Later On

A blog written for those whose interests more or less match mine.

Archive for the ‘Medical’ Category

“Shaken-baby” syndrome: Bad science

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Interesting article by Lee Scheier in the Boston Globe, providing an example of how strongly prosecutors resist admitting error. From the article:

AFTER COMING under attack in an political ad for not doing enough to protect children, Martha Coakley, the Democratic candidate for governor, defended her record. In a large above-the-fold photograph published in the Globe Oct. 3, Coakley is seen standing next to Deborah Eappen, mother of Matthew Eappen, the baby whom Louise Woodward was charged with shaking to death in 1997.

Coakley, the prosecutor in that infamous trial, set up the photo op ostensibly to remind the public of her commitment to protecting children. If so, Coakley must think Massachusetts voters have short memories.

Although Woodward was found guilty of second degree murder by the jury, trial judge Hiller Zobel reduced the sentence to manslaughter and set Woodward free. Zobel’s skepticism of the justice of Woodward’s murder conviction was prescient: Dr. Patrick Barnes, Coakley’s chief expert witness in the case, later publicly renounced his own trial testimony as based on flawed scientific assumptions.

And another brief article on Coakley, this one by Radley Balko. The conclusion of that article:

It’s probably not surprising, then, that as DA in Middlesex County, Coakley opposed efforts to create an innocence commission in Massachusetts, calling the idea “backward-looking instead of forward-looking.” Of course, that’s sort of the point — to find people who have been wrongfully convicted. So far, there have been at least 23 exonerations in Massachusetts, including several in Coakley’s home county.

I had my own exchange with Coakley in the letters section of The Boston Globe a few years ago over the issue of prescription pain medication. Coakley had told the paper that “accidental addiction” to opiate pain medications such as OxyContin was a common problem among chronic pain patients, despite considerable medical evidence to the contrary. Such wrongheaded statements by law enforcement officials and the policies that go with them are a big reason why doctors have become increasingly reluctant to treat pain patients. Coakley conceded that she’s “no medical expert” but then went on to question the body of medical literature showing accidental addiction to be a myth. Coakley cited only her own experience as a DA to contradict the litany of peer-reviewed medical research.

As a member of the Senate, not only would Coakley be creating new federal criminal laws; given her record as a prosecutor, there’s a good chance she’d serve on committees with oversight over the Justice Department and the judiciary. She’d also be casting votes to confirm or deny federal judicial appointments. Advocates for criminal justice reform should be wary. Coakley may share Kennedy’s opposition to the death penalty, but her record as a prosecutor leaves plenty of doubt about her commitment to justice.

Written by LeisureGuy

21 October 2014 at 12:47 pm

Politicians who cannot comment on climate change because they are “not a scientist” speak out about Ebola

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Inconsistency, thy name is Politician. Emily Atkin reports at ThinkProgress:

On Saturday, political blogger Lee Papa made an interesting observation about Republicans who widely recommend panicking about Ebola. “Does any Republican talking about Ebola say, “I’m not a scientist” like they do with climate change?” he tweeted, referencing the long list of political figures who claim to not know the science behind climate change, even though they actively oppose any policy to fight it.

On Monday, Papa answered the question for us with a resounding “no.” As might be expected, most prominent Republican politicians who are not willing to talk about climate change because they lack qualifications are willing to talk about Ebola, despite the fact that they lack qualifications. As might also be expected, all those politiciansfavor strict policy measures to deal with the disease, even though most scientists say Ebola is not easily transmittable and does not pose a widespread threat to Americans.

“Republicans are glad to tell you that either the evidence is inconclusive or that they are too dumb to understand the science when it comes to climate change, so they think it’s wrong to act like it’s a crisis and refuse to do anything to slow or halt it,” Papa writes at his blog Rude Pundit. “However, they will go bugnuts crazy and try to cause panic when it comes to the science around the spread of Ebola, even when they have it wrong.”

The list of perpetrators is long. . .

Continue reading.

Written by LeisureGuy

20 October 2014 at 4:09 pm

A scathing indictment of the (highly artificial) sports culture

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Somehow it reminds me of nothing so much as factory farming: playing music to the cows to increase milk production in the “whatever it takes” spirit. Or the way slaughterhouses are now designed by animal behaviorists to minimize problems due to the cattle becoming fearful or angry: soothing and reassuring environments right up until the hammer falls. Or how casinos have no windows, no clocks, and seating only at the game tables. Free/cheap booze, though…

All examples of how the behavior of animals must be managed to improve corporate profits.

Written by LeisureGuy

19 October 2014 at 5:32 pm

Interesting idea: Who you are lies not in your memes but in your decisions

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I sort of like that simply from a process viewpoint; perhaps it is more accurately stated, “We are the residue of our decisions.” Here’s the article.

Carla Needleman, in her excellent book The Work of Craft, writes… well, this is your assignment: go to the link, click the “Look Inside” link, and start reading. (The specific thing that brought it to mind is her anecdote about finishing a pot too quickly because she wanted certainty too much: she aborted the incubation period.)

Written by LeisureGuy

18 October 2014 at 4:56 pm

‘Voodoo Death’ and How the Mind Harms the Body

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Very interesting article—and I was intrigued to read that there is a genetic connection. Daphne Chen reports at Pacific Standard:

In 1977, the Centers for Disease Control and Prevention started receiving reports that otherwise healthy Southeast Asian men were dying mysteriously in their sleep, some with terrified expressions on their faces. Researchers, at a loss, called it SUNDS—Sudden Unexpected Nocturnal Death Syndrome. In particular, SUNDS disproportionately affected Hmong refugees from Laos. At the peak of the “epidemic” in 1981, Hmong men were dying from SUNDS at the same rate as American men in the same age group were dying from the five leading causes of natural death—combined.

“People didn’t know at all what was going on,” says University of California-San Francisco professor Shelley Adler, who was a graduate student studying medical anthropology at the time. But afterinterviewing 118 Hmong men and women about their experiences, her suspicions were confirmed. Many attributed the deaths to fatal attacks from dab tsog, an evil nighttime spirit in the traditional Hmong religion that crushes men at night. Their descriptions of dab tsog were similar to sleep paralysis, a disorder in which a person’s mind awakens while their body is still asleep or paralyzed; they often feel like they are being crushed and experience hallucinations.

But there were still unanswered questions. “Sleep paralysis alone is not fatal,” Adler says. “Sleep paralysis alone does not kill anyone. Why was it fatal for the Hmong?”

SCIENTISTS ARE JUST BEGINNING to understand how cultural beliefs can lead to psychological stress, illness, and even death. American physiologist Walter Cannon was one of the first people to write about the potentially fatal consequences of these intense beliefs. In 1942, reports were streaming in from around the world about “voodoo” death: South American Tupinamba men, condemned by medicine men, died of fright. Hausa people in Niger withered away after being told they were bewitched. Aboriginal tribesmen in Australia, upon seeing an enemy pointing a hexed bone at them, went into convulsions and passed away. “Voodoo” death, according to Cannon, was real: “It is a fatal power of the imagination working through unmitigated terror.”

Researchers today continue to find evidence of it. “I’d been thinking for a long, long time, how I would test this idea that fear makes a difference,” says David Phillips, a sociology professor at the University of California-San Diego. He learned from a student that many Chinese and Japanese people are superstitious about numbers, particularly the number four, which is considered unlucky because it sounds like the word for “death.” Phillips decided to crunch cardiac mortality figures for all Chinese and Japanese Americans who died from 1973 to 1998 on the fourth of each month. He found that cardiac deaths were seven percent higher than expected for Chinese and Japanese Americans on the fourth day of each month when compared to white Americans. That number rose to 13 percent for chronic heart disease deaths and was at its strongest, at 27 percent, in California, which accounts for almost half of the Chinese and Japanese deaths in the U.S.

After examining other plausible reasons for this phenomenon, Phillips’ paper concludes that . . .

Continue reading.

Written by LeisureGuy

17 October 2014 at 8:13 am

Really, very like the script for a medical disaster movie

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A “breaking news” email from the LA Times:

Frontier jet reportedly made 5 flights before being taken out of service in Ebola incident
Los Angeles Times | October 15, 2014 | 12:41 PM

The Frontier Airlines jet that carried a Dallas healthcare worker diagnosed with Ebola made five additional flights after her trip before it was taken out of service, a flight-monitoring website reported today.

Denver-based Frontier said in a statement that it grounded the plane Tuesday immediately after the carrier was notified by the federal Centers for Disease Control and Prevention about the Ebola patient.

The Airbus A320 was put away for the night Monday after it carried the woman and 132 other passengers from Cleveland to Dallas/Fort Worth on Flight 1143. But Tuesday morning the plane was flown back to Cleveland and then to Fort Lauderdale, Fla., back to Cleveland and then to Atlanta and finally back again to Cleveland, according to Daniel Baker, the chief executive of the flight monitoring site Flightaware.com.

This is more or less the beginning of any number of movies. 12 Monkeys, anyone?

BTW, it’s becoming increasingly clear that the Dallas hospital was incompetent—this emergency was way over its head, and it’s interesting to read of how much was not done properly in order to save money. The manager of that hospital sees it as a business with his job to maximize profit. That it involves healthcare is secondary. And note the degree to which the problems stem from management and administration, and not from the healthcare workers, who were doing the best they can with the shoddy equipment, inadequate supplies, and inadequate staffing—and, as we see, inadequate training. Training is always a big, fat target for cost-cutters because it cuts a real cost and the damage resulting is usually unobserved. In the case of the Dallas hospital, all those dollars saved by inadequate training and staffing and the incompetent management of the crisis suddenly look penny-wise, pound-foolish.

For more info:

C.D.C. Says It Should Have Responded Faster to the Dallas Ebola Case

Nurses at Dallas hospital describe poor safety measures with Ebola victim

Our Superbug Problem

In the meantime, of course, we continue to use enormous quantities of antibiotics fed to livestock in a determined effort to breed microbes and infectious diseases that are resistant to all the antibiotics at our disposal. Because we roll that way. The third article includes this:

Medically unsound practices may be part of the superbug problem. In India, antibiotics have been available over the counter for decades. This practice has led to the development and spread of ESBL-producing organisms and, more recently, the NDM-1 (New Delhi metallo-beta-lactamase 1) gene, which confers resistance to the strongest antibiotics available. The NDM-1 strain was first reported in 2010 among patients in India and Pakistan and those in theU.S. and Britain who had received medical care in those countries. Since that time, the NDM-1 gene has spread around the globe. Responding to concerns of Indian physicians and the international community, this year the Indian government mandated that a prescription would be required for all antibiotics, but this rule is not strictly enforced.

While India may indeed be at fault for overuse of antibiotics, the US is certainly in no position to point fingers. I would be the antibiotic usage in the US agricultural industry far exceeds that used for medical purposes in India. And note that in the US all the animals get the antibiotic, whether sick or not: we’re in a hurry to make sure our animals harbor only those microbes most strongly resistant to antibiotics. Why? To make a little bit more money: faster meat production, for example.

That tells you pretty much all you need to know about America’s current system of values.

Written by LeisureGuy

15 October 2014 at 1:09 pm

Puzzles that don’t: Cosmetics industry division

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The conclusion of an excellent article at Pacific Standard by Zen Liu:

. . . With cosmeceutical prices quickly skyrocketing—department store brands easily run between $450 to $700 for a few ounces—the FDA and FTC finally have taken notice of the potential for manufacturers to defraud the public. Since 2010, the FDA and FTC have issued 10 warning letters to cosmetics companies for making drug-like statements in their anti-aging creams’ marketing materials, including L’Oreal, Avon, Nivea, and L’Occitane.

L’Oreal is the world’s largest cosmetics group, amassing nearly $30 billion annually in sales. In a half-year financial report filed with the SEC in June 2014, L’Oreal reported spending around $450 million on research and development, but over $4 billion on advertising and promotions. Apparently, spending nearly $1 billion annually on research can generate enough evidence to assure consumers their cosmeceuticals work, but not quite enough to meet the FDA’s standards of proof.

The advertisements in question described their products as having the ability to, for example, change gene expression in the skin to induce collagen production and block the process of aging, or even promote weight loss. Under threat of legal action, manufacturers were ordered to produce scientific evidence to substantiate their claims and have products evaluated through the FDA’s New Drug Approval process, or cease making such statements altogether.

All of the firms chose the latter.

I bet any money I know why. Because revealing those secrets would have endangered national security. (It’s as valid here as when the DoJ and Obama Administration and CIA and NSA use it.)

I am pleased to see a Federal regulatory agency actually regulating the industry instead of rolling over for it in return for a plush sinecure upon retirement from the government.

Written by LeisureGuy

15 October 2014 at 12:51 pm

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