Voice of the People, Jul. 27 Chicago Tribune ... the American Medical Association to transform themselves into public employee unions — ignoring such issues as the freedom of physicians to practice ... |
Monthly Archives: July 2010
Glucosamine: The Unsinkable Rubber Duck
Glucosamine is widely used for osteoarthritis pain. It is not as impossible as homeopathy, but its rationale is improbable. As I explained in a previous post,
Wallace Sampson, one of the other authors of this blog, has pointed out that the amount of glucosamine in the typical supplement dose is on the order of 1/1000th to 1/10,000th of the available glucosamine in the body, most of which is produced by the body itself. He says, “Glucosamine is not an essential nutrient like a vitamin or an essential amino acid, for which small amounts make a large difference. How much difference could that small additional amount make? If glucosamine or chondroitin worked, this would be a medical first and worthy of a Nobel. It probably cannot work.”
Nevertheless, glucosamine (alone or with chondroitin) is widely used, and there are some supporting studies. But they are trumped by a number of well-designed studies that show it works no better than placebo, as well as a study showing that patients who had allegedly responded to glucosamine couldn’t tell the difference when their pills were replaced with placebos. The GAIT trial was a large, well-designed, multicenter study published in The New England Journal of Medicine that showed no effect in knee osteoarthritis. A subsequent study of hip osteoarthritis also showed it worked no better than placebo.
A new study shows that glucosamine works no better than placebo for osteoarthritis pain in the low back. It was published in the JAMA: Effect of Glucosamine on Pain-Related Disability in Patients with Chronic Low Back Pain and Degenerative Lumbar Osteoarthritis: A Randomized Controlled Trial, by Wilkens et al.
It is well-designed, randomized and double blind, with 250 subjects, a low drop-out rate, a 6 month duration with a one year follow-up, appropriate clinical criteria for improvement (disability, pain, quality of life, use of rescue medications), intention-to-treat analysis, and even an “exit poll” to insure that blinding had been effective, that patients couldn’t guess which group they were in. It used the doses of glucosamine sulfate that had been called for by critics of previous studies. It was done in Norway, where glucosamine is a prescription drug (in the US it is marketed as a diet supplement under DSHEA regulations so there is a greater possibility of dosage variations and impurities); it was independently funded, with no involvement of industry.
Although no one study can be definitive, this one is pretty convincing when viewed in the context of all the other published data. The authors rightly conclude that glucosamine doesn’t work any better than placebo, but they go on to say some rather strange things. They say it should not be recommended for “all” patients with osteoarthritic low back pain, implying that it might still be recommended for “some” patients. But if so, which patients and according to what criteria? They seem strangely defensive. They stress that glucosamine caused no side effects and could be used safely. They suggest that glucosamine might work for a subset of patients or for joints other than the spine. For instance, the knee. But another new study has confirmed that it is ineffective for the knee.
I don’t understand this. If they had found that a new antibiotic worked no better than a placebo for pneumococcal pneumonia, would they say it should not be recommended for “all” patients with pneumococcal pneumonia or would they simply say it should not be used for pneumococcal pneumonia? Would they speculate that it might work for a small subset of pneumonia patients or for infections in other parts of the body? Probably not. They thought glucosamine worked; they tested it; it didn’t. Why not just say so? Are they letting a prior belief in glucosamine influence their thinking? Unbiased science-based researchers are not usually so hesitant to give up on a treatment that repeatedly fails to pass tests.
I must be psychic, because I had predicted this in a post I wrote two and a half years ago (about the study showing that glucosamine didn’t work for hip pain). I said:
They can always complain that maybe it works for knees but not for hips, or that a different dosage might have worked better, or that it works for some small sub-set of patients. There will always be “one more study” to do.
This new study confirms my opinion that we shouldn’t spend any more research dollars doing “one more study” on glucosamine.
Colorado Republican Buck attacks tea party’s ‘birthers’ – The Upshot (blog)
Colorado Republican Buck attacks tea party's 'birthers' The Upshot (blog) ... Right before your very eyes one of the GREATEST fundermentals of our civil liberty, the very essence of our FREEDOM has been sacrificed. ... |
Crew to Perform Spacewalk Monday Night
Flight Engineers Fyodor Yurchikhin, a veteran of three spacewalks in 2007 during Expedition 15, and Mikhail Kornienko, a spacewalk rookie, will perform the six-hour spacewalk. The pair will exit the Pirs docking compartment and work outside the Zarya and Zvezda modules. The Pirs Docking Compartment hatch is slated to open at 11:45 p.m. to begin the excursion.
The pair will outfit the Rassvet module’s Kurs automated rendezvous system, install cables and remove and replace a video camera. Kurs is a Russian radio telemetry system that allows automated dockings of unmanned spacecraft such as the Progress resupply vehicle. The new video camera will document the rendezvous and docking of future Automated Transfer Vehicles to the aft end of the Zvezda service module.
The next spacewalk will take place Aug. 5 with Flight Engineers Tracy Caldwell Dyson and Doug Wheelock. The astronauts will exit the Quest airlock and install a Portable Data Grapple Fixture (PDGF) on the Zarya module extending the reach of Canadarm2, the station’s robotic arm, and increasing a spacewalker’s capabilities. They also will jettison old multi-layer insulation removed for the PDGF install and mate power connectors to Zarya.
Flight controllers will decide Tuesday whether or not to proceed with the robotic work by the Dextre Special Purpose Dexterous Manipulator to replace a failed Remote Power Control Module, or RPCM, on the station’s P1 truss. The RPCM replacement was slated for July 21, but during a test extraction procedure on July 20, ground teams determined that the force needed to remove the RPCM was higher than demonstrated with ground testing. The team is working towards the next attempt of the test extraction on Wednesday and the full replacement procedure Thursday of this week pending Tuesday’s review.
For More information visit http://www.nasa.gov/mission_pages/station/main/index.html
Getting Out of the Gravity Well on One Thin Dime
Frank Sietzen, Jr.: Seemingly lost among the noise following last week's actions of the House Commerce and Science Committee and the Senate Appropriations Committee on marking up a NASA budget is the issue of the agency's proposed new technology programs. Both the House and Senate sharply cut the Obama Administration's original request.
As of this writing no dissent has been heard from the other end of Pennsylvania Avenue, so the cuts might stick. It might be useful to review what the Obama Administration originally asked for - and why.
From the Administration's original FY2011 budget submission:
"The transformational technologies highlighted in this budget for development and demonstration address critical capabilities for sending crews to a variety of exciting destinations beyond low Earth orbit. By allowing for flight demonstrations, some at a flagship caliber, this ESMD budget resolves the achievement gap between lab demonstration and flight testing that might otherwise prevent NASA from implementing exciting new technologies. Prior to base lining them for crewed missions, these demonstrations will validate new technologies that are not yet fully developed, but are essential for mission success, such as automated and autonomous rendezvous and docking, in situ resource utilization, aero capture, large mass entry descent and landing, highly efficient in-space propulsion, precision landing and hazard avoidance, cryogenics storage and transfer, lightweight/inflatable modules, and others. And before sending humans on extended missions beyond low Earth orbit, accelerated biomedical research will help us to ensure crew health and safety."
The whole thing was to be run by ESMD - again, from the budget detail release:
"Activities within ESMD's Technology Demonstration Program will be aimed at advancing technologies needed to expand our human exploration opportunities, reduce mission costs, and contribute NASA innovation to broader national challenges and applications. This will be accomplished through investment in demonstration of flagship technology projects, as well as enabling technology development and demonstration. NASA will provide an assessment of the highest leverage technologies and demonstrations.
Flagship Technology Demonstrations: Projects selected as in-space, flagship demonstrations will be significant in scale, and offer high potential to demonstrate new capability and reduce the cost of future exploration missions. These missions will demonstrate such critical technologies as in-orbit propellant transfer and storage, inflatable modules, automated/autonomous rendezvous and docking, closed-loop life support systems, and other next generation capabilities key to sustainably exploring deep space.
In FY 2011, NASA will initiate several Flagship Technology Demonstrators, each with an expected lifecycle cost in the $400 million to $1 billion range, over a lifetime of five years or less, with the first flying no later than 2014. In pursuit of these goals, international, commercial, and other government agency partners will be actively pursued as integrated team members where appropriate. NASA will not give responsibility for all demonstrations to any single NASA center but rather looks forward to engaging with the expertise of various centers to accomplish these objectives. Specific architecture and approach for missions to demonstrate key capabilities will be developed for initiation in FY2011. Technologies targeted for demonstration will likely include:
In-Orbit Propellant Transfer and Storage: The capability to transfer and store propellant--particularly cryogenic propellants--in orbit can significantly increase the Nation's ability to conduct complex and extended exploration missions beyond Earth's orbit. It could also potentially be used to extend the lifetime of future government and commercial spacecraft in Earth orbit. This technology demonstration, building on previous ESMD technology investments and prior demonstrations such as Orbital Express, could test technologies and processes such as long-term storage of cryogenic propellant, automated physical connections between fuel lines in orbit, and verification of fuel acquisition, fuel withdrawal, and fuel transfer.
Lightweight/Inflatable Modules: Inflatable modules can be larger, lighter, and potentially less expensive for future use than the rigid modules currently used by the International Space Station (ISS). Working closely with industry and international partners who have already demonstrated a number of capabilities and interest in this arena, and building on previous ESMD investments, NASA will pursue a demonstration of lightweight/inflatable modules for eventual in-space habitation, transportation, or even surface habitation needs. The demonstration could involve tests of a variety of systems, including closed-loop life support, radiation shielding, thermal control, communications, and interfaces between the module and external systems. Use of the ISS as the testbed for this technology is an option being considered to potentially benefit both programs.
Automated/Autonomous Rendezvous and Docking: The ability of two spacecraft to rendezvous, operating independently from human controllers and without other back-up, requires advances in sensors, software, and real-time on-orbit positioning and flight control, among other challenges. This technology is critical to the ultimate success of capabilities such as in-orbit propellant storage and refueling, complex operations in assembling mission components for challenging destinations, in-space construction, and exploration operations far from Earth where the communications delay does not allow for effective human involvement.
NASA will also begin work in 2011 on an additional Flagship Technology Demonstrator mission to be selected within the Agency, and map out a sequence of Flagship missions to be initiated in 2012 and later. Potential candidates include but are not limited to:
Closed-loop life support system demonstration at the ISS: This would validate the feasibility of human survival beyond Earth based on recycled materials with minimal logistics supply. A follow-on demonstration could involve an integrated inflatable module/closed-loop life support system demonstration.
Aerocapture, and/or entry, descent and landing (EDL) technology: This could involve the development and demonstration of systems technologies for: precision landing of payloads on "high-g" and "low-g" planetary bodies; returning humans or collected samples to Earth; and enabling orbital insertion in various atmospheric conditions. Demonstrations could be ground-based or flight experiments."
Then there were propulsion-related demos:
"A major thrust of this research and development activity will be related to space launch propulsion technologies. This effort will include first stage engine development, in-space engine demonstrations, and foundational propulsion research in areas such as new or largely untested propellants that can result in more capable and less expensive future rockets, including heavy-lift rockets. In addition, NASA will provide $25 million annually to fund commercial, university, and other non-governmental research organizations to conduct foundational propulsion research."
Both the House and Senate budget bills have deeply cut the technology programs, although the program itself still stands. They have also mandated NASA to develop a heavy lift launch vehicle by 2016. Given the short horizon and budget this almost certainly means some form of SD HLV. While humans to Mars remains the national goal, here's my question to posters here on NASA Watch:
- 1. How would you reprioritize the technology program to support manned deep space missions; and
- 2. How would you spend funds for advanced propulsion work given the smaller budgets?
As far as launch systems are concerned, could history repeat itself?
In the late 1950s the Army, the Air Force and DARPA had large launch vehicles and new liquid rocket engines under design or test - many without a specific mission or payload in mind.
The Army actually had serious discussions underway about building a lunar surface facility or space troop transport, all for which their Huntsville team led by Von Braun thought of using the Saturns - the Saturn 1 that is. The Air Force was developing the F-1, M-1 and J-2 engines for some at the time unknown missions.
When the new President, John Kennedy, came along in 1961 and suddenly faced an ascendant Soviet space program, he had these technologies from which to choose to support a new expansive space goal. We all know how that movie ended.
Today, American Presidents routinely propose new space goals -think George W. Bush and Barack Obama-without strong defense of their rationales or budget needs (at least in the case of Obama, thus far). A manned mission to an asteroid has been proposed, but the budget to develop the launch vehicle to send the ship there, according to press reports of senior NASA officials is inadequate to actually field the launch vehicle itself for another decade.
If these technology cuts stand, what will stand between us and an asteroid investigation is a SD HLV (Shuttle-derived Heavy Launch Vehicle) and a capsule alone - since no deep space module is mandated or funded in the same time frame. While Mars is supposed to be the destination, will these technology programs be sufficient to advance the propulsion systems (VASIMR?) or life support systems (radiation hardened) to produce progress in getting there?
The problem with all this, folks, is we don't know what we don't know-and what new space discoveries, such as life on Mars or an errant asteroid, that might be cause for jump starting the space program. In the words of writer Frank Rich, none of us, then or now, can see around the corner and know what history will bring.
WikiLeaks shrouded in its own secrecy – USA Today
WikiLeaks shrouded in its own secrecy USA Today I get concerned about this," says Lucy Dalglish, executive director of the Reporters Committee for Freedom of the Press, which fights for journalists' ... |
Law Faculty Upset Over ABA’s Proposed Tenure Shift – The American Lawyer
Law Faculty Upset Over ABA's Proposed Tenure Shift The American Lawyer It has floated a proposal that would eliminate the term "tenure" from the ABA standards covering job security and academic freedom. The committee also wants ... |
Entries tagged with “Software Freedom Law Center” from O’Reilly Radar – O’Reilly Radar (blog)
Entries tagged with “Software Freedom Law Center” from O'Reilly Radar O'Reilly Radar (blog) Health care is the most fragmented industry in the country, with 80% of medical practices consisting of one or two physicians. |
Medical Officials: Kids With Lice Can Go To School – WCCO
![]() ABC Action News | Medical Officials: Kids With Lice Can Go To School WCCO (File) AP The thought may be enough to make your skin crawl but medical officials said you can be less squeamish out about head lice. ... Blog this on:TIME (blog) The AAP Says Children Can Be in School With Head LiceGossip Jackal Lice shouldn't keep kids at home: ReportVancouver Sun Spreadit -MedPage Today -ABC News all 51 news articles » |
Doctor’s cataracts partly blamed for medical error – Toronto Star
Doctor's cataracts partly blamed for medical error Toronto Star Another patient received an incorrect lumpectomy, freedom-of-information documents obtained by the Progressive Conservative party show. ... Cataracts partly to blame for pathologist's mistakesMontreal Gazette Windsor hospital blames diagnostic slip-ups on doctor's cataractsGlobe and Mail |
‘Guru’ jailed for attacking women – BBC News
![]() Daily Mail | 'Guru' jailed for attacking women BBC News ... the spiritual leader otherwise known as the Bhagwan Shree Rajneesh, who taught his devotees that promiscuity was the path to enlightenment. ... Rapist 'guru' in a Bentley cast his spell on hundreds of terrified young womenDaily Mail |
Cannabis Science Comments on NY Times Article Regarding Major Support From … – Trading Markets (press release)
![]() Washington Post | Cannabis Science Comments on NY Times Article Regarding Major Support From ... Trading Markets (press release) Those who fought for our freedom should not have to move to another state to get life saving medicine." On March 31 Cannabis Science issued a press release ... Mixed MessagesMcCook Daily Gazette (blog) |
Profile: Most Low-Risk Prostate Cancer Patients Receive Aggressive Treatment – Newswise (press release)
![]() CBC.ca | Profile: Most Low-Risk Prostate Cancer Patients Receive Aggressive Treatment Newswise (press release) CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School. PSA is a protein in the cells of the prostate gland which can be measured ... Most Men With Low-Risk Prostate Cancer Too Often Get High-Risk TreatmentMedscape Aggressive Treatment for Prostate Cancer Is the NormWebMD Most Men With Low-Risk Prostate Cancer Treated Aggressively, Study ShowsMSN Health & Fitness Wall Street Journal (blog) -DOTmed.com -MedPage Today all 42 news articles » |
LPIN Podcast: Greg Knott: ‘No Bull’ in District 9
Greg Knott’s novel slogan ‘No Bull’ is an acronym, signifying the six pillars of his platform in his bid to unseat incumbent Baron Hill in the US House in District 9.
In this diverse district, which is home to left-of-center Bloomington, and a large right-of-center rural area, Knott plans to outflank both of his opponents by [...]
Aegean Sea Opportunity
Ever dream of owning a piece of property in the tranquil and historic Aegean Sea? If so the perfect opportunity awaits you on Kardiotissa Island an impressive 280 acre island located in the Folegandros and Sikinos island chain.
The development possibilities are limitless in this region which has recently become a hotspot for resort development. A perfect tourist destination, area for holiday homes, and above all, a sought-after locale for permanent residence. Facilities for sailing, diving and adventure sports would take excellent advantage of the deep blue Aegean waters, and the rich sealife of the area could even sustain an off-shore aquarium or centre for oceanographic research.
The island is located between Folegandros (7min with speed boat) and Sikinos(10min with speed boat) in the heart of Cyclades. There is an every day all-year round link with ferries to Piraeus from both islands. With 280 acres of land ( 800 stremma) Absolute clear and solid titles and Greec State documentation.
For more information on this property visit Private Islands Online.
Uh-oh! Rothenberg moves 3 top Dem Senators to "Toss-up"
Three hateful ultra-liberals are now extremely vulnerable according to Democrat strategist Stuart Rothenberg. He blogs:
Right now, Democrats look poised to lose five to eight seats, and any net loss short of that would have to be regarded with relief by Democratic strategists.
Moving from the Lean Democrat category to "Toss-up":
Toss-Up/Tilt Democrat ( 0 R, 3 D)
Boxer (D-CA) *
Feingold (D-WI) *
Murray (D-WA) *
With help from Independent and 2008 McCain supporter Sen. Joe Lieberman, a sweep of 8 seats by the Republicans could hand the GOP a Senate majority.
Recent polls within the last two weeks have shown Boxer falling behind Carly Fiorna by 3 points, Murray behind her two likely GOP challengers by 3 points each, and even Feingold a 3 points behind Republican Ron Johnson. (All within the margin of error.)
(H/t Jim Antle, AS)
Moderate Republican floats secession idea for Tennessee, other States
A Tennessee Republican often accused in the past of being a moderate, establishment politician, has suddenly taken a sharp turn to the Right.
Congressman Zach Wamp who represents the Chatanooga/southeast Tennessee area, told CNN that American States should consider seccession, if things don't improve.
Rep. Zach Wamp, one of three candidates seeking the GOP gubernatorial nomination in Tennessee, told Hotline OnCall that [Texas Gov. Rick] Perry had the right idea. Wamp argued that mandates forced on the states by the Obama administration's health care bill have put secession on the table.
"I hope that the American people will go to the ballot box in 2010 and 2012 so that states are not forced to consider separation from this government," Wamp told Hotline OnCall Friday.
Wamp has been under fire from Tennessee conservatives for having voted for the TARP bailout.
Libertarian Republican contributor and Tennessee conservative activist JB Williams commented:
This was a calculated campaign statement from the start. Wamp is not known in Tennessee for a stiff conservative spine. He is moderate and is easily swayed across the aisle. The notion of Wamp ever seriously considering a move as serious as secession is laughable on its face. People familiar with Wamp's political career would never take that statement seriously to begin with. His recent recant of that statement is much more in line with the always politically correct Zach Wamp.
Wamp is currently one of two top Republican contenders for Tennessee Governor.
Major Development!! Christian Democrats agree to talks with Geert Wilders for coalition government
Radio Netherlands is reporting:
The Christian Democrats have agreed to join informal talks with the free-market VVD party and Geert Wilders’ far-right Freedom Party (PVV) to determine whether it would be possible to form a rightwing coalition.
From Israel News"Wilders anti-Islam party to enter government talks" July 26:
Anti-Islam lawmaker Geert Wilders has emerged as a possible member of the next Dutch government after the centrist Christian Democrats agreed to informal talks with Wilders and the VVD party that won recent Dutch elections.
Wilders says the Christian Democrats' move is "positive news" and he is prepared to start the talks as soon as possible. (AP)
Wilders' Freedom Party came in third and won 24 seats in June elections.
Michele Bachmann "goes all Ayn Rand" at Vegas conservative conference
Every American should be a Wealthy Capitalist
Conservative bloggers met over the weekend in Las Vegas for the RightOnline conference. The two top speakers were Reps. Mike Pence and Michele Bachmann.
A liberal blog, AlterNet snarkily describes Bachmann's role:
LAS VEGAS, NEV. — In two major speeches and in the scuttlebutt of break-out sessions, Tea Party movement activists yesterday witnessed a subtle melding of their ideology with the sensibilities of the religious right and the cold capitalism of libertarian she-ro Ayn Rand.
Over dinner, the RightOnline conference — which is sponsored by Americans for Prosperity — heard from Michele Bachmann...
Resplendently evoking the Gadsden flag — otherwise known as the “Don’t Tread on Me Flag” — in a yellow-and-black ensemble, Bachmann served up the usual dish about the deficit, and how the rescue of the auto industry amounted to some form of “gangster government.” (You can find my live Tweets of Bachmann’s speech here – hashtag #ro10 .)
But Bachmann also defined the Tea Party coalition this way: disaffected Democrats, conservative Republicans, libertarians and “Constitution Party types.”
The social safety net came in for more than its usual share of contempt: Bachmann actually called for ending Social Security and Medicare — which she defined as “welfare” — for all but “the truly needy and the truly disabled.” And then she went all Ayn Rand on her audience. “It is possible for every American to be able to retire a millionaire. It’s entirely possible to do that…if you put away money, and there are alternatives that we can offer.”
Democrat Congressmen in Texas may soon become an Extinct Species
Chet Edwards is on the ropes. Edwards has represented a central Texas district for over 20 years. Early on in his career he did well at pretending to be a moderate. But since the 1990s, he's let his liberal side shine. In 1996, when Ron Paul first ran for Congress, it was Edwards who went on the attack accusing Paul in the pages of Austin American-Statesman of being a gun nut with ties to extremist groups. Since, then his voting record reflects more of a Nancy Pelosi style, rather than a Texan middle-of-the-roader. His NTU score has consistently been in the 26 to 27% range, indicating a status as a "Big Spender."
Now the Dallas Morning-News is reporting that Edwards is on the endangered list of the Democrat Congressional Committee (DCC).
Rep. Chet Edwards could see a major infusion of TV ads in October, courtesy of the national party, which has set aside $28 million to help 40 vulnerable incumbents across the country.
Safe to say, the Democratic Congressional Campaign Committee wouldn't be spreading around that sort of largesse if it weren't at least a bit worried – about Edwards, Rep. Ciro Rodriguez of San Antonio and the others and, more to the point, about fending off the GOP's assault on their 40-seat majority.
For Edwards, in particular, the rescue effort does not bode well...
Edwards and Ciro Rodriguez are among the most endangered of Texas Democrats. But other Democrats, including crazed-liberal Sheila Jackson-Lee in the heart of Houston and Lloyd Doggett in Austin, are facing stiff Republican opposition. In fact, Doggett's GOP opponent Dr. Donna Campbell was recently added to the NRCC's "On the Radar" list, indicating that the National Republican group considers him to be exceptionally vulnerable, as well.
Doggett and Edwards are among the very last standing stalwarts of the Texas Democrat Congressmen. If they go down, the Democrat Party will be relegated to virtual "third party" status in the Lone Star State.
Photos of Dr. Donna Campbell running against Lloyd Doggett in the Austin area, and Quico Canseco challenging Ciro Rodriguez in San Antonio.