Archive for the ‘Medical’ Category
Adam Grant has an interesting column in the NY Times:
What does it take to be a good parent? We know some of the tricks for teaching kids to become high achievers. For example, research suggests that when parents praise effort rather than ability, children develop a stronger work ethic and become more motivated.
Yet although some parents live vicariously through their children’s accomplishments, success is not the No. 1 priority for most parents. We’re much more concerned about our children becoming kind, compassionate and helpful. Surveys reveal that in the United States, parents from European, Asian, Hispanic and African ethnic groups all place far greater importance on caring than achievement. These patterns hold around the world: When people in 50 countries were asked to report their guiding principles in life, the value that mattered most was not achievement, but caring.
Despite the significance that it holds in our lives, teaching children to care about others is no simple task. In an Israeli study of nearly 600 families, parents who valued kindness and compassion frequently failed to raise children who shared those values.
Are some children simply good-natured — or not? For the past decade, I’ve been studying the surprising success of people who frequently help others without any strings attached. As the father of two daughters and a son, I’ve become increasingly curious about how these generous tendencies develop.
Genetic twin studies suggest that anywhere from a quarter to more than half of our propensity to be giving and caring is inherited. That leaves a lot of room for nurture, and the evidence on how parents raise kind and compassionate children flies in the face of what many of even the most well-intentioned parents do in praising good behavior, responding to bad behavior, and communicating their values.
Paul Krugman has an excellent column on the nightmare of Obamacare—for the GOP. It’s worth looking at the comments to see how mean-spirited some of the commenters are. There are people who really don’t want the poor to get any assistance at all. Very ugly. His column begins:
When it comes to health reform, Republicans suffer from delusions of disaster. They know, just know, that the Affordable Care Act is doomed to utter failure, so failure is what they see, never mind the facts on the ground.
Thus, on Tuesday, Mitch McConnell, the Senate minority leader, dismissed the push for pay equity as an attempt to “change the subject from the nightmare of Obamacare”; on the same day, the nonpartisan RAND Corporation released a study estimating “a net gain of 9.3 million in the number of American adults with health insurance coverage from September 2013 to mid-March 2014.” Some nightmare. And the overall gain, including children and those who signed up during the late-March enrollment surge, must be considerably larger.
But while Obamacare is looking like anything but a nightmare, there are indeed some nightmarish things happening on the health care front. For it turns out that there’s a startling ugliness of spirit abroad in modern America — and health reform has brought that ugliness out into the open.
Let’s start with the good news about reform, which keeps coming in. First, there was the amazing come-from-behind surge in enrollments. Then there were a series of surveys — from Gallup, the Urban Institute, and RAND — all suggesting large gains in coverage. Taken individually, any one of these indicators might be dismissed as an outlier, but taken together they paint an unmistakable picture of major progress.
But wait: What about all the people who lost their policies thanks to Obamacare? The answer is . . .
It should be noted that the GOP totally opposes pay equity—that is, paying men and women the same amount for doing the same work. The GOP unanimously voted against a measure to remedy pay equity.
A hopeful report by Randy Robinson. Although one case doesn’t establish efficacy, it certain suggests that research is justified—and Obama will not budge on reclassifying marijuana from Schedule I. Randy Robinson writes in Culture:
At 14 years old, Alysa Erwin was diagnosed with terminal brain cancer. As it would with any family, the news hit hard. “When the doctor called me to tell me Alysa had cancer, she said there wasn’t a good outcome. There was no success rate whatsoever,” said Carly, Alysa’s mother.
“She told me all we could do was have hope.”
But that was in 2011.
In 2014, Alysa is cancer-free, and her family believes cannabis oil saved her life. At the time, the Erwins’ outlook appeared grim. Doctors call her condition Grade III anaplastic astrocytoma, an inoperable cancer with a near-zero survival rate. Alysa’s disease, caused by uncontrolled neuron growth, had spider-webbed throughout her brain. There were no individual tumors to target. A wiry network of cancerous cells penetrated so far into her skull that surgery was impossible. That meant Alysa would have to undergo aggressive chemo—and radiation therapies, a choice which leaves many terminal patients incapacitated during their final days. In Alysa’s case, even with traditional medical treatment, doctors expected she’d survive for only another one or two years. The situation became desperate, and the Erwins sought out another choice.
Alysa’s father David, heard about Rick Simpson’s Phoenix Tears Foundation through Michigan Compassion, a medical cannabis organization. After watching the documentaries What If Cannabis Cured Cancer? and Run from the Cure, the Erwins decided cannabis oil was their best bet for Alysa’s recovery.
“We knew what we wanted,” Carly said, “but we wanted to hear her choice.”
Alysa, presented with the options of chemotherapy or cannabinoids, tried the conventional route first. After just five days of popping Temedor pills—and enduring the debilitating nausea that comes with them—she abandoned chemo and went with cannabis. The Erwins were floored. They saw instant results.
Thirty minutes after she took her first half-teaspoon mix of concentrate and peanut butter, Alysa was laughing again. She was eating. Her pain vanished and she could hold down food. “She was like a regular teenager,” her mother said. . .
Continue reading. Why won’t Obama budge on reclassifying marijuana? It is an action he could take immediately, but he doesn’t and since he doesn’t have press conferences, there’s no way of asking him why. But none of the reasons I can think of are very complimentary to him.
Do not live or spend much time near fracking sites: the government is failing to regulate fracking and when businesses are given the opportunity, they poison the environment. Lisa Song and Jim Morris report at McClatchy:
People in natural gas drilling areas who complain about nauseating odors, nosebleeds and other symptoms they fear could be caused by shale development are usually told by state regulators that monitoring data show the air quality is fine.
But a new study suggests that the most commonly used air monitoring techniques often underestimate public health threats because they don’t catch toxic emissions that spike at various points during gas production. The study, reported this week in the peer-reviewed journal Reviews on Environmental Health, was conducted by the Southwest Pennsylvania Environmental Health Project, a nonprofit based near Pittsburgh.
A health survey the group released last year found that people who live near drilling sites in Washington County, Pa., in the Marcellus Shale, reported symptoms such as nausea, abdominal pain, breathing difficulties and nosebleeds, all of which could be caused by pollutants known to be emitted from gas sites. Similar problems have been reported by people who live in the Eagle Ford Shale in South Texas.
While residents want to know whether gas drilling is affecting the air near their homes – where emissions can vary dramatically over the course of a day – regulators generally use methods designed to assess long-term regional air quality.
They’re “misapplying the technology,” said lead author David Brown, who conducted the study with three of his colleagues at the Environmental Health Project. . .
Amazing to see something so well established and working so well in other countries being seriously considered in the US. But indeed the states are supposed to be the laboratories of democracy, so I hope this effort comes to fruition so we can see here what it would be like. (Of course, insurance companies and medical profession will undoubtedly do all they can to undermine and sabotage the effort: that’s the American way!)
Stinking mentally ill people don’t deserve treatment, seems to be the US attitude. Of course, some few of the mentally ill are treated outside the correctional system, but for more than 90% the US approach is to put the patient in prison or jail. And people think the US is uncaring!
Here’s the article. And here’s the ugly fact:
Jails and prisons now house 356,268 inmates with severe mental illness — more than 10 times the number in state hospitals, according to a report published Tuesday by the Treatment Advocacy Center.
In 44 states, the largest prison or jail holds more individuals with serious mental illness than the largest psychiatric hospital.
One must fight despair, but the US seems to be circling the drain in many ways. The way the US treats the mentally ill is Dickensian: mid-19th-century England, with debtors’ prisons (which the US is also bringing back in a de facto sort of way). Our treatment of the mentally ill recalls the Bethlem Royal Hospital (“Bedlam”) of that era.
UPDATE: And it’s not exactly surprising that using prisons to treat the mentally ill worsens the mental-health crisis.
I’m astonished by the sentence of 25 years in prison. The guy is obviously having some sort of schizophrenic break (hearing voices, 23 years old), and he should be in a (secure) mental-health facility. Oh, wait… we’re not that kind of country. We’re the kind that puts mentally ill people in prisons—and clearly not with an eye to helping some incapacitated.
At any rate, read the story.
Nina Martin of ProPubica has compiled an excellent set of annotated links. Check out the article at Pacific Standard. Interesting how a corporation believes that it has the right to decide medical questions between a woman and her doctor, overriding the doctor’s authority (and mission). And it’s the corporation, not the owners, who would pay for contraception: a distinction whose utility is more appreciated in the other direction, in which it is the corporation, not the owners, who is held liable, fined, and otherwise punished for breaking the law. In that case, the owners are quick to draw a sharp distinction between owner and corporation. Well, that sharp distinction cuts both ways.
Mainly, using the term “substance abuse” frames the issue in a particular (and non-productive) way. Maia Szalavitz explains at Pacific Standard:
“Abuse” is an ugly word. “Child abuse,” “sexual abuse,” “physical abuse,” “emotional abuse,” “domestic abuse.” And then, of course, there’s “substance abuse.”
But one of those things is not like the others: In all of the other types of abuse, there is a perpetrator who is harming a victim. In substance abuse, however, it makes no sense to argue that the victim is the poor innocent line of methamphetamine or a glass of Chardonnay. The damage done—both by the problem and by the term—is focused primarily on substance users themselves. The label is far from innocuous, and I vote that we retire it.
Debates over language often seem absurd or trivial. However, they make a difference in how issues are framed and therefore what solutions are proposed. Frame addiction as “substance abuse” and it is easy to see why it should be a crime, but call it “substance use disorder” and it sounds like something to be treated medically. If we want to make progress in ending stigma, we should think hard about the words we use.
In the case of “substance abuse,” there is empirical evidence of the harm that this framing can do. In a 2010 study, researchers surveyed over 500 mental health practitioners at a conference—two thirds of whom had Ph.D.s. Participants were asked to determine treatment for two hypothetical patients who were identical except that one was labeled as having a “substance use disorder” and the other was said to be a “substance abuser.”
Despite their training, the practicing clinicians favored a more punitive approach when the patient—who was described as having relapsed during court-ordered treatment—was labeled as being an abuser as opposed to having a disorder. More clinicians supported jail or community service rather than further treatment for the “substance abuser.”
This is one reason why the recent revision of the DSM—psychiatry’s diagnostic manual—no longer includes “substance abuse” as a diagnosis. The term brings up stigmatizing associations between abusive behavior and drug taking—even though the vast majority of people with drug problems do not engage in child abuse, sexual abuse, or domestic violence. While the DSM revision made many mistakes—for example, it conflates the milder substance-problem diagnosis with the more severe one (mild problems do not require abstinence and the last thing we need is more reason to apply “one size fits all” treatment in this area), the editors were right to get rid of the abuse label.
But there is another reason why labeling someone a “substance abuser” or as having a “substance use disorder” matters. . .
Sy Mukherjee writes at ThinkProgress:
Cook County Sheriff Tom Dart isn’t mincing words when it comes to his frustrations with Chicago’s — and America’s — broken and underfunded mental health care system.
“Every single day, I am faced with the mental health crisis in this county,” said Dart during testimony before the House Energy and Commerce Committee’s Subcommittee on Oversight and Investigation on Wednesday. “The unfortunate and undeniable conclusion is that because of dramatic and sustained cuts in mental health funding, we have criminalized mental illness in this country, and county jails and state prison facilities are where the majority of mental health care and treatment is administered.”
Illinois made the fourth-largest cuts to mental health services of any state in the country between 2009 and 2012, including the shuttering of two state-run psychiatric facilities. Combined with a lack of affordable housing units, those cuts have propagated a system wherein Americans with mental illnesses wind up in jails rather than clinics.
Dart said that the Cook County Jail houses approximately about 3,500 inmates with serious mental illnesses on any given day (about a third of its total inmate population), making it the largest de facto mental health provider in the nation.
To be clear, these inmates shouldn’t be in a jail setting. The most common illnesses that Dart encounters are mood and psychotic disorders, including severe depression, bipolar disorder, and schizophrenia. And many wind up in jail because they’re simply trying to grapple with a mental health safety net riddled with holes. “While some mentally ill individuals are charged with violent offenses, the majority are charged with crimes seemingly committed to survive, including retail theft, trespassing, prostitution and drug possession,” said Dart.
Keeping the inmates in jail is a pricey endeavor, as caring for a prisoner with mental illness is “easily” two or three times as expensive as the $143 per day that it costs to keep an average person in jail, according to Dart. The care isn’t particularly effective, either. Dart told ThinkProgress that the doctors who treat inmates with mental illnesses are more focused on simple triage rather than holistic care. “Their mission is to get [the inmates] stabilized, make sure they’re on their meds, and when they’re on their way out, [the doctors] give them a plastic baggie with two weeks’ worth of meds,” he said.
Dart also recounted several tragic stories about sick prisoners who were released into a society where they had little recourse for medical care or even simple housing during Wednesday’s hearing. “We’ve had inmates get released and try to break back into the jail so they can keep getting treatment,” he told the House committee. He then urged the committee to consider legislation that would make it easier to keep track of severely mentally ill patients’ cases.
One bill that might go a long way toward achieving that goal has actually . . .
Michael Hiltzik reports in the LA Times:
If there were fairness in this world, Rita Rizzo would be a media star.
Rizzo, 60, owns a management consulting firm for nonprofit groups and government offices in Akron, Ohio, with her husband, Lou Vincent, 64. Vincent, who suffers from Type 2 diabetes and high blood pressure, has gone without health insurance for 10 years. “We got 30 denial letters,” Rizzo told me last week.
Three years ago, Rizzo got a hip replacement. Her own insurance premiums were going to rise by $500 a month, to about $800, so she chose instead to triple her deductible to $6,000 to keep the increase to a mere $150 a month.
The couple used a $5,000 tax-deductible health savings account to cover her out-of-pocket expenses; Vincent’s medication, which ran to $178 a month; and his blood work-ups, at $2,400 a year.
In December, Rizzo signed up for Obamacare. She now has a policy that covers her and Vincent together, including all his meds and lab work, for $379 a month, with a $2,000 family deductible.
“I feel like I died and went to insurance heaven,” she says.
But you haven’t heard Rizzo’s story unless you tuned in to NBC Nightly News on New Year’s Day or scanned a piece by Politico about a week later. In the meantime, the airwaves and news columns have been filled to overflowing with horrific tales from consumers blaming Obamacare for huge premium increases, lost access to doctors and technical frustrations — many of these concerns false or the product of misunderstanding or unfamiliarity with the law.
While Rizzo was working her way to thousands of dollars in annual savings, for example, Southern California Realtor Deborah Cavallaro was making the rounds of NBC, MSNBC, CNBC, CBS, Fox and public radio’s Marketplace program, talking about how her premium was about to rise some 65% because of the “Unaffordable” Care Act. What her viewers and listeners didn’t learn was that she hadn’t checked the rates on California’s insurance exchange, where (as we determined for her) she would have found a replacement policy for less than she’d been paying.
With the March 31 deadline for 2014 enrollment in individual health insurance just days away, more questions are being asked about the mismatch in publicity about the Affordable Care Act by its opponents and supporters.
The millions of beneficiaries of the measure — families excluded from insurance because of high premiums or preexisting medical conditions, low-income individuals made newly eligible for Medicaid, seniors receiving a new subsidy for prescriptions, women granted the legal right to affordable maternity coverage for the first time — seem to be absent from the news media or political ad campaigns. But you can’t turn on your TV without seeing a well-produced 30- or 60-second spot featuring a purported tale of woe.
“Why aren’t Democrats taking this simple approach to defending Obamacare?” asked Slate.com in a recent headline.
It’s a good question, but the answer is that the approach isn’t all that simple.
“This is a difficult environment to sell this product,” says Robert J. Blendon, an expert on policy marketing at the Harvard School of Public Health. “There’s lots of anti-government feeling; the IRS is at the lowest point in its public standing, and people are asking if it’s going to be checking up on them. People are very cynical.”
Indeed, Rizzo says that when she tries to tell her story online, including through items on the Huffington Post, “I hear in response, ‘You’re a media plant’ or ‘You’re an Obama plant’ or ‘You’re not a real person.’ I’ve heard some really crazy stuff.” . . .
Here’s a Change.org petition I just signed. At the link:
My name is Sargeant Ryan Begin United States Marine Corps (Ret). I served two tours in Iraq. During my second tour on August 1, 2004, I was hit by an improvised explosive device, also known as a roadside bomb. I lost my right elbow and endured over 30 surgeries. On that day my elbow saved my life in two seperate ways. First it physically saved me by absorbing the shrapnel and blocking my vital organs from being ripped apart. The second way it saved me would not reveal itself until last winter, seven years later. It qualified me for medical marijuana in the state of Maine due to the intractable pain. I have also been diagnosed with severe PTSD, and although people with PTSD do not “qualify” for medical marijuana, it was my PTSD condition that received the greatest benefit from medical marijuana.
Every day veterans are returning home from combat and once they return they face their biggest battle, dealing with the PTSD they now suffer from. We know it works and we want research to be done so that we can find out how and why. Sadly, the National Institute on Drug Abuse (NIDA) and DEA refuse to allow research to be done on medical marijuana and PTSD.
The FDA has approved a protocol to study the therapeutic potential of marijuana for veterans suffering from PTSD. But amazingly, NIDA has a monopoly on the cannabis used for research in the U.S. and they continually refuse to allow researchers to purchase their marijuana for this study. Their decision is clearly political, and it’s impending research and prolonging suffering for America’s troops who have sacrificed so much for their country.
NIDA’s refusal also comes at a time when physicians themselves are recognizing the medical value of medical cannabis. Recently, the California Medical Association told the Los Angeles Times that the question of whether marijuana is a medicine “can only be answered once it is legalized and more research is done” (“California Medical Assn. calls for legalization of marijuana”, October 15, 2011).
Scientists, veterans, physicians, public health officials, and state governments are now calling for an end to the U.S. government’s blockade of medical marijuana research. I hope you’ll join us and sign this petition. . .
I wish Obama were more interested in fixing the Executive Branch of the government. He seems mainly focused on enabling it to continue as it is (cf. NSA, CIA, FDA, SEC, DOJ, and so on). Read Brady Dennis’s article in the Washington Post:
The tourists flocking to the French Riviera or Spain’s Costa del Sol this summer will slather on sunscreen containing the latest ingredients for protecting against the sun’s most harmful ultraviolet rays.But American beachgoers will have to make do with sunscreens that dermatologists and cancer-research groups say are less effective and have changed little over the past decade.
That’s because applications for the newer sunscreen ingredients have languished for years in the bureaucracy of the Food and Drug Administration, which must approve the products before they reach consumers.“We have a system here that’s completely broken down, and everybody knows that it has broken down,” said Wendy Selig, president of the Melanoma Research Alliance, the largest private funder of melanoma research.Her group and others, along with dermatologists and sunscreen manufacturers, have joined forces to make a public push for the FDA to approve at least some of the backlogged applications.The agency has not expanded its list of approved sunscreen ingredients since 1999. Eight ingredient applications are pending, some dating to 2003. Many of the ingredients are designed to provide broader protection from certain types of UV rays and were approved years ago in Europe, Asia, South America and elsewhere.
The FDA noted that U.S. consumers “have access to a great number of sunscreen products,” but said in a statement to The Washington Post that it recognizes the public health importance of sunscreen and has prioritized its review of the long-pending applications. The agency said “it is proceeding as quickly as practicable given available review resources and competing public health responsibilities.”
In the meantime, advocates for newer sunscreens have grown increasingly frustrated.
“These sunscreens are being used by tens of millions of people every weekend in Europe, and we’re not seeing anything bad happening,” said Darrell S. Rigel, clinical professor of dermatology at New York University and past president of the American Academy of Dermatologists. “It’s sort of crazy. . . . We’re depriving ourselves of something the rest of the world has.”
Even some FDA officials have expressed frustration about how the applications have become mired in a complex regulatory regime, adopted more than a decade ago, that was originally intended to simplify approvals for over-the-counter products used in other countries for at least five years.
“This is a very intractable problem. I think, if possible, we are more frustrated than the manufacturers and you all are about this situation,” Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, told lawmakers in November when asked about the agency’s sluggish over-the-counter reviews.
Part of the holdup, she said, is that . . .
Continue reading. Maybe sunscreen makers are lucky: scientists who wanted to study the effectiveness of marijuana as a treatment for PTSD waited 14 years to get approval—14 years.
Increasingly the US government seems to be badly broken, beholden to corporations and big money and unable to function.
The Catholic Bishops are loath to address the central issue of the lawsuit and are working hard to get the suit dismissed on procedural grounds. Nina Martin reports at ProPublica:
The story of Tamesha Means and her miscarriage three years ago, if it happened the way her lawyers claim it did, is truly awful: Means was 18 weeks pregnant when her water broke and she was rushed to a hospital in Muskegon, Mich. The fetus wasn’t viable, and the pregnancy — Means’ third — was doomed.
But doctors at the hospital, part of the Catholic healthcare network knows as Mercy Health Partners, didn’t tell her that, Means’ lawyers say. Instead of the normal course of treatment — inducing labor and terminating the pregnancy to stave off potentially risky complications — Means was allegedly kept in the dark about her condition, given painkillers, and sent home.
Bleeding and wracked with pain, she returned to Mercy twice over the next day or so and received more or less the same response, her lawyers claim. Just as she was about to be sent home a third time, by now feverish from a severe infection, she began to deliver. The baby died.
The case has received an enormous amount of attention because of who Means’ attorneys at the American Civil Liberties Union chose to sue last November: not her doctors or the hospital but the U.S. Conference of Catholic Bishops (USCCB).
Means’ lawyers claim that she was subjected to dangerously substandard treatment, that her own health was placed in peril, and that she was deprived of information about her condition because of rules issued by the bishops conference that govern all Catholic health care in the U.S. The rules — which Mercy and its staff are required to follow — prohibit abortion, and as a result, according to Means’ lawyers, doctors would not give up on the pregnancy.
The move to sue the bishops was unprecedented, and everyone from the New York Times to the National Catholic Register heralded the case as a new front in the culture war over religious liberty, gender equality and reproductive care — a version of the same raging conflict that will play out before the Supreme Court next week when it hears arguments in the Hobby Lobby/Conestoga Industries contraception cases. Those cases challenge the Affordable Care Act’s rules requiring employers to provide birth-control benefits to their workers, even if the employers have religious objections.
When the Means suit was filed, the bishops called the allegations “baseless” and “misguided” and defended Catholic health care’s “stellar history of caring for mothers and infants.” Otherwise, though, they were silent. [Because they could simply not address the facts of the case. Their approach to this case reminds one of the way that for decades they approached the problem of pedophiles in the church.- LG]
Now, the bishops and their attorneys have followed up with a motion to dismiss the case, and ProPublica has taken the first sustained look at their arguments.
The bishops, for the most part, have chosen to avoid sweeping language about constitutional rights and freedoms, instead focusing on the nitty-gritty procedural issues that are basic to high-stakes civil litigation. They argue, essentially, that the ACLU has chosen the wrong venue — federal court in Detroit — to sue (the USCCB is based in Washington D.C.) and is mistaken in blaming the USCCB for decisions made by individual bishops in their own dioceses. . .
Continue reading. Clearly the bishops do not want to face the outcomes from their senseless and unyielding decision.
Read the entire article. A little later, Martin writes:
. . . Some background: The ACLU and women’s groups have been voicing concern since the 1990s about the growing role of Catholic health care operations around the country and what they see as the resulting threats posed to women’s reproductive rights. Those complaints have grown louder in recent years as Catholic facilities have moved aggressively to merge with secular hospitals and reports have surfaced about the challenges – some say contortions — that doctors and nurses have sometimes had to face to comply with church teachings on abortion, birth control, and end-of-life care while fulfilling their duty to patients.
Catholic hospitals now account for about 16 percent of hospital beds in the U.S. And in eight states — including Washington, Oregon, Iowa, and Missouri — they control more than 30 percent of beds. Ten of the 25 largest health-care networks in the country are Catholic-sponsored.
The Means case touched a nerve because it seemed to bring together many of the issues that have worried women’s advocates the most. Indeed, if the allegations are true, what happened at Mercy Health Partners was even worse than has been reported at the time of the initial filing of the lawsuit.
According to the suit, Means’ alleged mistreatment came to light in late 2012 or early 2013 when an unidentified researcher working on a federally funded project at Mercy uncovered what she said were not one, but five instances in which doctors there failed to terminate the pregnancies of women who were clearly miscarrying.
When the researcher asked hospital officials to explain, they allegedly told her that they were following the Ethical and Religious Directives for Catholic Health Care, or ERDs — guidelines that govern medical treatment at every Catholic hospital and health system in the United States.
The ERDS — which are issued and regularly updated by the bishops council — ban abortion and limit many other medical options, including sterilization and birth control, and apply to patients and medical staff no matter what their religion.
Their impact, the advocates say, is greatest in places like Muskegon, where the only hospitals in the county are Catholic. Doctors who fail to comply with the ERDs risk losing their admitting privileges; other employees who similarly fail to abide by the ERDs face losing their jobs. (In Colorado recently, a cardiologist at a Catholic facility was reprimanded for merely mentioning abortion as a treatment option for a woman for whom pregnancy could have been deadly.)
“The bishops aren’t doctors, and yet they issue rules that tie doctors’ hands, preventing them from giving their patients full information about their health care options and, in some cases, preventing them from providing medically appropriate care,” the ACLU’s deputy legal director, Louise Melling, blogged on the organization’s website in December. “That’s not right.” . . .
Not at the time, necessarily, though of course a gang member encounters many risks while active in the gang, but most will leave the gang after around 3 years or less and move into adulthood—whereupon they encounter ill health (mental and physical) more than those who did join a gang.
Lauren Kirchner writes in Pacific Standard:
Gangs are a favorite topic among social scientists and criminologists. Research has consistently shown that, when kids join gangs, they immediately increase the risks that they will commit crimes and be incarcerated, become addicted to drugs, drop out of school, and be on either the giving or receiving end of violence. None of these findings are particularly surprising. But what about the long-term impact? Most gang stints are relatively short, with kids joining in their early teens and getting out a few years later. Then what? Amanda Gilman, a doctoral candidate in the University of Washington School of Social Work, saw a gap in this field.
“We think of gang membership as being an adolescent phenomenon, but what happens when they grow up and have their own families, and become adults?” asked Gilman, who is the lead author of a new paper out in the American Journal of Public Health. “Our theory was that we would see some of these negative outcomes in adulthood, but to some extent we were surprised to see how pervasive this sort of risky lifestyle of being in a gang could be in transitioning to adulthood.”
Gilman found that the impact of those risks and stress were very pervasive indeed. Most people in the study who said that they had been in gangs said their memberships lasted for only three years or less. Even so, they felt the impact of this set of choices for years. Compared to those people who had never been members of a gang, former gang members reported much worse overall health—both mental health and physical health. Former gang members were more likely to suffer from depression, anxiety, alcoholism, and “poor general health” physically when they were 27, 30, and 33. They were also three times as likely to be addicted to drugs.
The results stayed the same “even after controlling for individual, family, peer, school, and neighborhood characteristics.” It was gang membership that made the difference. And these negative effects of the gang life are so significant, the authors explained, that they go beyond the realm of mere community crime and disorder, and can actually impact the level of the overall health of a community.
“Gang membership has always been under the discussion of criminologists; it’s been like a juvenile justice issue, or a criminological issue,” says Karl Hill, a research associate professor and co-author on the paper. “What Amanda’s showing here is that it’s a bigger issue than that; it’s a public health issue. It’s not just the corrections systems and the police that need to be concerned about it, because it has broader public health impact.”
Aside from these particular findings, the source of Gilman’s data is also pretty remarkable. . .
Nicole Flatow reports at ThinkProgress:
As more states move to legalize all or some marijuana use, reform has remained stalled not just by outright federal prohibition, but also by federal policies that have suppressed research on cannabis.
On Friday, the federal government took a potentially momentous step back from this position, granting researchers who have for years borne the brunt of this policy access to a legal supply of marijuana. The decision means a psychiatry professor at the University of Arizona who specializes in treating veterans may for the first time be able to perform a triple-blind study on marijuana and post-traumatic stress disorder.
Veterans and others suffering from PTSD have long vouched anecdotally that marijuana provides unique relief for their symptoms. And a study last May that examined the brain without actually administering marijuana suggested that cannabis may mitigate the flashbacks, nightmares, anxiety, and other symptoms that plague PTSD sufferers.
But federal government denial of both the legal supply of marijuana to study the issue and a supply of federal funding have thwarted studies like this one, despite approval by the Food and Drug Administration and financial backing from the Multidisciplinary Association for Psychedelic Studies.
“MAPS has been working for over 22 years to start marijuana drug development research, and this is the first time we’ve been granted permission to purchase marijuana from NIDA,” the group said in a statement.
In August, CNN Chief Medical Correspondent Sanjay Gupta announced he had reversed his position on marijuana, saying, “we have been terribly and systematically misled,” and that “sometimes marijuana is the only thing that works” to treat medical conditions. He told the story of now-7-year-old Charlotte Figi, whose transformation after using a marijuana extract to treat her seizures inspired many other parents of children with seizures to flock to Colorado for treatment.
Marijuana remains classified as a Schedule I substance by the Drug Enforcement Administration, meaning it is deemed to be a dangerous drug with no currently accepted medical value. This designation is more severe than that of cocaine and opium poppy. Sttudies like this one are needed not just to put scientific backing behind the anecdotes and better adjust prescriptions; they are also necessary to persuade the Drug Enforcement Administration to reschedule the drug. The agency has maintained in response to numerous petitions that there is not sufficient rigorous research to rebut Congress’ 1970 decision to place the drug in the Controlled Substances Act’s most restrictive category.
Last February, a a theoretical physicist at the California Institute of Technology and one-time MacArthur Fellow analogized the suppression of marijuana research to creationist control over paleontology, citing this PTSD study. “The most blatant example of this behavior came last year, when NIDA blocked an FDA-approved clinical trial testing marijuana as a remedy for post traumatic stress disorder,” said John H. Schwarz. “… As a physicist, I can assure you that this not how physics works. … We are all expected to act like grownups and accept it gracefully as experiments prove our favorite theories are false. In physics, unlike marijuana policy, we consider the right message to send to be the message that’s true.”
He and others in the medical marijuana community have argued that the DEA and National Institute on Drug Abuse act as a “tag team” to censor science, with NIDA holding a monopoly over legal access to cannabis for research, and the DEA refusing to reconsider the drug’s designation in the Controlled Substances Act on the basis that sufficient research does not exist.
This study must still be granted DEA approval, but is expected to receive it.
Well worth reading and quite interesting. John Gravois writes at Pacific Standard:
All the guy was doing was slicing inch-thick pieces of bread, putting them in a toaster, and spreading stuff on them. But what made me stare—blinking to attention in the middle of a workday morning as I waited in line at an unfamiliar café—was the way he did it. He had the solemn intensity of a Ping-Pong player who keeps his game very close to the table: knees slightly bent, wrist flicking the butter knife back and forth, eyes suggesting a kind of flow state.
The coffee shop, called the Red Door, was a spare little operation tucked into the corner of a chic industrial-style art gallery and event space (clients include Facebook, Microsoft, Evernote, Google) in downtown San Francisco. There were just three employees working behind the counter: one making coffee, one taking orders, and the soulful guy making toast. In front of him, laid out in a neat row, were a few long Pullman loaves—the boxy Wonder Bread shape, like a train car, but recognizably handmade and freshly baked. And on the brief menu, toast was a standalone item—at $3 per slice.
It took me just a few seconds to digest what this meant: that toast, like the cupcake and the dill pickle before it, had been elevated to the artisanal plane. So I ordered some. It was pretty good. It tasted just like toast, but better.
A couple of weeks later I was at a place called Acre Coffee in Petaluma, a smallish town about an hour north of San Francisco on Highway 101. Half of the shop’s food menu fell under the heading “Toast Bar.” Not long after that I was with my wife and daughter on Divisadero Street in San Francisco, and we went to The Mill, a big light-filled cafe and bakery with exposed rafters and polished concrete floors, like a rustic Apple Store. There, between the two iPads that served as cash registers, was a small chalkboard that listed the day’s toast menu. Everywhere the offerings were more or less the same: thick slices of good bread, square-shaped, topped with things like small-batch almond butter or apricot marmalade or sea salt.
Back at the Red Door one day, I asked the manager what was going on. Why all the toast? “Tip of the hipster spear,” he said.
I had two reactions to this: First, of course, I rolled my eyes. How silly; how twee; how perfectly San Francisco, this toast. And second, despite myself, I felt a little thrill of discovery. How many weeks would it be, I wondered, before artisanal toast made it to Brooklyn, or Chicago, or Los Angeles? How long before an article appears in Slate telling people all across America that they’re making toast all wrong? How long before the backlash sets in?
For whatever reason, I felt compelled to go looking for the origins of the fancy toast trend. How does such a thing get started? What determines how far it goes? I wanted to know. Maybe I thought it would help me understand the rise of all the seemingly trivial, evanescent things that start in San Francisco and then go supernova across the country—the kinds of products I am usually late to discover and slow to figure out. I’m not sure what kind of answer I expected to turn up. Certainly nothing too impressive or emotionally affecting. But what I found was more surprising and sublime than I could have possibly imagined.
IF THE DISCOVERY OF artisanal toast had made me roll my eyes, it soon made other people in San Francisco downright indignant. I spent the early part of my search following the footsteps of a very low-stakes mob. “$4 Toast: Why the Tech Industry Is Ruining San Francisco” ran the headline of an August article on a local technology news site called VentureBeat.
“Flaunting your wealth has been elevated to new lows,” wrote the author, Jolie O’Dell. “We don’t go to the opera; we overspend on the simplest facets of life.” For a few weeks $4 toast became a rallying cry in the city’s media—an instant parable and parody of the shallow, expensive new San Francisco—inspiring thousands of shares on Facebook, several follow-up articles, and a petition to the mayor’s office demanding relief from the city’s high costs of living.
The butt of all this criticism appeared to be The Mill, the rustic-modern place on Divisadero Street. The Mill was also, I learned, the bakery that supplies the Red Door with its bread. So I assumed I had found the cradle of the toast phenomenon.
I was wrong. When I called Josey Baker, the—yes—baker behind The Mill’s toast, he was a little mystified by the dustup over his product while also a bit taken aback at how popular it had become. “On a busy Saturday or Sunday we’ll make 350 to 400 pieces of toast,” he told me. “It’s ridiculous, isn’t it?”
But Baker assured me that he was not the Chuck Berry of fancy toast. He was its Elvis: he had merely caught the trend on its upswing. The place I was looking for, he and others told me, was a coffee shop in the city’s Outer Sunset neighborhood—a little spot called Trouble.
THE TROUBLE COFFEE & Coconut Club (its full name) is a tiny storefront next door to a Spanish-immersion preschool, about three blocks from the Pacific Ocean in one of the city’s windiest, foggiest, farthest-flung areas. As places of business go, I would call Trouble impressively odd.
Instead of a standard café patio, Trouble’s outdoor seating area is dominated by a substantial section of a tree trunk, stripped of its bark, lying on its side. Around the perimeter are benches and steps and railings made of salvaged wood, but no tables and chairs. On my first visit on a chilly September afternoon, people were lounging on the trunk drinking their coffee and eating slices of toast, looking like lions draped over tree limbs in the Serengeti.
The shop itself is about the size of a single-car garage, with an L-shaped bar made of heavily varnished driftwood. One wall is decorated with a mishmash of artifacts—a walkie-talkie collection, a mannequin torso, some hand tools. A set of old speakers in the back blares a steady stream of punk and noise rock. And a glass refrigerator case beneath the cash register prominently displays a bunch of coconuts and grapefruit. Next to the cash register is a single steel toaster. Trouble’s specialty is a thick slice of locally made white toast, generously covered with butter, cinnamon, and sugar: a variation on the cinnamon toast that everyone’s mom, including mine, seemed to make when I was a kid in the 1980s. It is, for that nostalgic association, the first toast in San Francisco that really made sense to me.
Trouble’s owner, and the apparent originator of San Francisco’s toast craze, is a slight, blue-eyed, 34-year-old woman with freckles tattooed on her cheeks named Giulietta Carrelli. She has a good toast story: She grew up in a rough neighborhood of Cleveland in the ’80s and ’90s in a big immigrant family, her father a tailor from Italy, her mother an ex-nun. The family didn’t eat much standard American food. But cinnamon toast, made in a pinch, was the exception. “We never had pie,” Carrelli says. “Our American comfort food was cinnamon toast.” . . .