Monday, December 22, 2003

Along the lines of Calpundit's tradition of Friday cat blogging, we here at Respectful of Otters are beginning a tradition of Sunday baseball blogging.

In this case, slightly belated Sunday baseball blogging.

The Baltimore Orioles signed Javy Lopez last night, just a week after their huge Miguel Tejada signing. It's good to see money being plowed into the team after years of relentless downsizing. But the Javy Lopez deal has disturbing echoes of Orioles mistakes past. They've had a long history of signing aging or injured stars to extended contracts. Lopez is only 33, but catchers age more quickly than other position players, and he's already missed most of one season with injuries. Undisputably, he had a standout year last year. In 2001-2002, though, his performance at the plate was mediocre. The O's are primarily buying Javy's bat - he's never been a great great defensive catcher. I've seen speculation that they may still try to sign Pudge Rodriguez, and move Javy to first base or DH. That would be good strategy; Pudge is second to none behind the plate, and it would free Lopez to concentrate on his hitting game. Since the O's are still making a run for Vladimir Guerrero, though, whether they'll continue to pursue Rodriguez is anyone's guess. Even Peter Angelos's money has to run out sometime.

Is this a good deal for the O's? In the end, it will all depend on which Javy Lopez shows up for spring training: the 2003 version, or the 2001-2002 version. If it's the former, the new O's management team will look like geniuses. If it's the latter, in a couple of years we'll all be calling Javy Albert.

Friday, December 19, 2003

Moe Lane of Obsidian Wings is a very wicked man. (I can say this with impunity because, according to my Significant Otter, Moe doesn't actually believe that I exist.) Anyway, here's the proof:
Lieberman: Now is the winter of our discontent
Made glorious summer by this sun of Dean;
And all the polls that rained upon our cause
In the deep bosom of the ocean buried.
Now are our blogs bound with laudatory posts;
Our broken bats hung up for monuments;
Our stern reproofs chang'd to merry meetings,
Our tedious marches to joyful strippings.
Grim-toned Protest hath soothed his howling voice,
And now, instead of mounting great puppets
To fright the souls of fascist Rethuglicans,
He snickers loudly in left-wing chat threads
To the incestuous music of trackback links.
There's so, so much more at the link. Be afraid.

Elsewhere in today's wickedness news, Pen-Elayne sheds new light on the whole "Jewish neoconservatives" question by pointing out that Hannukah is all about oil.

Wednesday, December 17, 2003

Oh, now this is interesting. Apparently, that Democratic attack ad against Howard Dean was funded by a group of unions endorsing Gephardt. Two of the unions involved are so disgusted by the ads that they're asking the group to pull them:
The union, Mr. Sloan said, believed the group's commercials would focus on economic and health care policies.

But in the end, he said, the advertisements were not what the union had bargained for, especially the latest one, in which an announcer questions Dr. Dean's national security qualifications as a camera zooms in on a magazine cover showing Osama bin Laden's face.

"Osama bin Laden has nothing at all to do with this campaign; it's a travesty," Mr. Sloan said. "We think the ads are despicable and if it was up to me, we'd ask for a refund."
The New York Times has a nice editorial on this issue, as well.
From the looks of the CDC's map, people across most of the country have cause to be worrying about the flu right now. It's an early flu season, and it's hitting hard. Unfortunately, if you didn't get vaccinated months ago, you're not going to be able to get vaccinated now - they've pretty much run out nationwide, and the remaining doses are being saved for immuno-compromised people.

Why is this happening? The short answer is: the Invisible Hand of the market doesn't care whether you get sick.
Since the killer flu season of 1989-'90, flu outbreaks have been mild. Demand for flu shots has been declining, and, since the shots expire in June following each flu season, drug companies in each of the past five years have discarded unsold vaccine.

Last year they made 95 million doses, sold 83 million, discarded 12 million.
So this year they only made 83 million, another killer flu season hit, demand increased, and they ran out.

It's a lot worse for private manufacturers to have too much vaccine than it is for them to have too little. Too much, and they're out the whole cost of the extra doses - too little, and they've lost a much smaller amount of money per dose in foregone profits. So they'll try to make enough vaccine to meet demand, but they have no particular incentive to leave a wide safety margin.

We've ceded huge swaths of our public health infrastructure in this country to private corporations, mostly on the logic that privatization is more efficient and less expensive and good for campaign donations. And as long as it only involves private organizations contracting to perform services as directed by public agencies, it apparently works reasonably well. But public health decisions simply shouldn't be based on the profit motives of private companies. As a society, we can't afford to just hope that when an epidemic strikes, the Invisible Hand will reach out and give us a syringe.

(Incidentally, watch for conservative pundits to start blaming the flu vaccine shortage on lawsuits against vaccine manufacturers and saying that we need tort reform to protect us from future shortages. No matter what problem faces America, the answer is always one of these three things: tax cuts, "tort reform," and drilling in the Arctic National Wildlife Refuge.)
Terrorists you've never heard of, part 1:
A Christian fundamentalist who was trained as an Army Ranger pleaded innocent last week to bomb and weapons charges in an alleged plot to blow up abortion clinics, gay bars and churches he deemed disloyal. Prosecutors said 35-year-old Stephen John Jordi described himself as a terrorist and planned a bombing spree across the eastern United States.
Terrorists you've never heard of, part 2:
In April, as Baghdad fell and American soldiers began searching for weapons of mass destruction in Iraq, federal officials uncovered a cache of deadly chemicals much closer to home — in the eastern Texas town of Noonday. The stockpile included a fully functional sodium cyanide bomb capable of killing hundreds, as well as neo-Nazi and antigovernment literature, illegal weapons, half a million rounds of ammunition, and more than 100 explosives, including bombs disguised as suitcases.

In February, federal officials arrested Rafael Davila, a former Army National Guard intelligence officer from Washington State; they say Mr. Davila and his former wife planned to distribute highly classified documents to white supremacists and antigovernment groups in North Carolina, Texas and Georgia.
Remember, folks, racial profiling is what we really need to keep us safe in the war against terrorism, whatever those PC wackos might say to the contrary. If it means that white males come under additional scrutiny for a while and maybe are asked to give up some of the civil liberties they took for granted in a pre-Timothy-McVeigh era - they should consider it their patriotic duty. It's all on behalf of a safer America.

Monday, December 15, 2003

I've been invited to join the Liberal Coalition, which proves that entering the new blog showcase was a great idea even if I didn't win.

A quick tour of the Coalition: Kick the Leftist points to new poll results since Saddam Hussein's capture, which show only meager increases in the percentage of Americans who think the war is worthwhile and the percentage who plan to vote for Bush. It ain't over, folks, by any means. And Then... has an admirable call to arms on behalf of Democratic unity. It's Craptastic! won this week's new blog showcase, and finds, true to form, that a Republican candidate wants to subvert the voting process. Dohiyi Mir's "Queer Eye for the Deposed Guy" is just plain wrong. Corrente has the good news that the AARP may be backing off on its support of the godawful Medicare bill. And finally, Tao of Dowingba needs to go read Howard Dean's new foreign policy speech.

Well. This should be fun.
A new federal report tells us all about the valuable trade we've made, giving up our first, fourth, fifth, sixth, seventh, and eighth amendment rights in exchange for protection from dangerous terrorist criminals.

Of the tens of thousands of people jailed, investigators recommended prosecutions in 6,400 cases. Prosecutors only thought it worth their while to file charges in 2,001 cases. 879 people have been convicted, of which 58% didn't even go to jail.The average sentence? Fourteen days. Only 23 received sentences of five years or more - compared to 24 people sentenced to five or more years for terror-related crimes from 1999-2001.
Mark Corallo, director of public affairs at the Justice Department criticized the methodology of the research, saying that TRAC ignored the value of investigators disrupting planned terrorist attacks before they can unfold by charging suspected terrorists with a lesser crime.
Corallo did not, apparently, go on to explain how a 14-day sentence deters someone from committing a terrorist act once released.

This is hopeful, though: a Republican-led federal terrorism commission says that the government needs to give more weight to civil liberties.
Time, quoting an anonymous source, said the new Homeland Security Department is focused on "the crisis of the moment," yet no one in the administration was examining "the broader issues of economic security and societal stability."

"If they're doing it, they're doing it in such a superficial or under-the-radar fashion that it did not become apparent to the panel," the source told Time.
Many Republicans are potentially our allies on this one, if we can find a way to make common cause with them.

Sunday, December 14, 2003

Undoubtedly, the capture of Saddam Hussein will produce calls for those of us who opposed the war to "admit we were wrong." I'm glad he was captured - I think it's a good thing for the Iraqi people and for the chances of peace in Iraq.

But I want to go on record with this: I didn't oppose the war because I thought we wouldn't be able to catch Saddam Hussein. For me, his capture has little bearing on whether the war was a just action.

Saturday, December 13, 2003

Condemnation of the nasty smear campaign by the so-called "Americans for Jobs, Health Care and Progressive Values" is all over the place today, and rightly so. No matter who we support in the primary, Democrats have to keep our eyes on the prize: defeating George Bush. (Note to AJHCPV: defeating him, not writing his commercials for him.)

But an even more disgusting and pernicious dirty trick is being lost in the shuffle as everyone focuses on the commercial: someone has been sending out fake faxes purporting to be from Dean for America.
Households in at least one heavily Jewish region of New Jersey have been receiving faxes claiming to be from Dean's campaign promising to ''end support for Israel in favor of even-handedness'' and to ``promote greater understanding and tolerance of Islamic teachings.''

The faxes carry the letterhead ''Dean for President'' and ''Dean for America,'' the correct name for Dean's campaign, and one even cites his endorsement this week by Gore -- but tout fake positions clearly designed to mislead readers about Dean.
Could this have been done by one of the other Democratic campaigns? I wouldn't want to think so, but I have to concede that it's possible. But it also smells distinctly like the Bush campaign's SC primary push polls about McCain's "black baby."
Who knew that gay AIDS service organizations universally believe patent protection for drug companies is the most important weapon in the fight against AIDS? According to the sidebar in the Washington Blade, the best people to contact for more information about the scourge of drug resistance and the saving power of patents are... the Pharmaceutical Research Manufacturer's Association. How about that.

I'm a little shocked. I thought the Washington Blade was a reputable news organization, but this particular piece has Astroturf written all over it. I wonder if it was a paid placement, or if they just threw in a press release to fill up space.
Via Crooked Timber, I found a blog decrying the "hounding" of Elizabeth Loftus. Loftus was a primary figure in the "memory wars" that swept the mental health field in the 80s and early 90s.

The memory wars were an ugly, ugly time. What I can only call a therapeutic cult had grown up around the idea that depression and other psychological problems in adulthood were the result of repressed memories of childhood abuse, which could be retrieved through what we now know are unreliable memory-recovery techniques such as hypnosis. The battle over "repressed memories" - which typically had disastrous consequences for individuals and families - coincided with a growing understanding that witnesses' memories in criminal cases could be swayed by leading questions. (The McMartin preschool case is the most notorious example, but there were many similar cases.)

Loftus conducted excellent research about the unreliability of eyewitness testimony - that's how she made her professional reputation. But in their justified crusade against recovered-memory hysteria, she and her colleagues had a tendency to overstate their data and ellide important differences between cases. For example, they made no distinction between spontaneous recovery of abuse memories (triggered, for example, by revisiting a childhood home or seeing the abuser again) and recovery of abuse memories under coercive questioning. Cases in which always-remembered abuse was disclosed in adulthood also tended to be treated like cases in which abuse memories were recovered in therapy. In general, Loftus's "False Memory Foundation" tended to uncritically accept the stories of parents who claimed their children were making false accusations of abuse, without independent investigation. So: really ugly.

So what's Loftus being "hounded" about now? The details of the case, taken from an article sympathetic to Loftus, astound and repel me. Apparently, there was a case study published in 1997 which appeared to document a genuine case of a repressed and recovered memory. Loftus, skeptical, hired a private investigator to dig up information about the case, including the client's real name and location. Loftus and the private investigator then interviewed various members of the young woman's friends and family, decided that the abuse had never occurred, and wrote an article about it for a popular magazine. The article refers to the young woman as "Jane Doe," but includes a lot of information about her, some of it potentially identifying. Loftus has also apparently made speeches to professional organizations in which private details of Jane Doe's life were discussed.

Understandably, "Jane Doe" complained to the Loftus's employer, the University of Washington, about this appalling violation of her privacy. There was a long academic battle about whether Jane Doe was covered under statutes protecting the rights of research subjects, at the end of which the university decided that what Loftus did was not, technically, research. She was reprimanded and told to take an ethics class and not to contact Doe's family anymore. Instead of accepting this decision, she quit. Now she's complaining about the evil university establishment violating her academic freedom.

I'm not going to get into the question of whether or not Jane Doe was abused. What's clear to me is that Loftus's behavior was grossly unprofessional. Regardless of whether it violated research subject protection laws (and the case probably doesn't qualify as "research," given that it's neither systematic nor generalizable), it certainly violated the ethical code of the American Psychological Association, which applies to all contexts of professional behavior. It doesn't matter that Jane Doe was not Loftus's client or research subject. Loftus had a responsibility, as a psychologist, to preserve her confidentiality - and not to go beyond what's justified by the data to use this real person as her pawn in the memory wars. It's obvious to me who's being hounded here - and it's not Elizabeth Loftus.

Friday, December 12, 2003

An education professor at Black Hills State University, Len Austin, wrote a book called "What Teachers Need to Know About Their Students' Religious Beliefs," which purports to explain the major tenets of twenty-five religions. It explains, among other things, that Native Americans believe they are descended from one of the lost tribes of Israel, and are thus Jewish by bloodline.

Of course, Native Americans believe no such thing... unless they happen to be Mormon. It appears that the author's own Mormon beliefs slipped in somehow. (I don't know enough about Mormonism to know if that's also why the Trinity is bizarrely explained as "three Gods in one person.") He swears he wasn't trying to convert anyone to Mormonism, but admits that he did most of his research on the Internet and didn't have any religious scholars check his work.

You might be wondering, at this point, what happened to the whole concept of editorial fact-checking. It turns out that, according to the publisher - University Press of America - "a second edition with any changes is up to Austin...since UPA's publishing contracts require that authors supply camera-ready pages and are responsible for all editing tasks." Hmmm.

Turning to the UPA website, we find the proud assertion that "where other academic publishers stress a book’s profitability, UPA is committed to the belief that the most important question relevant to the publication decision is: Does this work provide a significant contribution to scholarship?"

I wonder how they decide that, without editing or - apparently - peer review.

Thursday, December 11, 2003

From time to time, I've heard bloggers make conversational remarks along the lines of, "I'm a slithering reptile!" I finally figured out what it meant when I discovered the blogosphere ecosystem. I think right now I'm probably somewhere around pond slime (is there something more obscure than pond slime?), but I'm aspiring to claw my way upward someday. If I can ever figure out how to let people know I exist.

The ecosystem site sponsors a new blog showcase (really a contest, where the votes are incoming links from other blogs) to alert readers to new voices. There's some interesting stuff (for example, I'm always a sucker for conservative remorse). Having clicked through to the blogs, though, I'm not sure that everyone chooses their best recent post to enter. (That might possibly include me.)

Wednesday, December 10, 2003

I got sidetracked in my last post, which was originally supposed to be about what a disaster the new Medicare bill is for HIV care.

Medicare covers health costs for many people with disabilities, including people who are disabled by HIV/AIDS. 50,000 indigent Americans with HIV have dual coverage: Medicare, to pay their major medical bills, and Medicaid, to pay for services - like prescription drugs - not covered by Medicare. When the Medicare prescription drug "benefit" comes into effect in 2006, they'll be required to use it - their Medicaid prescription benefits will be dropped entirely.

Why is this a particular problem for people with HIV?

- Under the Medicare bill, patients can only receive coverage for two drugs at a time in any given therapeutic class. Controlling the replication of HIV requires a "triple cocktail" - at least three drugs. Monotherapy and two-drug therapy consistently lead to treatment failure.

It's not clear to me how "therapeutic category or class" will be interpreted - are "antiretrovirals" (anti-HIV drugs) all in the same therapeutic category, or will the different kinds of antiretrovirals (such as NRTIs and protease inhibitors) be considered separate categories? The first interpretation would essentially mean that the bill doesn't cover HIV care at all - a two-antiretroviral regimen is clinically worthless. It's marginally less of a disaster if they mean the second interpretation, because a lot of HIV cocktails include, for example, two NRTIs and a protease inhibitor. But salvage regimens (used late in the course of the disease) might include 3 protease inhibitors, and all-NRTI regimens are often recommended for new patients.

- Also, the bill lets insurance companies offering Medicare benefits establish a formulary - a list of drugs they cover. They're required to include at least two drugs in each therapeutic category - a generic and a name-brand. That's it. If you need a drug that's not on the formulary, you can appeal - but Medicare won't necessarily pay for it. If you find some other way to buy it - keeping in mind, as I said in my last post, that purchasing Medigap coverage to do so will be illegal - your expenses won't be counted as part of the $3,600 out-of-pocket limit. Sure, probably most companies will choose to cover more than two antiretrovirals - but there's nothing in the law that says they have to, and there's certainly nothing to say they have to cover the newest drugs most needed by the sickest patients.

What all of this means, in the end, is that the cost of prescription drugs for people with HIV will be pushed back onto state AIDS Drug Assistance Programs. And ADAPs are already so overloaded and underfunded that many states are rationing access to AIDS drugs - including, thanks to Gov. Schwarzenegger, California. From now on, in California as in poorer states such as West Virginia, new HIV patients won't be able to get their drugs paid for by the state until an existing patient dies or gets private health insurance. And that's before all the Medicare/Medicaid patients get kicked back into ADAP.

It's an unmitigated disaster.
Much has already been written about how awful the new Medicare bill is - the big winners are HMOs (who get huge handouts to encourage them to "compete" with Medicare) and drug companies (Medicare is prohibited from negotiating bulk drug discounts for members, and re-importation of drugs from other countries is banned). Patients, on the other hand, are in trouble - and every day we're identifying new reasons why.

The latest: the Medicare bill bans Medigap policies, add-on insurance plans which cover the difference between what Medicare will pay and the actual cost of care. And that difference can be considerable - under the new plan, patients will be responsible for a $250 deductible, 25 percent of all their drug costs from $251 to $2,250, and then - strangely - all of the next $2,850 in drug costs. The goverment is supposed to pick up everything after the patient has paid $3,600 in out-of-pocket expenses, but the catch is that the $3,600 doesn't include payments for drugs that aren't on the insurance company's formulary. Seniors might end up with considerably more than that in out-of-pocket, unreimbursed expenses, and they're forbidden to buy additional insurance to help out.

Why on earth? - Because studies have shown that patients with Medigap coverage tend to have higher usage of care and greater overall medical expenses. Supposedly this is because their good coverage makes them "insensitive to the costs of care." But I'd want to see proof that it's not because (1) sicker patients are more likely to need, and therefore buy, Medigap coverage, or (2) in the absence of Medigap coverage, cost concerns lead patients and doctors to make less-expensive but also less-optimal care choices (such as substituting an older, cheaper drug with more drawbacks for an expensive new drug).

Monday, December 08, 2003

The big news tonight, of course, is Al Gore's imminent endorsement of Howard Dean. Democrats seem divided on exactly what this will mean (except Joe Lieberman, who doubtless knows exactly what it means). There have been, for example, both genuine and sarcastic declarations of the inevitability of a Dean nomination.

Josh Marshall says:
I was talking to a friend this evening about Gore's announcement and he said that Gore's endorsement wouldn't be all positive since a lot of people are still pissed at Gore for what happened in 2000.

But I think that's very much a DC reaction, and not one, I think, that's shared very widely among Democrats around the country. Whatever they thought of Gore going into 2000, I think most Democrats around the country see him as someone who by every measure was robbed of the presidency and thus has great credibility to make such an endorsement.
That makes sense to me. I think Gore screwed up the 2000 election badly, but that doesn't mean I don't think he was robbed in Florida - and every passing day of the Bush Administration makes Gore look better and better to me. And I'm not the only one.

I think the most important aspect of the Gore endorsement, though, is that it deflates the most persistent charge against Dean: that he's a far-left whacko fringe candidate who's out of step with the mainstream of the Democratic Party. Al Gore is as centrist as centrist gets - he was the DLC's golden boy. If he supports Howard Dean, then Howard Dean has centrist appeal. It's hard to spin it any other way.

It's probably unwise to declare that anyone's nomination is inevitable before any votes are cast, but it sure looks good for Dean. Yay!
John Kerry's getting desperate:
The campaign issued a memo Saturday night saying for the first time that Kerry is competing for "the top two" spots in the [New Hampshire] primary, not just for an all-out victory.
"Howard Dean was recently at 11 percent in a South Carolina poll, with the margin of error being 5 percent -- which means he could be as low as 6 percent," [campaign spokesman Michael] Meehan said. "Meanwhile, we're at 4 percent, and with the margin of error we could be at 9 percent."
Yes, Dean's current lead in SC is within the margin of error, and yes, it's unlikely that he'll actually win the SC primary. But John Kerry, for heaven's sake, is not going to be SC's preferred alternative to Dean. This hopeful interpretation of the poll results is just embarrassing.

Kerry's trailing Dean by more than 30 points in New Hampshire. Dean leads by six points in Massachusetts, Kerry's home state. Those need to be his states, if he's going to have any chance of winning the nomination. There's no point in trying to pretend otherwise.
The standard conservative line is that block grants are better than federal programs, because local authorities are better equipped to know what communities need.

I'm sure, for example, that the Department of Housing and Urban Development would never have guessed that what Boston needs most, in terms of economic revitalization of struggling neighborhoods, is a string of luxury hotels.
Three big hotel deals announced recently by the city -- in tony Back Bay, the North End's waterfront, and in South Boston near the new convention center -- are being financed with $40 million backed by Boston's HUD community development funds.

The Mandarin Oriental Hotel is being billed as the finest hotel Boston has ever seen, set in the "sophisticated panache" of the Back Bay. The Regent Boston Hotel on Battery Wharf is being described as a "spectacular" five-star experience in a parklike setting, with beautiful harbor views and "every conceivable amenity." The third is a 790-room Westin Hotel designed to accommodate convention guests near the South Boston Waterfront.
Two of the hotels will also offer condos - one starting at $700,000 for an 800 square foot apartment, and the other starting at $2 million. Clearly, this is a community development windfall in a city famously lacking affordable housing.

The city, of course, argues that building these hotels will create service-industry jobs. But Community Development Block Grants are supposed to be more than just another source of corporate welfare in the name of "job creation" - they're supposed to help communities develop businesses in low-income neighborhoods in which more traditional investors might balk at the risk involved. Lacking tighter federal control, they're apt to end up just another pile of pork.
Oh yeah, I have a weblog.

More posts to come...

Friday, October 17, 2003

That was then:
Army Gen. John P. Abizaid, in his first Pentagon briefing since taking charge of the U.S. Central Command last week [...] said that soldiers quoted yesterday on ABC News' "Good Morning America" questioning their mission in Iraq and calling for Rumsfeld's resignation were wrong and could be disciplined.
And also:
Soldiers' families are also being advised not to complain to the media, according to news reports.

After being told that 3rd ID soldiers would be staying in Iraq longer than expected, families received an e-mail message from a rear-detachment commander warning against contacting the press "in a negative manner regarding the military and this deployment."

This is now:
Army Lt. Gen. William G. Boykin has made several speeches — some in uniform — at evangelical Christian churches in which he cast the war on terrorism in religious terms. Boykin said of a 1993 battle with a Muslim militia leader in Somalia: "I knew that my God was bigger than his. I knew that my God was a real God, and his was an idol."

The defense secretary said he could not prevent military officials from making controversial statements.

"We're a free people. And that's the wonderful thing about our country," Rumsfeld said. "I think that for anyone to run around and think that that can be managed and controlled is probably wrong. Saddam Hussein could do it pretty well, because he'd go around killing people if they said things he didn't like."

Thursday, October 16, 2003

The online Museum of Menstruation (and I can't even begin to tell you how relieved I am to find that it's just a clever name for an informational website, and not a real museum) has been collecting responses to the question, "Would you stop menstruating if you could?" The breadth and range of the responses are utterly fascinating.
it's embarrassing. When suddenly you can't go somewhere you were supposed to and are asked why, if you excuse yourself from a commitment and it is a woman, perhaps she doesn't get as severe a period as you, so she assumes you are just being a hypochondriac/sissy who shouldn't let such things interfere with life and activities.

Have fantasized swapping my very fertile system with some poor female who is dying to have crying, money-eating, life-goals killing children, but cannot.

Bleeding once a month lets me know there's nothing wrong. Examples: if I'm stressed, I don't get my period. I didn't get my period once due to precancerous cells on my cervix, or from a very bad infection.

Please don't come up with that stuff about feeling more creative and better connected to Mother Earth and all that bullshit. Sorry for all women that define their relation to nature and spiritual things by bleeding.

Menstruation is a reminder to me that I am an organic creature, a child of Mother Earth. Menstruation is a sign of a healthy womb/healthy body. Menstruation is an emotional and spiritual thing for me. During my period, I am aware of the power I have as a woman to reproduce life and to become a living environment for the growth and development of a human being. To me, menstruation is sacred.

In my world, there were four things that qualified you as an adult; being able to wear makeup, having pierced ears, being baptized, and of course, having a period. I just wanted to feel like a grown woman, and I also wanted the responsibility.

I don't hate my period (usually), or think it's shameful or wrong; I'm fairly open about it, really. I just find it generally useless and pretty irritating. It doesn't have any "effect" on me - I'm not more emotional, more artistic, more connected to femininity. I'm just bleeding from the crotch for seven days.

Why, God? Why does God favor men? Why do women have to deal with all the pain, bloating, moodiness, odor, etc. Men have nothing they have to deal with.

Paging Connie Willis to the red courtesy phone.

More seriously, I'm struck by how few of the responses are as matter-of-fact as the second to last one. Women seem to project all kinds of things onto menstruation, and the factual correctness of the interpretation (no, there's no connection between lunar cycles and menstruation, and certainly menstruating doesn't mean that "nothing's wrong," as the third quote suggests) doesn't even seem to enter into it.

Monday, October 13, 2003

Some companies are designing their workplaces to force employees to exercise.
"It's, if you will, a forced wellness program," said Dan Jeakins, an architect in Dallas who has designed office buildings that encourage walking and stair-climbing. "We've had fitness centers, but that varies on who really uses those things."
As a health psychologist, I strongly approve of lifestyle modifications to promote healthy behavior, rather than short-term diets or "exercise programs." Most people, realistically, can't or won't take up high-intensity exercise in a gym, whereas most people can probably increase the amount of walking they do in their daily lives.

But as a disabled person, I have to wonder when the first ADA challenge will be brought against one of these companies. How are their employees with orthopedic disabilities, arthritis, asthma, emphysema, or severe seasonal allergies doing with all the required extra walking and time outdoors? What about female employees who are nine months pregnant? It's all very well to argue that the average employee is sedentary but nondisabled and could benefit from extra exercise, but public design is supposed to accomodate the needs of the entire population, not just the needs of the modal person. The ability to walk a half-mile to one's desk should not be a requirement for an office job. Period.

And as a woman, I wonder whether these new walking-intensive company campuses have dress codes for female employees which permit them to wear comfortable walking shoes, or whether women are expected to walk these "wellness-promoting" extra half-miles in the high heels typically required with women's formal office wear.

Thursday, October 09, 2003

The National Center for Biodefense at GMU has announced that smallpox vaccination might protect against HIV infection.
The study was conducted using blood cells from 10 vaccinated and 10 unvaccinated subjects. Despite the small number of subjects involved, there was a statistically significant difference in resistance to HIV infection between the blood cells from the vaccinated and the unvaccinated subjects. HIV failed to grow or grew at substantially reduced levels in the cells from the vaccinated group when compared to the unvaccinated group.
The researchers say they got the idea because HIV emerged in Africa at about the same time that smallpox vaccinations stopped there. The International AIDS Vaccine Initiative is apparently dubious, pointing out that we've had a lot of exciting early findings that have failed to pan out.

I'm dubious myself. I notice that Medscape doesn't have anything about this on their HIV home page (although if you search the Medscape site you'll find a Reuters article that's essentially the same as the GMU press release), and nothing about it appears to have been presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy or at the AIDS Vaccine 2003 conference. We've seen miraculous advances released to the popular press but not for scientific peer review before, and it hasn't typically boded well for the ultimate scientific value of the research.

There must be more to this theory than temporal correlation, but without anything to go on but the press release, there's no way I can tell what else there might be. In the United States, routine smallpox vaccination was halted in 1972 and the first cases of AIDS were identified in 1982. So virtually every adult infected with HIV in the early days of the epidemic would have been immunized for smallpox. Moreover, genetic analysis of HIV suggests that it's much older than smallpox eradication, and it appears that AIDS had already reached epidemic proportions in parts of Africa by the 1960s.

In short, I'm not expecting anything to come of this - although it would be nice to be pleasantly surprised a few years down the line.

Monday, October 06, 2003

Sweet suffering Jesus.
What I saw: A young family of five — father, mother, three young children, well-dressed, well-behaved, enjoying their night out, too. Except for the well-behaved children — mythical creatures with which we have no personal experience with — the family was unremarkable.

But they were black. And my husband whispered that in a nation where 70 percent of black children are born into homes without fathers, it was great to see a picture-perfect black family dining together. "I almost want to go give the guy a high five," he said, somewhat sheepishly.
I thought we were at least thirty years past the concept of "a credit to their race." What chills me most is that I'm dead certain that Graham thought she was being nice.

(Via Atrios.)

Friday, October 03, 2003

Because our church still hasn't gotten around to sending us a subscription to the UU World after two years of membership, I initially missed the July/August feature on Unitarian-Universalists and the military. The lead article, "Embattled Faith," does an excellent job of exploring historical and current conflicts within the denomination regarding war and peace. Unitarian-Universalism isn't pacifist either by creed (because there is no creed) or by history (Unitarians were strong promoters, for example, of the American Civil War), but pacifist viewpoints certainly dominate modern UU thinking to the extent that it can be uncomfortable to disagree. I credit the UU World for printing a sidebar piece by an Air Force wife who had to remind her church not to reject members of the military. It's not a very attractive view of Unitarian-Universalism, but I think it's important that practitioners of liberal religion be prepared to address our own hidden intolerances. Sure, it's more comfortable to focus on the beam in the other guy's eye, but UUs are supposed to believe in the inherent worth and dignity of all human beings, whether they're holding a peace sign at a rally or an M-16 in Iraq. No one ever said it was going to be easy.

Thursday, October 02, 2003

Monday, I heard Sten Vermund speak about the history of HIV epidemiology at the 2003 International Meeting of the Institute of Human Virology. Dr. Vermund mentioned, parenthetically, that bleach does not effectively remove virions from injection drug equipment, and thus is not recommended as a prevention technique.

I hadn't heard that. Given that I do HIV prevention work with my patients, 80% of whom have injection drug use histories, I thought it was a bit odd that I hadn't heard that - so I went researching. After several minutes of digging, I found a set of 1997 CDC recommendations for IV drug users emphasizing the importance of new, sterile syringes, with bleach mentioned as a backup option. The CDC's HIV FAQ also pushes the use of new syringes and mentions bleach as a less satisfactory alternative. Neither CDC site provided details of how needles should be cleaned with bleach, although established guidelines do exist.

An older CDC fact sheet presents a 1991 finding that addicts who reported always cleaning needles with bleach had the same seroconversion rates as addicts who didn't report using bleach. (I have to wonder about the accuracy of addicts' reports on their injecting behavior, though, given the typical state of mind immediately pre-injection.) Other studies have found that addicts often think they've rinsed their needle for a full 30 seconds when they haven't. These seem to be the results which led to the de-emphasis of bleach. But another recent study suggests that the recommendation might've been changed too soon:
"What we found is that for the type of syringe usually used by drug injectors, even a one-tenth diluted solution of bleach successfully disinfects the syringe if the solution is drawn in and squirted back out," Heimer says. "Even when we stacked the deck and left 10 times more blood in the syringe than is usually found, full strength bleach was effective in 152 of 153 attempts. We even found that rinsing three times with clean water reduced the likelihood of recovering live virus by 99%."

Most of the patients I see in my research don't share needles - Baltimore has an effective needle exchange program - and none of my therapy clients currently inject drugs. But damn it, it shouldn't take an hour of research for me to find out the latest evidence-based prevention recommendations. I should be drowning in the latest recommendations. But for some reason, that doesn't happen - especially when the latest recommendations contradict previous recommendations.

The best example of this is the spermicide nonoxynol-9. It used to be recommended because it was found to kill HIV in vitro, but in real life it actually increases the risk of HIV infection in both women and in gay men. Many AIDS service organizations still distribute condoms treated with n-9 - even the Institute of Human Virology, one of the premier HIV research institutions in the world. Information dissemination on this topic has just been poor. You shouldn't be able to get within ten feet of a condom without being exposed to full information about n-9. They should have warning labels on displays in stores. At a minimum, everyone working in the field should have had it hammered into their heads by now. I don't know why that hasn't happened.