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This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death. "In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future. "Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace." Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by health care-associated infections: sepsis, a potentially lethal systemic response to infection and pneumonia, an infection of the lungs and respiratory tract. The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high: For example, people who developed sepsis after surgery stayed in the hospital 11 days longer and the infections cost an extra $33,000 to treat per person. Even worse, the team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection. "That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure, and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control—and they can die." The team also looked at pneumonia, an infection that can set in if a disease-causing microbe gets into the lungs—in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.

By combining a hurricane model and coupled ocean-atmosphere general circulation model to investigate the early Pliocene, Emanuel, Brierley and co-author Alexey Fedorov observed how vertical ocean mixing by hurricanes near the equator caused shallow parcels of water to heat up and later resurface in the eastern equatorial Pacific as part of the ocean wind-driven circulation. The researchers conclude from this pattern that frequent hurricanes in the central Pacific likely strengthened the warm pool in the eastern equatorial Pacific, which in turn increased hurricane frequency — an interaction described by Emanuel as a “two-way feedback process.”�The researchers believe that in addition to creating more hurricanes, the intense hurricane activity likely created a permanent El Nino like state in which very warm water in the eastern Pacific near the equator extended to higher latitudes. The El Nino weather pattern, which is caused when warm water replaces cold water in the Pacific, can impact the global climate by intermittently altering atmospheric circulation, temperature and precipitation patterns.The research suggests that Earth’s climate system may have at least two states — the one we currently live in that has relatively few tropical cyclones and relatively cold water, including in the eastern part of the Pacific, and the one during the Pliocene that featured warm sea surface temperatures, permanent El Nino conditions and high tropical cyclone activity.Although the paper does not suggest a direct link with current climate models, Fedorov said it is possible that future global warming could cause Earth to transition into a different equilibrium state that has more hurricanes and permanent El Nino conditions. “So far, there is no evidence in our simulations that this transition is going to occur at least in the next century. However, it’s still possible that the condition can occur in the future.”�Whether our future world is characterized by a mean state that is more El Nino-like remains one of the most important unanswered questions in climate dynamics, according to Matt Huber, a professor in Purdue University’s Department of Earth and Atmospheric Sciences. The Pliocene was a warmer time than now with high carbon dioxide levels. The present study found that hurricanes influenced by weakened atmospheric circulation — possibly related to high levels of carbon dioxide — contributed to very warm temperatures in the Pacific Ocean, which in turn led to more frequent and intense hurricanes. The research indicates that Earth’s climate may have multiple states based on this feedback cycle, meaning that the climate could change qualitatively in response to the effects of global warming.

For most of the last 1,500 years, the river supported a sustainable salmon economy. Salmon were at the heart of all the Klamath’s tribal cultures, and Indians were careful not to over-harvest them. Each summer, the lower Klamath’s Yurok and Hoopa tribes blocked the upstream paths of spawning salmon with barriers; then, after ten days of fishing, they removed the barriers, allowing upstream tribes to take their share. As the salmon completed their lifecycle, dying in the waters where they’d been spawned, they enriched the watershed with nutrients ingested during years in the ocean. Among the beneficiaries were at least 22 species of mammals and birds that eat salmon. Even the salmon carcasses that bears left behind on the riverbanks fertilized trees that provided shade along the river’s banks, cooling its waters so that the next generation of vulnerable juvenile salmon could survive. “We tried to go to court, to go through the political process, but it didn’t work. …The big issues were still out there, and we still had to resolve them.” Salmon’s biological family may have started in the age of dinosaurs a hundred million years ago. They’ve survived through heat waves and droughts, in rivers of varying flow, temperature, and nutrient load – but they were as ill-prepared for Europeans’ arrival as the Indians themselves. Gold miners who showed up in the mid-nineteenth century washed entire hillsides into the river with high-pressure hoses and scoured the river’s bed with dredges. Loggers dragged trees down streambeds, causing massive erosion, and dumped sawdust into the river, smothering incubating salmon eggs. Cattle grazed at the river’s edge, causing soil erosion and destroying shade-giving vegetation. Farmers diverted water to feed their crops. The dams were the crowning blows. Between 1908 and 1962, six dams were built on the Klamath. The tallest, the 173-foot-high Iron Gate, is the farthest downstream, and definitively blocked salmon from the river’s upper quarter – after it was built, the river’s salmon population plummeted. In addition, the dams devastated water quality by promoting thick growths of toxic algae in the reservoirs. For Klamath basin farmers, however, the dams were deemed indispensable, as they generated hydropower that made pumping of their irrigation water possible.To the farmers, the potential loss of the dams’ hydropower was considered no less crippling than an end to Klamath-supplied irrigation.

For most of the last century, the farmers were oblivious to the damage that dams and water diversions caused downstream, while the tribes and commercial fishermen quietly seethed. The annual salmon run, once so abundant that people caught fish with their hands, was roughly pegged at more than a million fish at its peak; in recent years it has dropped to perhaps 200,000 in good years, and as low as 12,000 – below the minimum believed necessary to sustain the runs – in bad years. Spring Chinook, which once comprised the river’s dominant salmon run, entirely disappeared. Two fish species – the Lost River sucker and the shortnose sucker – that once supported a commercial fishery, were listed as endangered in 1988. Coho salmon were listed as threatened nine years later. All this has had a devastating impact on the tribes. Traditionally able to sustain themselves throughout the year on seasonal migrations of the river’s salmon, trout, and candlefish, tribal members suffered greatly as the runs declined or went extinct. For four decades beginning in 1933, the tribes were barred from fishing the river even as commercial fishermen went unrestricted. Members of the Karuk tribe once consumed an estimated average of 450 pounds of salmon a year; a 2004 survey found that the average had dropped to five pounds a year. The survey linked salmon’s absence to epidemics of diabetes and heart disease that now plague the Karuk. The 2001 cutoff left farmers without irrigated water for the first time in the Klamath Project’s history. Over the next four months, many farmers performed repeated acts of civil disobedience, most notably when a bucket brigade passed pails of banned water from its lake storage to an irrigation canal while thousands of onlookers cheered. The protests attracted Christian-fundamentalist, anti-government, and property rights advocates from throughout the West; former Idaho Congresswoman Helen Chenoweth-Hage likened the farmers’ struggle to the American Revolution.

1. The private sector will create enough jobs, if the government gets out of the way. Possibly, but when? Right now more than 2.7 percent of our entire population has been unemployed for more than 26 weeks -- an all time-record since the government began compiling that data in 1948. No one is predicting that the private sector is about to go on a hiring spree. In fact, many analysts think it'll take more than a decade for the labor market to fully recover. You can't tell the unemployed to wait ten years. Counting on a private sector market miracle is an exercise in faith-based economics. There simply is no evidence that the private sector can create on its own the colossal number of jobs we need. If we wanted to go down to a real unemployment rate of 5% ("full employment"), we'd have to create about 22.4 million jobs. (See Leo Hindery's excellent accounting.) We'd need over 100,000 new jobs every month just to keep up with population growth. It's not fair to the unemployed to pray for private sector jobs that might never come through. 2. We can't afford it. Funding public sector jobs will explode the deficit and the country will go broke: This argument always makes intuitive sense because most of us think of the federal budget as a giant version of our household budget - we've got to balance the books, right? I'd suggest we leave that analogy behind. Governments just don't work the same way as families do. We have to look at the hard realities of unemployment, taxes and deficits. For instance, every unemployed worker is someone who is not paying taxes. If we're not collecting taxes from the unemployed, then we've got to collect more taxes from everyone who is working. Either that, or we have to cut back on services. If we go with option one and raise taxes on middle and low income earners, they'll have less money to spend on goods and services. When demand goes down, businesses contract--meaning layoffs in the private sector. But if we go with option two and cut government services, we'll have to lay off public sector workers. Now we won't be collecting their taxes, and the downward cycle continues. Plus, we don't get the services. Or, we could spend the money to create the jobs and just let the deficit rise a bit more. The very thought makes politicians and the public weak in the knees. But in fact this would start a virtuous cycle that would eventually reduce the deficit: Our newly reemployed people start paying taxes again. And with their increased income, they start buying more goods and services. This new demand leads to more hiring in the private sector. These freshly hired private sector workers start paying taxes too. The federal budget swells with new revenue, and the deficit drops. But let's say you just can't stomach letting the deficit rise right now. You think the government is really out of money--or maybe you hate deficits in principle. There's an easy solution to your problem. Place a windfall profits tax on Wall Street bonuses. Impose a steep tax on people collecting $3 million or more. (Another way to do it is to tax the financial transactions involved in speculative investments by Wall Street and the super-rich.) After all, those fat bonuses are unearned: The entire financial sector is still being bankrolled by the taxpayers, who just doled out $10 trillion (not billion) in loans and guarantees. Besides, taxing the super-rich doesn't put a dent in demand for goods and services the way taxing other people does. The rich can only buy so much. The rest goes into investment, much of it speculative. So a tax on the super rich reduces demand for the very casino type investments that got us into this mess.

3. Private sector jobs are better that public sector jobs. Why is that? There is a widely shared perception that having a public job is like being on the dole, while having a private sector job is righteous. Maybe people sense that in the private sector you are competing to sell your goods and services in the rough and tumble of the marketplace--and so you must be producing items that buyers want and need. Government jobs are shielded from market forces. But think about some of our greatest public employment efforts. Was there anything wrong with the government workers at NASA who landed us on the moon? Or with the public sector workers in the Manhattan project charged with winning World War II? Are teachers at public universities somehow less worthy than those in private universities? Let's be honest: a good job is one that contributes to the well-being of society and that provides a fair wage and benefits. During an employment crisis, those jobs might best come directly from federal employment or indirectly through federal contracts and grants to state governments. This myth also includes the notion that the private sector is more efficient than the public sector. Sometimes it is, but mostly it isn't. Take health care, which accounts for nearly 17 percent of our entire economy. Medicare is a relative model of efficiency, with much lower administrative costs than private health insurers. The average private insurance company worker is far less productive and efficient than an equivalent federal employee working for Medicare. (See study by Himmelstein, Woolhandler and Wolfe) 4. Big government suffocates our freedom. The smaller the central government, the better -- period, the end. This is the hardest argument to refute because it is about ideology not facts. Simply put, many Americans believe that the federal government is bad by definition. Some don't like any government at all. Others think power should reside mostly with state governments. This idea goes all the way back to the anti-federalists led by Thomas Jefferson, who feared that yeomen farmers would be ruled (and feasted upon) by far-away economic elites who controlled the nation's money and wealth. In modern times this has turned into a fear of a totalitarian state with the power to tell us what to do and even deny us our most basic liberties. A government that creates millions of jobs could be seen as a government that's taking over the economy (like taking over GM). It just gets bigger and more intrusive. And more corrupt and pork-ridden. (There's no denying we've got some federal corruption, but again the private sector is hardly immune to the problem. In fact, it lobbies for the pork each and every day.) It's probably impossible to convince anyone who hates big government to change their minds. But we need to consider what state governments can and cannot do to create jobs. Basically, their hands are tied precisely because they are not permitted by our federal constitution to run up debt. So when tax revenues plunge (as they still are doing) states have to cut back services and/or increase taxes. In effect, the states act as anti-stimulus programs. They are laying off workers and will continue to do so until either the private sector or the federal government creates many more jobs. Unlike the feds, states are in no position to regulate Wall Street. They're not big enough, not strong enough and can easily be played off against each other. While many fear big government, I fear high unemployment even more. That's because the Petri dish for real totalitarianism is high unemployment -- not the relatively benign big government we've experienced in America. When people don't have jobs and see no prospect for finding them, they get desperate -- maybe desperate enough to follow leaders who whip up hatred and trample on people's rights in their quest for power. Violent oppression of minority groups often flows from high unemployment. So does war. No thanks. I'll take a government that puts people to work even if it has to hire 10 million more workers itself. We don't have to sacrifice freedom to put people to work. We just have to muster the will to hire them.