google Flu Trends avoids privacy pitfalls by relying only on aggregated data that cannot be traced to individual searchers. To develop the service, Google’s engineers devised a basket of keywords and phrases related to the flu, including thermometer, flu symptoms, muscle aches, chest congestion and many others.
Google then dug into its database, extracted five years of data on those queries and mapped it onto the C.D.C.’s reports of influenzalike illness. Google found a strong correlation between its data and the reports from the agency, which advised it on the development of the new service.
“We know it matches very, very well in the way flu developed in the last year,” said Dr. Larry Brilliant, executive director of Google.org. Dr. Finelli of the C.D.C. and Dr. Brilliant both cautioned that the data needed to be monitored to ensure that the correlation with flu activity remained valid.
Google also says it believes the tool may help people take precautions if a disease is in their area.
Others have tried to use information collected from Internet users for public health purposes. A Web site called whoissick.org, for instance, invites people to report what ails them and superimposes the results on a map. But the site has received relatively little traffic.
HealthMap, a project affiliated with the Children’s Hospital Boston, scours the Web for articles, blog posts and newsletters to create a map that tracks emerging infectious diseases around the world. It is backed by Google.org, which counts the detection and prevention of diseases as one of its main philanthropic objectives.
But Google Flu Trends appears to be the first public project that uses the powerful database of a search engine to track a disease.
“This seems like a really clever way of using data that is created unintentionally by the users of Google to see patterns in the world that would otherwise be invisible,” said Thomas W. Malone, a professor at the Sloan School of Management at M.I.T. “I think we are just scratching the surface of what’s possible with collective intelligence.”
Supreme Court Rules for Navy in Sonar Case
By ADAM LIPTAK, The New York Times, November 13, 2008
WASHINGTON — Courts must be wary of second-guessing the military’s considered judgments, the Supreme Court said Wednesday in lifting judicial restrictions on submarine training exercises off the coast of Southern California that may harm marine mammals.
In balancing military preparedness against environmental concerns, the majority came down solidly on the side of national security.
“The lower courts failed properly to defer to senior Navy officers’ specific, predictive judgments,” Chief Justice John G. Roberts Jr., joined by four other justices, wrote for the court in the first decision of the term.
For the environmental groups that sought to limit the exercises, Chief Justice Roberts wrote, “the most serious possible injury would be harm to an unknown number of marine mammals that they study and observe.” By contrast, he continued, “forcing the Navy to deploy an inadequately trained antisubmarine force jeopardizes the safety of the fleet.”
The decision, in Winter v. Natural Resources Defense Council, No. 07-1239, came in the latest of a series of skirmishes between the Navy and environmental groups, which have fought the service’s use of sonar for about a decade. The environmentalists have had some success, using lawsuits, negotiation and persuasion, in limiting that use in training exercises around the world.
The groups say that sonar can be as loud as 2,000 jet engines, causing marine mammals to suffer lasting physical trauma, strandings and changes in breeding and migration patterns. They contend that courts are perfectly capable of weighing the competing security and environmental concerns.
Chief Justice Roberts took a different view. Courts, he said, quoting a 1986 decision of the justices, must “give great deference to the professional judgment of military authorities” in making decisions about personnel, training and priorities.
He cited an observation, made by President Theodore Roosevelt in a 1907 message to Congress, that only “practice at sea, under all the conditions which would have to be met if war existed,” can guarantee a prepared Navy.
In a conference call with reporters, lawyers for the Natural Resources Defense Council sought to minimize the importance of the decision, stressing that the Navy had agreed to abide by other restrictions on the exercises and that the group’s work in monitoring and seeking to modify what it called dangerous testing and training would continue.
Chief Justice Roberts emphasized the importance and difficulty of sonar training exercises. The nation’s adversaries, he said, have at least 300 diesel-electric submarines that “can operate almost silently, making them extremely difficult to detect and track.”
So-called midfrequency active sonar, which emits pulses of sound and receives acoustic echoes back, is effective at finding enemy submarines, the chief justice said, but only if sonar operators have become proficient in its use. He said the extent of harm to marine mammals was sharply disputed, noting that the Navy asserted that there had not been “a single documented sonar-related injury to any marine mammal” in over 40 years of similar exercises off the California coast.
Whatever the correct answer to how many animals could be harmed, Chief Justice Roberts wrote, those injuries are “outweighed by the public interest and the Navy’s interest in effective, realistic training of its sailors.”
Justice Stephen G. Breyer, joined by Justice John Paul Stevens, concurred in the decision lifting two restrictions imposed by lower courts in California, saying those courts had not adequately explained why they had rejected the Navy’s contentions. But Justice Breyer, writing only for himself on this point, said he would have imposed more limited restrictions.
Justice Ruth Bader Ginsburg, joined by Justice David H. Souter, dissented.
“Sonar is linked to mass strandings of marine mammals, hemorrhaging around the brain and ears” and acute effects on the central nervous system as well as “lesions in vital organs,” Justice Ginsburg wrote.
And though the Navy has said it can find no previous documented case of sonar-related injury to a marine mammal in such exercises, Justice Ginsburg said the service had predicted that a current set of exercises off the California coast would cause lasting injuries to hundreds of beaked whales, along with vast behavioral disturbances to whales, dolphins and sea lions.
Justice Ginsburg would have upheld restrictions imposed by a federal judge in Los Angeles and affirmed in February by the United States Court of Appeals for the Ninth Circuit, in San Francisco. The restrictions, which the appeals court stayed while the Supreme Court considered the case, required the Navy to suspend the use of sonar if it detected a marine mammal within 2,200 yards and to reduce sonar levels when water temperatures reached certain levels whether or not animals were present.
Chief Justice Roberts took issue with both restrictions. The Navy had agreed to shut down its sonar if marine mammals were sighted within 200 yards. The appeals court’s requirement that it increase the zone to 2,200 yards, Chief Justice Roberts said, would “expand the surface area of the shutdown zone by a factor of over 100,” given “the exponential relationship between radius length and surface area.”
He also discounted the appeals court’s conclusion that the rarity of the temperature condition, “surface ducting,” made restrictions on sonar use acceptable.
“This reasoning is backwards,” Chief Justice Roberts wrote. “Given that surface ducting is both rare and unpredictable, it is especially important for the Navy to be able to train under these conditions.”
Neither the majority nor Justice Breyer’s opinion directly addressed the merits of the case, reaching only the question of whether a preliminary injunction had been properly entered.
Justice Ginsburg, by contrast, concluded that the Navy had violated the National Environmental Policy Act, which requires the government to prepare environmental impact statements before undertaking major actions that will affect the environment. In this case, Justice Ginsburg wrote, the Navy is scheduled to publish the impact statement only upon completion of the current exercises, which are to end in January.
The larger message of the majority opinion was one of judicial deference to military judgments. Quoting a passage from the majority opinion in last term’s Guantánamo decision, Boumediene v. Bush, Chief Justice Roberts stressed that “neither the members of this court nor most federal judges begin the day with briefings that may describe new and serious threats to our nation and its people.”
He went on to quote from sworn statements in the sonar case submitted by senior Navy officers emphasizing the importance of the exercises.
“Of course,” Chief Justice Roberts added, “military interests do not always trump other considerations, and we have not held that they do. In this case, however, the proper determination of where the public interest lies does not strike us as a close question.”
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2008-11-13 01:54 pm (UTC)That really saddens me about the Navy sonar case. I've been following that for years. The concluding sentence puts the ruling squarely on the side of public interest without even a consideration of the needs of many, many endangered species. I guess we'll have to wait for a better technological solution.
no subject
Date: 2008-11-14 03:03 am (UTC)no subject
Date: 2008-11-14 02:23 pm (UTC)no subject
Date: 2008-11-14 03:48 pm (UTC)no subject
Date: 2008-11-13 02:10 pm (UTC)no subject
Date: 2008-11-13 04:53 pm (UTC)no subject
Date: 2008-11-14 03:03 am (UTC)no subject
Date: 2008-11-14 03:02 am (UTC)And don't get me started on the reference to "the stomach flu." Sure, we all call it that, but I expect more from the newspaper when it comes to scientific accuracy than I do from the shorthand I use with my family when I'm, oh, say, on a mad dash for the bathroom on Christmas Eve five hours after eating dinner. But that's just an example...