Tuesday, January 30, 2007

The Doctor Won't See You Now

According to this article, many reps make in the range of 200,000 dollars a year!!!
Bye-bye Big Pharma sales rep. A host of forces is now converging to clamp down on hard-driving, gift-toting pharmaceutical pitchmasters who have been ambushing physicians for the last decade. Doctors, consumer groups, and government regulators have all had enough. And now, pharma CEOs are questioning whether the hard sell even pays off.
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The changes could also help repair the drug industry's damaged reputation. In a survey released on Jan. 9 by PricewaterhouseCoopers, 94% of physicians, hospital execs, and other health-care stakeholders said they think drug companies spend too much money promoting their products. And 94% of consumers said these companies can be too aggressive in promoting unapproved, "off-label" uses of their products--an illegal tactic. It's not just that pharma companies have been known to deploy as many as a half-dozen reps to hit the same doctor for the same product. The industry also spends $4 billion each year beaming their messages directly into consumers' homes. "Clearly, the public thinks the drug industry's focus is on increasing prescriptions rather than improving patients' health," says Peter Claude, a partner in Pricewaterhouse's pharmaceutical practice. "That's a turnoff."

Consider the profile of the typical pharma sales rep. He or she is often recruited straight out of college, lured by lush compensation and a company car. Top recruits are prized not so much for their scientific prowess--science degrees are rarely required--but for their movie-star looks, charisma, and talent in cheerleading new products.

Simple eye test can diagnose severe malaria

[NAIROBI] Cerebral malaria can be diagnosed by a simple eye examination, a method that is both quick and cheap and could save thousands of lives in malarial regions, a new study shows.

Diagnosing cerebral malaria — a severe complication of malaria in which the Plasmodium falciparum parasite infects capillaries that flow through the tissues of the brain — can be difficult, as patients can be unconscious and have a number of other illnesses.

Now researchers have found that certain changes on the retina, the light sensitive tissue at the back of the eye, are unique to severe forms of malaria.

Tremendous Rise In Syphilis in China

In 1993, the reported total rate of cases of syphilis in China was 0·2 cases per 100 000, whereas primary and secondary syphilis alone represented 5·7 cases per 100 000 persons in 2005. The rate of congenital syphilis increased greatly with an average yearly rise of 71·9%, from 0·01 cases per 100 000 livebirths in 1991 to 19·68 cases per 100 000 livebirths in 2005.

Is Using Lasers on Eye Gunk Worth It?

January 30,2007 | FALLS CHURCH, Va. -- Some people call them floaters. Eye doctors call them "vitreous opacities." Emily Flynn called hers "a little fuzzball," and she flew halfway around the world to have it removed. After more than 100 pinpoint zaps from a laser beam during a half-hour visit to a northern Virginia office park, the fuzzball was gone, obliterated within the clear, gelatinous goo that fills the eyeball.

The surgeon, John Karickhoff, has done the same procedure more than 1,400 times over the past 15 years and claims a success rate of better than 90 percent, with minimal risk of complications. Still, many ophthalmologists have never heard of the procedure -- and most would recommend against it. The procedure has drawn regulatory scrutiny in Florida.

Sunday, January 28, 2007

Incendiary guitar for your Sunday am

Three incredibly virtuostic guitarists performing "Mediterranean Sundance."

Thursday, January 25, 2007

PEOPLE BEFORE PATENTS: A Message from Doctors Without Borders

Pharmaceutical company Novartis is taking the Indian government to court. If the company wins, millions of people across the globe could have their sources of affordable medicines dry up.

Novartis was one of the 39 companies that took the South African government to court five years ago, in an effort to overturn the country's medicines act that was designed to bring drug prices down. Now Novartis is up to it again and is targeting India.

India produces affordable medicines that are vital to many people living in developing countries. Over half the medicines currently used for AIDS treatment in developing countries come from India and such medicines are used to treat over 80% of the 80,000 AIDS patients in Médecins Sans Frontières projects.

Wednesday, January 24, 2007

How Thinking Can Change the Brain

The Dalai Lama, who had watched a brain operation during a visit to an American medical school over a decade earlier, asked the surgeons a startling question: Can the mind shape brain matter?
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At the University of Toronto, Dr. Mayberg, Zindel Segal and their colleagues first used brain imaging to measure activity in the brains of depressed adults. Some of these volunteers then received paroxetine (the generic name of the antidepressant Paxil), while others underwent 15 to 20 sessions of cognitive-behavior therapy, learning not to catastrophize. That is, they were taught to break their habit of interpreting every little setback as a calamity, as when they conclude from a lousy date that no one will ever love them.

All the patients' depression lifted, regardless of whether their brains were infused with a powerful drug or with a different way of thinking. Yet the only "drugs" that the cognitive-therapy group received were their own thoughts.

The scientists scanned their patients' brains again, expecting that the changes would be the same no matter which treatment they received, as Dr. Mayberg had found in her placebo study. But no. "We were totally dead wrong," she says. Cognitive-behavior therapy muted overactivity in the frontal cortex, the seat of reasoning, logic, analysis and higher thought. The antidepressant raised activity there. Cognitive-behavior therapy raised activity in the limbic system, the brain's emotion center. The drug lowered activity there.

With cognitive therapy, says Dr. Mayberg, the brain is rewired "to adopt different thinking circuits."
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Through attention, UCSF's Michael Merzenich and a colleague wrote, "We choose and sculpt how our ever-changing minds will work, we choose who we will be the next moment in a very real sense, and these choices are left embossed in physical form on our material selves."

The discovery that neuroplasticity cannot occur without attention has important implications. If a skill becomes so routine you can do it on autopilot, practicing it will no longer change the brain. And if you take up mental exercises to keep your brain young, they will not be as effective if you become able to do them without paying much attention.
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Prof. Davidson then used fMRI imaging to detect which regions of the monks' and novices' brains became active during compassion meditation. The brains of all the subjects showed activity in regions that monitor one's emotions, plan movements, and generate positive feelings such as happiness. Regions that keep track of what is self and what is other became quieter, as if during compassion meditation the subjects opened their minds and hearts to others.

More interesting were the differences between the monks and the novices. The monks had much greater activation in brain regions called the right insula and caudate, a network that underlies empathy and maternal love. They also had stronger connections from the frontal regions to the emotion regions, which is the pathway by which higher thought can control emotions.

In each case, monks with the most hours of meditation showed the most dramatic brain changes. That was a strong hint that mental training makes it easier for the brain to turn on circuits that underlie compassion and empathy.

"This positive state is a skill that can be trained," Prof. Davidson says. "Our findings clearly indicate that meditation can change the function of the brain in an enduring way.

Tuesday, January 23, 2007

The Challenge of Global Health

Foreign affairs has a comprehensive article on global health

followed by a roundtable discussion

Paul Farmer in particular (one of my heroes in healthcare) makes some excellent points...

NEJM also has an article on global health

(via metafilter)

Monday, January 22, 2007

Get Me a Neurosurgeon, Stat

When I first returned to the States I didn't see what the big deal was with regard to taking emergency call. Although as a retina specialist, I thought that we should be on a separate call schedule as general ophthalmologists, since we are in essence always on call as many retina patients are emergencies. In fact, I think that we should append the moniker to "emergency" to the practice name, given how many urgent or emergent patients get added on to our schedule on a daily basis.

But this article makes some valid points that resonate with my concerns about taking call as an ophthalmologist: namely the local monopolistic hospital has decided that only some specialities deserve to be paid for taking emergency call, and ophthalmology is not among them. Second, in this litiginous society, taking call is a huge risk for any doctor...


Modern maladies. So where have all the specialists gone? They've been driven away, observers say, by three modern maladies of American healthcare: too much work, too little pay, and the fear of malpractice lawsuits. "Put all those things together, and who would want to be in this business?" asks Todd Taylor, who teaches emergency medicine at Vanderbilt University in Tennessee.

And it doesn't pay. The federal Emergency Medical Treatment and Active Labor Act, enacted in 1986 to prevent discrimination against the poor, requires that emergency departments screen all patients and ensure they are not in an immediate medical crisis, regardless of their ability to pay. That means hospitals need to maintain a roster of on-call specialists. But the law has also pushed hospitals to pressure doctors to provide on-call services for nothing in return for hospital affiliation. Doctors used to agree to this deal because they needed hospitals as places to perform surgery, and the workload wasn't too heavy. But as the workload spiraled up, surgeons spent more time answering ER calls and less time dealing with their own practices and paying patients. If they were affiliated with more than one hospital, as many doctors are, both hospitals made demands.

Recently, "office-based surgery and free-standing surgical clinics have given orthopedists and plastic surgeons and others a way out," says Rick Cameron, project manager of the Emergency Department Management Group in Palm Beach County, Fla., a partnership of county hospitals trying to solve the specialist shortage that has dogged that region. "Many don't need to be affiliated with hospitals to do their jobs."

Finally, there's fear of being sued. On-call surgeons worry there's more chance of getting sued by a stranger whom they rush to treat in an ER than by an established patient having elective surgery. "Anything can happen in an ER," says Jose Arrascue, a kidney specialist in Boynton Beach, Fla."If you have no rapport with the family, they may conclude you did something wrong, and you are wide open for a suit. That really concerns me." There have been calls for legislation exempting doctors on ER duty from lawsuits, but the idea of immunity from malpractice hasn't appealed to federal or state lawmakers.

To minimize risk, many doctors stop taking ER calls. Or, Valadka says, surgeons may limit the types of operations they do in regular practice, which means they won't be called in for emergencies that are beyond those limits. For example, some neurosurgeons—ironically—have stopped doing brain surgery and focus only on the spine.

The Limits of Democracy

The elections in Iraq had wondrous aspects, but they also divided the country into three communities and hardened the splits.

"The percentage of countries designated as free has failed to increase for nearly a decade and suggests that these trends may be contributing to a developing freedom stagnation," writes Freedom House director of research Arch Puddington in an essay released with the rankings.
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Regimes across the world are closing down nongovernmental organizations, newspapers and other groups that advocate for human rights. And, I would add, what is most striking is that these efforts are not being met with enormous criticism. Democracy proponents are on the defensive in many places.

What explains this paradox—of freedom's retreat, even with a U.S. administration vociferous in promoting democracy? Some part of the explanation lies in the global antipathy to the U.S. president. "We have all been hurt by the association with the Bush administration," Saad Eddin Ibrahim, the Egyptian activist, told me last month. "Bush's arrogance has turned people off the idea of democracy," says Larry Diamond, co-editor of the Journal of Democracy.

But he goes on: "There's a lot more to it than that. We need to face up to the fact that in many developing countries democracy is not working very well."

Diamond points to several countries where elections have been followed by governmental paralysis, corruption and ethnic warfare. The poster child for this decline has to be Nigeria, a country often lauded for its democracy.

Africa: War on the Rescuers


Darfur: The newest targets in the territory's widening violence are the aid workers keeping its people alive.

Jan. 29, 2007 issue - Last Sept. 11 was a momentous day in Darfur, too. After unidentified militiamen attacked aid workers from the Nobel Prize-winning Médecins sans Frontières at a roadblock on that date, most of the international aid groups ministering to Darfur's 6 million people stopped using the roads. On Dec. 18, in the southern town of Gereida, unrelated gunmen attacked the compounds of Oxfam and Action Contre la Faim. More than 70 aid workers subsequently pulled out of the refugee camp there—Darfur's largest, with 130,000 people—leaving only 10 Red Cross employees behind. Yet at the time no one revealed what had really sparked the dramatic pullbacks. In both cases, international staff, including three French aid workers, were either raped or sexually assaulted in territory controlled by the Sudanese government and its allies.

Wednesday, January 17, 2007

What $1.2 Trillion Can Buy

The way to come to grips with $1.2 trillion is to forget about the number itself and think instead about what you could buy with the money. When you do that, a trillion stops sounding anything like millions or billions.

Religious Moderates are Kidding Themselves

This should be interesting...

Best-selling atheist Sam Harris and pro-religion blogger Andrew Sullivan debate the merits of faith.

The Making and Unmaking of a Child Soldier

This is a compelling account of a child soldier in Sierra Leone, who describes how he was able to kill without mercy, but still retained an underlying guilt, which haunted him once he was removed from the frontlines and withdrew from "brown brown," (a mixture of cocaine and gunpowder), and other drugs...It is a tragic story, which echoes the sorts of experiences of those I worked with and interviewed on my trip to Sierra Leone several months ago. What really amazed me in my interviews is how many of these young people seemed to be psychologically healthy, despite undergoing unspeakable trauma...seeing pregnant women being sliced open and the babies falling from the bellies, while the killers laughed at the dying mother and child; being given a choice between being killed or watching one's wife get gang-raped, living for a month in the jungle with a broken leg and subsisting on a single papaya after a rebel attack etc...As Mohammed described to me, he became so emaciated after a month of a single papaya that when he finally returned to his family...they were unable to recognize him... They thought he was a ghost.

The other issue is that there is now a whole generation of youngsters (who were given blanket amnesty) after the war, who have not been educated. Many are also still hooked on "brown brown." It is frightening indeed to imagine that these will be the future adults in this country, which is already in such dire straits---no electricity for 40 years, few passable roads, endemic corruption etc...

Much of the history, economic dynamics, and yes, natural beauty of the country is captured in the movie, "Blood Diamond," which I highly recommend.


During that time, a lot of things were done with no reason or explanation. Sometimes we were asked to leave for war in the middle of a movie. We would come back hours later after killing many people and continue the movie as if we had just returned from intermission. We were always either on the front lines, watching a war movie or doing drugs. There was no time to be alone or to think. When we conversed with one another, we talked only about the movies and how impressed we were with the way either the lieutenant, the corporal or one of us had killed someone. It was as if nothing else existed.

The villages that we captured and turned into our bases as we went along and the forests that we slept in became my home. My squad was my family, my gun was my provider and protector and my rule was to kill or be killed. The extent of my thoughts didn’t go much beyond that. We had been fighting for more than two years, and killing had become a daily activity. I felt no pity for anyone. My childhood had gone by without my knowing, and it seemed as if my heart had frozen. I knew that day and night came and went because of the presence of the moon and the sun, but I had no idea whether it was a Sunday or a Friday.

Tuesday, January 16, 2007

5 Ideas for Stressful Living

I’ve compiled a short list of ideas for those who wish to add a dash of stress into their lives — all fairly easy to implement, not to mention widely encouraged by society at large and often easily observed in the behavior of those around you.

Why Do Today What You Can Put Off Until Tomorrow

I am a moderate procrastinator. Even when I believe that I would be best served by finishing a task (say, filing this story), I will occasionally put it off in favor of some short-term reward (like a much needed caffeine fix). This tendency on my part to delay what is in my long-term interest can now be explained by a simple mathematical equation, according to industrial psychologist Piers Steel of the University of Calgary.

Steel developed the equation U = E x V / I x D, where U is the desire to complete the task; E, the expectation of success; V, the value of completion; I, the immediacy of task; and D, the personal sensitivity to delay, as a way of mathematically mapping a given individual's procrastination response. So, for example, my desire to finish this article is influenced by my relative confidence in writing it well and the prospect of a paycheck as well as a looming deadline and my inherent desire to go home at the end of the day. "You're more likely to put something off if you're a very impulsive individual," Steel says. But, "if you only work at the last minute, time on task tells."

Car Washes and Genocide - New York Times

President Bush and other world leaders have dropped the ball on Darfur. But that vacuum of moral leadership has been filled by university students, churches and temples, celebrities like George Clooney and Mia Farrow, and armies of schoolchildren.

Their arsenal — green armbands, phone calls to the White House, bake sales to raise money — all seem pallid. How can a “Save Darfur” lawn sign in Peoria intimidate government-backed raiders in Sudan or Chad who throw babies into bonfires?

Yet, finally, we see evidence that those armbands and lawn signs can make a difference. Last week, the Save Darfur Coalition — the grass-roots organization that puts out those lawn signs — sponsored a trip by Bill Richardson, the New Mexico governor, to Khartoum to negotiate with President Omar al-Bashir.

A Rifle in Every Pot

IT’S a phenomenon that gives the term “gun control” a whole new meaning: community ordinances that encourage citizens to own guns.

What Shamu Taught Me About a Happy Marriage

This was one of the top ten emailed articles of 2006 from the New York Times, in which an author on animal training techniques uses similar techniques to modify the behavior of her husband....

So, like many wives before me, I ignored a library of advice books and set about improving him. By nagging, of course, which only made his behavior worse: he'd drive faster instead of slower; shave less frequently, not more; and leave his reeking bike garb on the bedroom floor longer than ever.

We went to a counselor to smooth the edges off our marriage. She didn't understand what we were doing there and complimented us repeatedly on how well we communicated. I gave up. I guessed she was right — our union was better than most — and resigned myself to stretches of slow-boil resentment and occasional sarcasm.

Then something magical happened. For a book I was writing about a school for exotic animal trainers, I started commuting from Maine to California, where I spent my days watching students do the seemingly impossible: teaching hyenas to pirouette on command, cougars to offer their paws for a nail clipping, and baboons to skateboard.

I listened, rapt, as professional trainers explained how they taught dolphins to flip and elephants to paint. Eventually it hit me that the same techniques might work on that stubborn but lovable species, the American husband.

Monday, January 15, 2007

Gem War


The diamonds pictured below are real -- only they cost about 15% less than other stones of similar size and quality. The reason: They were produced in a lab. How a new generation of high-quality diamonds is shaking up the jewelry world. By

Courses on the Net

Massive Resource List for All Autodidacts

What Oprah Can't Forget

The Oprah pasting that took place over the New Year's holiday, in reaction to the pressapalooza surrounding her Oprah Winfrey Leadership Academy for Girls in South Africa, reveals a lot about the venality, racism and hypocrisy of the talk-show host's critics, yes. But less remarked upon and equally interesting is what the explosive news cycle -- one that notably seemed to veer free of Winfrey's usual iron-fisted control -- reveals about the talk show host's own frailties, not as a philanthropist or educator, but as one of the United States' most powerful, unlikely, anomalous and isolated success stories.

Winfrey's unguarded comments about the opening of her school revealed the degree to which arguably the most influential woman in the United States is still driven by the specter of her own beginnings as a poor, sexually abused child in Mississippi, and her seemingly endless spiral of desire to set the world right not simply for other young women, but for her own prepubescent self. For a moment, her self-spin veered out of control, and we got a brief snapshot not just of Winfrey's good intentions, but of the loneliness and solitude experienced by a woman who is historically and culturally unique in her power, wealth, life story and position in the world.

Ordinary Oprahs

January 11, 2007 · We were interested in the hullabaloo surrounding the opening of Oprah Winfrey's Leadership Academy for Girls in South Africa. We stumbled onto a story, actually. We realized that two people we see all the time are doing what Oprah has just done, and let me tell you, they don't have Oprah-sized pockets.

Saturday, January 13, 2007

Rod Dreher: "Hadn't the hippies tried to tell my generation this"?

I read Rod Dreher regularly at his blog site...I also have his book, "Crunchy Con" sitting on my bookshelf, but haven't read it. I respect his thought processes greatly...

Rod Dreher is as conservative as it gets -- a contributor to National Review and the Corner, a current columnist for The Dallas Morning News, a self-described "practicing Christian and political conservative."

Today, Dreher has an extraordinary (oral) essay at NPR in which he recounts how the conduct of President Bush (for whom he voted twice) in the Iraq War (which he supported) is causing him to question, really to abandon, the core political beliefs he has held since childhood.
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Dreher's essay is extreme and intense but also increasingly commonplace and illustrative. The disaster of unparalleled magnitude that President Bush and his integrity-free and bloodthirsty administration and followers wrought on this country will have a profound impact not only on American strength and credibility for a long, long time to come, but also on the views of Americans towards their political leaders and, almost certainly, towards the Republican Party.

One of the very few potential benefits of the Iraq tragedy is that it may raise the level of doubt and cynicism with which Americans evaluate the claims of the Government when it tries -- as Dreher put it -- "to send them to kill and die for noble-sounding rot."

Here is the link to the NPR interview: http://www.npr.org/templates/story/story.php?storyId=6817201

Mystical Morning


Mystical Morning
Originally uploaded by ~The Olis In 'Consin~.
As an ophthalmologist, I have a weakness for eyes...but eyes in the sky--what a trip!

David Torn

One of my favorite modern music composers/creators has just put up a website. I normally am not a fan of flash websites, but the otherworldly, intriguing aspect of this site is reflective of the musical muse that is David Torn. Explore some of the musical selections as well...

Friday, January 12, 2007

Guitar never seemed so hard

Guitar never seemed so hard...or so beautiful....

Guitar never seemed so hard

Brain scans predict shoppers' purchasing choices

The possibilities are limitless...It would be cool to be able to image a brain scan of someone you are talking to so you could have an idea if you are e.g., coming together or moving futher apart in a negotiation...


NEW YORK (Reuters Health) - Scientists can now look into the brains of people making a purchase decision and predict whether or not they will buy.

When people see something they want to purchase, a portion of the brain called the nucleus accumbens "lights up" on a brain scan. If the price is too high, another region of the brain called the insula is activated and the mesial prefrontal cortex (MPFC) is deactivated, Dr. Brian Knutson of Stanford University in California and colleagues report.

Based on the activation and deactivation of these regions, Knutson and his team were able to predict whether or not people would purchase something before they were conscience of making a decision.

Saturday, January 06, 2007

M.I.T. OpenCourse Ware

M.I.T. will be placing on all its courses on line for free as part of an open source movement...

A free and open educational resource (OER) for educators, students, and self-learners around the world. It is true to MIT's values of excellence, innovation, and leadership.

MIT OCW:

* Is a publication of MIT course materials
* Does not require any registration
* Is not a degree-granting or certificate-granting activity
* Does not provide access to MIT faculty

Thursday, January 04, 2007

On Evil

I have long been preoccupied by the problem of evil. Not being a philosopher, I have no satisfactory explanation of evil to offer, nor even, indeed, a satisfactory definition of it. For me, evil is rather like poetry was for Doctor Johnson: easier to say what it isn’t than what it is. All I know for certain is that there’s a lot of it about - evil, I mean, not poetry.

Why? Is the heart of man irredeemably evil, or at any rate inclined to evil? What are the conditions in which evil may flourish?

My medical practice, admittedly of a peculiar kind, in a slum and in a prison, convinced me of the prevalence of evil. ...
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I have seen so much, both at home and abroad, that I am not easily taken aback. When you have heard of baby-sitters who impale babies on railings in order to quieten them during a televised football match, or of men who suspend their girlfriends by their ankles from the fifteenth floor balcony, and this kind of thing daily for many years, you develop a kind of emotional carapace. One almost begins to take a pride in one’s own unsociability, which one takes to be a kind of sophistication. It is a form of spiritual pride, I suppose. Still, I nevertheless read a book that shocked me. It was about the Rwandan genocide, called A Time for Machetes, by a French journalist called Jean Hatzfeld. He interviewed several men who had taken part in the genocide, probably the most murderous in human history, at least in terms of numbers of deaths per day while it lasted, and were now imprisoned...
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the participation of the general population in the slaughter was its most remarkable feature: usually in mass murder, it is the state that does the killing, or rather the state’s agents, since the state is an abstraction without an existence independent of those who work for it.
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There is no real remorse for what they did, only regret that it landed them in their current predicament. They feel more sorry for themselves than for their victims, or the survivors. They are not even altogether unhappy in prison, and look forward to resuming their lives where they left off (before the genocide) as if nothing too much had really happened - or should I say been done by them? They hoped for, and expected, forgiveness on the part of the survivors, amongst whom they would have to return to live, because resentment and bitterness are useless emotions and because they (the perpetrators) had all been gripped by a collective madness. This, of course, absolved them in large part from personal responsibility.
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One of the most haunting things in this book, if it is possible to pick anything out in particular, is that many of the victims did not so much as cry out when caught by the murderous genocidaires: they died in complete silence, as if speech and the human voice were now completely worthless, redundant, beside the point. I have often wondered why the people went into the gas chambers silently, without fighting back, but I suppose that when you witness absolute human evil committed by the people with whom you once lived, and who, at least metaphysically, are just like you, you see no point in the struggle for existence. Non-existence, perhaps, seems preferable to existence.

via Crunchy Con blog

Free Will: Now You Have It, Now You Don’t

bevy of experiments in recent years suggest that the conscious mind is like a monkey riding a tiger of subconscious decisions and actions in progress, frantically making up stories about being in control.
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Daniel C. Dennett, a philosopher and cognitive scientist at Tufts University who has written extensively about free will, said that “when we consider whether free will is an illusion or reality, we are looking into an abyss. What seems to confront us is a plunge into nihilism and despair.”

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That is hardly a new thought. The German philosopher Arthur Schopenhauer said, as Einstein paraphrased it, that “a human can very well do what he wants, but cannot will what he wants.”

Einstein, among others, found that a comforting idea. “This knowledge of the non-freedom of the will protects me from losing my good humor and taking much too seriously myself and my fellow humans as acting and judging individuals,” he said.

How comforted or depressed this makes you might depend on what you mean by free will. The traditional definition is called “libertarian” or “deep” free will. It holds that humans are free moral agents whose actions are not predetermined. This school of thought says in effect that the whole chain of cause and effect in the history of the universe stops dead in its tracks as you ponder the dessert menu.

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But most of the action is going on beneath the surface. Indeed, the conscious mind is often a drag on many activities. Too much thinking can give a golfer the yips. Drivers perform better on automatic pilot. Fiction writers report writing in a kind of trance in which they simply take dictation from the voices and characters in their head, a grace that is, alas, rarely if ever granted nonfiction writers.

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Dr. Libet found that brain signals associated with these actions occurred half a second before the subject was conscious of deciding to make them.

The order of brain activities seemed to be perception of motion, and then decision, rather than the other way around.

In short, the conscious brain was only playing catch-up to what the unconscious brain was already doing. The decision to act was an illusion, the monkey making up a story about what the tiger had already done.

Dr. Libet’s results have been reproduced again and again over the years, along with other experiments that suggest that people can be easily fooled when it comes to assuming ownership of their actions. Patients with tics or certain diseases, like chorea, cannot say whether their movements are voluntary or involuntary, Dr. Hallett said.
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Dr. Wegner of Harvard said: “We worry that explaining evil condones it. We have to maintain our outrage at Hitler. But wouldn’t it be nice to have a theory of evil in advance that could keep him from coming to power?”

He added, “A system a bit more focused on helping people change rather than paying them back for what they’ve done might be a good thing.”

Dr. Wegner said he thought that exposing free will as an illusion would have little effect on people’s lives or on their feelings of self-worth. Most of them would remain in denial.

“It’s an illusion, but it’s a very persistent illusion; it keeps coming back,” he said, comparing it to a magician’s trick that has been seen again and again. “Even though you know it’s a trick, you get fooled every time. The feelings just don’t go away.”

In an essay about free will in 1999, Dr. Libet wound up quoting the writer Isaac Bashevis Singer, who once said in an interview with the Paris Review, “The greatest gift which humanity has received is free choice. It is true that we are limited in our use of free choice. But the little free choice we have is such a great gift and is potentially worth so much that for this itself, life is worthwhile living.”

Wednesday, January 03, 2007

Inside Abbott's Tactics To Protect AIDS Drug

In the fall of 2003, Abbott Laboratories grew worried about new competition to its flagship AIDS drug, Kaletra. Then it seized on an unusual weapon that helped Kaletra's global sales top $1 billion a year, even as it exposed Abbott to criticism that it was endangering patients.

The weapon was an older Abbott AIDS drug called Norvir. It is a key part of drug regimens that include rival companies' pills. Previously undisclosed documents and emails reviewed by The Wall Street Journal show how Abbott executives discussed ways to diminish the attraction of Norvir, with the goal of forcing patients to drop the rival drugs and turn to Kaletra.

At one point the executives debated removing Norvir pills from the U.S. market and selling the medicine only in a liquid formulation that one executive admitted tasted like vomit. The taste would discourage use of Norvir and competitors' drugs, the executives reasoned, and Abbott could claim it needed Norvir pills for a humanitarian effort in Africa. Another proposal was to stop selling Norvir altogether.

A third proposal carried the day: quintupling the price of Norvir. One internal document warned the move would make Abbott look like a "big, bad, greedy pharmaceutical company." But the executives expected a Norvir price hike would help Kaletra sales, and they bet any controversy would eventually die down.

They were right. Kaletra sales in the U.S. rose 10% over the next two years. Some objected that the price hike made it harder for patients who needed drug combinations pairing Norvir with non-Abbott pills to get their medicine. After an initial burst, the criticism faded, partly because Abbott exempted government health plans and AIDS drug-assistance programs from the Norvir price increase.

Tuesday, January 02, 2007

Insurer hits millions of seniors with drug cost hike

December 31, 2006

The more than two million senior citizens nationwide who signed up last year for Humana Inc.'s least expensive Medicare prescription drug plan face average premium increases of 60 percent -- and in seven states, increases of 466 percent -- starting tomorrow . The higher prices will affect about 50,000 seniors in Massachusetts, where premiums are going up by 130 percent, from $7.32 to $16.90 a month.
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"You have to state the obvious," said David Shove , a stock analyst with Prudential Equity Group in New York. "You sell something cheaply and get a lot of customers, and then you raise the price to improve the profitability."

Shove said the start-up of the Medicare prescription drug benefit "was a once-in-a-lifetime opportunity" for Humana to attract new customers.

Steve Findlay , a healthcare analyst with Consumers Union, the publisher of Consumer Reports, called Humana's price increases a "bait and switch" tactic.

"That's not an acceptable inflationary increase in prices," he said. "That's sucker them in and you just start raising the prices."

Saturday, December 30, 2006

As Health Middlemen Thrive, Employers Try to Tame Them

Perdue and Caterpillar are grappling with a big issue in U.S. health care: the role of middlemen. Employers are trying to make sure they get their money's worth from intermediaries, some of whom are reaping bonanzas as they stand between patients, doctors and those who pay the bills.

But a lot of the money goes more toward fattening middlemen's bottom lines than toward improving the quality or efficiency of American health care. "At the end of the day, the only reasonable conclusion is that we waste a huge amount of money on the most nuttily cumbersome administrative system in the world," says Henry Aaron, a Brookings Institution economist.
While the middleman business booms, health-care costs keep rising, the ranks of the uninsured grow, and paperwork expands as each party in the system tries to enlarge its slice of the pie. "There's more money to be made by monitoring cash flow than monitoring patients," says David Cutler, a prominent Harvard University health economist.

Friday, December 29, 2006

Yes, There Are Two Americas

Review from the WSJ:
WHO REALLY CARES
By Arthur C. Brooks

(Basic, 250 pages, $26) The book's thesis is offered not as a sermon or platitude -- telling people what they ought to be doing -- but as a work of skillful and intensive empirical research, revealing what people are doing already. Our most pervasive cultural assumptions about the generosity of liberals and the stinginess of conservatives turn out to be almost completely wrong.
(..)

If Mr. Brooks is right, our era's common sense of the matter -- that the political left is more compassionate than the political right, and that America is a remarkably ungenerous nation by world standards -- is demonstrably inaccurate. In fact, Sen. John Edwards's repeated claim that there are "two Americas" turns out to be correct but misstated: The line of separation runs most saliently not between the haves and have-nots but between the gives and the give-nots, between those Americans who respond to social needs with their own money and time and those who do not.

Mr. Brooks speaks here with the authority of a liberal who has been mugged by the data. "These are not the sorts of conclusions I ever thought I would reach,"...
(..)
By consulting a wide range of metrics, ranging from rates of charitable giving to hours of volunteer work donated, Mr. Brooks concludes that four distinct forces appear to have primary responsibility for making people behave charitably: religion, skepticism about the government's role in economic life, strong families and personal entrepreneurship. Those Americans who have all four, or at least three, are much more likely to behave charitably than those who do not...

Wednesday, December 27, 2006

Parrot's Oratory Stuns Scientists

The finding of a parrot with an almost unparalleled power to communicate with people has brought scientists up short.
(..)

The bird, a captive African grey called N'kisi, has a vocabulary of 950 words, and shows signs of a sense of humour.

He invents his own words and phrases if he is confronted with novel ideas with which his existing repertoire cannot cope - just as a human child would do.

N'kisi's remarkable abilities, which are said to include telepathy, feature in the latest BBC Wildlife Magazine.

N'kisi is believed to be one of the most advanced users of human language in the animal world.

About 100 words are needed for half of all reading in English, so if N'kisi could read he would be able to cope with a wide range of material.

Polished wordsmith

He uses words in context, with past, present and future tenses, and is often inventive.

One N'kisi-ism was "flied" for "flew", and another "pretty smell medicine" to describe the aromatherapy oils used by his owner, an artist based in New York.

When he first met Dr Jane Goodall, the renowned chimpanzee expert, after seeing her in a picture with apes, N'kisi said: "Got a chimp?"

N'kisi with picture card and teacher Grace Roselli
School's in: He is a willing learner
He appears to fancy himself as a humourist. When another parrot hung upside down from its perch, he commented: "You got to put this bird on the camera."

50 Things We Know Now (That We Didn't Know This Time Last Year) 2006 Edition

50 Things We Know Now (That We Didn't Know This Time Last Year) 2006 Edition

Beyond Charity: Micro-Lending as Good Business

A good listen on how microfinance is evolving as well as a tribute to Mr. Yunus...

The year's Nobel Peace Prize was awarded to Muhammad Yunus and his Grameen Bank, for their pioneering work in the field of micro-finance, lending money to the poorest of the world's poor.

For the most part, the bulk of the money used in micro-lending has come from philanthropic groups.

But that is beginning to change. High-tech millionaires are providing venture capital. And mainstream investors and institutions are looking at micro-lending as a way to make money while doing good.

Tuesday, December 26, 2006

The Case Against Ladies Night:Drinking Has Hidden Health Risks for Women

Toasting the new year with an alcoholic beverage is probably good for your health -- if you're a man. If you're a woman, the impact of that glass of alcohol is far more confusing.

Overall, science shows that for both men and women, drinking a small amount of alcohol each day is better for you than never drinking at all, and it likely lowers your risk of heart attack, diabetes and mental decline. But for women, moderate alcohol consumption also carries risks you may not know about.

Even small amounts of alcohol consumption are linked with higher risk for breast cancer. Women who drive after drinking are at higher risk than men of dying in a car accident, even at similar blood-alcohol concentrations. And women are at higher risk than men for serious health problems related to alcohol abuse, including liver, brain and heart damage.
(..)

One of the most troubling effects of alcohol is that even small amounts increase a woman's risk for breast cancer. A pooled analysis by Harvard researchers of all the data on alcohol and breast cancer shows that a woman's risk increases by about 9% for every 10 grams of alcohol a day that she drinks. In the U.S., the typical serving of 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor delivers about 12 grams to 14 grams of alcohol, according to the Harvard School of Public Health.

That means a woman who consumes just two drinks a day has about a 27% higher risk of getting breast cancer than a woman who doesn't drink alcohol.

It's worth noting that the absolute risk of alcohol consumption to an individual woman is slight. Consider that the typical 50-year-old woman has a five-year breast-cancer risk of about 2.1% -- so two drinks a day would boost her risk to only about 2.7%....

Saturday, December 23, 2006

Charities in Africa

At this time of the year many of us make our charitable donations.
If you are interested in contributing two charitable causes in Africa,
I would wholeheartedly recommend:
orphansofrwanda.org
and
greeneyesinafrica.org

I know the founders of both of these organizations. They are upstanding and trustworthy individuals with huge hearts..


A sincere thanks to those of you who have already given to these organizations...

Nadia--Jeff Beck

Perhaps while you click on the link to the previous article about global poverty, you might want to let Jeff Beck's wailing guitar play in the background...and let the collective tears of humanity touch your soul...

It was at a concert three years ago, seeing Beck play "Nadia" live after a series of rocked out songs from "You Had It Coming," that sent me into another stratosphere...a moment when time stood still and...well, it was just indescribable

Thank you Brother Al for insisting that I continue to seek and learn of Jeff Beck, even after I mistakenly bought an album from a techno-pop namesake,"Beck," and was utterly confused as to why Brother Al was insisting on the greatness of Jeff Beck.

Thank you Brother Freeze for the tickets to the most transcendent musical moment of my life...

I bow down to both of you....and of course to Jeff Beck--click NOW!

What Should a Billionaire Give – and What Should You?

The iconoclastic Princeton philosopher, Peter Singer, asks what to me is one of the most important questions for all of humanity...As usual the metaphor of children drowning in a well in the midst of a group of adults partying has more impact than the drier logical arguments regarding charity put forth....PLEASE READ...

What is a human life worth? You may not want to put a price tag on a it. But if we really had to, most of us would agree that the value of a human life would be in the millions.
(..)
With Christmas approaching, and Americans writing checks to their favorite charities, it’s a good time to ask how these two beliefs — that a human life, if it can be priced at all, is worth millions, and that the factors I have mentioned do not alter the value of a human life — square with our actions. Perhaps this year such questions lurk beneath the surface of more family discussions than usual, for it has been an extraordinary year for philanthropy, especially philanthropy to fight global poverty.
(..)
According to the Global Forum for Health Research, less than 10 percent of the world’s health research budget is spent on combating conditions that account for 90 percent of the global burden of disease. In the past, diseases that affect only the poor have been of no commercial interest to pharmaceutical manufacturers, because the poor cannot afford to buy their products. The Global Alliance for Vaccines and Immunization (GAVI), heavily supported by the Gates Foundation, seeks to change this by guaranteeing to purchase millions of doses of vaccines, when they are developed, that can prevent diseases like malaria. GAVI has also assisted developing countries to immunize more people with existing vaccines: 99 million additional children have been reached to date. By doing this, GAVI claims to have already averted nearly 1.7 million future deaths.

Philanthropy on this scale raises many ethical questions: Why are the people who are giving doing so? Does it do any good? Should we praise them for giving so much or criticize them for not giving still more? Is it troubling that such momentous decisions are made by a few extremely wealthy individuals? And how do our judgments about them reflect on our own way of living?
(..)
More important than questions about motives are questions about whether there is an obligation for the rich to give, and if so, how much they should give. A few years ago, an African-American cabdriver taking me to the Inter-American Development Bank in Washington asked me if I worked at the bank. I told him I did not but was speaking at a conference on development and aid. He then assumed that I was an economist, but when I said no, my training was in philosophy, he asked me if I thought the U.S. should give foreign aid. When I answered affirmatively, he replied that the government shouldn’t tax people in order to give their money to others. That, he thought, was robbery. When I asked if he believed that the rich should voluntarily donate some of what they earn to the poor, he said that if someone had worked for his money, he wasn’t going to tell him what to do with it.

At that point we reached our destination. Had the journey continued, I might have tried to persuade him that people can earn large amounts only when they live under favorable social circumstances, and that they don’t create those circumstances by themselves. I could have quoted Warren Buffett’s acknowledgment that society is responsible for much of his wealth.
“If you stick me down in the middle of Bangladesh or Peru,” he said, “you’ll find out how much this talent is going to produce in the wrong kind of soil.” The Nobel Prize-winning economist and social scientist Herbert Simon estimated that “social capital” is responsible for at least 90 percent of what people earn in wealthy societies like those of the United States or northwestern Europe. By social capital Simon meant not only natural resources but, more important, the technology and organizational skills in the community, and the presence of good government. These are the foundation on which the rich can begin their work. “On moral grounds,” Simon added, “we could argue for a flat income tax of 90 percent.” Simon was not, of course, advocating so steep a rate of tax, for he was well aware of disincentive effects. But his estimate does undermine the argument that the rich are entitled to keep their wealth because it is all a result of their hard work. If Simon is right, that is true of at most 10 percent of it.
(..)
Is there a line of moral adequacy
that falls between the 5 percent that Allen has given away and the roughly 35 percent that Gates has donated? Few people have set a personal example that would allow them to tell Gates that he has not given enough, but one who could is Zell Kravinsky. A few years ago, when he was in his mid-40s, Kravinsky gave almost all of his $45 million real estate fortune to health-related charities, retaining only his modest family home in Jenkintown, near Philadelphia, and enough to meet his family’s ordinary expenses. After learning that thousands of people with failing kidneys die each year while waiting for a transplant, he contacted a Philadelphia hospital and donated one of his kidneys to a complete stranger.
(..)
If we are obliged to do no more than our fair share of eliminating global poverty, the burden will not be great. But is that really all we ought to do? Since we all agree that fairness is a good thing, and none of us like doing more because others don’t pull their weight, the fair-share view is attractive. In the end, however, I think we should reject it. Let’s return to the drowning child in the shallow pond. Imagine it is not 1 small child who has fallen in, but 50 children. We are among 50 adults, unrelated to the children, picnicking on the lawn around the pond. We can easily wade into the pond and rescue the children, and the fact that we would find it cold and unpleasant sloshing around in the knee-deep muddy water is no justification for failing to do so. The “fair share” theorists would say that if we each rescue one child, all the children will be saved, and so none of us have an obligation to save more than one. But what if half the picnickers prefer staying clean and dry to rescuing any children at all? Is it acceptable if the rest of us stop after we have rescued just one child, knowing that we have done our fair share, but that half the children will drown? We might justifiably be furious with those who are not doing their fair share, but our anger with them is not a reason for letting the children die. In terms of praise and blame, we are clearly right to condemn, in the strongest terms, those who do nothing. In contrast, we may withhold such condemnation from those who stop when they have done their fair share. Even so, they have let children drown when they could easily have saved them, and that is wrong...

Sudan 'accepts UN Darfur force'

Sudan will agree in principle to the deployment of UN troops as part of an expanded peacekeeping force in Darfur, a top Sudanese envoy has confirmed.

Friday, December 22, 2006

Your Turn to Tell the Story: The Darfur Genocide

Stories can be told in countless ways and understood in countless forms. Here’s an invitation to try your hand at a little interactive journalism.

Here’s a link to a collection of columns, videos, and photographs from my recent trip to Chad to covering the spread of the genocide in Darfur. Take a look at the material and, if you’re interested, I’d like to see how you would’ve told the story. Use some of the quotes, the stories, the facts and weave together your own column, essay, article — or some other kind of quilt. I can imagine someone writing a poem, a song, a map, video or audio slide show. Don’t let convention get in the way of your storytelling. And don’t feel as if it needs to be long; hey, a haiku is sometimes more effective than an epic.

I’m eager to see how you’d approach things – what you’d do differently. I hope you do better – these stories are too important to
be told only once.

Please use this form to send me your story by Jan. 10. If it’s a multimedia presentation send us the link via the form. The best will posted here in “On the Ground.”

* Link
* Comments (2)

Wednesday, December 20, 2006

Body Worlds

I saw this exhibit last month in, of all places the MGM Casino, in Las Vegas. As a physician, it was like a refresher course in gross anatomy. But I must say I found the exhibit somewhat distasteful, as the bodies were exhibited in various poses, e.g., throwing a dart. I am relatively sure that the people used in this exhibit did not "consent" to such posing. In fact, I had the eerie feeling that the people in the exhibit were not "asked" whether or not they wanted to be carted off for exhibition in various museums around the world as part of a capitalistic enterprise. Rumors are that these are in fact cadavers of political prisoners. As expected, an email query (by my son) to the website associated with this exhibit elicited no response...

Tuesday, December 19, 2006 "Body Worlds" Heard about the "Body Worlds" exhibit, in which actual eviscerated and dissected human bodies are turned into a plastic-like substance, then posed and exhibited for museum crowds? It's here in Dallas now, and I asked two smart guys to go see it and write their opinions for the section I edit.

Tuesday, December 19, 2006

Window in the Skies



From the Rolling Stone Magazine:
We think this video for U2’s new song “Window in the Skies” is the most sentimental yet ballsy clip we’ve seen in a while. Who besides U2 could appropriate footage of every famous musician — from Sinatra to Elvis to Iggy Pop to Karen O and about 400 others — for their own purposes and end up with something uplifting and tasteful instead of self-congratulatory and distasteful? To Bono we rhapsodize.

Even though we know Elvis isn’t actually singing “oh can’t you see-he-he-heee” in that last black-leather-jacket-featuring frame — but this video makes us feel like he totally meant to.

Which scene is your favorite

Sunday, December 17, 2006

Another video of one of the greatest guitarists ever, Jeff Beck.

Helping Trafficking Victims

Advice from Nicholas Kristof if you want to help organizations fighting human trafficking...

Helping Trafficking Victims

Gotta read it!

This is a great book I read last year...Tom Peters, business guru, apparently agrees!

Okay, it's last year's book. But I just found it in Logan airport at the start of my current Madrid-Paris-L.A. trip. Wow! Fantastic! Amazing!
The book: The Travels of a T-shirt in the Global Economy: An Economist Examines the Markets, Power, and Politics of World Trade, by Pietra Rivoli. The complex issues of trade, globalization, market-power, and market imperfections are brilliantly told via the life of a single T-shirt. Made in China? Obviously! Sorta. How about "Teksa"? The T-shirt "maker," Chinese, patiently explained to the author that this saga starts in Teksa. That is, West Texas, where the cotton is grown. And why is Texas-the U.S.A. still tops in the global cotton market? Um, our markets are not quite as open as we'd like to make the rest of the world believe. There is no "big political message" here. As a professional economist, the author began the story with a very "open markets" bias. It's not that she lost that bias, but that the can of worms (T-shirt) she opened turned out to be, well, full of worms. Nothing is as it seems; think of this as a product of the John LeCarré School of Economics. Though published in 2005, this is my 2006 "book of the year." No issue.

Mad Biking Skills

How the Public School System Crushes Souls

Thoughtful and provocative post here...

Thursday, December 14, 2006

Editorial: Dr. Lawyer

Only in America...

Dec. 14, 2006
Las Vegas Review-Journal

EDITORIAL: Dr. Lawyer


Fearless prediction: Within 20 years, when you visit your family physician seeking relief for that sore throat or stomach bug, you'll have company in the examination room. And your guest won't be a nurse or a medical assistant. Joining you and the good doctor will be ... the doctor's lawyer.

What other recourse will physicians have, given the coming wave of malpractice lawsuits forecast in the journal Tobacco Control?

According to the periodical, research suggests that tobacco companies aren't the only parties at fault in keeping Americans hooked on smokes. The study says doctors can be successfully sued for failing to browbeat their patients into quitting the nasty habit.

"Experience clearly suggests that, faced with a sympathetic and very ill plaintiff who swears that he would have heeded a warning if it had been given, the jury's sympathy for the plaintiff will incline them to award him some damages, even if empirical evidence as well as common experience suggests how hard it often is to quit," John F. Banzhaf III, a George Washington University law professor who's active in tobacco litigation and supports obesity-related lawsuits, wrote in response to the research. Juror "sympathy" could overpower "dry empirical and statistical evidence and related arguments put forth by 'rich doctors and their greedy insurance company lawyers.' "

In fact, the only greedy party here is the trial bar. Such ridiculous litigation isn't about righting a wrong, it's about creating new revenue streams to support golf and yacht club memberships.

So in the near future, don't be surprised to see a lawyer sitting in on your routine physical exam -- or to see him snap on rubber gloves.

Wednesday, December 13, 2006

That Ring Makes a Difference

For Ms. Hymowitz, the two Americas do not divide between the poor who are supposedly in need of government assistance and the rest of us. The division is best defined in another way: between those who see marriage as an indispensable condition of child-rearing and those who don't. If we are becoming two Americas, it is one America in which parents are married and another in which they are not. The Marriage Gap, as Ms. Hymowitz calls it, appears likely to have a more profound effect on the future of both Americas than the gender gap so lamented by the feminists.

Despite the "unmarriage revolution" ushered in by the noxious 1960s, the anti-civilization decade, marriage is again flourishing among well-educated women. Today's educated mothers may work outside the home or not, but they and their husbands are committed to what Ms. Hymowitz calls The Mission -- the project of shaping their children into adults (and citizens) who have the requisite skills and self-discipline to prosper in a complex, postindustrialist society.

The Mission, notes Ms. Hymowitz, requires not a village but two married parents. And, no, cohabitation doesn't do the trick. Even cohabiters who have the education levels of their married counterparts are less effective as parents. "As the core cultural institution," Ms. Hymowitz writes, "marriage orders life in ways that we only dimly understand. It carries with it signals about how we should live, signals that are in line with both our economy and our politics in the largest sense."
(..)

The answer, in Ms. Hymowitz's view, is that many among the urban poor have lost the "life script" for future-oriented child-rearing. Policy makers may assume that the problem is a shortage of employed, marriageable men. But the problem is more existential, a loss of a sense that marriage and children are connected.

Circumcision May Cut Risk of HIV

WASHINGTON - Circumcising adult men may reduce by half their risk of getting the
AIDS virus through heterosexual intercourse, the U.S. government announced Wednesday, as it shut down two studies in Africa testing the link.

Advice I'll Pass Along to My Daughter

In 1985, I graduated from college. This past August, I dropped off my daughter Hannah for her freshman year.

Despite the two decades in between, I can still vividly recall the financial struggles of early adulthood, including grappling with credit-card debt, scrambling to come up with a house down payment and watching as one of my stocks plunged 80% in a few short months.

Hannah, of course, will have her own financial struggles, and those will teach her far more about money than I ever could. Still, there are nine key financial insights I'm hoping to pass along -- and most have precious little to do with picking stocks and buying mutual funds.

Tuesday, December 12, 2006

TimesSelect A Cambodian Girl’s Tragedy: Being Young and Pretty

Is there any greater evil?

Slavery seems like a remote part of history, until you see scholarly estimates that the slave trade in the 21st century — forced work in prostitution and some kinds of manual labor — is probably larger than it was in the 18th or 19th centuries.


Or until you take a rutted dirt path in northwestern Cambodia to a hut between a rice paddy and a river, and meet a teenage girl named Noy Han. The girl, nicknamed Kahan, suffered the calamitous misfortune of being pretty...

(..)
Typically, a girl like Kahan would be imprisoned in a trafficker’s house, tied up and beaten if she resisted, inspected by a doctor to certify her virginity, and sold for hundreds of dollars to a Cambodian or Thai businessman. Virgins are in particular demand by men with AIDS because of a legend that they can be cured by having sex with a virgin.

Afterward, Kahan would have been locked up in a brothel in Pailin, and sold for $10 a session for the first couple of months. The price eventually would drop to $1.50, and by then she would be given greater freedom.
(..)
And slavery is what this is. The real problem isn’t prostitution or trafficking, it’s the enslavement of people.

The Lancet, the British medical journal, once estimated that 10 million children 17 and under may work in prostitution worldwide
. Not all are coerced, but in the nastier brothels of Cambodia, Nepal, India, Malaysia and Thailand, the main difference from 19th-century slavery is that the victims are mostly dead of AIDS by their 20’s.

“It seems almost certain that the modern global slave trade is larger in absolute terms than the Atlantic slave trade in the 18th and 19th centuries was,” notes an important article about trafficking in the current issue of Foreign Affairs...

Craisglist Meets the Capitalists

I love this story!...

Jim Buckmaster, the chief executive of Craigslist, caused lots of head-scratching Thursday as he tried to explain to a bunch of Wall Street types why his company is not interested in “monetizing” his ridiculously popular Web operation. Appearing at the UBS global media conference in New York, Mr. Buckmaster took questions from the bemused audience, which apparently could not get its collective mind around the notion that Craigslist exists to help Web users find jobs, cars, apartments and dates — and not so much to make money.
Wendy Davis of MediaPost describes the presentation as a “a culture clash of near-epic proportions.”
(..)
The Tech Trader Daily blog ponders this question: “If YouTube was worth $1.65 billion, who knows what Craigslist would be worth if Jim and [site founder] Craig Newmark ever considred becoming — what’s the word? — capitalists.”
(..)
Larry Dignan, writing on Between the Lines blog at ZDNet, called Mr. Buckmaster “delightfully communist,” and described the audience as “confused capitalists wondering how a company can exist without the urge to maximize profits.”

Conflict Diamonds In the Spotlight

Charmian Gooch, director and co-founder of Global Witness, will be online Tuesday, Dec. 12, at 2 p.m. ET to discuss the issue of "conflict diamonds" and their links to violence in parts of Africa. The new movie "Blood Diamond," starring Leonardo DiCaprio, is a story of the human cost associated with the mining of diamonds in Sierra Leone.

Monday, December 11, 2006

'Heartless Stone' Tracks Rough Diamond Trade

This insightful interview gives an overviews of the dark side of the diamond trade in West and Central Africa. In speaking with various individuals when I was in Sierra Leone last month, it is clear that diamond mining is the equivalent of gambling here in Nevada. However, instead of sticking coins in a slot machine, these desperately poor people engage in back-breaking labor for pitiful wages in hopes of finding the "big one"...

The film Blood Diamond is about the violent underbelly of the international diamond trade. Writer Tom Zoellner's book The Heartless Stone chronicles how diamonds are mined in some of the world's poorest countries.

Friday, December 08, 2006

Blood Diamonds' Decline, but Not Poverty

More on "Blood Diamonds"

DAKAR, SENEGAL — Hollywood's take on "conflict diamonds" has brought attention back in a big way to how gems associated with wealth and glamour have too often meant war and suffering in Africa.

The film "Blood Diamond," which opened Friday in U.S. theaters, is set in late 1990s Sierra Leone, when the West African country was in the throes of a civil war in which untraceable diamonds allegedly funded fighters who hacked off people's hands with machetes and burned entire villages.

The Best Unlocked Cellphones

If you are thinking of buying a cellphone for a Christmas gift, make a political statement to U.S. wireless carriers, by buying an unlocked one...

Cingular Music applications. Relatively few unlocked phones are sold in the U.S., because they're more expensive than subsidized, locked models. That warps our market, giving the carriers veto power over which phones Americans see. If we buy more unlocked phones, more advanced models will come to our shores as cell phone manufacturers decide we're friendlier to phones that the carriers don't necessarily love.

Blood Diamonds

Check out this link for a preview of the movie coming out, "Blood Diamonds.:

http://video.msn.com/v/us/fv/fv.htm?http://video.msn.com/v/us/v.htm

There are two links in the middle of the page to click regarding the movie.

Thursday, December 07, 2006

If you need a Laugh...

If you need a laugh this morning, as I do...check out this video:

Monday, December 04, 2006

What it Takes to Make a Student

This is a fascinating (albeit long) article on the interesection between class status and academic achievement

...In the first few years of this decade, two parallel debates about the achievement gap have emerged. The first is about causes; the second is about cures.
(..)

Hart and Risley showed that language exposure in early childhood correlated strongly with I.Q. and academic success later on in a child’s life. Hearing fewer words, and a lot of prohibitions and discouragements, had a negative effect on I.Q.; hearing lots of words, and more affirmations and complex sentences, had a positive effect on I.Q. The professional parents were giving their children an advantage with every word they spoke, and the advantage just kept building up.

In the years since Hart and Risley published their findings, social scientists have examined other elements of the parent-child relationship, and while their methods have varied, their conclusions all point to big class differences in children’s intellectual growth. Jeanne Brooks-Gunn, a professor at Teachers College, has overseen hundreds of interviews of parents and collected thousands of hours of videotape of parents and children, and she and her research team have graded each one on a variety of scales. Their conclusion: Children from more well-off homes tend to experience parental attitudes that are more sensitive, more encouraging, less intrusive and less detached — all of which, they found, serves to increase I.Q. and school-readiness. They analyzed the data to see if there was something else going on in middle-class homes that could account for the advantage but found that while wealth does matter, child-rearing style matters more.

(..)
Lareau found that the middle-class families she studied all followed a similar strategy, which she labeled concerted cultivation. The parents in these families engaged their children in conversations as equals, treating them like apprentice adults and encouraging them to ask questions, challenge assumptions and negotiate rules. They planned and scheduled countless activities to enhance their children’s development — piano lessons, soccer games, trips to the museum.

The working-class and poor families Lareau studied did things differently. In fact, they raised their children the way most parents, even middle-class parents, did a generation or two ago. They allowed their children much more freedom to fill in their afternoons and weekends as they chose — playing outside with cousins, inventing games, riding bikes with friends — but much less freedom to talk back, question authority or haggle over rules and consequences. Children were instructed to defer to adults and treat them with respect. This strategy Lareau named accomplishment of natural growth.
(..)
Concerted cultivation, she wrote, “places intense labor demands on busy parents. ... Middle-class children argue with their parents, complain about their parents’ incompetence and disparage parents’ decisions.” Working-class and poor children, by contrast, “learn how to be members of informal peer groups. They learn how to manage their own time. They learn how to strategize.” But outside the family unit, Lareau wrote, the advantages of “natural growth” disappear. In public life, the qualities that middle-class children develop are consistently valued over the ones that poor and working-class children develop. Middle-class children become used to adults taking their concerns seriously, and so they grow up with a sense of entitlement, which gives them a confidence, in the classroom and elsewhere, that less-wealthy children lack. The cultural differences translate into a distinct advantage for middle-class children in school, on standardized achievement tests and, later in life, in the workplace.
(..)

But the real advantages that middle-class children gain come from more elusive processes: the language that their parents use, the attitudes toward life that they convey. However you measure child-rearing, middle-class parents tend to do it differently than poor parents — and the path they follow in turn tends to give their children an array of advantages. As Lareau points out, kids from poor families might be nicer, they might be happier, they might be more polite — but in countless ways, the manner in which they are raised puts them at a disadvantage in the measures that count in contemporary American society.


What would it take to overcome these disadvantages? Does poverty itself need to be eradicated, or can its effects on children somehow be counteracted? Can the culture of child-rearing be changed in poor neighborhoods, and if so, is that a project that government or community organizations have the ability, or the right, to take on? Is it enough simply to educate poor children in the same way that middle-class children are educated? And can any school, on its own, really provide an education to poor minority students that would allow them to achieve the same results as middle-class students?(read on)

"Frikkin Amazing" how nets stop kids' malaria

Video from Sports Illustrated writer who went to Nigeria to distribute bed nets. If link below doesn't work, you can find the video on cnn.com

javascript:cnnVideo('play','/video/us/2006/12/03/stouffer.nets.cnn','2006/12/10');

Sunday, December 03, 2006

Puffing on Polonium

WHEN the former K.G.B. agent Alexander V. Litvinenko was found to have been poisoned by radioactive polonium 210 last week, there was one group that must have been particularly horrified: the tobacco industry.
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The tobacco industry of course doesn’t like to have attention drawn to the more exotic poisons in tobacco smoke. Arsenic, cyanide and nicotine, bad enough. But radiation? As more people learn more about the secrets hidden in the golden leaf, it may become harder for the industry to align itself with candy and coffee — and harder to maintain, as we often hear in litigation, that the dangers of tobacco have long been “common knowledge.” I suspect that even some of our more enlightened smokers will be surprised to learn that cigarette smoke is radioactive, and that these odd fears spilling from a poisoned K.G.B. man may be molehills compared with our really big cancer mountains.

Robert N. Proctor is a professor of the history of science at Stanford University

Thursday, November 30, 2006

The Spirituality of Parenting

This is a fantastic podcast in which the hostess of "Speaking of Faith" interviews a very wise female rabbi,Sandy Eisenberg Stasso. Even those without children will imo find her insights very valuable...You can also listen to it on your computer if you are not an ipod user...HIGHLY RECOMMENDED

More and more people in our time are disconnected from religious institutions, at least for part of their lives. Others are religious and find themselves creating a family with a spouse from another tradition or no tradition at all. And the experience of parenting tends to raise spiritual questions anew. We sense that there is a spiritual aspect to our children's natures and wonder how to support and nurture that. The spiritual life, our guest says, begins not in abstractions, but in concrete everyday experiences. And children need our questions as much as our answers.

Wednesday, November 29, 2006

African Baby Deaths Preventable

More than one million African babies each year die within their first month of life, says a report. The World Health Organisation reveals many newborns are dying from infections which could be cheaply prevented.

Lure of Great Wealth Affects Career Choices

A decade into the practice of medicine, still striving to become “a well regarded physician-scientist,” Robert H. Glassman concluded that he was not making enough money. So he answered an ad in the New England Journal of Medicine from a business consulting firm hiring doctors.

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And today, after moving on to Wall Street as an adviser on medical investments, he is a multimillionaire.
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“There were doctors at the reunion — very, very smart people,” Dr. Glassman recalled in a recent interview. “They went to the top programs, they remained true to their ethics and really had very pure goals. And then they went to the 20th-year reunion and saw that somebody else who was 10 times less smart was making much more money.”

The opportunity to become abundantly rich is a recent phenomenon not only in medicine, but in a growing number of other professions and occupations. In each case, the great majority still earn fairly uniform six-figure incomes, usually less than $400,000 a year, government data show. But starting in the 1990s, a significant number began to earn much more, creating a two-tier income stratum within such occupations.

The divide has emerged as people like Dr. Glassman, who is 45, latched onto opportunities within their fields that offered significantly higher incomes. Some lawyers and bankers, for example, collect much larger fees than others in their fields for their work on business deals and cases.
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Bill Gates and Warren Buffett are held up as models, certainly by Dr. Glassman. “They are going to make much greater contributions by having made money and then giving it away than most, almost all, scientists,” he said, adding that he is drawn to philanthropy as a means of achieving a meaningful legacy.



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Tuesday, November 28, 2006

13 things that do not make sense

13 things that do not make sense

A Favorite Charity That Won’t Accept Donations

An interesting article which fleshes out a doctor's desire to help an individual patient of her's in the context of modern American medicine...


...The idea is preposterous. Even if she would take money, doctors simply do not give it. We give our time and skills; we give out tests, advice and little pieces of paper written in Latin. The various ethical codes that guide our behavior go into some detail about when and from whom we should not accept money. They never bother to discuss when we should not give it out, because, in theory, we never do.

The theory is reasonable: the relationship with patients is complex enough without adding yet another layer of guilt, obligation and responsibility.

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But despite this instructive lesson, I still indulge in fantasies of saving my needy patient with a solid hunk of cash, an anonymous check — enough to buy her food and transportation; expert, consistent medical care; a few treats; and a little something in the bank.

It is an idiotic fantasy. But perhaps no more idiotic than for me to write out checks this month that will cover an infinitesimal fraction of some giant charity’s overhead. No more idiotic than for me to labor over Latin incantations on little scraps of paper in the illusion that they alone will make a difference in my patient’s health and life.

"Blue Jay Spreads His Wings" 60 Minutes

I rarely get a chance to watch "60 minutes," the Sunday night news show on CBS--this used to be a family tradition when I was growing up. But this last Sunday, after an 8 hour drive from Salt Lake City, I plopped down exhausted in front of the TV set and fortuitously "60 Minutes" was on. There were two interesting stories: the "memory erase" pill story in the previous post on this blog, and another segment about an incredible child prodigy composer named Jason Greenberg. At my son, Ryan's piano recital last week, a student had played a very unusual piece entitled, "Storm." It turns out that the composer was Jason, profiled in this piece on "60 Minutes."

CBS) Jay Greenberg is an American composer who some say is the greatest musical genius to come along in 200 years. He wrote five symphonies by the time he was 13 years old.

"We are talking about a prodigy of the level of the greatest prodigies in history when it comes to composition. I am talking about the likes of Mozart, Mendeelsson, and Saint Saens"...Sam Zyman

Pill to Erase Bad Memories--60 minutes

If you experienced a painful or traumatic event, would you want a pill which could lessen the bad memories of what happened? That option might soon be here because of a drug called propranolol.

Monday, November 27, 2006

We're all Racists, Unconsciously

AFTER A PAROXYSM of racial viciousness at the Laugh Factory last week, Michael Richards, the 57-year-old comedian who played Kramer on "Seinfeld," explained to David Letterman and his "Late Night" audience Monday: "I'm not a racist. That's what's so insane about this."

Richards' shattered demeanor and heartfelt repentance leaves us with what I shall call Kramer's Conundrum: How can someone who spews racial epithets genuinely believe he is not a racist? The answer is to be found in the difference between our conscious and unconscious attitudes and our public and private thoughts.

Consciously and publicly, Richards is probably not a racist. But unconsciously and privately, he is. So am I. So are you.
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The insidiousness of racism is because of the fact that it arises out of the deep recesses of our unconscious. We may be unaware of it, yet it lurks there.

How do we know this? One indication is the Implicit Association Test, developed by Harvard scientists, which asks subjects to pair words and concepts. The more closely associated the words and concepts are, the quicker the response to them will be in the key-pressing sorting task (try it yourself at https://implicit.harvard.edu/implicit/ ).

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Richards' sin was his deed; his thoughts are the sin of all humanity. Only when all people are considered to be members of one global in-group (in principle if not in practice) can we begin to attenuate these out-group associations. But it won't be easy. Vigilance is the watchword of both freedom and dignity.

We should accept Richards' apology for losing his temper and acting out those hateful thoughts. Perhaps we also ought to thank him for having the courage to confess in public what far too many of us still harbor in private, often in our unconscious minds. As the Russian novelist Fyodor Dostoyevsky wrote: "Every man has reminiscences which he would not tell to everyone but only his friends. He has other matters in his mind which he would not reveal even to his friends, but only to himself, and that in secret. But there are other things which a man is afraid to tell even to himself, and every decent man has a number of such things stored away in his mind."

Pin the Tail on the Victim

So what is the statute of limitations on stupid, insensitive comments?
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Public opinion now turns on which of our leaders makes the best case for having been persecuted, and which has most effectively used the words "I've suffered" as a substitute for "I'm sorry."

Perhaps this great national game of pin the tail on the victim is truly the best we can do in evaluating the "character" of our leaders. In an era in which every gaffe and blunder is recorded for eternity on YouTube, who among us is really fit to judge whether Lott or Allen is a racist? And who can decide whether the former racists have been reformed and redeemed?

Perhaps this is just too old-fashioned, but I wonder if we could agree that at least part of a person's character can be measured by his ability to say, "I am sorry. I was wrong," as opposed to "I am sorry you victimized me."

Happy Birthday Jimi

Jimi Hendrix would have been 64 years old today

Tuesday, November 21, 2006

Boy's Wish: Kill Them All

The genocide that started in Darfur in 2003 is now threatening to topple the governments of Chad and the Central African Republic. If these two countries collapse into chaos and civil war for years to come, then neighboring countries like Cameroon and Niger will be threatened as well — and the death toll triggered by the Darfur genocide will eventually number in the millions.

None of this was — or is — inevitable. In late 2003 and early 2004, some Republican appointees in the Bush administration (particularly in the Agency for International Development) were among the first to push for a government response to the slaughter in Darfur, but the White House wasn’t interested.

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The most common question I get from readers about Darfur is: What can I do? The simplest answer is to write or call the White House and members of Congress. (See how your representative does on the issue at www.darfurscores.org). Imagine if Mr. Bush had made Darfur an important issue at the Asian summit meeting last week, if he had returned via Cairo for a meeting with Arab leaders, if he had dispatched Condi Rice to Chad to shore it up.

Beyond pushing our own government, we can write the embassies of countries like France and Egypt that could play especially crucial roles. The same is true of China, which provides Sudan the guns used to shoot children like Ismail. We in the news business, including Arab and European television networks, could use a few pokes to appreciate that genocide is newsworthy.

The heroic efforts of aid groups in Darfur and Chad — 13 aid workers have been killed in Darfur since May — deserve support as well. (I list some groups active in Darfur in my blog, nytimes.com/ontheground.) The aid workers risk their lives daily to try to save people, putting up with janjaweed, scorpions, camel spiders and pit toilets inhabited by bats. They can use our backup.

When Young Doctors Strut Too Much of Their Stuff


MIAMI, Nov. 20 — When I was a new faculty physician, I worked with a resident doctor who was smart and energetic and took excellent care of her patients.

There was just one problem. As she delivered her thoughtful patient presentations to me and the other attending doctors, it was hard not to notice her low-cut dress.

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In a study published last year in The American Journal of Medicine, patients surveyed in one outpatient clinic overwhelmingly preferred doctors photographed in formal attire with a white coat to photos of doctors in scrubs, business suits and informal clothes — jeans and a T-shirt for men, an above-the-knee skirt for women. The patients also said they were more likely to divulge their social, sexual and psychological worries to the clinicians in the white coats than to the other doctors.

Plaintiffs’ attorneys sometimes ask about a doctor’s attire in malpractice depositions, Dr. Rowland said. Her research has also found that physician clothing can influence scores on board certification oral exams, in which a senior doctor assesses a younger doctor’s medical knowledge.

“You don’t want to look too attractive to be serious,” she said, adding that “a certain amount of the nerd factor” can help a doctor’s performance.

Okay, so according to the author of the article above, doctors should be careful of how they display their style and beauty--what about beautiful newswomen like Melissa Theuriau?


Stem cells core of more cancers

A spate of new discoveries about the basic biology of cancer is pushing researchers toward an astonishing conclusion: For decades, efforts to cure the disease may have targeted the wrong cells.

Current therapies treat all cancer cells the same. They're aimed at shrinking tumours on the basis that the various cells within them all have similar powers to spawn new cancers and spread destruction.

But mounting evidence suggests that cancer's real culprits -- the roots of perhaps every tumour -- are actually a small subset of bad seeds known best to the world as stem cells.
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