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Funnily many of the examples you provided are driven by the enforcement of white supremacy perpetuated by the anti-drug establishment.

Here's somebody who developed that idea for the BMJ (formerly British Medical Journal) and made a good argument for the racism motivation.

http://blogs.bmj.com/bmj/2015/...
Art Cohen and Selwyn Ray: The lessons of late April in Baltimore
8 May, 15
BMJ

After years of suffering and resignation about disrespect and mistreatment at the hands of local police, young and older African-American residents of inner city west and east Baltimore, joined by others, came together these past two weeks to say: “we’ve had enough.” The spark for this was the fatal injuring, while in police custody on 12 April, of 25 year old Freddie Gray, who died a week later on 19 April. Gray was a resident of the Sandtown-Winchester neighborhood and also a childhood victim of lead paint poisoning. He was arrested for making eye contact with a policeman and then trying to run away. His death acted as the proverbial straw that broke the camel’s back.

Fortunately, the Baltimore City States Attorney took swift action on 1 May to charge all six police officers implicated in the death of Freddie Gray.

Lesson #1—The public’s health includes being free not only from the threat of gun violence, but also from the violence suffered at the hands of police officers and other government agencies.

Lesson #2—A long history in Baltimore and elsewhere of police disrespect and abuse of authority eventually can become intolerable and lead to explosions of public outrage, some of which may include violence against property or persons. The relentless, massive “war on drugs” is largely responsible for this police abuse. America’s longstanding decision to criminalize the abuse of drugs has virtually eliminated the practice of requiring “probable cause” for arrests, and has led to thousands of lives damaged and wasted by wholesale warehousing in jails and prisons.

Lesson #3—This specific public outrage about police misconduct is fueled by a broader and deeper public outrage at the severe economic, social, and health disparities which have persisted for many years within some Baltimore City neighborhoods.

https://www.themarshallproject...
04.29.2015
Q&A
David Simon on Baltimore’s Anguish
Freddie Gray, the drug war, and the decline of “real policing.”
By Bill Keller
(The war on drugs led to ignoring the Bill of Rights.)
Probable cause was destroyed by the drug war.
the drug war was as much a function of class and social control as it was of racism.

Are you so mentally deranged that you claim a blog post is evidence? No, it's not! Instead of wallowing in your pathetic OPINION step back and review FACTS.

Uhh, the blog post was by a medical doctor, and it was filled with facts.

Was he reprimanded in any way by any medical board? NO

Was he found guilty of any form of malpractice? NO

Probably because his actions on a talk show aren't covered by malpractice.

If the doctors want to claim he is a quack they must provide evidence. If you claim he's a quack YOU must provide evidence. No evidence == delusional opinion.

Fine:

For recommendations in The Dr Oz Show, evidence supported 46%, contradicted 15%, and was not found for 39%.

This report details the tea party astroturf movement very well.

http://tobaccocontrol.bmj.com/...

The Tea Party is an astroturf effort that started in the mid 80's primarily driven by Phillip Morris to oppose tobacco regulations, with lots of support from Koch industries to expand it to all regulations. There is nothing spontaneous or grass roots about it.

Very well documented and sourced by this report- originally dug in to to see the extent of tobacco astroturfing when the tobacco lawsuits started turning up tons of documents on the topic during discovery.

http://tobaccocontrol.bmj.com/...

I grew up in Port Hope, Canada, where Eldorado Mining and Refining was located on Lake Ontario... http://en.wikipedia.org/wiki/E... http://www.toxipedia.org/displ... In 1969 worked for one year at a factory in town called Westinghouse Atomics that made the fuel rods for CANDU reactors... https://books.google.co.uk/boo... http://www.world-nuclear.org/i... Eldorado used to dump truckloads of refined uranium on the loading dock of Westinghouse, which I could watch from my work station, which was then scooped up and eventually turned into round ceramic-like pellets 1cm x 2cm. These were inserted into 2 foot long zirconium tubes. Bundles of the tubes were made to insert into the 50 foot long zirconium calandria tubes in the reactor core. http://en.wikipedia.org/wiki/C... I thought I was quite clever when I snuck one of the pellets out. We all had radiation badges, but no one actually checked them. Everyone that I knew who worked there for a long time eventually died young of some type of cancer. I only worked directly with uranium for 6 months, but in my late 50s I developed rheumatoid arthritis, which apparently is rather unusual. They used to dump waste sludge behind our high school, where we all went to smoke dope after class. Subsequently there was a massive cleanup in many areas of the town. http://bmjopen.bmj.com/content... https://books.google.co.uk/boo... http://www.world-nuclear.org/i... How does all this relate to the original topic? Well, at the time, everyone thought it was harmless, like the toy. Everyone I worked with at the time could be called a chav or a redneck or a good old boy - some of them were really good people, some not so. But Hey, it took me 6 effin months of handling uranium pellets to finally realize that this might not be the best way to spend my life making money, so I quit. The rest of them believed the company line that everything was safe. https://www.google.co.uk/url?s... cheers

Not going to specifically defend what the AC said but perhaps the statement was related to alcohol's benefits being walked back recently:
http://www.bmj.com/content/350...

Coupled with the resveratrol marketing scheme over recent years, it's getting very difficult to make any unequivocal comments about the benefits of alcohol consumption.

Since you are obviously cherry-picking your sources again (which I have pointed out to you before), let me add some recent sources from highly respected journals about the risk of low-dose radiation. Ofcourse, according to Mr. D. all these journals just publish pseudo-science. Reminds me of the old joke with the wrong-way driver.

"... First, it is clear that we have now passed a watershed in our field, where it is no longer tenable to claim that CT risks are "too low to be detectable and may be non-existent" (5). A large well-designed epidemiologic study has clearly shown that the individual risks are small but real..."
Journal: Radiology
Link: http://pubs.rsna.org/doi/full/...

"...We noted a positive association between radiation dose from CT scans and leukaemia (...) and brain tumours (...)."
Journal: The Lancet
Link: http://www.sciencedirect.com/s...

"Conclusions The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. ..."
Journal: British Medical Journal
Link: http://www.bmj.com/content/346...

"The study supports the extrapolation of high-dose rate risk models to protracted exposures at natural background exposure levels."
Journal: Leukemia
Link: http://www.nature.com/leu/jour...

And with respect to Fukushima there were recent estimates from a Stanford guy:
"We estimate an additional 130 (15â"1100) cancer-related mortalities and 180 (24â"1800) cancer-related morbidities incorporating uncertainties associated with the exposureâ"dose and doseâ"response models used in the study. We also discuss the LNT model's uncertainty at low doses. .... Radiation exposure to workers at the plant is projected to result in 2 to 12 morbidities. An additional [similar]600 mortalities have been reported due to non-radiological causes such as mandatory evacuations."
Journal: Energy & Environmental Science
Link: http://pubs.rsc.org/en/content...

Incorrect. The Tea Party was formed in 1986 by the Heritage Foundation and Phillip Morris as an astroturf effort. It just got popular enough to be noteworthy in the 2004 elections, and really took off in 2008.
All revealed in the documents obtained from heritage and Phillip Morris in the tobacco trials.
http://tobaccocontrol.bmj.com/...

we know that dairy product consumption is correlated with higher density and fractures. There is no consensus on how to explain that,

If you're talking about this study, there is no consensus that milk causes fractures other than "looks interesting, more study needed." Even the authors say that.

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

Damn What are factual studies doing in the pro-drug/anti-drug arguments? We can't have that! (Satire aside, I would like to have all recreational drugs legalized, not just the grandfathered ones - alcohol, nicotine, caffeine. Even the stupid ones, such as meth, have a place -they help clean the human gene pool of stupidity.

Alcohol makes you more aggressively confident, pot makes you more careful of your driving.

Not as such.

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

Acute cannabis consumption nearly doubles the risk of a collision resulting in serious injury or death

Effects on Driving:

... Marijuana has been shown to impair performance on driving simulator tasks and on open and closed driving courses for up to approximately 3 hours. Decreased car handling performance, increased reaction times, impaired time and distance estimation, inability to maintain headway, lateral travel, subjective sleepiness, motor incoordination, and impaired sustained vigilance have all been reported. Some drivers may actually be able to improve performance for brief periods by overcompensating for self-perceived impairment. The greater the demands placed on the driver, however, the more critical the likely impairment. Marijuana may particularly impair monotonous and prolonged driving. Decision times to evaluate situations and determine appropriate responses increase.

The study you reference appears to be from 2002. More current research is finding something else, and you've apparently already seen it:

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis
Acute cannabis consumption nearly doubles the risk of a collision resulting in serious injury or death; this increase was most evident for studies of high quality, case-control studies, and studies of fatal collisions

As you point out, getting high and crashing cars are not the same thing. But getting high makes you more likely to crash the car due to the multiple impairments it creates.

Even the National Highway Traffic Administration says measured active THC levels can't be correlated with impairment:

They quote research that indicates driving while intoxicated by marijuana increases risk.

Effects on Driving:

The drug manufacturer suggests that patients receiving treatment with Marinol® should be specifically warned not to drive until it is established that they are able to tolerate the drug and perform such tasks safely. Epidemiology data from road traffic arrests and fatalities indicate that after alcohol, marijuana is the most frequently detected psychoactive substance among driving populations. Marijuana has been shown to impair performance on driving simulator tasks and on open and closed driving courses for up to approximately 3 hours. Decreased car handling performance, increased reaction times, impaired time and distance estimation, inability to maintain headway, lateral travel, subjective sleepiness, motor incoordination, and impaired sustained vigilance have all been reported. Some drivers may actually be able to improve performance for brief periods by overcompensating for self-perceived impairment. The greater the demands placed on the driver, however, the more critical the likely impairment. Marijuana may particularly impair monotonous and prolonged driving. Decision times to evaluate situations and determine appropriate responses increase. Mixing alcohol and marijuana may dramatically produce effects greater than either drug on its own.

That seems consistent with emerging research.

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

Acute cannabis consumption nearly doubles the risk of a collision resulting in serious injury or death; this increase was most evident for studies of high quality, case-control studies, and studies of fatal collisions

Would it surprise you to learn that not all the data out there supports the position of the primary advocacy group for the legalization of marijuana?

Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis

Acute cannabis consumption nearly doubles the risk of a collision resulting in serious injury or death; this increase was most evident for studies of high quality, case-control studies, and studies of fatal collisions

Effects on Driving:

The drug manufacturer suggests that patients receiving treatment with Marinol® should be specifically warned not to drive until it is established that they are able to tolerate the drug and perform such tasks safely. Epidemiology data from road traffic arrests and fatalities indicate that after alcohol, marijuana is the most frequently detected psychoactive substance among driving populations. Marijuana has been shown to impair performance on driving simulator tasks and on open and closed driving courses for up to approximately 3 hours. Decreased car handling performance, increased reaction times, impaired time and distance estimation, inability to maintain headway, lateral travel, subjective sleepiness, motor incoordination, and impaired sustained vigilance have all been reported. Some drivers may actually be able to improve performance for brief periods by overcompensating for self-perceived impairment. The greater the demands placed on the driver, however, the more critical the likely impairment. Marijuana may particularly impair monotonous and prolonged driving. Decision times to evaluate situations and determine appropriate responses increase. Mixing alcohol and marijuana may dramatically produce effects greater than either drug on its own.

Marijuana Might Make You a Worse Driver Than Alcohol Does

Maybe people who couldn't get anything better than "shift work" had duller brains to start with.

While this is certainly a possibility, even if you took a quick glance at TFA (I know, I know...), you might find out there seems to be more than that:

Those with more than 10 years of shift work under their belts had the same results as someone six and a half years older. The good news is that when people in the study quit shift work, their brains did recover. Even if it took five years.

Why would dumb people "recover" lost brain function if they never had it in the first place?

And once you read that in TFA, it might actually make you want to click on the link to the study itself, where you can discover the methodology in the abstract without even reading the article:

Methods: We conducted a prospective cohort study of 3232 employed and retired workers (participation rate: 76%) who were 32, 42, 52 and 62â...years old at the time of the first measurement (t1, 1996), and who were seen again 5 (t2) and 10 (t3) years later. 1484 of them had shift work experience at baseline (current or past) and 1635 had not.

"Prospective cohort" -- i.e., they had a control group, which they measured periodically. The shift workers did significantly worse....

(Why is it that everyone at Slashdot seems to automatically assume every study is done by idiots who could not possibly foresee their first possible objection? And why do such posts get modded up? There are lots of crap studies out there, but not every obvious objection was unforeseen by most research teams. Sorry for the exaperation, but if you're not even going to bother to RTFA, stop modding idiots up who also haven't.)

The article, and the actual study which requires a purchase of at least US$30 to view, do not appear to take the nature of the work into account. Shift work doesn't mean factory work or manual labor. Factory work is going to be exhausting no matter what the shift, right? From what I gather, the study is paying attention to the hours worked and not necessarily the work performed.

I spent about 5 years in a mostly nocturnal habit, doing development and sysadmin work remotely from my apartment. I'd wake up around 2 or 3 in the afternoon, shit/shower/shave, spend a couple of hours getting my food and coffee and watching a bit of TV, sit around working on things until around 2 or 3 AM, and then venture off into gaming or Slashdot or Fark or what have you (this was the late 90s and early 2000s) until I went to bed at 8 or 9 AM. Rinse and repeat. I enjoyed this schedule and in fact there's evidence that I thrived on this schedule. Being awake when nobody else is, there are few distractions, I can focus on what needs to be done while the majority of my fellows and users are asleep. Lack of interruption is a treasure.

Then I moved into the enterprise doing development and DBA stuff. Almost 8 years getting up at 6 AM most days, showing up to work tired half the time, having to suck down several cups of coffee prior to being fully awake at all. The story, always the same. Despite any weariness or necessity for caffeine, I still accomplish my best work by far and away prior to lunch, and then attempt to ride the day out until 5:30 hits. The morning is my productive time, after lunch I mostly exist to put out fires, sit in on meetings of lower importance where I'm barely a stakeholder, and plan out the actual work that I'll be doing tomorrow morning. I dislike the schedule because I know that once I get home and the sky grows dark I'll be picking up my second wind and going straight back into a work frame of mind.

My own personal rhythm thrives at night, this has always been true and remains so despite any schedule change you might throw at me. Even with a normal business hours gig in the enterprise, I've still probably done some of my best work from home (after hours but salaried, whatever I accomplish tonight I don't have to fuck with in the office tomorrow) than I've done in the office. I would be, and have been, way more productive if my work schedule was 8:30 PM to 5:30 AM. Was that physically killing me or dulling my mental performance faster than running 8:30 AM to 5:30 PM? It sure doesn't feel like it.

I wonder if I could parlay my penchant for overnights into some sort of International Ops Lead scenario? I'd love to be awake and cranking around the same time that the offshore teams are doing whatever they do/don't.

We need a randomized controlled trial to be sure the procedure is effective.

but getting out of bed is far less likely to leave you a pancake.

That hasn't been proven

RTFP (read the fucking paper).

While I'm sure you're much more of an expert then the researches who actually conducted this study, they do specify that the strains present are from livestock based on genetic testing. The introduction in the paper specifies why those strains are livestock-associated and what that means.

Here's the link, since you seem to have missed it even though the link is the first two words of the summary:
http://oem.bmj.com/content/ear...

So it seems to me that responsible researchers would go a bit farther before reporting: Like by doing genetic testing on the strains of bug in the various workers and the livestock, and running models on the results to try to identfy whether the bugs are from the herd or the workers.

So it seems to me that a responsible commenter would go a bit farther before accusing the researchers of not thinking of something that they in fact did think of and went to great effort to do genetic testing on hundreds of samples for. But I guess you couldn't be bothered to at least RTFA (read the fucking abstract).

I'm actually pretty impressed that the summary linked to the actual paper and not just the journalist article. I'm not impressed that you didn't at least read the abstract before commenting.

1) There is not a lot of evidence that most people who share this material are actually involved in harming children in any way.

18 years for trading child pornography?

I'll come out and say it, these laws are wrong. We have a higher incarceration rate than anyplace else in the world, rivaling Russia and China. Do you want to send those rates up even further?

I agree that child sexual exploitation is wrong. I think child pornography should be used as evidence for prosecuting the underlying crime. I can accept a reasonable criminal punishment for distributing child pornography, if that's the only way to send a message that our society strongly condemns child sexual exploitation. It seems that prosecuting people for having child pornography on their computers does more harm than good overall. I'm not convinced that prosecuting people at six degrees of separation from the underlying crime should be a crime itself. And I'm also not convinced that possessing child pornography created outside the U.S. should be a crime within the U.S. (Our bombs blow children to pieces in our many wars, which I think is a greater harm than their being sexually abused.) We don't prosecute web sites like bestgore.com that show beheadings and rapes.

But 18 years for trading child pornography is way out of bounds. That's the sentence we should give to somebody who originally abused the children to create the pornography, not someone at several steps removed who winds up with the images of it.

I think child pornography prosecutions are like traffic tickets. It's a lot easier for a cop to sit on his ass eating donuts in front of a computer monitor than it is to go out and prosecute actual sex crimes. And it would take a large shift in budget from uneducated cowboy cops to social workers, criminologists and social scientists who actually understand child sexual abuse and how to stop it.

http://www.sciencedaily.com/re...
Child abuse rises with income inequality
February 11, 2014
Summary: As the Great Recession deepened and income inequality became more pronounced, county-by-county rates of child maltreatment -- from sexual, physical and emotional abuse to traumatic brain injuries and death -- worsened, according to a nationwide study.

http://www.bmj.com/content/347...
Research: Preventing sexual abusers of children from reoffending: systematic review of medical and psychological interventions
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.... (Published 9 August 2013)

http://www.miamiherald.com/201...
Florida spurns $50 million for child-abuse prevention

And this is part of why all the drug development work ends up happening in private industry.

You're joking, right?

Pharmaceutical Companies Spent 19 Times More On Self-Promotion Than Basic Research: Report

Has nothing to do with the relative spending of academia vs industry on development.

Pharmaceutical research and development: what do we get for all that money?

Also has nothing to do with the relative spending of academia vs industry on development.

Why Pharma Needs the NIH: Basic Biology Drives the Industry, Says Genentech VP

This is about basic research, not development. As I said in my post, "That said, when it comes to the basic research side of things pharma companies do tend to let the academics do the work for them."

I love research about research

Also has nothing to do with the relative spending of academia vs industry on development.

My point was that most drug DEVELOPMENT costs are incurred by private industry, because it isn't a low-risk publication environment.

I wasn't saying that the drug industry didn't have problems.

And this is part of why all the drug development work ends up happening in private industry.

You're joking, right?

Pharmaceutical Companies Spent 19 Times More On Self-Promotion Than Basic Research: Report

Pharmaceutical research and development: what do we get for all that money?

Why Pharma Needs the NIH: Basic Biology Drives the Industry, Says Genentech VP

I love research about research

Sure it was stopped before commercialization. But this is hardly something you get when splicing.

You are flat out wrong. This is a case of why GM is so safe, and an example of the system working as designed.

Take a look at Solanine in potatoes. As a member of the nightshade family, there is always the potential that a new variety of potato will contain dangerous levels of solanine or other glycoamyloids just due to random interaction between the parent genomes. Bombarding potatoes with mutagens like ionizing radiation, or carcinogenic chemicals are OK by organic standards, and how new varieties of potatoes were developed before we even understood that DNA was the source of inheritance. This kind of genetic modification is MORE likely to result in accidental changes in Solanine concentration because so many genes are changed simultaniously. Several varieties of potatoes that were not GM have been removed from the market only AFTER they made people sick.

The targeted nature of modern techniques mean we can characterize the new strain to a previously impossible level BEFORE they hit the market. Who cares how many mistakes they make in the lab, as long as they STAY in the lab. The 78 UK made sick by Solanine poisoning in Britain in the 1970's are 78 more adverse events than have ever been reported for ALL GM products combined over the last 20 years precisely BECAUSE we scrutinize all new GM strains so closely before they are allowed on the market.

Followed the chain of citations through this 2000 article to this 1986 journal entry. Briefly, and if I'm remembering my A-level Stats correctly, they found that there is no correlation between an adoptive parents BMI and the adoptee's BMI, there is a very strong correlation between biological mother and child, and a strong correlation between father and child.

Second, appeal to "scientific purity" is overshooting. Science is constantly advancing, improving models, replacing wrong assumptions with less wrong assumptions. There is nothing "pure" about it, and in no way does it need to be to advance the cause and be useful to our lives. Words such as "purity" are much too loaded to be used, exactly because of the scientific approach. There's no need to deny - the scientific world does not have all the T's crossed and the I's dotted on AGW, just as it doesn't on gravity, physics and quantum theory, but we still happily cross bridges every day. The degree of certainty has long reached sufficient levels to warrant seriously looking at how to realistically (not politically, stupid carbon credits) mitigate instead of discussing a black and white position on AGW's existence.

And thirdly the AGW debate is much bigger than the USA. I understand that you have bipartisan issues across the board (not just AGW, and to be clear: I think both parties are in the wrong) but that doesn't extend to the rest of the world and this is a global issue.

So I think that while I don't entirely agree with your argumentation, I agree with your position. AGW is a science thing - and science has agreed that it exists though not to which degree. The challenge is to find solutions, and that's also with science.

Finally, I find the actual article very intriguing and somewhat challenging to my own views on AGW, as evidenced by my first thoughts on this: could it be that the geology of the antarctic is becoming destabilized because of the lessening of the weight of the ice sheet, in turn causing more geological activity? But that's a conjecture from an explanation that wouldn't challenge AGW, and real science must of course also look for other hypotheses.

I don't get it, why don't they just use asphyxiation in an atmosphere of Helium? Cheap, painless, easy.

Almost everything you said there is wrong. Broccoli has more protein per calorie than steak does, and there are plenty of plants with tons of fat. In fact, healthier fats (mono and poly unsaturated) mostly all come from plants. Try some nuts or an avocado if you don't think you're getting enough fat. This is exceedingly unlikely though, since you don't really need much fat to get by. The recommended minimum is 15% of your calories, but it's not like you're going to die within three months if you don't eat any fat - this guy didn't consume any calories at all, including fat, for 382 days with no ill-effects.

Your statements about carbs are a little difficult to deal with, "one of the main contributors" is a hard statement to disprove. Really, type 2 diabetes is (mostly) caused by obesity and certainly you can get fat by eating carbs. But you can get fat by eating too much of anything. It's how much you eat (calories), not how you eat it, that determines how much weight you loose. Fad diets, like a low carb diet, do work, but they work by restricting your calories, not by some special voodoo.

Oh really? Which problem are you saying is common? Having 20 toxic chemicals found in your body?

I'd probably say that most of us have toxic chemicals in our bodies. Look at what chemicals are found in animals in remote areas in the world. Now consider that most of us live in non-remote areas where pollution is higher. Add in our homes, which outgas other pollutants, from the construction of the home, furnishings, cleaning supplies, etc.

Even the food we eat tends to have residential pesticides and persistent organic pollutants.

For example, say you have someone with Chlordane, DDE, DDT, Dieldrin, Dioxin, Endrine, Heptachlor, Hexachlorobenzene, and Toxaphene. Sounds like they walked through a Soviet-era industrial zone, right? But those chemicals can be found in a typical daily diet (table 1).

So yes, we all probably have detectable levels of hazardous materials in our bodies.

What I would like to see, before I pass judgement, is if the toxic chemicals in their bodies correlates with the chemicals and their amounts used in fracking.

Look, you can make a lot of claims about the impact of the gun control laws in Australia, but depending on the early government statistics to prove your point is intellectually dishonest.

Use actual studies, done when time has passed so you can see the impact. Here's a good one Australia’s 1996 gun law reforms: faster falls in firearm deaths, firearm suicides, and a decade without mass shootings. Quoting from the abstract, emphasis mine:

Results:
In the 18 years before the gun law reforms, there were 13 mass shootings in Australia, and none in the 10.5 years afterwards. Declines in firearm-related deaths before the law reforms accelerated after the reforms for total firearm deaths (p=0.04), firearm suicides (p=0.007) and firearm homicides (p=0.15), but not for the smallest category of unintentional firearm deaths, which increased. No evidence of substitution effect for suicides or homicides was observed. The rates per 100 000 of total firearm deaths, firearm homicides and firearm suicides all at least doubled their existing rates of decline after the revised gun laws.

However, she is an associate editor of the Journal of Medical Ethics,

But hopefully not for too much longer.

Her PhD is in philosophy. However, she is an associate editor of the Journal of Medical Ethics, so we should all still be pretty worried.

You mean like how they currently add acetaminophen to most opiates (check out your next codeine prescription) so that if you take too much you'll suffer liver damage? If you can't lead a horse to water, just poison every other source of water in the area and that fucking horse better damn well drink the right water... if not it's the horses fault its pissing blood.

Can you provide a source which shows acetaminophen has no medical purpose in those drugs? Those drugs are used in combination in most places I've heard of, so there would have to be a worldwide conspiracy for it to be just a poison.

A quick search found this: http://www.bmj.com/content/313/7053/321. That says that if you want to remove one drug from the combination, it's codeine. Also, up to 10% of white people apparently "immune" to codeine (side note: I do not know the academic field of medicine, and do not know if that paper is connected to anyone/thing reputable).

So basically, acetaminophen is an analgesic. You can get it by itself, or in combination with another analgesic. I think it's somewhat less far-fetched to believe that a painkiller is there for pain relief, than that it's there because of a worldwide conspiracy...

I always think of this when I think of evidence based medicine. It is a reminder that the details of implementation are important, often more important than the big picture ideology surrounding them.

It is a hypothesis that collecting more data will find a pattern that will predict heart failure earlier, and that will lead to earlier interventions.

They haven't demonstrated that it works.

In order to demonstrate it, they have to do a controlled trial. They have to use these data collection systems in a group of 5,000 patients, and use the usual methods in another 5,000 similar patients, and see if there's any difference in a meaningful outcome. Do the patients live any longer? Are they any less likely to get strokes?

Sometimes it works, sometimes it doesn't. The New England Journal of Medicine just published a report on the use of a high-tech surgical intervention -- implanting cardiac resynchronizing devices in a new subset of heart failure patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1306687 It turned out the resynchronization patients had more deaths than the control group, and they stopped the study early. You don't know until you've done the randomized, controlled trial. That's the method of science, the experimental method. You take your brilliant ideas and put them to a test.

That's science. Everything else is bullshit.

There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.

EMR replaced a simple, effective system -- paper and pen -- with a more difficult system. What's the point?

Read what doctors are actually saying about electronic medical records, http://www.kevinmd.com/blog/ http://www.nejm.org/

There are systems that actually make it easier to treat patients. As I understand it, the Veterans Affairs and Kaiser Permanente have systems that actually collect useful data. The Scandinavians have great useful databases. http://www.bmj.com/content/347/bmj.f5906 But a lot of the new systems, particularly the ones that are merely being installed because they're required and subsidized under new federal regulations, are driving doctors crazy. They complain that they have to log in, go through screens, fill out checklist after checklist, and wind up with records that go on for hundreds of pages that nobody ever looks at again. Traditionally, on paper, they were forced to write a concise narrative for their colleagues and themselves, of useful information that got to the point and helped them make a decision about what to do next. These poorly-designed EMRs stopped forcing doctors to think. It simply forced them to collect a lot of data. Data isn't information. Useless data is noise.

And maybe most of all, they complain that instead of looking at their patients, they're looking at a computer screen. If you have to tell somebody that he's going to die in 6 months if he doesn't stop smoking, you shouldn't be looking at your computer screen. Maybe there's an element of human communication that computer nerds don't appreciate.

In any computerized records, there's a tradeoff between how much data you collect, and how much time you have to spend entering data. You can spend an extra hour a day just entering more data. Is this pill a tablet or a capsule?

And more important than time, when you write a medical record, you should be filtering information for just the important information. Otherwise you're just adding noise to the record, and making it harder for the humans to spot patterns.

If you want to prevent heart failure, the basic job is to stop smoking, lose weight, and exercise. When patients get outside of certain well-understood parameters, you can give the

Wrong, there is was this little experiment conducted on 11 million people living in the Caribbean. See results of this pear reviewed paper published in the British Medical Journal

http://www.bmj.com/content/346/bmj.f1515#ref-40

So eat less and do more *REALLY* does work. The people who don't think it works are in denial and want someone else to blame for the fact they are overweight.

Perhaps true, but if you where to watch the U.K. Channel 4 program Secret Eaters you would come to understand that overweight people don't eat ~2000 Calories they eat *MUCH* more than that. For really obese people they eat more than double that.

Not only that it clearly showed that obese people outright lie to themselves and others about how much food they consume.

The basic premise of the program is the people keep a food diary of what they eat for a week, and the programme makers engage in 24/7 surveillance over the same period to record what they actually eat.

The reality is that people are getting fatter because they are consuming more calories. You only need to look a Cuba to see it all playing out. The austerity brought about by the collapse of the Soviet Union the calorie intake dropped and people lost weight across the board. The economy recovered, calorie intake surged as did waist lines. That's peer reviewed research in a high impact journal dumass.

http://www.bmj.com/content/346/bmj.f1515#ref-40

In the end it *REALLY* is hard thermodynamics. If you are over weight unless you are suffering from a really really rare and invariably fatal genetic condition stop stuffing your face and exercise more and you WILL loose weight over the long term.

And that would be the kind of thing I would look for - take a food we've seen as generally harmless, find someone who is off the charts on a satiety index with it, and see if it can possibly get them obese. Until that's demonstrated, the whole satiety thing seems more like a 2nd or 3rd order effect than a core reason for obesity.

Palatability, not satiety (satiety is how filling it is).

The better test would be to have people rate the relative palatability of different foods. Build them a diet around those foods, and see how well the palatability tracks with weight change.

But even then there's the difficulty carrying out the study, changing palatability preferences (and what that means), maybe the fat prone people find everything tastier, etc. It sounds like a study with a lot of moving parts that's hard to do properly.

I leave it to Lustig to talk further on that, especially regarding the difference between fructose taken in juice form versus whole fruit (he seems to imply there is a difference in digestive process that mitigates the deleterious effects in that case).

Or that's the only way he can get rid of most of the non-industrial populations. After all how many non-industrial cultures drink a bunch of juice sweetened with refined sugar? Oops, found one (the Kuna)

I just thought of something - we could test this stuff on someone with no taste buds. By the satiety hypothesis, such a person would be unable to overeat, because nothing is tasty. The insulin hypothesis supposes that given insulin resistance, even if the tongue doesn't recognize that something is tasty, the muscles will know if they are being starved or not, and drive hunger.

Palatability not satiety.

I couldn't find anything on that but there seems to be an inverse correlation between taste bud sensitivity and weight. I'm not really sure what to make of it. Sweet and sour lower but bitterness, saltiness, and unami were depressed the most, I don't even know if that would balance out into increasing total palatability (less bitter) or decreasing (less salt). Could be a result of overstimulus, a defensive measure to reduce palatability, or causal somehow.

This nature article seems to imply we become less sensitive to flavours after eating a lot, though I'm not certain how that would related to palatability or satiety.

Bladder cancer:
  http://www.bmj.com/content/329/7468/712
Lung cancer too:
http://en.wikipedia.org/wiki/Canine_cancer_detection

I think the main problem is communicating to the dog what you're trying to detect.

It's like blind people (humans) trying to get a sighted person to detect objects with certain coloured patterns.

most countries have taxes on sugar etc.

Which countries? (seriously). I'm curious if we're talking levels high enough to alter behavior (which I suspect would be awfully high). The US taxes sugar imports, which is part of why HFCS is used so much.

Denmark had a fat tax, and proposed a sugar tax, but both were scrapped in 2012. http://blogs.nature.com/news/2012/11/denmark-abandons-sugar-and-fat-taxes.html

I found a paper copy of the British Medical Journal, and found this article informative: http://www.bmj.com/content/344/bmj.e2931 but I don't have a subscription (there's a paywall).

Biggest problem is heart attacks among elderly people. http://www.bmj.com/content/330/7483/133?

Since hand-washing one of the most important ways of infection control, that's a fortunate convergence.

First: thanks for putting effort in your answer.

One last little point, I think such studies are often overstated but not necessarily deliberately so--rather, with the genuine belief that the assumptions and generalizations being made are valid.

Yeah, probably at least in part. For the record, though: I was referring to how PR departments and the media in general spin pretty much every nutritional study into what amount to either flat out lies or terribly misleading statements. Using 'X linked to Y' in the headline leads most people away from the commutative nature of the relation, but I guess headlines like 'X and Y associated with each other' sell less ads.

@1a:
The thing with preservatives is that we've actually evolved quite strikingly to like their taste. I'm specifically talking about naturally occurring preservatives like salt, pepper, garlic, onions, sugar, soy sauce and pretty much every herb in existence. See f.i.: http://www.unl.edu/rhames/courses/ppoint/spice.pdf and http://www.nature.com/srep/2011/111215/srep00196/full/srep00196.html#/f4
Digestive systems generally suffer from thriving colonies of 'wrong' gut bacteria (the poop transplant is becoming a more and more popular cure: http://en.wikipedia.org/wiki/Fecal_bacteriotherapy ) or mechanical issues (lack of fibers etc.), not necessarily from having a hard time breaking down food.

@1b:
If I'm not mistaken, oxidization requires being exposed to oxygen. There's a reason why some stuff can be stored for weeks in a closed package and mere days when the packaging is opened. There's still oxygen exposure, but it is greatly reduced and fairly predictable.

In addition to that, 'non-packaged food' may also have been or be exposed to significant amounts of oxygen and other deteriorating influences. Sure, if you take stuff directly from your own garden you have total control over that, but this is not an option for daily nutrition for pretty much everyone.
Things like frozen vegetables have been indicated to be better in containing nutrients like vitamins than 'fresh' vegetables. See f.i.: http://www.smdisteel.org/~/media/Files/SMDI/Containers/Container%20-%20UC%20Davis%20Executive%20Summary.pdf
or a more popularly written one: http://www.dailymail.co.uk/health/article-1255606/Why-frozen-vegetables-fresher-fresh.html

With regard to the supplements: they do seem to have an effect for children with glaring deficiencies: http://www.bmj.com/content/343/bmj.d5094
We're very aware that deficiencies of certain vitamins can cause diseases or disorders, but it seems that just overloading our body with the pure versions of them has a bad effect, as per TFA. I guess that means we should exercise some .. moderation ;-)

@2:

I'm sure you know as well as I that labels such as "all natural" and "heart-healthy" are little more than marketing slogans.

Oh man, don't get me started. In my country, there's a foundation that attaches certain national labels on all types of products. Its board is made up of mainly ex-(marketing)employees of Unilever, Procter & Gamble and Ahold.

Then, the less a food resembles the component ingredients, the less I know what I'm actually eating, and the more a company can, in my mind, easily get away with (whether by intentional profit-grubbing or just because money motivates shortcuts and rationalizations).

True. The upside at this point is that most of the pu

Your points are excellent, but I think you missed one. The editors of Lancet retracted the paper: http://www.bmj.com/content/342/bmj.c7452#ref-9

I have heard of authors retracting a paper, but this is the first time that I heard of the editors doing so.

Of course they're at war. This is one of the most incompetent and scientifically illiterate governments in living memory. It's packed full of lunatic ideologues like Ian Duncan Smith and Teresa May who sideline professional academic advice time and time again in favour of their own prejudices stupidity and ignorance. I just wish their misguided, harmful and plain unworkable policies wouldn't wreck this countries social and political fabric for generations to come. It would be funny if the human cost wasn't so high

And you know what? In spite of this, the main opposition is still unable to differentiate itself as a better alternative than this shower of charlatans, bigots and liars.

I despair at this country. I really do.

Hand guns were banned in England back in 97.

According to this paper:
http://www.bmj.com/content/336/7643/539

The suicide rates for men between 25 and 34 spiked AFTER that ban.

If you're going to commit suicide, you'll find a way.

Well, if the thing can be easily flashed, the whole concept is pretty pointless. As far as simply using another means of suicide, people who try to commit suicide with guns are far more successful than those who use other means. This article has data on suicide success rates, and guns are much more lethal than other suicide methods. Personally, I've known people who attempted suicide with guns, and now they're dead, and I know people who tried with other means, and they've recovered and gone on to live full lives.

The remander are largely crimes of passion for which any serviceable weapon can and will do (suicide falls under this as well).

I don't have a handy source for crimes of passion in general, but your claim with regards to suicide is definitely false. From a study of 48,000 attempted and successful suicides, firearms are by far the most lethal suicide method: successful 2.6 times more frequently than suffocation, which is the second-most lethal method. Do you have reason to believe that other crimes of passion are any different?

It's worth noting that Asian americans have a higher life expectancy than residents of japan.

Japanese Americans have a higher economic status than the median American, and higher than the median citizen of Japan: http://en.wikipedia.org/wiki/List_of_ethnic_groups_in_the_United_States_by_household_income

Since race is strongly correlated with life expectancy, the mere fact of a more diverse population brings US numbers down, even if we handle every racial group better.

When we control for socioeconomic status the race correlation of life expectancy either is drastically reduced or else disappears entirely. You are trying to paint an economic problem the U.S. has (extreme disparity of wealth and serious poverty) which we could attempt to rectify as an inevitable genetic thing that no one can do anything about.

Life expectancy is a poor measure to star with, since it's not closely tied to medical care in particular.

Since it contradicts the considered option of the world medical community you need to at least try to post a link to substantiate such a radical claim.

In fact since 3/4 of the potential years of life lost in the U.S. before the age of 65 are due to medical conditions your claim is nonsense. The link is very strong.*

Social factors are a major cause of premature deaths. Life expectancy at later ages may be more relevant, as medical conditions start taking over causes of death instead of accidents and violence.

The claim is false for those under 65, as well as for those over 65, which are acknowledging here.

The definition of live birth as actually calculated differs from country to country and this has a large impact on numbers. As a way of avoiding those differences in counting live births, I suggest perinatal mortality instead. And, go figure, the US is better than some of the countries that regular infant mortality would suggest would surpass it. The UK (25th) for instance goes from being 2 better than us to 1 worse on rates. It's funny, but the numbers on that wiki link do not correspond to sorty by any of the actual infant mortality numbers. I believe perinatal has it's own landmines, but the time frame immediately surrounding birth is more connected to medical system than from birth to 1.

We do better true, but we are still 24th on the list.

*There is a claim that has been bouncing in the right wing megaphone echo chamber for four years asserting that if you control of accidents and violence U.S. life expectancy jumps to number one. The claim is false and traces to a single miscaptioned table in a report by conservative think tank economists Robert L. Ohsfeldt and John E. Schneider. The table shows that the U.S. would lead in life expectancy if U.S. life expectancy tracked the life vs GDP trendline of the OECD. In fact it does not, it does far worse - which is exactly the problem that needs to be solved.

It's worth noting that Asian americans have a higher life expectancy than residents of japan. I can't find a breakdown for life expectancy by ethnicity for Japan. Since race is strongly correlated with life expectancy, the mere fact of a more diverse population brings US numbers down, even if we handle every racial group better. Life expectancy is a poor measure to star with, since it's not closely tied to medical care in particular. Social factors are a major cause of premature deaths. Life expectancy at later ages may be more relevant, as medical conditions start taking over causes of death instead of accidents and violence.

The definition of live birth as actually calculated differs from country to country and this has a large impact on numbers. As a way of avoiding those differences in counting live births, I suggest perinatal mortality instead. And, go figure, the US is better than some of the countries that regular infant mortality would suggest would surpass it. The UK (25th) for instance goes from being 2 better than us to 1 worse on rates. It's funny, but the numbers on that wiki link do not correspond to sorty by any of the actual infant mortality numbers. I believe perinatal has it's own landmines, but the time frame immediately surrounding birth is more connected to medical system than from birth to 1.

The Tea Party was actually started by big tabacco in the 1980s to stop taxation on cigarettes.

And these people think they are against crony capitalism.

Got a better idea, bozo? No? Thought not.

The influenza vaccines are the best tool that we have. It's a lousy tool, but oh well, play the hand that you're dealt.

And before somebody goes off on and thinks this is Scary New News, influenza vaccine has ALWAYS sucked on infants and older people. Precisely the people that the virus wreaks the most havoc on and likely for the same reason (poorly developed or worn out immune system). This year's vaccine seems to do particularly poorly on the strain of B that we've been seeing. But you never really know how good or bad the vaccine does in any given year until you can tally up all the statistics and look at previous years (and fudge a few numbers).

The bigger news is that Tamiflu is really worse than it was made out to be (which wasn't so hot to begin with). The usual suspects - money and political influence (but I repeat myself).