Later On

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

Archive for May 2nd, 2009

Rethinking masks on the flight

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Maybe no mask:

Wash your hands.

I know this sounds silly, but it is far more effective at preventing flu than having a dose-pack of Tamiflu in the medicine chest. Take it from a doctor, mother and reporter who covered SARS as well as bird flu where they were most virulent.

In 2003, as SARS was spreading across Asia, I was posted in Beijing. Many families fled. My children’s school — the International School of Beijing — was one of the very few in the city to stay open, although my daughter’s class of 25 dwindled below 10. For the children who remained, the school instituted strict policies — the ones that schools promote all the time but never really enforce. For parents, the first was: Don’t send your child to school sick. For students, it was: Wash your hands frequently and thoroughly during the day — before meals, after recess. No one got SARS. But more than that, the stomach bugs and common colds that are the bane of elementary schools all over the world disappeared as well.

If hand-washing is the first lesson of the SARS epidemic to apply to today’s swine flu outbreak, the others are: Masks, the symbol of protection, are only rarely useful. And enjoy being outside; it’s not where you will get the flu.

I hate seeing pictures of people in Mexico riding bicycles and walking down the street in masks. Infectious diseases are not transmitted well outside and in sunlight. As a doctor and as a reporter, my cardinal rule is to interview sick people with infectious respiratory diseases — from garden-variety flu to tuberculosis to bird flu — in open spaces. That sometimes means an open-air hospital ward. So yes, avoid crowded, closed spaces in places where there may be danger.

Also, avoid touching things that lots of other people touch — door knobs and escalator handrails, for example — and then touching your nose or mouth. Having worked in an emergency room, I got into the habit.

Masks are for when you can’t avoid a closed space during a serious outbreak — when, say, you need to travel by a crowded bus or plane or subway. In 2003 I had a mask in my bag as I traveled to severely affected cities across Asia, but wore it only rarely. When transmitting an infectious disease through the air, a patient is generally sneezing or coughing. During the height of the SARS outbreak in China, if a nearby passenger exhibited symptoms, I moved to another part of the subway or plane.

I can tell you from my experience in Beijing that having an entire city of masked people is devastating to the social fabric. It is hard to have conversation through a mask — you can’t see smiles or frowns. Also, not all masks are equal. A good mask, well fitted and worn properly, is uncomfortable and hard to breathe through. And wearing a mask casually draped over your ears is more of a totem against disease than a scientifically valid form of protection.

In a normal season in the United States, tens of thousands of people die of complications of influenza. A baby’s death in Texas or the 200 people who have succumbed in Mexico are tragic cases, but not by themselves worrisome totals. They could even suggest that this strain of swine influenza is quite mild. We have no idea how many people came down with lesser infections — presumably a huge number — that went unrecorded by the public health system. More data is needed to sort this out.

Which is why public health officials are frantically performing contact tracing and surveillance to track where the outbreak is going. It is the best way to head off something worse and help society prepare. But watching them perform this important business should be reassuring, not a reason to panic…

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Written by LeisureGuy

2 May 2009 at 5:52 pm

Democrats to be replaced

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Written by LeisureGuy

2 May 2009 at 3:30 pm

Ukulele Bach

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Written by LeisureGuy

2 May 2009 at 2:32 pm

Posted in Daily life, Music, Video

Torture works best if you starve the victim first

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Spencer Ackerman in the Washington Independent:

According to a recently declassified Justice Department document, the CIA believed that so-called “enhanced interrogation” techniques like sleep deprivation worked better when a detainee’s resistance was weakened from hunger. The agency, with the legal approval of the Justice Department, employed a regimen that sharply restricted the caloric intake of detainees in its custody — an intake distinctly below federal nutritional guidelines for inmates in U.S. prisons.

Steven Bradbury, chief of the Justice Department’s Office of Legal Counsel in during George W. Bush’s second term, provided an overview of an authorized CIA technique to manipulate detainee’s diets in order to make them receptive to interrogation. Using references to calories, Bradbury wrote in a May 10, 2005 memo, “[T]he recommended minimum calorie intake is 1,500 kcal/day, and in no event is the detainee allowed to receive less than 1,000 kcal/day.” While having his diet restricted, a detainee would be fed not solid food, but “commercial liquid diets (such as Ensure Plus).” The restricted diet, according to Bradbury’s memo, would be subject to “frequent medical monitoring,” and a detainee would be measured “weekly” to ensure that he did not lose more than “10 percent of his body weight,” which would trigger termination of the diet.

That caloric intake would be unacceptable for the Justice Department to administer to an inmate in a federal prison. The department’s Bureau of Prisons requires federal prisons to adhere to “the Daily Reference Intake (DRI) for nutrients published by the Food and Nutrition Board of the National Academy of the Sciences” in order to “ensure proper nutrition,” according to the bureau’s 2006 policy handbook. The National Academy of the Science’s Dietary Reference Intakes estimates nutritional requirements on a sliding scale depending on Body Mass Index and level of activity. But for adult men who stand just under five feet tall and who maintain a “sedentary” level of physical activity with a low body mass index, the minimum caloric requirement in the guideline is 1,848 calories. All other nutritional elements of the guideline require greater caloric intakes for adult men, ranging from 2,000 to 3,720 calories…

Continue reading. What a nation we became!

Written by LeisureGuy

2 May 2009 at 11:43 am

Interesting: A challenge to the Voting Rights Act

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A FindLaw article by Roger Citron, Assistant Professor of Law at Touro Law Center on Long Island:

Today, the Supreme Court hears oral argument in Northwest Austin Municipal Utility District Number One v. Holder ("NAMUDNO"), arguably the Court’s most important – and perhaps most difficult – case of the term. NAMUDNO involves a powerful challenge to Section 5 of the Voting Rights Act ("the Act") and implicates fundamental constitutional principles, pitting the Fourteenth and Fifteenth Amendments’ protections of civil rights against the value of state sovereignty. Paradoxically, the very success of the Act in combating racial discrimination in voting has enabled such a strong challenge to one of its basic provisions.

(Apparently recognizing the significance of and public interest in NAMUDNO, the Court will provide same-day access to audio of the oral argument, something it hasn’t done since the oral argument more than a year ago in District of Columbia v. Heller, involving the Second Amendment right to bear arms.)

In this article, I will briefly describe the legislative history of the Voting Rights Act, discuss the challenge to Section 5 asserted by the plaintiff in NAMUDNO and the lower court’s rejection of that challenge, and offer a prediction about the outcome of the case before the Supreme Court. Among legal commentators, the conventional wisdom is that Justice Anthony Kennedy’s vote will be decisive; I agree. As I will explain below, my view is that Justice Kennedy will vote to uphold the constitutionality of Section 5.

The Voting Rights Act of 1965 and Its Subsequent Reauthorizations

The history of the Voting Rights Act dates back to the period shortly after the Civil War, when the Fourteenth and Fifteenth Amendments were adopted. The Fifteenth Amendment specifically guarantees that the "right of citizens to vote shall not be denied or abridged by the United States or by any State on account of race, color, or previous condition of servitude." Despite this guarantee, however, African Americans encountered substantial obstacles to voting – including literacy tests, property qualifications, and other impediments intended to thwart their right to vote – for nearly a century after the ratification of the amendment in 1870.

Eventually, in 1965, Congress responded with …

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Written by LeisureGuy

2 May 2009 at 11:40 am

Controlling teens’ sexual explorations

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"Good luck" is my first response. But the article by Julie Hilden is interesting:

Recently, the Wall Street Journal and its law blog reported on a Pennsylvania controversy over "sexting" – the practice of sending nude or semi-nude photos of oneself or others via cellphone. After some "sexted" photos were confiscated from students at a high school, the local District Attorney threatened to file broad child-pornography charges if the teens were not willing to enroll in a five-week compulsory educational program covering topics such as "what it means to be a girl in today’s society." (This topic is telling; sexting controversies often seem to be connected to adults’ discomfort with girls’ expression of their sexuality. It seems likely, too, that discomfort with gay teens’ sexuality will eventually lead to a sexting controversy as well.)

The ACLU rightly responded with a lawsuit. Because First Amendment rights were at issue, the suit could properly be filed prior to charges being brought, in order to address the ongoing "chilling effect" on speech of the threat of prosecution hanging overhead. A federal judge has temporarily enjoined the D.A. from filing charges, with a hearing to occur in June.

These particular charges are ill-grounded in law, as the ACLU has pointed out. The photos at issue show teen girls in their bras or, in one case, topless. In contrast, child pornography laws typically cover lascivious displays of the genitals and/or sexual activity. Thus, this is likely to be an easy case — as the judge’s initial ruling, granting an injunction in the ACLU’s favor in part because of its high likelihood of success on the merits, indicates.

This is not the first time that old laws have proven to be a bad fit with recent technology. But it’s an especially worrying example of a general problem, because both criminal charges and First Amendment rights are at issue.

In this column, I will consider how the law should respond when much harder cases regarding sexting come along, as they inevitably will. These cases would involve photos of underage teens having sex, displaying their genitals in a lascivious way, or both. Accordingly, these cases could validly form the basis for child-pornography charges. But should they always trigger charges? Or should the law be adjusted to take into account the factual nuances of the case?

Should There Be "Romeo and Juliet" And Age-Specific Exceptions for Sexting?

There is no question that if an adult traffics in photos that fit the child pornography laws – that is, photos that include a lascivious display of an underage person’s genitals, or show an underage person having sex — it is a very serious crime, as well as despicable behavior. Indeed, the Supreme Court recently issued an opinion allowing the prosecution of even those traffickers who offer virtual child pornography (involving no real children) but believe it is real – as I discussed in a prior column.

But what if teenagers take the photographs and do the trafficking, and the subjects and recipients of the photos are exclusively the teenagers themselves? Should the crime – and the penalties – be the same?

My answer is a strong …

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Written by LeisureGuy

2 May 2009 at 11:37 am

Posted in Daily life, Government, Law, Technology

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Tracking the flu

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The Flu Wiki Forum offers a forum for up-to-date information on the flu.

Written by LeisureGuy

2 May 2009 at 11:33 am

Posted in Daily life, Medical

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