Our third floor has been a work in progress for an embarrassingly long time now. We had some water problems the first spring we lived here, so Andy basically ripped a hole in the wall (it was this flimsy particle board) to get into the crawlspace to find the source; that began the journey, way back in spring 2007. In the fall of that year we gutted the third floor and replaced the wood-chip "insulation" with something that actually provides, you know, insulation.
With that, our heating bills plummeted and we kind of lost steam. Andy, with the help of many, gradually put up the vapour barrier over the next, um, year or so (hey, it takes a long time), but we didn't really need the space so it kind of got put on the back burner. Especially when we decided to put on a new roof to keep our brand-spanking-new insulation all dry.
Then along came Robin, who was doing fine sleeping in a bassinet in our room for a few months. Then we set up her crib in the second bedroom on the second floor, which is also our office. This was also fine, because she was a very sound sleeper, so after she was good and asleep, we could still go in and use our computers.
But now she doesn't sleep quite as soundly (don't get me wrong, she sleeps fine, as long as she doesn't wake up while we're in there and realize that hey, mom's here -- it must be playtime!) so we can't use our computers as much now. I must apologize for the lack of picture updates these days, as I can't get in there to upload them off the camera.
Anyway, the vapour barrier is long finished and the drywalling is well underway. We have WALLS! Pretty soon there will also be new flooring, light fixtures and (dare I say it) baseboards! Ooh, I got a shiver just thinking that!
I'm so domesticated.
Tuesday, May 19, 2009
Thursday, May 14, 2009
Thursday, May 07, 2009
why we immunize robin
The "debate" over the risks and benefits of childhood immunizations drives me batty.
There is a lot of information out there, but it's crucial to be very critical of each source that you look at. While not everyone has the same experience with vaccines or anything else for that matter, I think the best you can do is to look not at individual experiences but at what happens to the majority of people, because that gives you a better idea of what is likely to happen in your own case.
The problem with looking at individual cases is that it's very difficult and usually impossible to prove causation (ie. that action A caused result B) when an outcome is isolated. That's not my opinion or interpretation, that's a well-established fact; it's why we have the field of statistics. I'm not saying that A didn't cause B. A might very well have caused B, but you just don't know. Unless there's a very, very clear cause-and-effect relationship with a well-understood mechanism (eg. pushing the glass off the table caused it to fall to the ground and smash via the well-known mechanism of gravity) then it is necessary to study many cases and see if the result happens more often when the suspected cause is present than when it is absent. That's why they do clinical trials.
These trials, especially vaccine trials, are huge (30-70 thousand people, with recent vaccines), because when a result (such as a serious side effect) is rare, you have to study a LOT of people to get the side effect enough times to find out whether or not it happens in more people who get the vaccine than who get the placebo. Again, this is a statistical fact, not my opinion.
There was a vaccine against rotovirus, which causes vomiting and diarrhea and can cause severe dehydration and death especially in young children, a few years ago that was pulled off the market because it was linked to intussusception, which is an intestinal problem that can be dangerous and may require surgery to fix. There were 28 cases of intussusception that were reported after the infants had been vaccinated with RotaTeq; based on the number of doses of the vaccine that were given out, statistically this didn't exceed the number that would have been expected in that population ie. there were no more cases in the vaccinated babies compared to the unvaccinated ones, so there was no evidence that the vaccine caused the intussusception. But public outcry in the US, led by the very vocal anti-vaccine lobby, caused the manufacturer to the pull the vaccine despite the large trials (over 70 000 kids) that had demonstrated its safety.
I'm not saying that RotaTeq should have remained available; there was a potential problem that was identified and action was taken, which is what must happen. But there was a cost to having this vaccine become unavailable. The pulling of the vaccine off the market because of these 28 cases that may or may not have been caused by the vaccine has led to the illness and death of countless children in the developing world who are extremely vulnerable to rotovirus because it is very common (due to a lack of clean water in many places) and because if they do get it they have limited access to treatment, even simple hydration.
This is the problem -- the anti-vaccine lobby isn't accountable to anyone. Nobody blames them for the deaths of these kids in Africa. They can cite poor studies, anecdotal "evidence" and outright conjecture as fact because they do not answer to anyone. They have provoked enormous fear without any high-quality evidence; simply by saying, "Well, it MIGHT be a problem" they can make parents, who of course are appropriately horrified at the thought that something they do might cause harm to their children, they cast doubt on an intervention that has been so successful at reducing the burden of these diseases that people have the luxury of forgetting how serious they can be.
It is not enough to simply state that there are two opinions on an issue; it is equally or more important to carefully evaluate the evidence behind each opinion and to decide what evidence deserves to be weighed more heavily. You can't have a debate if one side is citing high-quality evidence while the other side just says, "Well, I BELIEVE it's a problem." That's not a debate -- that's just an argument.
There is a lot of information out there, but it's crucial to be very critical of each source that you look at. While not everyone has the same experience with vaccines or anything else for that matter, I think the best you can do is to look not at individual experiences but at what happens to the majority of people, because that gives you a better idea of what is likely to happen in your own case.
The problem with looking at individual cases is that it's very difficult and usually impossible to prove causation (ie. that action A caused result B) when an outcome is isolated. That's not my opinion or interpretation, that's a well-established fact; it's why we have the field of statistics. I'm not saying that A didn't cause B. A might very well have caused B, but you just don't know. Unless there's a very, very clear cause-and-effect relationship with a well-understood mechanism (eg. pushing the glass off the table caused it to fall to the ground and smash via the well-known mechanism of gravity) then it is necessary to study many cases and see if the result happens more often when the suspected cause is present than when it is absent. That's why they do clinical trials.
These trials, especially vaccine trials, are huge (30-70 thousand people, with recent vaccines), because when a result (such as a serious side effect) is rare, you have to study a LOT of people to get the side effect enough times to find out whether or not it happens in more people who get the vaccine than who get the placebo. Again, this is a statistical fact, not my opinion.
There was a vaccine against rotovirus, which causes vomiting and diarrhea and can cause severe dehydration and death especially in young children, a few years ago that was pulled off the market because it was linked to intussusception, which is an intestinal problem that can be dangerous and may require surgery to fix. There were 28 cases of intussusception that were reported after the infants had been vaccinated with RotaTeq; based on the number of doses of the vaccine that were given out, statistically this didn't exceed the number that would have been expected in that population ie. there were no more cases in the vaccinated babies compared to the unvaccinated ones, so there was no evidence that the vaccine caused the intussusception. But public outcry in the US, led by the very vocal anti-vaccine lobby, caused the manufacturer to the pull the vaccine despite the large trials (over 70 000 kids) that had demonstrated its safety.
I'm not saying that RotaTeq should have remained available; there was a potential problem that was identified and action was taken, which is what must happen. But there was a cost to having this vaccine become unavailable. The pulling of the vaccine off the market because of these 28 cases that may or may not have been caused by the vaccine has led to the illness and death of countless children in the developing world who are extremely vulnerable to rotovirus because it is very common (due to a lack of clean water in many places) and because if they do get it they have limited access to treatment, even simple hydration.
This is the problem -- the anti-vaccine lobby isn't accountable to anyone. Nobody blames them for the deaths of these kids in Africa. They can cite poor studies, anecdotal "evidence" and outright conjecture as fact because they do not answer to anyone. They have provoked enormous fear without any high-quality evidence; simply by saying, "Well, it MIGHT be a problem" they can make parents, who of course are appropriately horrified at the thought that something they do might cause harm to their children, they cast doubt on an intervention that has been so successful at reducing the burden of these diseases that people have the luxury of forgetting how serious they can be.
It is not enough to simply state that there are two opinions on an issue; it is equally or more important to carefully evaluate the evidence behind each opinion and to decide what evidence deserves to be weighed more heavily. You can't have a debate if one side is citing high-quality evidence while the other side just says, "Well, I BELIEVE it's a problem." That's not a debate -- that's just an argument.
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