Accidental Blogger

Fighting fear with fear

Not so different from fighting poison with poison. Here.

Veterans Affairs Nurses [Strikeout Nurses] Management Scrutinized After Patient Deaths (Norman Costa)

Nurse - Anonymous

Veterans Affairs Nurses Management Scrutinized After Patient Deaths in Two States (Norman Costa)

A re-editing of an article by Tracy Weber and Charles Ornstein

ProPublica, April 30, 2012, 1:19 p.m. 

After a patient died last year at a Veterans Affairs hospital in Manhattan, federal inspectors discovered nurses in his unit [Management] had a startling gap in their skills [supervision and training of nursing staff]: They [Management] didn't understand [they were responsible for the competence and training of nursing staff as to] how the monitors tracking vital signs worked. 

Management - Gen. Eric Shinseki

None of the nurses [management] interviewed could accurately explain [their lapse in supervision and training of nursing staff, so that nurses could tell] what would happen if a patient became disconnected from a cardiac monitor — which allegedly occurred to the patient who died, according to an October 2011 report from the U.S. Department of Veterans Affairs' inspector general. 

The incident followed two deaths in the cardiac monitoring unit at a VA hospital in Denver that raised similar questions about nurse [Management] competency. 

Earlier this month, a broader review by the VA inspector general of 29 VA facilities found only half had adequately documented that their nurses had the needed skills. Some nurses "did not demonstrate competency in one or more required skills," but there was no evidence of [Management taking charge and providing the] retraining [for nursing staff], the report said. 

An outside nursing [management] expert who reviewed the reports at ProPublica's request called them "troubling" and said the fact that the [management] lapses weren't caught and corrected "signified much broader [management] problems." 

Save A Mother - "Beyond Sultanpur": 2012 Appeal

Progress Report for 2011 - 2012 _ Dr. Shiban Ganju, Founder of Save A Mother

SAM Activities for 2011-2012

• Last year was a turning point in the growth of Save A Mother. The program of maternal mortality reduction developed by Save A Mother (SAM) is being expanded by Mahila Vikas Parishad to 45 districts of UP with the funding from UNICEF and Melinda and Gates Foundation. SAM helped to launch this expansion and participated in 351 training sessions for new health workers, communities and public health officials.  
• 75 Health activists (Swasthya Sakhi) who had volunteered for SAM for last 4 years have been deputed as Community Health Trainers for the last one year under the UNICEF funded project.
• SAM will expand maternal mortality program to Gadag district in Karnataka in summer of 2012. The program will be funded by Deshpande Foundation. If more financial resources become available SAM may expand program to Kurkhshetra in Haryana, Ajmer in Rajasthan and Guna in MP.
• SAM has launched a TB eradication program in about 200 villages in Sultanpur area in UP. This program will be expanded to 1000 villages in next 3 years.
• SAM is helping to improve the operation of 16 rural health clinics which give free care to 1500 patients daily. These clinics are funded by Asia Heart Foundation. With the help of the doctors working in the clinics, SAM is launching a program to reduce water borne diseases by 80% in next four years.
• SAM has developed a software program to manage rural clinics and facilitate the work of public health workers in the field by giving them a GPRS phone application by which they can upload the field data and receive messages. The software will be in operation by the summer of 2012.
• Bangalore chapter of SAM is organizing a music concert by Alka Yagnik on 21 April to raise funds to expand work in Karnataka.

 

I am pleased to be part of Save A Mother (SAM) and its commendable work in reducing maternal and infant mortality in rural India. My association with the organization dates back to 2009 when I responded to Dr. Ganju's invitation urging me to become a volunteer with the Houston chapter, around the time he decided to take his outreach efforts beyond his hometown of Chicago. Since then I have met and worked with a dedicated and enthusiastic group of Houstonians who work year round to make possible the realization of the stated goals and objectives of SAM. As the report above explains and the title of this year's fundraiser suggests, the effort that began as Dr. Ganju's personal and modest mission in a village named Sultanpur in the northern Indian state of Uttar Pradesh has expanded to benefit several more villages in UP and other states.

The 4^thannual fund-raising gala for Save A Mother in Houston is scheduled for May 4, 2012.The bulk of our fund raising is achieved through direct personal contact with individuals and businesses. The blog appeal is our way of reaching friends, family and generous strangers outside the Houston area who may find it simpler to donate on-line. The response to our previous fundraisers has been very generous so far. We hope to generate similar levels of support in 2012 both here on the blog as well as in the real world. This year I have set a goal of raising $3,000 on Accidental Blogger on behalf for SAM. If you wish to help, please use the ChipIn widget on the left side column of the page to make your contribution. Any amount you give is appreciated and will be put to good use. Thank you very much.

For more information on the mission of the organization see the message from the founder here and in the excellent video above, narrated by Dr. Ganju and Indian actors Shabana Azmi and Anupam Kher. More information is available at the Save A Mother website.

Note: I plan to keep this post at the top of the page for a while. Please scroll down to see new posts that appear during this period.

(If you don't see the ChipIn logo in its entirety, adjust the zoom level on your browser. Many thanks to Rahul Singhal for his help; he puts up with my technical ineptitude each year around this time.)

Cancer in a Can (Sujatha)

Move over, BPA, make room for the new kid on the block: 4- MI ( the 'cute' name for 4-methylimidazole), a byproduct of the process used to create one of the coloring agents used in what is obliquely termed 'caramel color' on the ingredients list of many processed foods, most notably sodas like Coca Cola and Pepsi.

 The Center for Science in Public Interest had submitted a docket to the FDA, requesting that the caramel colorings with 4-MI be banned, but can claim success of a different sort from what it had hoped. Because of regulations in the state of California, where Coke and Pepsi would have had to label their drinks with warnings similar to "This product contains chemicals known to the State of California to cause cancer and birth defects or other reproductive harm."

If it causes cancer in California, surely, it must cause cancer elsewhere. Ah, the power of truth in advertisement, and the things manufacturers will do in order to not have to issue disclaimers that their product contains substances that are considered carcinogens, even it is only in California. Or is the fear that they could be sued in California by any private citizen or group over the 4-MI in their formulation? This article sheds more light on their concerns.

"Our member companies will still use caramel coloring in certain products, as always. The companies that make caramel coloring for our members' soft drinks are producing it to meet California's new standard,” the beverage association said in a separate statement.

“Consumers will notice no difference in our products and have no reason at all for any health concerns.”

The question is still up in the air as to whether the results of lab tests that show that 4-MI is indeed carcinogenic in lab rats, at high concentrations that far exceed the normal levels that even the most avid drinker of sodas would be exposed to, can be used to argue that 4-MI in caramel color is indeed responsible for a variety of cancers in the population ingesting it. My guess is that at best, it would be one of a gazillion contributing factors towards any cancers that did develop.

 

 

Thus Spake the Crocodile...(Sujatha)

 

Carefully crafted, teary-eyed sentiments indeed. As well they should be, given the outrage poured on Susan G. Komen Foundation's decision to stop giving grants to the Planned Parenthood for breast cancer screening and preventative education. This could mean a huge drop in liberal contributions to the Orgy of Pinkfulness that the Komen Foundation sustains not only in October, but year-round as part of its effort to 'eradicate breast cancer', a goal that remains muddied by the numerous partnerships it forges with corporations who don't exactly promote good health through their products.

"Critics of the decision have pointed to the fact that Komen recently hired a vice president who had pushed for the defunding of Planned Parenthood during a gubernatorial run. 

According to Komen, the decision was born not out of political pressure but rather as part of an ongoing effort to exact "stronger performance criteria for our grantees."

The outrage has so far garnered from the public a substantial proportion of the funds that Planned Parenthood stood to lose.

Planned Parenthood said Wednesday that it received more than $400,000 from 6,000 donors in the 24 hours after news broke that its affiliates would be losing grants for breast screenings from the Susan G. Komen for the Cure breast-cancer foundation.

Komen, meanwhile, incurred heated criticism from some members of Congress, numerous liberal advocacy groups and some newspaper editorial writers. But it was applauded by many conservative religious and anti-abortion groups that abhor Planned Parenthood for its role as the leading U.S. abortion provider.

If we are all a little less pinked-out after this, we can thank Karen Handel for her decision to push through the defunding 'organizations under investigation' rule. But I have a feeling that come October, the frenzy for the Pinking of America will rebound, as it always does, with the fresh legions of the newly-diagnosed.

 

Grief: Is it a mental disorder?

Some doctors now believe that extreme grief due to the loss of a loved one should be medically classified and treated like any other form of depression. Others argue that grief is a natural (and sometimes, necessary) human emotion and it should not be categorized as an ailment that needs to be corrected by "Happy Pills." I don't know whether grief is a "disorder." I am inclined to say "no." I don't think that our brains, and therefore our lives, are meant to be relentlessly cheerful. I suspect that in the absence of "negative" emotions such as sadness, fear or anger, we would also be lacking in beneficial qualities like empathy and survival skills.  We all cope with life's ups and downs in our own ways. Throughout the world social rites and religious rituals are designed to help survivors deal with suffering due to bereavement. Despite that the loss of a loved one affects different people with vastly different levels of trauma; some come to terms with it requiring no third party intervention while others may need prolonged periods of solace, and even professional counseling. Surely, a grieving person is depressed. The question however is whether such depression requires medication and if so, what carefully considered criteria ought to be in place regarding the duration of the condition and the severity of the debilitation.

Grieving the loss of a friend, family or loved one may soon be considered a form of depression. While many doctors acknowledge that grief is a very normal part of losing someone close to us, they also acknowledge that it’s important to deal with that grief.

Speaking to the New York Times one doctor explains why turning grief into a depression diagnosis could end up hurting those people suffering from some for of grief.

“This would pathologize them for behavior previously thought to be normal.” says one doctor.

Opponents to the diagnosis also say to could lead many people with short term grief receiving drug treatments that would normally be unnecessary outside of depression symptoms.

I asked my co-bloggers to weigh in with their opinions on the matter. Unsurprisingly, their responses fall on both sides of the argument.

Concrete Jungle vs Concrete Common Sense

As usual, being familiar with the living conditions in much of the Third World, I say that this makes a lot of sense. 

'tis the Season to be giving... and receiving?

Why do we give to charities or causes from which we expect nothing more tangible than the usual warm fuzzy satisfaction? There are sociological and now evo-biological explanations for our altruisms. Most of us give for simple reasons - compassion, willingness to share, support for a worthy cause. Sometimes we also give for more mundane monetary or social reasons - tax breaks or because we cannot turn down a friend's request.

My donations continue through the calendar year depending on who needs my help at a particular time or fundraiser. However, the bulk of the check writing takes place right around this time when I go through my list of regular charities and send out the customary funds. I expect nothing in return although many of the organizations send me token gifts of address labels, note pads, car decals or some such item of appreciation along with a thank-you note and another form for future donations. Occasionally, some of them would have  special gifts associated with different levels of donations. Most of the time I pass on these unless it is something quirky or mildly useful that I want. I have in the last thirty years, opted to receive perhaps three or four such gift items while making charitable donations. This year however, I lusted after an "All Things Considered" commemorative coffee mug when I donated to the Houston area NPR station. It was one of the gifts being offered at the level of contribution that I made. The cost of receiving the gift was $10 ($6 for the mug + $4 for shipping & handling) which was deducted from my total contribution. The donation was made a few months ago during the radio station's fund raising drive and soon thereafter I received a receipt for my net contribution. I had forgotten about the whole thing. But a few days ago when I sat down to write the remaining charity checks, I remembered the mug and realized that I haven't yet received it. This fact bothered me a lot! I have been wondering why. It is after all only a six dollar mug and I would have made the same contribution even without the lure of the mug. Please explain this strange gnawing acquisitive feeling in an endeavor whose essence was really an act of giving on my part. Why does the missing mug make me feel slightly cheated? Is it because even in our generosity, we like to receive what we are promised, however trivial the gift may be?

One of my long time favorite charities, the World Wildlife Fund customarily offers gifts with donations. Except for two gifts (a stuffed tiger and a tote bag, both of which were delivered as promised) in the last twenty five years, I routinely decline their gifts. But this year again, the WWF has something I really wanted. So I wrote them a check and checked the "yes" square next to the item. Now I will wait for my WWF Butterfly Umbrella!!

Neurological Basis of Really, Really Bad Behavior (Norman Costa)

The Neurological Basis of Really, Really Bad Behavior (Norman Costa)

Anatomy Of A Psychopath : The Neurobiological Basis Of Evil

WRITTEN BY JONATHAN PARARAJASINGHAM SEPTEMBER 30, 2011,

Editor’s Note: This is the first part of “Mind’s Matter”, a new series of articles by Dr. Jonathan Pararajasingham, exploring the Neurobiological basis of behaviour.

“We serial killers are your sons, we are your husbands, we are everywhere.” – Ted Bundy
One of the most controversial areas of research in neuroscience involves the search for biophysical causes of sadistic thought and behaviour. But there now seems to be enough complementary evidence to at least begin piecing together a coherent materialistic description of the psychopathic mind. A number of potential genetic and pathophysiological causes of violence and aggression have been investigated over recent years. These include things like the monoamine oxidase A gene, head trauma, serotonin deficiency, epilepsy, stress, and neuropeptides. But since the recent surge in quality of neuroimaging techniques, we are now finding exceptionally detailed anatomical correlates to certain types of behaviour, including antisocialism and criminality. Research now points to the discovery that impulsive aggression and violence arise as a consequence of faulty emotion regulation circuitry in the brain. In this paper I aim to outline the evidence and implications of this finding.

Read more HERE:

"Toward Precision Medicine" (Dean)

From the National Academies: "A new data network that integrates emerging research on the molecular makeup of diseases with clinical data on individual patients could drive the development of a more accurate classification of disease and ultimately enhance diagnosis and treatment, says a new report from the National Research Council." (Courtesy of DocuTicker's DocuBase.)

Careful readers will note that the NA press release highlights the goal of a new taxonomy, while the report itself emphasizes the benefits to health care of layered data integration. Nor does the press release explicitly mention privacy or consent issues, alluding only to the report's recommendation of "gradually eliminating institutional, cultural, and regulatory barriers to widespread sharing of individuals' molecular profiles and health histories while still protecting patients' rights." The report itself is more forthcoming, particularly on pages 56-58 of chapter 4, "How Do We Get There?," where it addresses "the ethical and policy challenges" of an "Information Commons" populated with individuals' molecular data, medical histories, profiles of social and environmental environments, and medical outcomes.

Clearly, the authors are queasy about privacy concerns, in two competing respects. First, they view current rules for handling of patient information (fundamentally, HIPAA) as ineffective and obstructive of progress. The vision is for a "commons," after all, accessible not only to academic, but also commercial researchers. Second, even if participating researchers and practitioners can demonstrate trustworthiness, data security remains fraught with potential vulnerabilities. The cultural barrier, a euphemism for personal expectations of privacy, may very well become the challenge most easily adjusted to support the project.

Visitors from beyond

On this Halloween, with nothing much on my mind, let me share some ghostly goings-on in Houston.

A houseful of visiting relatives - it's a classic mixed blessing.

Just ask businessman Tony Barton and his wife, Kim.

First came a relative, then the relative's friend, then relatives of relatives who lived with the couple. Soon, the trim, three-bedroom house at the end of a Pearland cul-de-sac was packed and life was a nonstop romp.

The real problem with these kinfolk, though, was that they were all dead. Tony Barton, 43-year-old ex-military man, salesman, and connoisseur of craft beer, was haunted.

It's the type of tale - filled with woooos, boos and goosebump-popping fright - that you'd expect to hear around Halloween, which, of course, is Monday. The Bartons say their woes started in the sunny days of summer.

"Nothing big happened right away. It was little accumulations," Barton says. "The wife and I both disregarded them - maybe hearing something, shadow movements, feelings of being watched. ... Only when things really escalated did we look at each other and say, 'Something's going on here.' "  (more here)

The Houston - Galveston area abounds with stories of hauntings. One of the more famous supposedly spooky sites here is the historic Hotel Galvez in Galveston.

Backspiration (Cyrus)

It has been a slow last few months, the way time always seems to be when it's full of variety rather than intense drive.  Sadly, my back has been full of intense pain, from general soreness during the day, to spasms when I try to get out of bed in the morning.  As a welcoming present upon my return to the U.S., I was denied health insurance, so I've largely been dealing with it myself.

Yoga, walks, and mornings that drift toward full movement around noon.  The last week has been better, largely thanks to these remedial cures, such that (until this morning) I had already started to think of the previous months as the "era of the bad-back," past tense.  Joy!

However, the bad posterior has been cause for much creative thought, or, more accurately, the annoying antagonist that reminded me to do things not only good for my back, but also my mind.  In particular, daily walks. Walking without immediate purpose almost always puts me in a contemplative mood, and the natural open space of Boulder does much to incite the inner voice.  Allora, backspiration, one of which I want to share.

I've always enjoyed soaking up the ambiance of a scene.  Or, maybe, it's the other way: I take in the ambiance when I'm relaxed.  The brain opens up and starts to notice things normally edited out in the name of concision.  As a aurally focused person, sound particularly brightens up. Birds, conversation, a distant flute.  Volume itself becomes fascinating, as people walk by, children scream joyfully, and the wind acts as DJ, mixing it all together.  Last week, one gust brought a sudden onset of bagpipes.

But I can only walk so far, only go to so many places.  You may have experienced similar problems with time and space.  How about recording it? Put it online, let others listen to it, and accept their donated wanderings in return?

Alone, this isn't a particularly interesting idea, but the advent of large, semi-public geoinformation databases opens up a range of fascinating possibilities.  The presence of GPS on most modern phones makes it easy for anyone to make a highly accurate track of their movements.  Put these together with the recorded audio, and you have a website that explores the interface between place, context, time, and sound.

Imagine two windows on the screen, one a time-line/audio player, the other a Google map widget.  As one plays the audio, a little figure on the map moves synchronously, following the GPS track.  Somewhere, the time is presented.  Hear something interesting?  Calm?  Calamity?  Cacophony?  Click the map, and the location will be looked up in the numerous public image databases, the resulting images revealing the context of the place.

I suppose this is somewhat related to Google's Street View, but two things things set it apart.  First, of course, the audio is the heart of the project.  A particular snapshot of time, I would hope that people would walk the same or similar routes multiple times, sampling them for their variance.  Second, each recording would be a path set upon not becuase streets happen to be there, but because a person, an individual chose to go there.  That agency adds something unique to every recording.  Does the person choose to speak, saying hi to strangers?  Do they spit?  Cough?

I'm almost convinced to build the thing in my spare time.  If only it didn't hurt to sit for extended periods of time.  Backspiration failing.

To PSA or not PSA (Sujatha)

Remember the great Mammo or no Mammo debate that erupted a couple of years ago? The task force is back in action again. This time they recommend 'No PSA', as the evidence builds up that the cure is worse than the disease.

"The U.S. Preventive Services Task Force examined all the evidence and found little if any reduction in deaths from routine PSA screening. But it did conclude that too many men are diagnosed with tumors that never would have killed them and suffer serious side effects from resulting treatment."

From the New York Times:

"As the P.S.A. test has grown in popularity, the devastating consequences of the biopsies and treatments that often flow from the test have become increasingly apparent. From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”  (italics mine)

There is a flourishing industry whose success depends on treating the incontinence and impotence that is such a common side effect of those who have undergone treatment for the possible prostate cancer, whether slow-growing or fast.

The real question, at this point, given the weak economy, is whether the bending of the health care cost curve tthat comes from less aggressive testing for prostate and breast cancers is worth the loss of jobs in the healthcare and pharmaceutical industries. Maybe it is worth it, in terms of quality of life for say 48 out of 50 who might have been diagnosed on the basis of the test, and subjected to needless treatment. But the 2 who were saved will always be much more vociferous in their support of universal testing, as is very evident from the flurry of angry letters following the articles.

Or maybe, they should just let things be between men and their doctors, just as in the case of women and the mammogram recommendations.

Pathological Altruism

Today's NY Times has a discussion of 'Pathological Altruism', but is it truly 'altruism' to give till it hurts the giver?

Altruism, on the face of it, is the opposite of selfishness. The dictionary definition (Merriam Webster)

1: unselfish regard for or devotion to the welfare of others

2: behavior by an animal that is not beneficial to or may be harmful to itself but that benefits others of its species

The NYT article starts with an interesting headline, but the very first example is poor: A physician insisting on heroic measures to save a dying patient, despite considerable pain and trauma to the patient, and resulting in a miserable death rather than a peaceful one. This seems to me not 'altruism' but a manifestation of selfishness, as in  the physician maintaining 'I am convinced beyond reason that I will save this patient, damn the costs.'

A far better example of the 'pathological altruism' occurs at the end of the article- the case of animal-hoarders. But there too, the question arises. How much of it is predicated on the person 'doing good'  doing it for the sake of the momentary rush of happiness at their perceived selflessness?

Worse than the fear of death

From the Associated Press:

FORWARD OPERATING BASE JACKSON, Afghanistan (AP) — It is a conversation, the military surgeon says, that every U.S. Marine has with his corpsman, the buddy who is first to treat him if he is wounded by an insurgent's bomb.

The Marine says, "'If I lose my manhood, then I don't want to live through it,'" according to Navy Lt. Richard Whitehead, surgeon for 1st Battalion, 5th Marine Regiment, which is fighting in one of the most treacherous combat areas of Afghanistan.

"They ask us not to save them if their 'junk' gets blown off," said Whitehead, using a slang term for genitals. "Usually, we laugh. We joke with them about it. At the same time, you know that you're going to treat them anyway."

This is a world of fear, resolve and dark humor that is mostly hidden from accounts of the human cost of the war in Afghanistan. American troops who patrol on foot in bomb-laced areas know they might lose a leg, or two, if they step in the wrong place. But for young men in their prime, most unmarried and without children, the prospect of losing their sexual organs seems even worse.

Whitehead said: "It's one of the areas we can't put a tourniquet on."

  

Yes, a bit of dark humor would be in order to cope with the nervousness associated with such an eventuality. But there is nothing funny about young soldiers experiencing the gut wrenching and natural fear of a truncated life. After all, it is the young who always fight old men's wars.  Life, for a man in his twenties may be less important than the pursuit of happiness.

 

30 years of the AIDS epidemic: An alarming rise of infection among a new group

This year is the officially recognized 30th anniversary of the HIV /AIDS epidemic in the USA. The focus on the disease is once again in the forefront - its spread, its prevention and its treatment have revealed many new medical facts about the virus, some hopeful and others frustrating. There is still no effective "cure" for the condition and afflicted patients continue to die although contracting HIV infection is no longer viewed as an immediate death sentence. Various groups have been identified as "at risk" at different times, beginning of course, with gay men and IV drug users in the early days of the epidemic. However, AIDS has gradually spread among other demographic groups, including heterosexual women. Secrecy and shame are often factors in hampering an accurate assessment of the true extent of the spread of the disease in certain groups. One group, considered relatively safe from HIV/AIDS in the past, Asian American women, has now been shown to have a sharp increase in the rate of infection in recent years. The problem for these women may be further complicated by the Asian community's resistance to admitting and therefore treating the condition which is considered a huge cultural stigma. The report here. (Link via Razib)

(I would like to point out that this report relates only to Asian American women who were until recently considered "safe" from HIV / AIDS. In Africa and Asia the epidemic has targeted men and women in almost equal numbers, irrespective of sexual preference)

A few not very memorable Memorial Day weekend links

Without further analysis from my side, the links are followed by exchanges that occurred elsewhere - in an e-mail thread among A.B. authors and my Facebook page. (Joe, see I always follow good advice!)

 

The most complete 3-D map of the universe: (link Dean) 

Norman Costa: The 2MRS image is a hoax. It is actually a recently discovered, and previously unknown, Jackson Pollack canvas. The astronomers superimposed a Mercator Projection of grid lines upon the image. The fraud was uncovered by a grandson of Pollack, a graduate student at Yale University in the Art History department.

Missing mass of the universe found: (link Dean)

Dean: Love this sentence: "We don’t know where it went. Now we do know where it went because that’s what Amelia found." Reads like one of my kids' bedtime books!

Prasad (our own resident physicist): Ah, I have nothing to say about the universe, but mass is a weird thing, psychologically speaking. You think of what masses want, and basically it's to be left to do as they please, Newton's first law style. And the heavier something is, the better it withstands your pushes and pokes at it. It's a principle of self-respect and stateliness, combined with some John Wayne type loner. But then there's gravity. Masses lose their minds when they encounter each other. You take more than one of these dignity-soaked objects, and right there they have to run right toward each each other. And if there's something really top-dog around like the earth, you can see how everything around it, feather or ten-ton weight, runs toward it at the same rate, independent of how much heft it has in its own right. It would be hard to make sense of a person who behaved in this peculiar way.

"Storming" gender biases: (a link I posted on Facebook; do read the news report before you look at the comments that follow)

 

Jordan Brand: They are definitely getting a large amount of attention about this. 

Ruchira Paul: ‎Jordan, that in itself is quite bad, don't you think? Ironically, people are now focusing exactly on what the parents don't want to reveal. Who would have cared if Storm was just another little boy or girl?
BTW, I think it is a boy. 

Jordan Brand: I also think the child looks like a boy. I guess we'll never know. Until he rebels and grows up to be an ultra right wing talk show host or something.

Elatia Harris: Well, if you want to seriously make a fetish of something, keep it a secret! These people have gone to too many Marilyn Manson concerts. I suppose the reductio ad absurdum here is starting a special account for Storm's transgender surgery, in the event he or she shall have been raised with too many choices.

Akim Reinhard: They don't want to burden their children with society's definitions, but they have a son named Jazz. 

Ruchira Paul: The parents have embarked upon a crusade and are using the children as weapons. This is how Jazz feels:  

But Stocker and Witterick's choices haven't always made life easy for their kids. Though Jazz likes dressing as a girl, he doesn't seem ...to want to be mistaken for one. He recently asked his mother to let the leaders of a nature center know that he's a boy. And he chose not to attend a conventional school because of the questions about his gender. Asked whether that upsets him, Jazz nodded.

Elatia Harris: Okay, well, this has left the sphere of Progressivism raised to eccentricity. This is pussyfooting around child abuse. Childhood is not a time of life when being "the odd one" in a group feels okay; rather, it is a time of life when most ki...ds want to differentiate themselves very slowly. Ask any kid who had 30 IQ points on the rest of the smart ones in 2nd grade how good that difference felt; you will not find one to say it was highly rewarding to be off the charts at age 7. Letting an unusual child be unusual is good, and refraining from privileging the mainstream over all other options is good, but if a little boy is asking to identify as such, and avoiding situations where his mother's refusal to designate him a boy causes pain, then these parents are not all about choice for their kids but about flouting norms they're angry with, and sending the bill for that to the kids. If they want to create a gender-free society they should start by muddying up their own genders, not with inflicting that life on their kids.

Lester Hunt: The first time I saw this title I literally thought it was an Onion headline. It reads like a stinging parody of parenting styles I have actually seen. My wife calls it "trying to raise a boy-girl."

Samina Raza: Way to confuse the hell out of the poor child... life is confusing enough without crazy parents...

Elatia Harris: Ruchira, it'll be a post to remember! Do you find it funny that no one has come out for the parents' rights to their philosophical conceits and the methods those conceits generate? Christian Scientists teach their children to have no truck ...with medical science, after all, even if physicians say their lives are at stake. And countless people raise their children to expect the End of Days -- soon! Still more teach their children to disregard evolution, global warming, and certain nagging problems with Hitler. Civil liberties lawyers seem to embrace all that at the legal and philosophical level, while not of course liking it personally. Could it be the parents in this case are afflicting their children with problems that education, peer pressure, and the eventual embarkation on a life beyond the parental grasp just cannot ameliorate?

Lester Hunt: Elatia, I do think these parents have a right to do what they are doing, but whether it is wise to exercise these rights in this way is a separate question for me.

Elatia Harris: If they have rights to raise there children this way, then our questioning their wisdom is only an exercise. I'll bet we all know some very impaired people who raise their children with love and precious little judgment. As long as love is ...present, life at home may be better than life in the foster care system. But defiantly presenting your child to the world as ungendered, and digging out on all the ensuing confusion because, s--t, man, your point is made, and you HAVE gotten in peoples' faces, is really unhinged. Malicious stage-mothering x 10, and I wish a sane auntie would step in.

Lester Hunt: By "have the right" I just mean it would be wrong to use force or violence against them. The rest of us have a right to remonstrate with them, ridicule them, and so forth. To start coercing people about things like this would be a slippery slope to Hell, I believe.

Elatia Harris: I agree, Lester -- the greater harm would not be outbalanced by the isolated good. This is like the Neo-Nazis parading in Skokie, IL, home to many Holocaust survivors, some decades ago. A real test case. If these parents are let alone, to w...oefully compromise their kids' journey to puberty, because they are not doing anything illegal, only something grotesque and harmful, then the rights of unconventional parents who do not expose their children to harm are safeguarded. Difficult as it all is, it's better so.

Lindsay Beyerstein: This is a publicity stunt. I don't see why people are so exercised about it, though. Basically, they're saying that they're not going to announce the kid's gender based solely on his (?) anatomical sex. They're waiting for him (?) to come t...o his own conclusions. If you accept the thesis that gender is primarily a matter of what's in your brain, as opposed to what's between your legs, it seems only reasonable to wait until the individual can express their identity. Odds are, Storm will come to the conclusion that his brain matches his junk--but if not, so what? I don't buy the whole "confusion" argument as to why you're abusing your kids if you don't relentlessly drill gender norms into them. I'm too much of a biological determinist for that. Kids know who they are. The worst-case scenario is if the brain doesn't match the junk and society spends an entire childhood trying to ignore or suppress the mismatch. That's what's confusing.

"Save A Mother": Annual Appeal

(Bringing the post to the front as we make a final push before the May event. Many thanks to those who have contributed. Your help will go a long way towards achieving our goals.)

A message from Dr. Shiban Ganju, founder of Save A Mother:

Save A Mother is a non-profit organization working to reduce maternal and infant mortality in India. Since our beginning in 2008, we have grown steadily in our operations in India and in number of supporting chapters in the USA, UK. 

 In 2008, we started working in partnership with local NGOs in the state of Uttar Pradesh, India, which has one of the highest maternal mortality rates in the world. We started in one districts and now expanded to five districts including one in Karnataka. We aim to minimize suffering and death due to pregnancy and childbirth. We are currently working in 854 villages in India and we will expand to 1400 villages by the end of 2011.

Health is not possible in the absence of health literacy. Save a Mother trains health activists from the community to spread health literacy. The trained health activists educate women about pregnancy, nutrition, immunization, delivery and care of the child. The activists not only complement the public and private health delivery system but also amplify their effect. They also educate the population about their rights to hold the health delivery system accountable. Some of the key services include: three day initial health literacy training followed by many one day refresher training sessions. We conduct about 8 training sessions a month and have conducted over 950 training sessions so far.

Save A Mother conducts periodic impact analysis to assess both quantitative data and as quality of life achieved. We collect data on the number of trained health activists, number of mothers registered, number of their prenatal visits, medicines supplied, immunization status and deaths due to pregnancy and delivery. Neonatal deaths are also recorded.

We have trained over 2000 activists so far. We have successfully reduced maternal mortality ratio by 93 % from 645 to 65 and neonatal mortality by 66% from 41 to 9. We spend about $100 per village in one year to achieve these results. Our cost is low because we are a volunteer organization and our administrative cost is zero. All donations go for field work.

Save-a-Mother recognizes the need of an aware, sensitized population, who would consider health care as a collective responsibility. Health care should begin with owning responsibility of personal and community health.  Many other regions in the world are in a similar situation, and we hope to bring this special effort to other countries. 

We believe that one preventable death is one too many. We urge you to support Save A Mother and together we can save millions.

The 3^rd annual fundraiser for Save A Mother, a non-profit organization I am actively involved with is under way. The fundraising gala in Houston is scheduled for May 13, 2011. As I did last year, I am posting an appeal here for donations from readers and also from friends and family in distant locations who may find a secure electronic mode of payment more convenient than sending a check in the mail. As I had indicated before, I am a volunteer for the Houston chapter of this organization that benefits poor women in rural India by educating them about pre and post natal maternal health as also, neo-natal child care.

The bulk of our fundraising is through direct solicitation in the real world from individuals and businesses. We also want to extend our reach into the cyber-world through on-line donations.  One of my roles in the organization is to facilitate the effort by offering this blog as a venue for fundraising.  I request readers to please look over the website of Save A Mother and the brief summary above by Dr. Shiban Ganju about our objectives and the results of the efforts so far. Kindly use the ChipIn widget link on the left hand side column of this blog to make your contribution. Thanks.

 

For further information about the organization’s work and progress please visit the Save A Mother website where you can find out more about the impact the program has made and other news.

(Many thanks to Rahul Singhal for setting up the necessary widget for the donation link and updating the website)

 

FDA's remorse: too little, too late?

A couple of weeks ago I posted the news about KV Pharmaceutical's price gouging tactics involving a common  drug used to prevent premature labor in pregnant women. The FDA, which gave exclusive manufacturing license for the drug Makena to KV, has now reacted to the massive bad press generated by the extortionist ways of the pharmaceutical company. Frank Pasquale has a wrap up on the FDA aided KV fiasco as well as other pertinent issues regarding price fixing, ineffectual cost control and cost shifting in the US health care system.

Are the Japanese culturally better equipped to handle catastrophes?

The extremely orderly, law abiding and co-operative culture of Japan, as also its long history of living with natural (and one major man-made one during WWII) disasters may have given rise to a mindset capable of dealing with catastrophes with calm. The recent scenes of public order amidst natural chaos from areas of Japan devastated by the massive earthquake and tsunami have led to much discussion about the Japanese character of stoicism and discipline.

TAGAJO, Japan – Close to the epicenter of Japan's devastating earthquake and tsunami, workers at a warehouse hauled out cans of coffee and soda this week to offer to passers-by for free.

"Help yourself! Take what you need!" they yelled as they put box after box on the sidewalk. Their boss Kazuyoshi Chiba said the phone lines are down, so he can't reach company headquarters, but "I think this is the right thing to do."

With the same mixture of resilience and resignation that has lifted Japan out of previous disasters, many survivors of last Friday's calamity are calmly pitching in to help themselves and others, taking life one day at a time. Four days on, there is little of the public anger and frustration that so often bursts forth in other countries.

The one exception may be near the troubled Fukushima nuclear plant, where fears of radiation leaks are spooking residents and fraying tempers. Elsewhere, survivors search for missing loved ones, clean up their streets and wait patiently for gas — with regret, for sure, but hardly a complaint.

Osamu Hayasaka was among those snapping up the free drinks handed out in Tagajo. "There are a lot of older people near where I live, so I'll give them some of this," the 61-year-old man said, strapping two boxes onto his red bicycle with a bungee cord.

His extended family of six has no power, intermittent water and little food. But, he said, he isn't angry at the government; he understands that officials have other priorities.

Japan is a nation of 127 million people with a long history of disasters, both manmade and natural, from a 1923 earthquake that killed 142,800 in the Tokyo region to the country's doomed entry into World War II, which ended with the atomic bombings of Hiroshima and Nagasaki.

Through these and more recent traumas, including a 1995 earthquake that killed 6,400 in Kobe, the Japanese have endured and rebuilt their country with a usually quiet and uncomplaining resolve. Now, the country's spirit is once again being tested by what its prime minister has called its most severe crisis since the end of the war....

... Amid the chaos, foreign journalists have remarked on the polite demeanor, the lack of anger, the little if any looting or profiteering that seems to characterize disasters elsewhere.

An American academic, Robert Dujarric, was stuck in a halted bullet train overnight after the earthquake. Passengers remained calm and didn't pester railroad employees with questions such as when the train would move again, said Dujarric, the director of the Institute of Contemporary Japanese Studies at the Temple University campus in Tokyo.

"Basically," he said, "if you have to spend 16 hours in a stationary train and an additional nine hours getting home, do it in Japan."

Two phrases offer some insight into the Japanese psyche.

One is "shikata ga nai," which roughly translates as "it can't be helped," and is a common reaction to situations beyond one's control. The other is "gaman," considered a virtue. It means to be patient and persevere in the face of suffering.

Is the FDA a public watchdog or a corporate sponsor?

This news story is beyond absurd; it smacks of ethics violations. The company awarded the special privilege doesn't even have the excuse of recuperating the costs of R&D! And we wonder why the health care costs go up?

Still think the US Food and Drug Administration (FDA) has your best interests in mind? According to new reports, the agency has arbitrarily decided to grant exclusive approval to KV Pharmaceutical to produce the one-and-only FDA-approved premature birth prevention drug -- which is really just a modified, patented version of the common hormone progesterone -- administered to women with a high risk of preterm delivery. So what used to cost women as little as $10 to buy from their local compounding pharmacy will now cost $1,500, thanks to the FDA.

Progesterone injections have long been custom-made by compounding pharmacies and sold for very little to women in need of them because, frankly, they cost very little to produce. But a backroom deal over at the FDA has changed everything, allowing a single pharmaceutical company to gain monopolistic control over the drug, which in turn allows that company to charge whatever it wants to for the injections, even if it is thousands of times more than what the drug actually costs to produce.

"This is a huge increase for something that can't be costing them that much to make," said Dr. Roger Snow, deputy medical director for Massachusetts' Medicaid Program. "For crying out loud, this is about making money."

And Snow is exactly right. The costs associated with producing progesterone are minimal, and there is absolutely no justification for charging $1,500 -- or as much as $30,000 throughout an entire pregnancy -- for progesterone treatment. But the FDA decision and the subsequent price increase are a natural result of what happens when government regulatory agencies are bought and paid for by the very industries they are supposed to be regulating.

Ignorance and inequality, hand-in-hand (Cyrus)

Some thoughts and stories about what is arguably the largest inequality remaining in the world: the sexual intimidation of women. This piece wasn't written specifically for International Women's Day, but the coincidence in timing is certainly appropriate.

---

7:12.

Shit.

Her body released a milligram of adrenaline, enough to force her heart to pound uncomfortably and a chill to travel from her neck down to her little toes.

She looked up from her computer screen and stared at the police phone number, the direct line to local dispatch. Hopefully it didn't come to that. The operator wouldn't speak English.

The thought of him knocking at the door and her trying to eek out a few words in Italian released another few debilitating shots of whatever neurochemical was starting to poison her ability to reason.

Him. She didn't even know who he was. He had shown up at her door one week past with a hard knock, the thuds demanding entrance. His voice has soon backed up the demand in accented Italian.

"What?"

"Open the door." Flat, not openly angry, but you could imagine suppressed rage.

"Who are you?," her words were now flowing a little better.

"Open the door."

"No." She backed away, glancing around her room, looking for her mobile. She hasn't been completely shaken, not yet. But his next words would completely rattle her.

"Open the door."

Open the door. In Arabic. Who was this guy? Did he know she would understand, or was he just guessing from her appearance? Had he seen men enter her apartment, and now he was out to enforce his medieval conceptions of social order?

"Go away. I will not open the door," in Arabic now. She spotted the phone, half-hidden under her pillow.

He had gone away that time, but he had come back. Every couple days, the evening would roll around, and at 7:30 he would show up, apparently as pious about time as about religion. At least that was her working assumption, as his intentions remained unclear. Did he just assume she was some slut who was asking for it?

What was clear was her fear.

Sniff Sniff (narayan)

Something had changed at Blockbuster and it was not the annual rearrangement of shelves and their culling of the excellent in favor of the trite. I hurried. Taking advantage of my grise, if not eminence, I leaned toward the young man at the check-out and said, "This place smells like vomit". "We are required by management ..." - shades of Nuremberg! Bereft of empathy, he switched off his smile and said, "Due back Wednesday".

Even before middle-age, when phobias translate to self-righteous smugness, I had started a one-man war against other people's smells, and I don't mean BO. So I was pleased, in '95, when I read an article in TNR by Richard Klein titled "Get a Whiff of This". OK, two-man war, I thought. The article was nowhere to be found on line and I had to rummage through my archives for a copy I had squirreled away.

Klein, a professor of French, had previously published the book "Cigarettes are Sublime"; I feel your winces. Though I am still on the cusp of criminality myself in that respect I do not like the smells associated with the vice. The smoke and others' exhalations suck, and my enjoyment, if not the habit, is a matter of the past.  Cigars, that vaunted concomitant of success and those seeking it, are an abomination to me, as is the stench surrounding uncultivated pipe-smokers.  It is easy to elicit your sympathy by saying that I too am revolted by the odors that assail me when I come back home from the movies, open a long unused closet, or board a German train (the very worst).

As for that other commonplace, everyone has a threshold of tolerance for body odors that get adjusted up or down depending on who it is that offends. There are those who for little reason are afraid of it in themselves and resort to masking with deodorants.  Compassion kicks in when I smell the presence of another so afflicted, but not when they over-compensate for it. When bathing at least once a month was considered a quaint custom of the French rich, hygeine consisted of changing shirts daily, or more often. Rank clothes these days are more objectionable to me than humors that can't be helped.

Aside from my nose and brain, my COPD scarred lungs protest, for perfumes are a health hazard.

Hot Flashes and Headlines (Sujatha)

Here we go again. The headline reads "Study Ties Hot Flashes to Lower Breast Cancer Risk". The article goes on to blabber thusly:

'Here's some good news for women ever bothered by hot flashes and other menopausal symptoms: Your risk for breast cancer may be reduced as much as 50 percent, researchers from the Fred Hutchinson Cancer Research Center in Seattle report.'

I imagine the next step would be 'Grin and bear it, it's all for the good.' to soothe the women asking for medication to alleviate the symptoms. I recall similar annoying headlines about the 'benefits of being a migraine sufferer is reduced breast cancer risk', when studies on that association were published a couple of years ago .

Optogenetics Relieves Depression in a Mouse Trial (Norman)

Optogenetics Relieves Depression in a Mouse Trial

    * By David Dobbs Email Author
    * November 30, 2010
    * 5:00 pm
    * Categories: Neuron Culture, Science Blogs
    * Wired magazine  

Forget about Area 51.  The action is at Area 25.

"...A team of researchers has used light to make a mouse’s brain run better and relieve the mouse’s mousy version of depression....This optogenetic work suggests a less intrusive, even more exacting way to test, define, and tweak...[brain] circuits.

"The researchers, led by Stanford University’s Karl Deisseroth and UT Southwestern psychiatrist Eric Nestler, used optogenetics — a technique that makes specific neurons sensitive to light and then lets you use light to activate or silence them — to increase activity in a key part of a mouse’s prefrontal cortex.

"As the researchers put it,

"...[O]ptogenetic stimulation of mPFC exerted potent antidepressant-like effects, without affecting general locomotor activity, anxiety-like behaviors, or social memory. These results indicate that the activity of the mPFC is a key determinant of depression-like behavior, as well as antidepressant responses."

This is a line of research that has been yielding excellent results for some time. Read more HERE.