Friday, February 29, 2008

The true cost of war

Steve Bell - The Guardian

In 2005, a Nobel prize-winning economist began the painstaking process of calculating the true cost of the Iraq war. In his new book, he reveals how short-sighted budget decisions, cover-ups and a war fought in bad faith will affect us all for decades to come. Aida Edemariam meets Joseph Stiglitz in The Guardian

Link to the Guardian article


elo

Carl Zimmer writing for The New York Times (February 26, 2008) in

The Encyclopedia of Life, No Bookshelf Required

Imagine the Book of All Species: a single volume made up of one-page descriptions of every species known to science. On one page is the blue-footed booby. On another, the Douglas fir. Another, the oyster mushroom. If you owned the Book of All Species, you would need quite a bookshelf to hold it. Just to cover the 1.8 million known species, the book would have to be more than 300 feet long. And you’d have to be ready to expand the bookshelf strikingly, because scientists estimate there are 10 times more species waiting to be discovered.

It sounds surreal, and yet scientists are writing the Book of All Species. Or to be more precise, they are building a Web site called the Encyclopedia of Life (www.eol.org). Its authors, an international team of scientists, introduce the first 30,000 pages, and within a decade, they predict, they will have the other 1.77 million.

While many of those pages may be sparse at first, the authors hope that the world’s scientific community will pool all of its knowledge on the pages. Unlike a page of paper, a page of the Encyclopedia of Life can hold as much information as scientists can upload. “It’s going to have everything known on it, and everything new is going to be added as we go along,” said Edward O. Wilson, the Harvard biologist who spearheaded the Encyclopedia of Life and now serves as its honorary chairman.

John D. and Catherine T. MacArthur Foundation contributed money to a consortium of universities, museums and scientific institutions. The Alfred P. Sloan Foundation and some of the partners are adding money as well. So, the encyclopedia will have a budget of about $50 million in its first five years.

The researchers wanted to make the site useful to scientists and nonscientists, so they created a sliding button that readers can move to choose how much detail they want. They are also developing ways of manipulating the information to make it useful in many ways.

Link to the Encyclopedia of Life


Link to New York Times article

Stephen Fry - horror stars

stephen fry: condom language

G spot

Linda Geddes writing for The New Scientist (February 23 -29, 2008) reports

Ultrasound nails location of the elusive G spot

"For the first time it is possible to determine by a simple, rapid and inexpensive method if a woman has a G spot or not," says Emmanuele Jannini at the University of L'Aquila in Italy, who carried out the research.

As a side bar in the article, Rowan Hooper in

Can women ejaculate or not?

Looks at the work of Marian Koster and Lisa Price of Wageningen University in the Netherlands


Reference:


Measurement of the Thickness of the Urethrovaginal Space in Women with or without Vaginal Orgasm
Giovanni Luca Gravina, MD, PhD, et al

The Journal of Sexual Medicine Volume 5 Issue 3 Page 610-618, March 2008

Link to JSM abstract


Rwandan female genital modification: Elongation of the Labia minora and the use of local botanical species
Marian Koster & Lisa Leimar Price

Culture, Health & Sexuality, Volume 10, Issue 2 February 2008 , pages 191 - 204

Link to CHS abstract


Link to New Scientist article

Vitamins & Cancer

BBC News on line reports (February 29, 2008)

Vitamin E linked to lung cancer

Taking high doses of vitamin E supplements can increase the risk of lung cancer, research suggests.

In a US study of 77,000 people found taking 400 milligrams per day long-term increased cancer risk by 28% - with smokers at particular risk.
It follows warnings about similar risks of excessive beta-carotene use.
In an editorial in the American Journal of Respiratory and Critical Care Medicine, an expert warns people should get their vitamins from fruit and veg.
Dr Tim Byers, from the University of Colorado, said a healthy, balanced diet meant people took in a whole range of beneficial nutrients and minerals, which might help to reduce cancer risk.

In the study, researchers followed people aged between 50 and 76 for four years and looked at their average daily use of vitamin C and folic acid, and vitamin E supplements.
Over the course of the study, 521 people developed lung cancer.
Smoking, family history and age all had unsurprisingly strong links to cancer risk.
And while neither vitamin C or folic acid use had any effect on lung cancer risk, vitamin E use did.
The researchers extrapolated their findings, and concluded that over a decade, there was an additional 7% increase in risk for every 100 milligrams taken per day.
The vitamin E trend was most prominent among smokers, but was not confined to them.
Vitamin E is known to be an antioxidant - protecting cells from molecules called free radicals.
But the US researchers speculate that, in high doses, it may also act as a pro-oxidant - causing oxidation and therefore damage to cells.

Dr Christopher Slatore of the University of Washington in Seattle, who led the study, said: "In contrast to the often assumed benefits or at least lack of harm, supplemental vitamin E was associated with a small increased risk of lung cancer.
"Future studies may focus on other components of fruits and vegetables that may explain the decreased risk of cancer that has been associated with fruit and vegetables.
"Meanwhile, our results should prompt clinicians to counsel patients that these supplements are unlikely to reduce the risk of lung cancer and may be detrimental."

In 2002 a Finnish study of 29,000 male smokers found taking beta-carotene - which is converted into vitamin A in the body - was linked to an 18% increased risk of developing lung cancer


Reference:


Nutrition and Lung Cancer: Lessons from the Differing Effects of Foods and Supplements
Tim Byers

American Journal of Respiratory and Critical Care Medicine Vol 177 pp 470-471, (2008)

Link to AJRCCM editorial


Long-Term Use of Supplemental Multivitamins, Vitamin C, Vitamin E, and Folate Does Not Reduce the Risk of Lung Cancer

Christopher G. Slatore et al
American Journal of Respiratory and Critical Care Medicine Vol 177 pp. 524-530, (2008)

Link to AJRCCM abstract

Link to BBC news report

C. diff - the new MRSA?

BBC News on line reports (February 28, 2008)

Dramatic rise in C. diff deaths

The number of deaths linked to hospital bug Clostridium difficile has soared in England and Wales, figures from the Office for National Statistics show.
Between 2005 and 2006 the number of death certificates which mentioned the infection rose by 72% to 6,480, most of which were elderly people.
In over half of cases, it was listed as the underlying cause of death.
It is thought that some of the increase may be due to more complete reporting on death certificates.

C. difficile usually affects the elderly, and can prove fatal if antibiotic treatment fails to kill all the spores in the gut, and they take hold again before the patient's own gut bacteria have had chance to mount a resistance.

It is also very difficult to eradicate from the ward environment, which means it is easy for other patients to become infected.

Professor Brian Duerden, chief microbiologist at the Department of Health, said in July 2005 they called for more accurate reporting of infections such as MRSA and C. difficile on death certificates.
"These statistics from 2006 show that this move has worked and our figures are now in line with other developed countries."
"Since 2006 we have taken significant steps to tackle infections."
"These include stringent hand-washing guidance for the NHS, a bare below the elbows dress code, putting matrons back in charge of cleanliness on their wards and an ongoing deep clean of every ward." And he added hospital infection rates were now falling.

The Health Protection Agency reported in November 2007 that rates of C. difficile infection may be levelling off with the number of new cases down 7% to 13,660, while MRSA cases are falling.


Link to BBC News report

Thursday, February 28, 2008

Swedish Chemist

Gay Christian

Not the Nine O Clock News

Bush League Justice

Little HOPE in this CHANGE!


Raves from Lulu's

The shrink was whinging again about Washington becoming a "nanny" state. Of course we all joined in with remarks about how the Governess says “FU” to Seattle but he wasn't amused. Actually, some of us felt kind of guilty. When he warned us last year of the plan to abolish the 18,000 Registered Counselors and to cut out private practice we assumed it was an exaggeration and just could not happen.

OK we don't really take that much interest in the State Legislature even if they only meet for a couple of months. And the Governess' initiatives? Well she seems to issue three press releases a week --- more about PR than progress. And who can keep track of all the audits and task forces? It's a bit like any good totalitarian system, the info is there but finding it is another story.

OK but now he can produce actual House and Senate Bills. We loved the title---Modifying credentialing standards for counselors.

What about truth in advertising? If that ain’t smoke and mirrors for an election year--- nothing is! Not the mention that added attraction “Appropriations: NONE”. The politicians’ wet dream : dramatic action with no immediate costs.

It all seems rather odd, given the recent news that anti-depressant medication doesn't work. In these troubled times , it seems the rest of the world is recognizing the value of 'the talking cure'. The Brits have an emergency plan to recruit and train 3,600 therapists during the next three years in England to increase patient access to “talking therapies”, which ministers see as a better alternative to drugs the, BBC reports.

The Governess, by contrast, is abolishing 18, 000 Registered Counselors under the guise of her famed claim of keeping "patients safe by building an effective, efficient health care system". Worse still, flying in the face of current think, she intends to ossify a rigid medical model of mental illness for all. This is a troublesome shift for the state into not only more credentialing but also increasing control of 'treatment'.

The shrink was fond of pointing out that despite the fact that his clients paid personally, they were in control and could determine their own needs and actions. Not to mention the control of their own ‘mental health’ histories. There was not some administrative machine doing triage and deciding whether or not they were sick enough to warrant attention. Now we will have all the disadvantages of socialized control without any of the advantages --- not to mention having to increasingly pay more for it.

The nurse raised the issue of the Kent schoolgirl. Either she is a child --- so why didn't the school take care of her with discretion and privacy --- or she is a mature client?

If that it so, why are all her records being touted by the media? An effective, efficient health care system? --- Bad Nanny! The one good thing in that sorry saga would have been the healing relationship between the counselor and client. Of course, that's the one thing that has been 'rectified' by the public spectacle. If the Governess' mandate to the Secretary of Health really was patient care, the aim would be to encourage the lost tradition of a ”therapeutic community" where members cared about ethics, values, history and tradition. Then, the Department of Health's Quality Assurance would actually be concerned with just that. Not, as it is now, where the focus is on investigating and policing breaches in the letter of the law. Perhaps that’s inevitable when you focus exclusively on credentials. Then things like a 'therapeutic relationship' don't matter --- why they don't even exist at all.

The Business major brought us all down to earth with his notion that the State should be in the business of 'registration' not fostering and managing the mental health industry.

We didn't all get it. So he explained. The Registration process offers the opportunity to demonstrate a sense of social involvement and responsibility. There is a recognized place of business, State and Local Licenses, Local and Federal Taxes are paid. There could be professional insurance (but WA State chickened out of that one some years ago.) Yes, complaints could be recorded and activities disciplined. But WA State has never fulfilled its obligation in the field. How many "credentialed" practitioners are their out and about operating without business licenses, not paying taxes and no kind of insurance? Isn't that what the State should have done first?

What really pisses us of is that we are energized by all this nonsense and the real issues of the day are forgotten. Other cities are dealing with HIV and AIDS, other states are providing their children with an education --- rather than schooling them in the credentials game at an ever early age. We took too long to admit there is MRSA here --- let alone TB and meningitis. Then there is the infrastructure (but ‘Appropriations NONE’ can’t work there!)

Ah well, have another cocktail --- there is always Hope and Change!



AIDS Untreated

365gay.com News (February 26, 2008) covers The Canadian Press report in

40% Of AIDS Deaths In Canadian Province Untreated

Forty per cent of the people who died of HIV-AIDS in British Columbia never accessed life-saving treatment even though it was free, according to a new study.

The study by the B.C. Centre for Excellence in HIV-AIDS looked into more than 1,400 HIV-related deaths in the province between 1997 and 2005.
In the time, a total of 567 people died without ever receiving the highly effective antiretroviral treatment.
Low income was strongly associated with delay in starting therapy and the ensuing high mortality rate.
Residence in a poor neighborhood was associated with an increased risk of mortality among HIV patients.

Twenty-five per cent of those infected with HIV in Canada are not aware of their infection, according to the centre.

The centre distributes the cocktail of antiretroviral medications to all eligible British Columbians, free of charge, through the provincewide Drug Treatment Program, funded by Pharmacare.

Typical examples are single mothers who don't have the resources to get a babysitter or a homeless, mentally ill drug addict who lives on the Downtown Eastside and doesn't even know he's HIV-positive.

But it is not just Vancouver, there is a problem right across the country and the percentage could even be worse in smaller communities where fewer resources are available.

Ken Buchanan, of the British Columbia Persons with AIDS Society, said the long-term solution is to bring some stability to the lives of HIV-AIDS sufferers.

"For a person who is homeless, taking medications, even free medications, is pretty low in their priorities."

Buchanan warned that access to medication isn't enough. A person who begins treatment and doesn't maintain the proper dose regime will build up a resistance to the drugs and end up more likely to die.
``You can't take them for a few days and then stop for a few days,'' he said. ``If your life is chaotic ... you don't have the ability or the need or the desire to take your meds.''
It is not only the ethical and human thing to do, he said, it's also better for society at large because it reduces HIV-related illnesses that drain the health care system.

Link to 365gay.com News report

Wednesday, February 27, 2008

February 27 2008:
British Government
told to release
cabinet minutes on Iraq war
Information commissioner orders disclosure because of the 'gravity and controversial nature' of the subject.

The Dogs of War
Steve Bell - The Guardian

Malawi gets Real

Africa Reuters reports (26 Feb 2008)

Malawi drafts law against "healers" of AIDS

Malawi has drafted a law to stop traditional healers from claiming they can cure AIDS and religious leaders from advising their flocks to discard treatment for prayer, a government official said on Tuesday.

Malawi, with a population of about 13 million, ranks among the countries hardest hit by the pandemic in sub-Saharan Africa, home to two-thirds of those infected with HIV/AIDS worldwide.

"The draft law is due to be presented on March 4 to parliament and when it passes into law, all those traditional healers claiming to cure AIDS and religious leaders stopping people from taking ARVs (anti-retroviral drugs for HIV/AIDS) will be dealt with," said Mary Shawa, Principal Secretary for Nutrition and HIV/AIDS in the president's office.

"These are desperate times and we need stern action to deal with these people misleading people," she said.

Shawa declined to disclose the details of the draft law, saying that they would be made public when parliament meets.

Last week the Malawi Council of Churches said five AIDS patients on anti-retroviral treatment died after their church pastor advised them to stop take the medication because they had been healed by prayer.

Official estimates show AIDS kills about 10 people an hour in the impoverished southern African nation. Health officials estimate that a million Malawians are infected with HIV and about 640,000 have died of AIDS-related causes since 1985.

Link to Africa Reuters report


This is a marked difference in both emphasis and actions by the Malawi Government of President Bingu wa Mutharika who took office in 2004



This video, from 2002, shows how self-interested politicians were dealing with the pandemic. The President has also confronted the issue of donor 'influence'.



Alas, there are still too many orphaned hungry children!

Link to YouTube video



TB

Michael Carter for Aidsmap (February 27, 2008) in

5% of all TB cases multi-drug resistant; XDR-TB reported by 45 countries

Also covers the report released by the World Health Organization (WHO) showing there were nearly 500,000 cases of multi-drug resistant tuberculosis (MDR-TB) worldwide in 2006, which represented approximately 5% of all cases of TB.

The report also showed that there was a connection between MDR-TB and HIV. But the report’s authors think that poor infection control rather than “host” factors are the reason for this.

Extensively drug resistant TB (XDR-TB), which has resistance to second-line TB drugs and is associated with rapid disease progression and a high risk of death, was present in 45 countries.

Reference

Anti-tuberculosis drug resistance in the world: fourth global report. February, 2008.
The WHO/IUATLD Global Project on Anti-tuberculosis drug resistance surveillance

Link to WHO report


Link to Aidsmap article

Mr Hilter?

The New York Times (February 27, 2008) reports

Survey Finds Teenagers Ignorant on Basic History and Literature Questions

The survey demonstrate that a significant proportion of teenagers live in “stunning ignorance” of history and literature, said the group that commissioned it, Common Core.

The organization describes itself as a new research and advocacy organization that will press for more teaching of the liberal arts in public schools.

The group says President Bush’s education law, No Child Left Behind, has impoverished public school curriculums by holding schools accountable for student scores on annual tests in reading and mathematics, but in no other subjects.

About a quarter of the teenagers were unable to correctly identify Hitler as Germany’s Chancellor in World War II, instead identifying him as a munitions maker, an Austrian premier and the German Kaiser.


Link to New York Times story




Depression and Teenagers

The New York Times National Briefing | Science and Health (February 27, 2008) covers a Bloomberg News report in

Studies on Depression and Teenagers


Depressed teenagers who are not helped by antidepressants like Celexa or Prozac may improve if they switch drugs and receive a certain type of behavioral therapy, a review of studies found. A separate analysis of 35 clinical trials of antidepressants in adults submitted to regulators found that the drugs were no more effective than placebos, other than a small minority with the most severe levels of depression. The study of adolescents, published in The Journal of the American Medical Association, gives mental health professionals guidance about how to treat teenagers who do not improve using antidepressants, said David Brent, a psychiatrist at the Western Psychiatric Institute at the University of Pittsburgh.



Reference:


Switching to Another SSRI or to Venlafaxine With or Without Cognitive Behavioral Therapy for Adolescents With SSRI-Resistant Depression
The TORDIA Randomized Controlled Trial

David Brent, MD et al

JAMA. 2008;299(8):901-913.

Link to JAMA article

Link to New York Times report

TB

Imogen Foulkes reports on line (February 26, 2008) for BBC News, Geneva in

Drug resistant TB 'at new high'

Drug resistant tuberculosis has hit the highest levels ever recorded, according to a report on the disease from the World Health Organisation (WHO).

In a survey of over 90,000 TB patients in 81 countries, the WHO found that levels of multi-drug resistant (MDR) TB were far higher then expected and have hit the highest level ever recorded..

The survey also found cases of extensively drug resistant TB which is virtually untreatable in 45 countries.

MDR-TB is resistant to at least the two most powerful anti-TB drugs, isoniazid and rifampicin. As a result patients do not respond to the standard six month treatment and have to take more expensive - and more toxic - drugs for up to two years.

The actual figures may well be higher. Many African countries do not have the diagnostic tools to identify the disease, so the exact level of this often fatal form of TB remains unknown.

The WHO is calling for a major expansion in TB surveillance and for treatment programs for drug resistant tuberculosis to be scaled up The $5bn needed would be money well spent, says the WHO.

TB is not "last century's disease". There were nine million new cases in 2006 alone, of which 1.7m died. Nor is it confined to poor countries. In parts of east London, rates of TB are higher then in some developing nations.

Dr Mario Raviglione, director of the WHO Stop TB Department, said: "TB drug resistance needs a frontal assault.

"If countries and the international community fail to address it aggressively now we will lose this battle.

"In addition to specifically confronting drug-resistant TB and saving lives, programs worldwide must immediately improve their performance in diagnosing all TB cases rapidly and treating them until cured, which is the best way to prevent the development of drug resistance."

The report also found a link between HIV infection and MDR-TB.

Link to BBC News story

Tuesday, February 26, 2008

Presidential Library

Steve Bell - The Guardian

Please Talk To Kids About AIDS

Donald G. McNeil Jr. writing for The New York Times (February 26, 2008) in

Talking With Children About Sex and AIDS: At What Age to Start?

Raises the question of what age is the right age to have “the talk,” not just about where babies come from, but also about sex and AIDS?

A new documentary, “Please Talk to Kids About AIDS,” raises this question in a cute but discomfiting way. So far it has been seen only at film festivals and at schools of public health, including those at Harvard and Johns Hopkins. But the film will soon be available at.

The startling aspect is that, as one childish question leads to the next, they ask things like: “How does AIDS get into your body?” and “How come they want to have sex with each other?”

For a reporter, it is a guilty pleasure to see some of the world’s leading scientists squirm — or not — when grilled by a child.

An unplanned stop at the Condom Project’s table inspired the filmmakers, Brian Hennessey and Radia Daoussi, to center the film on their girls.

Sevilla thought the bright packages were candy and loved the Cinderella ball gown and tutus made of blue and pink condoms. She asked about them, and a volunteer’s struggle to turn her boilerplate spiel into words simpler than “destigmatize” made it clear that a child’s innocence would elicit good interviews.

But innocence — being fleeting — fled. At one point, Vineeta draws for the camera a picture of two people in bed. “These are condoms,” she explains of the bowl beside them, “that you put in the boy’s penis, so they don’t get AIDS with a woman or with a man. A man can do it with a man if you like it.”


The video is available at eztakes.com

Link to Please Talk to Kids About AIDS

Link to New York Times article

Take a chill pill?

BBC News on line (February 26, 2008) in

Anti-depressants' 'little effect'

Research published today in the Public Library of Science Medicine journal suggests that antidepressants may be no more effective than a placebo for many people.

A UK research team from the University of Hull concluded the drugs actively help only a small group of the most severely depressed.

As might be expected the makers of Prozac and Seroxat, two of the commonest UK prescribed anti-depressants, said they disagreed with the findings.
A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available". And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant".

In total, the Hull team reviewed data on 47 clinical trials. They reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.
They focused on drugs which work by increasing levels of the mood controlling chemical serotonin in the brain. These included fluoxetine (Prozac) and paroxetine (Seroxat), from the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), alongside another similar drug called venlafaxine (Efexor) - all commonly prescribed in the UK.

The number of prescriptions for anti-depressants hit a record high of more than 31 million in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression. There were 16.2m prescriptions for SSRIs alone.

The researchers found that the drugs did have a positive impact on people with mild depression - but the effect was no bigger than that achieved by giving patients a sugar-coated "dummy" pill.

Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.
"This means that depressed people can improve without chemical treatments.
"Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit."

Professor Kirsch said the findings called into question the current system of reporting drug trials.

Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light. He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.

He called for drug companies to be forced to publish all their data.


Alan Johnson
, the Health Secretary, has announced that 3,600 therapists are to be trained during the next three years in England to increase patient access to talking therapies, which ministers see as a better alternative to drugs.

Link to BBC News report


Sarah Boseley Health Editor of The Guardian (February 26 2008) puts it more strongly and focuses on

Prozac, used by 40m people, does not work say scientists


Having covered in the study, in a separate comment section

The bitterest pill

She examines The big question raised by today's study on antidepressants --- why drug companies control data on their products and not governments

Link to The Guardian report

Link to Sarah Boseley’s Comment


Reference:


Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration.

Irving Kirsch et al

PLoS Med 5(2): e45 (2008)

Link to PLoS Med article

Monday, February 25, 2008

Michael Martin, Speaker of the British House of Commons is under growing pressure to explain his use of parliamentary expenses and allowances.
Martin Rowson - The Guardian

Who gets brutalized?

James Randerson writing for The Guardian (February 25 2008) in

Guantánamo guards suffer psychological trauma

The guards at the Guantánamo Bay prison camp are the "overlooked victims" of America's controversial detention facility in Cuba, according to a psychiatrist who has treated some of them.

In some cases, a tour of duty at the camp has made guards suicidal and prompted a variety of psychiatric symptoms, from depression and insomnia to flashbacks. The guards' testimony also provides a harrowing insight into the treatment of prisoners.

Professor John Smith, a retired US Air Force captain, treated a patient who was a guard at the camp. "I think the guards of Guantánamo are an overlooked group of victims," Smith told the American Academy of Forensic Sciences annual meeting in Washington DC on Saturday. "They do not complain a lot. You do not hear about them."

The patient ('Mr H') is a national guardsman in his early 40s who was sent to Guantánamo in the first months of its operation, when prisoners captured in Afghanistan were beginning to flood into the camp. Mr H reported that he found conditions at the camp extremely disturbing. For example, in the first month two detainees and two prison guards committed suicide.

The taunts of prisoners and the things his superiors required him to do to them had a severe psychological impact on Mr H. "He was called upon to bring detainees, enemy combatants, to certain places and to see that they were handcuffed in particularly painful and difficult positions, usually naked, in anticipation of their interrogation," said Smith.

On occasion he was told to make prisoners kneel, naked and handcuffed, on sharp stones. To avoid interrogation the prisoners would often rub their wounds afterwards to make them worse so that they would be taken to hospital.

Some of the techniques used by interrogators resulted in detainees defecating, urinating, vomiting and screaming.

Mr H told Smith he felt profoundly guilty about his participation. "It was wrong what we did," he said.

The prisoners also threatened Mr H. "They would tell him they had networks of people throughout the world," said Smith. "If he did not take letters out and mail them then they would see to it that his family suffered the consequences."

When he returned to the US he was suffering from panic attacks, insomnia, nightmares, flashbacks and depression.

Another guard whom Smith treated described an incident in which a prisoner had hanged himself in his cell after partially knawing his own arm off. The prisoner lost a substantial amount of blood but was cut down by guards and survived.

Amnesty International UK spokesperson Neil Durkin pointed out that the psychological trauma inflicted on the Guantánamo inmates should not be overlooked. "With numerous suicide attempts and reports of Guantánamo prisoners on the edge of psychosis, we are extremely concerned that even those eventually released from the camp will be mentally scarred for the rest of their lives," he said. "Over 200 of the Guantánamo prisoners are now held in solitary confinement - and after years of detention without charge or trial this is taking a heavy toll."

There have been few scientific studies of the psychological effects of working as a prison guard, but classic experiments in the 1960s and 1970s showed how easy it is to prompt ordinary people to perpetrate extremely cruel acts given the right conditions.

In the so-called 'Stanford prison experiment' in 1971, college students were asked to act out roles as guards and detainees in a mock prison in the basement of the university's psychology department. Both groups quickly adapted to their roles and the guards became increasingly sadistic and cruel in their treatment of the prisoners. The results were so shocking the experiment was stopped early.

"It's not that we put bad apples in a good barrel. We put good apples in a bad barrel. The barrel corrupts anything that it touches," the experiment's author Dr Philip Zimbardo is quoted as saying on the American Psychological Association's website.

Link to The Guardian article

Microbicides

Gus Cairns, writing for Aidsmap (February 25, 2008) in

Microbicides 2008: First hint of efficacy in rectal microbicide trial, thanks to new biopsy assay

reports from the 2008 Microbicides Conference in Delhi that a study presented there offers a strong hint that a rectal microbicide gel containing a non-nucleoside HIV drug may prove to be effective at stopping infection in humans.

The same preliminary analysis also seems to indicate that the drug may be safe, at least if volunteer reports, and the results of a battery of tests of inflammation marker chemicals, are reliable indicators of likely harm.

Peter Anton of the ‘U19’ rectal microbicide program was presenting data from the first subjects enrolled into a phase I safety study of two doses of a microbicide gel containing the NNRTI drug UC-781. This program, funded by the US National Institutes of Health, is the first series of studies to trial rectal microbicides in human subjects

This initial study is primarily designed as an acceptability study. However the use of some innovative inflammation markers and assays allows early educated guesses to be made about toxicity and even eventual efficacy.

Anton was presenting data from the 19 out of 28 subjects who have completed all visits. Importantly, all the data he was presenting was blinded: so we cannot be sure whether results are due to the microbicide, the placebo, the participants, or chance. However they do describe general changes within the trial population over time.

The really innovative aspect of this trial is the way the biopsies are being used as ‘surrogate markers’ for HIV seroconversion.

Microbicide studies have suffered from the huge disadvantage that up till now there has been no early way of estimating their likely protective effect in humans. Animal models can give unreliable results and there have been no ‘correlates of protection’ such as the immunogenicity markers that have been used in vaccine trials to select promising candidates (though those are currently being called into question). The only way up until now has been to put on a huge and expensive efficacy trial on the basis of results in a handful of monkeys, or even in vitro data, and hope the candidate proves to be effective.

The U19 Program is getting round this by using an ‘in vivo-ex vivo’ HIV infection model. In this, volunteers use the microbicide or placebo gel as instructed, and biopsies are taken. These are then cultivated as cellular explants – small pieces of tissue kept alive on gel rafts in a nutrient medium. Two hours after being set up, the explants are then incubated with HIV. The proportion that gets infected with HIV is then determined by measuring the amount of the HIV p24 protein in the culture medium over the next month (which typically grows exponentially in cases of infection).

“It would be convenient to anticipate from this blinded data,” said Anton, “that the high drug dose group will turn out to be the ones whose cells showed no response.”
However, this being blinded data, with full unblinded results not available until the end of this year, anything could turn out to be the case.

References


Anton PA.
A phase 1 safety and acceptability study of the UC-781microbicide gel applied rectally in HIV seronegative adults: an interim safety report at 50% completion.
Microbicides 2008 Conference, Delhi, abstract BO5-290, 2008.

Elliott JE. Ex vivo HIV-1 challenge of colorectal explants may be an important predictor of micobicidal effectiveness invivo. Early, blinded results from a phase 1 rectal microbicide trial of UC-781.
Microbicides 2008 Conference, Delhi, abstract BO4-241, 2008.

Cho DD. Stability of mucosal cytokine profiles and mononuclear lymphocyte phenotype following rectal administration of UC-781 microbicide gel in a phase I safety assessment.
Microbicides 2008 Conference, Delhi, abstract BO6-427, 2008.


Link to Microbicides 2008


Link to Aidsmap article

encouraging 'pro-ana'?

BBC News on line (February 24, 2008) in

Pro-anorexia site clampdown urged

UK campaigners are calling for social networking websites, such as Facebook and MySpace, to clamp down on pro-anorexia sites.

Doctors at one of Britain’s largest eating disorders treatment centers said they needed to act more responsibly. The eating disorders charity, B-eat, said little progress had been made on combating "pro-ana" sites.

The networking sites said it was hard to distinguish between support groups and "pro-anorexia" groups. But a spokesperson for MySpace said they were working with organizations such as B-eat.

Specialists and charities say the rise of the internet and new media has played a significant part in providing easier access to information on how to get thin.

It is suggested that young women exposed to pro-ana websites feel more negative, have lower self-esteem, and perceive themselves as heavier and were more likely to compare their bodies with other women.

Dr Ty Glover, consultant psychiatrist on the Eating Disorders Unit at Cheadle Royal Hospital, said it had proven difficult to shut down pro-ana websites, but the situation was slightly different for sites such as Facebook.
"Social networking sites can censor their material and we expect them to act responsibly," he said. “We are horrified at the content of these sites and the tips they give on how to be thin”.
"People with eating disorders are extremely vulnerable and often have very low self esteem, so pro-ana and pro-mia sites can be very damaging as they are sending out the wrong advice."

It is thought there are more than 500 pro-ana and pro-mia internet sites.

Susan Ringwood from B-eat, who are due to launch a report this week calling for better support for families of people with eating disorders, said the websites encouraged people to avoid treatment.
"We believe that the sites should act responsibly."
"They have acted to remove other content that is seen as 'dangerous', or could encourage young people to do dangerous things."
She said they were not calling for such sites to be banned completely, but for greater awareness of the dangers and for more support online so the sites are not the "only refuge".

But Shannon Bonnette, who is recovering from anorexia, told the BBC that looking at anorexia web pages actually helped her overcome the illness.
"What I found through visiting those site was that there was a common theme - everybody stays miserable," she said.

A spokesperson for MySpace said: "It's often very tricky to distinguish between support groups for users who are suffering from eating disorders and groups that might be termed as "pro" anorexia or bulimia.
"Rather than censor these groups, we are working to create partnerships with organizations like B-eat.
"We have also placed ads on pro-anorexia profiles for up to a year from the National Eating Disorder Association to target these groups with positive messaging about how and where they can get help."

A spokesperson for Facebook said the site supported the free flow of information.
"Many Facebook groups relate to controversial topics; this alone is not a reason to disable a group.
"In cases where content is reported and found to violate the site's terms of use, Facebook will remove it."


The original BBC posting also contains a selection of reader comments on this story:

Link to BBC News on line article

Detecting Alzheimer's

BBC News on line (February 22, 2008) in

Computers 'spot Alzheimer's fast'

A study, by University College London researchers, published in the journal Brain, found computers can identify brain damage caused by Alzheimer’s with an accuracy as high as 96%.

At present a definitive diagnosis is usually only possible after death. It is currently diagnosed using a combination of brain scans, blood tests and patient interviews, but distinguishing the disease from other forms of dementia is difficult, and time consuming, and the accuracy of diagnosis is only about 85%.

The new method works by teaching a standard computer the differences between brain scans from patients with proven Alzheimer's, and people with no signs of the disease.

The two conditions can be distinguished with a high degree of accuracy on a single clinical MRI scan.

Researcher Professor Richard Frackowiak said: "The advantage of using computers is that they prove cheaper, faster and more accurate than the current method of diagnosis.

"The new method makes an objective diagnosis without the need for human intervention.

"This will be particularly attractive for areas of the world where there is a shortage of trained clinicians and when a standardized reliable diagnosis is needed, for example in drug trials."

Professor Frackowiak emphasized that as symptoms only emerge after a considerable amount of damage has already occurred in the brain it is important to make an accurate diagnosis early to improve the chances of effectively preventing further deterioration.

He said: "The next step is to see whether we can use the technique to reliably track progression of the disease in a patient.


Reference:


Automatic classification of MR scans in Alzheimer's disease
Stefan Klöppel et al

Brain 2008 131: 681-689; doi:10.1093/brain/awm319

Link to Brain abstract


Link to BBC News report

Sunday, February 24, 2008

Ooh, Vicar!


'teen exploited at Kent school'


MSNBC
are reporting the story of the "disabled teen exploited " at a Kent school in WA State. You would think the story was not harrowing enough as it impacts the life of a young girl. Unfortunately it has wider implications.

The reported story notes:

“We examined more than 400 pages of school records, e-mails and counseling notes about a girl named Amanda, who was supposed to be protected and watched.”
Instead, the documents show a picture of a disabled teenager with many problems and a disturbing secret. They also suggest a counselor knew all about that secret but didn't tell anyone who could have kept Amanda safe."

At the end of the piece the report lists:


Public Records and Resources for Investigation

Many records were obtained for this investigation by utilizing the state's Open Records Act. Medical records and assessments were obtained by family members. The following records and sources were relied upon for this story:

*Revised Codes of Washington

*Health Care Information Act

*Medical records of Seattle & King Co. Public Health

*Kent Youth & Family Services Progress, Contact Notes

*Kent Youth & Family Services Individualized Treatment Plans

*King County Sheriff's Department Incident Reports

*Kent School District Special Education Team Evaluations

*Kent School District Special Education Re-evaluation Summary Analysis

*Kent School District Individualized Education Plans

*UW Autism Center Evaluation Summary

*Minutes from Kentridge High School Special Education Team Meetings

*Information from Advocates for the Rights of Citizens with Developmental Disabilities

*Information from the Washington State Department of Health

*Hundreds of e-mail exchanges between school staff members, family members and between students

So, we have a graphic example of how privacy and confidentiality is going to be safeguarded in the new era of 'keeping patients safe by building an effective, efficient health care system' in Washington State.

This example is egregious enough in itself. But there is a cruel irony if the 'rules' of confidentiality are being used as an excuse for the non-intervention.

Moreover, it seems that the counselor was a WA State Licensed Mental Health Counselor (LMHC) -- so, fully credentialed and embodying the standards that the Governess requires. Thank goodness we are not talking about a Registered Counselor in private practice. Though, come to think of it that would have been much more politically expedient. But no, this unfortunate 'professional' was 'supervised' in an Agency (with, we assume, the added safeguard of a clinical director of some kind). This is the standard the 'modifying registered counselors credentials' legislation is intended to impose.

This is a warning of the problem of assuming that credentialing takes care of everything. In fact, it seems more likely that the 'professional' becomes more concerned about following the letter of the law than relating to the client -- let alone 'being there'. Maybe it also raises the question of how helpful it is for the State to be so intimately involved in mental health treatment issues. Health Department Quality Assurance in general and its 'credentialing' in particular is no substitute for fostering and ethical therapeutic community. But then, I think therapeutic is probably another word that has been declared off- limits

Link to MSNBC report


'he's got the whole world in his hands'


Anglicans!
Oh Anglicans!


The saga continues despite the interest in the Tudors - if we take the movie The Other Bolyn Girl as an indicator. But The Associated Press reported this week most of the United States' 25 largest church bodies either lost members or experienced no growth in the past year, according to the 2008 yearbook produced by the National Council of Churches. It also notes The Episcopal Church, locked in a conflict over the Bible and homosexuality, suffered the steepest decline, reporting a more than 4 percent drop to slightly fewer than 2.2 million members.

Meanwhile, The Southern Comfort – under the explosive leadership of the Dark Lord Archbishop Peter Akinola of Nigeria, five Episcopal Archbishops (one from South American and four from Africa) have publicized their intentions to boycott the 2008 Lambeth Conference in a letter responding to a group of English bishops who had urged them to attend the once-a-decade gathering. Included in the five is Archbishop Benjamin Nzimbi of Kenya. Is it churlish of me to ask, given the current situation in Kenya if he should not be focused on more immediate dangers than “gayness”?

Never fear, the British newspaper The Telegraph reports the Archbishop of Canterbury is backing secret plans to create a "parallel" Church, for American conservatives, to avert fresh splits over homosexuality.

This is unlikely to find favor with Presiding Bishop Katherine Jefferts Schori, the head of the US Episcopal Church, who has been cracking down on any diocese or parish that seeks to leave. This has included legal actions!

Link to The Telegraph report



Saturday, February 23, 2008

Woody Guthrie at Greystone Asylum

The Soup: Make Me a Supermodel

Pink Freud



Lady Constance's Culture Corner






The Morning News (February 22, 2008) presents a Rosecrans Baldwin interview with Andre von Morisse, who explains his Pink Freud painting is part of a body of paintings called Pink Freud and The Pleasant Horizon. Which he describes ass a playful, funny look at psychology, symbols of sexuality, the suburban utopia, the distraction of trains and tunnels, and the mystery of electricity at night. All set in a fictitious town in northern Europe

Link to the Morning News article