Archive for the ‘Medical’ Category
High time. When personal beliefs have a social cost that results in harm to the public, then it’s right that the government can act to protect the public. Kaleigh Rogers reports at Motherboard:
It’s official: California has passed a law prohibiting parents from using personal belief as an excuse to keep their kids unvaccinated.
Under the new law, parents can still choose not to vaccinate their children if they wish, but those kids won’t be allowed to attend public schools or daycares, and will have to either be homeschooled or enter a private school.
There are a few exceptions: kids who can’t be vaccinated for medical reasons are exempt from the ruling, and only 10 specific vaccines are required, including the vaccine for measles, mumps, and rubella. Children who have special education needs will also still be guaranteed access to resources they need if they are booted from public school for being unvaccinated.
Last week, California’s State Assembly considered the bill, which had already been green-lit by the state senate, ultimately voting to approve it 46-30. This week, the senate approved the amendments that were added to the bill before passing it to the desk of Democratic Governor Jerry Brown, who signed the bill this morning.
“The science is clear that vaccines dramatically protect children against a number of infectious and dangerous diseases,” the governor wrote in a memo about his decision. “While it’s true that no medical intervention is without risk, the evidence shows that immunization powerfully benefits and protects the community.” . . .
Darryl Greer published a vivid description of a young criminal (psychopath? cyber-terrorist?) recently in Motherboard:
It begins with a phone call to a police force that could be thousands of miles away, claiming wild threats of violence and mayhem or desperate pleas for help—and then, the sound of a doorbell or a hard knock at the door.
Under the watchful eye of a webcam, victims can be seen lifting a headphone from one ear and momentarily pausing to listen. Some stand up from their computer screens to go investigate, while others go right back to gaming. Whatever the case, the outcome is always the same: well-armed police officers storm in and shout orders to get-the-fuck-on-the-floor.
The phenomenon, known as “swatting,” is not new. But some, hiding behind a shroud of internet anonymity, have taken the practice to new extremes. Such is the case of a 17-year-old teen with a knack for hacking and a penchant for terrorizing fellow gamers—mostly young women—whose fate will be decided in a courtroom in the Vancouver, British Columbia suburb of Port Coquitlam later this month.
In May, he plead guilty to 23 charges of extortion, public mischief and criminal harassment related to several swatting incidents in Canada and the US—out of 40 total charges—but as a young offender he cannot be named.
His guilty plea made international headlines, in part due to his association with a hacking group called Lizard Squad, known for its attacks on the Playstation Network and Xbox Live online gaming services, amongst other video gaming sites. In one eight-hour video, which has since been taken offline, Ars Technica reported that the teen identified himself as a member of the group, and has used the handles “obnoxious” and “internetjesusob” online (Lizard Squad denies the teen was a core member).
But, as local media has reported, the young hacker’s victims were not only the large networks and institutions that Lizard Squad targeted, but unsuspecting fans of the popular video game League of Legends, as well as other gamers who had the misfortune of crossing his path online.
Florida’s Polk County Sheriff’s Office first identified the teen after he placed several threatening calls to locations in the area in late 2014, including threats to shoot and blow up a high school where one of his targets attended. According to a report in The Province, “when [targets] would not acknowledge friend and follow requests or send him things that he wanted, such as photos, he would harass them and their families.”
There was a woman in Arizona, swatted repeatedly and terrorized to the point of dropping out of university for a semester, and the Minnesota parents whose credit was in shambles after the teen swatted their child and posted the parents’ personal information online. In other instances, the teen would call in hostage situations, murders, bomb threats, and threatened to kill police, The Province reported, and would then hack and harass targets and their families for months with “phone calls, texts and by spamming social media accounts.”
In the case of the Arizona woman, the teen even “cancelled utilities, phone and Internet accounts, called her parents in the middle of the night and released their financial information online.” . . .
He’s now gone to trial, and from this report I don’t think the system really has an effective approach. He will be sentenced on 9 July.
Very interesting article in Salon by Laura Miller. The whole thing’s worth reading, but note this:
. . . This conception of addiction as a biological phenomenon seemed to be endorsed over the past 20 years as new technologies have allowed neuroscientists to measure the human brain and its activities in ever more telling detail. Sure enough, the brains of addicts are physically different — sometimes strikingly so — from the brains of average people. But neuroscience giveth and now neuroscience taketh away. The recovery movement and rehab industry (two separate things, although the latter often employs the techniques of the former) have always had their critics, but lately some of the most vocal have been the neuroscientists whose findings once lent them credibility.
One of those neuroscientists is Marc Lewis, a psychologist and former addict himself, also the author of a new book “The Biology of Desire: Why Addiction is Not a Disease.” Lewis’s argument is actually fairly simple: The disease theory, and the science sometimes used to support it, fail to take into account the plasticity of the human brain. Of course, “the brain changes with addiction,” he writes. “But the way it changes has to do with learning and development — not disease.” All significant and repeated experiences change the brain; adaptability and habit are the brain’s secret weapons. The changes wrought by addiction are not, however, permanent, and while they are dangerous, they’re not abnormal. Through a combination of a difficult emotional history, bad luck and the ordinary operations of the brain itself, an addict is someone whose brain has been transformed, but also someone who can be pushed further along the road toward healthy development. (Lewis doesn’t like the term “recovery” because it implies a return to the addict’s state before the addiction took hold.)
“The Biology of Desire” is grouped around several case studies, each one illustrating a unique path to dependency. A striving Australian entrepreneur becomes caught up in the “clarity, power and potential” he feels after smoking meth, along with his ability to work long hours while on the drug. A social worker who behaves selflessly in her job and marriage constructs a defiant, selfish, secret life around stealing and swallowing prescription opiates. A shy Irishman who started drinking as a way to relax in social situations slowly comes to see social situations as an occasion to drink and then drinking as a reason to hole up in his apartment for days on end.
Each of these people, Lewis argues, had a particular “emotional wound” the substance helped them handle, but once they started using it, the habit itself eventually became self-perpetuating and in most cases ultimately served to deepen the wound. Each case study focuses on a different part of the brain involved in addiction and illustrates how the function of each part — desire, emotion, impulse, automatic behavior — becomes shackled to a single goal: consuming the addictive substance. The brain is built to learn and change, Lewis points out, but it’s also built to form pathways for repetitive behavior, everything from brushing your teeth to stomping on the brake pedal, so that you don’t have to think about everything you do consciously. The brain is self-organizing. Those are all good properties, but addiction shanghais them for a bad cause.
As Lewis sees it, addiction really is habit; we just don’t appreciate how deeply habit can be engraved on the brain itself. “Repeated (motivating) experience” — i.e., the sensation of having one’s worries wafted away by the bliss of heroin — “produce brain changes that define future experiences… So getting drunk a lot will sculpt the synapses that determine future drinking patterns.” More and more experiences and activities get looped into the addiction experience and trigger cravings and expectations like the bells that made Pavlov’s dogs salivate, from the walk home past a favorite bar to the rituals of shooting up. The world becomes a host of signs all pointing you in the same direction and activating powerful unconscious urges to follow them. At a certain point, the addictive behavior becomes compulsive, seemingly as irresistibly automatic as a reflex. You may not even want the drug anymore, but you’ve forgotten how to do anything else besides seek it out and take it. . .
The VA too often fails in its mission, and very little seems to be done to fix that. If we had a functioning Congress, they could exercise their oversight, but Congress is almost totally dysfunctional at this point. Caitlin Dickerson reports on NPR (and there’s an audio report at the link):
In secret chemical weapons experiments conducted during World War II, the U.S. military exposed thousands of American troops to mustard gas.
When those experiments were formally declassified in the 1990s, the Department of Veterans Affairs made two promises: to locate about 4,000 men who were used in the most extreme tests, and to compensate those who had permanent injuries.
But the VA didn’t uphold those promises, an NPR investigation has found.NPR interviewed more than 40 living test subjects and family members, and they describe an unending cycle of appeals and denials as they struggled to get government benefits for mustard gas exposure. Some gave up out of frustration.
In more than 20 years, the VA attempted to reach just 610 of the men, with a single letter sent in the mail. Brad Flohr, a VA senior adviser for benefits, says the agency couldn’t find the rest, because military records of the experiments were incomplete.
“There was no identifying information,” he says. “No Social Security numbers, no addresses, no … way of identifying them. Although, we tried.”
Yet in just two months, an NPR research librarian located more than 1,200 of them, using the VA’s own list of test subjects and public records.
The mustard gas experiments were conducted at a time when American intelligence showed that enemy gas attacks were imminent. The tests evaluated protective equipment like gas masks and suits. They also compared the relative sensitivity of soldiers,including tests designed to look for racial difference.
The test subjects who are still alive are now in their 80s and 90s. Each year more of their stories die with them.
“We weren’t told what it was,” says Charlie Cavell, who was 19 when he volunteered for the program in exchange for two weeks’ vacation. “Until we actually got into the process of being in that room and realized, wait a minute, we can’t get out of here.” . . .
There’s lots more: it’s a lengthy report.
Justice Scalia seems to have trouble remembering his own opinions. Linda Greenhouse reports in the NY Times:
Sometimes the Supreme Court moves in mysterious ways. The health care decision was not one of those times.
A case that six months ago seemed to offer the court’s conservatives a low-risk opportunity to accomplish what they almost did in 2012 — kill the Affordable Care Act — became suffused with danger, for the millions of newly insured Americans, of course, but also for the Supreme Court itself. Ideology came face to face with reality, and reality prevailed.
The 6-to-3 vote to reject the latest challenge means that one or perhaps two of the justices who grabbed this case back in November had to have jumped ship. Here’s why: It takes at least four votes to add a case to the court’s docket. Given that the decision to hear this case, King v. Burwell, was entirely gratuitous — the Obama administration had won in the lower court, and an adverse decision in a different appeals court had been vacated — we can assume the votes came from the four justices who nearly managed to strangle the law three years ago in National Federation of Independent Business v. Sebelius.
These four were Justices Anthony M. Kennedy, Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. Maybe Chief Justice John G. Roberts Jr., excoriated in right-wing circles for having saved the statute with a late vote switch last time, also agreed to hear the new case. Or maybe his four erstwhile allies were trying to put the heat on him. It’s a delicious question without, at least for now, an answer.
When I think of this case on its trajectory toward the court, the image that comes to mind is of the great white shark in “Jaws,” swimming silently under the water, its lethal teeth bearing down on the statutory language freshly discovered by the administration’s enemies: “Exchange established by the State.”
Do “words no longer have meaning,” as Justice Scalia put it in his angry dissenting opinion? What, after all, could be clearer? The state, not the federal government. The two are not the same. They are different! So poor and middle-class people in the 34 (mostly red) states that refused to set up their own insurance exchanges, defaulting that task to the federal government, are just out of luck. They aren’t eligible for tax subsidies to help them buy insurance, subsidies that are critical to making the law work. End of story, end of case, end of the Affordable Care Act (or Scotuscare, as Justice Scalia said the law should be re-named).
The chief justice’s masterful opinion showed that line of argument for the simplistic and agenda-driven construct that it was. Parsing the 1,000-plus-page statute in a succinct 21-page opinion, he deftly wove in quotations from recent Supreme Court opinions.
Who said that we “must do our best, bearing in mind the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme”? Why, it was Justice Scalia (actually quoting an earlier opinion by Justice Sandra Day O’Connor) in a decision just a year ago.
And who said that “a provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme” because “only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law”? Why, Justice Scalia again.
“In this instance,” Chief Justice Roberts wrote, “the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.” He concluded: “A fair reading of legislation demands a fair understanding of the legislative plan.” Among the chief justice’s silent partners in the six-justice majority opinion was Justice Kennedy, by most accounts the driving force behind the near miss three years ago. . .
Pete Smith reports in the NY Times:
Eighteen vials were rocking back and forth on a squeaky mechanical device the shape of a butcher scale, and Mark Lyte was beside himself with excitement. ‘‘We actually got some fresh yesterday — freshly frozen,’’ Lyte said to a lab technician. Each vial contained a tiny nugget of monkey feces that were collected at the Harlow primate lab near Madison, Wis., the day before and shipped to Lyte’s lab on the Texas Tech University Health Sciences Center campus in Abilene, Tex.
Lyte’s interest was not in the feces per se but in the hidden form of life they harbor. The digestive tube of a monkey, like that of all vertebrates, contains vast quantities of what biologists call gut microbiota. The genetic material of these trillions of microbes, as well as others living elsewhere in and on the body, is collectively known as the microbiome. Taken together, these bacteria can weigh as much as six pounds, and they make up a sort of organ whose functions have only begun to reveal themselves to science. Lyte has spent his career trying to prove that gut microbes communicate with the nervous system using some of the same neurochemicals that relay messages in the brain.
Inside a closet-size room at his lab that afternoon, Lyte hunched over to inspect the vials, whose samples had been spun down in a centrifuge to a radiant, golden broth. Lyte, 60, spoke fast and emphatically. ‘‘You wouldn’t believe what we’re extracting out of poop,’’ he told me. ‘‘We found that the guys here in the gut make neurochemicals. We didn’t know that. Now, if they make this stuff here, does it have an influence there? Guess what? We make the same stuff. Maybe all this communication has an influence on our behavior.’’
Since 2007, when scientists announced plans for a Human Microbiome Project to catalog the micro-organisms living in our body, the profound appreciation for the influence of such organisms has grown rapidly with each passing year. Bacteria in the gut produce vitamins and break down our food; their presence or absence has been linked to obesity, inflammatory bowel disease and the toxic side effects of prescription drugs. Biologists now believe that much of what makes us human depends on microbial activity. The two million unique bacterial genes found in each human microbiome can make the 23,000 genes in our cells seem paltry, almost negligible, by comparison. ‘‘It has enormous implications for the sense of self,’’ Tom Insel, the director of the National Institute of Mental Health, told me. ‘‘We are, at least from the standpoint of DNA, more microbial than human. That’s a phenomenal insight and one that we have to take seriously when we think about human development.’’
Given the extent to which bacteria are now understood to influence human physiology, it is hardly surprising that scientists have turned their attention to how bacteria might affect the brain. Micro-organisms in our gut secrete a profound number of chemicals, and researchers like Lyte have found that among those chemicals are the same substances used by our neurons to communicate and regulate mood, like dopamine, serotonin and gamma-aminobutyric acid (GABA). These, in turn, appear to play a function in intestinal disorders, which coincide with high levels of major depression and anxiety. Last year, for example, a group in Norway examined feces from 55 people and found certain bacteria were more likely to be associated with depressive patients.
At the time of my visit to Lyte’s lab, he was nearly six months into an experiment that he hoped would better establish how certain gut microbes influenced the brain, functioning, in effect, as psychiatric drugs. He was currently compiling a list of the psychoactive compounds found in the feces of infant monkeys. Once that was established, he planned to transfer the microbes found in one newborn monkey’s feces into another’s intestine, so that the recipient would end up with a completely new set of microbes — and, if all went as predicted, change their neurodevelopment. The experiment reflected an intriguing hypothesis. Anxiety, depression and several pediatric disorders, including autism and hyperactivity, have been linked with gastrointestinal abnormalities. Microbial transplants were not invasive brain surgery, and that was the point: Changing a patient’s bacteria might be difficult but it still seemed more straightforward than altering his genes.
When Lyte began his work on the link between microbes and the brain three decades ago, it was dismissed as a curiosity. By contrast, last September, the National Institute of Mental Health awarded four grants worth up to $1 million each to spur new research on the gut microbiome’s role in mental disorders, affirming the legitimacy of a field that had long struggled to attract serious scientific credibility. Lyte and one of his longtime colleagues, Christopher Coe, at the Harlow primate lab, received one of the four. ‘‘What Mark proposed going back almost 25 years now has come to fruition,’’ Coe told me. ‘‘Now what we’re struggling to do is to figure out the logic of it.’’ It seems plausible, if not yet proved, that we might one day use microbes to diagnose neurodevelopmental disorders, treat mental illnesses and perhaps even fix them in the brain.
In 2011, a team of researchers at University College Cork, in Ireland, and McMaster University, in Ontario, published a study in Proceedings of the National Academy of Science that has become one of the best-known experiments linking bacteria in the gut to the brain. Laboratory mice were dropped into tall, cylindrical columns of water in what is known as a forced-swim test, which measures over six minutes how long the mice swim before they realize that they can neither touch the bottom nor climb out, and instead collapse into a forlorn float. Researchers use the amount of time a mouse floats as a way to measure what they call ‘‘behavioral despair.’’ (Antidepressant drugs, like Zoloft and Prozac, were initially tested using this forced-swim test.)
For several weeks, the team, led by John Cryan, the neuroscientist who designed the study, fed a small group of healthy rodents a broth infused with Lactobacillus rhamnosus, a common bacterium that is found in humans and also used to ferment milk into probiotic yogurt. Lactobacilli are one of the dominant organisms babies ingest as they pass through the birth canal. Recent studies have shown that mice stressed during pregnancy pass on lowered levels of the bacterium to their pups. This type of bacteria is known to release immense quantities of GABA; as an inhibitory neurotransmitter, GABA calms nervous activity, which explains why the most common anti-anxiety drugs, like Valium and Xanax, work by targeting GABA receptors.
Cryan found that the mice that had been fed the bacteria-laden broth kept swimming longer and spent less time in a state of immobilized woe. ‘‘They behaved as if they were on Prozac,’’ he said. ‘‘They were more chilled out and more relaxed.’’ The results suggested that the bacteria were somehow altering the neural chemistry of mice.
Until he joined his colleagues at Cork 10 years ago, Cryan thought about microbiology in terms of pathology: the neurological damage created by diseases like syphilis or H.I.V. ‘‘There are certain fields that just don’t seem to interact well,’’ he said. ‘‘Microbiology and neuroscience, as whole disciplines, don’t tend to have had much interaction, largely because the brain is somewhat protected.’’ He was referring to the fact that the brain is anatomically isolated, guarded by a blood-brain barrier that allows nutrients in but keeps out pathogens and inflammation, the immune system’s typical response to germs. Cryan’s study added to the growing evidence that signals from beneficial bacteria nonetheless find a way through the barrier. Somehow — though his 2011 paper could not pinpoint exactly how — micro-organisms in the gut tickle a sensory nerve ending in the fingerlike protrusion lining the intestine and carry that electrical impulse up the vagus nerve and into the deep-brain structures thought to be responsible for elemental emotions like anxiety. Soon after that, Cryan and a co-author, Ted Dinan, published a theory paper in Biological Psychiatry calling these potentially mind-altering microbes ‘‘psychobiotics.’’
It has long been known that much of our supply of neurochemicals — an estimated 50 percent of the dopamine, for example, and a vast majority of the serotonin — originate in the intestine, where these chemical signals regulate appetite, feelings of fullness and digestion. But only in recent years has mainstream psychiatric research given serious consideration to the role microbes might play in creating those chemicals. Lyte’s own interest in the question dates back to his time as a postdoctoral fellow at the University of Pittsburgh in 1985, when he found himself immersed in an emerging field with an unwieldy name: psychoneuroimmunology, or PNI, for short. The central theory, quite controversial at the time, suggested that stress worsened disease by suppressing our immune system.
By 1990, at a lab in Mankato, Minn., Lyte distilled the theory into three words, which he wrote on a chalkboard in his office: . . .
An editorial in the NY Times:
One would imagine that congressional Republicans, almost all of whom are on record as adamantly opposing abortion, would be eager to fund programs that help reduce the number of unwanted pregnancies.
That would be the common sense approach, anyway.
And yet since they took over the House in 2011, Republicans have been trying to obliterate the highly effective federal family-planning program known as Title X, which gives millions of lower-income and rural women access to contraception, counseling, lifesaving cancer screenings, and treatment for sexually transmitted diseases.
They tried and failed in 2011, when the Senate was under Democratic control — although they still managed to extract significant cuts from an already underfunded program. Now that Republicans run the show, opponents of sensible and effective family planning are back to kill it off for good. Last Tuesday, a House subcommittee on Labor, Health and Human Servicesproposed to eliminate all Title X funding — about $300 million — from a2016 spending bill.
The bill would also slash funding by up to 90 percent for sex education, specifically President Obama’s teen-pregnancy prevention initiative. The only winner was abstinence-only education, whose funding the subcommittee voted to double, despite the fact that it has basically no effect on abstinence and has been associated with higher rates of teen pregnancy.
Meanwhile, Title X, which was enacted by overwhelming bipartisan majorities in Congress in 1970, is caught up once again in the nation’s abortion wars — even though like all federal programs, it is barred from providing any funding for abortions.
Republicans have complained that this ban is subverted by Planned Parenthood, which performs abortions and is Title X’s biggest recipient. They want to deny the organization any federal funds at all. But 90 percent of the women who visit Planned Parenthood clinics are there to get contraception or other reproductive health care, not abortions.
What Title X grants actually do is help prevent unwanted pregnancies —more than one million in 2012, which translates to about 363,000 abortions avoided. . .