free paper: drug marketing and unconscious bias among physicians


graph from Think Progress

This free paper has 17 double-​spaced pages of easy read­ing text.Cor­rup­tion of Phar­ma­ceu­ti­cal Mar­kets: Address­ing the Mis­align­ment of Finan­cial Incen­tives and Pub­lic Health by Marc-​Andre Gagnon in the Jour­nal of Law, Med­i­cine and Ethics, Forth­com­ing at the Social Sci­ence Research Network


This paper explains how the cur­rent archi­tec­ture of the phar­ma­ceu­ti­cal mar­kets has cre­ated a mis­align­ment of finan­cial incen­tives and pub­lic health that is a cen­tral cause of harm­ful prac­tices. It explores three pos­si­ble solu­tions to address that mis­align­ment: taxes, increased finan­cial penal­ties, and drug pric­ing based on value. Each pro­posal could help to partly realign finan­cial incen­tives and pub­lic health. How­ever, because of the lim­its of each pro­posal, there is no easy solu­tion to fix­ing the prob­lem of finan­cial incentives.

SSRI induced mania and dopaminergic supersensitivity from antipsychotics


abstract: Antidepressant-​associated mania and psy­chosis result­ing in psy­chi­atric admis­sions. at PubMed

Despite the pos­i­tive changes in the side effect pro­file of anti­de­pres­sant drugs, the rate of admis­sions due to antidepressant-​associated adverse behav­ioral effects remains significant.

free online arti­cle at The Jour­nal of Neu­ro­science “Break­through” dopamine super­sen­si­tiv­ity dur­ing ongo­ing antipsy­chotic treat­ment leads to treat­ment fail­ure over time.

Antipsy­chotics often lose effi­cacy in patients despite chronic con­tin­u­ous treat­ment. Why this occurs is not known. It is known, how­ever, that with­drawal from chronic antipsy­chotic treat­ment induces behav­ioral dopamin­er­gic super­sen­si­tiv­ity in ani­mals. How this emerg­ing super­sen­si­tiv­ity might inter­act with ongo­ing treat­ment has never been assessed. There­fore, we asked whether dopamine super­sen­si­tiv­ity could over­come the behav­ioral and neu­ro­chem­i­cal effects of antipsy­chotics while they are still in use. Using two mod­els of antipsychotic-​like effects in rats, we show that dur­ing ongo­ing treat­ment with clin­i­cally rel­e­vant doses, haloperi­dol and olan­za­p­ine pro­gres­sively lose their effi­cacy in sup­press­ing amphetamine-​induced loco­mo­tion and con­di­tioned avoid­ance responding.

extreme heat, avoiding heat stroke, recognizing heat stroke and first aid


Dan­ger­ous Heat Wave in the West; Fol­low Red Cross Tips

In recent years, exces­sive heat has caused more deaths than all other weather events, includ­ing floods. A heat wave is a pro­longed period of exces­sive heat, gen­er­ally 10 degrees or more above aver­age, often com­bined with exces­sive humidity.

Dur­ing a Heat Wave:

Never leave chil­dren or pets alone in enclosed vehicles.

Stay hydrated by drink­ing plenty of flu­ids, even if you do not feel thirsty. Avoid drinks with caf­feine or alcohol.

Avoid extreme tem­per­a­ture changes.

Wear loose-​fitting, light­weight, light-​colored cloth­ing. Avoid dark col­ors because they absorb the sun’s rays.

Slow down, stay indoors and avoid stren­u­ous exer­cise dur­ing the hottest part of the day.

Post­pone out­door games and activities.

Use a buddy sys­tem when work­ing in exces­sive heat. Take fre­quent breaks if you must work outdoors.

Check on fam­ily, friends and neigh­bors who do not have air con­di­tion­ing, who spend much of their time alone or who are more likely to be affected by the heat.

Check on your ani­mals fre­quently to ensure that they are not suf­fer­ing from the heat.

Heat Stroke: Symp­toms and Treat­ment at WebMD

the micro-​politics of “shadow mothering”

Book Review – Shadow Moth­ers: Nan­nies, Au Pairs, and the Microp­ol­i­tics of Moth­er­ing by Susan Sapiro at Care Work Live

One of the inspi­ra­tions for Macdonald’s book comes from a per­sonal care­giv­ing expe­ri­ence. When she was 16, she was a sum­mer babysitter/mother’s helper for a fam­ily. She had worked with the fam­ily for some time and had grown close to their chil­dren, espe­cially the baby. One day, some­thing hap­pened that upset the baby and she reached for Mac­don­ald for com­fort, not her mother. Almost imme­di­ately, Mac­don­ald was “frozen out” by the mother. Shortly after, the fam­ily paid her for the sum­mer but let her go from the job. It wasn’t until many years later, as she started the research that became Shadow Moth­ers, that she under­stood the mother’s reac­tion and the com­plex emo­tions and rela­tion­ships between moth­ers and their children’s caregivers.

correspondence. 9th century. china.


i was ready to sink into earth with shame

Yes­ter­day, hav­ing drunk too much, I was intox­i­cated as to pass all bounds; but none of the rude and coarse lan­guage I used was uttered in a con­scious state. The next morn­ing, after hear­ing oth­ers speak on the sub­ject, I realised what had hap­pened, where­upon I was over­whelmed with con­fu­sion and ready to sink into the earth with shame.

universe. doomed. bummer.


lhc sci­en­tists say the uni­verse is doomed

If you use all the physics that we know now and you do what you think is a straight­for­ward cal­cu­la­tion, it is bad news… It may be that the uni­verse we live in is inher­ently unsta­ble and at some point bil­lions of years from now it’s all going to get wiped out,” Lykken stated.

Stud­ies on the Higgs’ related par­ti­cles are under­way and, if con­firmed, the dis­cov­ery can help solve the puz­zle about the ori­gin of the uni­verse and how it will end.

“This cal­cu­la­tion tells you that many tens of bil­lions of years from now, there’ll be a cat­a­stro­phe,” said Lykken, who is also on the sci­ence team at Europe’s Large Hadron Col­lider (LHC), the world’s largest and highest-​energy par­ti­cle accelerator.

A lit­tle bub­ble of what you might think of as an ‘alter­na­tive’ uni­verse will appear some­where and then it will expand out and destroy us.”

iran. the west. nuclear negotiations.


com­men­tary: make tehran a seri­ous offer by yousaf butt

There is no evi­dence to indi­cate that Iran is cur­rently devel­op­ing nuclear weapons — in fact, the U.S. direc­tor of national intel­li­gence, James Clap­per, has a “high level of con­fi­dence” that they have made no such deci­sion. Yet there is no rea­son not to strike a deal with Iran on sus­pend­ing their 20 per­cent ura­nium enrich­ment, espe­cially since they are amenable to such a bar­gain. The future tra­jec­tory of Iran­ian pol­i­tics is uncer­tain, with new pres­i­den­tial elec­tions due to take place in June. Given that pres­i­den­tial can­di­dates are offi­cially vet­ted by the Guardian Coun­cil, it is pos­si­ble that the next pres­i­dent may be even more hard­line than Mah­moud Ahmadine­jad. Indeed, in most coun­tries where the mid­dle class is suf­fer­ing under foreign-​imposed hard­ships, the ten­dency is to elect more nation­al­is­tic and hawk­ish lead­ers. Wit­ness Ger­many in the 1930s, for instance. And when Rus­sia and Argentina went through a sim­i­lar eco­nomic melt­down about a decade ago — as Iran is going through now — their peo­ple voted in more nation­al­is­tic lead­ers: Vladimir Putin and Nés­tor Kirchner.

Even though the Supreme Leader holds the real power in major nuclear deci­sions and has indi­cated he is firmly against nuclear weapons, it still makes sense to try to curb Iran’s enrich­ment work. And sanc­tions relief would be a small price to pay to get this con­ces­sion from them.

becoming a man. youth mentorship. chicago.

becoming a man and obama

pres­i­dent vis­its the becom­ing a man sports edi­tion program

…while in Chicago, Pres­i­dent Obama par­tic­i­pated in a group coun­sel­ing ses­sion of the Becom­ing A Man – Sports Edi­tion (BAM-​Sports) pro­gram. The visit high­lighted a joint effort by World Sport Chicago and Youth Guid­ance that is one of the few pro­grams to have been proven to reduce crime and increase school engage­ment by help­ing young men from high risk com­mu­ni­ties com­bat the chal­lenges they face in their neighborhoods.

Across the coun­try youth gun vio­lence, and youth vio­lence in gen­eral, is out of con­trol. How­ever there remains sig­nif­i­cant debate about the best approach to address­ing the prob­lem. The President’s visit today draws atten­tion to a pro­gram that has been proven effec­tive at strength­en­ing the char­ac­ter of young men in becom­ing resis­tant to vio­lent behav­iors. BAM-​Sports has demon­strated that, by focus­ing on six core val­ues, the young male par­tic­i­pants showed 40% fewer vio­lent crime arrests and 30% less arrests in other crimes while increas­ing their engage­ment in school. These results are proven out­comes from a com­bi­na­tion of ser­vices aimed at address­ing the under­ly­ing issues that cause impul­sive behav­iors and can lead to vio­lence, includ­ing: the BAM-​Sports coun­sel­ing deliv­ered by Youth Guid­ance and the BAM-​Sports after school pro­gram­ming, deliv­ered by World Sport Chicago.

women. constitutional law. justice ginsburg.


jus­tice ruth bader gins­burg head­lines thomas jef­fer­son law school women and law conference

Jus­tice Gins­burg spoke at mod­er­ate length on the unfor­tu­nate politi­ciza­tion of the con­fir­ma­tion process. She noted that, “I hope for the day that we can get back to where the sys­tem was when I was nom­i­nated in 1993. There was a true bi-​partisan spirit pre­vail­ing in our Con­gress. We are head­ing in the wrong direc­tion. We need to reverse gears and go back to the time when there was bi-​partisan sup­port for the president’s nom­i­nees. I won­der if the pres­i­dent would even nom­i­nate me now with my long­time affil­i­a­tion with the ACLU. Dur­ing my con­fir­ma­tion, not one Sen­a­tor asked me about it.”

Jus­tice Gins­burg was also very clear about the need for women on the bench, empha­siz­ing that women judges bring per­spec­tive that the court oth­er­wise lacks, and that a com­mit­ment to equal­ity requires more than just tokenism. She spoke of how, dur­ing her first year on the bench, lawyers would refer to her as Jus­tice O’Connor, although they look noth­ing alike. But in recent years, the con­fir­ma­tion of addi­tional women Jus­tices has changed the dynamic of the Court.

doctors without borders. northern afghanistan. trauma care.

Kunduz, northern Afghanistan, December 2011

a doc­tors with­out bor­ders slideshow: trauma care where there was none in north­ern afghanistan all pho­tos by michael goldfarb

Before the open­ing of the Doc­tors With­out Borders/​Médecins Sans Fron­tières (MSF) sur­gi­cal hos­pi­tal in Kun­duz Province, north­ern Afghanistan, peo­ple in the region suf­fer­ing from severe injuries had two options. They made the long and dan­ger­ous jour­ney to Kabul or Pak­istan, or they vis­ited an expen­sive pri­vate clinic. As a result, few patients received the trauma care they needed.

In less than a year, the MSF trauma cen­ter, equipped with an emer­gency room, two oper­at­ing the­aters, and an inten­sive care unit, has seen more than 3,700 patients. The major­ity are vic­tims of so-​called “gen­eral trauma” — road traf­fic acci­dents, domes­tic vio­lence, or civil­ian gun­shot wounds.