Different Perspectives on Emergency Contraception

Medscape News (free registration) has 2 (two) articles on emergency contraception.  One article is essentially worthless; the other, alarming.

Worthless:

US Official Defends Morning-After Pill Delay

By Susan Heavey

WASHINGTON (Reuters) Aug 30 - U.S. Health and Human Services Secretary Mike Leavitt on Monday defended the Food and Drug Administration's delayed ruling on over-the-counter access for a "morning-after" pill, saying officials never guaranteed a "yes or no" decision by this week.

On Friday, the FDA postponed a ruling on Barr Laboratories' Plan B emergency contraception because it said officials were unsure how to enforce a prescription requirement for younger girls while easing access for women over 16.

"We did take a step forward in the process," Leavitt said. "Sometimes action isn't always yes and no. Sometimes it requires additional thought."

The FDA, which is part of Leavitt's department, called for 60 days of public comment but gave no further deadlines.

Supporters and critics of the controversial drug expected the FDA to rule by Thursday, when Leavitt and FDA Commissioner Lester Crawford said the agency would "act."

Democratic Sens. Patty Murray of Washington and Hillary Clinton of New York, who both dropped objections over Crawford's nomination as commissioner based on that pledge, said Leavitt was playing "word games." [...]

Alarming:

Access to Emergency Contraception Poor in Hospital ERs in US

By Megan Rauscher

NEW YORK (Reuters Health) Aug 30 - Results of a survey show that the availability of emergency hormonal contraception to prevent unintended pregnancy is limited in hospital emergency departments in the US, regardless of circumstances or affiliation with the Catholic Church.

Posing as women in need, trained interviewers telephoned emergency department staff at all 597 Catholic hospitals in the U.S. and 17% of non-Catholic hospitals (n = 615) to inquire about the availability of emergency contraception.

According to the results, published in the August issue of the Annals of Emergency Medicine, staff at 42% of non-Catholic and 55% of Catholic hospitals reported that they do not dispense emergency contraception, even in cases of sexual assault. [...]

Among staff that said their hospital does not provide emergency contraception under any circumstance, only about half gave callers a valid referral to where they could obtain emergency contraception. [...]

Alarming?  Alarmist?  Emergency contraception has been in use since 1999 under FDA approval.  It has been available over the counter in Europe for 20 years.  Canada and five US states permit OTC sales.  Advocates estimate that it could prevent half of the unintended pregnancies, and half of the elective abortions, each year.  

Those persons who believe that life begins with conception probably should not use EC.  Those who lean more toward the view that life begins with implantation, or at some later time, should have access to it.  Those who believe that they have the right to make decisions about other people's moral choices should become dictators of poor countries, where nobody has any rights.  Last I checked, several are still available.

I can't find the link now, but I read earlier that the FDA already had received thousands of public comments on the issue, even before this latest call for comments.  I suppose they want more.  Comments can be sent to the FDA here, although it seems doubtful that more comments will change anything.  

Meanwhile, women who find themselves in need of EC can call 888-NOT-2-LATE or go to www.themorningafterpill.net.

Peace Protests

I have to remember (I can be absent-minded, sometimes) to sign up for the march on Washington that is planned for Sept. 24th.  Especially after reading this:  

The words of First Sergeant Perry Jeffries, 20-year Army veteran, recently returned from Iraq:

[T]he only way that we can maintain our way of life is to have a strong defense.... And we had that before we started this little adventure here. Now we're beginning to eat it up....The equipment and the people are getting chewed up and spat out. And that's not the right way to defend our country.....

I tell you I was in Iraq and we saw some of the peace protests that were done at that time. And I felt like people really cared about me because they were taking the time to address the issues. And get really involved and do something rather than just emit jingoistic slogans....

Tip o' the Fedora to Middle Earth Journal

45 Years Ago

Bill in garden: August 1960

Platonic

I felt inspired to write poetry. I've got Platonic on my mind. The first subject that came to mind, was the five Platonic solids. I got stuck, though, because I could not think of anything that rhymes with icosahedron.

This Could Work

Get five acres of land.  Put up a building with a windmill power generator, two community showers and bathrooms*, a meeting room, day care, a communal kitchen, and a wireless network connection.  Make a storm shelter in the basement.  Surround the building with yurts.  You could have ten or twenty family-like groups live for what it costs to have a medium-sized house in Burns Park.  
_____
*I'm still too Catholic to consider having just one community shower.

Categories: armchair musings

He Jumped.

We spent hours out in 85 degree heat, got sunburned, putting up the fence.  And he just waited, less than 24 hours, when we both were gone, he went and jumped over the fence.  Less than five months old.  

The only clue was the red stripe on his underbelly.  Laboratory testing showed that it was Ragu on his belly.  There is no question about it: the Flying Spaghetti Monster touched him with his great noodley appendage.

Categories: miracles
Tags: FSM

More Thoughts on the Great Divides

My first clinical months, in the third year of medical school, were in Mott Children's Hospital. Those rooms always had been decorated with balloons and teddy bears and the like, and it seemed to make sense to me.

Later, working with adults, I sometimes wondered why people would put up pictures of their family and stuff. Obviously, I had a lot to learn. I did notice, eventually, that it is a lot easier to think of a patient as a person, if there are personal effects in the room. Conversely, it is a lot harder to dehumanize a patient if you know what their kids and grandkids look like.

A few years ago, when my father was in the hospital after back surgery (which went very well), my middle sister took it upon herself to decorate the room.  She runs a day care center.  All the kids in the center knew my father, and liked him.  So my sister had them all make get-well massages on sheets of construction paper.  There must have been a couple dozen of them, all cute; some quite endearing.  As I recall, they covered most of one of the walls.  

It was effective.  Anyone with two surviving neurons and at least one molecule of serotonin would have recognized the man recovering in the bed, as a treasured member of the community.  Such efforts are a part of what makes a community.  People showing support for each other, openly showing that they care.  

The most obvious function of the get-well messages was to help the patient feel better.  But it does more than that.  It helps the doctors and hospital staff feel good about what they are doing.

Categories: medicine, armchair musings
Tags: medicine, Health, medblogger

The Great Divides in Medical Practice

Today, my father-in-law and I put up a fence.  It's a solar-powered electric fence, that divides our paddock in two.  Why?  Because it is time for Champie to be weaned.  

After we put up the fence, we tested it.  135 volts.  Champie can be a bit insouciant, as the picture shows, but I think 135 volts might get his attention.  He won't like being separated from his mother, but sometimes you just have to do these unpleasant things.  

This turns out to be an analogy that we can use to understand some of the Great Divides that occur in the course of medical practice.  Continue reading here.

Categories: medicine, armchair musings
Tags: medicine, Health, medblogger

Why Hats Should Be Iron, Not Tinfoil

A new study done at the University College, London, shows that it is possible to use a magnetic field to turn of that part of the brain that notices when the visible environment has changed.  The background is this: When something critical changes in the environment, for example, a traffic light changes from green to red, the right parietal lobe is supposed to notice the change and alert the rest of the brain.  

This was a bit of a surprise, since most processing of visual information occurs in the occipital lobes.  Be that as it may, it is the right parietal lobe that serves to alert us to such changes.  And, as it turns out, repetitive transcranial magnetic stimulation (rTMS) can be used to turn off that part of the brain, temporarily.  The subject does not have any way of knowing that his or her brain has been tampered with.  

In previous experiments using brain scanning (functional magnetic resonance imaging or fMRI), the team led by Professor Nilli Lavie at the UCL Department of Psychology, discovered that detection of visual changes was not only correlated with activity in conventional visual areas of the brain but also with activity in the parietal cortex.

But, until this experiment, when the team actually switched off the parietal cortex using TMS, they didn't know that noticing change critically depends on activity in the parietal cortex. When that region of the brain was effectively switched off, 'change blindness' (a failure to notice large changes in a visual scene) occurred.

The people in black helicopters can use this technique to render us unaware of their presence.

For years, bloggers have been urging others to wear hats made of tinfoil (which is actually aluminum) to prevent this kind of thing.  However, a thin piece of aluminum is not able to block the effects of rTMS.  Therefore, we need to put away our tinfoil hats, and use iron instead.

Friday Head Blogging

I've always wanted to belong to an exclusive club, wherein acceptance is automatically guaranteed, once certain strict criteria are met:

The Fraternity of the Shaven Head
Raffi Melkonian at 07:15 PM

The day after the bar exam, I went to the local barber in Cambridge and had my head shaved down to a close crop. I suppose some other people might have done so out of ritualistic excitement, but my reasons were mostly aesthetic - enough of my hair had fallen out that I was in danger of becoming one of those people who try to pretend they aren't balding. So I took action. [...]

But in the meantime, I've noticed that balding men who have shaved their heads share a few more glances and nods than men generally exchange in public. It's as if one is saying to another something like - "yeah. I too saw the light".

...not that I would consider this, realistically.

Grazie, Silvio

I told myself that I was going to write about science today, perhaps this or this; but I got sidetracked.

You may recall that Halliburton announced, in January 2005, that it would be pulling out of Iran, citing "a poor business climate."  We learned later that this was not really true.   Now it turns out that things are not going so well for Halliburton: Agenzia Gournalistica Italia has a news section, News for Arab Countries, which it describes as a "Special service by AGI on behalf of the Italian Prime Minister's office."  They are reporting something about Halliburton that American news agencies are not, but that American voters, as well as certain investors, might like to know.  Continue reading, here.

Categories: politics, rant tangents
Tags: Halliburton

In Case You Didn't Notice:Tom Delay Edition

Never one to walk away from a fight, former Yellow Hammer Award holder Tom DeLay put forth a mighty effort to reclaim the coveted award.  

Textile workers in the Mariana Islands work 16 hours a day, seven days a week. Belonging to the U.S., legislation was drafted to bring workers under the minimum wage law. Although much support exists for legislation, Republican Leader Tom Delay flew to the islands, met with industry leaders and allegedly received $300,000 to stop the legislation. Delay earns his money by keeping legislation in committee.

Not content merely grinding the poor and underprivileged under his boot heel, he followed up with blatant hypocrisy.  He boasted about the White House's recent budget projections (unaware that Brad DeLong was lying in wait with a blistering refutation).  DeLay was quoted in the Houston Chronicle:

"The falling deficit projections should come as no surprise to anyone aware of Republican fiscal policies," House Majority Leader Tom DeLay, R-Sugar Land, said. "Lower taxes and spending discipline spur economic growth, which in turn cuts the deficit."

But if pending discipline spurs economic growth, then why does he boast, on his own website...

Washington, Jul 29 - House Majority Leader Tom DeLay (R-Texas) today announced significant transportation funding increases for Texas, bringing highway funding levels to the highest in state history.

Why? I guess spending discipline is appropriate only for textile workers, not DeLay's own constituents.

What was Dr. DeLong's objection to Mr. DeLay's claim about the effects of tax cuts?  He quoted Gregory Mankiw, the former chairman of Mr Bush's Council of Economic Advisers:

Left out of these calculations is any guide to what happens when taxes are cut but spending is not. The budget deficits that ensue will tend to "crowd out" investment, slowing growth. The CBO calculates that every extra dollar of federal borrowing reduces investment in the economy by 36 cents.

The White House['s]... latest forecast... assumes (absurdly) that Congress will not add a single dollar to its discretionary spending on anything except defence and homeland security from 2006 to 2010. It also leaves out of its projections any extra money for Iraq, Afghanistan or the war on terror...

The material above originally appeared in The Economist, a publication which, you may recall, endorsed John Kerry in the last US Presidential election.

The Power of Zero

Via a rather loose concatenation of links, I began reading the first page of the book, Zero: The Biography of a Dangerous Idea by Charles Seife:

An Eastern concept, born in the Fertile Crescent a few centuries before the birth of Christ, zero evoked images of a primal void, it also had dangerous mathematical properties.  Within zero there is the power to shatter the framework of knowledge.

It is not so strange that I would read this eventually, although it is a bit strange that I would be reading it now.  Last night, I was reading The Golden Ratio : The Story of PHI, the World's Most Astonishing Number, by Mario Livio.  What is strange is the confluence of ideas thus provoked.  I went from the mathematics of Zero, to the amount of postwar planning for Iraq.  Continue reading here.

categories: politics, rants
tags: downing street memo, BBA

I Hope Santorum Comes to Ann Arbor...

...But he's too much of a coward.  The "honorable" Senator Rick Santorum (that's a googlebomb link; also see official page here) has come under fire, because a small group of young ladies wanted to protest his well-publicized homophobic comments, at a book signing in Delaware.  I found this royal link at King of Zembla, who credits Suburban Guerrilla.  SG quotes an article at Common Dreams Newscenter, which in turn quotes an opinion piece by Al Mascitti of Delawareonline.com.  (Del. state trooper helps enforce Rick Santorum's 'family' values)

The young ladies, all in their late teens, were ejected from the premises of Barnes and Noble by an off-duty state trooper.  One of their mothers went to have a talk with the cop, and was ejected summarily.  None of them even set foot inside the building, much less created any kind of disturbance.

If he does come to the Barnes and Noble in Ann Arbor, I'll make sure he gets an appropriate welcome.  Hell, I'll even get my right earlobe pierced for the occasion.  I think my wife would understand; in fact, she'd probably go along with me.

Improving Empathy in Medical Training

Used worldwide, The Empathy Belly  has proven itself to be an extremely beneficial teaching tool resource for medical students, obstetrical physicians and allied professionals in the fields of Maternity Health Care and Education. By wearing The Empathy Belly they significantly increase their understanding and sensitivity about the pregnant condition. Consequently they are better trained, more effective, and more likely to establish genuine rapport with the pregnant women in their care. For obvious reasons, this is especially true for service providers who are male, or women who have never experienced a full-term pregnancy.

No thanks.  But seriously, we all know that many doctors need to be more empathic.  A Google search on the string, "empathy in medical training" gets about 745,000 hits (including the one above).  Many medical schools have incorporated empathy training into their curricula.  Even so, the problem persists.  We see articles in the NYT such as Awash in Information, Patients Face a Lonely, Uncertain Road; also see Sick and Scared, and Waiting, Waiting, Waiting, for an additional perspective on the problem.  

Later, I encountered a physician's essay on the topic of empathy: Empathy: Lost or Found in Medical Education? (Medscape: free registration required) by Sonal Singh, MD, that inspired me to write this post.  Continue reading here.

Categories: medicine, being nice
tags: medicine, health, medblogger

Who Smiles More at Princeton?

Via a link found at misbehaving.net ("Well-behaved women seldom make history"), I found this picture.  It is a set of computer-generated average faces of students at Princeton.  The one on the left is the average man; the middle, the average student; the right, the average woman.  The images on the bottom are "processed representations of differences between faces which are used in algorithms".

I had to shrink the picture a bit in order for it to fit.  The differences are more apparent when viewed at full size.  It appears from this, that Princeton women smile more than Princeton men.  Princeton men pout a lot.  Why is that?

---

Every time I pose a new question here, I will answer the last one.  The last one was: Why did I wake up with the song, Girls Just Want to Have Fun, playing in my head?  It's because before I went to bed, I had gotten a phone call from my wife.  She had gone to Ohio with her mother and sister.  They went to look at pottery and fabric, for their various hobbies.  They ended up getting lost, would be late getting back, and I could hear all kinds of joking and laughing in the background.  I never knew that getting lost could be so much fun.

Back On Line

We had a power failure, and it appears to have done something unpleasant to the boot sector on my primary drive. That happened despite having a UPS and a second surge protector. (The UPS has surge protection built-in). I heard that lighting hit the power substation near us, which actually is about twelve miles away. Since the storm did not seem very close, I had not turned off my computer. It will take a while to get everything set up the way I want it, so it probably will be a day or two before I post anything substantive.

Friday Horse Blogging

Champ's Vivid Image, Reclining

Why?

This morning, I awakened with a song playing in my head: Girls Just Want To Have Fun, by Ms. Lauper. Why is that?

Trying Something New

From time to time, I will leave brief posts mentioning what I am thinking about blogging about in the near future.  If anyone has any input about what they would like to see or not see, you are welcome to leave comments. 

Sometimes comments have inspired me to write particular things, although I don't always get a round tuit.

Currently, I am considering writing about the recent NEJM articles about the racial and gender disparities in health care, along with some ideas for research into the causes and possible solutions.  There also is a Medscape item (free registration) about the problems of improving empathy in physicians-in-training, which may be related, in some oblique way. 

I also may write a history of the usage and meaning of the word, snert.

Just In Case You Didn't Notice;Just In Case You Care

Most US papers aren't printing it, but at least WaPo put it in section A, albeit on page 13.

700 More Troops to Be Sent To Iraq
Aim Is to Bolster Prison Operations

By Bradley Graham
Washington Post Staff Writer
Thursday, August 18, 2005; Page A13

Responding to an appeal for more forces in Iraq to help manage a rising number of detainees, the Pentagon is dispatching an additional 700 troops from the 82nd Airborne Division, defense officials said yesterday.

The previously unscheduled deployment is intended specifically to bolster prison operations, the officials said. It is not part of a temporary increase in U.S. troop levels in Iraq that commanders have said is likely to enhance security for a planned constitutional referendum in October and governmental elections in December.

I don't know, maybe this isn't really important.  But maybe, just maybe, our citizens do care that we are increasing troop deployment.  Maybe they do care that we are running into a problem handling the fact that the number of prisoners in Iraq has doubled in the past seven months.  We are in the process of building a fourth prison there.  The article points out:

Military officials have attributed the influx of detainees to intensified counterinsurgency operations by Iraqi as well as U.S. forces. But the burgeoning prison population also appears to reflect the persistence of the insurgency itself.

The good news is that the insurgents are being captured.  The bad news, which is not reflected in the article, is that it doesn't seem to be making any difference how many are captured.  The attacks continue to increase, and our troops continue to get killed.

categories: politics, war
tags: Iraq

The Toughest Job In the World

Studies show that ten to thirty percent of young students engage in bullying behavior.  These behaviors are associated with anger, poor interpersonal relationships, and reduced quality of life -- for the bullies, that is.  It's not so nice for the rest of us, either.  

There is hope, however.  Marius Nickel, from the Clinic for Psychosomatic Medicine, has completed a study (free registration required) that shows a positive effect from family therapy.  That is, instead of trying to get the bully to engage in individual therapy, it is possible to obtain the desired effect by treating the entire family.

"The results of this study show that outpatient family therapy seems to be an effective method of reducing anger and improving interpersonal relationships and health-related quality of life in male youths with bullying behavior," the authors write. "This study indicates that even bullying boys can cope well with outpatient family therapy. The clear time frame and the relatively minimal time commitment boosted compliance."

Like all studies, this study has certain limitations.  The authors take care to point out:

Study limitations include relatively small sample size, sample consisting only of male youths, sample composed of moderately aggressive individuals who had not engaged in criminal conduct and who still had the resources to enter therapy, study duration of only six months, and relatively select population.

Now, the plan is to repeat the study with bullies of both genders, a different age group, and those with a history of criminal conduct.  This will be a much more difficult group to treat.  It probably will take more than six months.

---

In other news, James Coburn stars in the film, The President's Analyst.

Bizarre satire lampooning espionage flicks. James Coburn is a psychiatrist asked to take on the President of the United States as a client. The secrets told during the sessions unnerve him, and finally he finds himself in a real espionage plot -- or is it just his imagination? The parody ultimately works well, but it takes a mind that's both patient and clever enough to pick up on the subtleties to endure the weirder parts of the film.

How Puritanical Are You?

Some people think I am an atheist.  That is not correct.  Some people think that people with my kind of religious beliefs are immoral or amoral.  That is not correct.  To illustrate:

Last week, I was at Busch's with my wife.  Usually, I am in front, and I use the debit card.  That day, she was in front.  She swiped the card through the little machine, and then reached up to key in her PIN.  I averted my eyes, because it is not polite to watch someone else type their PIN.  

Now, as it happens, we only have one account, so it really does not matter if I know her PIN.  It is probably the same as mine.  She would tell me what it is if I asked her.  But it still is not polite to watch someone else type their PIN.

A couple of weeks ago, I went to a restaurant.  A pretty good restaurant.  The hostess, I happened to notice, was wearing a short skirt.  That particular skirt would have been a capital offense in Saudi Arabia, a bit inappropriate in Paris, and a traffic hazard in Manhattan.  

To my horror, she started to lead us up the stairs.  The geometry of the situation brought my optical axis to the same altitude as her greater trochanters.  The rather thin fabric I was seeing appeared to be some sort of polymeric hydrocarbon.  It had assumed a distinctly interesting curvature.  

Everyone knows that it is not polite to look at a woman's greater trochanters, so I looked off to the right.  Bricks.  Not interesting.  I looked to the left.  More bricks.  Not interesting.  I could look down, but then it would appear to others that I was looking at her legs.  Not polite.  I could look up, but then I probably would trip on the stairs, flailing nose-first into her Ward's Triangle.  Not polite.  Women get particular about their triangles.

Sometimes, nature makes it difficult to be polite.  We just have to accept that.

Defining Victory in Iraq:Liberal Blogger Admits That We Are Winning

I almost turned off my computer and went to bed, after reading through some news articles and liberal blog posts, many of which discuss the question of whether we are winning in Iraq.  I though about visiting some of the right-leaning blogs to see what they had to say, but decided it wasn't worth it.  That's when I almost went to bed.  Instead, I am simply going to say: everyone is wrong.  Even I was wrong.  

I never thought the war was about WMD, or about terrorism, or about getting rid of a brutal dictator, or about spreading democracy; nor did I ever think we wanted to go in and take their oil.  If we simply had wanted to take their oil, we would have done that already.  No, I thought the war was about oil company contracts.  We would not take the oil; we would buy it.  Or rather, oil companies friendly with the Administration would buy it, and sell it to us, and make a handsome profit in the process.  (See Judicial Watch page on Iraq Oil Foreign Suitors.)  

That was short-sighted of me.  If that were the measure of winning, I would have to say we are loosing the war.  It does not appear that Iraq will have sufficient political stability for any large-scale oil projects anytime soon.  But -- and this is where I went wrong -- oil companies are still making record profits, as is Halliburton.  

By that measure, we are winning.  In fact, if the objective was profit, we couldn't loose!  It was/is a brilliant strategy.  In one scenario, we start the war, bring peace to Iraq, and Exxon/Mobil, Halliburton, and the rest, all get lucrative oil and oil field development contracts.  In the other scenario, we go to war, make a royal mess of things, the price of oil goes through the roof,  Exxon-Mobil makes a ton of money, and Halliburton keeps getting lucrative mercenary contracts.  

So the left-leaning folks, the ones who say we are loosing, are wrong.  The right-leaning folks, those who insist we are winning, are sort of right, but for the wrong reason: it is not We (as in We the People) who are winning; it is Bush's "we" (the haves and the have-yachts) who are winning.

This, by the way, is why the Administration is not particularly concerned about the Downing Street Memo, nor about Cindy Sheehan, nor even about Carl Rove and the outing of Valerie Plame.  None of that matters.  The Administration does not care if we learn the whole thing was based on lies.  They do not care, because they win the war no matter what happens.

Categories: rants, politics
Tags: Iraq, Downing Street Memo, Valerie Plame, Cindy Sheehan, Karl Rove

Sunday Night Not Blogging

I was in the hospital all weekend.  My plan was to get home and write the definitive post about avian influenza, but that will have to wait.  On CNN tonight they mentioned that we are spending five and a half billion dollars to prepare for a biological attack (that probably will never happen.)  We have spent less than a tenth of that preparing for a pandemic that probably will happen.  My only hope is that some thought is being put into making that bioterror defense planning flexible enough, so that we can use whatever preparedness it gets us, to fight off the more likely threat.

Army Earth Day

Again, the liberal Blogosphere has been found to be lacking.  We just never seem to catch the good news that would present our Government in a positive light.  Although this is old news, as "they" say, better late than never.

You can download an image suitable for printing as a poster, or images for computer wallpaper, here.  A short Quicktime movie is available here.

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In other news, the luxury resort for Gitmo detainees has expanded its library.  Although the reading list is tightly controlled...

The library bans certain book categories, such as ones that deal in political thought.  "We try to keep people calm and not incite riots," Lori said.

...they have added another author to the approved list: J.K. Rowling

Harry Potter's worldwide popularity is so broad-based that it has become favorite reading for Islamic terror suspects at the U.S. prison at Guantanamo Bay.

Lori, who for two years has overseen the detention center's library, said J.K. Rowling's tales about the boy wizard are on top of the request list for the camp's 520 al Qaeda and Taliban suspects, followed by Agatha Christie whodunits.

"We've got a few who are kind of hooked on it. A couple have asked if they can see the movie," said Lori, a civilian contractor who asked that her last name not be publicized.

Friday Cat Blogging

Gizmo (top) and Microsoft (bottom)

Photo Series

These are pictures from Palm Springs & Environs 2003

I Think This Is Amusing...

Help stop global warming with this bumper sticker.

Aye, but thar prob'ly be swabbies who'd be insulted by 't. Arrr!

CNS Update: Sleep Medicine

Michael Rack, MD, (blog: sleepdoctor) scooped me on this one: ramelteon (formerly named TAK-375, now called Rozerem® - Takeda Pharmaceuticals North America) was recently approved by the USA FDA for treatment of insomnia.  Check his post for details.  Basically, it acts on melatonin MT1 receptors, so it should be nonaddictive and should be extremely safe in overdose.  That latter point is of great interest to psychiatrists.  

Melatonin is a popular "natural" substance used to treat insomnia.  Success is highly variable.  It helps some people, but it seems that most people get no benefit.  There is no FDA quality control for nutritional supplements, so some OTC versions of "melatonin" actually contain no active ingredient.  That is one reason why traditional MD's tend to be skeptical of such products.  Plus, there was a small case series of patients with bipolar disorder who did not improve when treated with melatonin; one developed a free-running (unentrained) sleep-wake cycle after melatonin withdrawal.  I hope Takeda is watchful for this kind of thing in their post-marketing surveillance; it's the kind of thing that is unlikely to show up in phase I-III studies, but may show up when a larger, more heterogeneous population is exposed.

Practical matters aside, it is time to move on the the fun part: pure, preclinical, science, with no obvious practical application.  In this post, I ramble on about some basic science related to sleep disorder research, that may someday enlighten us about an important subsystem in the brain.  Continue reading here.

Categories: science, sleep disorders, neurochemistry
Tags: medicine, psychiatry, sleep disorder, sleep apnea, neurochemistry, insomnia

Naming the New Planet

Suggestions for the name of our solar system's recently-discovered tenth planet are rolling in.  Michael Brown, the California Institute of Technology astronomer who led the discovery team, traditionally gets to suggest the name, then the International Astronomical Union (IAU) makes it formal.  Although the IAU hasn't even officially christened the object a planet, hundre4ds of suggestions have been sent in, informally, to NewScientistSpace.com, in anticipation of the christening.  In an article at National Geographic:

The clear winner was "Persephone" (Greek spelling) or "Proserpina" (Roman).

In Greco-Roman mythology, Pluto/Hades, god of the underworld, kidnapped Persephone/Prosperina and made her his wife. Her mother's sadness was such that it caused winter—making the name especially apt for a cold, distant planet. [...]

Brown pronounced the runner-up—"Peace," or its Latin root, "Pax"—"a good name." And according to O'Neill, of NewScientistSpace.com, Brown "really liked [sixth-ranked] 'Bob' as a possible name."

"Galileo," "Xena," "Rupert" (after a gag in The Hitchhiker's Guide to the Galaxy), "Titan," "Nibiru," "Cerberus," and "Loki" round out the NewScientistSpace.com readers' top ten.

Apparently, some consideration is being given to the fact that of the nine named planets, only one has a woman's name.  That gives an edge to Persephone or Xena.  

To avoid controversy, I think we should name it "Pat."

Categories: armchair musings
Tags: astronomy

Tuesday Roadrunner Blogging

I can't take credit for this...



...because it's Cyndy's picture.

Cindy Sheehan's diary

From http://www.upbeatdefiance.com/xoops/modules/news/article.php?storyid=22
Day 3 of the Peace Occupation of Crawford
by CindySheehan
Mon Aug 8th, 2005 at 21:10:24 PDT
Camp Casey
Day 3
The Peaceful Occupation of Camp Crawford

Where do I begin?

Today was a highly eventful day. This entry won't be artful, but utilitarian.

CindySheehan's diary :: ::
I conservatively got 3 to 5 phone calls a minute. I did about 25 phone interviews and several TV interviews. I did several right-wing radio interviews. I was supposed to do: The Today Show, MSNBC live interview, Connected Coast to Coast (MSNBC) and Hardball (MSNBC). The Today Show just never showed up and the other 3 MSNBC shows cancelled for no reason. Could it be because NBC is owned by General Electric, a major defense contractor??

Another big story that was going on today was about my first meeting with Bush in June of 2004. For you all I would like to clarify a few things. First of all, I did meet with George, and that is not a secret. I have written about it and been interviewed about it. I will stand by my recounting of the meeting. His behavior was rude and inappropriate. My behavior in June of 2004 and is irrelevant to what is going on in 2005. I was in deep shock and deep grief. The grief is still there, but the shock has worn off and the deep anger has set in. And to remind everybody, a few things have happened since June of 2004: The 9/11 commission report; the Senate Intelligence report; the Duelfer WMD report; and most damaging and criminal: the Downing Street Memos. The VERY LAST THING I HAVE TO SAY ABOUT THIS IS: Why do the right wing media so assiduously scrutinize the words of a grief filled mother and ignore the words of a lying president?

In the early afternoon, we got word that if we were still there by Thursday, we were going to be deemed a "security threat" to the president. Condi and Rummy are coning in on Thursday for a "policy" meeting. Don't they mean conspiracy to commit crimes meeting? I just don't understand why we will be a security threat on Thursday when we aren't now? If we don't leave on Thursday, we will be arrested. Well, I am not leaving. There are only three things that would make me leave: if George comes out and talks to me; if August comes to an end, or if I am arrested.

People are heading here from all over the country. I have some more Gold Star Families for Peace members coming tomorrow. We are amazed by the outpouring of love and support we are getting. If you can come, then come. 62% of the American public are against this war and want our troops home. We need to show the media that we are in the majority. We need to show George Bush and his evil cabal of neocons that when we say "bring the troops home, now" we mean "bring the troops home, now!!!"

In the late afternoon, many of us left to go back to the peace house in Crawford because there was going to be a major lightening storm. While most of us were gone, the Sheriff came and told us that what we were told was county property really was private property and we would have to remove our stuff to a tiny place, or get it confiscated. I find it interesting that the county sheriff did not know that roads in his county that lead up to the presidential vacation home are private roads. I find it very hard to believe. The bastards think that they are pushing us off, but we will not leave there voluntarily or without handcuffs on. My only hope is, there will be tons of media there when they carry me to the squad car.

Today was so bizarre for me. I got phone calls from famous people pledging their support, and phone calls from mothers with sons in Iraq who are overcome with emotion when they talk to me. And it is so brave for them to call me, because I am their worst fear. We had a young man who is in the US Army at Ft. Hood come this morning and spend hours with us. He has been there and his unit is scheduled to go back in October. How much courage did that take for him to come within earshot of his commander in chief's home and spend time with some old hippy protestors???

We have lawyer working on getting us closer and working on magically turning the private property back into county property again. I have some awesome young ladies for Code Pink answering my phone and taking phone calls. We have Veteran's for Peace out there putting up banners (our tiny campsite looks real nice). We have concerned citizens from all over America starting to come in. IT IS FREAKIN' AMAZING, FOLKS!!!

Come and join us and let your voices be joined with ours. AMEN!!!

Grand Rounds #46

Dr. Emer, writing in Manila, brings us the forty-sixth edition of Grand Rounds, here. It's nicely done. I notice that there are several first-time contributors.

Finally, Good News From Iraq

The liberal Hemiblogosphere often is criticized for neglecting to mention "all the good news" coming from Iraq.  I intend to rectify that here, and atone for my past omissions.  Original source here.

Q: But, still, those countries who didn't support the Iraqi Freedom operation use the same argument, weapons of mass destruction haven't been found. So what argument will you use now to justify this war?

THE PRESIDENT: We found the weapons of mass destruction. We found biological laboratories. You remember when Colin Powell stood up in front of the world, and he said, Iraq has got laboratories, mobile labs to build biological weapons. They're illegal. They're against the United Nations resolutions, and we've so far discovered two. And we'll find more weapons as time goes on. But for those who say we haven't found the banned manufacturing devices or banned weapons, they're wrong, we found them. [emphasis added]

Ooops.  Check the date.  May 29, 2003.  I guess that's not exactly news, then.

Now, the apology.  I did not dig this up.  Another blogger did, who deserves a link back, but I closed the tab and now can't remember who it was.

Categories: rants
Tags: WMD, Bush is an idiot

Stigma of Schizophrenia

The latest issue of PLoS Medicine contains a short open-access article, The Global Fight against the Stigma of Schizophrenia.  The authors, Nadia Kadri and Norman Sartorius, coordinate the World Psychiatric Association's global program to combat the stigma of mental illness.  Their program, Open the Doors, specifically targets the stigma associated with schizophrenia.  

The authors point out that "The stigma attached to mental illness is the greatest obstacle to the improvement of the lives of people with mental illness and their families."  The implied significance of this is that the single most important advance for improving the lives of persons with schizophrenia will not come from the laboratory; it will come from changes in society.  

The WPA's effort differ from previous, similar programs, it that it is intended as an ongoing effort, rather than a time-limited campaign.  The international scope of the effort is intended to help generate and spread new ideas.

[I]t emphasises the need for sharing experience and information obtained in the course of the programmes among all concerned, within and between countries.

In addition, it emphasizes collaboration with family and patient advocates and advocacy groups.  They state that their central focus, possibly the most important element of the program, is upon boosting the self-esteem of patients and families.  One of the things that they have learned, is that success takes years of continuous effort.  Empirical measures of the success of such programs often have been disappointing; in their words, the initial efforts "often produce only meagre results."  

The Open the Doors website lists some of the specific misconceptions that contribute to stigma:

• Nobody recovers from schizophrenia.
• Schizophrenia is an untreatable disease.
• People with schizophrenia are usually violent and dangerous.
• People with schizophrenia are likely to infect others with their madness.
• People with schizophrenia are lazy and unreliable.
• Schizophrenia is the result of a deliberate weakness of will and character ("the person could snap out of it if he would").
• Everything people with schizophrenia say is nonsense.
• People with schizophrenia cannot reliably report the effects of treatment or other things that happen to them.
• People with schizophrenia are completely unable to make rational decisions about their own lives (e.g., where to live).
• People with schizophrenia are unpredictable.
• People with schizophrenia cannot work.
• People with schizophrenia get progressively sicker all their lives.
• Schizophrenia is the parents' fault.

On the same page, they list strategies for combating stigma.  In the interest of brevity, I won't reproduce them here, but I do encourage people to read them.

A few comments: one of the unfortunate byproducts of the early research into schizophrenia is the misconception that the parents are to blame.  That belief was fashionable in scientific circles in the 1950's, but no health professionals believe it today.  Yet, the misconception persists.  Some of these misconceptions are not specific to schizophrenia.  In particular, the belief that mental illness is "a deliberate weakness of will and character" is almost universal.  Anyone closely acquainted with such a person should stop and ask: why in the world would anyone deliberately do this to themselves?  

The authors report that they do have some early indications of success, although the specifics still are in publication.  It will be interesting to see what they end up with.  

One of the reasons the WPA's sustained effort is so important is that the funding climate in the USA generally favors quick results.  If they are able to show that it is not reasonable to expect dramatic results in a short time frame, but that an extended effort can be useful, it may encourage funding sources in the US to be a little more generous.  The Open the Doors program is tackling an enormous problem, and it deserves more attention.

Categories: science, medicine
Tags: health policy, medicine, psychiatry, schizophrenia 

Antidisestablishmentarianism In Action

What does antidisestablishmentarianism mean?  

[...] pick up the Oxford English Dictionary. Turning to page 59, we find that antidisestablishmentarianism is indeed a word. The definition is as follows: “Properly, opposition to the disestablishment of the Church of Bush England, but popularly cited as an example of a long word.” Catching the irony here? [...]

We will try to catch the irony.

If one were to read an essay (Darwin's Compost) that decried the influence of "the elite", meaning scientists and everyone else the author doesn't like, you might expect to find the essay on a site called 'Humility in Action,' or perhaps 'The Washers of the Feet.'  Instead, it appears on the pompously-named site "The American Thinker".

I won't bother to fisk the anti-anti-Intelligent Design essay itself, that task being well beneath my elitist prétentions.  Rather, I will try to explain to my humble antidisestablishmentarianist friends why scientists and other thinkers are upset by Mr. Bush's proclamation that Intelligent Design should be taught in schools.  And why it is so dangerous.  Continue reading here.

Friday Cornucopia Blogging

Photograph courtesy NOAA

Hurricanes and typhoons have become stronger and longer-lasting over the past 30 years as global temperatures have risen, a new study has found.

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Disappearing Lakes in Siberia

This image pair shows lakes dotting the tundra in northern Siberia to the east of the Taz River (bottom left). The tundra vegetation is colored a faded red, while lakes appear blue or blue-green. White arrows point to lakes that have disappeared or shrunk considerably between 1973 (top) and 2002 (bottom). After studying satellite imagery of about 10,000 large lakes in a 500,000-square-kilometer area in northern Siberia, the scientists documented a decline of 11 percent in the number of lakes, with at least 125 disappearing completely.

As the Arctic warms, loss of snow and ice make the region less efficient at reflecting incoming sunlight, which accelerates warming. As a result, the Arctic is warming faster than Earth’s middle or equatorial latitudes.

Corpus Callosum advice: don't buy lakefront (or oceanfront) property.

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Smithsonian magazine has the winners of their annual photo contest, here.

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Skeptic's Circle has come around again.  This time, narrated in a supremely clever Rawlingseque fashion.  

Hi All,

The fourteenth Skeptics' Circle has occurred, and a full report can be
found here:

http://www.lambic.co.uk/blog/archives/2005/08/wizardly-skepticism/

A big thank you to all the contributors, and to Orac for his hints, tips
and overall management of the circle. And of course a big thankyou must
go to St Nate too for creating this thing in the first place.

Hope you enjoy this edition.

"The ceiling of the great hall was studded with stars, the milky way splashed across the centre of it, mimicking the night sky outside Hogwarts. The long house tables were groaning under the weight of hundreds of bowls, plates and platters. Ron Weasley was in the middle of his second large helping of chocolate ice cream when, with a bright flash, all the food vanished. The buzz of conversation died down as Professor McGonagall stood and surveyed the room..."

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According to Blogpulse, the number one blog post at this time is by Ann Arbor's own Juan Cole, Fisking the "War on Terror".  The number three post is Pharyngula's post on ID, which I've mentioned in the last couple of posts.  Dr. Myers had been keeping a log of all the mostly science-oriented) bloggers who participated in the outcry, but tired of it after logging over 150 of them.  Blogpulse now lists over 450 in the past two days.  

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Partnership for a Secure America is a new, bipartisan coalition of former statespersons who are hoping to bring some degree of moderation to American statecraft.  Significantly, they promote an emphasis on multilateralism and national security.  It appears that they hope to shape the national debate away from the "grunt loudly and carry a big stick" approach, toward a saner approach.  Oddly, they placed a full-page ad in the NYT on August 2, but as of today, the only news item pertaining to them is in Asia Times: Reviving 'the radical center'.  Hat tip to The Impolitic.

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Forging a connection between the post above, and a recent one by Ron Beasley at Middle Earth Journal, The "Gray Lady' has fallen and she can't get up, I too wonder what the devil is going on with our media.  Here we have a group of very prominent statespersons (e.g. Howard Baker, Samuel R. Berger, Zbigniew Brzezinski, Warren Christopher, et. al.) forming a group to try to restore sanity to foreign policy, and the media in the USA simply ignore them.  Don't the folks at NYT read their own paper???

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Friday Dog Blogging

Now That's a Spike!

As predicted, there was a lot of blogging yesterday related to Mr. Bush's statement about Intelligent Design.  Via Blogpulse:

The blue line shows the percentage of blog posts that contained the string "Intelligent Design".  Because it is hard to put the percentage into perspective, I included the yellow line, which represents the percentage of blog posts that include the string "George Bush".  0.25% of blog posts is not a large percentage, but when a phrase is mentioned twice as often as "George Bush," you know it is a subject that people really care about.  What this graph does not show is the amount of commentary the various posts have generated; that's too bad, because it would be even more impressive if it did.

I skimmed the summaries of the first 50 posts, and found a couple of far-right bloggers supporting Bush on this (see link above, and this), and many far-to-middle right bloggers expressing exasperation (1 2 3).

On Blogs for Bush, there was a noteworthy comment:

Comments

Matt:
I appreciate your willingness to give President Bush the benefit of the doubt on the ID issue (well, what would I expect from Blogs for Bush, after all).

However, I can already predict that this cannot be painted as a Republican vs. Democrat issue. I have read numerous right-wing posters on sites such as Right Wing News who belittle ID and anyone who believes that God created the universe. You'll get Republican posters who believe that this is just the issue that the DNC will use to demonstrate how the far-right, Dobson-influenced, theocratic Bush lovers want to force their stupidity on the rest of the country.

For the record, I believe in GOd, the Father Almighty, maker of heaven and earth. (and the rest of the historic Christian faith as presented in the Apostles' Creed).

Posted by: adriandrews at August 2, 2005 07:33 PM

I think this is a good point.  For what it's worth, I did not see any liberal bloggers using this issue to criticize Republicans; they were pretty much focused on Bush himself.  

From a political standpoint, since Bush can't run for re-election, this may not turn out to be a very important issue, despite the vast blogbuzz is has generated.  However, now that Mr. Bush himself has put the ID card down of the political poker table, we might expect to see it become part of the political debate in future elections.  Perhaps it will become common for candidates to be asked their position on the issue.  That could get interesting.

Categories: Science, politics
Tags: intelligent design, evolution

Bush is an Idiot

4:15PM on Tuesday, August 2, 2005.  The memory of that moment is seared into my hippocampus as if by a cattle branding iron.  Much as my father recalls the bombing of Pearl Harbor, and my older brother recalls the assassination of John F. Kennedy, and I remember the strike on the Twin Towers, and everybody remembers when Bush used the word, "Crusade," it is one of those memories that simply will not die.

Bush Remarks Roil Debate Over Teaching of Evolution

By ELISABETH BUMILLER
Published: August 3, 2005

WASHINGTON, Aug. 2 - A sharp debate between scientists and religious conservatives escalated Tuesday over comments by President Bush that the theory of intelligent design should be taught with evolution in the nation's public schools.

In an interview at the White House on Monday with a group of Texas newspaper reporters, Mr. Bush appeared to endorse the push by many of his conservative Christian supporters to give intelligent design equal treatment with the theory of evolution in public schools.

Recalling his days as Texas governor, Mr. Bush said in the interview, according to a transcript, "I felt like both sides ought to be properly taught." Asked again by a reporter whether he believed that both sides in the debate between evolution and intelligent design should be taught in the schools, Mr. Bush replied that he did, "so people can understand what the debate is about."

Mr. Bush was pressed as to whether he accepted the view that intelligent design was an alternative to evolution, but he did not directly answer. "I think that part of education is to expose people to different schools of thought," he said, adding that "you're asking me whether or not people ought to be exposed to different ideas, and the answer is yes." [...]

I credit the reporter for pointing out that Bush evaded the most pertinent question, then lied by saying that he had been asked something other than what he actually had been asked.  Too often journalists let politicians (of both major parties) get away with things like that.  

First of all, there is a difference between "teaching the controversy," and teaching intelligent design.  I have no problem with the notion of teaching scientific controversies.  In fact, I think there should be more of that.  Too many kids graduate from high school with a faulty notion of how science works, and teaching some real controveries would help correct that deficiency.

As I write this, I am aware that there are nice, serious, and thoughtful ladies and gentlemen who will disagree with me.  I do not mean to offened them.  However, I do mean to stress the point, that there is a difference between teaching the controversy, and teaching Intelligent Design.  Perhaps the distinction is subtle, but it is valid and it is important...

(Also as I write this, I am aware that this post will end up containing the words "assassinate," "President," and "Bush."  Note to the underpaid, overworked FBI agent reading this: I am a near-pacifist.  The last time I hit someone in anger was when I was in seventh grade.  And the other guy hit me first.  I then proceeded to knock him flat on his back.  But really, I'm harmless.  If you want to come and take my computer, fine.  Just be sure to get a search warrant, signed by a judge, first.)  

...Second,  as scientific controversies go, Intelligent Design is pretty close to the bottom of the list (in fact, it is not even on the list).  It is not particularly controversial in scientific circles, and it is not particularly interesting.  See Carl Zimmer's essay on the subject for a review of the truly interesting aspects of the questions pertaining to the origin of life.  {Carl already has responded [43,000 Scientists: Bush Puts Schoolchildren At Risk] to the Bush Blunder, as I am sure hundreds -- if not thousands -- of other bloggers are doing this evening.}  Dr. Myers already has 55 comments to his post on the subject.

I used to post of this subject a lot, when I was a newbie, before I realized that Panda's Thumb and Talk.Origins were already thrashing the subject to its well-deserved death.  I think I even posted, a while back, that I wasn't going to write about this anymore.  But when the President of the United States of America went on the public record with such a bizarre, concocted, and yes -- politically-motivated -- load, I just had to speak up. Sometimes, you just have to brand a heifer for what it really is.

(Image used with apology to William M. Thayer)

Update: Pharyngula already has a list of 133 bloggers who have spoken up on this. Many more will follow...
Categories: rants, politics, science
Tags: Bush is an idiot

What A Kid's Life Should Be Like

Helping his father and uncle put a symbol of freedom on grampa's garage



Hat tip: Grampa

Graph Paper

Like The Corpus Callosum, "Mahmoud" (age 13) uses graph paper as his background image.  If you are curious, click on the picture to see what it is about.



Hat tip: NPR.org

October Light and Shadow

Tag: horses