Chronic pain and brain injury

BBC NEWS | Health | Pain link to permanent brain loss

They scanned the brains of 26 patients with chronic back pain and 26 healthy people.

The patients with chronic pain caused by damage to the nervous system showed shrinks in the brain by as much as 11% - equivalent to the amount of gray matter that is lost in 10-20 years of normal aging.

The decrease in volume, in the prefrontal cortex and the thalamus of the brain, was related to the duration of pain.

Every year of pain appeared to decrease gray matter by 1.3 cubic centimetres.

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Is the loss related to inactivity, or to pain itself? Is it related to neuronal depletion in the spinal cords (mentioned in article) or to persistent high cortisol levels (known to cause neuron depletion)? Why is the brain so vulnerable to pain or stress anyway? Doesn't seem to make any evolutionary sense. Does the brain injury somehow perpetuate the inactivity/pain cycle -- making the condition untreatable? What can we do to change the dynamic of chronic pain development? Is the pain the primary cause, or have we discovered an unrecognized primary neurologic disorder that has, as one of its correlates, a predisposition to chronic pain syndromes? Does this neuronal loss affect cognition, or is it primarily related to perception, sensation and movement?

And those are just the truly obvious questions.

We know that chronic pain, especially when associated with disability, is very, very hard to treat. The burden on families is staggering. The economic cost is awesome. The suffering of afflicted seems never ending.

We're just beginning to understand what's going on.

America -- a broken democracy?

Spending Bill Held Up by Tax Provision (washingtonpost.com)

Our democracy is broken.

A $388 billion government-wide spending bill, passed by Congress on Saturday, was stranded on Capitol Hill yesterday, its trip to the White House on hold as embarrassed Republicans prepared to repeal a provision that could give the Appropriations committees the right to examine the tax returns of Americans....

... "It's simply representative of the way Congress is now operating," said Allen Schick, a professor of public policy at the University of Maryland. "It shows on the one hand how easy it is to put something in [an omnibus bill] without anybody else knowing about it." Although this may look particularly egregious, he said, the giant bill also contains hundreds of other provisions that could not be enacted into law if they were offered as single bills requiring full debate and scrutiny in both houses.

Such huge bills, lawmakers acknowledge, represent a breakdown of the normal budget process. For the second time in three years, House and Senate Republicans, bitterly divided over the level of domestic spending, failed to agree on a budget blueprint, as required by law.

The impasse forced delays in drafting many of the spending bills, and when Congress returned last week from its election recess, it had yet to complete nine of the 13 annual appropriations bills. Seven of the spending bills had never been to the Senate floor for debate, one had never been to the House floor, and one funding the nation's nuclear weapons programs and Army Corps of Engineers water projects was still in a Senate subcommittee.

To overcome this problem, GOP leaders crammed all the remaining legislation into a single omnibus package that, under congressional rules, could not be amended.

It contained all the unfinished spending bills, along with three other pieces of major legislation -- the Satellite Home Viewer Extension and Reauthorization Act, the Snake River Water Rights Act, and the Federal Lands Recreation Enhancement Act.

Along with those measures, lawmakers and staffs added thousands of local projects benefiting home states and districts. Also included in the final bill was a major provision barring states from enforcing laws that require health care providers, hospitals, HMOs or insurers to pay for, provide or give referrals for abortion.

But when the measure was rushed to the floors of the two chambers Saturday, few members had read it. Lawmakers absent from the Capitol for weeks while campaigning for reelection returned for a brief lame-duck session to complete the work of the 108th Congress.

The secretive process, Schick noted, gives GOP leaders enormous power to add provisions that they or special interests might want, and to delete provisions that GOP factions or the White House find objectionable.

Frist, for example, ordered negotiators to accept the abortion provision, even though it had never gone to the Senate floor and was only in the House-passed version of the bill covering health appropriations. Senate opponents agreed not to block its consideration after Frist promised to schedule a vote soon on a bill drafted by Sen. Barbara Boxer (D-Calif.) to repeal the provision.

GOP leaders also deleted provisions on overtime regulations and the outsourcing of government jobs despite support in both houses.

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Republicans control the entire government, yet they cannot manage a budget bill.

Oddly enough, the process we now follow gives a few leaders enormous power to punish their enemies and rewards their friends -- and to do so without inconvenient publicity. Imagine that; just by accident we've evolved a budget process that facilitates oligarchic rule and perpetuation of a single party system. This is the way Japanese democracy has worked for the past 40-50 years.

Puzzles in behavior: why would anyone work for Electronic Arts?

The New York Times > Business > Your Money > Digital Domain: When a Video Game Stops Being Fun

For around $60,000 a year in an area with a high cost of living, he had been set to work on a six-day-a-week schedule. On weekdays, his team worked from 9 to 10 (that is, 9 a.m. to 10 p.m.), and on Saturdays, a half-day (that means 9 to 6). Then Sundays were added - noon to 8 or 10 p.m. The weekly total was 82 to 84 hours.

By tradition, Silicon Valley employers have always offered their bleary-eyed employees lottery tickets in the form of stock options. E.A.'s option grants, however, offer little chance of a Google-like bonanza. An employee who started today with an options package like that of the E.A. worker just described (and who stayed with the company the four years required to fully vest) would get $120,000, for example, if the share price quadrupled - and proportionally less for more modest increases. The odds of a skyrocketing stock grew much longer this month, when the company said competition had forced it to cut prices on core sports titles.

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Surgical residents work those kinds of hours, but typically only for a few years. The pay is less, but there's a clear goal in mind. Not a few of them enjoy that life, which has a certain simplicity to it.

Why do these engineers stay with these jobs? That's the real mystery.

What did Arafat die of?

The New York Times > International > Middle East > Arafat's Death Remains a Mystery, Nephew Says After Seeing Records

And so the rumor mill goes. The most convincing theory I've heard is that he drank himself to death. It's less scandalous and more prosaic than the HIV theory, but it still explains why those in the know would want to keep the cause of his death secret. Alcohol consumption is forbidden to observant muslims.

I suspect the story will leak out over the next few months. If the bottle count was high I'd increase my confidence in the alcoholism therapy with secondary liver, cardiac and marrow failure. It's killed more than a few men Arafat's age.

Planet of the microbes

BBC NEWS | Science/Nature | Science taps into ocean secrets

'In that regard, I think the big discovery is that 90% of all the carbon that's taken up in life in the oceans is taken up in microbes, and a large number of those may be in the deep-ocean sediments buried beneath the sea floor,' he told BBC News.

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To a reasonable first approximation, earth is a planet of microbes. Macroscopic life is a relative aberration -- perhaps a transient aberration.

Many more details emerge on the Fallujah insurrenction

KRT Wire | 11/21/2004 | Al-Zarqawi underling emerges as force behind Fallujah insurgency

Knight-Ridder has had some of the best Iraq reporting anywhere. I wonder what drives them.

This KR article provides much more depth to the Fallujah story. Tribal relationships loom large. Omar Hadid may have been the key player, a man who made the hopefully fatal decision to stand and fight.

African american SAT scores

Universities Record Drop In Black Admissions (washingtonpost.com)

1,877 African American students nationwide scored higher than 1300 out of a possible 1600 on the SAT last year, compared with nearly 150,000 students overall who achieved that score.

Almost 80 to 1. Should be about 20 to 1 based on population. This is really bad. I'd love to know what the comparable ratio is in Canada -- a country with decent public education.

Melee in Chile: Bush 1 World 0

Spats Over Security Roil Summit in Chile (washingtonpost.com)

Then Bush either realized he was missing something, or he heard the commotion. The president, who is rarely alone, even in his own house, turned and walked back to the front door unaccompanied, facing the backs of a sea of dark suits. Bush, with his right hand, reached over the suits and pointed insistently at Trotta. At first the officials, with their backs to him and their heads in the rumble, did not realize it was the president intervening. Bush then braced himself against someone and lunged to retrieve the agent, who was still arguing with the Chileans. The shocked Chilean officials then released Trotta.

Trotta walked in behind Bush, who looked enormously pleased with himself. He was wearing the expression that some critics call a smirk, and his eyebrows shot up as if to wink at bystanders.

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You know Bush has won big when even I have to give him points. If the Chilean agents had unwittingly socked him things might have gotten even uglier, but I can't imagine him going anywhere without his security team. If he were still up to reelection I'd grumble that he'd staged the entire thing.

Political points aside, there's a substantially bad undercurrent:

...CNN's Mark Walz had his camera trained on Bush when a thundering herd of Asian reporters hit him in his blind spot. Walz, who has covered the White House since the last year of the Reagan administration, said it was the first time he had been knocked down. The cameraman landed on his feet and kept shooting, with an Asian reporter wedged under his right bicep.

Walz's colleagues commended him, both for keeping the camera on Bush and for not making a jerk of himself in front of the president. "I didn't want to embarrass myself or the American press by kicking it up a notch," he said.

In the hall afterward, a couple of pairs of journalists went at each other like a locker-room fight.

Bush has indeed united the world. Even our allies hate us now.

States Rights -- NYT Magazine

The New York Times > Magazine > The Way We Live Now: A States' Rights Left?

Marriage affords a vivid example. In some states it is evidently more imperiled than in others. The Bible Belt states, in particular, have a shockingly high divorce rate, around 50 percent above the national average. Given such marital instability, these states are anxious to defend the institution of heterosexual matrimony, which may explain their hostility to gay marriage. The state of Massachusetts, by contrast, has the lowest divorce rate in the nation. So its people -- or at least its liberal judges -- perhaps feel more comfortable allowing some progressive experimentation. It will be interesting to see how this experiment plays out, assuming the Bush administration does not succeed in choking off the right of a state to recognize same-sex marriages by getting the Federal Marriage Amendment enacted...

... One of the most striking differences among states is in their levels of wealth. Liberals tend to live in more economically productive states than conservatives. The top five states in per capita personal income (Connecticut, New Jersey, Massachusetts, Maryland and New York) all went to Kerry; the bottom five (Utah, New Mexico, West Virginia, Arkansas and Mississippi) all went to Bush. Since the blue states are generally richer than the red states, they must bear a greater portion of the federal tax burden. Most of them pay more to Washington than they receive, whereas most of the red states receive more than they pay. Some liberals in blue states must wonder exactly what they get in return for subsidizing the heartlanders, who are said to resent them.

Here is where President Bush is their friend. According to a recent Brookings Institution analysis, as much as two-thirds of the benefits from the income tax cuts he pushed through in his first term go to taxpayers making more than $100,000 a year. These well-off Americans tend to be concentrated around New York City, Boston, Seattle, San Francisco and other liberal enclaves. By contrast, relatively few of the benefits from the Bush tax cuts go to the Southern and Prairie states, where low-income working families with children are more the norm. At present, the Bush tax cuts are scheduled to expire by 2010. If the president succeeds in making them permanent, as he has vowed to do, it will mean lasting relief for the blue states. The money they had been sending to the red states could then be spent locally, according to their own liberal values -- say, on public schools (where they already spend more per pupil than the red states) or stem-cell research.

The more conservatives succeed in reducing the size and scope of the federal government, the more fiscal freedom the blue states will have to pursue their own idea of a just society....

/// Meanwhile, blue-state liberals should stop despairing and start thinking locally. Instead of saying, ''The United States is. . . . '' try saying, ''The United States are. . . . '' See? You feel better already.

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This is a sly article, slashing at the hypocrisies of the red states while nobly asking for the rights of states to differ.

I, of course, am a huge fan of states rights.

Note that Bush's plan to remove the deduction for state income tax will make the blue states even bigger donors to the red states than we already are.

The fact that will not speak its name

The New York Times > Opinion > Op-Ed Contributor: A Doctrine Left Behind

They might have said that it is a deeply uncontroversial fact that the United States has from the beginning had too few troops in Iraq: too few to secure the capital or effectively monitor the borders or even police the handful of miles of the Baghdad airport road; too few to secure the arms dumps that litter the country; and too few to mount an offensive in one city without leaving others vulnerable.

They might have said that it is a deeply uncontroversial fact that the insurgency is spreading: when I arrived in Iraq 13 months ago, the insurgents were mounting 17 attacks a day; last week there were 150 a day. If the old rule of thumb about counterinsurgency warfare holds true - that the guerrilla wins by not losing and the government loses by not winning - then America is losing the Iraq war. The Iraqi insurgents have shown 'outstanding resilience,' as a Marine intelligence report compiled after Falluja put it, and 'will continue to find refuge among sympathetic tribes and former regime members.'

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In every discussion that goes nowhere, there's an elephant in the room who's name cannot be spoken. The elephant in this room is the draft.

Yes, we don't have enough soldiers to conquer Iraq. Half-conquering Iraq has inflicted vast sorrow upon that nation; the humane choice would have been either to give up on the sanctions and focus on assassinating Saadam, or to invade with 350,000 troops.

So where would we get 350,000 troops for a 2-5 year period? It's not clear we have them -- not given other commitments, even if we did redeploy.

We're not a very youthful nation any more. Qualifications for troops have risen. Commitments have increased -- even outside of Iraq and Afghanistan. Even if we increased compensation by 50%, could we really fill a volunteer army large enough to meet demands?

I've read the arguments against the draft. They don't persuade me. It's true that the draft is a lousy way to create a modern fighting force -- but the draft could be used to fill a lot of non-critical non-fighting spots. This is particularly true in supporting services -- from packaging gear to sewing up abdomens.

So those of us who say Bush/Rumsfeld/Cheney are probably war criminals, are also saying that the decision to conquer Iraq implied a draft. That's not a popular thing to say -- either on the right or the left. That's why no-one names the elephant in the room -- and the sterile argument continues.

Power corrupts - Republicans want access to tax returns

MSNBC - Republicans red-faced over tax-disclosure gaffe

Congress debated legislation Saturday giving two committee chairman and their assistants access to income tax returns without regard to privacy protections, but not before red-faced Republicans said it was all a mistake and would be swiftly repealed.

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A mistake? Only in its presumption.

What would they do with those returns? Decide who to reward -- or who to punish?

Don't worry. This will happen in a less public way. Or, since there won't be much reaction to this, it will happen in a quite public way.

The ghosts of the children

Children Pay Cost of Iraq's Chaos (washingtonpost.com)

As near as we can tell about 50,000-150,000 Iraqi women and children were killed during the invasion and insurrection. Now we learn malnutrition has doubled following the invasion.

Do the "moral values" people give a damn?

What does the "missing link" mean?

The New York Times > Science > Fossils Found in Spain Seen as Last Link to Great Apes

In their report, the researchers noted that the skeleton showed that those early great apes 'retained primitive monkeylike characters' and thus did not seem to support 'the theoretical model that predicts that all characters shared by extant great apes were present in their last common ancestor.'

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This doesn't shock me as much as the mini-human discovery. I don't think it's quite in the same league; there was no real doubt among scientists that there was a primate ancestor of both humans and gorillas. The primary surprise seems to be that we actually found something from the miocene. Now we'll look for more.

It doesn't seem surprising that gorillas would have evolved over the past few million years. Why wouldn't they?

Of course this won't have any effect on the anti-rational anti-evolutionists. They're in a different universe.

Degenerative democracy

The New York Times > Opinion > Op-Ed Colmunist: No More Sham Elections

...The U.S. electoral system looks increasingly dysfunctional, and those of us who used to mock the old Soviet or Iraqi 'elections' for lacking competition ought to be blushing.

In Arkansas, 75 percent of state legislative races this year were uncontested by either the Republicans or by the Democrats. The same was true of 73 percent of the seats in Florida, 70 percent in South Carolina, 62 percent in New Mexico.

And Congressional races were an embarrassment. Only seven incumbents in the House of Representatives lost their seats this month. Four of those were in Texas, where the Republican Legislature gerrymandered Democrats out of their seats.

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American democracy is somewhere between 35 (civil rights movement), 100 (women vote), 140 (emancipation) and 300 (first revolutionary war) years old. During those times there've been periods where it was pretty sick, and periods where it was quite healthy.

This is not one of those healthy times.

I wonder if this is merely a historic cycle, or a consequence of applying technology and technique to elections between two cynical and adaptive parties. In a system designed for two parties, wouldn't the combination of adaptability, research and information technology ultimately carve the population into balanced sets?

Of course a very cynical party could always take power and then change the rules, or exploit flaws in existing rules, so that we had an effective one party system.

Irelands smoking ban closing pubs ...

Europe: Where The Smoke Is Clearing

So Europe is finally facing reality. About time. The interesting item, though, is the fall off in pub business. I dimly recall reading some months ago that there's a synergistic pleasure interaction between smoking and alcohol use. I wonder if these patrons find drinking less pleasurable when they smoke less.