Category Archives: Politics & Issues

Links: Dogs help children read/Becoming an MD/Overdiagnosis/Misdiagnosis/Patient modesty/An MD’s compassion

Listening dog helps children readThe dogs who listen to children reading (Guardian)
“Listening dog” encourages children to read aloud. “It helps with their self-esteem in reading out loud because he is non-judgmental. He doesn’t judge them and he doesn’t laugh at them.” Greyhounds are the dog of choice. Adopt a greyhound website.

18 Stethoscopes, 1 Heart Murmur and Many Missed Connections (NYT)
A woman (journalist/author) with a clearly audible mitral valve click volunteers to let second year med students listen. Interesting observations on doctor/patient relationship, learning to be a doctor. Read more

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Obama supports Wyden-Brown bill

Obama on Wyden-Brown BillOn the PBS Newshour last night, Judy Woodruff interviewed first Kathleen Sibelius and then Orrin Hatch on the issue (Sibelius being the Secretary of Health And Human Services (HHS) and Hatch the conservative Republican senator from Utah). Woodruff repeatedly tried to confront Hatch’s opposition to the proposal. She would cite a state governor who wanted the flexibility of the 2014 waiver option — for example, someone who thought his state could do better than the federal plan if it offered a single-payer system – only to have Hatch repeat, over and over, that the states can’t afford to implement health care reform, so there’s no point in talking about it. It’s all “bull corn.” Read more

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Imagine a future without cosmetic surgery

American Plastic Laurie EssigA less pithy title – and what I really mean – would be “Imagine a future where aesthetic cosmetic surgery wasn’t motivated by the images of celebrities/advertising/porn and by the dissatisfaction with normal bodies that these images create.”

In the concluding chapter of her new book, American Plastic: Boob Jobs, Credit Cards, and the Quest for Perfection, Laurie Essig suggests we might try creating and joining reality-check groups before going under the knife. We could weigh our decision, benefit from the input of friends, then relentlessly pursue “perfect beauty at any cost” if we wished. Read more

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Links: Birthing your own grandchild/Welch’s Overdiagnosis/Al Qaeda/Cats/Polar bears

Woman gives birth to own grandchild61-year-old woman gives birth to her own grandchild, and so what? (Practical Ethics)
The news is that it’s not news. Euthanasia, divorce, same sex marriage, in vitro fertilization — the common perception of these practices has changed radically in the last 30 years. Comments from Italian bioethicist.

Creeping sickness: Our epidemic of diagnosis (New Scientist)
Review of H. Gilbert Welch’s new book, Overdiagnosed: Making People Sick in the Pursuit of Health (just got my copy). Today people have pre-diseases: pre-diabetes, pre-hypertension, pre-hyperlipidemia, pre-osteoporosis. Healthy people with no symptoms are urged to seek treatment. Read more

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Sex, lies, and pharmaceuticals

Sex lies and pharmaceuticals Ray MoynihanMost people experience times when as much as it’s blindingly obvious a problem is not theirs alone, it’s up to them alone to fix it – and a pill is often the quickest or only means.

That’s exactly what Margaret Thatcher and Ronald Reagan wanted us to believe. “There’s no such thing as society.” Unfortunately, many medical distorders do have social, not biological causes. Like poverty.
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Union busting and the inequality of wealth

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

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

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

Greater Germ Exposure Cuts Asthma Risk (WSJ)
Another example of the hygiene hypothesis. Children living on farms have a lower risk of asthma than children who don’t because they are surrounded by a greater variety of germs. Key is exposure to diversity of germs, not just more of them. “You have to have microbes that educate the immune system. But you have to have the right ones.”
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Links: Cerrie Burnell/Widow’s Lament/Drug shortages/Insurance profits/Cholesterol & women/Kochs

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

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

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Feeling sorry for plastic surgeons

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

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

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

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

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

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

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

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

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

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

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

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

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

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The states’ rights argument against health care: An ugly tradition

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

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

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

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

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Links: Awake cosmetic surgery/Dentist demographics/more

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

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

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

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

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

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

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Inequality and the financial crisis

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

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Misc Links 2/6/11

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

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

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Guest post: A fat lot of good

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

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Misc Links 2/5/11

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

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

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Misc Links 2/4/11

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

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

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Misc Links 2/3/11

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

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

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Misc Links 2/2/11

Marion Nestle What to eat2010 Dietary Guidelines, deconstructed (Food Politics)
Marion Nestle digests the new 95-page “policy document.” Being a vegetarian is no longer high risk. Change the food environment. “Eat less cake, cookies, ice cream, other desserts, and candy.” That’s pretty explicit.

How Often Does the Oldest Person in the World Die? (Village Voice)
Every six months, more or less. The world’s oldest person in the world died on Monday at the age of 114 years, 195 days. The honor is now held by a woman 37 days younger. Eight out of ten of the last “winners” have been 114, with the other two living to 115. Read more

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Misc Links 2/1/11

Tiger gets hip replacementTiger, tiger, moving right: Pioneering hip operation gives Girl a new start (Guardian)
Eight-year-old Malayan tiger received world’s first prosthetic hip. Expected to live another 12 years. Malayan tigers are an endangered species, with only 500 living in the wild.

Better communication leads to better care (American Medical News)
Patients should speak up when they have concerns about patient modesty, and doctors should listen. Read more

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