Wednesday, October 31, 2012

On the last day of Breast Cancer Awareness Month, Jackie Fox's excellent "10 Commandments of Breast Cancer"

The 10 Commandments of Breast Cancer

The value of advocacy in obstetrics and maternal-fetal medicine

 2012 Oct 26. [Epub ahead of print]

The value of advocacy in obstetrics and maternal-fetal medicine.


Cavarocchi-Ruscio-Dennis Associates, LLC, Society for Maternal-Fetal Medicine.



To show that advocacy on behalf of an individual or organization has improved the practice of obstetrics and maternal-fetal medicine.


Advocacy by an individual or a large group aims to influence public policy and resource allocation decisions within political, economic, and social systems and institutions. For obstetrician-gynecologists and maternal-fetal medicine physicians, there is a health policy medical practice intersection that may be often overlooked. In the areas of research, reimbursement, federal policies surrounding maternity care, and quality improvement, physician leaders have influenced the policymaking process and can improve upon it in the future.


Because of advocacy efforts by organizations whose members may include physicians and patients, pregnant women will have access to better quality of care, and physicians will be better off. Also, quality measures that will be implemented will make sense to those who must comply with them because of expert involvement. Advocacy is an investment for the future of the practice of obstetrics and maternal-fetal medicine - to ensure that the workforce is strengthened and that the care of women and their babies is the best it can be.

Regarding the publication of health quality data in Switzerland

 2012 Oct 26;12(1):368. [Epub ahead of print]

Chances and risks of publication of quality data -- the perspectives of Swiss physicians and nurses.


BACKGROUND: The release of quality data from acute care hospitals to the general public is based on the aim to inform the public, to provide transparency and to foster quality-based competition among providers. Due to the expected mechanisms of action and possibly the adverse consequences of public quality comparison, it is a controversial topic. The perspective of physicians and nurses is of particular importance in this context. They are mainly responsible for the collection of quality-control data, and are directly confronted with the results of public comparison. The research focus of this qualitative study was to discover what the views and opinions of the Swiss physicians and nurses were regarding these issues. It was investigated as to how the two professional groups appraised the opportunities as well as the risks of the release of quality data in Switzerland.


A qualitative approach was chosen to answer the research question. For data collection, four focus groups were conducted with physicians and nurses who were employed in Swiss acute care hospitals. Qualitative content analysis was applied to the data.


The results revealed that both occupational groups had a very critical and negative attitude regarding the recent developments. The perceived risks were dominating their view. In summary, their main concerns were: the reduction of complexity, the one-sided focus on measurable quality variables, risk selection, the threat of data manipulation and the abuse of published information by the media. An additional concern was that the impression is given that the complex construct of quality can be reduced to a few key figures, and it that it is constructed from a false message which then influences society and politics. This critical attitude is associated with the different value system and the professional self-concept that both physicians and nurses have, in comparison to the underlying principles of a market-based economy and the economic orientation of health care business.


The critical and negative attitude of Swiss physicians and nurses must, under all conditions, be heeded to and investigated regarding its impact on work motivation and identification with the profession. At the same time, the two professional groups are obligated to reflect upon their critical attitude and take a proactive role in the development of appropriate quality indicators for the publication of quality data in Switzerland.

American Academy of Pediatrics statement on Human Embryonic Stem Cell and Human Embryo Research

 2012 Oct 29. [Epub ahead of print]

Human Embryonic Stem Cell (hESC) and Human Embryo Research.


Human embryonic stem cell research has emerged as an important platform for the understanding and treatment of pediatric diseases. From its inception, however, it has raised ethical concerns based not on the use of stem cells themselves but on objections to the source of the cells-specifically, the destruction of preimplantation human embryos. Despite differences in public opinion on this issue, a large majority of the public supports continued research using embryonic stem cells. Given the possible substantial benefit of stem cell research on child health and development, the American Academy of Pediatrics believes that funding and oversight for human embryo and embryonic stem cell research should continue.

From U Manchester: Ethics in action: Consent-gaining interactions and implications for research practice

 2012 Oct 29. doi: 10.1111/bjso.12009. [Epub ahead of print]

Ethics in action: Consent-gaining interactions and implications for research practice.


School of Psychological Sciences (Psychology Division), University of Manchester, UK.


This article deals with the topic of social psychological research methods in practice, by examining how informed consent is gained from research participants. In most research, the consent-gaining process is hidden from analytic scrutiny and is dealt with before data collection has begun. In contrast, conversation analytic research, which records interactional encounters from beginning to end, enables examination of this methodological 'black box'. We explored how 'requests' to consent in research played out across different institutional settings. We found that participants had to 'opt-out' of a research process that was already underway. Consent-gaining sequences constrained opting out in two ways: (1) because research activity was already underway, it must be stopped affirmatively by participants; (2) consent-gaining turns were tilted in favour of continued participation, making opting out a dispreferred response. We also found a mismatch between what ethics guidelines specify about consent-gaining 'in theory' and what actually happens 'in practice'. Finally, we make suggestions about interventions in and recommendations for existing practice to best achieve informed consent.

From U Chicago: Personalized targeted therapy for lung cancer

 2012;13(9):11471-96. doi: 10.3390/ijms130911471. Epub 2012 Sep 13.

Personalized targeted therapy for lung cancer.


Department of Medicine, University of Chicago, Chicago, IL 60637, USA; E-Mails: (K.W.); (L.H.).


Lung cancer has long been recognized as an extremely heterogeneous disease, since its development is unique in every patient in terms of clinical characterizations, prognosis, response and tolerance to treatment. Personalized medicine refers to the use of markers to predict which patient will most likely benefit from a treatment. In lung cancer, the well-developed epidermal growth factor receptor (EGFR) and the newly emerging EML4-anaplastic lymphoma kinase (ALK) are important therapeutic targets. This review covers the basic mechanism of EGFR and EML4-ALK activation, the predictive biomarkers, the mechanism of resistance, and the current targeted tyrosine kinase inhibitors. The efficacy of EGFR and ALK targeted therapies will be discussed in this review by summarizing the prospective clinical trials, which were performed in biomarker-based selected patients. In addition, the revolutionary sequencing and systems strategies will also be included in this review since these technologies will provide a comprehensive understanding in the molecular characterization of cancer, allow better stratification of patients for the most appropriate targeted therapies, eventually resulting in a more promising personalized treatment. The relatively low incidence of EGFR and ALK in non-Asian patients and the lack of response in mutant patients limit the application of the therapies targeting EGFR or ALK. Nevertheless, it is foreseeable that the sequencing and systems strategies may offer a solution for those patients.

From the Voice of Russia: Meningitis: "American authorities are ready to shut their eyes to the gross violations by big business"


Who is blamed for outbreak of meningitis in the US?

According to a Food and Drug Administrations’ report, the pharmaceutical companies that are responsible for the outbreak of the meningitis have deliberately ignored warnings of danger of infection issued by experts.

"Notably, NECC has been more than once caught by the Federal control bodies for violating safety standards. But as it often happens, despite warnings by experts, the authorities continue to ignore the danger. The incident linked with the distribution of tainted drugs, has confirmed once again but the American authorities are ready to shut their eyes to the gross violations by big business.

All these incidents are logical result of the American authorities’ inaction, progressing bureaucracy and the skillfully used of the American political machine by big business that lobby for its interests. The longer this situation is preserved, the more will be the danger posed to America by the unscrupulous businessmen and politicians who are incapable of defending the interests of their own people."

Talk is cheap

Pharmacy in meningitis outbreak touted cleanliness

By: Associated Press | The Associated Press 

But during that same period, the company's own internal testing showed that 33 surface samples from the clean rooms contained bacteria or mold at levels requiring corrective action, according to company records."

3 more deaths from meningitis outbreak linked to injections

3 more deaths from meningitis outbreak linked to injections

"Three more patients have died after contracting fungal meningitis from potentially tainted steroid injections supplied by a Massachusetts company, the U.S. Centers for Disease Control and Prevention said on Tuesday, bringing the death toll from the outbreak to 28 nationwide.

Two of the new deaths were in Michigan, which now has reported seven fatalities, and one in Tennessee which has confirmed 11 deaths, the CDC said. The two states have been the hardest hit by the outbreak, first discovered in Tennessee late last month."

Read more:

South Dakota's child obesity rate rises

South Dakota's child obesity rate rises

"more than 15 percent of kids younger than 19 reported as obese."

Italian scientists suspend resignation over quake ruling

Italian scientists suspend resignation over quake ruling


Major Risks president points to 'encouraging signals' from govt

"Rome, October 30 - Italy's principal natural-disaster risk-assessment body suspended its resignation Tuesday after members stepped down in protest against last week's conviction of former group members for manslaughter in connection with the 2009 L'Aquila earthquake that killed more than 300 people. The president of the Major Risks Commission, Luciano Maiani, credited the move to "a very important and encouraging signal" from the office of Premier Mario Monti. Last Monday a court sentenced seven former members of the commission to six years in jail and barred them from public office for allegedly providing "superficial and ineffective" assessment of seismic risk and of disclosing "inaccurate, incomplete and contradictory" information regarding earthquake danger. The ruling, which spurred disbelief and dismay across the global scientific community, also raised concern among the government." 

"We don't take action against scientists and forecasters presumably because we understand the nature of science"

In our opinion: Jailing Italian scientists discourages discovery in scientific community

"We don't take action against scientists and forecasters presumably because we understand the nature of science. A forecast is a reporting of probabilities based on observable conditions, taking into account that those conditions can change in unpredictable ways. If we held scientists accountable for every failed prediction, they eventually would cease to base those predictions on data, choosing instead to err on the side of caution in order to minimize their own liabilities.
As absurd as it sounds, an Italian court has turned these presumptions upside down by convicting seven Italian scientists to six years each in jail for manslaughter because they failed to predict a deadly earthquake. Some claim the reporting in this case has stoked unneeded controversy, saying the crime wasn't a failure to predict the quake, but a failure to communicate the risks to the public. That is so small a distinction as to be nonsensical. The scientists observed a series of minor tremors, then gave inexact and unclear information about whether those were precursors to a larger quake." 

"we are increasingly led to believe that if nature can be subjugated by technology, it necessarily follows that we understand it"

Does uncertainty allow scientists the right to remain silent?

The scientific method of experiments doesn’t mean it’s the universal password to make sense of every mystery in nature

"Had weather agencies in the US gone by the book and bet that Sandy would’ve been relatively tepid, they would’ve been in trouble and yet the Italian scientists went exactly by what the textbooks told them about earthquakes and faced criminal flak. The natural question that follows is, should science be lauded when scientists make a leap of faith, and are right? Obversely, should we castigate scientists if they go by the book and end up being wrong? It isn’t the case that science must always bear the burden of certainty, but when it is uncertain, does it merit scrutiny or criticism? Does uncertainty allow scientists, much of them funded by taxpayers, the right to remain silent?
The strength of the scientific method is its reliance on testable claims, experiments and careful deductions and yet the history of scientific progress rests on lucky guesses and inexplicable insight. The scientific method is the best tool that we have to make sense of the world around us, but that doesn’t necessarily mean it’s the universal password to make sense of every mystery in nature.
That’s been the singular message of quantum mechanics, which essentially says that matter at its fundamental level cannot be understood in an intuitive, commonsensical way. Yet we are increasingly led to believe that if nature can be subjugated by technology, it necessarily follows that we understand it. As the sobering reality of earthquakes, cyclones and India’s annual attempts to forecast the monsoon reminds us, nothing could be further from the truth."

Jailing of Italian scientists "has a strong whiff of the Middle Ages about it"

Brendan O’Neill

A disaster that science brought upon itself

The jailing of scientists for failing to predict an earthquake is the sad conclusion to the scientific community’s depiction of itself as soothsayer.

The jailing of six Italian scientists and a government official for failing to predict an earthquake has caused uproar in the scientific community. The men were convicted of manslaughter on the basis that they failed to give an adequate risk assessment of the 2009 earthquake in the central Italian city of L’Aquila, which killed 300 people. Outraged by the court’s verdict, the CEO of the American Academy for the Advancement of Science wrote to the president of Italy to tell him ‘there is no accepted scientific method for earthquake prediction that can be reliably used to inform citizens of an impending disaster’. The verdict is ‘perverse’ and ‘ludicrous’, says the science journal Nature.

"That’s true - the verdict is perverse. It has a strong whiff of the Middle Ages about it, except instead of dunking witches for bringing about a harsh winter and destroying crops, we lock up scientists for failing to foresee a fatal earthquake. But at the same time, isn’t the verdict also the tragically logical conclusion to the scientific community’s feverish adoption in recent years of the role of soothsayer, predictor of the world’s end and proponent of solutions for how to prevent it? Over the past decade, leading scientists have repositioned themselves as modern-day diviners, particularly in the climate-change debate, where they insist that not only can they tell us what the world will look like in 50 years’ time, but also what minute changes all of us must make now if we want that future world to be different. And their predictions are treated as unchallengeable credos, as all those awkward, anti-green question-askers who have been branded ‘deniers’ will know."

Thomas Sowell: Benghazi and 'Cooling Out' the voters

SOWELL: 'Cooling Out' the voters

27 minutes ago  •  

"STANFORD, Calif. | Confidence men know that their victim -- "the mark" as he has been called -- is eventually going to realize that he has been cheated. But it makes a big difference whether he realizes it immediately, and goes to the police, or realizes it after the confidence man is long gone.
So part of the confidence racket is creating a period of uncertainty, during which the victim is not yet sure of what is happening. This delaying process has been called "cooling out the mark."
From the time it took office, the Obama administration has sought to suppress the very concept of a "war on terror" or the terrorists' war on us. The painful farce of calling the Fort Hood murders "workplace violence," instead of a terrorist attack in our midst, shows how far the Obama administration would go to downplay the dangers of Islamic extremist terrorism.
The killing of Osama bin Laden fed the pretense that the terrorism threat had been beaten. But the terrorists' attack in Libya exposed that fraud -- and required another fraud to try to "cool out" the voters until after election day."

Senator Mike Johanns: America deserves answers on Benghazi

America deserves answers on Benghazi

"Clearly, mistakes were made here. We need to get to the bottom of this, correct whatever went wrong and hold accountable anyone responsible for carrying out the attacks or impeding a necessary response. It’s also time to stop the delays.
The Administration’s actions have given many Americans and the media reason to believe the facts are being withheld until after the election for political reasons. I hope this isn’t the case and releasing the facts now could put these concerns to rest." 

SF Chronicle's Debra Saunders: MSM on Benghazi: “not optimal”

MSM on Benghazi: “not optimal”

Published on October 30th, 2012

Benghazi: Tombstone at the grave of journalism ethics?

The Media's Benghazi Blackout

By Jonah Goldberg - October 31, 2012

"Where is the Benghazi media feeding frenzy?
I don’t think there’s a conspiracy at work. Rather, I think journalists tend to act on their instincts. And, collectively, the mainstream media’s instincts run liberal.
Yet Fox News is alone in treating the story like it’s a big deal. During the less significant Valerie Plame scandal, reporters camped out on the front lawns of Karl Rove and other Bush White House staff. Did Obama confiscate those journalists’ sleeping bags?
Of the five news shows last Sunday, only “Fox News Sunday” treated this as a major story. On the other four, the issue came up only when Republicans mentioned it. “Meet the Press” host David Gregory shushed a guest who tried to bring up the subject, saying, “Let’s get to Libya a little bit later.” He never did, but he saved plenty of time to dive deep into the question of what Indiana Senate candidate Richard Mourdock’s comments on abortion and rape mean for the Romney campaign.
I’m willing to believe that journalists like Gregory are sincere in their desire to play it straight. But among those who don’t share his instincts, it’s hard to distinguish between conspiracy and groupthink. Indeed, it’s hard to think why one should even bother trying to make that distinction at all."

Tuesday, October 30, 2012

6 Scariest Issues in Healthcare Right Now (do not completely agree, but an interesting list)

6 Scariest Issues in Healthcare Right Now

“We are told that our medical malpractice system is broken. Doctors are sloppy without punition; patients are injured without compensation; juries seek revenge without proof; and lawyers get rich without justification.”

“Evidence-Based” Medical Malpractice Research and Changing the Patient Safety ParadigmTimothy C. Allen, MD, JD

Published: 16 August 2012

Cite as: Allen TC. “Evidence-Based” Medical Malpractice Research and Changing the Patient Safety Paradigm. 
Bull Health L Policy. 2012;1(1): e2.

“We are told that our medical malpractice system is broken. Doctors are sloppy without punition; patients are injured without compensation; juries seek revenge without proof; and lawyers get rich without justification.”1 

The problem of medical errors is staggering2 and efforts to address the medical liability crisis have provided at best “only symptomatic relief.”3 Medical malpractice lawsuits and the plaintiffs’ lawyers that bring them are unpopular; but nonetheless the debate over changing health care liability remains centered on “tort reform”—capping of non-economic damages within the long-standing paradigm of negligence-based medical malpractice litigation. Serious alternatives to negligence-based medical malpractice liability have been proposed but not realistically considered.2 Perhaps the best alternative to medical malpractice litigation, no-fault liability, remains academically but not politically popular and has only been broadly instituted successfully in Virginia and Florida for cases of severe newborn injury.2

The fundamental problem—medical error—requires a systems approach similar to approaches widely and routinely used in industry, with a focus on determining error epidemiology to correctly identify medical error (as opposed to bad outcomes unassociated with error) and utilize all available tools, including, but not limited to, risk management, error disclosure, continuing education, and apology in order to reduce medical error. The “shame and blame” approach of medical malpractice litigation not only fails to achieve medical error reduction; indeed, its adversarial structure is counterproductive in those goals.

Medical Professionalism, Revenue Enhancement, and Self-Interest: An Ethically Ambiguous Association

 2012 Oct 27. [Epub ahead of print]

Medical Professionalism, Revenue Enhancement, and Self-Interest: An Ethically Ambiguous Association.


Ethics and Spiritual Care, PeaceHealth Southwest Medical Center, 400 NE Mother Joseph Place, PO Box 1600, Vancouver, WA, 98668, USA,


This article explores the association between medical professionalism, revenue enhancement, and self-interest. Utilizing the sociological literature, I begin by characterizing professionalism generally and medical professionalism particularly. I then consider "pay for performance" mechanisms as an example of one way physicians might be incentivized to improve their professionalism and, at the same time, enhance their revenue. I suggest that the concern discussed in much of the medical professionalism literature that physicians might act on the basis of self-interest is over-generalized, and that instead we ought to argue about ways to distinguish permissible and impermissible self-interested actions. Also, I argue that financial incentives for medical professionals ought to be permissible but considered as "by-products" of doing what physicians are expected to do as professionals in any case. Nevertheless, I conclude that, even if a positive association between increasing professionalism and revenue enhancement can be established, in the long term it may not be an unambiguous good for physicians as professionals in that this association may tend to reduce their professional discretion.

Affordability as a discursive accomplishment in a changing National Health Service

 2012 Sep 28. pii: S0277-9536(12)00690-9. doi: 10.1016/j.socscimed.2012.09.026. [Epub ahead of print]

Affordability as a discursive accomplishment in a changing National Health Service.


Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London E1 2AB, UK. Electronic address:


Health systems worldwide face the challenges of rationing. The English National Health Service (NHS) was founded on three core principles: universality, comprehensiveness, and free at the point of delivery. Yet patients are increasingly hearing that some treatments are unaffordable on the NHS. We considered affordability as a social accomplishment and sought to explore how those charged with allocating NHS resources achieved this in practice. We undertook a linguistic ethnography to examine the work practices of resource allocation committees in three Primary Care Trusts (PCTs) in England between 2005 and 2012, specifically deliberations over 'individual funding requests' (IFRs) - requests by patients and their doctors for the PCT to support a treatment not routinely funded. We collected and analysed a diverse dataset comprising policy documents, legal judgements, audio recordings, ethnographic field notes and emails from PCT committee meetings, interviews and a focus group with committee members. We found that the fundamental values of universality and comprehensiveness strongly influenced the culture of these NHS organisations, and that in this context, accomplishing affordability was not easy. Four discursive practices served to confer legitimacy on affordability as a guiding value of NHS health care: (1) categorising certain treatments as only eligible for NHS funding if patients could prove 'exceptional' circumstances; (2) representing resource allocation decisions as being not (primarily) about money; (3) indexical labelling of affordability as an ethical principle, and (4) recontextualising legal judgements supporting refusal of NHS treatment on affordability grounds as 'rational'. The overall effect of these discursive practices was that denying treatment to patients became reasonable and rational for an organisation even while it continued to espouse traditional NHS values. We conclude that deliberations about the funding of treatments at the margins of NHS care have powerful consequences both for patients and for redrawing the ideological landscape of NHS care.

Pussy Riot: "well-connected people are simply treated differently in the courts"

Trendwatcher: A Free Man is Hard to Find

20:37 29/10/2012
Weekly column by Natalia Antonova

"Whatever you may think about Pussy Riot or Razvozzhayev, you have to admit that well-connected people are simply treated differently in the courts.
Russia is not at all unique in this, of course, but what is disturbing is the comparative lack of dialogue on the issue."

Pussy Riot: "harsh, Soviet-style prison camps where their lives may be in danger due to a lack of medicine and no hot water amid sub-zero winter temperatures"

Pussy Riot 'risk lives' in Soviet prisons

"MOSCOW - Two women from punk band Pussy Riot sentenced to jail for an anti-Putin protest in a Moscow cathedral face harsh, Soviet-style prison camps where their lives may be in danger due to a lack of medicine and no hot water amid sub-zero winter temperatures, according to a recently released band member.

Pussy Riot's protest has attracted global attention because of the two-year jail sentences meted out to its members for what prosecutors called "hooliganism motivated by religious hatred".

Opposition figures say the punishments formed part of a wave of repression against opponents of President Vladimir Putin, now in his 13th year ruling Russia.

Putin said last Thursday that the women "deserved what they got" because their punk prayer in Moscow's main cathedral last February, during which the balaclava-clad women appealed to the Virgin Mary to get rid of the president, amounted to "group sex" and threatened the moral foundations of Russia."

Pussy Riot: "Russia 'returns to Stalin-era show trials'"; "Little progress has been made on de-Stalinisation"

Russia 'returns to Stalin-era show trials': Memorial

"AFP - Russia's leaders are using Stalin-era tactics against the opposition including show trials and camp sentences, one of its most authoritative rights groups warned Tuesday.

Memorial rights group slammed the treatment of activists after two members of the Pussy Riot feminist rock group were sent to prison camps for a protest against President Vladimir Putin and several protest leaders were charged in criminal probes.

"The events of recent weeks show that in its dialogue with the opposition, the Russian authorities intend to rely on the language of repression -- arrests, courts, camps," Memorial said.


Both President Vladimir Putin and his predecessor Dmitry Medvedev have spoken out against Stalin-era repression but only sporadically and Russia has resisted opening up its archives from the period.

In a rare comment in 2007, Putin called the deaths of those killed in purges a "particular tragedy" for Russia, while Medvedev as president called for a programme of de-Stalinisation.

Little progress has been made on de-Stalinisation, Memorial's chairman Arseny Roginsky said Tuesday."

Jay Fidell to Hawaiians: Saddle up. "Could there be a more ideal place for cycling?"

It's time for Hawaii's people to get on our bikes and ride

POSTED: 01:30 a.m. HST, Oct 30, 2012
"Hawaii has some tough problems: traffic congestion, the rail controversy, energy costs, the ravages of obesity and shrinking disposable income. Bicycles could be a broad solution, right under our noses.
Could there be a more ideal place for cycling?"

Too young to remember the awfulness of the Soviets and the Cold War? Read this.''

“Iron Curtain: The Crushing of Eastern Europe” by Anne Applebaum

By John Connelly, Published: October 26

Two of the 20th century’s iconic moments took place within a few hundred yards of each other in the German capital, Berlin: the storming of the Reichstag by Soviet troops in April 1945 and the scaling of the Berlin Wall by East Germans 44 years later. We sense that the two are related — Soviet troops brought the communism that East Germans toppled in 1989 — but the years between those events are a vacuum in the minds of most Americans.

Even a quarter-century after the opening of Eastern Europe’s archives, we know virtually nothing about how people lived behind the Iron Curtain, though billions of U.S. tax dollars were spent to keep that kind of life from being exported further west. How was it that Eastern Europe — a mostly agricultural region, deeply conservative and religious, historically hostile to Russia — was made by 1949 to look much like Stalin’s heavily industrial and atheist Soviet Union? Surely the outcome had much to do with the Red Army. Yet after Iraq, most will agree that occupation troops do not create political regimes.

And when they gazed toward the East, they witnessed a self-confident power that had borne the brunt of defeating Hitler and claimed to be on the cutting edge of history. They may not have liked the despotic face of this regime, but it seemed forward-moving, the unquestionable verdict of history.

Still, for many the new faith was hard to swallow. History for socialists turned out to be as inscrutable as divine will seems to many religious believers. In the stories Applebaum recounts, young cadres received party orders that made no sense (they were routinely slotted for positions for which they had no experience) or witnessed arrests of comrades known to be loyal. At the same time, their new party lenses made the society that surrounded them inscrutable: They knew that the enemies who plotted against them wore masks to seem the opposite of their true selves.

What kind of organization was this — uncomprehending and incomprehensible, blind to its surroundings, yet essentially invisible to the societies it purported to rule? Historian Jan Gross called the Stalinist regime a “spoiler state,” capable of destroying but not generating real power.

Within weeks of Stalin’s death in March 1953, workers took to the streets of Czechoslovakia and East Germany to demand free elections; three years later, their counterparts in Poland and Hungary followed suit, accompanied by intellectuals. In Budapest ironworkers set their torches to the base of an immense Stalin statue, and the dictator tumbled to Earth. The world has perhaps never seen a more compelling international workers’ solidarity — aimed against the regimes that claimed to rule in their names. Before an invasion by Soviet armored columns in November 1956, Hungarians controlled their own destiny for a few short weeks.

How did Eastern Europe’s communist regimes recover and continue to 1989?"

“Charlie Woods? Who’s he?”

Benghazi’s invisible man

  • Last Updated: 12:00 AM, October 30, 2012
  • Posted: October 30, 2012

"As a matter of fact, you’d have been hard put to even hear the word “Benghazi” mentioned at all on those same programs. And when it was, it was invariably raised by Republicans — and just as quickly shot down by most of the allegedly unbiased moderators. “Charlie Woods? Who’s he?”
Woods’ misfortune is that his son was killed under a Democratic administration. And it’s considered neither polite nor acceptable to question the competence of Democrats — especially this Democrat.
Now, if Woods had been Cindy Sheehan...."

Mona Charen: "Tyrone Woods certainly didn’t have any doubt about what to do when Americans were under attack."

Benghazi: A Symbol of Obama’s Leadership
The president’s account of his directives doesn’t square with Panetta’s story.
By Mona Charen

"Most of the press was willing to let the story fade, because the man in charge is their man and he is in a tight race for reelection. But Fox News, Eli Lake ofThe Daily Beast, and one or two others have revealed details about the administration’s handling of the crisis that are beyond embarrassing — they verge on malfeasance.
According to Fox’s Jennifer Griffin, former Navy SEAL Tyrone Woods, who was part of a small team at the CIA safe house about a mile from the consulate, heard shots fired at 9:40 p.m. He urgently requested backup from the CIA and asked permission to head to the consulate to help. The request was denied three times. He and his team were told to “stand down.”
General David Petraeus says that the CIA never denied a request for help — which raises the question: Who else but the White House would have made such a decision?
Secretary of Defense Leon Panetta may have answered the question — and exposed as false Obama’s claim that the White House directed that our personnel be secured. Panetta explained that the “basic principle is that you don’t deploy forces into harm’s way without knowing what’s going on, without having some real-time information about what’s taking place. And as a result of not having that kind of information, the commander who was on the ground in that area, General Ham, General Dempsey and I felt very strongly that we could not put forces at risk in that situation.”
Really? Is the Secretary of Defense really saying that we can’t put forces at risk when Americans are already at risk and are being shot at? Why do we have a military again? Tyrone Woods certainly didn’t have any doubt about what to do when Americans were under attack. He defied orders and rushed to help, sacrificing his own life. It’s what any member of the armed forces would normally do — unless restrained by incompetent civilian authority."

Monday, October 29, 2012

Need another reason to work out? Obese Teens Face Higher Risk for Kidney Disease

Obese Teens Face Higher Risk for Kidney Disease: Study

Extra weight has real health consequences, but losing pounds can lower chances, expert says

"They noted, as expected, the risk for kidney disease was significant for those who were diabetic. However, the risk was also significant for those who didn't have diabetes.
"Although the results for diabetic [end-stage kidney disease] were remarkable, with risks increasing sixfold and 19-fold among overweight and obese adolescents, respectively, our results also indicate a substantial association between elevated BMI and nondiabetic, end-stage renal disease," the authors wrote in the report. BMI, or body mass index, is a measurement that takes into account height and weight."

Sandy vs. our Military, walking the mat at the Tomb of the Unknowns (HT:GB)

NEJM: SCt Obamacare opinion "seems to have expanded federal power to tax people for “doing nothing,” the primary fear that brought this case to court"


Reframing Federalism — The Affordable Care Act (and Broccoli) in the Supreme Court

Wendy K. Mariner, J.D., M.P.H., Leonard H. Glantz, J.D., and George J. Annas, J.D., M.P.H.
N Engl J Med 2012; 367:1154-1158September 20, 2012
"Remarkably, given all the commentary about the importance of this case to the future authority of the federal government, none of the opinions made any attempt to limit the currently broad power to regulate interstate commerce that the federal government currently possesses. Rather, the Court seems to have expanded federal power to tax people for “doing nothing,” the primary fear that brought this case to court. It is hard to believe that this power is as expansive as the chief justice suggested, but his opinion did not discuss limitations. The current taxing power certainly would permit an increased income or payroll tax to expand Medicare or create a new federal substitute for Medicaid. However, the limits of the taxing power probably will not be tested soon. It is the power that Congress is least likely to exercise in an era of widespread antipathy to tax increases."

Requirement to purchase health insurance

 2012 Oct 24;308(16):1628-9; author reply 1629. doi: 10.1001/jama.2012.12625.

Requirement to purchase health insurance.

Comment on

To the Editor: Dr Rulli and colleaguesclaimed that a physician's duty to provide acute and emergency care, ie, to rescue, is “not grounded solely in individuals' right to be rescued.” Without this claim, their argument that the duty to rescue grounds a duty to buy insurance is less interesting because if individuals can waive their right to rescue, citizens can escape the duty to buy insurance.