Acronym Required

"Black Tuesday" and South Africa's Secrecy Bill

2011-11-25T20:23:08Z

On October 19, 1977, the apartheid government of South Africa banned The World, the Sunday World, and Pro Veritas, and 19 other people and organizations who stood with the Black Consciousness Movement.

The National Press Club called on people who were opposed to wear black clothes, ribbon or armband, and they refer to October 19th as "Black Wednesday."

Black Tuesday

South African media groups are now calling last Tuesday, November 22, 2011, "Black Tuesday".

The lower house of the South African Parliament controlled by the African National Congress (ANC) approved the Protection of State Information Information Bill in a 229-107 vote. The bill would allow the state to classify documents as secret because of "national interest". Anyone caught possessing such a document would serve 25 years in jail. The bill will be debated and voted at the upper house of parliament, the ANC controlled National Council of Provinces, before it goes to President Zuma to sign. [The Wikipedia page for South Africa's ruling political party the African National Congress (ANC) was temporarily "censored" in protest of the secrecy law, shown here]

When Governments Aim to "Own" The Media

South Africa's National Editor's Forum chairman, Mondli Makhanya, said the press corps were devastated
"watching the bill become law." As he put it:

"We never thought we would come here dressed in black to witness the Constitution of our country being betrayed by those who built it."

The motivations behind the bill are suspect. The wife of the ANC's State Security Minister Siyabonga Cwele has been convicted of running an international drug ring. Two years ago, we wrote on President Zuma's successful bid to get the National Prosecution Authority (NPA) to drop 16 charges against him related to several billion dollars of bribes for arms deals.

Recently, the Sunday Times reported that Zuma's government spokesperson Mac Maharaj sued newspapers reporting that 1.2 million French francs was paid to his wife to facilitate those arms deals. In the two years since ANC's Zuma was elected, allegations of this and that, like massive misuse of official funds have continued.

Hypocrisies of the Powerful

Perhaps there's no reason to ask then, if Zuma will sign the bill? Acronym Required has checked-in on the ANC's continued attempts to censor the vibrant South African media over public health issues over the years. Former President Thabo Mbeki expended hundred of thousands of spoken as well as written words typed into his weekly reports excoriating the media for covering the horrific conditions in hospitals, corruption, the lack of public infrastructure, the broken promises of his administration, and his twisted logic for not dealing with the AIDS crisis.

President Zuma seems to be taking it one step further by backing up rhetoric with more publicly forceful maneuvers. Last year we told parts of journalist Mzilikazi wa Africa's story of being kidnapped by the police as he was investigating ANC corruption in "South Africa'a Media Crackdown."

The officers who kidnapped wa Africa pestered him about why he was investigating ANC officers in the Mpumalanga province. They tried to extract his sources. They trumped up charges accusing him of fraud, forgery and passing forged documents that were later dismissed, and tried to force him to sign an admission of guilt. Under the new law, the documents that wa Africa received about the corruption and murders in Mpumalanga would be illegal for him to possess.

President Zuma has vigorously put down widespread outcry against the secrecy bill. He said that concerns were absurd and proclaimed the ANC to be a vigorous defender of the constitution. He has continually accused journalists of trampling the rights of others, who must "have recourse through legitimate institutions". As Zuma said in weekly address (August, 2010):

"The media has put itself on the pedestal of being the guardian. We therefore have the right to ask, who is guarding the guardian? All institutions, even parliament, has mechanisms in place to keep them in check."

Zuma accused the media, as did Mbeki before him, of not "reflecting the society it claims to protect and represent". Worst of all, he said, deploying the usual ANC strategy, the media defames the ANC party that worked so hard against apartheid. This isn't just Africa's problem, he pointed out, using Russia as an improbable example:

"Let us move beyond the hysteria, let the real debate begin. Our first point is that before looking at what they regard as external threats and perceived external threats, the media should conduct introspection first. During our State visit to Russia a week ago, Russian television was running a promotional jingle saying: 'How dependent is the independent media? Who pays for the news?'"

There's hardly a need to point out again, as we did last year, that using Russia, where investigative journalists and state critics regularly get murdered, to bolster professed ANC benevolence seems cynical and sinister.

Rebukes From Those Who Know

Many see the bill as a harbinger of more serious curtailments of freedom that the country has struggled to overcome in the 17 years since apartheid. Archbishop Desmond Tutu said in an address about the Chinese suppression of Tibetans that the current ANC government was worse than the apartheid government, when "at least you could expect to eat." He said that by now you should expect a South African government to be "sensitive to the sentiments of the constitution", and continued:

"You, President Zuma and your government, you do not represent me. You and your government represent your own interests. I am warning you, as I warned the [pro-apartheid] nationalists, one day we will start praying for the defeat of the ANC government."

A strong independent media (if there is such a thing), and investigative journalism are keystones to democracy, in South Africa, America, and everywhere else. A strong democracy is critical to science, to commerce, to health, to welfare, and to all of civil society. South Africa's Bill of Rights provides:

"freedom of expression, which includes freedom of the press and other media; freedom to receive or impart information or ideas; freedom of artistic creativity; and academic freedom and freedom of scientific research".

It also gives anyone the right to:

"Any information held by the state; and any information that is held by another person and that is required for the exercise or protection of any rights."

Constitutional scholars lay out excellent arguments why this bill is unconstitutional², and the opposition party has said that if Zuma signs the bill, they would push for constitutional review in the Constitutional Court. Zuma's highly political evasion of charges against him, as well as other irregularities have shown that the judiciary and other institutions are increasing in the grip of the ANC. Snuffing out investigative journalism will accelerate that trend.

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¹ I should note that the move is not endorsed by smaller press who think that "Black Wednesday" should not be conflated with "press freedom" by major newspapers dependent on advertisers in their battle with the government over advertising spend. (Here's an article on that.)

² The website Constitutionally Speaking has an excellent discussion of this that I found unfortunately, after this was post was written. Go there for a thorough presentation of that scholar's reasoning and for the discussion that follows.

The 1987 movie Cry Freedom offers a look at a South African reporter muzzled covering the anti-apartheid movement and suspicious murder of activist-hero Steve Biko. I liked it when I watched it a couple of years ago, although I have to warn you that the mainstream media reviews called the movie a watered down version of the real story, with Robert Ebert saying it was: "sort of a liberal yuppie version of that Disney movie where the brave East German family builds a hot-air balloon and floats to freedom." I'm sure it would be fascinating to compare their harsh criticism of the movie to the MSM watered down coverage of years of South Africa's apartheid, but I'll leave that for another time.

Thanksgiving - Politicians, Recipes & Brussel Sprouts

2011-11-24T17:41:02Z

We're big fans of Thanksgiving and usually try to write a post. This year we wanted to stick with our preferred genre and write about something undercovered or underloved in other media. In 2005 we wrote about that the myth that tryptophan causes post Thanksgiving meal sleepiness, a myth that is now pretty much a Thanksgiving Day media meme.. In 2007 we wrote about the origins of the domesticated turkey in "Thanksgiving - All Things Ottoman.

Happy Thanksgiving

We didn't want to write a Thanksgiving holiday-history story because whatever is not covered in 1st and 2nd grade is almost always politically freighted. Wanting to stay away from politics, we decided to write about food again, ironically inspired by politicians who are collectively deadlocked on multitudes of really important issues, but who nevertheless manage to muster up recipes to share with reporters. What in this world isn't political, I guess?

[Image is from Wikipedia Commons, and is licensed under Creative Commons 3.0 (CC by-SA 3.0)

We can't imagine where recipe sharing inclinations came from. Is this an old, lingering tradition from a time when everyone - churches, ladies groups, and neighborhood potluck groups - put out recipe books? I can't imagine announcing that for tonight's dessert we'll be enjoying Rick Santorum's "Apple Tarte Tatin"!!

But it seems popular. Last week, for instance, Representative Nancy Pelosi shared her chocolate mousse recipe -- a Thanksgiving Day tradition in her home. It has 1 pound of dark chocolate, 8 ounces of butter, 8 eggs, 4 tablespoons of sugar and 1/2 a cup of heavy cream. It's probably delicious -- The Hill has to whole recipe -- but you have to admit it's not exactly a heart-happy dessert.

Michelle Obama might disapprove, and the GOP would no doubt accuse her of excessive caloric spending. To model such thriftiness, I'm sure, Representative John Boehner (R-Ohio) told The Hill he was looking forward to his mother's turkey brine. And, he wouldn't give the publication the recipe.

What To Write

I don't know about turkey brine, so I looked on the Food Network, which has this. It's peppercorns, allspice berries, salt, rosemary, sage, and other sundry spices and herbs, plus vinegar. Don't knock turkey brine, A whopping 3,603 people endorsed it. Perhaps Mrs. Boehner's secret recipe is better, but I'd bet my party on 3,603 votes if I were going that way. Apparently one soaks their turkey in the brine before cooking. The whole process takes about 10 hours, so you have to be comfortable cooking on Congress-Time. Hopefully John's mom adds extra "sage" that is magically, surrealistically absorbed by anyone who eats/drinks it.

I didn't really realize the extent of this whole politicians' recipes thing until I came across internet caches of recipes from US governors, senators and congressman. Who knew? The internet is a wonderful, learning environment. Speaking of sage and wisdom, North Carolina Congressman Howard Coble had a truly brain related recipe called, actually, "Brains N'Eggs", which he described as a can of "brains in gravy", "preferably" Rose Brand, with bacon grease and eggs. His mother served it as a "not at all unusual" breakfast, that alas it can't be found in Washington D.C., he reported.

What To Write

Obviously you can please many people with chocolate mousse, and probably gross others out with pork brains, depends on what you're going for. Politicians also provide recipes of their heritage, like Olympia Snowe's "Baklava". Others donate recipe's reminiscent of their state like Senator John Kerry's "Massachusetts Cranberry Bread". Some offer what I think of as anti-cooking, like "microwave chicken": chicken, microwave, a bottle of (your favorite) salad dressing, and water.

Some long-serving productive politicians like former Senator Edward Kennedy never dished out recipes to the media. A Rockefeller gave out four. Others who were only very briefly in office must have entered with a recipe in hand, like Sarah Palin and her Alaska Crab Wrap Sandwich, which, if I weren't allergic to crab, I might like her best for.

Ignoring all good evidence, Californians ousted Governor Gray Davis in favor of Governor Schwarzenegger, who was obviously too busy with other household chores to write recipes for reporters. Davis got served up lemons and gave the press his Lemon Chicken recipe.

Happy Thanksgiving

So back to our unchosen subject. We're weary of pumpkin pie, we've done turkey, cranberries are all bogs and antioxidants, what's left? We could talk about the turkey dinner where they actually go and feed the turkeys? Hmmm...Brussels sprouts? The thing about Brussels sprouts is nobody writes about them because they're only slightly more popular, I wager, than canned pork brains scrambled with eggs and grease.

Nobody knows where Brussels sprouts originated, unlike the excellently documented domesticated turkey. Most people agree they don't come from Belgium but some say their actually a centuries old source of "Flemish national pride". It seems like when it comes to Brussel Sprout's, everyone's making something up. A few say they originated in Rome where they were thought to make people smarter. Maybe they were popularized in WWI, maybe they came to Louisiana when the French immigrated, maybe they're the most disliked British vegetable...on and on.

But they are considered healthy for many reasons, like because they contain sulfoaphane and indole-3-carbinol and a lot of research finds they have anti-cancer properties.. They look pretty cool on the vine. And to eat? Curried? Roasted?

Best wishes to all and Happy Thanksgiving to those readers who have a holiday.

Earthquake Prediction in Oklahoma and L'Aquila

2011-11-24T04:36:43Z

If you look at the USGS earthquake map of the US, it all seems fairly predictable. The West Coast has earthquakes, - mostly in California. The rest of the country - not so much. Until recently. The 5.8 East Coast earthquake last August left people unharmed but "rattled". Last month, Oklahoma of all places, had a slew of earthquakes, including one that was 5.6.

Sparks, Oklahoma - Redefining Red State

That particular area of Oklahoma, around where the pipeline is slated to go through, has had over 1000 earthquakes in the past year, but historically had only 50 earthquakes a year. The biggest of the latest series of Oklahoma earthquakes measured 5.6 on the Richter scale. It was pretty scary, as the San Francisco Chronicle, reported: "'WHAM!', said Joe Reneau, 75, gesturing with swipes of his arms. 'I thought in my mind the house would stand, but then again, maybe not.'"

There's speculation that recent fracking activity is causing the spike in earthquakes. The way the media has it, fracking might precipitate earthquakes -- or it might not. IEEE Spectrum weighs in on the issue noting that yes, human activities like fracking and dam-building definitely cause seismic activity along established faultlines. Indeed, the USGS put out a report earlier this year linking fracking in Oklahoma to an increase in smaller temblors. Other experts say that fracking could only cause small earthquakes. A Stanford geologist characterized it: "as if you knocked a gallon of milk off the table".

The spate of activity had Oklahoma residents worried. If you've ever been through a series of earthquakes you understand the skittishness. Reeling from the earthquake and aftershocks, their unease became ripe breeding ground for rumors. One of the rumors said officials knew of another impending earthquake even larger than the 5.6 earthquake, but weren't telling residents. In response, officials held a meeting to quell both the rumors and the fears a couple of weeks ago.

Apparently 400 to 500 people attended the two hour meeting organized by the American Red Cross, and officials presented from the Oklahoma Geological Survey, state Emergency Management Department, Lincoln County emergency management office, state Insurance Department, Salvation Army and other groups. They moved the meeting to a bigger facility to accommodate the huge turnout. They wanted to dispel the rumors. As Newsok.com reported: "There should be no bigger quake coming, said G. Randy Keller, director of the OGS" Officials assured people they most likely wouldn't feel the aftershocks, and that governments were prepared for whatever happened. All things you would expect them to say.

Nothing's Too Different in Oklahoma

Officials thought the Oklahoma audience was perhaps frustrated by the experts inability to explain the spate of the earthquakes, though they were reassured. And that nervousness in Oklahoma is just the same as nervousness anywhere -- except Japan, I guess where they've had hundreds of aftershocks in the 5-7 range since Fukushima, including a 5.9 earthquake today, and they all just seem ho-hum about it.

In San Diego, California, the Juanita Faultline has recently caused a series of small earthquakes, leading SignsOnSanDiego to interview a local geologist about the likelihood of another earthquake. The article, "Should We Worry About Shaking on San Jacinto Fault?" illustrates the difficulty geologists have predicting the next earthquake. Foreshocks and tiny shocks called microseismicity sometimes precede earthquakes, but often they don't. The geologist spent most of the interview, citing the history of earthquakes along known faultlines to answer questions about the "next earthquake".

In Berkeley, California last month, a series of earthquakes along the Hayward fault led to similar nervousness in the Bay Area about the possibility of a larger temblor. Speculation abounded, and again geologists worked to get the facts out based on what they know about "hazard probabilities" along Califonia faults. Small earthquakes don't relieve stress they said. Mathematically, they noted, there's a very small chance that on any given day after a series of small earthquakes.

This all seems slightly analogous to a doctor predicting your likelihood of getting a particular disease by looking at your family's medical history. They can tell you that you too, are at risk of a heart attack. The insurance company might be more precise. And along some faultlines, geologists know the history and other details enough to say in the next 30 years, the probability of and earthquake larger then 6.5, say, is 65%.

And in L'Aquila?

Now a good part of the US knows what a temblor feels like, and many people have been told by experts to not worry. We can then imagine how the situation erupted after scientists reassured citizens of L'Aquila in March, 2009, that an earthquake was unlikely. In addition to the earthquakes, Italian citizens were subjected to the prognostications of a fellow citizen with no scientific knowledge who busied himself making dire predictions prior to the earthquake (similar to the earthquake soothsayer we recently blogged about, featured on FOX News.)

The next week, a 6.3 earthquake killed 309 people. A group calling themselves "309 martyrs" sued seven scientists. They accused the scientists of not providing enough evidence about both the hazardous buildings and risks of an earthquake. The town is also suing for about $68m in damages.

In Oklahoma and L'Aquila, multiple officials met with hundreds of people and the press. The press later noted cheerfully that scientists "calmed" peoples fears and "reassured" them. Through all that communication, it's clear that there might be a possibility for misinterpretation?

The trial has been delayed multiple times and according to people who know the Italian court system, will most likely drag on for years. The episode chills earthquake scientists, who constantly grapple with how to relay risks in ways that people understand without freaking them out. It's a science in progress.

NIMBY-ing the Keystone XL Pipeline

2011-11-11T23:20:03Z

"God help us if this becomes like baby seals", said a University of Alberta energy economist after research about the extent of pollution downstream from the Athabasca Tar Sands became public a couple of years ago. Protests decrying the Keystone XL pipeline with its associated tar sands may not have reached "baby seals" fervor, but the plan to pump crude oil from Alberta to Texas certainly hasn't raised the popularity of Alberta and its oil extraction industry.

Baby-Sealing the Pipeline, If Not The Tar Sands

The extended pipeline would route through Nebraska's ecologically sensitive Sandhills and the Ogallala Aquifer that supplies millions of people drinking and agriculture water. Nebraskans are especially apoplectic about the prospect of the pipeline with all its hazards running through their lands. They worry about how 91 predicted leaks in the next 50 years will endanger drinking water.

Meanwhile, the company is urging the US to approve laxer standards to allow them to pump more oil at higher pressure through a thinner steel pipeline. TransCanada has promised the safety of the pipeline running over the aquifer and backed that up with bonds.

Of course people have challenged TransCanada's promises, but in corroboration, the US State Department reviews of the project had also been reassuring. That is, until this week, when the agency announced an independent investigation of the pipeline following revelations that the contractor hired by State to do environmental studies and public relations listed TransCanada as a client.

The Environmental Protection Agency (EPA), for its part, issued a scathing review of the pipeline project, criticizing projected greenhouse gas emissions, the history of Keystone pipeline spills, probable wetlands destruction, migratory bird disruption, and the impacts the pipeline could have on poor and indigenous populations.

Obama: Not In My Backyard (At Least Not Until After The Election)

Striking against the greenhouse gas emissions from the tar sands and the pipeline, the continued investment in oil energy technologies, and the related environmental affronts, protestors had noisily decamped to Washington DC over the last few months, letting their opinions be known as they marched around the White House and the EPA.

The total of all this -- the thousand turning up to hold hands in a giant circle round President Obama's home, the uncovering of conflicting interests, and the affected state governments discontents built to a grand crescendo until finally the White House announced it needed more time to study the situation.

The administration effectively put the decision off until after the election. (OK, I know, I Obama built my reputation on community organization, but enough for now...) The White House protestors went home to declare success.

Lobbying So Hard It's "Not Lobbying"

It's not for lack of lobbying that the pipeline was postponed. TransCanada and friends did just about all they could do. They spent millions, wrote editorials in places like the Wall Street Journal and USA Today, and got good support from entities like the American Petroleum Institute, not to mention economists, journalists and citizens on all sides of the political spectrum who impressed talking points like jobs, energy, international cooperation, and opportunity.

The Premier of Alberta, Alison Redford, so new to the job that an internet search results shows her predecessor as Premier, will visit Washington D.C. next week. "Not to lobby", she says, rather she'll explain the economic situation of her oil dependent province and try to improve Alberta's public image. The previous Premier was a big lobbyist for both the tar sands and the pipeline, as depicted in "Ed Stelmach's Clumsy American Romance". British Columbia's The Tyee scoffed at the duplicity of the full page "get out the facts" ad former Premier Stelmach posted in the Washington Post, and winced over the $55,800 of tax payers' dollars he spent on it after the Post rejected his editorial. Between this and visuals of the province as a giant tar sand pit, the new Premier is wasting no time trying to remake Alberta's image in order to sell some oil.

Who Will Love The Pipeline In Their Backyard?

In announcing the postponement, the State Department said it wanted to look at "alternate routes" for the pipeline. While protestors had been promising to stop the pipeline, the Governor of Nebraska was also busy taking his state's cause to Washington. He's not opposed to the pipeline, he said, explaining why he was pushing to get the pipeline rerouted, just didn't want it in that particular part of his state.

This delay that the Obama Administration just served to TransCanada is exactly what corporations do to everyone else when they're trying to keep business the same. One delay at a time, it is actually an end game, and the oil companies play it well. And it turns out they're not happy when someone else is doing the delaying. TransCanada has not been responsive to requests for it to voluntarily change its route. A company spokesperson had warned The Guardian: "You can't just erase a line on a map and draw one somewhere else", and said the move would put the whole project in doubt.

That's doubtful, given how much oil and money is on the table. As Nebraska and grassroots efforts claim a coup, TransCanada will accelerate its lobbying, of course. And where will the pipeline end up? If they keep the current siting, it runs not only through the Ogallala aquifer, the Sandhills and a Nebraska seismic zone, it also crosses through Oklahoma's seismic zone with its recent 5.6 earthquake (and 36 aftershocks in the past week). Would that be good? But what state wants the pipeline in their backyard?

Whatever the new plan, however positive the delay, I'm not sure the protestors can necessarily claim victory quite yet.

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Acronym Required wrote about the Alberta Tar Sands in Gas Pipeline: Open Season Coming to Alaska; Higher Pollution From Alberta Tar Sands, and others.

FDA Goes One Nudge Over "The Line" on Tobacco

2011-11-10T20:39:37Z

A US Court blocked the FDA from requiring cigarette warnings on boxes this week, calling the graphics "emotion-provoking images...". U.S. District Judge Richard Leon decided in a Washington court yesterday that tobacco companies shouldn't have to display images of diseased lungs or a cadaver bearing chest staples on an autopsy table, because this would "unconstitutionally compel speech." Nor should companies have to print 1-800-QUIT on cigarette boxes.

I guess what he's saying is that cigarette companies have the right to package fantasies up in the tobacco they manufacture, fantasies of how cool smokers are, that blithely omit the disease and death their product metes out. The FDA, on the other hand, has no right to present the more accurate side of the story.

You know that smoking causes cancer, heart disease, vascular problems. Did you know that smokers have 7 times the risk of abdominal aortic aneurism (AAA) than non-smokers? You probably know about second-hand smoke. Did you know about third hand smoke which stays in home and hotel walls and ceiling tiles for 30 or 40 years, affecting the health of not only present but future occupants?

The judge says the images on cigarette boxes crossed the line between "factual information" and "government advocacy". The line is "frustratingly blurry", he says, but he sees it.

Malaria Vaccine Data - Release then Patch?

2011-10-29T07:12:34Z

Does International Public Health News Compel Us to Cheer Enthusiastically?

Everyone wants drugs to cure diseases. Everyone wants vaccines to prevent them. And in a world of urgent international public health problems, what is more publicly urgent then developing solutions for AIDS or malaria? Positive news on this front is always welcome, and in line with that, you don't win popularity points by sticking pins in up-beat public health reports, results, or clinical trial data. Popular science journalists generally talk about cool, politically neutral science; or slick technology; or brilliant research successfully advanced to save lives; they write about winning clinical trials that will end scourges, any scourge - cancer, AIDS, Hepatitis, obesity... Good news!

Cheerful news, like recent headlines highlighting research showing a vaccine for malaria that may be 55.1% effective. NPR headlines enthused "Vaccine Slashes Infection Risk By Half", whereas a more cautions USA Today said: "Malaria Vaccine May Have Potential to Save Millions".

The RTS,S/AS01 vaccine is a decades long effort, now a collaboration between The Gates Foundation funded PATH Malaria Vaccine Inititive (MVI) and GlaxoSmithKline (GSK). The partners recently published interim results in the New England Journal of Medicine (NEJM)² and presented their results to the media. By all accounts, the Phase III trials delivered very good news.

The Mosquito Drawing by M. R. Villarreal can be found at Wikipedia ¹

But What Does "May" Mean, in "May Save Millions"?

No one would say that Bill and Melinda Gates haven't changed the face of international public health. Mr. Gates leads a relentless campaign pushing the power of vaccines; he berates governments that don't vaccinate enough people; and he effectively leverages the media to deliver his messages. Last year the Gates Foundation held a fund-raiser hoping to collect $3.7 billion from governments and instead received $4.3 billion. As Global Alliance for Vaccination & Immunization's (GAVI) chief executive put it, "Bill was a little like a poker player who put a lot of chips on the table and scared everyone else off." Perhaps Gates is more a bridge guy, but point taken.

Given this, who would write-up the newest Gates Foundation news as, a vaccine shown to be at best 44.9% ineffective in a half-done clinical trial? With the intense drive for upbeat news, I credit USA Today for their cautious "may save millions". But if you look more closely, for instance read the editorial accompanying the NEJM report³; listen to scientists around the web and in journals like The Lancet ⁴; or heed the malaria researchers interviewed by "Nature News⁵, the caveats of this recent malaria study grab your attention:

First, there's the announcement itself. The data released is interim data; the full results of the malaria trial will be released in three years. Interim data releases are not unprecedented but past experiences, for instance with an AIDS vaccine, caution us against overly enthusiastic receptions for incomplete trials.
The interim results were reported for children aged 5-17 months, but the target age group is infants aged 6-12 weeks. In other words, these results don't address the main question the trial seeks to answer.
NEJM reported that at 12 months, the vaccine reduced episodes of malaria by 55.1%. However a US military scientist working with Sanaria, a competing vaccine maker, told Nature News that RTS,S actually offered only 35-36% protection after 12 months. It appears that the efficacy of the vaccine might wane over time.
Although the reports noted reduced mortality, another scientist emphasized to Nature News that the data didn't support that announcement. Scientists hypothesize that the vaccine may just delay infection.
Although the vaccine reportedly cut severe disease in older kids by 47%, combining that data with the available data of the younger kids gave only a 34.8% decrease. This suggests the data for the target group of younger kids might turn out lower than reported in these interim results.
In addition, incidents like convulsions and meningitis might be more frequent in the vaccinated group.

These might not be showstoppers. For instance researchers hope that booster shots will improve efficacy. But what if in the end it turns out not to be a vaccine but just another shot? Scientists and public health workers concern themselves with such non-trivial caveats. What's behind the apparently waning efficacy? How is the adjuvant effecting immunity? Science is exacting even when media reports are not. People also have underlying concerns about what's driving policy, science or the press releases?

Is Marginal Progress, "Success"?

Two of the people interviewed by Nature News are affiliated with Sanaria, a company that is also developing a malaria vaccine. Sanaria just released their own news of a Phase I malaria vaccine study testing the safety of a live attenuated virus. Nature interviewed the first author on the Sanaria study published by Science, as well as the CEO and last author on the Science study, who was complementary of the RTS,S effort, if critical on some points.⁶

The history of the Sanaria vaccine is also an interesting, expensive, and laborious endeavor. The underlying idea seems promising, but for starters, technicians dissect out the salivary glands of mosquitoes to develop the vaccine.⁷

In the first trial, Sanaria injected 44 subjects. 42 people got malaria and 2 didn't, a 4.5% "success" rate. Although those subjects might have been better protected from malaria lounging in a malaria endemic region in mosquito-infested huts, Sanaria quickly pointed out that it wasn't the stunning failure it looked like. Rather, it was a trial that "yielded positive results" -- as their press release put it (without including relevant numbers). The company is buoyed by the success of their trial and primed for the next controversial⁷ phase. At the moment, every possible vaccine holds promise, since we have none.

Their position as competitors, doesn't invalidate their commentary on RTS,S (complementary as well as critical), since Sanaria executives voiced reservations shared by many others. An editorial in last week's "The Lancet indicated that the release of unorthodox partial results seemed to be more politically than scientifically driven. Diplomatically, The Lancet editors wrote: "although the latest findings are encouraging, we look forward to the full results of the RTS,S/AS01 trial in 3 years time."⁵

When There is No Treatment, What Does A More Effective "Treatment" Look Like?

Will the upcoming younger cohort data meet World Health Organization (WHO) goals of 'Protective efficacy of more than 50% against severe disease and death lasting longer than one year'? ⁵ This is an important question. Vaccine experts usually aim for 80% or more efficacy, and representatives for PATH say they hope to get there eventually. Does that make this vaccine a beta version?

Is all the media hoopla deserved for a beta version vaccine? A physician working in Africa distributing bed-nets warned against statements that might mislead people "to overestimate the impact of any single new intervention", in a comment at NEJM. Acknowledging this commenter also has vested interests doesn't detract from his message. 75% of the MVI/GSK study participants used bed-nets. But would people in real-life discontinue the more cumbersome bed-net efforts with a vaccine on the horizon? Will bed-nets still be funded with a 50% effective vaccine? A 30% effective vaccine? If you're a mom and your kid gets a vaccine that is 50% effective, what precautions do you then take to prevent infection? Does a 50-50 vaccine make your life better?

The tremendous investment in the vaccine routes, both in terms of money and expectations, shouldn't slow other prevention and treatment efforts. But realistically, we don't have unlimited resources. It would be naive to think that the prolonged difficulty of vaccine development, the immense investment, and lack of a viable alternative don't influence funding and policy decisions.

Some of the problems scientists identified with this vaccine trial have persisted for years. In this 2006 book chapter recently released online, an economist analyzes RTS,S vaccine data of previous trials (PDF) (HT Nature News⁵). He reports on waning efficacy; and questions how the public health community decides which vaccine candidates merit further investment. 5 years later, as the latest trial barely noses over the 50% bar, we grapple with the same issues and questions he raised back then, but billions more dollars have been invested.

Which leads us to wonder whether mid-trial fanfare primes us react to whatever future malaria vaccine news comes along with knee-jerk positive determinism? What if the younger data shows only (say, hypothetically) 30% efficacy? Would we ever abandon the effort? As more and more money gets invested, do decision makers begin to act less rationally?

Media reports may boost stocks, may raise money and may discourage competitors, but in the end, the science behind the vaccine, the science that's supposed to underpin public health decisions, is fussy and complicated -- caveats matter. After all, you're asking people and governments to donate tens of billions of dollars, and you're promising 7 billion people that your vaccine will keep millions safe.

Tough Economy for an IPO?

Can we push for an end to malaria as if we were trying to put a computer on every desktop? Does this big money, big marketing, big media approach to public health that some find so jarring actually work? I'm not saying it doesn't. Perhaps it will become a more accepted way of developing medicines and vaccines. Maybe public health needs exactly this kind of paradigm shift.

But even if a 40% or 50% effective vaccine is acceptable public health perspective, once this vaccine is developed, governments will still need to consider costs. In this economy, some ask, how much will governments shell out for a vaccine with a 50% efficacy rate? Can you and should we market vaccine with lots of pre-release fanfare to push governments towards buying the vaccine?

Asked about cost per vaccine, GSK wouldn't answer directly, but stressed how the company will reinvest all the proceeds to improve the vaccine. Shares of GSK rose slightly on the RTS,S vaccine news, and shares of biotech company Agenus which makes the RTS,S vaccine adjuvant rose from $.48 prior to the announcement, to $2.80 (which got Agenus re-listed by the SEC). However when questioned about the unconventional data release, PATH's MVI director didn't mention politics, billions of invested dollars, stakeholder expectations, or the saved Massachusetts biotech companies. He said: "we felt it was our scientific and ethical duty to make the results public when they become available."⁵

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¹ The mosquito drawing is by Mariana Ruiz Villarreal. It is the anatomy of a Culex pipiens, a vector for malaria. This image was selected as Wikipedia's Picture of The Day for 10 September 2010.

² The RTS,S Clinical Trials Partnership; First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African Children, October 18, 2011 10.1056/NEJMoa1102287

³White, N. F.R.S.; A Vaccine for Malaria October 18, 2011 10.1056/NEJMe1111777

⁴Editorial: The Lancet, Volume 378, Issue 9802, Page 1528, 29 October 2011, doi:10.1016/S0140-6736(11)61659-0

⁵Butler, D.; Malaria Vaccine Results Face Scrutiny: Published online 26 October 2011, Nature 478, 439-440 2011, doi:10.1038/478439a

⁶Epstein et al: "Live Attenuated Malaria Vaccine Designed to Protect Through Hepatic CD8+ T Cell Immunity": September 8 2011 Science 28 October 2011: Vol. 334 no. 6055 pp. 475-480 DOI: 10.1126/science.1211548

⁷ Kappe1, S., and Mikolajczak1, S.; "Another Shot at a Malaria Vaccine". Science 28 October 2011: Vol. 334 no. 6055 pp. 460-461 DOI: 10.1126/science.1213934

⁸ Farlow, Andrew.; "A Review of Malaria Vaccine Candidate RTS,S/AS02A", Chapter Three of The Science, Economics, and Politics of Malaria Vaccine Policy, a report written in 2005 and 2006 and published 14 April 2006 and January 2010. Department of Economics, and Oriel College, University of Oxford.

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We previously wrote about Phase II Clinical Trials of the RTS,S vaccine here. We wrote about US funding for malaria here and here; vaccine strategy here; malaria prevention here and here. We've also written frequently on international public health, including the development of a AIDS vaccine, here and here.

Vaccine Preventable Deaths

2011-10-27T18:01:47Z

The Map

Acronym Required previously wrote about parents who self-vaccinate in lieu of getting vaccinations, a sort of barbaric hazing for this era's unlucky children. And while some people in the West shun vaccines because they think they're dangerous, people in Africa shun them because they suspect shots are a Western plot to kill them. The US shockingly fanned the flames of the vaccine avoidance trend when it faked a vaccine campaign in Pakistan in order to to get access to Osama bin Laden. Meanwhile, tragically, people continue to die because there aren't enough vaccines to protect them.

When people refuse vaccinations, we lose herd immunity; microbes have get a chance to mutate; and of course people get sick and die. The trend has contributed to large outbreaks of whooping cough, mumps, chicken pox, and measles world-wide, as well as polio, typhoid fever, meningitis and hepatitis A. Now there's a great map Vaccine-Preventable Outbreaks, put out by the Council on Foreign Affairs, so you can see the impact of this all.

(The vaccination map ranks as one of my favorite maps, as does Newspaper Map.¹)

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¹ Granted the UI's sometimes not entirely there

We previously discussed vaccinations in Maher's Mainstream Media Anti-Vaccination Campaign; The Wild Wooly Internet; Polio Vaccines, The End of a Scourge?; Vaccine Development For Developing Countries and others.

The Four Dog Defense

2011-10-21T01:18:29Z

It's a well known strategy they say. But how well known is it if Wikipedia doesn't even have an entry? It goes like this. Say you're the owner of a dog who's just bitten someone. If you're a chuff, churl or cretin -- or you may say, your average defensive citizen -- you deny it via the so called "Four Dog Defense". Here's how one lawyer explained it to the St. Petersburg Times in 1997 ¹:

First of all, I don't have a dog.
And if I had a dog, it doesn't bite.
And if I had a dog and it did bite, then it didn't bite you.
And if I had a dog and it did bite, and it bit you, then you provoked the dog."

The St. Petersburg Times article wasn't actually about a dog, but about the landmark tobacco cases. And the tobacco industry played it something like this, as you may know:

Smoking definitely doesn't cause cancer, there's no evidence it causes cancer.
There's no consensus on the evidence; smoking may cause cancer but second hand smoke definitely doesn't.
Mice may get cancer but mice are not humans, cigarettes are not additive.
People choose to smoke -- and who are we to impose on people's constitutional rights? - etc.

Four Dogs Launched a Thousand Ways

"Four Dogs Defense" might to you sound more like a Kung Fu movie, but once introduced, you'll recognize it more often then you'd like. Some people describe the Four Dog Defense as a trial lawyer's adage, but the tobacco industry used it for decades to successfully deflect charges that cigarettes cause cancer. Despite volumes of documents proving of their deception in the form of the tobacco papers, the same companies today mount the same defense, albeit with diminishing success.

You might also be familiar with this strategy not only because of tobacco, but asbestos, lead, bisphenol A or any number of chemicals or "benign" products (sugar, alcohol, etc.) currently on the market.

The Natural Resources Defense Council (NRDC) used the "Four Dog Defense" to frame their recent investigation: "The Delay Game: How the Chemical Industry Ducks Regulation of the Most Toxic Substances". The report compellingly describes tactics the industries used to stall regulation. It focuses on three chemicals, trichloroethylene (TCE), formaldehyde, and styrene, which have been on the market for decades despite proof they cause morbidity and mortality.

NRDC describes how vested industries spend millions of dollars demanding the EPA conduct new science reviews, how the industries demand "independent" assessments and hire "independent" scientists to do favorable studies; and how they dispatch lobbyists to "influence" politicians and the EPA. Thus, toxic chemicals like formaldehyde, lead, atrazine, TCE stay on the market thanks to a collection of vested interests preventing the EPA from acting on well established science.

Of course for every move that industry makes to stall the EPA - demanding studies, suing, producing biased studies, and publicizing contrarian views aimed to confuse and stall regulation - the EPA and tax payers pay mightily to defend science. Circularly and ironically, taxpayers who already paid for the research to make their living environment healthy, then pay for defense when industry and lobbyists to attack that very science. The taxpayer pay for these attacks on science and the EPA (that the Tea Party and GOP so dearly want to abolish), both with our money and our health.

The TCE Story

This four dog defense strategy has kept trichloroethylene (TCE) on the market for decades. TCE is a solvent used for metal degreasing, commonly for cleaning airplane parts. It's also used in household items such as paint removers, glues, correction fluid, electronic equipment cleaners, rug cleaners, and adhesives. TCE is linked with leukemia, cancers, developmental defects, and problems with the male reproductive system, the immune system, liver, kidney and nervous systems.

TCE is found in hundreds of Super Fund sites, places like like Lawrence Livermore National Laboratory, and military bases. Many of these sites are not giant dumps somep other place in America but right in our communities. When a new housing development gets built in the vicinity of some high stature physics lab in an expensive suburb, for instance, the EPA describes how TCE can contaminate air that gets into homes and water. TCE leaches from the soil into water supplies, evaporates into the air, and poisons humans by any means of ingestion.

And what happens when homeowner's get sick? The four dog defense continues. The effects of TCE on human health were detailed in Jonathan Harr's 1996 non-fiction book A Civil Action.

A Civil Action

As Harr recounts, a large number of people began to die in Woburn, Massachusetts, in what public health officials identified as a leukemia cluster. Three companies, including W.R. Grace and a tannery owned by Beatrice Foods, dumped TCE onto land and it leached into the water supply. During discovery before the trial, companies' defense lawyers deposed the plaintiffs, grilling them on the details of their daily lives. As Harr describes in his book, they produced exhaustive inventories of products used in each plaintiff's house, what they ate, drank, cleaned with...

"five hundred brand-name household products -- cleaning agents and detergents, rug shampoos, cosmetics, nail-polish removers, insect repellents, paints, lawn fertilizers, cold remedies, cough syrups, herbal teas, coffee, even peanut butter."

The goal-oriented lawyers are relentless:

"Do you eat peanut butter?" one of Facher's young associates asked Anne Anderson.
"No," said Anne.
"Did you ever eat peanut butter?"
"I guess everybody living has probably tried it," replied Anne.
"Do your kids eat peanut butter?"
"Well, the same jar has been sitting there an awfully long time, so I guess we don't eat much"
"What kind is it, plain or chunky?"
"Plain, smooth," said Anne."
"You made your children peanut butter sandwiches?"
"They ate some, when they were small"
"When you say, 'some,' could you quantify that?" One or two sandwiches a week for the children?"

Peanut butter can contain aflatoxin, a carcinogen.

As Harr writes, Jan Schlichtmann, lawyer for the plaintiffs, knows that the defendant's lawyers are trying to dilute the evidence in order to develop uncertainty about the origin of the cancers. When at 5:00PM, he requests that the defense lawyers to end their deposition, they ignore him and continue their questioning.

"Do you eat bacon?...(Bacon contains dimethylnitrosamine, a carcinogen.) How often? How many slices? Do you fry it or bake it? Do you have Teflon pans (Teflon is made of a resin containing acrylonitrile, a carcinogen.) How often do you use them? Do you chew sugarless gum? (Saccharin, a carcinogen in mice.) How often? Do you pump your own gas?..."

It continues with each plaintiff, over the next three weeks -- do you bathe, shower, wear deodorant, own a cats, have plastic shower curtains, drink beer, smoke? Each activity or product contains certain carcinogens, passes on certain risks...

While the pre-trial "discovery" of "A Civil Action" drags on, people continue drinking TCE polluted water and breath TCE polluted air.

"Roland Gamache was dying of leukemia by the time his second deposition began. Neither he nor his wife could admit this to each other. But the lawyers all knew. In early October, Gamache did not have strength enough to get out of bed...."

And while these leukemia victims answer inquiries by lawyers working on behalf of TCE dumpers, somewhere else in the world, in another room, at another polished bird's eye maple conference table, lawyers for a different chemical or product question different plaintiffs about their possible exposure to solvents -- have you ever glued anything (glues contain can TCE)? Walked by the old Naval base in the next block?

In the end the Woburn case didn't repair the TCE victims, nor did it motivate universal action on TCE. But law schools use the book as a case study to instruct future lawyers prosecuting (as well as defending) the makers of toxic chemicals. As you can imagine then, with this sort of defense fully proven to work, people injured from environmental toxins have a difficult time getting remedy from the courts.

The Doggy-Dog World of Politicians

Given the tenacity and success of the four dog defense, it was against great odds that after decades years of stalling, not only by industry and lawyers, but by politicians, White House administrations, and the Department of Defense and Department of Energy, the EPA released its final IRIS assessment of TCE last week.

The EPA's last assessment of TCE came in 1987, almost a quarter of a century ago. In 2001 the EPA calculated that based on research to that date, TCE was 5-65 times as toxic as previously thought, especially to children. It can be found in 761 Superfund sites. Since the Department of Defense and Department of Energy would be responsible for cleaning up many of the sites, the agencies fought vigorously to prevent EPA action. OMB reports that DOD action against the rule cost taxpayers a million dollars.

The EPA's path to updating the Toxic Substance Control Act (TSCA) was tortuous, likewise for the the EPA's completion of the IRIS assessments for the backlog of chemicals with suspected or proven health affects. The EPA is struggling to overcome a failed strategy of depending on industry to produce safety profiles of chemicals, which hasn't adequately safeguarded our health. (Acronym Required started reporting this here in 2005, decades into the battle ²). But progress is hindered - as you can see, industry mounts gargantuan hurdles against the EPA.

Even once people are somewhat convinced that a chemical such as bisphenol A is toxic, lobbyists for industry deploy the four dog defense. This is long after the media loses interest, long after the public tires of hearing about it, long after the environmental groups start in on their next agenda, and long after most politicians drop the issue (now that they're not getting calls from their constituents).

As we speak, politicians that we (you) voted for, "working in our interest" actively fight against the EPA's IRIS assessments and against EPA moves to strengthen TSCA. Their most successful claim against regulating chemicals that cause the loss of life and impede people's ability to work? That the "stringent" rules will "cost jobs". Politicians are lawyers after all, so they know the four dog defense perhaps better than we or Wikipedia.

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¹ "Can This Man Tame Tobacco?" David Barstow St. Petersburg Times April 7, 1997

² Acronym Required wrote about TSCA in of posts a couple of posts about Teflon in 2005; in a few posts on Europe's REACH, for instance The EU on Chemicals: More Strife Across the Pond?; a here and in many posts about bisphenol-A.

Technology Glitches and Patient Health

2011-10-11T18:40:06Z

Mundane Data Breaches

Mistakes usually occur after a conflagration of seemingly small, quotidian errors. Often no one seems to own the problem, it's simply a "glitch". In our technological world, we're quite accustomed to glitches and large data integrity losses. We stick the newly issued credit card into our wallet before even knowing (or caring) about the details of why it was replaced.

Technology "glitches" are not to be trifled with though, they shut down metropolitan train systems, admit ~32,000 students instead of ~16,000, and compromise the most private data of 31,000 people, 100,000 people, 4 million people...They're just boring news.

In medicine, repercussions from computer glitches make train outages seem trivial. From August 2008 through February 2009, a computer glitch in the Veteran's Affairs record system tied patients to the wrong medical records, leading to incorrect dosing, delays in treatment, and other errors. A computer glitch in another case incorrectly cleared women of breast cancer after mammogram screens showed they actually had tumors.

Bodily Injury and Death

Imagine the most unimaginable "glitch" and it's probably already happened. In one, famous 1980's case (PDF), cancer patients undergoing radiation treatments from the Therac 25, manufactured by Atomic Energy of Canada (AECL), intermittently received radiation doses 100X the prescribed dose. The resulting radiation could burn through the torso and leaving a burn marks on the victim's back. The trauma from radiation trauma killed some patients within weeks.

An investigation of the Therac 25 history showed how multiple errors begot fatal injuries. The high doses occurred when a technician first entered an "X" to incorrectly select a certain dose of high beam photon mode; then "cursor up"; then "E" to correctly select a certain dose in the electron mode; then "Enter", all within 8 seconds. This accidental series of keystrokes activated the high beam instead of the low-beam, but the high beam diffuser wasn't in place, so intense radiation burned ears, breasts, groins, clavicles.

When it happened to one patient, the sound system between the treatment room and the operator wasn't functioning. He had been treated multiple times in the past, so knew something was wrong when as he lay on the table for treatment he suddenly heard unusually loud noises, saw a flash of light, and felt a searing burn. Pause. Then it happened again. The technician only learned something was wrong when the patient pulled himself off the treatment table and began banging on the locked door.

Because the burns happened infrequently, because the error messages were imprecise or oblique, and because technicians, engineers and managers couldn't believe the Therac 25 was malfunctioning, operators continued to injure patients until 1987. In a letter to one hospital physicist AECL explained that their machines couldn't be malfunctioning because of modifications that improved the "hazard rate" by "at least five orders of magnitude! With such an improvement in safety (10,000,000%) we did not believe there could have been any accelerator malfunction."

A glitch -- an "accelerator malfunction"? Or errors attributable to peoples' actions?

Errors Upon Errors

The persistence of medical physicists at several hospitals quickened Therac-25 problem solving, but clumsy safety processes, a reluctant manufacturer, and slow FDA action impeded resolution. In the final analysis, a long list hardware, software, quality assurance and process issues such as these, contributed to the injuries and fatalities:

The hardware and software were built by two different companies and only tested when the system was installed in the hospital.
Code wasn't independently reviewed.
Some engineering errors permitted overrides after malfunctions, other errors allowed for safety check bypasses.
The FDA hadn't thoroughly tested the Therac 25 (a medical device) because previous models had a reasonable safety record. But the Therac 25 had undergone numerous changes, for instance manual control systems transitioned to software controlled systems.
The company recalled the machines at one point, but because the first patients didn't die, the FDA under-classified the severity of the problem. But an intense radiation beam to the head could result in a more lethal dose than another body part, so later incidents were fatal.
The medical physicists and the FDA made recommendations to AECL. The company complied with some safety directives, but ignored others.
Technicians incorrectly diagnosed issues, for instance in one case a problem was wrongly attributed to a switch. The company replaced the switches. The problem recurred.
AECL wrongly told some institutions who reported incidents that theirs was the first report. So each hospital thought their case[s] unique.

Elusive Intangible Injury

In the Therac-25 case, each contributor -- a software programer, an engineer, a technician, someone in quality assurance, a safety officer, staff at the FDA, a company executive -- made a small mistake. Lawsuits, FDA investigations, out of court settlements, and eventually national media exposure brought the case attention. The entire compendium of errors in the Therac-25 case is so classic and dramatic that it's used as a case study. But what about computer glitches where less harm is done to fewer patients over a shorter period of time? Or what if so many are hurt - millions, say - that the plight of any one individual gets diffused? What if the evidence is unclear - there there are no burn marks on the front and back of the body?

Can injured patients be made whole? In Therac-25 cases, the lawyers of families of patients with terminal cancer argued that patients died sooner and suffered more because of their Therac-25 injuries.

What if doctors delay cancer treatment and the person dies an early death from breast cancer, as in the case we mentioned above? What can lawyers prove, how can victims be compensated? In the case where Veteran's Administration patients were matched with the wrong record, the VA denies that any negative outcomes. No harm reported, no harm done?

What about still "lesser" glitches, everyday database breaches?

Patients: Students of Misfortune?

The US HIPAA laws protect a person's medical data, file, or record from being accessed by an unauthorized person. Therefore someone couldn't enter your doctor's office, grab your paper record from the thousands stuffed floor to ceiling, and forward it on. Sometimes the law seemed overly strict. In the name of HIPAA, unmarried lifelong partners of hospitalized patients were forbidden from learning about their loved one's health.

Although HIPAA has provisions for electronic records, today's larger, more frequent mishaps leaves this regime seeming quaint. Consider the recent data breach at Stanford, where the emergency room records of 20,000 patients were posted on line. A New York Times article details how it happened. One billing contractor dealt with one marketing contractor, who interviewed one potential employee who leaked the data. The marketing contractor received got the data from Stanford Hospital, "converted it to a new spreadsheet and then forwarded it" to a job applicant, challenging them to

"convert the spreadsheet -- which included names, admission dates, diagnosis codes and billing charges -- into a bar graph and charts. Not knowing that she had been given real patient data, the applicant posted it as an attachment to a request for help on studentoffortune.com, which allows students to solicit paid assistance with their work. First posted on Sept. 9, 2010, the spreadsheet remained on the site until a patient discovered it on Aug. 22 and notified Stanford."

Would any of these patients know if they were harmed? What if they had some condition that an insurance company, employer, teacher or other would use to disqualify them as in this Stanford case? Will the class action lawsuit that's filed make them whole? What if someone recognized the value of such data and stole it, as in a recent Orlando, Florida case where hospital employees forwarded emergency room data for over 2,000 accident victims to lawyers? In the old days, hauling 20,000 patient files out of a doctor's office unobtrusively would be a challenge. Not so much with electronic data, all you need is a glitch.

HIPAA specifies that each responsible individual can be fined $250,000. Will the job applicant who outsourced her Excel Worksheet problem to StudentofFortune.com pay $250,000? The marketing contractor? The billing contractor? Stanford?

Often the public has no idea about medical injuries resulting from glitches, physical or otherwise, just as they didn't with the Therac-25. If someone dies, as in the Therac-25 case, perhaps the news will get out. But the more common the incidents, the more data is lost, the more are made to seem benign, the more harm is done, the less we learn about any particular incident.

You can read all this as a depressingly negative outlook on technology and health, but my view is different. Injuries and deaths due to vague "glitches" can be prevented by fixing small, but very tangible errors. The outsourcing of everything has increased the number of contractors, and with all these people, looser interpretations of rules and diffuse culpability. But it's not just contractors. Many employees are also very cavalier about data. Walk-in or call any major medical center and you will see glaring errors. Fixing such errors, attention to detail, and yes - support for regulatory oversight, can reduce harm.

Lest You Want to Do More Than Sit Under The Tuscan Sun

2011-10-07T00:27:30Z

Blue Screens

When I traveled to Italy a few years ago I found the blue screens on computers to be the most memorable travel experience, you know, aside from the terraces and olives and Caravaggios of travel lit - the "Blue Screens of Death". I hadn't seen so many blue screens since the 1990's. Fresh off the plane, the machine to purchase tickets took our money without producing train tickets. The station agent cocked his head and displayed doleful eyes at our request for a refund. Like it was the most absurd thing he'd ever heard! Then he walked around the room gesticulating at exhibits A, B, C, D...all blue screens on all computers, and he explained verbosely in Italian: That's why we wouldn't get a refund. He did finally produce our tickets, not because we explained how to fix the screen problem - which he dismissed with a flick of the hand; not because we subsequently insisted that he use a telephone work-around; but most likely because we threatened to sit there forever. We are usually in a big business hurry, but...

That was only the beginning of Blue Screens in Italy. Blue screens at the airport, blue screens at internet cafes, the hotels, the train stations, the offices, even at the empty museum exhibit -- how? This was a far cry from countries even a decade earlier where the remotest places, say in Asia, got on online and stayed up and doing business. That was my Italian experience.

Trials

Today, Italy is still looking a little medieval, isn't it? All that ancient stone architecture with the tiny little windows romantic in one view, lends a sinister backdrop to the bizarre Perugia murder trial, which Perugians complain sullied their town's reputation.

Then there's the other trial, that of the seismologists being tried for information they supposedly didn't provide to townspeople of L'Acquila before the earthquake. Thousands of scientists have written to protest the prosecution of scientists. Actually, the scientists did relay the risk of earthquake on that day, about 1:1000, but subsequently a government official garbled the message. At the same time, disturbingly, a non-scientist was claiming (falsely) to be able to predict earthquakes based on radon gas measurements. So that radon-guy jacked the townspeople up, then the official tried to reassure them, now the scientists are on trial.¹

Shutting Down Speech

This week, the computer screens went black in Italy. The government introduced a new wiretapping bill that imposed severe restrictions on online speech. The Italian bill declared that the online author of any 'alleged defamation' would need to correct the problem within 48 hours or be punished by a large fine. Guilt of defamation would be in the eyes of the "defamed". Wikipedia protested with a blackout.

Wikipedia's action got the bill partially changed to apply only to larger businesses, not blogs and Wikipedia. But as Nieman Lab explains, the bill stills stands. Furthermore, it's the overall state of press freedom in Italy that's "dismal". As Nieman Lab writes:

"Berlusconi owns the influential private media company Mediaset; he exercises direct control over state television. Italy's 100,000 professional journalists, to get work, must belong to the Ordine dei Giornalisti -- a group that is, in effect, a modern-day guild. This year's Freedom House survey of global press freedom, citing 'heavy media concentration and official interference in state-owned outlets,' ranked Italy as only 'partly free."

It makes it seem like blue screens would be the least of their problems. I know, it's totally biased to judge Italy on these select things, just it would be to judge Americans on their predilection for their cowboy hats, guns and anti-science moves. Nieman Labs interviews several people (from Perugia) who understandably worry how severely the government threatens press freedom. And of course many other governments, not only Italy, seek to curtail internet expression. If governments continue to corral the "Internet" -- rather, the now familiar "internet" - will we have to start calling it the "Intranets"?

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¹ In a recent post, we criticized Fox News for profiteering on the weird, absurd, and false earthquake predictions of Jim Berkland. This trial adds another dangerous twist to Berkland's odd-ball predictions. Confusing people about the real risks isn't just bad for science, it's an actual liability for governments.

Secret Geoengineering? Says Who?

2011-10-04T20:42:32Z

A recent Financial Times article reported on a £1.6 million geoengineering trial launched by Spice (stratospheric particle injection for climate engineering) at a British Science Festival. In "Trial Seeks to Hose Down Warming Climate", Clive Cookson describes how the company aimed to test the feasibility of cooling the planet by creating atmospheric conditions simulating volcanic activity. Beyond the trial:

"A full-scale global cooling system would cost more than £5bn and take two decades to install, said Hugh Hunt of Cambridge university, another team member. It would require 10 to 20 gigantic balloons, each the size of Wembley stadium, attached to ships distributed in the world's oceans and pumping 10m tonnes a year of material into the stratosphere.""

Geoengineering - How Far Have We Really Come?

Interesting enough. We often hear of plans for geoengineering. Certainly weather modification has been around for so long that when a Texas licensing board approving projects convened recently, one member suggested that the technology was so routine the licensing board should disband. Although we know generally about cloud seeding and futuristic geoengineering, we don't often hear about experiments with some of the more sophisticated climate technologies, which makes the FT article somewhat interesting.

But even more interesting than the article itself was a letter to the editor in response to the article, published by the FT a couple of days later (Sept. 15). In it, the President of an American aerospace company wrote that the "trial" reported by FT was old news. He explained that injecting particulate matter into the atmosphere has "been in full swing at it for nearly a decade...", and continued "Dozens of aerospace, defence and technical companies like ours have been advising into the initiative for many years. He explained:

"...[a] series of tests to create a polymerised and ionised mixture of certain metals, including aluminium, barium, thorium and selenium, among other contents, was perfected and tested in US facilities. A joint public-private operation, initially called "Cloverleaf", was operationalised and subsequently supported by US state and federal weather modification legislature.

Throughout the continental US, dozens of tanker and other aircraft are daily applying thousands of gallons of aerosol nano-particulates that serve several objectives, including the purported ability to reflect UV radiation. Similar operations are being conducted in Canada and parts of Europe.[emphasis ours]

What the actual secondary effects of this operation are, including human health impacts, are currently unknown or undisclosed. The Bristol university team may be wise to "hose down" those facts as well. In the meantime, anthropogenic climate impact is in this regard, quite real indeed."

REALLY?

Before the Financial Times boldly printed this editorial, people firmly relegated "Cloverleaf Operations" to conspiracy theory territory. True, thousands of YouTube videos devote bazillions of hours to documenting "chemtrails" streaked across blue skies -- often accompanied by music of the producer's choosing, making them no less boring.

And true, hosts of crackling talk radio shows tell audiences that their guests "risk death" divulging whatever huge secret government chemical spraying operation they then divulge.

A search for "chemtrails" on YouTube actually turns up 29,200 results. But have you heard of this chemtrail thing? It's easy to ignore, unless, say, one or more of your formally rational friends goes through some weird mid-life crisis, and with testosterone flagging (my theory), veers off bizarrely denouncing the rational in favor of numerology, Mad Hatter utterings, and chemtrails. Else how would you know? Unless you read the Financial Times editorial section.

Fact or Fiction?

Of course some people -- the subset who espouse chemtrails and read the Financial Times editorials -- were elated: "PROOF!", they crowed on their blogs. But try to find one other mention of such a program in any other respected publication -- one who's mission isn't to divulge "scary secrets your government's hiding from you". Even if the chemtrail crowd isn't totally sniffing glue, the Financial Times editorial seems like a rather casual airing of the news -- and it is news.

It must be true, you say, it's the Financial Times! Many people attest that the FT and its sister publication The Economist do an above respectable job covering science. I really like both publications, but they both publish quite a few "science" articles that are more or less press releases for some company's pie in the sky technology that you've never heard of and will never hear of again. Yes, they have some in depth coverage of science, and sometimes feature British science establishment luminaries like Paul Nurse, but frankly I think their coverage of economics, yachts, and watches is better. The original article on the water aerosol trial was sort of in this in the sky technology vein. But the theme got way more interesting with the editorial.

Existent or Not Existent?

The editorial was written by Mr Matt Andersson, who signed as the CEO of a Chicago company called Indigo Aerospace. Indigo Aerospace is not listed in Hoover's, so it's hard to guess how much money he makes "advising into the initiative". Or maybe he didn't really mean in his letter that his company was running geoengineering programs but more literally that companies "like his" were. Or maybe his company does advise such initiatives.

Being curious, I easily learned that Indigo Aerospace used to be incorporated in Illinois, where they reportedly consulted to Booz Allen Hamilton, known for its military and government business. But as of May, 2011, Illinois lists the Indigo Aerospace Inc. as "involuntarily dissolved". So then is the corporate entity for which he signed as CEO not in existence anymore? This unfortunately throws doubt on his whole Cloverleaf assertion (at least to us). But why be judgmental? FT wasn't.

But we unfortunately don't know if the FT editorial is credible. If we were the FT editorial team we would do a bit more checking into this story -- really. Now we can only wonder: Do governments drastically change weather patterns, ruin sunsets, and subject us to chemical experimentation, and is this so ho-hum that we only read about it on conspiracy theorist sites, on Ron Paul 2012's blog, and in the editorial section of the Financial Times? It's potentially very interesting news people, more please. Or is it a conspiracy theory, as contended by every state agency, military organization, scientist, urban legend site, and news publication -- except for the FT? Mildly interesting but worthwhile noting. What do you wager?

Hurricane Irene Disaster Management

2011-08-29T19:18:06Z

Just Like 1908?

After Hurricane Irene, some people joked that the media sees hurricanes as a grand opportunity to dress up in the newest outdoor gear and brace against the howling wind, downed trees, and rain driving sideways (although sometimes pranksters steal the show.) Hurricanes have all the right elements for media profiteering too - drama, death, destruction and lots of "human interest". But to build drama, you need to build up the storm. On Friday night, August 25th, we linked to these four news stories in successive Tweets:

Hurricane Irene could be the most destructive hurricane to strike New York City since: 1903 (Published August 26, 2011) 25 Aug tweet acronymrequired
Hurricane Irene could be the most destructive hurricane to strike New York City since: 1908 (Published August 24, 2011) 25 Aug tweet acronymrequired
Hurricane Irene could be the most destructive hurricane to strike New York City since: 1938 (Published August 26, 2011 10:28 p.m. EDT) 25 Aug tweet acronymrequired
Hurricane Irene could be the most destructive hurricane to strike New York City since: 1985 (Published August 26, 2011 1:23AM) 25 Aug tweet acronymrequired

Not only can't forecasters predict with 100% accuracy the power or path of a storm, but certainly, as we showed, newspaper reporters can't. The media can't necessarily be faulted though, after all a hurricane is a moving target. In fact, as long as everyone tunes in, the media actually plays an helpful role public safety role, that is by creating more drama on television then any one person can witness outside, over-the-top media coverage can actually aid public safety officials.

The list of East Coast storms throughout history is extensive, but reporters plucked somewhat random mix of historical events out of the hundreds available: The so called Vagabond Hurricane of 1903, produced 65mph winds in Central Park; the deadly New England Hurricane of 1938, was a Category 3 at landfall; and Hurricane Gloria in 1985 struck as a Category 2 hurricane. It's unclear what storm in 1908 the Lehigh Valley Morning Call reporter was talking about, since none of the storms that year amounted to much, and on August 24th 2011, when the Morning Call published, most reporters were comparing Irene to Hurricane Katrina, not some random storm that blew out to sea in the Caribbean. Maybe the reporter hadn't had their morning coffee.

But there you have it, taken together, it's clear that storms can go many different ways and we don't have the technical or intuitive abilities to predict them exactly accurately, or at least to the degree that audiences seem to be demanding after the event.

That Healthy Cry, The Complainer - Alive and Well

When Irene actually hit, the hurricane created lots of flooding and destruction not to be trifled with. But as the New York Times reported after the storm, some New Yorkers were peeved at the pre-storm hype. New Yorkers expressed anger at the cops on bullhorns telling people to go inside, anger at the storm itself for not living up to its potential, and of course anger with Mayor Bloomberg. One person complained Bloomberg made people spend too much money: "The tuna fish and the other food, O.K., we're going to eat it. I don't need all this water and batteries, though."

But lets compare this outcome with the great bungling of Katrina in 2005, to see how things can easily go the other way. At least 1,836 people died in Katrina and property damage was estimated to be $81 billion 2005 USD.

FEMA took most of the fall for the Hurricane Katrina management disaster, along with FEMA administrator Michael Brown ,who appeared utterly useless despite fervent support from George W. Bush. As we wrote at the time in "FEMA- Turkey Farm Redux?", FEMA had failed US citizens in multiple hurricanes during the administration of George H.W. Bush in the 1980's, and had been expertly revived and made useful during the Bill Clinton administration under the leadership of James E. Witt. Then George W. Bush decimated the revived FEMA, using it as his father had. As the House Appropriations Committee reported in 1992, FEMA had been used as a "political dumping ground, 'a turkey farm', if you will, where large numbers of positions exist that can be conveniently and quietly filled by political appointment". (Washington Post July 31)

So given the recent history of Katrina, and the debacles of several state and city governments in last winter's multiple blizzards, it seems inane that so many people who lived through those disasters now fault Bloomberg as "the boy who cried wolf". But then people might complain no matter what, and given the somewhat unpredictable path of storms, I think everyone would agree that it's better to be alive complaining, than dead and swept out to sea because of lack of government warning.

Assuring Future Disasters are Worse

Of course we don't know how the government would have fared in a worse disaster. And while people complain about the lack of a bigger hurricane, FEMA is currently hindered from helping with Irene. Why? Apparently, a FEMA funding bill is being held up in the Senate while politicians with idiosyncratic proclivities indulge their hypocritical "family values" by meticulously delineating all the organizations that can't be paid with FEMA money.

To our detriment, we ignore larger issues while we complain. FEMA's role takes a role not only during and after a hurricane, but in adequately preparing people ahead of time, as we wrote in "FEMA and Disaster Preparedness". Neither FEMA nor state or local governments adequately helped prepare for Katrina, as we detailed in: "Disaster Preparedness - Can We?". Although states and cities didn't play as large a role in the the federal government failings as G.W. Bush would later say, rewriting of history, their role is important.

Of course, disaster preparedness means not only motivating citizens to buy supplies and stay inside, not only mobilizing a deft response, but shoring up infrastructure ahead of time. In the wake of Katrina, we all heard about the failure of governments to build adequate New Orlean's levees, an issue Acronym Required wrote about in "Levees - Our Blunder". However before Katrina, few people realized just how flagrantly officials ignored warnings about the weak levees. When the hurricane breached the walls, politicians acted surprised, that surprise masking the blunt unwillingness of politicians and US citizens to support and fund infrastructure.

We wrote about more widespread infrastructure failings in 2007, in "Guano Takes the Bridge, Pigeons Take the Fall". But infrastructure is easy to ignore. Just as vociferously as citizens complain about the hype preceding Hurricane Irene¹, they remain stunningly silent on the lack of infrastructure preparedness. In fact there's loud clamoring to dismantle the very agencies that assure our safety. Obama has tried in some ways to address the infrastructure problem, not without criticism.

In the case of the New Orleans levees, the New Orlean's Times-Picayune reports that although $10 billion has been spent upgrading the levees, the Army Corps of Engineers is giving them a failing grade. The report says that the refurbished levees might stand a 100 year event, but a larger event will result in thousands of deaths and billions of dollars in property damage. This was exactly the criticism of the levees after Hurricane Katrina in 2005.

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¹ Here's an interesting analysis of the hype-factor of news relating to Hurricane Irene. The author uses a quantity of publications analysis to argue is that the storm was not hyped.

Autism and the Internet, Drugs, Television, Rain, the Victorian Era & the Media

2011-08-12T00:35:24Z

New Scientists Who Don't Do Science

Every so often, actually with disturbing frequency, claims about the underlying cause of autism spring up like fungii in manure after a rain. It's practically required that claims of this genre be built on false premises or make invalid conclusions, like this week's link between internet use and autism. Oxford personality Baroness Susan Greenfield breathed life into this rumor in an interview with New Scientist, then defended herself by saying provocatively: "I point to an increase in the internet and I point to autism, that's all." But where's the evidence, and why is this stuff being published?

Greenfield's been at this for a while, "popularizing science" for decades, and recently "popularizing science" at the cost of science itself. In 2008 she warned the children's brains were being destroyed by technology in a book reviewed in the Times:

"As it happens, her new book, ID: The Quest for Identity in the 21st Century, digresses all over the place in little flash floods of maddening provisos and second thoughts. It's as if she dictated it while bouncing on a trampoline, fixing an errant eyelash and sorting her fraught schedule on a BlackBerry."

Back in 2009, before the UK's Royal Institution fired Lady Greenfield, she argued that the total immersion in "screen technologies" was linked to a "three-fold increase in prescriptions for methylphenidate" (prescribed for attention deficit disorder). She told the paper that people were losing empathy and becoming dependent on "sanitized" screen dialogues, just like packages of meat in supermarkets had replaced "killing, skinning and butchering an animal to eat".

Had you ever thought of the internet like that? No? Science popularizing has that power. I'm not deriding science popularizers, I'm criticizing the practice of distorting science. Greenfield's analogies opened up new worlds of understanding for Guardian readers too. 254 people commented, some sarcastically:

"That's exactly what my mum said about reading The Beano."
"I hear it gives you cancer as well""

Guardian readers know how to take a piss. But Oxford's Greenfield knows how to get publicity. So her 2009 headline followed and preceded myriad other claims, all to scare people about technology. To her latest, scientists online responded briskly, with vitriol, meaning that in terms of popularity, Greenfield had a field day. We've been following false arguments about autism for a few years, so we wanted to look more closely at how Greenfield's latest claim about the internet causing autism differs from the claim that television caused autism that we covered back in 2006. For one, back in 2006 they actual did research -- well, economics research.

But Who Needs To Do Research When They'll Print the Stuff You Make Up?

Maturing her arguments of 2008-2009, Greenfield now adds autism to the mix, upping the ante by playing not just to fuddy-duddy technophobes but to all parents and their worst nightmares. One day the child seems fine, then something mysterious happens and the child is no longer themselves. What happened? Doctors and scientists have no clinically actionable idea. Greenfield knows.

Perhaps it makes life easier for some autism suffering families to attribute changes in their child to some outside agent. It's also common to say that a crime has been perpetrated by people from another state or town or country. We've seen autism blamed on vaccines, television, rain...Uncomplicated agents that can be controlled by parents are especially attractive - TV. But where's the evidence? When the New Scientist asked that, Greenfield replied:

"There's lots of evidence, for example, the recent paper "Microstructure abnormalities in adolescents with internet addiction disorder" in the journal PLoS One...There is an increase in people with autistic spectrum disorders. There are issues with happy-slapping, the rise in the appeal of Twitter - I think these show that people's attitude to each other and themselves is changing."

How nimbly she links computer use, with "internet addiction disorder" (IAD) -- not recognized by US psychiatrists; with brain change; with behaviors; and even with attitudes - facile. But the paper didn't say anything about attitudes; didn't prove "addiction", didn't prove detrimental brain changes, didn't prove behavior changes.

Can You Compare the Cognition of Chinese 19 Year Olds Playing Games 12 Hours A Day To 1 Year Old Cooing Babies?

The PLoS One paper deserves more comment than I'm going to devote here. To note, though PLoS One depends on the community for peer review, and although this paper has over 11,000 views (14/08/11), not one person has peer-reviewed - "rated" - the paper. Nevertheless, it's cited all over the internet as proof that "internet use" does bad stuff to the brain, take your pick - "shrinks it", "wrinkles it", "damages", "contracts", "re-wires" it... But the paper is not about "internet use". It's about on-line gaming.

The PLoS One authors write that the research is particularly important to China because unlike in the US, in China, IAD is recognized, and is cited as a big problem. The Chinese vigorously treat the "disorder" with strict treatment regimens including until 2009 shock therapy.

The authors used addiction criteria (i.e. "do you feel satisfied with Internet use if you increase your amount of online time?"), and asked the subjects to estimate how long they had had the addiction. They then used brain imaging to show that brain changes correlated with self-reported duration of online game playing. There were 18 subjects, 12 males average age 19.5 years, and presumably 6 others (females?) who the authors do not characterize.

The subjects played online games 8-13 hours a day. I can't evaluate the data, I don't know enough about voxel based morphology. But I'm not surprised someone "playing online games" 8-13 hours a day, 6.5 days a week for 3 years is different than the controls, who were "on the internet" less than 2 hours a day. Likewise, I would expect a soldier engaged in street patrol in Afghanistan 10 hours a day, 6 days a week for three years to be different than someone who walked their dog around the block in sunny suburbia 3 days a week for the last month. (If I were in a joking mood I'd say that kids playing online games 13 hours a day 6 days a week must have extraordinary abilities to actually still be in college.)

Even if you believe in IAD, the authors acknowledge the study's limitations. They say they don't prove IAD caused changes; don't prove that the subjects brains weren't different to begin with; acknowledge the "IAD duration" measurements (self-assessment) are crude; and the data aren't rigorous to conclude negative changes.

None of these caveats slowed Greenfield, who cited this paper and linked it to all sorts of unrelated things. But autism is NOT related. Wikipedia describes what she calls "Happy-slapping" as an outdated British fad", evidently more a media fad than a scary phenomenon - it's not related to autism. There's nothing inherently sinister about using Twitter - it's not related to autism.

Greenfield trained as a neuroscientist. Does she not know this stuff? In 2003, she mocked people who attributed anything to "scary technology." So why is she now popularizing the opposite message? Her PLoS One example is nothing more than pulling some study out of thin air and linking it to her own machinations about technology. Claims such as hers provide ripe fodder for quacks, crazies and zealotry.

How Does Technology Change Us? Research Shows Beneficial Effects in Online Gamers

Here's the second instance of "proof" Greenfield gives in the New Scientist interview, and note that again cites an academic paper and links it incongruously to her own made up stuff. She says:

"...A recent review by the cognitive scientist Daphne Bavelier in the high-impact journal Neuron¹, in which she says that this is a given, the brain will change. She also reviews evidence showing there's a change in violence, distraction and addiction in children."

But the Bavelier et al review says something different. The scientists specifically warn that no research predictably links brain changes to behavior like violence, distraction or "internet addiction" to technology - TV, video games. The authors cite studies showing the research remains too confounding, as they say in their conclusions:

"the interpretation of these studies is not as straightforward as it appears at first glance"
most reports tabulate total hours rather than the more important content type, therefore are "inherently noisy and thus provide unreliable data."
technology use is "highly correlated with other factors that are strong predictors of poor behavioral outcomes, making it difficult to disentangle the true causes of the observations"
Perhaps "children who have attentional problems may very well be attracted to technology because of the constant variety of activities."

Bavelier et al stress that the effects are unpredictable, for instance "good technology" like the once ballyhooed Baby Einstein videos can turn out to have zero or negative effects. Conversely assumed "bad technology" can be good. They write:

"action video games, where avatars run about elaborate landscapes while eliminating enemies with well-placed shots, are often thought of as rather mindless by parents. However, a burgeoning literature indicates that playing action video games is associated with a number of enhancements in vision, attention, cognition, and motor control."

This point from Bavelier et al is quite interesting because it appears to contradict the general conclusions of the PLoS One authors we cited above concerning online gamers -- assuming the study subjects played comparable games. Exploring these different results is potentially more interesting than a rhetorical sleight of hand tossing a science study citation in to falsely bolster gobbledygook.

To wit, the studies Greenfield uses don't support her points. That technology's effects are still unpredictable is widely acknowledged. Greenfield herself used to promote a computer program called MindFit which claimed to improve mental ability. The game didn't work. But it also didn't make kids pick up knives and murder each other. It's hard to understand Greenfield's motivation for denouncing technology as anything other than provocation.

Greenfield says: "It is hard to see how living this way on a daily basis will not result in brains, or rather minds, different from those of previous generations." But "hard to see" isn't science. A "brain", is not a "mind", nor is it "behavior", nor an "attitude". That's not to say brains don't change, or that technology couldn't affect us. Brains show changes during many activities, often temporarily. It's just to say that technology is not inherently, as she called it, "chilling".

I Point to Television and I Point to Picnics, To Family Dinners, To Teens Doing Charity, To Children Building Sand Castles on Sunny Days

As she is now vilifying the internet as a physiological change agent, Greenfield previously claimed that television changes the brain deleteriously. Now she dismisses the notion. When New Scientist asked her: "What makes social networks and computer games any different from previous technologies and the fears they aroused?" she responded:

"The fact that people are spending most of their waking hours using them. When I was a kid, television was the centre of the home, rather like the Victorian piano was. It's a very different use of a television, when you're sitting around and enjoying it with others..."

Nice image, the innocent television, like the innocent Victorian piano. Happy family times of the Victorian Era, singing around the piano, food aplenty, spirits flowing, enlightened, goal oriented well adjusted children unhindered by repressive social situations. Oh wait, it wasn't always like that? We learn more about the good 'ole days by venturing dangerously out on the internet where you can find the following first hand accounts:

Isabella Read, 12 years old, coal-bearer, as told to Ashley's Mines Commission, 1842: "Works on mother's account, as father has been dead two years. Mother bides at home, she is troubled with bad breath, and is sair weak in her body from early labour. "I am wrought with sister and brother, it is very sore work; cannot say how many rakes or journeys I make from pit's bottom to wall face and back, thinks about 30 or 25 on the average; the distance varies from 100 to 250 fathom. I carry about 1 cwt. and a quarter on my back; have to stoop much and creep through water, which is frequently up to the calves of my legs."

Sarah Gooder, 8 years old, trapper, as told to Ashley's Mines Commission, 1842: "I'm a trapper in the Gawber pit. It does not tire me, but I have to trap without a light and I'm scared. I go at four and sometimes half past three in the morning, and come out at five and half past. I never go to sleep. Sometimes I sing when I've light, but not in the dark; I dare not sing then. I don't like being in the pit. I am very sleepy when I go sometimes in the morning."

Greenfield's current glorification of TV defies the fact that TV has been roundly implicated for causing all sorts of unsocial behavior and not only by Greenfield before she changed her mind.

The Autism TV Link: "Why Not Tie it To Carrying Umbrellas?"

In 2006 Acronym Required used a study by economists linking autism and television to write a satirical ten step tutorial on how to publish bad science and get lots of media attention for it. The authors proved that a theories popularity, if brought to the attention of a non-critical media was independent of clearly stating no link between autism and television in your study. You didn't even need to be a scientist.

After reviewing those economists' work, Joseph Piven, director of the Neurodevelopmental Disorders Research Center at the University of North Carolina, weighed in on the autism television-watching idea, asking the Wall Street Journal "[W]hy not tie it to carrying umbrellas?" And so the researchers did! And in 2009, in "It's Back! The Rain Theory of Autism", we described how the same researcher group that blamed autism on televisions decided that it wasn't television causing autism, but rain.

The nice thing about making up "science" or just leveraging your status for narcissistic purposes, is that you can change, chameleon-like, at will. If your aim is to generate a headline in mainstream media rather than research, it doesn't matter what the science says. Most people don't remember headlines from one day to the next and they aren't that curious to dig further.

I believe a natural response to Greenfield's wild claims is humor and sarcasm, the same response the Guardian readers had. To Greenfield's latest foray, Carl Zimmer started an amusing twitter exchange with this: "I point to the increase in esophageal cancer and I point to The Brady Bunch. That's all. #greenfieldism".

A string of #greenfieldisms followed, like "@carlzimmer I point to Alzheimer's and I point to cheese doodles. That's all. #greenfieldism". (Of course this territory is risk ridden, because of the prevalence of actual real random "studies" like the one about mice who eat fast food and get Alzheimer's.)

When challenged, Greenfield didn't back down, instead she spewed forth with more analogies, like a clogged toilet if test-flushed. Asked for a response to the fact that there's not evidence claiming detrimental effects of technologies, she scoffed that you wouldn't see effects for 20 years. With just as absurd a distracting non-sequiter she once asked someone who challenged her on the technology-is-bad assertions if they denied smoking causes cancer.

Flexible "Theories" Make For Good Publicity for Scientists, For Newspapers...

I think it's cathartic, funny and educational to diffuse Greenfield's claims with humor. Wicked-fast coordinated Twitter de-bunking of such people is of course useful and could be made even more useful. Unfortunately the issues aren't always as simple as a Greenfieldism. And debunking the rhetoric of individuals seeking publicity on the backs of science is only one angle.

I think it's important to note that it wouldn't be news if there weren't ready and willing news outlets. The New Scientist printed all her assertions about links between technology, brain structure, autism, and behavior. They didn't ask questions. They didn't challenge. They didn't say: wait, isn't autism diagnosed at ages 2-4? Who's propping their 6 month old up in from on the computer to play war games? Why?

The Guardian, like most papers, publishes articles that range in quality. A Guardian comment on the 2009 article about Greenfield's theories, that called the article "absolute nonsense", and wrote I am surprised that the Guardian has published this..."sloppy journalism"..."absolute drivel", pulled in 160 "approve" votes, far more than any other comments. So even if readers hate the article, they'll still read it. Media succeeds because of advertising and hundreds of comments translates to how many hundreds of thousand of hits?

The media is quite capable of selective coverage. They ignore important scientific, political, and economic stories that they consider politically sensitive. But is anti-science coverage ever "censored"? Not if it can drive traffic, and sell ads - provide economic benefit to media outlets.

But to what extent can we accept this concession to the market if it gives us in return uncritical readers, uncritical patients, and uncritical citizens? Does it create an atmosphere amenable to medical quacks? Might it prime a population to be more receptive to political efforts to curb real free speech via social media technologies? Too bad so many potential critics (even bloggers) are involved with or depend on mainstream news outlets, which makes them understandably hesitant to bite the hand that feeds (or might feed) them.

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¹ Bavelier, D., Green, C.S., & Dye, M. (2010). Children, wired - for better and for worse. Neuron. 67, 692-701, Volume 67, Issue 5, 692-701, 9 September 2010 Copyright © 2010 Elsevier Inc. All rights reserved. 10.1016/j.neuron.2010.08.035

Acronym Required writes frequently on the diffusion and distortion of science in politics. We've written about individuals mixing religion with science, art with science, for instance here

Science Blogging: The Better Journalism?

2011-08-03T12:39:48Z

Science Journalism Debauchery

Has anyone aside from science bloggers had so many rules imposed on them? OK, maybe science journalists. In the 1990's, when the debate over genetically modified (GM) seeds motivated the headline: "MUTANT CROPS COULD KILL YOU" (Express February 18, 1999), the British government attempted to correct the fear-mongering headlines. That didn't work, so to stem future journalistic liberties of that sort, the Parliament tried to subdue the culture that propagated such rumors.

They issued a a lengthy report warning of further journalistic depredation from "the approaching era of digital TV" and the "increasing ghettoisation". (No mention of the internet.) More journalists needed to be "scientists", they said, after surveying GM stories put out by all of eleven UK publications over two days. Only 17% of the stories were written by science journalists, they found, and not any of the commentary came from "science writers". The Science and Technology Committee of the House of Commons, the Royal Society, and SmithKline Beecham suggested punishing future misbehavior, especially for getting the facts wrong:

"media coverage of scientific matters should be governed by a Code of Practice which stipulates that scientific stories should be factually accurate. Breaches of the Code of Practice should be referred to the Press Complaints Commission."

Of course an editor at the Independent responded describing how writers could conquer the facts but still mislead the reader. Thankfully, there's often a compelling counterargument. So in the end, the report's authors settled for a rather bland collection of guidelines dealing with Balance; Uncertainty; and Legitimacy.

And of course while the Parliament fretted about the fate of genetically engineered crops, over at News of The World...

Digital Science Journalism - Publishing Freedom

When science blogging came along it seemed to offer an alternative to the maligned mainstream media science journalism. But despite its growing stature, it too has been besieged by criticism. Some of this came from mainstream media, especially in the beginning.

But interestingly, while traditional science journalism often gets attacked from the outside, online science journalists indulge in lots and lots of self-flagellation. Perhaps this is to be expected from people who labor at the frontier of the often masochistic bench science, replete with high rates of experimental failure. Or perhaps self-criticism makes it easier for science bloggers to generate conversation? Work out their identities? Get traffic?

Of course there's much more to online science journalism then blogging, but I'm going to limit my comments to that. Acronym Required started about seven years ago, and from the rather echoey halls of 2004 science blogging, the medium exploded. Now it impressively fills some of the gaping holes in other science journalism.

We last commented on the state of "science" television programming in 2007 -- and why comment further? The science blogging world offers an amazingly vibrant alternative, filled with witty, reflective, analytical, smart, and generous writers -- especially considering the frequent debauchery of mainstream journalism. Which makes the persistent whine of self-criticism all the more puzzling. Is it some evolutionary thrust gripping science bloggers to impose governing rules on their peers?

This is especially amusing in the context of how blogs started, to augment search. Search itself started in a era that included the (albeit, totally unrealistic) perception of internet as free of boundaries, regulations, and governments. Consider this piece from early 1996:

"We are creating a world that all may enter without privilege or prejudice accorded by race, economic power, military force, or station of birth. We are creating a world where anyone, anywhere may express his or her beliefs, no matter how singular, without fear of being coerced into silence or conformity."

Radical, but the philosophy is actually alive and well among quite a few technologists today.

Search back then was pretty rudimentary, thus the role of blogs. To understand just how rudimentary, look at this old Yahoo page with its awesome user interface. (Accompanied by the great ad with a winking person who looks photoshopped from two different faces, asking awkwardly: "So, My Yahoo! or yours?".)

My point is, the world in which blogging started was simple. For one, an early blog was often not much more than some geek saying -- "hey I found this cool site": link -- so I'm cool too, right? These "trusted links" made a prehistoric stab at "community" and "personalization" -- because who could trust something called the "World Wide Web", with its random collection of and unknown "links"?

Secondly, through innovation if not mindset, the Internet and blogging celebrated independence from tradition. As the internet expanded, many bloggers took to the medium in defiance of the exclusive world and onerous rules of offline publishing. The audience for blogs in the beginning was a very small group of internet users, frontiersmen strongly connected by their independence, who were by default "the community".

Page Views

As the originators of the real commercial internet intended, soon people realized they could make advertising money on the internet, and "pageviews" became an all important metric. The number of people publishing on the internet grew and bloggers were then advised to "keep it short". This advice about post-length was couched as insight about readers short attention spans. But it was as much about drawing pageviews and revenue. "Keep it short" and the unspoken "make us money" became compulsory over 'make it interesting'.

When Tumblr and Twitter arrived on the scene with truly short-form platforms, some of the same organizations then suggested that blogs could actually be a venue for "long-form posts". Finally, just as the fashion industry moved away from dictating skirt lengths sometime in the 1980s, people eventually stopped dictating ideal post length. Of course they still told people what to do, they just moved on from making demands on post length.

To Join Or Not To Join

It's my impression that science bloggers find more rules to bandy about than others, but granted, I don't have enough data to swear that economists, say, are really more laissez-faire. I couldn't possibly document all the various rules that science bloggers have proposed for other science bloggers over the years, but to illustrate my point, I'll mention a few.

First there's the question of where to host your blog. Some insist that science bloggers should join a science blogging network. This came about when the number of online science bloggers reached a point where they could actually form a group. Those advocating joining offer compelling reasons -- traffic, exposure, "community". Now, the number of such science blogging "communities" has surpassed our ability to keep track of them. There are still pros and cons to joining of course, depending on your goals, technical abilities, impressions of the different online venues, how your schedule might accommodate blogging, etc. But your agreeable answer to join is existentially far more critical to a potential host than to you. After all, the hosts wouldn't exist without the bloggers.

Of course the notion of "online community" includes many possibilities. Communities can be collaborative, nurturing, educational - great; or, if you've observed them in action, joining such an online science community can be like joining the military, where participants -- "travel to exotic foreign lands, meet interesting and exciting people, then kill them."

Proving Your Worth

Once the blogger decides where to put their blog, a barrage of other considerations and demands will follow. For example, in 2007 bloggers for peer-reviewed research reporting (BPR3) emerged, proposing

"to identify serious academic blog posts about peer-reviewed research by offering an icon and an aggregation site where others can look to find the best academic blogging on the Net."

While interesting as a business aggregation proposal, the blog "Peer-To-Peer" diplomatically commented on the idea, saying it would be impossible for such an icon to assure the "quality of the blog post itself". Or, we might add, to insure the quality of the writer's analysis, the quality of the science journal, the quality of the science research, and so on.

Questions of ethics in science blogging are constant, carrying on from earlier discussions of ethics in blogging and science journalism. Way back in 2003, bloggers started wondering whether they should adopt journalists' standards. Perhaps journalism in 2003 was wrapped in mystique that shrouded realities like "MUTANT CROPS COULD KILL YOU", but the drumbeat of ethics has since trailed science bloggers. I can't see how this could be useful people have written strong arguments noting that blogging wouldn't exist if bloggers weren't ethical. Nor has the whole ethics thing really led to changed behavior as far as I can see, but those who push "ethics" will forever peer over our shoulders, stick in hand.

Still other people demand, as the Parliament did 1999, that science bloggers/journalists only blog about things they know. Quite a qualitative statement considering variations in breadth and depth of knowledge among both scientists and journalists. A comment here provides a good rebuttal to that idea. You could also reason that writing solely about what you know at any moment, like the biomechanics of kangaroo tendons, for instance, despite how interesting, might also be good way to become a lazy, narrow minded, outdated, and one bored stiff writer.

Recently the subjects of anonymity and pseudonymity re-emerged and preoccupied many science bloggers. I'm not going to weigh down this post talking about that, except to note 1) that the discussion has largely revolved around the value and necessity of a particular type of individual authentication, and 2) that the discussion has largely ignored the politics and economics driving such individual authentication.

Other people try mark out precise roles for science bloggers/journalists. Science writers should be "educators", they say, or "explainers", or priests of "how things work". Each such suggestion is an invitation for extensive discussion and cogitation, and naturally other people will vehemently disagree with every proposal. So then why don't bloggers just do what suits them best? Or does the constant criticism and re-definition create "community" (and pageviews)?

Getting The Details Right

We've touched on some general instructions to bloggers about how to blog about science. There are more detailed demands too, aimed at all of science blogging and journalism, as the divisions between online and offline media blur. For instance:

2005: Don't use the word "Global Warming": Thus implored some scientists reasoning that people would confuse climate change with their local weather.
2006: Don't use big words: So lectured the film "Flock of Dodos: The Evolution-Intelligent Design Circus". The version I saw at Tribeca 2006 highlighted words used by scientists in dialogue that were "too big", while characterizing Intelligent Design folks as small word people, i.e. comparatively approachable and understandable. It employed character assassination on all fronts by advising scientists to drop their testy, pompous attitudes, while it basically infantilized people who were religious. Some scientists took this whole thing to heart, overlooking how the movie slyly played to both audiences. People who knew the fairly simple polysyllabic words could be secretly smug that they knew the words when the definitions flashed on the screen like some weird spelling bee; and the other side of the audience could be smug about the portrayal of scientists as surly and smug.
2007: Don't publish on Fridays: The IPCC panel and hundreds of scientists took flack from the communication "framers" for publishing their 2007 report on a Friday (link accessed 04/11) because 'any veteran journalist would know better'. The same post chastised the report for lacking "drama" like portraying "polar bears on melting ice". The authors gave another paper kudos for "reframing the IPCC report" with a "corruption angle" that gave it "more legs". In other words, said the framers, don't be scientists or reporters be PR ringmasters.
2008 "Don't use the word "denial", "denialist", or "denier": Some scientists said that labeling climate change denialists as such was pejorative.

At the time, each of these instructions drew passionate discussions. But times change -- or don't change. Today it's fine to use "global warming" and "denialist". Science Friday still airs to large audiences on Fridays, and Science Magazine successfully publishes, Friday, after Friday, after Friday.

As charming as "Flock of Dodos" was, do big words really make science/scientists extinct? If we believe that message, should we then be discouraged that in 4 years, the Flock of Dodos trailer has 13,376 views on Youtube, while Hoax of Dodos, the Discovery Institutes pathetically best response, has almost as many -- 11,405 views? OK true, the "Pulled Punches" video (cut scenes from Flock of Dodos) has 18,605 views. But for perspective on what 18,605 views means on YouTube, the video "Emma Watson Punches Interviewer" (Jan 19, 2006), has 4,159,895 (all view numbers as of 05/11). Despite the fact that "Punch" is a catchy keyword to put in your comparatively boring science video, what does all this mean for science and science journalism?

"Blogging" is Worthy

What if none of these rules and instructions make science blogging "better", whatever better is? What if people still deny climate change for example, no matter what the facts and no matter what manner we convey them? While pursuing better communication is incredibly important, as is presenting ideas compellingly, how much of science knowledge lost by miscommunication is really any responsibility or fault of scientists and journalists (online or offline)? How much should be attributed to the political inclinations, personal distractions, and various passions of our audiences?

In reality most science journalists have zero time to write stories, whether or not they have generous deadlines. Those stories must always be very compelling just to get read. The extreme example of this fact, illustrated by a UK journalist, applies to most writing:

"You are writing to impress someone hanging from a strap in the tube between Parson's Green and Putney, who will stop reading in a fifth of a second.

We may not like this. We may wish readers didn't prefer reading science only when it's infused with sex or violence or something that 99% of the population have some opinion on. We may wish that journalists really comprised some "fourth estate", or could make a difference, or could educate readers. What if science writers could just all write about their own fascinating interest, rather than about something dictated by advertising? And what if the audience would just read, and not worry about about ethics, badges of legitimacy or whether education was happening as they read?

But until science journalists make a lot more money or have a lot more time, that won't happen on any large scale basis. But most science bloggers write for free or pittance. And if you write mostly for free on a blog, shouldn't you just write? Or does it have to be for some higher purpose (agreed upon by the consensus of one of many "communities")? Because wasn't that the whole purpose of blogging?

Science bloggers should keep in mind what their up against. The lifeblood of mainstream media consists of headlines the likes of this week's "GM Blunder Contaminates Britain With Mutant Crops", about "Frankenstein" crops.

So I'm sure whatever you write, dear blogger, will stand up just fine. And until "offline" journalism reaches different standards, can we stop insisting/demanding/pleading that bloggers "ARE journalists too"? Maybe science blogging could stand on its own apart from journalism if the community of science bloggers trusted themselves.

Why Do Drugs Cost So Much?

2011-07-26T06:04:37Z

The Pharmaceutical Research and Manufacturers of America (PhRMA) says it costs $1.3 billion to bring a new drug to market, and researchers dispute the lobby's claim. Could the ponderous costs of clinical trials, increasing regulation, a burgeoning FDA, and a litigious society keep driving drug prices up?

Perhaps we should we go back to simpler times, like 1895:

"The Cost of Making Antitoxin In the District:

Health Officer Woodward appeared before the Commissioners on the 10th inst., and submitted the following estimate for the suppression of contagious diseases: For the production of antitoxin for the treatment of diphtheria:

twelve horses at $40 each, $480;

maintenance of twelve horses at $10 each per month, $1200;

bacteriologist, $1,800;

materials and apparatus, $320;

Total: $3,800."

-The Journal of the American Medical Association Vol. XXIV, January 19th 1895: Miscellany.

It was the horses, obviously, driving costs up. Or perhaps they overestimated the cost of horses to support resistance to cheaper imports and generics, and to justify raising drug prices...