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In The News
Featured Article
Naidoo, Kumi. Climate: A question of justice. BBC News. 16 November 2009.
http://news.bbc.co.uk/2/hi/science/nature/8362831.stm
This week, lifelong human rights activist Kumi Naidoo takes over as international executive director of Greenpeace. Here, he explains why he is making the jump to a mainstream environmental organisation, and what role he sees for organisations such as Greenpeace in the modern world.
Addiction
Johnson, Kirk. For Marijuana, a Move into the Open in a Ski Town. The New York Times. 13 November 2009.
http://www.nytimes.com/2009/11/14/us/14smoking.html
BRECKENRIDGE, Colo. — High-altitude partying is a deeply carved tradition in ski country, where alcohol in the open and illicit drugs in the shadows have been intertwined for years. Even before last week’s town vote here that decriminalized the possession of small amounts of marijuana, one of the best-selling T-shirts at Shirt and Ernie’s on Main Street winked at what it means to live and play 9,600 feet up in the Rockies. “Dude,” the shirt says, “I think this whole town is high.”
Children’s Issues
Rampell, Catherin. How Old Is Old Enough? The New York Times. 14 November 2009.
http://www.nytimes.com/2009/11/15/weekinreview/15ramp.html
THIS past week the Supreme Court heard arguments about whether children should ever be sentenced to life without parole for crimes that don’t involve murder.
End of Life
Urbina, Ian. Ohio Is First To Change To One Drug In Executions. The New York Times. 1 Novmeber 2009.
http://www.nytimes.com/2009/11/14/us/14ohio.html
Breaking ranks with the 35 other states that use lethal injections to execute prisoners, Ohio on Friday became the first state to say it would switch to a single drug, rather than a three-drug cocktail, in its death penalty procedure.
Environmental Issues
Broder, John. Obama Hobbled in Fight Against Warming. The New York Times. 15 November 2009.
http://www.nytimes.com/2009/11/16/science/earth/16climate.html?_r=1
This weekend in Singapore, Mr. Obama was forced to acknowledge that a comprehensive climate deal was beyond reach this year. Instead, he and other world leaders agreed that they would work toward a more modest interim agreement with a promise to renew work toward a binding treaty next year.
Mouawad, Jad. Gloomy Energy Report Sets the Stage for Climate Negotiations. The New York Times. 10 November 2009.
http://www.nytimes.com/2009/11/11/business/energy-environment/11oil.html
As the world heads for tough negotiations over a global climate deal next month, an influential forecasting agency said on Tuesday that current energy policies were not sustainable, and that a vast transformation of energy use was required to fend off the worst consequences of global warming.
Health Care
Greenhouse, Steven. Law Seeks to Ban Misuse of Genetic Testing. The New York Times. 15 November 2009.
http://www.nytimes.com/2009/11/16/business/16genes.html?emc=eta1
The most important new antidiscrimination law in two decades — the Genetic Information Nondiscrimination Act — will take effect in the nation’s workplaces next weekend, prohibiting employers from requesting genetic testing or considering someone’s genetic background in hiring, firing or promotions.
Rifkin, Dena. Checking the Right Boxes, but Failing the Patient. The New York Times. 16 November 2009.
http://www.nytimes.com/2009/11/17/health/17case.html
It has been 10 years since the Institute of Medicine’s seminal report on deaths caused by medical errors (numbering at least 44,000 a year). Since then, there has been tremendous focus on how many mistakes physicians and hospitals make, how much they cost and how to prevent them.
Wilson, Duff. Rising Prices Of Drugs Lead to Call For Inquiry. The New York Times. 18 November 2009.
http://www.nytimes.com/2009/11/19/health/policy/19drugs.html
Democrats in Congress asked for two separate investigations of drug industry pricing Wednesday as they continue working on legislation to overhaul the nation’s health care system. Responding to news reports of unusually high wholesale price increases in brand-name prescription drugs, four House leaders and one senator asked for government reviews of the pricing practices.
Rabin, Roni Caryn. New Guidelines on Breast Cancer Draw Opposition. The New York Times. 16 November 2009.
http://www.nytimes.com/2009/11/17/health/17scre.html
The new screening guidelines, issued on Monday by the Preventive Services Task Force of the Department of Health and Human Services, recommend against routine screening mammography in women 40 to 49. They would scale back screening for women 50 to 74, to every other year from annually.
Mental Health
Healy, Patrick. The Anguish of War for Today's Soldiers, Explored by Sophocles. The New York Times. 11 November 2009.
http://www.nytimes.com/2009/11/12/theater/12greeks.html
The ancient Greeks had a shorthand for the mental anguish of war, for post-traumatic stress disorder and even for outbursts of fratricidal bloodshed like last week’s shootings at Fort Hood. They would invoke the names of mythological military heroes who battled inner demons: Achilles, consumed by the deaths of his men; Philoctetes, hollowed out from betrayals by fellow officers; Ajax, warped with so much rage that he wanted to kill his comrades. Now officials at the Defense Department are turning to the Greeks to explore the psychic impact of war.
In The Journals
The Journal of the American Medical Association
Drake, Bettina and Graham Colditz. “Assessing Cancer Prevention Studies – A Matter of Time” The Journal of American Medical Association. 302.19 (18 November 2009): 2152-3.
http://jama.ama-assn.org/cgi/content/full/302/19/2152
To reduce the incidence of neural tube defects, the US Food and Drug Administration (FDA) mandated folic acid fortification of flour and other grains beginning in 1998. Subsequent studies showed an overall increase in mean folic acid levels among US residents. Within a few years of this mandate, a decrease in the incidence of neural tube defects was noted in newborns. However, longer-term benefits of folic acid fortification for disease prevention, including multiple cancers, remain to be documented. Animal studies suggest that modest supplementation can reduce carcinogenesis. On the other hand, high doses of folic acid may speed cell division and increase tumor progression in preneoplastic lesions. Better understanding of time frame and dosage is key to balancing risk and benefits.
Mitka, Mike. “FDA Exercises New Authority to Regulate Tobacco Products, But Some Limits Remain” The Journal of American Medical Association. 302.19 (18 November 2009): 2078-81.
http://jama.ama-assn.org/cgi/content/full/302/19/2078
With great fanfare, the US Food and Drug Administration (FDA) on September 22 announced a ban on certain flavored cigarettes that, the agency says, are aimed at enticing children to smoke. "Almost 90% of adult smokers start smoking as teenagers, and these flavored cigarettes are a gateway for many children and young adults to become regular smokers," said FDA Commissioner Margaret Hamburg, MD, at a press conference announcing the ban.
Mitka, Mike. “FDA: Flush Certain Unused Medications” The Journal of American Medical Association. 302.19 (18 November 2009): 2082.
http://jama.ama-assn.org/cgi/content/full/302/19/2082
Because of safety concerns, certain prescribed medications no longer needed for treatment, including several opioids and other controlled substances, should be flushed down the sink or toilet, said US Food and Drug Administration (FDA) officials during the launching of a new consumer Web site.
The New England Journal of Medicine
Chernichovsky, Dov. “Not ‘Socialized Medicine’ – An Israeli View of Health Care Reform” The New England Journal of Medicine. 361.21 (19 November 2009).
http://content.nejm.org/cgi/content/full/361/21/e46
In 2007, the United States spent about 15% of its gross domestic product (GDP) on health care, whereas Israel's health care spending was about 8% of its GDP. In other words, on average, Americans work almost 2 months a year to pay their medical bills — nearly twice as long as the average Israeli does. Reflecting higher U.S. earnings and incomes, as well as the U.S. population's older average age, these figures translate into per capita U.S. spending (standardized for age) amounting to more than three times that of Israel — over $6,000 versus nearly $2,000. And the spending gap is widening, not only between the United States and Israel but also between the United States and the average of the 22 other most affluent countries in the Organization for Economic Cooperation and Development (OECD).
Stewart, Alexandra. “Mandatory Vaccination of Health Care Workers” The New England Journal of Medicine. 361.21 (19 November 2009): 2015-7.
http://content.nejm.org/cgi/content/full/361/21/2015
Mandatory vaccination of health care workers raises important questions about the limits of a state's power to compel individuals to engage in particular activities in order to protect the public. In justifying New York State's regulations requiring health care workers who have direct contact with patients or who may expose patients to disease to be vaccinated against seasonal and H1N1 influenza, New York State Health Commissioner Richard Daines recently argued, “[T]he welfare of patients is . . . best served by . . . very high rates of staff immunity that can only be achieved with mandatory influenza vaccination — not the 40-50% rates of staff immunization historically achieved with even the most vigorous of voluntary programs. Under voluntary standards, institutional outbreaks occur. . . . Medical literature convincingly demonstrates that high levels of staff immunity confer protection on those patients who cannot be or have not been effectively vaccinated . . . while also allowing the institution to remain more fully staffed."
The Lancet
“20 Years On: The Clinical Importance of Children’s Rights” The Lancet. 374.9703 (21 November 2009): 1723.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)62006-7/fulltext
During the past week, the Australian Government apologised for the mistreatment of UK children who were resettled in Australia between 1930 and 1970 as part of the child migrants programme; a similar apology from the UK Government is expected. This forced resettlement of 500 000 children is a reminder of their vulnerability. The 20th anniversary on Nov 20 of the UN Convention on the Rights of the Child (CRC) gives an opportunity to reflect on children's rights today—and the responsibility of health professionals to respect and defend those rights in all settings, including the clinic.
Birnbaum, Jeanette. “Sceptical Optimism: A New Take on Global Health Data” The Lancet. 374.9703 (21 November 2009): 1730-1.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61426-4/fulltext
What was the state of the US manganese market in 1916? The USA imported 308,000 tonnes of manganese in 1916, with a unit value of US$50 per tonne. What was the weather like in Seattle on Sunday, Sept 6, 1970? One could safely assume it rained—and indeed, it rained 9 mm and the temperature was a moderate 15°C. Finally, how many people died of HIV/AIDS in 2007? Even though HIV has captivated public discourse and funding, including over $5·1 billion in development assistance for health in 2007 alone, there are only rough estimates of its disease burden.
“Force-Feeding of Prisoners – A Shameful Practice” The Lancet. 374.9703 (21 November 2009): 1724.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)62007-9/fulltext
A judge in Connecticut, USA, is considering whether to continue to allow a prisoner on hunger strike to be force-fed. Superior Court Judge James Graham is expected to rule on the case of William Coleman, who is in the Corrigan-Radgowski Correctional Center, in the coming weeks. Coleman and his lawyers argue that he has a constitutional right to determine what happens to his body, and the right to refuse medical treatment including resuscitation or assisted feeding. He has been force-fed via a nasogastric tube inserted by a physician on occasions since January, 2008, when Judge Graham issued a temporary injunction that allowed the state to feed Coleman by force.
Nutt, David. “Government vs Science Over Drug and Alcohol Policy” The Lancet. 374.9703 (21 November 2009): 1731-3.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61956-5/fulltext
My statement in October1 that alcohol was more dangerous than many illegal drugs, including cannabis, ecstasy, and LSD, referred back to a paper I published in The Lancet 2 years ago.2 It would be an understatement, given the political, media, and academic interest, to say that I stirred up a hornets' nest in the UK Parliament and elsewhere. The Home Secretary, Alan Johnson, sacked me from my role as chair of the ACMD (the government's Advisory Council on the Misuse of Drugs, on which I had served with distinction for 10 years), and the Conservative shadow minister said it should have happened earlier this year when I published a paper comparing the harms of ecstasy and another addiction (which I had termed “equasy”—ie, horse riding).
Opinion
Boston Globe
Editorial. Study says drug does little, proving need for more testing. Boston Globe. 16 November 2009. http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2009/11/16
The next time pharmaceutical companies raise dire warnings about federal proposals to measure the cost-effectiveness of their products, they should be required to read the recent study in the New England Journal of Medicine about a kidney drug called Aranesp. For decades, doctors have prescribed this drug or others like it to patients with type 2 diabetes and kidney disease in the belief that the drugs would prevent heart disease and combat fatigue in patients.
Chicago Tribune
Dolin, Jordan. Health care's greatest untapped resource: patients. Chicago Tribune. 15 November 2009.
http://www.chicagotribune.com/news/opinion/chi-oped1115healthnov15
A few months ago, I sat with my mother in the emergency room as she recovered from a minor heart attack. The cardiologist entered the room and told her she needed an angioplasty immediately. My mother was clearly scared. She asked what she needed to know, but the doctor dismissed her by saying, "Honey, all you need to worry about is if I am going to listen to opera or Steely Dan during the procedure."
Parker, Kathleen. The storm before the calm about mammograms. Chicago Tribune. 18 November 2009.
http://www.chicagotribune.com/news/columnists/chi-oped1118parkernov18
That's not a word one hears much these days, but calm is what some are urging in the wake of a new federal report on breast cancer screening.
Los Angeles Times
Krinsky, Miriam Aroni. The flaws of lethal injection. Los Angeles Times. 16 November 2009.
http://www.latimes.com/news/opinion/la-oe-krinsky16-2009nov16
It has been a year and a half since the Supreme Court ended the nationwide moratorium on lethal injections, finding that Kentucky's three-drug protocol had adequate safeguards to protect inmates from "cruel and unusual" punishment. But in California, executions remain on hold, as they have been for more than three years. Some have urged the governor and others to move things along. They point to executions without incident, like Tuesday's of John Allen Muhammad in Virginia. But other recent executions compel a contrary conclusion: We still haven't found a way to get it right.
Editorial. Saving young victims of the sex trade. Los Angeles Times. 14 November 2009.
http://www.latimes.com/news/opinion/editorials/la-ed-trafficking14-2009nov14
Autumn is the beginning of a dangerous season for the youngest victims of the sex trade. Sports championships, beginning with the World Series in October, are magnets for traffickers. In upcoming weeks, authorities say, dozens of children will be transported as prostitutes to the National Football League playoffs, the Super Bowl and, in the spring and summer, the NBA finals and other tournaments. But these days, along with the teams and the fans, the FBI will be there too.
New York Times
Michelman, Kate and Frances Kissling. Trading Women’s Rights for Political Power. New York Times. 11 November 2009.
http://www.nytimes.com/2009/11/12/opinion/12michelman.html
A GRIM reality sits behind the joyful press statements from Washington Democrats. To secure passage of health care legislation in the House, the party chose a course that risks the well-being of millions of women for generations to come.
Kristof, Nicholas D. America’s Defining Choice. New York Times. 11 November 2009.
http://www.nytimes.com/2009/11/12/opinion/12kristof.html
President Obama and Congress will soon make defining choices about health care and troops for Afghanistan.
Wall Street Journal
Editorial. The Rationing Commission. Wall Street Journal. 15 November 2009.
http://online.wsj.com/article_email/SB10001424052748703792
As usual, the most dangerous parts of ObamaCare aren't receiving the scrutiny they deserve—and one of the least examined is a new commission to tell Congress how to control health spending. Democrats are quietly attempting to impose a "global budget" on Medicare, with radical implications for U.S. medicine.
Editorial. A Breast Cancer Preview. Wall Street Journal. 19 November 2009.
http://online.wsj.com/article/SB10001424052748704204304574543
A government panel's decision to toss out long-time guidelines for breast cancer screening is causing an uproar, and well it should. This episode is an all-too-instructive preview of the coming political decisions about cost-control and medical treatment that are at the heart of ObamaCare.
Lomborg, Bjorn. Ethiopia, Malnutrition and Climate Change. Wall Street Journal. 15 November 2009.
http://online.wsj.com/article_email/SB10001424052748704431804574
Global warming has captured the attention of politicians around the world. The following article is part of a series leading up to the December United Nations conference in Copenhagen on how ordinary people in different countries view the issue.
Washington Post
Turley, Jonathan. When a child dies, faith is no defense. Washington Post. 15 November 2009.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/13
"Suffer little children to come to me." So begins one of the most cited passages in the Bible. Yet, in cases involving the deaths of children in faith-healing families, the second half of Jesus's admonition from Luke 18:16 is at the heart of legal controversy: ". . . and forbid them not."
Baker, Timothy, Richard McFall and Varda Shoham. Is your therapist a little behind the times? Washington Post. 15 November 2009.
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/13
A young woman enters a physician's office seeking help for diabetes. She assumes that the physician has been trained to understand, value and use the latest science related to her disorder. Down the hall, a young man enters a clinical psychologist's office seeking help for depression. He similarly assumes that the psychologist has been trained to understand, value and use current research on his disorder.
