Later On

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

Archive for March 10th, 2019

Yet another great BC whisky

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I don’t know whether this is available in your country, but it is amazingly tasty. More info here.

Written by Leisureguy

10 March 2019 at 6:23 pm

Posted in Drinks

Interesting paragraph from Charles McCurry’s “The Shanghai Factor”

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From The Shanghai Factor: A Novel, by Charles McCarry

Evenings and weekends, I worked on re-Americanizing myself. I had half-forgotten how to live in my own country while I spent one-fourth of my life blundering around Afghanistan or lying in army hospitals or living a lie as every honest secret agent must do, or reducing my mind to rubble by speaking nothing but Mandarin and screwing Chinese women whom I could not permit myself to love without breaking my solemn oath of loyalty to my country and my craft. In my absence, everything had changed just slightly—the slang, the food, the music, the clothes, the drugs, the etiquette or such potsherds as remained of it, the conscience of the nation and its hopes and fears, the president, the Constitution. The educated class, always less happy than it deserved to be, was deeply, maybe incurably peeved. Many who died on 9/11 were people like themselves, who were not supposed to die in American wars. Now that the taboo was shattered, something worse could happen with even more disconcerting results. No one was safe, no matter how many diplomas he or she had, no matter how special he or she might be. Suicide bombers could not be far in the future—in fact, they should have started blowing themselves up in America long ago. This loss of immunity, this end of specialness, was somebody’s fault, probably a hidden somebody or more likely a vast conspiracy of hidden somebodies. Mother had been right, America was askew. Anger was the fuel of politics. In her opinion, the atmosphere was worse than the sixties. Now as then, the nonconformists only succeeded in being all alike—same thoughts, same vocabulary, same costumes, same delusions, same cookie-cutter behavior masquerading as rebellion. Coming home to this country on the brink of a nervous breakdown was like waking from a coma and seeing two moons in the sky.

Written by Leisureguy

10 March 2019 at 6:11 pm

Posted in Books

How my mind works now, regarding food

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It was a fairly simple question on Quora: “What’s better: cabbage cooked in a microwave or cabbage sauteed in butter on the stove?” My answer shows the path my mind took after being poked by the quesiton:

Personally, I would go with sautéed cabbage in a heartbeat.

Some thoughts: I would use my largest cast-iron skillet (my Field No. 12 Cast Iron Skillet) because cast iron holds a lot of heat (it doesn’t become cool when you add the cabbage and it absorbs some of that heat) and moreover it cooks by radiative heat as well as by conduction (unlike stainless steel) and because the large cooking area means no crowding, which means better sautéing.

I would put the skillet into a cold oven and turn the temp to 350ºF to load it with heat. (Cast iron is not a particularly good conductor, and while warming the pan on a gas range would work—the flame spreads out—it’s not practical to warm a pan so large on an electric coil burner, which is what I have.) I do use a handle cover to (a) protect my hand and (b) to remind me the handle is hot.

I would probably use extra-virgin olive oil, though, rather than butter. I do use butter for some things, but for this, EVOO sounds better to me. I might add just a little toasted sesame oil to the mix, and then perhaps some good soy sauce at the end.. And I might chop a couple of shallots or a few scallions to cook in the oil first. Then add the cabbage, and I would go with shredded rather than chopped. Salt—probably Maldon salt for this—and pepper and I think just a little smoked paprika, like 1/4 tsp, 1/2 tsp at most. And for a wild card, 1 tablespoon of grated horseradish (the good kind, from the refrigerated section, not that dreck that sits on the shelf in the middle of the store). It’s possible I would add a handful of nuts (peanuts, walnuts, pecans, pistachios).

My picks for best cast-iron skillets includes a list of some of the advantages of that cookware, but carbon-steel pans are also good.

Written by Leisureguy

10 March 2019 at 5:56 pm

Subtle things that deteriorate your mental health over time

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Alyss Thomas, Registered Psychotherapist since 1992, posted on Quora a list that in her experience cause slow but inexorable deterioration in mental health:

This list may surprise you, and you are of course free to disagree! It is my opinion only, based on my observations of over 30 years of psychotherapy practice.

1. Watching TV

2. Watching violent, negative or scary movies

3. Avoiding time spent in nature, instead just spending time outdoors

4. Avoiding strenuous physical exercise or exertion

5. Being interested in what other people think about you or how they judge you. This is none of your business.

6. Not practising some form of mental discipline and thought control so you are not the master of your mind and it runs all over the place

7. Bad diet

8. Being in the company of negative people

9. Not doing the things you really long to do, whatever these may be, whether big or small.

10. Pretending you are not creative and not engaging in any creative activities that you really enjoy

11. Trying to please anyone else but yourself, as you will definitely fail.

12. Avoiding dealing with the big issues in your life such as what you are scared or anxious about, or unfulfilled desires.

13. Staying too long in a relationship that has become unhappy, where you have lost love and respect for each other.

14. Indulging in drink, drugs, or food as a way of self-medicating or numbing emotional pain. Just deal with the pain instead.

15. Too much or not enough routine and structure, depending on what works for you individually.

16. Basing your life on anyone else’s ideas or rules.

Written by Leisureguy

10 March 2019 at 4:19 pm

The Aftertaste of Slavery Still Haunts American Cooking

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This illustrates how memes have a ripple effect on the memes that define the various spheres of human existence—cooking, in this instance. Tom Philpott writes in Mother Jones:

Amid the ongoing controversy over Virginia Gov. Ralph Northam and his  racist medical-school yearbook hijinx, his wife, Pam Northam, recently plunged into another one. During a school tour of the governor’s mansion, built by slave labor in 1813, Pam Northam handed cotton and tobacco to kids and “asked them to imagine being enslaved and having to pick the crop,” the Washington Post reports. According to some attendees, the first lady singled out the black kids in the group for this exercise in historical imagination; she and another witness deny it.

A small detail in the Post piece caught my eye: Northam’s hands-on history lesson took place outside a cottage adjacent to the mansion “that had long ago served as a kitchen,” the Post noted. That reminded me immediately of archaeologist and historian Kelley Fanto Deetz’s excellent 2017 book Bound to the Fire: How Virginia’s Enslaved Cooks Helped Invent American Cuisine. In the latest episode of Bite, Deetz talks about her deep dive into the world of enslaved cooks on antebellum Virginia’s plush plantations.

In her work, Deetz describes how Virginia’s planter elite developed a fashion for kitchens built apart from their mansions and a cuisine based on lavish abundance. The Virginia territory started in 1607 as a scrappy colony of fortune-seeking English settlers—mostly men—and their African slaves and European indentured servants. Houses tended to be small affairs, with internal kitchens. And food was a simple, functional matter—”really about staying alive,” she says. As she puts it in Bound to the Fire, “these early settlers ate what they could: rats and other vermin, grains, and even each other when necessary.”

As more women arrived from the old country, Deetz adds, the settlers began starting families and building bigger homes. Meanwhile, indentured Europeans and enslaved Africans began forming alliances and bristling at their place at the bottom of colonial society, a loose alliance that ultimately took the form of Bacon’s Rebellion in 1676. After the landed planters crushed the uprising, Deetz says, they phased out reliance on indentured labor and emphasized chattel slavery. Simultaneously, they isolated enslaved black people from poor whites as much as possible, hoping to prevent any new white-black revolts from forming. In her book, Deetz calls this shift the “strategic ideological promotion of white supremacy,”designed to enshrine the power of the planters.”

Around this time, plantation dwellings began being built with external kitchens of the kind on display in Virginia’s governor’s mansion, the structure Pam Northam chose as the site of her demonstration. The point was to separate enslaved black cooks, and the messy, smelly act of cooking massive feasts, from the elegant, genteel big house. And the feasts—which underpinned a then-emerging, now-enduring culture of Southern hospitality—were grand indeed.

The not-so-secret ingredient was slave labor, embedded in everything from the elaborate dishes made from plantation-grown and -processed ingredients to the wine “shipped from Portugal and France on ships that might have also been carrying enslaved Africans” to the “rum from the Caribbean that was literally from seed to bottle grown and and farmed and created by slave labor.”

The dining room’s bacchanalia stood in stark contrast to life in kitchen cottage, which doubled as living quarters for enslaved cooks. These structures tended to be about 16 feet wide, one side dominated by an enormous hearth with a fire that often burned nonstop—obligating cooks to be “literally bound to the fire 24 hours a day,” Deet says. “The smells, the heat the humidity were something that you couldn’t escape.”

On top of grueling labor, rough living conditions, and the agony of being someone else’s property, enslaved cooks had to constantly perform hospitality and polite subservience to the planter family and their guests—a formidable psychological burden, Deetz says.

But intimate relationship between cooks and the people they feed could also proved stressful to the planter family—especially after the Nat Turner slave rebellion of 1831, when rebel slaves killed as many as 65 white people in Southampton County, Virginia, and ushered in an age of fear and trembling among the planter class.

And suddenly, frightened eyes were cast at the cook minding the stove—and what she might be sneaking into the stew. Deetz says that post-Turner,  “you see a flood of letters” from “white ladies really uncomfortable about what their cook might do to them—and lots of fear about the risk of being poisoned.” Deetz calls it “one of those rare moments during the history of slavery in America where some of the enslaved people had a little bit of soft power over their slavers.”

Of course, these antebellum Southern kitchens operated before Louis Pasteur had established the germ theory of disease, and long before the advent of refrigeration. So routine cases of unintended food poisoning could be easily be misconstrued as malicious, especially by a plantation mistress put on high alert by the specter of the Turner uprising. So the tension over food poisoning also heightened pressure on the cooks themselves, Deetz says.

In her book, Deetz notes that the era’s grand plantation mansions have . . .

Continue reading.

Update: This was the article I was actually thinking of: Where Soul Food Really Comes From.

Written by Leisureguy

10 March 2019 at 12:36 pm

Posted in Daily life, Food, Memes, Recipes

Some interesting articles on partisan perceptions

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Written by Leisureguy

10 March 2019 at 12:12 pm

Posted in Democrats, GOP, Politics

6 Reasons Paul Manafort Got Off So Lightly

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Ken White, attorney and former federal prosecutor, writes in the Atlantic:

Paul Manafort, the former campaign manager for President Donald Trump, entered Virginia federal court on Thursday facing a recommended sentence of 19 to 24 years, and left with a sentence of less than four years. Many people are outraged by what they see as an unreasonably lenient penalty for an unrepentant crook, and have accused United States District Judge T. S. Ellis of bias. Others have decried the sentence as an example of America offering two tiers of justice:  one for the rich (and more often white) and one for the poor (and more often not white).

Criticizing American criminal justice is fitting and proper. But there are two kinds of critiques—simplistic ones, which let the larger system off the hook, and complicated ones, which point out that many factors combined to get Manafort the dramatic break he enjoyed. Any criticism of Ellis as an individual is woefully inadequate. The American criminal-justice system works at every stage and every level to give chances to people like Manafort and deny them to poorer people.

First, there can’t be a sentence without an investigation. After 9/11, the United States Department of Justice and the U.S. Attorney’s Offices that it controls shifted resources and focus from white-collar crime to drugs, guns, and immigration. In Los Angeles, the U.S. Attorney’s Office shuttered the Public Corruption and Government Fraud Section, where I served. Investigations of people like Manafort—people who have committed complex financial crimes—are time-consuming and resource-intensive. You can jail 20 drug traffickers for life with the resources it took to prosecute Manafort. America picks who goes to jail when it picks whom to investigate—which is one of the reasons so few people involved in the 2008 Wall Street debacle went to jail.

Second, prosecutors have enormous power over who goes to jail and for how long. That power doesn’t just involve deciding who gets indicted. It involves deciding how he gets indicted. Manafort faced a recommended sentencing range of 19 to 24 years under U.S. sentencing guidelines. But that range was driven only in part by what he actually did. It was driven just as much by how the special counsel’s office chose to pursue the case—what charges it brought, what evidence it presented to Ellis, and what part of Manafort’s history it cited as “relevant conduct” at sentencing. Federal prosecutors can substantially shape a sentence by the plea deal they offer, choosing which parts of the sentencing guidelines apply. Prosecutors are more inclined to wield that power to benefit people like Manafort, not people charged with crimes involving drugs, blue-collar property crimes, and violence.

Third, Congress has given Ellis the power to give people like Manafort a break, but has denied him that power when the defendant is accused of many blue-collar crimes. Last year, Ellis sentenced a 37-year-old man named Frederick Turner to 40 years in federal prison for methamphetamine distribution. He had no choice: Congress passed laws making 40 years the mandatory minimum sentence.

More than half of federal prisoners received a mandatory minimum sentence. Congress has passed mandatory minimum laws for drugs, guns, child abuse, and child porn. President Trump pushed for harsher mandatory minimum laws for immigration cases. These laws reflect America’s judgment about which people are so irredeemable that federal judges should not have the discretion to show them the sort of lenience Ellis showed Manafort. That judgment favors the rich at the expense of the poor.

Fourth, the U.S. sentencing guidelines treat some crimes more harshly than others, and though, unlike mandatory minimums, they are only recommendations, not strictures, they strongly influence judges. USA Todayreported that fraud cases in Ellis’s district yielded an average sentence of 36 months, versus 66 months for firearms charges and 84 months for drug charges, all higher than the national average. Ellis announced that he was sentencing Manafort below the recommended guideline range because that range was far above what defendants received in similar cases. That is, in fact, a factor that he’s required by law to consider. Manafort’s case was arguably much more serious than others, but there’s no question that his sentencing range was atypically high for a white-collar defendant. This is how the system’s discrepancies become self-justifying and self-perpetuating: Judges give white-collar criminals lower sentences because white-collar criminals typically get lower sentences.

Fifth,  . . .

Continue reading.

Written by Leisureguy

10 March 2019 at 9:00 am

Irresponsible parents: Unvaccinated Boy, 6, Spent 57 Days In The Hospital With Tetanus

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Sasha Ingber reports for NPR:

A new report published by the Centers for Disease Control and Prevention details the harrowing story of a child in Oregon who contracted tetanus because he wasn’t vaccinated.

The boy was playing outside on a farm in 2017 when he cut his forehead. Six days later, he started having symptoms: a clenched jaw, muscle spasms and involuntary arching of his neck and back. When he started struggling to breathe, his parents realized he needed help and called for emergency medical services.

Doctors diagnosed the 6-year-old boy with tetanus and administered a dose of the vaccine, but it took 57 days in a hospital, including 47 days in intensive care, to restore his health.

“It was difficult to take care of him, to watch him suffer,” says Judith Guzman-Cottrill, a pediatric infectious-disease physician who co-authored the article in the CDC’s online journal Morbidity and Mortality Weekly Report.

At first, he asked for water but couldn’t open his mouth. The boy had to spend weeks in a dark room on a respirator. He was able to walk 20 feet, with help, after 50 days.

At a time when preventable outbreaks are making headlines in the United States, Guzman-Cottrill tells NPR that she has met many families who hesitate to give their children vaccines.

“These days, there are so many different places parents can go to for vaccine-related education and advice that many families struggle with knowing who to believe.”

The Internet and social media have made it harder for people to distinguish fact from fiction, she says.

The boy’s infection marked the first pediatric case of tetanus in the state of Oregon in more than 30 years, according to the researchers.

After allowing the first dose of vaccine, the parents refused a second dose for their son, despite doctors giving them information about the advantages of being immunized against tetanus. “I did provide education about the benefits of all pediatric vaccinations and that was also refused,” Guzman-Cottrill says. [The parents are thus not only irresponsible but actively malicious. And ignorant. – LG]

The report of his illness comes after outbreaks of measles occurred this winter in the Pacific Northwest. Measles is also preventable with a vaccination.

The rise in measles cases, spurred by the anti-vaccination movement, is pushing authorities to address the issue.

Continue reading.

Written by Leisureguy

10 March 2019 at 8:06 am

Two studies of nearly 1.2 million Danish kids agree: The measles vaccine doesn’t cause autism

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From an NPR newsletter:

The latest study, covering data collected from all children born in Denmark to Danish-born mothers between 1999 and 2010, found no link, even when subgroups especially susceptible to autism were studied. “Parents should not avoid vaccinating their children for fear of autism,” the lead researcher says.

A separate study found that live vaccines have surprising benefits, priming the immune system to fight off infections other than the targeted pathogen. Researchers are still trying to determine exactly how that happens.

Written by Leisureguy

10 March 2019 at 7:05 am

Posted in Daily life, Health, Science

How Federal Disaster Money Favors The Rich

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Rebecca Hersher and Robert Benincasa report for NPR:

If they had known, they never would have bought the house on Bayou Glen Road. Sure, it was a beautiful lot, tucked in a bend of the creek, backyard woodsy and wild, the neighbors friendly and the street quiet. A little piece of nature just 20 minutes from downtown Houston. It was exactly what John and Heather Papadopoulos — recently married, hoping to start a family — were looking for in 2007. They didn’t think much about the creek that ran along their yard, aside from appreciating the birds it attracted to the neighborhood.

Across town, the Evans family was similarly indifferent to the wooded bayous that cut through their neighborhood. Janice Perry-Evans chose the house she rented because it was conveniently located near the local high school, which made it easy for her two boys to get to class and home from football practice. Her commute to the post office wasn’t far either. Plus, at $800 per month, the rent was affordable. By 2017, the family had lived there for four years, and didn’t have any plans to move.

And then, in August of that year, both homes were destroyed. Both families had to start over from nothing. But today, one family is financially stable. The other is facing bankruptcy.

Disasters are becoming more common in America. In the early and mid-20th century, fewer than 20 percent of U.S. counties experienced a disaster each year. Today, it’s about 50 percent. According to the 2018 National Climate Assessment, climate change is already driving more severe droughts, floods and wildfires in the U.S. And those disasters are expensive. The federal government spends billions of dollars annually helping communities rebuild and prevent future damage. But an NPR investigation has found that across the country, white Americans and those with more wealth often receive more federal dollars after a disaster than do minorities and those with less wealth. Federal aid isn’t necessarily allocated to those who need it most; it’s allocated according to cost-benefit calculations meant to minimize taxpayer risk.

Put another way, after a disaster, rich people get richer and poor people get poorer. And federal disaster spending appears to exacerbate that wealth inequality.

class=”edTag”>The Flood

Nowhere are the economic and racial inequities of disaster aid more apparent than in communities that have experienced one of the most costly and widespread disasters: urban flooding.

Houston is arguably ground zero for urban flooding — a sprawling city built on low and marshy flatlands exposed to hurricanes blowing in from the Gulf of Mexico. In the past decade, there have been five major floods in the city, culminating in the largest amount of rain ever recorded from a single storm: Hurricane Harvey in August 2017.

The Papadopoulos and Evans families were two of the hundreds of thousands of families who evacuated their homes during the storm.

“We were the first ones to evacuate out of our house, up the street,” remembers John Papadopoulos. In the years before the hurricane, their home had gone from a refuge to a nightmare. It flooded in 2009, in 2015 and in 2016. By 2017, they knew what to do: Put the valuables up high, and get out. They went to a neighbor’s house first, and then to a hotel.

It was a new experience for the Evans family. “When the water started coming up, we thought we were going to have to go on the roof,” says Janice Perry-Evans. “But we ended up not going on the roof. We ended up, me and the kids, packing up a little bit of stuff” in a plastic container.

“We got out and we walked in that water,” she remembers. The water was up to her armpits in places. Eventually, a dump truck carried them to a bus, and the bus dropped them at the convention center downtown.

The next morning, Perry-Evans and Papadopoulos took the same first step to start rebuilding their lives — they turned to the federal government for help. But almost immediately, their experiences diverged.

From the beginning, a lot of things went right for the Papadopoulos family. John’s employer, Microsoft, gave him as much time off as he needed and more than $10,000 to help with rent and other bills that piled up after the flood. The Papadopouloses rented a townhouse nearby and, within a few months, the federal aid they had applied for began to arrive.

The Federal Emergency Management Agency gave them $30,000; because the family owned a home that had been destroyed in the flood, the Internal Revenue Service sent checks for more than $100,000 in refunded taxes — a perk of having a relatively high income. The Small Business Administration gave the family a low-interest loan.

About a year after the storm, Papadopoulos said, his family was financially stable.

The Evans family was not.

Janice Perry-Evans had one goal after the floodwaters receded: find a place to stay. She didn’t have any savings for a hotel or a new apartment, so when a co-worker offered her a room in his house, she took it, even though it was one room for her and her three kids and it was a 45-minute drive from work and school.

Then, she started applying for help from FEMA.

The agency gave her about $2,500, enough to cover a deposit and first month’s rent in a new place, but Perry-Evans needed the money for something else. Her oldest son was hoping for a college football scholarship. He couldn’t afford to miss school or football practice that fall, and the family couldn’t afford for Perry-Evans to miss shifts as a mail carrier for the post office.

“I had to go to work, and I had to get these boys back and forth to school. So I took that [money] and I put it for a car,” she explains.

With her immediate transportation needs met, Perry-Evans went back to FEMA to see about getting more money for housing, but she says agency representatives reprimanded her for incorrectly using the money she had been given.

“Some of them were kind of rude,” she remembers. “Some of them felt sorry for me because I would be crying, [saying] ‘Hey, I have nowhere to go. I don’t have no money. You guys are not helping me like I thought.’ ”

FEMA didn’t block Perry-Evans from reapplying for housing money, but she says after the scolding she turned to other potential sources of federal aid, unsuccessfully. Her income wasn’t high enough to claim a significant tax refund. She says she was denied a low-interest loan from the Small Business Administration because her credit score was too low. A FEMA representative suggested she try to get housing money from the Department of Housing and Urban Development, but after she used her day off to go to an information session, she was informed that her income was too high to qualify. . .

Continue reading. There’s much more.

Later in the article:

Perry-Evans is not alone in her struggle. “Recovery for vulnerable families [looks] a lot different than it does for more affluent neighborhoods,” says Kathy Payton, the director of the Fifth Ward Community Redevelopment Corp., a neighborhood nonprofit that works a few miles from where Perry-Evans lives.

Payton grew up in Houston and has spent decades supporting the basic needs of her neighbors, many of whom live on fixed incomes or do not have a cushion of savings to fall back on after a disaster.

“We had loss of income because people lost their jobs. We had increased health issues as a result of them living in bad situations,” she says, ticking off the cascade of challenges lower-income families have contended with since the flood. Many families struggle to successfully apply for money because they do not have access to a computer, she says, or do not have all the paperwork they need, or can’t take time off from work to meet with a FEMA representative.

Payton says wealthier families are more able to comply with the rigid application requirements. “There shouldn’t be a cookie-cutter, one-size-fits-all template,” she says. “You’ve got to make adjustments based on the vulnerabilities and the needs of the families. And that’s not what we do.”

Those application requirements are not explicitly designed to favor some citizens over others. Under the 1988 federal disaster relief law, the requirements exist to protect taxpayers from fraudulent or improper payouts after a storm, by keeping track of who has been given money for what.

But Payton says the upshot in Houston is that the more affluent parts of the city have recovered more quickly and deeply since the flood. Private insurance accounts for some of that, but Payton also believes residents in those areas have been more successful at getting federal money.

“Those families who are more apt to be able to respond to that [funding] will do so quickly, will do so more efficiently and the funds will be available on a first come, first serve basis,” she says. Families who cannot, she says, “will be left behind again.”

A new and growing body of research backs up Payton’s observations. Studies by sociologists, as well as climate scientists, urban planners and economists, suggest that disasters, and the federal aid that follows, disproportionately benefit wealthier Americans. The same is also true along racial lines, with white communities benefiting disproportionately.

“Cities are often very unequal to begin with,” says James Elliott, a sociologist at Rice University. “They’re segregated and there are lots of income disparities, but what seems to happen after natural hazards hit is these things become exacerbated.”

“We see these same patterns of wealth inequality being exacerbated in communities that receive more FEMA aid,” explains sociologist Junia Howell of the University of Pittsburgh. Howell and Elliott have published multiple studies that find a pattern in who wins and who loses after floods and other disasters: Rich people get richer after a storm, and poor people get poorer.

“That’s particularly true along racial lines, along lines of education, as well as homeownership versus renting,” explains Howell. And rather than mitigating the inequity, federal aid exacerbates it, in part because of the biases Payton has noticed that are baked into how federal money is distributed. . .

There’s much more. Read the whole thing. It says a lot about the US.

Written by Leisureguy

10 March 2019 at 6:58 am

Posted in Daily life, Government

FDA Approves Esketamine Nasal Spray For Hard-To-Treat Depression

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Jon Hamilton writes at NPR:

The Food and Drug Administration approved the first drug that can relieve depression in hours instead of weeks.

Esketamine, a chemical cousin of the anesthetic and party drug ketamine, represents the first truly new kind of depression drug since Prozac hit the market in 1988.

The FDA’s decision came Tuesday, less than a month after a panel of experts advising the agency voted overwhelmingly in favor of approval.

“There has been a long-standing need for additional effective treatments for treatment-resistant depression, a serious and life-threatening condition,” said Dr. Tiffany Farchione, acting director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research, in a press release about the decision.

“This is potentially a game changer for millions of people,” said Dr. Dennis Charney, dean of the Icahn School of Medicine at Mount Sinai in New York. “It offers a lot of hope.”

Esketamine works through a mechanism different from those of drugs like Prozac, Charney said. And that is probably why studies show it can often help people with major depressive disorder who haven’t been helped by other drugs.

“Many of them are suicidal,” Charney said. “So it’s essentially a deadly disease when you haven’t responded to available treatments and you’ve been suffering for years if not decades.”

Charney was part of the team that first showed two decades ago that ketamine could treat depression. He also is named as co-inventor on patents filed by the Icahn School of Medicine relating to the treatment for treatment-resistant depression, suicidal ideation and other disorders.

Esketamine, developed by Johnson & Johnson, will be administered as a nasal spray and be used in conjunction with an oral antidepressant. It will be marketed under the brand name Spravato. The FDA has approved it for patients who have failed to respond adequately to at least two other drugs.

That means about 5 million of the 16 million people in the U.S. with major depression might benefit from esketamine, said Courtney Billington, president of Janssen Neuroscience, a unit of Johnson & Johnson.

But esketamine presents some challenges because of its similarities to ketamine. In high doses, both drugs can cause sedation and out-of-body experiences. And ketamine, often called Special K in its illicit form, has become a popular party drug.

So Johnson & Johnson is taking steps to make sure esketamine will be used only as intended, Billington said.

“Spravato will not be dispensed directly to a patient to take at home,” he said. “It will only be available in approved and certified treatment centers.”

Patients will inhale the drug under supervision at these centers once or twice a week. And they will receive a dose that is unlikely to produce side effects such as hallucinations.

“The amount of active ingredient that’s in this product, it’s at a very, very low dose,” Billington said. . .

Continue reading.

Written by Leisureguy

10 March 2019 at 6:50 am

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