SMOKINCHOICES (and other musings)

February 28, 2011

Rallies (unity) for Labor

Filed under: Uncategorized — Jan Turner @ 1:30 pm
New York Times 

Rallies for Labor, in Wisconsin and Beyond


Max Whittaker for The New York Times

S. Montgomery Priz, a demonstrator, lampooned the rich on Saturday in Madison to protest Gov. Scott Walker’s labor proposal. More Photos »

Published: February 26, 2011

MADISON, Wis. — With booming chants of “This will not stand!” at least 70,000 demonstrators flooded the square around the Wisconsin Capitol on Saturday in what the authorities here called the largest protest yet in nearly two weeks of demonstrations.

Wisconsin’s Blow to Union Power

Will the governor’s war on public employees’ collective bargaining rights sweep the nation?

Narayan Mahon for The New York Times

Demonstrations took place for a 12th day in the state capital. More Photos »

It was a call heard in sympathy protests that drew thousands of demonstrators to state capitals and other cities from Albany to the West Coast.

The protesters were rallying against a proposal by Wisconsin’s new Republican governor, Scott Walker, that would strip the state’s public employee unions of nearly all their bargaining power and impose sizable take-home pay cuts by diverting more of their paychecks to finance health care and pension plans.

“We’ve had bargaining for 50 years, and he wants to end it in a week,” Al Alt, who has taught school for four decades in Waukesha, Wis., said as he paused on a bench after marching around the Capitol with other protesters.

A spokesman for the Madison police, Joel DeSpain, who provided the crowd estimate, said there had been no arrests during the rally.

The demonstrators in Madison were loud but peaceful, according to the Madison police.

But there was unease and confusion over the fate of the hundreds of people who have spent every night in the hallways, stairwells and public areas of the Capitol and have become the heart of the protest movement. State officials have said they would be evicted on Sunday afternoon.

“There will be no more sleeping over in the Capitol” beginning at 4 p.m. Sunday, Jodi Jensen, a senior official at the Department of Administration, the state agency that includes the Capitol police, said in an interview.

After that, she said, the building would be open during normal daily hours and closed at night. She said the decision was made because of health and safety concerns and that Mr. Walker did not influence the move as far as she knew.

Some union officials and protesters said the evictions could lead to conflict. “It’s a bit confusing,” said Alex Hanna, co-president of the Teaching Assistants’ Association.

Later, Jim Palmer, the leader of a large law enforcement union, said that he had been told that the Capitol Police were backing away from the eviction plan.

“Now it sounds like they are going to let people stay,” said Mr. Palmer, whose union, the Wisconsin Professional Police Association, has 11,000 members. The police, he said, might only ask for people to “voluntarily comply” with requests to leave the building. He added that his union and other labor leaders had urged their members to comply with whatever the police asked.

“We don’t want anything to happen to create a blemish on what has been a model for civil discourse,” Mr. Palmer said. The Capitol Police referred all inquiries to the Department of Administration.

Two protesters, Alexandra and Alison Port, twins who attend the University of Wisconsin, were turned away Saturday because they were carrying sleeping bags as they tried to enter the Capitol. If people are evicted Sunday, the twins said, the protesters will circle the building holding hands.

Mr. Walker’s plan is far from the only proposal to curb union power, and crowds of teachers, firefighters and other public workers held rallies Saturday in cities from Albany and Miami to Olympia, Wash.

“This is a national issue,” Jim Goodnow, who attended the demonstration in Miami, where about 150 people rallied at Bayfront Park. Many of them said they were concerned that Gov. Rick Scott, a Republican, might try to strip away the few protections that unions have in Florida. A bill in the Legislature would block union dues from being automatically deducted from paychecks.

Still, the revolt in Wisconsin has become the main stage for arguments on both sides. Mr. Walker and other Republicans say the changes are necessary to put the state back on solid financial footing and to prevent wide-scale layoffs.

The protesters and Wisconsin’s Democratic leaders — including 14 state senators who are hiding out in Illinois to prevent a vote on Mr. Walker’s proposal — say the bill is an attempt to use fiscal problems to deal a crippling blow to the unions that are traditional Republican opponents.

Democrats from the Indiana House of Representatives also remained sequestered in Illinois on Saturday to avoid being forced by the State Police to attend a legislative session on a bill that would limit unions.

Although the Wisconsin protests have been peaceful, they have also reflected a strong personal dislike for Mr. Walker, who was elected in November, and many of the placards criticized his relationship with Charles G. and David H. Koch, the billionaire brothers who bankroll conservative causes and Republican campaigns, including Mr. Walker’s race. “We will not tolerate Koch heads in Wisconsin,” one said.

The largest unions have said they would agree to the benefit changes that Mr. Walker is seeking. State officials have said that the resulting cut in take-home pay could be 6 to 8 percent for the typical state worker. But for many lower-income state workers, the proposal would mean cuts in take-home pay of more than 10 percent.

Richard A. Oppel Jr. reported from Madison, Wis., and Timothy Williams from New York. Erik Bojnansky contributed reporting from Miami.

Leeches OK’d by FDA

Doctors, researchers keep turning to the leech in the operating room, lab


Medicine has advanced to the point where a severed finger can be reattached or a hand, crushed by an industrial press, can be surgically repaired.  Patients expect this.   But when Dr. Paul Cook, a Riverside Methodist Hospital vascular microsurgeon, tells his patients that a leech — yes, a leech — will help them regain the use of their severely damaged digits, he has a little more explaining to do.      “It’s disconcerting to most people,” Cook said. “When you tell them ‘Either we do this or your finger is going to die,’ most people will say, ‘Do what you’ve got to do.’ ”

Hirudo medicinalis have come a long way.    In ancient times, leeches were used to draw headaches and foul “humors” from patients.    Today, leeches are approved by the Food and Drug Administration as medical devices and are valued for their ability to draw blood and keep it from clotting.

Past research involving leeches has helped to create blood-thinners. Researchers also have examined an anti-inflammatory compound that leeches inject into their hosts to keep wounds from swelling and restricting blood flow.      But it’s their genetic structure that excites scientists now. What they teach us could help explain why some animals can regenerate lost limbs, and how nervous systems transmit messages that help animals and people make decisions.    One of those researchers is Bill Kristan.    “It’s closing in on 40 years,” said Kristan, a University of California, San Diego neurobiologist. “I keep finding ever-more interesting things in their nervous systems.”    There are more than 500 known species of leeches, which are members of the worm family.

Let it bleed

Although leeches fell out of favor in modern medicine, they are back and routinely are used during reattachment surgeries.    Leeches draw excess blood from severed or crushed fingers. A component of leech saliva, called hirudin, keeps the blood from clotting.    All of this, Cook said, gives the reattached digit time to regrow capillaries needed to keep the tissue alive.

Riverside keeps about 40 leeches in a jar in the hospital’s basement pharmacy. To prevent infection issues, each leech is used once and discarded, said Michele Holley, the pharmacy operations manager.

A genetic link

Deciphering the leech’s genetic code could help describe how a whole range of invertebrate animals including earthworms and mussels evolved, said David Weisblat, a cell-development   biologist at the University of California, Berkeley.    Weisblat said that although a leech’s genetic code is similar to that of an earthworm, the differences could provide the biggest benefit to science.

An earthworm cut in half by a shovel, for example, can grow into two separate worms.    “You cut a leech in two, you have a dead leech,” Weisblat said. “We’re pretty sure it’s an evolutionary loss in the development of leeches.”    Studies that compare the two could help scientists identify the genes involved in regeneration, Weisblat said. That could, in turn, provide clues to why some amphibians can regenerate lost limbs while humans cannot.

Nerves and free will

Kristan said the leech’s nervous systems could reveal similar secrets about how animals and humans make choices.    “What I’m interested in is how a nervous system causes behavior,” he said.    The leech is ideal to study, Kristan said, because its nervous system is organized simply, with a nerve cluster, or “ganglion,” in each segment and two “brains” — one in the head and the other in the tail. “You can find the same cells again and again and again in each segment of the leech,” he said.      Early research identified a cell in each ganglion that works like a switch. Switch it on, and the leech swims.    Researchers stimulated the cell with a microelectrode and got the same reaction. When a similar cell in the leech’s brain was stimulated, the leech would either try to swim or wriggle.

More work found that the depth of water the leech was in triggered the swim or wriggle. If the water was deep, the leech would swim. Shallow water triggered wriggling.    Kristan said his research might help unravel how nervous system messages help animals and humans make choices. He was quick to say, however, that nerves don’t control what choice is made.      “My core belief is that the leech is using the same kind of (nervous system) mechanisms that we use, but is doing it at only a single level,” Kristan said. “In our brains there are maybe 30 levels, and it becomes very abstract.”

KYLE ROBERTSON DISPATCH    Riverside Methodist Hospital keeps a jar of leeches in its pharmacy.

AARON OWEN    Riverside doctors used a leech to draw excess blood from Aaron Owen’s reattached pinky finger.

February 27, 2011

Pointing with pride

Filed under: fit2play,Jeff Turner - Fitness Coach — Jan Turner @ 3:29 pm

Let me introduce you to. .

Some of you know, I’m blogging since 2008 and I enjoy it.  Most of you have figured out that my interests are all over the place even tho I think of myself as some kind of crusader for health.  Injustice pushes my buttons.  I am passionate about our country and our citizens doing what they believe  ‘defends it’ and I understand there are many and divergent opinions on how that works.

I may write about where North is or our latest Supreme Court nominee,   the state of our ‘bees’, and yes – quitting smoking or how to do EFT.  But there is one glaring omission. . . I have never once told you about my son Jeff.  No reason – it just never happened.  I felt I was one of the most blessed mothers in the world;  perfect baby – let me sleep nine hours thru our second night home from the hospital.  He was easy. A joy, the light of our eyes.  Always into sports, Bruce Lee, friends and surfing, it was pretty easy to see he was going to cut his own path as he revealed how comfortable he was in his body while Marty and I were so into our ‘heads’ –  philosophy, that kind of thing.  We three were individualists to be sure; we may have drunk from the same well, but our expressions were divergent.  From his birth, I have had the greatest respect for him which is strange to say, I know – but it is there and I honor his uniqueness, depth and caring nature. . .his fine brilliance and sparkling wit.  What can I say, I’m his mother and greatest fan.  In him I am well pleased.

Since he was always so involved in physicality, apparently it was a natural segue into learning all he could, throwing himself fully into things.  Even as a teen he was training his friends who were generally older than him and yet they could see he knew what he was talking about and it worked.    I remember a few years later as I taped Maria Shriver’s first TV special in which she was revealing all that was involved in preparing Lyle Alzado for his much desired comeback into Football at age 41. Guess who was working with Lyle in the trenches?  Jeff and Lyle became good friends.  There were  reputed, world-famous  Docs who were orchestrating Lyle’s rehab back to the game and Jeff is who they choose to work with him.  Was a proud Mama then,  am still.

He sent me an email this week informing me about his revised website – – he knew I’d get a kick out of it, and I did.  Jeff is the founder of Fit2Play, so I’ll just give you my email I got and it bears a link right to his sight which I really liked.  No wonder he is so happy with it, it’s pretty darned good. . . .but then I’m his mother – you be the judge. ( He was always in my blogroll!)   Jan

Fit2Play debuts new website at
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What Is Fit2Play Coaching?

  • Personalized
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Learn more. Get Coached.

Get Fit with New Website

Welcome to Fit2Play’s new website – – designed to help you get physically prepared for Sport and Life.

For more than 20 years I’ve been doing strength, conditioning and movement training and have developed programs for clients taking them to higher levels of fitness. Now it’s time to take Fit2Play to the next level with a stronger website and brand that accurately shows people what we do — get you fit.

With our new website, blog and Monday Morning Lift, we’ll show you how to fit fitness into your busy life. And we’ll show you where and how to start–coaching you a little or a lot. Go ahead, take a chance, make a commitment, energize your life in ways you never imagined. Through our new website, one-on-one fitness sessions, nutrition guidance and group workouts, we’ll be there to help you along the way.

Jeff Turner

Copyright © *|2011|* *|Fit2Play|*, All rights reserved. 

We are currently located at:
655 Metro Place South, Dublin, OH 43017

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Worst air in U.S.? – OHIO

(This 2010 year-end informational piece caught my attention and I had fully intended to post it then.  Life’s plans sometimes alter our own.  I grew up/ lived in and loved California.  Everything about California is spectacular but the smog levels were horrendous, often interfering with simple acts like breathing.  Yet here I am in OHIO.  I had nothing to do with this!  Jan)

Ohio’s air cleaner, but still worst in U.S.


The economic downturn has meant climbing unemployment and plummeting house values nationwide.    But in Ohio, it also has meant cleaner air.

The amount of toxic air pollutants pumped out by Ohio businesses declined by 15.2 million pounds in 2009 compared with 2008, according to figures released this week by the U.S. Environmental Protection Agency.    State officials say new pollution controls and a recession-based drop-off in production are the reasons. Still, Ohio produces the   nation’s most air pollution.

Ohio’s plants, factories and businesses emitted about 75 million pounds of health-threatening chemicals into the air last year. That’s a 17 percent decrease from 2008, when Ohio businesses reported releasing more than 90.2 million tons of toxins. “A lot of the decreases are due to the electric utilities installing new controls,” said Cindy DeWulf, assistant chief of air pollution control at the Ohio EPA.    For example, the American Electric Power plant in Conesville reported emitting 4 million fewer pounds of airborne toxins last year   compared with 2008. And Akron-based FirstEnergy Corp.’s W.H. Sammis plant in Stratton cut 2 million pounds of pollutants.    “We installed a scrubber at the Conesville plant that came online in June 2009,” said Melissa McHenry, an AEP spokesperson.    AEP also noted a 16 percent decrease in power generation.

“Our emissions are directly tied to the generation of our coal plants,” McHenry said. “And, in 2008 and 2009 there was less of a demand for electricity.” Even with the decrease in toxins, Ohio still sent more harmful pollutants into the air than any other state. Texas ranked second with 62 million pounds.

The statistics come from the U.S. EPA’s toxic-release inventory, an annual accounting of 650 pollutants linked to diseases and cancers that industry releases into the air, land and water. Nationwide, 3.37 billion pounds of toxic chemicals were released into the environment, a 12 percent decrease   from 2008.    Ohio released 130 million pounds of toxic material into the environment last year; that was 50 million pounds fewer than in 2008.    But some environmental groups say the decrease says more about the state’s economy then it does its efforts to curb pollution. It actually creates more questions than answers,” said Jen Miller, conservation coordinator at Ohio’s Sierra Club chapter.    “Are we moving toward a cleaner production cycle, or is Ohio simply producing less waste right now because of the recession?”

February 26, 2011

Distorted hype on debt-crisis

Ryan “WRONG” about European crises


President Barack Obama’s State of the Union address was a ho-hum affair. But the official Republican response, from Rep. Paul Ryan, was really interesting. And I don’t mean that in a good way.

Ryan made highly dubious assertions about employment, health care and   more. But what caught my eye, when I read the transcript, was what he said about other countries: “Just take a look at what’s happening to Greece, Ireland, the United Kingdom and other nations in Europe. They didn’t act soon enough; and now their governments have been forced to impose painful austerity measures: large benefit cuts to seniors  and huge tax increases on everybody.”    It’s a good story: Europeans dithered on deficits, and that led to crisis. Unfortunately, while that’s more or less true for

Greece, it isn’t at all what happened either in Ireland or in Britain, whose experience actually refutes the current Republican narrative.

But then, American conservatives have long had their own private Europe of the imagination — a place of economic stagnation and terrible health care, a collapsing society groaning under the weight of Big Government. The fact that Europe isn’t actually like that — did you know that adults in their prime working years are more likely to be employed in Europe than they are in the United States? — hasn’t deterred them. So we shouldn’t be surprised by similar tall tales about European debt problems.    Let’s talk about what really happened in Ireland and Britain.

On the eve of the financial crisis, conservatives had nothing but praise for Ireland, a low-tax, low-spending country by European standards. The Heritage Foundation’s Index of Economic Freedom ranked it above every other Western nation. In 2006, George Osborne, now Britain’s chancellor of the Exchequer, declared Ireland “a shining example of the art of the possible in long-term economic policy making.” And the truth was that in 2006-07 Ireland was running a budget surplus and had one of the lowest debt levels in the advanced world.

So what went wrong? The answer is:    out-of-control banks.  Irish banks ran wild during the good years, creating a huge property bubble.   When the bubble burst, revenue collapsed, causing the deficit to surge, while public debt exploded because the government ended up taking over bank debts.  And harsh spending cuts, while they have led to huge job losses, have failed to restore confidence.

The lesson of the Irish debacle, then, is very nearly the opposite of what Ryan would have us believe. It doesn’t say “cut spending now, or bad things will happen”;   it says that balanced budgets won’t protect you from crisis if you don’t effectively regulate your banks — a point made in the newly released report of the Financial Crisis Inquiry Commission, which concludes that “30 years of deregulation and reliance on self-regulation” helped create our own catastrophe.

Have I mentioned that Republicans are doing everything they can to undermine financial reform?

What about Britain? Well, contrary to what Ryan seemed to imply, Britain has not, in fact, suffered a debt crisis. True, David Cameron, who became prime minister last May, has made a sharp turn toward fiscal austerity. But that was a choice, not a response to market pressure. And underlying that choice was the new British government’s adherence to the same theory offered by Republicans to justify their demand for immediate spending cuts here — the claim that slashing government spending in the face of   a depressed economy will actually help growth rather than hurt it.

So how’s that theory looking? Not good. The British economy, which seemed to be recovering earlier in 2010, turned down again in the fourth quarter. Yes, weather was a factor, and, no, you shouldn’t read too much into one quarter’s numbers. But there’s certainly no sign of the surging private-sector confidence that was supposed to offset the direct effects of eliminating half-a-million government jobs. And, as a result, there’s no comfort in the British experience for Republican claims that the United States needs spending cuts in the face of mass unemployment.    Which brings me back to Paul Ryan and his response to Obama.

Again, American conservatives have long used the myth of a failing Europe to argue against progressive policies in America. More recently, they have tried to appropriate Europe’s debt problems on behalf of their own agenda, never mind the fact that events in Europe actually point the other way. But Ryan is widely portrayed as an intellectual leader within the GOP, with special expertise on matters of debt and deficits. So the revelation that he literally doesn’t know the first thing about the debt crises currently in progress is, as I said, interesting — and not in a good way.

Paul Krugman writes for The New York Times.

February 25, 2011

North? whadayamean?

Headed north? It might not be where you think it is


FORT LAUDERDALE, Fla. — Magnetic north, the point at the top of the Earth that determines compass headings, is shifting its position about 40 miles a year. In geologic terms, it’s racing from the Arctic Ocean near Canada toward Russia.

As a result, everyone who uses a compass, even as a backup to modern GPS navigation systems, needs to be aware of the shift, make adjustments or obtain updated charts to ensure they get where they intend to go, authorities say. That includes pilots, boaters and hikers. “You could end up a few miles off or a couple hundred miles off, depending how far you’re going,” said Matthew Brock, a technician with Lauderdale Speedometer & Compass, a Fort Lauderdale company that repairs compasses.

Although the magnetic shift has little effect on the average person and presents no danger to Earth overall, it costs the aviation and marine industries millions of dollars to upgrade navigational systems and charts.

Earth’s core of hot liquid iron is constantly moving. That motion, combined with forces such as Earth’s rotation, dictate the position of   magnetic north, not to be confused with geographic north, or the North Pole. “Magnetic north is shifting all the time; it’s a continuous process, not an event,” said Jeffrey Love, a geophysicist with the U.S. Geological Survey’s National Geomagnetism Program in Golden, Colo.

Over the past century, the shift has gained speed. It went from creeping as slow as 9 miles per year in the early 1900s to more than 35 miles per year in the 2000s. The acceleration is part of a natural cycle, Love said.    “In 10 to 20 years from now, it might be slowing down,” he said.      Currently, the shift creates about a one-degree difference in compass direction every five years, Love said. Accordingly, the Federal Aviation Administration evaluates airport runway numbers every five years, said Kathleen Bergen, FAA spokeswoman.

Scores of large and small airports in the United States have either changed or plan to change their runways’ numbers, which are based on compass directions.    Because GPS navigation draws on satellites, it has no reliance on magnetic north. However, satellites and GPS systems can malfunction. For that reason, Tom Cartier of   Maritime Professional Training in Fort Lauderdale recommends keeping a compass handy as backup.

“The magnetic compass is what gets you home in your boat or plane when everything else quits,” said Cartier, a senior deck instructor at the academy, which offers training for merchant marine and yachting careers.    Cartier said large ships and planes have sophisticated electronic navigation systems, but most small boats and planes have magnetic compasses and rely on them heavily.    “They don’t have the money to spend for a sophisticated system,” he said.

Many mobile companies equip smart phones with magnetometers, allowing their customers to see what direction they’re heading. Those phones are likely to have a device that adjusts for the shift in magnetic north, said Manoj Nair, a research scientist with the National Oceanic and Atmospheric Administration’s National Geophysical Data Center.

Humans aren’t the only ones affected. Birds that fly south for the winter and some sea turtles that migrate from Africa to South America must learn to adjust their senses so they end up migrating in the right direction, Love said.

Supreme Court – “Vaccine Case”

Supreme Court rejects appeal of vaccine case

Parents had lost in ‘vaccine court’


WASHINGTON — The Supreme Court closed the courthouse door yesterday to parents who want to sue drug-makers, claiming their children developed autism and other serious health problems from vaccines.

The court voted 6-2 against the parents of a child who sued the drug-maker Wyeth in Pennsylvania state court for the health problems that they say their daughter, now 19, suffered because of a vaccine she received in infancy.    Justice Antonin Scalia, writing for the court, said Congress set up a special vaccine court in 1986 to handle such claims as a way to provide compensation to injured children without driving drug manufacturers from the vaccine market. The idea, he said, was to create a system that spares the drug companies the costs of defending against parents’ lawsuits.

Justices Ruth Bader Ginsburg and Sonia Sotomayor dissented.

  • Nothing in the 1986 law “remotely suggests that Congress intended such a result,” Sotomayor wrote.

Scalia’s opinion was the latest legal setback for parents who felt they got too little from the vaccine court or collected nothing. Such was the case for Robalee and Russell Bruesewitz of Pittsburgh, who filed their lawsuit after the vaccine court rejected their claim for compensation.   According to the lawsuit, their daughter, Hannah, was a healthy infant until she received the diphtheria, pertussis and tetanus vaccine in April 1992. The vaccine was made by Wyeth, now owned by Pfizer Inc.

Within hours of getting   the DPT shot, the third in a series of five, the baby suffered debilitating seizures, and Hannah suffers from residual seizures today, the suit said.    A federal trial judge and the Philadelphia-based 3rd U.S. Circuit Court of Appeals ruled in favor of Wyeth.  State and federal appeals courts have almost always sided with the vaccine manufacturer in preventing such lawsuits from going forward.

  • Scalia said that when a vaccine is properly prepared and is accompanied by proper directions and warnings, lawsuits over its side effects are not allowed under the 1986 law.

The American Academy of Pediatrics praised the decision. “Childhood vaccines are among the greatest medical breakthroughs of the last century,” academy President Dr. Marion Burton said. “Today’s Supreme Court decision protects children by strengthening our national immunization system and ensuring that vaccines will continue to prevent the spread of infectious diseases in this country.”

Pfizer also applauded the decision. “We have great sympathy for the Bruesewitzes,” Pfizer Executive Vice President Amy Schulman said. “We recognize, however, that the Vaccine Act provides for full consideration of the liability issues through the National Vaccine Injury Compensation Program. Here, the Vaccine Court concluded that the petitioners failed to prove their child’s condition was   caused by vaccination.”

The vaccine court, in the Federal Court of Claims, has paid out more than $1.9 billion to more than 2,500 people who claimed a connection between a vaccine and a health problems.

(Why is it that parents aren’t clearly advised about their right to protect their children?  During the last half of the 20th century this is a problem which has burgeoned out of all proportion, continually rising in sheer numbers of recommended vaccinations, starting at birth and continuing for years.     DPT!  Sure any disease is serious for a newborn but hardly ranks in importance with the child’s immune system and/or it’s destruction!  The sheer volume of autistic children has grown so dramatically and always in tandem with the increase of chemical-laden toxic vaccines.  People who refuse to see this connection are either criminally biased or are reading too many comic books.

One needs to check the laws of one’s own state to see what is available to you for opting out of these threatening and dangerous vaccines.  Each state has different rulings.  Go to Barbara Lowe Fisher’s web-cite National Vaccine Info Ctr where   reference material is available to you [in the blog-roll]

And one more thing –  – please notice that our Supreme Court has shown it’s consistency in continuing to  rule for the CORPORATE entity over the well fare or needs of ordinary citizens who are the backbone of this country .      Jan)

February 24, 2011

Power-Grab in Madison

It’s about power, not the budget


Last week, in the face of protest demonstrations against Wisconsin’s new union-busting governor, Scott Walker — demonstrations that continued through the weekend, with huge crowds on Saturday — Rep. Paul Ryan made an unintentionally apt comparison: “It’s like Cairo has moved to Madison.”      It wasn’t the smartest thing for Ryan to say, since he probably didn’t mean to compare Walker, a fellow Republican, to Hosni Mubarak. Or maybe he did — after all, quite a few prominent conservatives, including Glenn Beck, Rush Limbaugh and Rick Santorum,   denounced the uprising in Egypt and insist that President Barack Obama should have helped the Mubarak regime suppress it.

In any case, however, Ryan was more right than he knew. For what’s happening in Wisconsin isn’t about the state budget, despite Walker’s pretense that he’s just trying to be fiscally responsible. It is, instead, about power. What Walker and his backers are trying to do is to make Wisconsin — and eventually, America — less of a functioning democracy and more of a third-world-style oligarchy. And that’s why anyone who believes that we need some counterweight to the political power of big money should be on the demonstrators’ side.

Some background: Wisconsin is indeed facing a budget crunch, although its difficulties are less severe than those facing many other states. Revenue has fallen in the face of a weak economy, while stimulus funds, which helped close the gap in 2009 and 2010, have faded away.      In this situation, it makes sense to call for shared sacrifice, including monetary concessions from state workers. And union leaders have signaled that they are, in fact, willing to make such concessions.    But Walker isn’t interested in making a deal. Partly that’s because he doesn’t want to share the sacrifice: Even as he proclaims that Wisconsin faces a terrible fiscal crisis, he has been pushing through tax cuts that make the deficit worse. Mainly, however, he has made it clear that rather than bargaining with workers, he wants to end workers’ ability to bargain. The bill that has inspired the demonstrations would strip away collective-bargaining rights for many of the state’s workers, in effect busting public-employee unions. Tellingly,   some workers — namely, those who tend to be Republican-leaning — are exempted from the ban; it’s as if Walker were flaunting the political nature of his actions.

Why bust the unions? As I said, it has nothing to do with helping Wisconsin deal with its current fiscal crisis. Nor is it likely to help the state’s budget prospects even in the long run: Contrary to what you may have heard, public-sector workers in Wisconsin and elsewhere are paid somewhat less than private-sector workers with comparable qualifications, so there’s not much room for further pay squeezes.

So it’s not about the budget; it’s about the power.

In principle, every U.S. citizen has an equal say in our political process. In practice, of course, some of us are more equal than others. Billionaires can field armies of lobbyists; they can finance think tanks that put the desired spin on policy issues; they can funnel cash to politicians with sympathetic views (as the Koch brothers did in the case of Walker). On paper, we’re a one-person-one-vote nation; in reality, we’re more than a bit of an oligarchy, in   which a handful of wealthy people dominate.

Given this reality, it’s important to have institutions that can act as counterweights to the power of big money. And unions are among the most important of these institutions. You don’t have to love unions, you don’t have to believe that their policy positions are always right, to recognize that they’re among the few influential players in our political system representing the interests of middle- and working-class Americans, as opposed to the wealthy. Indeed, if America has become more oligarchic and less democratic over the past 30 years — which it has — that’s to an important extent due to the decline of private-sector unions.

And now Walker and his backers are trying to get rid of public-sector unions, too.

  • There’s a bitter irony here. The fiscal crisis in Wisconsin, as in other states, was largely caused by the increasing power of America’s oligarchy. After all, it was super-wealthy players, not the general public, who pushed for financial deregulation and thereby set the stage for the economic crisis of 2008-09, a crisis whose aftermath is the main reason for the current budget crunch. And now the political right is trying to exploit that very crisis, using it to remove one of the few remaining checks on oligarchic influence. So will the attack on unions succeed? I don’t know. But anyone who cares about retaining government of the people, by the people, should hope that it doesn’t.

Paul Krugman writes for The New York Times.

February 23, 2011

PhRMA pushing back

Some drugs running out; makers blame FDA rules


CHICAGO—Hospitals across the country are running out of key drugs used in surgeries and to treat some diseases, including cancer, causing doctors to turn to older treatments.    In some cases, hospitals are paying higher prices to get their patients necessary care because wholesalers are hoarding needed medicines.

Part of the shortage is being caused by manufacturing issues and quality-control problems at a number of companies as they respond to the federal government’s crackdown on drug safety. Even after a company restarts production of a drug, it takes time to catch up to the back orders.

And injectable drugs in particular, unlike pills and tablets, tend to require long lead times to produce.    The problem started several   years ago but has been escalating in the past year, said Robert Weber, senior director of pharmacy at Ohio State University Medical Center.

  • “The shortages are at the worst point as I can recall them as a pharmacist,” said Weber, who has been a pharmacist for 30 years.

About 150 drugs — triple the number only five years ago — are in short supply, the American Society of Health-System Pharmacists says.   About 60 of those are considered by federal health officials as “medically necessary,” and they include prescription medicines used to treat or prevent serious diseases or other medical   conditions.    “There have been cases where surgeries have been postponed or canceled because of the inability to get the drug,” said Bob Parsons, executive vice president of the Ohio Society of Health-System Pharmacists.      “Cancer patients are treated with drugs less promising because the drug needed isn’t available anymore.”

Drug-makers say they are following tougher safety rules put in place by the U.S. Food and Drug Administration, which has intensified scrutiny to avoid allowing unsafe medicines on the market. The FDA came under fire for its role in monitoring the painkiller Vioxx, which was pulled off the market in 2004.    The drug shortages have attracted the attention of members of Congress. Last week, Sens. Amy Klobuchar, D-Minn., and Bob Casey, D-Pa., introduced legislation that would require drug-makers to give the FDA early notification “when a factor arises that may result in a shortage,” according to a joint statement.

Dispatch reporter Suzanne Hoholik contributed to this story.

February 22, 2011

Lymph-Node study/breast-cancer

New York Times

Lymph Node Study Shakes Pillar of Breast Cancer Care

Published: February 8, 2011

A new study finds that many women with early breast cancer do not need a painful procedure that has long been routine: removal of cancerous lymph nodes from the armpit.

The discovery turns standard medical practice on its head. Surgeons have been removing lymph nodes from under the arms of breast cancer patients for 100 years, believing it would prolong women’s lives by keeping the cancer from spreading or coming back.

Now, researchers report that for women who meet certain criteria — about 20 percent of patients, or 40,000 women a year in the United States — taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to recur. And it can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling.

Removing the cancerous lymph nodes proved unnecessary because the women in the study had chemotherapy and radiation, which probably wiped out any disease in the nodes, the researchers said. Those treatments are now standard for women with breast cancer in the lymph nodes, based on the realization that once the disease reaches the nodes, it has the potential to spread to vital organs and cannot be eliminated by surgery alone.

Experts say that the new findings, combined with similar ones from earlier studies, should change medical practice for many patients. Some centers have already acted on the new information. Memorial Sloan-Kettering Cancer Center in Manhattan changed its practice in September, because doctors knew the study results before they were published. But more widespread change may take time, experts say, because the belief in removing nodes is so deeply ingrained.

“This is such a radical change in thought that it’s been hard for many people to get their heads around it,” said Dr. Monica Morrow, chief of the breast service at Sloan-Kettering and an author of the study, which is being published Wednesday in The Journal of the American Medical Association. The National Cancer Institute paid for the study.

Doctors and patients alike find it easy to accept more cancer treatment on the basis of a study, Dr. Morrow said, but get scared when the data favor less treatment.

The new findings are part of a trend to move away from radical surgery for breast cancer. Rates of mastectomy, removal of the whole breast, began declining in the 1980s after studies found that for many patients, survival rates after lumpectomy and radiation were just as good as those after mastectomy.

The trend reflects an evolving understanding of breast cancer. In decades past, there was a belief that surgery could “get it all” — eradicate the cancer before it could spread to organs and bones. But research has found that breast cancer can begin to spread early, even when tumors are small, leaving microscopic traces of the disease after surgery.

The modern approach is to cut out obvious tumors — because lumps big enough to detect may be too dense for drugs and radiation to destroy — and to use radiation and chemotherapy to wipe out microscopic disease in other places.

But doctors have continued to think that even microscopic disease in the lymph nodes should be cut out to improve the odds of survival. And until recently, they counted cancerous lymph nodes to gauge the severity of the disease and choose chemotherapy. But now the number is not so often used to determine drug treatment, doctors say. What matters more is whether the disease has reached any nodes at all. If any are positive, the disease could become deadly. Chemotherapy is recommended, and the drugs are the same, no matter how many nodes are involved.

The new results do not apply to all patients, only to women whose disease and treatment meet the criteria in the study.

The tumors were early, at clinical stage T1 or T2, meaning less than two inches across. Biopsies of one or two armpit nodes had found cancer, but the nodes were not enlarged enough to be felt during an exam, and the cancer had not spread anywhere else. The women had lumpectomies, and most also had radiation to the entire breast, and chemotherapy or hormone-blocking drugs, or both.

The study, at 115 medical centers, included 891 patients. Their median age was in the mid-50s, and they were followed for a median of 6.3 years.

After the initial node biopsy, the women were assigned at random to have 10 or more additional nodes removed, or to leave the nodes alone. In 27 percent of the women who had additional nodes removed, those nodes were cancerous. But over time, the two groups had no difference in survival: more than 90 percent survived at least five years. Recurrence rates in the armpit were also similar, less than 1 percent. If breast cancer is going to recur under the arm, it tends to do so early, so the follow-up period was long enough, the researchers said.

One potential weakness in the study is that there was not complete follow-up information on 166 women, about equal numbers from each group. The researchers said that did not affect the results. A statistician who was not part of the study said the missing information should have been discussed further, but probably did not have an important impact.

It is not known whether the findings also apply to women who do not have radiation and chemotherapy, or to those who have only part of the breast irradiated. Nor is it known whether the findings could be applied to other types of cancer.

The results mean that women like those in the study will still have to have at least one lymph node removed, to look for cancer and decide whether they will need more treatment. But taking out just one or a few nodes should be enough.

Dr. Armando E. Giuliano, the lead author of the study and the chief of surgical oncology at the John Wayne Cancer Institute at St. John’s Health Center in Santa Monica, Calif., said: “It shouldn’t come as a big surprise, but it will. It’s hard for us as surgeons and medical oncologists and radiation oncologists to accept that you don’t have to remove the nodes in the armpit.”

Dr. Grant W. Carlson, a professor of surgery at the Winship Cancer Institute at Emory University, and the author of an editorial accompanying the study, said that by routinely taking out many nodes, “I have a feeling we’ve been doing a lot of harm.”

Indeed, women in the study who had the nodes taken out were far more likely (70 percent versus 25 percent) to have complications like infections, abnormal sensations and fluid collecting in the armpit. They were also more likely to have lymphedema. But Dr. Carlson said that some of his colleagues, even after hearing the new study results, still thought the nodes should be removed.  “The dogma is strong,” he said. “It’s a little frustrating.”

Eventually, he said, genetic testing of breast tumors might be enough to determine the need for treatment, and eliminate the need for many node biopsies.   Two other breast surgeons not involved with the study said they would take it seriously.Dr. Elisa R. Port, the chief of breast surgery at Mount Sinai Medical Center in Manhattan, said: “It’s a big deal in the world of breast cancer. It’s definitely practice-changing.”

Dr. Alison Estabrook, the chief of the comprehensive breast center at St. Luke’s-Roosevelt hospital in New York said surgeons had long been awaiting the results.   “In the past, surgeons thought our role was to get out all the cancer,” Dr. Estabrook said. “Now he’s saying we don’t really have to do that.”   But both Dr. Estabrook and Dr. Port said they would still have to make judgment calls during surgery and remove lymph nodes that looked or felt suspicious.

The new research grew out of efforts in the 1990s to minimize lymph node surgery in the armpit, called axillary dissection. Surgeons developed a technique called sentinel node biopsy, in which they injected a dye into the breast and then removed just one or a few nodes that the dye reached first, on the theory that if the tumor was spreading, cancer cells would show up in those nodes. If there was no cancer, no more nodes were taken. But if there were cancer cells, the surgeon would cut out more nodes.   Although the technique spared many women, many others with positive nodes still had extensive cutting in the armpit, and suffered from side effects.

“Women really dread the axillary dissection,” Dr. Giuliano said. “They fear lymphedema. There’s numbness, shoulder pain, and some have limitation of motion. There are a fair number of serious complications. Women know it.” After armpit surgery, 20 percent to 30 percent of women develop lymphedema, Dr. Port said, and radiation may increase the rate to 40 percent to 50 percent. Physical therapy can help, but there is no cure.

The complications — and the fact that there was no proof that removing the nodes prolonged survival — inspired Dr. Giuliano to compare women with and without axillary dissection. Some doctors objected. They were so sure cancerous nodes had to come out that they said the study was unethical and would endanger women.

“Some prominent institutions wouldn’t even take part in it,” Dr. Giuliano said, though he declined to name them. “They’re very supportive now. We don’t want to hurt their feelings. They’ve seen the light.”

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