Union busting and the inequality of wealth

International Association of MachinistsIn principle, every American citizen has an equal say in our political process. In practice, of course, some of us are more equal than others. Billionaires can field armies of lobbyists; they can finance think tanks that put the desired spin on policy issues; they can funnel cash to politicians with sympathetic views (as the Koch brothers did in the case of Mr. Walker). On paper, we’re a one-person-one-vote nation; in reality, we’re more than a bit of an oligarchy, in which a handful of wealthy people dominate. Given this reality, it’s important to have institutions that can act as counterweights to the power of big money. And unions are among the most important of these institutions. Read more

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Links: History of modesty/Hygiene hypothesis/Men into boys/Koch brothers/Obese pets

Patient modesty mothers and sonsHistory of Modesty, Part 2 (Patient Modesty & Privacy Concerns)
Part two of my post on the history of patient modesty is up as a guest post on the Patient Modesty blog. I discuss how, in the 19th century, doctors got patients to accept a much more invasive physical exam than what they were used to.

Greater Germ Exposure Cuts Asthma Risk (WSJ)
Another example of the hygiene hypothesis. Children living on farms have a lower risk of asthma than children who don’t because they are surrounded by a greater variety of germs. Key is exposure to diversity of germs, not just more of them. “You have to have microbes that educate the immune system. But you have to have the right ones.”
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Reluctant patients: The mental health of doctors

Mental health of doctorsI once walked out of a surgical residency because I didn’t like the way they bullied and yelled at me but not everyone would do that. Students are exposed to brutal violence in ER rooms, are underpaid, and basically end up suffering from PTSD [post-traumatic stress disorder]. But no one comes to talk to you and you’re left on your own.

Dr. Ores decided against a career in surgery and now treats low-income patients in New York City. “I feel I can actually help people. So much is out of your control in the ER room or operating theatre.” Read more

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Links: Cerrie Burnell/Widow’s Lament/Drug shortages/Insurance profits/Cholesterol & women/Kochs

Cerrie BurnellTV presenter Cerrie Burnell: ‘I don’t care if you are offended’ (Guardian)
Born without a right forearm, Burnell now sings, dances, and presents on children’s show. Some parents objected (it frightened their kids). Others suggested long sleeves. “Ultimately, I don’t care if you’re offended.”

Joyce Carol Oates’s Widow’s Lament (NYT)
“A Widow’s Story: A Memoir.” She “has assembled a book more painfully self-revelatory than anything Oates the fiction writer or critic has ever dared to produce.” Touches on the power balance between artist and spouse. Read more

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Feeling sorry for plastic surgeons

sean-mcnamara-christian-troy-plastic-surgeons-nip-tuckThey meant to be reconstructive surgeons, they meant to fix people after horrific accidents or cancer, and they started doing some boob jobs on the side and it started to eat up more and more of their practice because it was so lucrative. They want to send their kids to nice schools, they have mortgages, they have family, and you could see that they felt a little bit helpless as well. It wasn’t what they meant to do. They seemed just as much products of the system as the middle-aged women going in for a facelift or boob job. They were hoping for a better future.

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Links: Sociable robots/MSG/”Fresh”/Male pregnancy/Pubic hair fashions/Climate change

Paro the seal sociable robotA Soft Spot for Circuitry (NYT)
Paro the seal, a sociable robot, accomplishes its lifelike interaction through hidden sensors that monitor sound, light, temperature and touch. Sociable robots now used as therapy for the elderly. “We as a species have to learn how to deal with this new range of synthetic emotions that we’re experiencing — synthetic in the sense that they’re emanating from a manufactured object.”

If MSG is so bad for you, why doesn’t everyone in Asia have a headache? (Guardian)
History of Japanese discovery of the fifth taste, ‘umami’ (translated ‘savoury,’ ‘deliciousness’) and the manufacture of MSG. How MSG got a bad reputation in the US and how the food industry fought back. Fascinating.
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Love and marriage in China

Chinese weddingBecause China has never had a humanist revolution, sex and marriage have always been relatively divorced. That is why many Asian cultures have an immensely commercialised and categorised [sex industry]. … [I]f a husband is a man of means, and has a significant income, then he can take on a second wife without violating his obligation to his first wife. … This does not mean that the Chinese are incapable of love, it means that romantic love competes with that transactional element in a society where people are insecure because their individual interests are not institutionally protected. Read more

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Links: Planned Parenthood/Sleep/Internet empathy/Tobacco in China/Doctors who tweet

Planned parenthood opposition in CongressHouse votes to defund Planned Parenthood, national health-care law (WaPost)
In votes on amendments to federal spending bill, House Republicans block federal funding of Planned Parenthood and cut off funds to implement health care law. Republican congresswoman took the floor to relate her abortion.

The Fact-Free Far Right: Laura Ingraham’s Lies are Dangerous to Our Health (RH Reality Check)
Fox: Planned Parenthood makes most of its money from abortions. Fact: It’s 15% and not federally funded. PP’s main services: contraceptive delivery, testing/treatment of sexually transmitted diseases, screening for cervical and breast cancer
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Links: Superbugs on meat/Insomnia/Longevity gene/Severe weather & climate change/Baby animals

Superbugs on chickenFDA Report: Alarming Amounts of “Superbugs” in Supermarkets (Bnet)
Superbugs (bacteria resistant to antibiotics) in meat is a much more common and widespread problem than anyone would like to admit, according to federal government report. Chicken breasts, ground turkey, ground beef and pork chops tested.

Superbugs in Canadian chicken? Yes, and US too (Wired)
15% of bacteria on chicken breasts and ground turkey are resistant to 4 or more classes of antibiotics. Drug-resistant bacteria in food won’t diminish until we reduce the amount of drugs that food animals receive while they are raised. Read more

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Links: Patient modesty history/Value of life/Human clones for body parts/UK health inequalities

Modesty catHistory of Patient Modesty – Part 1: How Bodily Exposure Went from Unacceptable to Required (Patient Modesty & Privacy Concerns)
I have a guest post today on the #1 medical privacy blog. Part one describes what medicine used to be like before modern, anatomically-based theories of disease. Well into the 19th century, doctors did not expect patients to remove their clothes.

U.S. Raises Value of a Life, and Businesses Fear Impact (NYT)
How much should the government spend to prevent a single death? Environmental, consumer, and worker protection standards have been going up, despite protests from business. Read more

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Links: Hygiene hypothesis/Grief/Computers vs. humans/ Tobacco for the poor/Genetics via Lady Gaga

Girl playing in mud - hygeine hypothesisWhy Keeping Little Girls Squeaky Clean Could Make Them Sick (NPR)
The hygiene hypothesis: children exposed to lots of germs early in life less likely to develop allergies, asthma, autoimmune disorders. Women have higher rates of these disorders. Is that because girls are held to higher standards of cleanliness?

Grief, Unedited (NYT)
Memoirs on the loss of a spouse, such as the latest from Joyce Carol Oates, don’t teach us about typical mourning experience. Most older people whose spouse dies from natural causes recover much more quickly than we have come to expect. For many, acute grief subsides less than six months after the loss. By the author of The Truth About Grief: The Myth of Its Five Stages and the New Science of Loss. Read more

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Links: Cosmetic surgery as investment/DSD/Never let me go/Losing a spouse/Kissing

Cosmetic surgery as an investmentWhen cosmetic surgery is a marker of ambition (Guardian)
Why aren’t people more concerned about medical risks of cosmetic surgery? We’re increasingly socialised to believe we must invest in ourselves to improve our life chances and opportunities, whether it’s paying for higher education, looks or both.

The Tale of Tea with Jim the Third (Bioethics Forum)
Alice Dreger on the story of a man with disorder of sex development (formerly known as intersex). The biggest issue is not surgery, hormonal treatments, or lack of psychological support for families. It’s shame and how no one deals with it.
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Chocolate has antioxidants but is that a good thing?

Chocolate antioxidants Valentine's dayFirst, studies piled up showing that taking antioxidants—even such common and seemingly innocuous ones as beta carotene and vitamins C and E—as supplements was not beneficial to health and might even be dangerous, though the reason for the danger wasn’t clear. (One always pays attention when a study concludes with a phrase like “seems to increase overall mortality.”) Now the research is challenging an even more fundamental tenet of the antioxidant craze. Many of the free radicals that are neutralized by antioxidants perform valuable functions in the body. The most important: fighting toxins (white blood cells churn out free radicals by the battalion to fight bacterial infection) and fighting cancer. Read more

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Links: Handedness/Spare parts baby/Thinspiration/Vaccine/Ripeness/Sore muscles

Left handed parrotHere’s why you’re right-handed or left-handed (MSNBC)
It depends on eye dominance. In recent U.S. history, the majority of presidents have been left-handed (Ford, Reagan, G.H.W. Bush, Clinton, Obama), but scientists haven’t yet found a link between hand preference and an individual’s abilities. Study based on eye and foot preferences of parrots (see left-footed parrot, right).

France’s first genetically-engineered baby born (M&C)
Headline misleading. First “savior sibling,” “spare parts baby” (think “My sister’s keeper”) in France. Embryo screened for disease and sibling match. Genetic engineering implies something was changed, not just selected.
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The states’ rights argument against health care: An ugly tradition

Constitutionality of health care individual mandate“Opponents of health care reform are not really seeking to vindicate the power of states to regulate health care. Rather, they are counting on the fact that if they succeed with this legal gambit, the powerful interests arrayed against health care reform—the insurance industry, doctors, and drug companies—will easily overwhelm any efforts at meaningful reform in most states. Unless the Supreme Court is willing to rewrite hundreds of years of jurisprudence, however, they will not succeed.” Read more

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Links: Veggies & skin color/Individual mandate/Diet soda/Healthy eggs?/DTC ads

Vegetables give skin golden glowHow vegetables can give you that golden glow (Guardian)
Carotenoids, stored in fat under the skin and found in tomatoes, peppers, plums and carrots, can give Caucasian skin a healthy-looking golden glow – a look equated with attractiveness.

Is Health Care Reform Unconstitutional? (NY Review)
One of the best discussions I’ve read on the subject. Constitutionality won’t be an issue. Health care opponents simply looking for a way to prevent government from imposing a collective solution to a social problem. Read more

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The ethics of a neuroenhanced future

NeurosciencePharmaceuticals … are now being consumed at high rates as off-label “cognitive enhancers” to boost mood, memory, and alertness. … What will happen to the fabric of society and the character of our interactions with one another? Are these altered states a genuine reflection of a new and improved “me” or “we”, or some transient drug-induced condition that thoroughly confounds what we inherently value? Will we be coerced into conforming to a wave of drug intervention in the ever expanding, do-it-yourself, self-help world? Read more

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Links: Awake cosmetic surgery/Dentist demographics/more

Awake cosmetic surgeryNipped, tucked and wide awake? (MSNBC)
Awake cosmetic surgery can be performed by doctors with two days of training and no hospital privileges. “This is just a gimmick by people who can’t operate their way out of a wet paper bag.”

Awake Cosmetic Surgery–The Pros and Cons (EmpowHer)
Growing trend alarms doctors. Presented to patient as a benefit. No side effects (or cost) of anesthesia, but requires near toxic levels of lidocaine. Selecting a cup size during surgery is like “making a decision while drunk.”
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Constitutional law will trump politics on health care reform

Health care individual mandate consitutional law“Since the New Deal, the court has consistently held that Congress has broad constitutional power to regulate interstate commerce. This includes authority over not just goods moving across state lines, but also the economic choices of individuals within states that have significant effects on interstate markets. By that standard, this law’s constitutionality is open and shut. Does anyone doubt that the multitrillion-dollar health insurance industry is an interstate market that Congress has the power to regulate?” Read more

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Links: Female infanticide/Goodbye Darvon/End-of-life talks/more

Riwayat the filmThe tyranny of tradition (Lancet)
Review of film written by two doctors: “Riwayat” (traditions). Indian practice of killing baby girls. 10 million girls aborted in last 20 years, even though prenatal sex determination outlawed in 1994.

Physicians Say Good Riddance to ‘Worst Drug in History’ (Medscape Today)
Pain reliever propoxyphene (Darvon, Darvocet): “No single drug has ever caused so many deaths.” Small benefits, big risks, addictive. Banned in UK 5 years ago due to suicide risk. Read more

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Inequality and the financial crisis

Inequality shoeshine“Inequality has been getting worse. … One thing that this has done is it has encouraged governments, who are aware of the resentment caused by the rising inequality, to try to take some kind of steps to make it more politically acceptable.” Rajan has a chapter called ‘Let them eat credit’. “The US in particular has stimulated the housing market, it has subsidised lending to people, which drove up home prices in an unsustainable way.” Read more

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Misc Links 2/6/11

Alone Together Sheryl TurkleHit Send, Take a Bow (WSJ)
Sherry Turkle’s Alone Together. Precisely because there is so much opportunity for digital communication, we are losing the ability to make simple, genuine connections with actual human beings. “A behavior that has become typical may still express the problems that once caused us to see it as pathological.”

Who’s the Boss, You or Your Gadget? (NYT)
All of this amped-up productivity comes with a growing sense of unease. Too often, people find themselves with little time to concentrate and reflect on their work. Or to be truly present with their friends and family. “Nobody seems to actually pay full attention; everybody is doing a worse job because they are doing more things.” Read more

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Guest post: A fat lot of good

Slow bicycleThis delightful person, who signed off with “Yours fatly,” is a woman after my own heart. Her wise words took me back to a holiday in France, where the supermarkets were filled with full, fat, soft, unpasteurized cheeses, divine pastries, calorie and fat-laden crème fraiche and whole aisles of wine. I looked for low fat products and found one tiny, slender end-of-aisle display, where a small coterie of non-Europeans searched for fat-free yogurt and pre-packaged egg whites. Read more

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Misc Links 2/5/11

Cloned dogDog cloning is not as cuddly as it looks (New Scientist)
Review of Dog, Inc.: The Uncanny Inside Story of Cloning Man’s Best Friend. Dogs are very difficult to clone due to opaque eggs. Requires large canine population, which Korea had, since canines are on the menu there.

Role of Age, Sex, and Race on Cardiac and Total Mortality Associated With Super Bowl Wins and Losses (Clinical Cardiology)
A Super Bowl loss for individual’s favored team triggered increased deaths in both men and women, especially in older patients. A Super Bowl win reduced deaths more in people age 65+ and women. Read more

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A doomed and dysfunctional medical culture

Newborn babyJ.D. Kleinke is a medical economist, health information industry pioneer, and author of the forthcoming Catching Babies. In a dramatic, powerful, and beautifully written post on The Health Care Blog, he captures the essence of what’s wrong with modern medicine. “Who would not find great drama in a medical culture so doomed and dysfunctional, and so utterly driven by the conflict between patient preference and provider prejudice.” Read more

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Misc Links 2/4/11

Child in imaging machinePicture This: The Average US Child Has Nearly 8 Imaging Tests by Age 18 (JAMA)
That excludes dental x-rays. First large, population-based study examines the use of radiography, computed tomographic (CT) scans, and other imaging procedures in pediatric populations. 42% of children get imaged.

Close Look at a Flu Outbreak Upends Some Common Wisdom (NYT)
A study of the 2009 swine flu epidemic found that children did not catch the flu by sitting near classmates, adults probably were not infected by their children, and closing schools had little effect. Disease spread through child’s network of friends. Read more

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The absurdity of widowhood

Joyce Carol Oates and husband Raymond SmithThe New Yorker published a beautiful piece by Joyce Carol Oates on the death of her husband, Raymond Smith. Oates and Smith, who had been married 48 years, were in a car accident three years ago. The engine of their car was struck at high impact from the side, and their airbags inflated. Both Oates and Smith walked away from the scene, feeling lucky to be alive. Read more

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Misc Links 2/3/11

Couple kissingThe mysteries of kisses (New Scientist)
Review of The Science of Kissing: What Our Lips Are Telling Us. At its most basic level, an exploratory kiss offers a reproductive advantage, providing genetic and hormonal information to those who pucker up.

Virginia to seek expedited Supreme Court review of suit over health-care law (Wash Post)
In a rare legal request to bypass appeals and get early intervention, Virginia attorney general asks Supreme Court for immediate review. Read more

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Are doctors tired of practicing medicine?

Dr. Ben Carson George BushIn the mid-20th century, physicians were among the most highly admired professionals, comparable with Supreme Court justices. … Depictions of physicians on television were overwhelmingly positive. Doctors were able to trade on this cultural perception for an unusual degree of privilege and influence.

Today, medicine is just another profession, and doctors have become like everybody else: insecure, discontented and anxious about the future.
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