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16 posts categorized "Revere"

May 11, 2005

Dumb and dumber

Guest post by Revere

Removing your shoes at the airport is dumb. Here is something dumber: Proposed Federal rules restricting foreign researchers' access to equipment subject to export controls, even if the underlying research is exempt from licensing (Chronicle for Higher Education [subscription required, alas]).

Example: a fermenter, a piece of equipment is used to grow cells, often cells with recombinant DNA. This is a common piece of equipment, widely available. The new rules would require universities and biotech companies to obtain licenses for foreigners using such devices, even if the work itself will be openly published and is uncontroversial. Why?

The Commerce Department says the changes are necessary to ensure that spies and terrorists do not obtain access to equipment that could have military applications.

[snip]

. . . some academics say that the government has gone overboard, imposing so many licensing and clearance requirements that it is becoming difficult for universities to attract foreign students and scholars. The number of foreign students on American campuses declined last year by 2.4 percent -- the first drop in foreign enrollments since the 1971-72 academic year.

"The issue here is death by a thousand cuts," said Eric L. Hirschhorn of the Industry Coalition on Technology Transfer, noting that some foreign researchers must already undergo extensive background checks before obtaining a visa.

Peter Lichtenbaum, assistant secretary of commerce for export administration, said the department would "not shy away from doing the right thing because of impacts in other areas."

As I said: Dumb and dumber.

May 10, 2005

Critically few beds

Guest post by Revere

We all know it's true: if there is an influenza pandemic, we aren't ready for it. Among the things "not ready" means is not enough critical care beds in the hospital. But do we know what that means? A review over at Bandolier (the "evidence based" group at Oxford in the UK) spells it out:

Limited availability of healthcare resource in the face of permanent or temporary excess demand leads inevitably to rationing. Hardly news, that, though the R word is perhaps the hardest to use. Given that rationing is a fact of life, it behoves us to have some idea of the consequences. A systematic review of rationing of critical care beds tells us that more people die who might have lived.

This is a broad literature review on the consequences of rationing critical care beds. The papers included triaging studies that compared patients admitted to the Intensive Care Unit (ICU) with those not admitted; studies comparing patients admitted during at least two different periods, one of which was reduced bed availability; and studies of patients either admitted or refused admission during a single period of bed shortage. There were ten studies that met the criteria for rigor and informativeness.

Some results. In four of the triaging studies, 1220 patients admitted to ICUs were compared to 558 not admitted:

Overall mortality was 29% (357/1,220) in those admitted to ICU, compared with 50% (280/558) in those refused an intensive care bed (relative risk 1.7; 95% confidence interval 1.5 to 1.9). For every five patients refused an intensive care bed, one more died (95% CI 4 to 6) than would have been the case if they had been admitted to intensive care. [my emphasis]

Bandolier's bottom line: "Rationing comes with the price, for intensive care beds, of more deaths in those refused admission."

The current lack of planning for critical care bed surge capacity will cost lives if there is an influenza pandemic or other sudden demand. This isn't a surprising result. Although it was arrived at by surveying existing literature, assessed for reliability, it is also common sense.

But as we know, common sense isn't all that common.

[Cross-posted at Effect Measure]

May 09, 2005

i sing of Olaf . . .

Guest post by Revere

I received the following from Dahr Jamail, an independent journalist now in Jordan. Read it and then read last Sunday's Sermonette.

The following was written by Fernando Suarez, who lost his son in Iraq.

To all media outlets To all who love peace and justice To the citizens of the United States To the entire world

Pablo Paredes and Kevin Benderman will be subjected to a court martial for having opposed Bush's criminal war in Iraq. Both applied for conscientious objector status and were denied. Both are accused of disobeying orders among other charges. In San Diego and at Fort Stewart, Georgia, both will be tried in proceedings that without a doubt will mirror the absurd theater in which Camilo Mejia was pronounced guilty by a military tribunal that sentenced him to a year in prison.

Beginning tomorrow, May 11, we will see similar trials in which justice will be conspicuously absent, in which the power of the state will impose its will over international law, and in which young men will be sentenced and shipped to military prisons.

But all of this can be avoided if the international peace community comes to the defense of these two brave human beings and brave soldiers. Why brave soldiers? Because they understand their duty as members of the military to defend the Constitution of the United States, to defend democracy and freedom, and they understand that the war in Iraq has nothing to do with these hallowed values. Why courageous human beings? Because by refusing to take part in war crimes they risk their personal safety and their careers. These war crimes have been perpetrated in Iraq by a president who has brought only economic hardship to families in the United States and death and destruction to the people of Iraq.

These young men are the spokesmen for thousands of soldiers who have deserted and we must give them our total support. I invite you to participate in a day of international resistance, to sign petitions of solidarity, and to demonstrate against these courts martial, against the illegal occupation of Iraq, and for the immediate return of our troops. More than 1600 U.S. soldiers have died already and more than 100,000 innocent Iraqis have perished including thousands of children. Thousands of children are now orphans in both nations.

Now is the time to overcome our fear and to protest and demand an end to Bush's historic crimes.

SIGN THE PETITION

Weighing in on obesity

Guest post from Revere

There is a lot of handwringing in public health circles over the obesity debacle. The latest CDC article (Flegal KM, Graubard BI, Williamson D, et al. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293:1861-1867) essentially repudiates an earlier one (Moktad et al. that featured CDC Director Gerberding as a co-author; JAMA. 2004;291:1238-1245). It has not only confused people, but given them license to eat whatever they want (with a little help from their enemies; see the first of several good posts from Lindsay; and one from Effect Measure along the same lines). We are now probably further back then we were when the first CDC article came out in 2004 touting obesity as the leading cause of death in the US.

Let's get the facts out of the way first. Americans eat too much and much that they eat is unhealthy. The definition of an "epidemic" is a sudden increase in incidence beyond the expected. The Behavioral Risk Factor Surveillance Survey (BRFSS)  found  that the obesity rate (BMIs above 30, where the Flegal et al. paper found marked increased mortality) went from 11.6% in 1990 (measured in 45 states) to 21.1% in 2002 (measured in 54 states, DC and US possesions). By that definition, "obesity" was an epidemic.

Whose fault is this? The Right wants to make it an issue of personal responsibility and choice. The Left wants to make it a structural issue. I'm on the "structure" side. But we can't win that argument and we shouldn't be tempted to try. What's worse, the public health community wasn't clear what it thought, addressing ordinary people and trying to convince them to eat a better diet. Public health essentially bought into a personal choice perspective.

The reason we can't win the structure argument is that most people--including those that espouse it--aren't completely solid themselves about it. I'd be willing to bet not a few were inwardly relieved and relaxed their diets as well. This isn't that surprising. How we think about things is strongly conditioned by our personal experience. When we were hunter gatherers we had no real choice about food; we ate what was edible and were able to catch or find, or later what we were able to grow for ourselves. But in today's world, where others produce our food in a competitive market, choice is at the center of eating. Our internal and largely unconscious experience is that we do get to choose what we eat. That sense may be largely illusory, but it is a powerful illusion. The public health campaign was directed at that experience: we should choose something different (healthier, purer, leaner, smaller). It didn't take into account that the fact that our choices are channeled, restricted and manipulated is not part of our conscious experience. As Lakoff and other cognitive scientists have emphasized, the facts are rarely enough to overcome unconscious inferences based on experience.

As long as public health confined itself to personal choice it was allowed to wage a "campaign against obesity." When it attacked the structure directly in the tort system or by applying pressure to schools to get junk food out of the vending machines, the Right took action, effortlessly identifying public health initiatives (occupational health and safety, for example) with "public health nannyism." It was a political bonanza. What made it so easy for them was the way their version fits so nicely and comfortably with ordinary (internal and unconscious) experience, while our story requires conscious processing, argument and some political "buy-in." This was a very, very tough game to win, and in today's media climate not possible. We should have foreseen it.

So how do we pick up the pieces? We should focus on aspects of the food supply where there demonstrably is no choice. Some possibilities: the idea of "chemical trespass" associated with involuntary exposure to food additives, pesticide residues and environmental contaminants (like the flame retardant polybrominated diphenyl ethers [PBDEs], the teflon feedstock chemicals perfluorooctanoic acids [PFOA], the plastic components bisphenol A and phthalates, etc.). Ordinary people don't know they are now carrying around substantial body burdens of these chemicals and don't like it when they find out. They immediately identify it as a "structural" issue, not a "choice" issue. There is a great deal of opportunity here to focus attention to agribusiness and the failing family farm and good groups working on it. We can bring in agribusiness's role as risk factors in obesity, attacking inadequate labeling laws (the "Right to Know" touches a core value and is a powerful lever we should use more), juices that have no juice in them or blueberry muffins that have no blueberries, trans fatty acids that aren't there because consumers want them but because it makes it easier for food processors. People would not willingly choose these things. We can make it work for us. People are forced to choose them by a structure beyond their control. Indeed, portraying a forced choice as the choice of a free subject is precisely the ideological message the Right wishes to reinforce.

The bottom line is we can't win on obesity or any food issue if we portray it as a problem of "wrong choices," which is what we have done. Even those who don't espouse that view went along with it because it seemed like it got us to a healthier place. It was a trap. And we fell into it.

(cross-posted at Effect Measure)

May 08, 2005

Sunday Sermonette: i sing of Olaf glad and big

Guest post by Revere

With Lindsay away, it falls to me to Sermonize. But first, the news (from Human Rights Watch):

U.S.: Abu Ghraib Only the Tip of the Iceberg

(New York, April 27, 2005) The crimes at Abu Ghraib are part of a larger pattern of abuses against Muslim detainees around the world, Human Rights Watch said on the eve of the April 28 anniversary of the first pictures of U.S. soldiers brutalizing prisoners at the Iraqi jail.

Human Rights Watch released a summary of evidence of U.S. abuse of detainees in Iraq, Afghanistan, and Guantnamo Bay, Cuba, as well as of the programs of secret CIA detention, extraordinary renditions, and reverse renditions. 

Abu Ghraib was only the tip of the iceberg, said Reed Brody, special counsel for Human Rights Watch. Its now clear that abuse of detainees has happened all over from Afghanistan to Guantnamo Bay to a lot of third-country dungeons where the United States has sent prisoners. And probably quite a few other places we don't even know about.

[snip]

Sermonette by E. E. Cummings (aka ee cummings):

i sing of Olaf glad and big (1931)

XXX

i sing of Olaf glad and big
whose warmest heart recoiled at war:
a conscientious object-or

his wellbelov├ęd colonel(trig
westpointer most succinctly bred)
took erring Olaf soon in hand;
but--though an host of overjoyed
noncoms(first knocking on the head
him)do through icy waters roll
that helplessness which others stroke
with brushes recently employed
anent this muddy toiletbowl,
while kindred intellects evoke
allegiance per blunt instruments--
Olaf(being to all intents
a corpse and wanting any rag
upon what God unto him gave)
responds,without getting annoyed
"I will not kiss your fucking flag"

straightway the silver bird looked grave
(departing hurriedly to shave)

but--though all kinds of officers
(a yearning nation's blueeyed pride)
their passive prey did kick and curse
until for wear their clarion    
voices and boots were much the worse,
and egged the firstclassprivates on
his rectum wickedly to tease
by means of skilfully applied
bayonets roasted hot with heat--
Olaf(upon what were once knees)
does almost ceaselessly repeat
"there is some shit I will not eat"

our president,being of which
assertions duly notified         
threw the yellowsonofabitch
into a dungeon,where he died

Christ(of His mercy infinite)
i pray to see;and Olaf,too

preponderatingly because
unless statistics lie he was
more brave than me:more blond than you.

Sunday meta-Sermonette: brown-nosing the religious Right

Guest post by Revere

Three weeks ago James Wolcott posted some Tom Paine and called it a Sunday Sermonette. I thought it a grand opportunity for a secular post every Sunday under that title. Lindsay picked up the meme here and so did others. Since I started posting secular Sunday Sermonettes over at Effect Measure (here, here, here and here) I have been surprised at the reaction. Even a member of my own family was offended. Of course this only encouraged me further.

It also put me in mind of the farmer who went to the veterinarian complaining his cow was constipated. "No problem," said the vet. "Just take a glass tube, insert it in the cow's rectum and blow on it. That'll take care of it in a jiffy."

So the farmer gave it a try but it didn't work. He called the vet again. "You must be dong something wrong," the vet said. "I'll have to come out there." The vet arrives, and sure enough, there is the cow, standing placidly under a tree with a glass tube stuck in her rectum and a stool positioned in back.

"Show me how you were doing it," the vet said. So the farmer sat down on the stool and started to blow on the glass tube. "No wonder," said the vet. "You're doing it all wrong. Let me show you."

The vet sat down on the stool, pulled the glass tube out, turned it around 180 degrees, re-inserted it in the cow's rectum and started to blow on it. The farmer couldn't believe his eyes. "Wait a minute. What did you do that for?"

Taken aback and slightly disgusted, the vet looked at him sternly and replied, "Why, you had your mouth on that end!"

So when President Bush holds a news conference 180 degrees from reality, perhaps I can be taken aback and slightly disgusted when he ends it with his little sermonette, "May god bless our country." He doesn't just have his mouth on that end. He has his whole head up there.