Tuesday, October 31, 2006

Music: Ann Friedman (of Feministing) interviews Colin Meloy (of The Decemberists)

And it only gets better:

Ann: I can imagine you’d tell fabulous bedtime stories.

Colin: The first lullaby I ever sang to him was “The Old Main Drag,” the Pogues song about prostitution. Both of us [me and Carson] have real fixations on dark subject matter. But he might rebel against it and be a Republican or something.

I've thoroughly refrained from gushing on and on about how ridiculously amazing The Crane Wife is, because this would quickly become a Decemberists blog.

Zombies: First Person

So what are the zombies thinking?

Gladly Suffering Fools: "I'm a Zombie."

Also funny: "Monday Things Around the House Blogging: An Illegal Immigrant's Tale."

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Politics: Don't Say the T-word

I would suppose that any al Qaida operative who's any good at it already knows a torture method or two, and has thought about it enough. The real (and obvious) reason that Mr. Bush doesn't want to speak publicly about how US agencies question suspects that is that he wants VOTERS to stay in the dark. But you knew that, right? Check out this conversation between Mr. Bush and O'Reilly at Catholic Anarchy.

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Sunday, October 29, 2006

Medicine: Lawrence C Kolb (1911-2006)

I'd summarize all the stuff this uber-psychiatrist did, but my hands would fall off. Lawrence Kolb, psychiatric pirate ninja, died in his sleep at the age of 95 of natural causes.

I'm glad to see he died of natural causes. It always scares me when people die of unnatural causes. Especially this close to Halloween.

Zombies: Dawn of the Dead Zombie Walk!

Dude, if anything would make me move to Pittsburgh, it would be the opportunity to participate in the Walk of the Dead.

LGBT: New Rules for Gay Catholics

This NY Times article describes the draft of new guidelines being put before the US Bishops regarding ministering to gay and lesbian Catholics.

They are apparently trying to "reach out" while maintaininging a safe distance. Some pretty offensive stuff.

For instance, while they are suggesting that I "may benefit" from sharing my "tendencies" with close family and friends, they strongly discourage "public announcements" about it at church (are they serious? tendencies? come on, that's just downright ignorant!). And they also say that I shouldn't be allowed to serve as a Eucharistic Minister.

Are these people serious? Do they really think this is a step forward?

Tuesday, October 24, 2006

Medicine: Creative writing classes lead to better bedside manner

Or at least, that's what this Yale study reports, that by taking a writing workshop, 15 residents were better able to empathize with their patients.

Yale University researchers found that medical residents who completed a creative writing workshop felt the experience helped them better view their patients as people, and not just medical cases.

The effect, according to the researchers, seems to stem from the fact that the residents not only reflected on their own emotions and the experiences of their patients, but also wrote it down as a story.

Now of course, the study methods don't come anywhere close to meeting any sort of criteria to be included as "evidence-based" practice. But who cares? How about the simple institution of ars medicinae artis gratia?

But I wonder why researchers decided to wait until residency, when a culture of helplessness and pessimism is already deeply ingrained. Why not include this in medical school training during the clinical years, or at least during the fourth year, when nobody's doing anything important anyway, and med students have a taste, but not a total disillusionment, of what it means to be paged at four in the morning by a borderline asking for pain meds while trying to put in an A-line on your pneumonia patient who's probably going to have to be transferred to the unit anyway.

Yay for narrative medicine. But let's not go so far as to say that creative writing classes will make better doctors. Let's just say that it might make better human beings, and let the doctors fall where they will.

Monday, October 23, 2006

Medicine: TV-Autism Smackdown/CounterSmackdown

So Time GOES OFF on the TV-autism study from last week, making a handful of excellent points mostly about the way that the media (statisticians and research scientists) make improper derivations from correlational studies. It is notable to say that the study hasn't actually been published yet, but these quotes are from press releases and the such:

"Approximately 17% of the growth in autism in California and Pennsylvania during the 1970s and 1980s was due to the growth of cable television," and "just under 40% of autism diagnoses in the three states studied is the result of television watching due to precipitation."

Result of? Due to? How can these researchers suggest causality when no actual TV watching was ever measured? "The standard interpretation of this type of analysis is that this is cause and effect," Waldman insists, adding that the 67-page study has been read by "half a dozen topnotch health economists."

Could there be something to this strange piece of statistical derring-do? It's not impossible, but it would take a lot more research to tease out its true significance. Meanwhile, it's hard to say just what these correlations measure. "You have to be very definitive about what you are looking at," says Vanderbilt University geneticist Pat Levitt. "How do you know, for instance, that it's not mold or mildew in the counties that have a lot of rain?" How do you know, for that matter, that as counties get more cable access, they don't also get more pediatricians scanning for autism?
Sure, and Wallis does make some good argument that going Freakonomic on health care statistics leads us all to use language that we can't use. We can't say that TV causes autism, but we can say they are very associated. In the case of this correlation, it seems most likely that a confounder affecting both variables probably gives us the R-squared, the "caused-by" variable, that we're seeing. Or maybe it's TV. Who knows.

But we have to give props to Gregg Easterbrook for SLAMMING Wallis and Time for what he thinks is absurd scientific idealism. Short enough to post in full:

This article is awfully casual about accusing others of "irresponsibility." It is common for ideas in research to begin with incomplete statistical observations that inspire National Science Foundation- or Institutes of Medicine-sanctioned studies to prove or disprove the underlying larger claim. The sort of research TIME takes two Cornell University professors to task for not having already conducted at their own expense would require millions of dollars for a very complex multi-year home-monitoring study with hundreds of families in the study group allowing two-way recording devices throughout their homes and hundreds more in the control group.

A correlation found during initial research is exactly the sort of event that triggers funding for such major studies. TIME declaring that a statistician who finds a clue should not publish unless he can offer definitive proof is like saying an astronomer who discovers a star should not reveal its location unless he can prove the origin of the universe. And suppose this theory of autism turns out to be true. Should those with suspicions remain silent, offering no caution to parents of young children?

At any rate, since TIME sees fit to accuse others of irresponsibility, it would have been nice if TIME's article had disclosed that its corporate parent has a financial interest in denouncing this research. TIME is owned by the same company that owns Time Warner Cable, a leading cable television carrier, and owns Cartoon Network, which is marketed to young children.

Ouch. I'm bleeding after reading that.

So let's blame who we should blame: the folks who publish "TV causes autism" crap all over their headlines to drive traffic to their sites, to sell newspapers, and even, oddly enough, boost ratings. The Cornell study might need an editor to throw in some subjunctive verbs. But this army of media douchebags who couldn't properly interpret a medical study if their Blackberrys depended on it need some good old fashioned Cuckoo's Nest-style ECT (before the widespread use of neuromuscular blockers that has made the procedure perfectly uneventful to watch).

Sunday, October 22, 2006

Medicine: preschoolers on Ritalin, and how the media doesn't know what to do with them

So this headline about a study published in JAACAP last week on the safety and benefits of prescribing methylphenidate to kids under 6 has pretty much been taken every which way. Joe Yaroch at Corpus Callosum beat me to this post, but I might have a few more things to add. Dr Y points out two versions of the headline he ran across:

Meds Help Preschoolers with ADHD
Psych Central News Editor
Tuesday, Oct, 17, 2006

Study warns of risks of preschool Ritalin
Associated Press
Posted on Fri, Oct. 20, 2006
WTF? Now, one might simply look at the source of the article and say that Psych Central might have a vested interest in spinning the study positively. But as Dr Y notes, these headlines are both right. They're also entirely unsurprising and absolutely vanilla. This study simply wasn't that newsworthy, and doesn't say anything more than "ritalin helps clinically hyperactive kids under 6, and you gotta be careful giving it to them and watch them closely." No shit, AP.

But that's not my favorite part of the CNN article. This is:
"This is a catastrophe. It just opens up the way for drugging the younger kids," said Dr. Peter Breggin, a New York psychiatrist and longtime critic of psychiatric drug use in children.

Breggin said the research is part of a marketing push by the drug industry to expand drug use to the youngest children.
A New York psychiatrist. As if that is ALL Peter Breggin is. Breggin has made a career out of being anti-psychiatry. He doesn't use meds. He bitches about his little conspiracy theories and is generally a fairly annoying douche. He takes a reasonable message, which is "be careful with these crazy meds," and turns it into prosetylizing assholery, like "meds are bad, you are bad if you give meds, you are bad if you take meds, bwahahahaha!"

Now, is this study even CLOSE to the final word on giving kids under the age of 6 methylphenidate? Of COURSE not. I'm all for stern critique of giving kids with developing nervous systems a potentially neurotoxic chemical, especially when preschoolers don't really have such a great need to sit still until they get into graded school. But I'm even less for popular anti-psychiatry "the drug companies are trying to turn us into capital robots" conspiracy theory.

Friday, October 20, 2006

Colbert Report: Cooking With Feminists & Ice Cream 3-Ways

Thursday, October 19, 2006

LGBT: Boycott a blood drive?

A group of students in Milford, CT are boycotting a blood drive to protest a national law preventing men who've had sex with men to donate blood. The law currently states that any male who's had sexual contact with another male, even once, since the mid 1970's is banned from givving blood. On a national level, the Red Cross would like to change the policy... but something tells me that the current atmosphere in Washinton, DC is not quite ammenable to such a discussion at this time :)

As much as this pains me, I still don't believe it's ok to lie to the questioners when you go to give blood. So I guess I'll just sit on the sidelines and wait for our lawmakers to find some better sense... I may be waiting a long time!

Thursday, October 12, 2006

Books: Is It Just Me

... or is Thomas Friedman's The World is Flat the worst-written nonfiction book to sell more than 200 copies ever?

I'm only on chapter two, but I feel like advanced middle-schoolers could fact check this guy, and raise the stock of red ink. And it's nice to make things simple for people, but simplicity at the expense of sense doesn't seem worth much.

I have a thing about finishing books I start, so I'm stuck reading this turd. Pity me, please. Or at least tell me why this book doesn't suck.

Politics: My frontrunner pulls out

Democrat Mark R. Warner, the former governor of Virginia, has decided not to run for president in 2008, fearing the impact of a drawn-out campaign on his family. "I want to have a real life," he said.

Warner scheduled a late morning news conference in Richmond to make the announcement. In a written statement, he said he made the decision after celebrating his father's 81st birthday and taking his oldest daughter, Madison, on a college tour.

"I know these moments are never going to come again," Warner said. "This weekend made clear what I'd been thinking about for many weeks -- that while politically this appears to be the right time for me to take the plunge, at this point I want to have a real life.

"And while the chance may never come again, I shouldn't move forward unless I'm willing to put everything else in my life on the back burner," he said.
I admit I'd be very interested to see if this "want to have a real life" explanation is really Warner's #1 motivation. But if so, can't blame the guy for being a decent human being.

Bill Richardson and Evan Bayh are still in the pipeline, and Bayh is CERTAINLY running. Daniel at KyDem would be out of a job if Bayh withdrew, so I think he'd make Bayh run at knife-point if necessary.

But then that'd see us with possibly a Jew-vs-Mormon election. Much better than the Hillary-McCain battle forecasted.

I'm not ready for presidential elections yet.

Saturday, October 7, 2006

Medicine: Genentech (expensive) vs Genentech (cheap)?

Finally, anyone with an even mild interest in health management and policy should be following Genentech's new drug for macular degeneration. So Genentech dumped tons of money into making a new drug for that purpose, and a zillion dollars later, come up with Lucentis, a monoclonal antibody that will cost about 2000 bucks per dose and require monthly dosing. The only problem is that, while developing Lucentis, folks started wondering if one of Genentech's other drugs, Avastin, from which Lucentis is derived, might be helpful in its own right.
Avastin is a cancer drug which inhibits tumor angiogenesis. You can guess what happened next:

Before Lucentis was approved, as doctors started hearing the results of its clinical trials, many retina specialists began using Genentech’s cancer drug Avastin off-label as an eye treatment, at a cost of $20 to $100 a dose.

Both Avastin and Lucentis work in a similar way, and some eye doctors say they believe Avastin is equally as effective. However Avastin has not been tested in rigorous clinical trials as Lucentis has. So interest has been growing for a trial to compare the drugs.
This case demonstrates why having a prescription drug plan attached to Medicare might have some tremendous upside, in that the federal government now has a vested interest in controlling drug costs which will indubitably be in conflict with the interests of pharma and biotech firms. And that's something new, because the government doesn't really do ANYTHING to get in the way of pharma and biotech firms, besides making sure they don't directly poison the population. Incentives for innovation are good, but making profits with bad innovation (such as when you spend a zillion dollars developing a new drug for a new indication when one of your own damn proprietary products treats the disorder already) shouldn't be encouraged. Science depends on serendipity, and this time, serendipity bit Genentech in the ass. Don't feel bad, serendipity has made Genentech zillions of dollars in the past.

And just imagine, that Genentech wasn't interested in funding this research itself! It's wonderful to see NIH taking a role researching A) off-label usages of already approved drugs (generally left to the drug companies, who will only do so when having approval helps their profit margins, not when medicine needs further information), and B) trying to contain costs for a drug of prime interest to the Medicare population.

Medicine: News Roundup

The CDC is funding the biggest ever study of autism, including 2700 kids, to try to hash out genetic and environmental aspects of the disorder. But conspiracy theory dumbasses still abound:

But some parents of autistic children say the CDC — which promotes childhood vaccinations — is not interested in fully exploring vaccinations as a potential cause.

“We don’t want the CDC to do anything. We don’t trust them,” said Wendy Fournier, president of the National Autism Association.
Also on the autism front, Risperdal now has FDA approval for treatment of aggression and other positive symptoms in autism. Atypical antipsychotics have been used for years off-label for such indications, but now physicians and insurance companies will feel legally obligated to choose risperidone over quetiapine or other atypicals, which are probably just as effective.

Unsurprisingly, Children with ADHD use significantly more health services 2 years before and 2 years after they are diagnosed compared with children without ADHD. Even less surprising:
Despite similar insurance status, Asian American, African American and Hispanic American children had $221 lower total average costs per year related to ADHD than white American children did. They also had lower ADHD-related pharmacy costs than white American children.

"Lower use of medications among ethnic minorities may be explained in part by cultural differences in the acceptance of ADHD diagnoses and treatment," the authors suggest.
People with IBS are much more likely to have depression, migraines, and fibromyalgia. Grumpy physicians would probably say that whiny people have whiny people diseases. Sparky says those physicians should be drug out and shot in the back yard. Even so, this study furthers theories that a single sort of neurobiological error might account for these, and several other, disorders. I would be that epilepsy and bipolar disorder would also be found to be elevated, but that's my neurobiological conspiracy theory.
Compared with non-IBS patients, those with the condition were 60 percent more likely to also have any one of the three disorders, the report indicates. The elevated risks for depression, migraine, and fibromyalgia were 40 percent, 60 percent, and 80 percent, respectively.

Thursday, October 5, 2006

MedPol: Ali endorses Granholm over stem cell policy fight

I have to appreciate another Kentuckian supporting Granholm for Michigan governor. Michigan has some of the most restrictive stem cell policies in the nation.

State law does not permit Michigan researchers to get embryos left over from fertility treatments in the state.

State scientists can use embryonic stem cell lines from California, Illinois or other states with less restrictive laws, but those lines sometimes are patented by other researchers.

In Monday’s first gubernatorial debate, Republican Dick DeVos said he is against embryonic stem cell research but supports research using adult stem cells.

Opponents say embryonic stem cell research destroys human life, one reason President Bush earlier this year vetoed federal legislation expanding federal funding of such research.

Granholm supports legislation being sponsored by state Rep. Andy Meisner, D-Ferndale, that would allow more embryonic stem cell research in Michigan, and has asked citizens to voice their support for easing restrictions on such research in Michigan by signing an online petition.

Ali’s endorsement enabled Granholm to make a point of her support in her campaign against DeVos. Observers said she’s more likely than DeVos to benefit from raising the issue.

“The Granholm camp can start painting a picture of him as an out-of-synch true-believer,” said Craig Ruff of Lansing-based Public Sector Consultants.

“A plurality of voters support the Granholm position,” said Ed Sarpolus of the Lansing-based polling company EPIC-MRA. “She’s looking for those on-the-fence voters” whose decision doesn’t hinge on the economy.
Ali suffers from Dementia Pugilistica, a fancy name for a Parkinson's-like disease developed after getting bashed upside the head for way too many years.

Wednesday, October 4, 2006

PC Comics: Garfield has gone too far

While reading my comics I was rather annoyed by this one, and not just because Garfield tends to be kind of pointless and annoying (except for those clever lasagna jokes). I see that Jon is referring to the "juice harp" in the final pane. I had always thought it was a Jew's harp, and Wikipedia backs me up on this. Saying that though it has no particular semitic connection, the common term is Jew's Harp and people have taken to using the terms jaw harp, juice harp, English trump, and guimbard to avoid controversy. This seems stupid. I'm all for respecting other races/religions/etc by avoiding pejorative terms (thus I don't use the term Negro, and find Phoenix's Squaw Peak to be offensive, and try to never "Jew down" anyone on prices), but we go too far when we take non-offensive phrases and remove any possible racial/ethnic reference to make them politically correct (e.g. cross legged instead of indian style). That's just gay.

Light from the Heart Nebula
Credit & Copyright: Matt Russell

Tuesday, October 3, 2006

Politics: Mark Foley Jokes!

"Former Florida Congressman Mark Foley has resigned over allegations he sent explicit emails to underage boys. What is it with Congress? If they’re not grabbing your wallet, they’re grabbing your ass." –Jay Leno

"How about that Florida congressman Mark Foley? Whoa. At least the Democrats wait until the interns are 18." –David Letterman

“The Republicans reacted quickly. They transferred Foley to a different parish." –David Letterman

"So basically Pages are brought down there to perform sexual exploits for legislators?" –Jon Stewart
“No, that’s what the interns are for. Pages are just the aphrodisiacs, set the mood, get them primed. They’re the Fluffers of Liberty.” –Samantha Bee
Don't worry, there's more.

Politics: Thoughtful Republican Leadership

Is Trent Lott stupid, lazy, or both?

WASHINGTON (CNN) -- President Bush barely mentioned the war in Iraq when he met with Republican senators behind closed doors in the Capitol Thursday morning and was not asked about the course of the war, Sen. Trent Lott, R-Mississippi, said.

"No, none of that," Lott told reporters after the session when asked if the Iraq war was discussed. "You're the only ones who obsess on that. We don't and the real people out in the real world don't for the most part."

Lott went on to say he has difficulty understanding the motivations behind the violence in Iraq.

"It's hard for Americans, all of us, including me, to understand what's wrong with these people," he said. "Why do they kill people of other religions because of religion? Why do they hate the Israelis and despise their right to exist? Why do they hate each other? Why do Sunnis kill Shiites? How do they tell the difference? They all look the same to me."
I'd tell you what I think about this, but it should be obvious...

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Sunday, October 1, 2006

Medicine: Trojan judges access to sexual health information on college campuses

Those horndogs at Yale top the list, followed by those horndogs at... umm... Iowa? UofM and Stanford share second place with Iowa. As I've blogged before, UofM and Stanford can't ever be far away from each other in just about any ranking, even in the sex survey. UK came in at an acceptable 28th, still scoring a 2.4/4.

The study examines a number of sexual health outcomes, including availability of condoms, contraception, STD testing, sexual assault services, and outreach programs.

Complete Rankings.

All that really matters