Disease Mongering At Its Best

What is disease mongering?

"Disease mongering is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments. It is exemplified most explicitly by many pharmaceutical industry-funded disease-awareness campaigns — more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health."
- The Fight against Disease Mongering: Generating Knowledge for Action, PLoSMedicine, 2006

Drug companies profit from giving names to conditions for which they want to sell drugs, conditions that don't necessarily warrant drugs.

Here's a drug being sold for ES and SWD. I've never heard of ES and SWD, have you?

ES: Excessive Sleepiness
SWD: Shift Work Disorder

Nuvigil's website offers a free prescription. Nice, since a 90-day supply costs $1238.94 (at drugstore.com). Having insurance cover the cost for these drugs raises the price of insurance for everyone.

What acronyms will they think of next?
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Spiced Apple In 5 Minutes

Clean 1 apple (or 2 small ones). This a a Gala apple.  Quarter it and slice out the seeds:



Grate it. Leave the skin on:



Put it in a small saucepan with a few tablespoons of water, just enough to pool about 1/4 inch at the bottom of the pan. Cover it. Bring it to a simmer using a low heat setting:



It will look like this after about 5 minutes. Stir a few times as it heats. If you use more water or cook longer it will be more like applesauce than grated apple.  I stop cooking here because I like the texture.



Let it sit in the pan covered for a couple minutes to even out in temperature. Then add spices. I added about 1/8 teaspoon cinnamon and two shakes of salt. (Salt at the subthreshold level enhances sweet taste without having to add sweetener.)



Side view. I like adding hot spiced apple to a bowl of oatmeal.


________Photos: Bix

Are What We Call "Causes" Just Stories That Help Us Make Sense Of Things?

I've been saying "I don't know" a lot more.  The more I read, the less I feel I know, and the more confused I get. I'll admit. And the more amazed I am at people who know.  But Jonah Leher, in his article:

Trials And Errors: Why Science Is Failing Us , Wired, 16 December 2011

... says that I'm probably not alone. That trying to understand all the minutia may end up confusing me:

"We assume that more information will make it easier to find the cause. ... All those extra details end up confusing us; the more we know, the less we seem to understand."

Why? Because:

"The variables cannot be isolated. Such situations require that we understand every [Leher's emphasis] interaction before we can reliably understand any of them."

I visualize this as a fabric. When you pull one thread, you perhaps unintentionally tug or distort hundreds of other threads. The whole is not simply the sum of its parts - a fact that modern science best not lose sight of:

"This assumption - that understanding a system’s constituent parts means we also understand the causes within the system ... defines modern science. In general, we believe that the so-called problem of causation can be cured by more information, by our ceaseless accumulation of facts. Scientists refer to this process as reductionism."

He gives some examples:

• The notable costly failure of Pfizer's heart-saving drug torcetrapib. Torcetrapib was supposed to raise HDL and lower LDL. It did, but it also raised blood pressure (the unintended thread tug).
  
  
• We thought the cause of low back pain was disc abnormalities, which we could view in MRI and which could be rectified with surgery. But was it the surgery or the person's own healing mechanisms that relieved pain, since "about 90% of people with back pain [get] better within six weeks"? A 1994 NEJM study suggested it was probably the person's own healing: "the discovery of a bulge or protrusion on an MRI scan in a patient with low back pain may frequently be coincidental."

So, are what we call "causes" (as opposed to correlations) just stories that help us make sense of things? I bet that's often the case, even though some "causes" are indefatigable, like, say, that a deficiency of vitamin C causes scurvy.
________Thanks to Shaun for the article.
Thanks to xkcd for the comic.

Touched By A Wild Gorilla

I would have been terrified.




________Via shehab ahmad.

Christmas Lights 2011

I wish everyone a moment of joy today.


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The Jungle, Part 4: Sausage And Lard

Yesterday I commented that I couldn't believe what went on in meatpacking plants 100 years ago. Here's an excerpt from Upton Sinclair's The Jungle:

"There was never the least attention paid to what was cut up for sausage; there would come all the way back from Europe old sausage that had been rejected, and that was moldy and white--it would be dosed with borax and glycerine, and dumped into the hoppers, and made over again for home consumption.

There would be meat that had tumbled out on the floor, in the dirt and sawdust, where the workers had tramped and spit uncounted billions of consumption germs.

There would be meat stored in great piles in rooms; and the water from leaky roofs would drip over it, and thousands of rats would race about on it. It was too dark in these storage places to see well, but a man could run his hand over these piles of meat and sweep off handfuls of the dried dung of rats. These rats were nuisances, and the packers would put poisoned bread out for them; they would die, and then rats, bread, and meat would go into the hoppers together. This is no fairy story and no joke; the meat would be shoveled into carts, and the man who did the shoveling would not trouble to lift out a rat even when he saw one--there were things that went into the sausage in comparison with which a poisoned rat was a tidbit. There was no place for the men to wash their hands before they ate their dinner, and so they made a practice of washing them in the water that was to be ladled into the sausage."

It's hard to believe this really went on. Wikipedia says that "Sinclair spent seven weeks gathering information while working incognito in the meatpacking plants of the Chicago stockyards."

This next bit is just incomprehensible.  Sinclair is describing the different jobs men performed in the plant, and the risks that accompany each job.  For the men who worked in the tank rooms:

"... there were open vats near the level of the floor, their peculiar trouble was that they fell into the vats; and when they were fished out, there was never enough of them left to be worth exhibiting, -- sometimes they would be overlooked for days, till all but the bones of them had gone out to the world as Durham's Pure Leaf Lard!"

A lot of people ate this meat.  From the Civil War to the 1920s, more meat was processed at Chicago's Union Stockyards than in any other place in the world.

I should have read this book years ago.  I've been, and probably still am, terribly naive.  I've come to see that businesses, even today, are not above this.

• In 1991, 25 people were killed in a fire at the Hamlet chicken processing plant because the owners, who went to prison, had kept the doors locked and the windows boarded. ("One worker stated that much of the chicken meat was rotten, and that the reason it was processed into chicken nuggets was to disguise the foul taste.")


• Just 2 years ago, the Peanut Corporation of America was responsible for 9 deaths and hundreds of illnesses because their plant was filthy, their peanut products contaminated with toxic bacteria and mold.


• Many examples of the contamination of leafy greens and related death and illness can be found in Bill Marler's recent post. He describes an increasing and troubling lack of transparency from both the industry as well as the FDA and state food safety teams.

Could these tragedies have been avoided with more inspections? Who requires the inspections? Who conducts them?

The Jungle, Part 1: Breakfast And Dinner
The Jungle, Part 2: Honeycombed With Rottenness
The Jungle, Part 3: Food Was Not As It Seemed
The Jungle, Part 4: Sausage And Lard
________For the photos, I'm very grateful to Kathy who writes The Food Company Cookbooks blog.

"Armour and Company published a booklet, The Business of Being a Housewife - A Manual to Promote Household Efficiency and Economy (1917, 60 pages) that contains several nice illustrations of their ham and bacon products and some of the products from their Veribest line of foods."

High-Fat Diets Cause Insulin Resistance Despite An Increase In Muscle Mitochondria

Here's Laurie's recent post:
Scientists Know that Fatty Diets Cause Blood Sugar Problems

I have to say, I agree with her. High-fat diets likely contribute to insulin resistance, and in turn, diabetes. I've read a number of studies over the years that support this link - both epidemiological and clinical studies, the latter on animals as well as humans. I don't know why this link isn't discussed much in the media.

I've also wondered whether low-carb (and so, by default, high-fat) diets disguise this problem. As long as you continue to eat very little carbohydrate, insulin resistance that a high-fat diet may be promoting might not be apparent - that is, if you're just looking at blood glucose levels.

(The rats in the study Laurie mentions, the ones that experienced insulin resistance, were eating about 50% of their calories from fat and 30% from carbohydrate.  There were 2 high-fat groups: one eating flax seed and olive oil, the other lard and corn oil.)
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USDA Wants Monsanto To Conduct Their Own Environmental Reviews, Good Or Bad?

The USDA, which oversees production of genetically engineered (GE) crops, is:

"... training the world's biggest biotech firms, including Monsanto, BASF and Syngenta, to conduct environmental reviews of their own transgenic seed products.

... testing new cost-sharing agreements that allow biotech firms to help pay private contractors to prepare mandatory environmental statements on GE plants.

This would eliminate a critical level of oversight for the production of GE crops.

Activists say biotech firms like Monsanto are concerned only with profit and routinely supply regulators with one-sided information.

Bill Freese, a policy expert with the Center for Food Safety (CFS):

"It's the equivalent of letting BP do their own Environmental Assessment of a new rig."

- From: EXCLUSIVE: Under Industry Pressure, USDA Works To Speed Approval Of Monsanto's Genetically Engineered Crops, Truthout, 12 December 2011

Where the world stands:

• The US promotes biotech (both Obama and Bush).
• China, Argentina, and Brazil have embraced biotech.
  
• Europe, including France and Spain, have been cautious, in some cases hostile towards biotech.  Europe labels its food, US does not.
• GE crops are banned in Hungary and Peru [and Ireland].

What do you think?  My first reaction: not a good idea.  On second thought, maybe it's not that bad.  I guess these are the options:

1. Allow biotech plants to go to market without more in-depth environmental reviews.
2. Suspend commercial planting of biotech until the government can complete environmental reviews.
3. Farm out the job of environmental review - let someone pay for it besides the taxpayer.
4. Increase USDA resources.  Raise taxes?  Reallocate?  Borrow?

The USDA, I imagine, doesn't have the resources, even though they have the mandate, to conduct Environmental Impact Statements on every biotech plant.  So options 1, 2, and 4 would result in no in-depth review, not anytime soon.  But Biotech, I imagine, spent way too much on research and development not to bring these plants to market, sometime soon.  Having Monsanto do their own review is smelly.  But some review is better than no review.  It may also mean USDA is privy to more industry facts, figures, and finaglings than if they conducted their own independent reviews.
________Photo of Roundup Ready Soybeans from Monsanto's site.

What Is The Single Best Thing We Can Do For Our Health?

Dr. Mike Evans says ...
Exercise.
30 minutes a day.

I love how this video was produced.
I don't exercise for 30 minutes a day :(
Do you?
I wonder if your job is something that requires exercise, like trash collector, waitress, housekeeper, landscaper, roofer, does it still apply?
________

New Census Figures: 1 in 2 Americans Poor Or Low-Income

Nearly half of Americans (From the graph: 16.1% + 31.8% = 47.9%) are living at or close to poverty levels. Many of them are children and the elderly, groups with little ability to change their situation:

Reading Between the Poverty Lines New York Times, 19 November, 2011



How do you grow an economy when half the population struggles to put food on the table? And what is that food? How can we advance diets that feature expensive organic non-industrially-farmed vegetable and animal products when they are out-of-reach for so many?

I see with ever more clarity that what people eat is more a question of economics and politics than of health. I'm understanding why Michelle Obama may be deemphasizing the food aspect of her Obesity Campaign in favor of the move aspect:

Let’s Move Campaign Gives Up On Healthy Diets For Kids?, Marion Nestle's Food Politics blog, 5 December, 2011

How can she be "ensuring that every family has access to healthy, affordable food" while the price and access to that food each day becomes more out-of-reach for millions of Americans?
________Related: Census Shows 1 In 2 People Are Poor Or Low-Income: Nearly half of Americans are low-income as rising expenses, unemployment shrink middle class, Yahoo Finance, 16 December, 2011

Commenting On Google Blogs

I think I discovered why I can't comment on other people's blogs, and why they can't comment on mine. When I put a check-mark next to "Accept third party cookies" in my browser options, which I had purposely left unchecked before, suddenly I could post to others' blogs. So, Google must have changed their code?

It looks like they did:
Cookie Filtering, And Commenting Ability, The Real Blogger Status, What Blogger Won't Tell You, June 2011

I changed my comment settings to use the full page instead of the pop-up window. I'm hoping this allows people to comment without having to "Accept third party cookies," adjust any other cookie permissions or other browser options.
________

Affable Bears

Mirror neurons? Or just good friends?

I can't help it...


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How Much Do Fruits and Vegetables Cost?

Talking about what to eat on a budget led me to this report by the USDA:

How Much Do Fruits and Vegetables Cost? (pdf), Economic Research Service of the USDA, February 2011

Processed fruits and vegetables weren't always more or less expensive than fresh. I saw that, for example, carrots were cheaper to eat fresh, but peaches were cheaper to eat canned.

Carrots:

• Fresh 0.77/lb
• Canned 0.69/lb
• Frozen 1.19/lb

• Fresh 0.25/cup
• Canned 0.34/cup
• Frozen 0.39/cup

Peaches:

• Fresh 1.84/lb
• Canned 1.05/lb

• Fresh 0.66/cup
• Canned 0.58/cup

Some graphs from the report (you can click them for better resolution):





So, the least expensive vegetables were potatoes, cauliflower, cabbage, onions, and carrots. The least expensive fruits were watermelon, bananas, honeydew, oranges, and grapefruit. (Mangoes were cheaper than apples?)
________Cabbage still life by Jonathan Koch. I'd love to see that in-person.

Rats Appear To Help Other Rats In Distress

Rats Free Trapped Friends, Hint at Universal Empathy, Wired, 8 December 2011

"In a study published Dec. 7 in Science, Mason and University of Chicago psychologists Jean Decety and Inbal Ben-Ami Bartal describe their rat empathy-testing apparatus: An enclosure into which pairs of rats were placed, with one roaming free and the other restrained inside a plastic tube. It could only be opened from the outside, which is exactly what the free rats did — again and again and again, seemingly in response to their trapped companions’ distress."

This looks to me like activity of mirror neurons, which I read about in Ramachandran's book, The Tell-Tale Brain. It makes sense to me that animals would share anatomical structures, like eyes, or in this case, wads of neuronal networks. Not that we all fine-tune them in the same way. I envy birds' ability to fly!
________Thanks to BL.

The Budget Diet

Here's one dietitian's "grocery list to help you cut food prices while you boost nutrition:"
Cheap and Healthy: 15 Nutritious Foods for About $2

1. Brown Rice
2. Whole-Wheat or Multigrain Pasta
3. 100% Whole-Wheat Bread
4. Nonfat Greek Yogurt
5. Old-Fashioned Oats
6. Frozen Vegetables
7. Russet Potato
8. Fresh Bagged Spinach
9. Canned Refried Beans
10. Canned Tuna
11. Canned or Jarred Marinara Sauce
12. Whole Wheat Pita Bread
13. Store-Brand Egg Substitute
14. Frozen Edamame (Soybeans)
15. Dried Lentils

Anything you would add? Or take away?

I think I may get roasted for this, but, well, it works on a budget. Last night's dinner (red potatoes tossed in oil and spices, roasted at 370ºF for 1 hour):




________Photos: Bix

The Political Class Vs. The Working Poor, And The Elusive Perfect Diet

From:
Land Of The Free, Home Of The Hungry: Nowhere Is The Chasm Between America's Political Class And Its Working Poor More Vast Than In The Demand To Cut Food Stamps, The Guardian, 9 December 2011

• According to Gallup polling, one in five Americans reported not having enough money to buy food in the past 12 months


• An analysis by the New York Times revealed a 17% increase in the number of school students receiving free and reduced lunches across the country between 2006/07 and now.


• Between 2008 and 2011, the number of those living on food stamps, assistance to those who lack sufficient money to feed themselves and their families, soared by 50%, putting one American in seven in the programme.


• "This is a special interest group that not many people talk about because they don't have the wealth to lift a candidate to be president of the United States," explained D Jermaine Husser, the former executive director of South Carolina's Low Country Food Bank.


• A new measurement of poverty by the Census Bureau, which takes regional cost of living, medical payments and other expenses that do not intrude on the official poverty count, found a third of Americans are either in poverty or desperately close to it.

The Census Bureau says 100,000,000 Americans are in or near poverty. Is that high for one of the wealthiest countries in the world?

Interesting that Gary Younge chose to describe the two ends of the wealth chasm as the "political class" and the "working poor." The working poor, "not so much the destitute – America is always forgetting about them," vs. the political elite, a group opposed to the tenets of Populism, "political ideas and activities that are intended to represent ordinary people's needs and wishes."

Another notable bit, from the New York Times article that Younge links, adds weight to the notion that food assistance programs are, in effect, grain subsidies:

"Congress passed the National School Lunch Act in 1946 to support commodity prices after World War II by reducing farm surpluses while providing food to schoolchildren."

Does that imply that cutting food assistance programs could affect supply? Perhaps increase it? Lowering the price farmer's get for their grain? I don't know. I marvel at the days farmers were paid to keep their fields fallow.

The Perfect Diet

Back in my engineering classes, we were taught not to chase the elusive perfectly built structure. You could, of course, imagine designing a perfect building, using the best materials, taking all the time you needed, but you wouldn't produce something that was on time and on budget. It would be merely an academic exercise. (Boy, did we get grilled in finals if we were overbudget!) In the real world, there are constraints, mistakes, and sure-as-shootin', politics. So you compromise.

In the same way, I've learned there is no such thing as a perfect diet; you cannot provide all the best materials to all people, not logistically¹, not economically, and not all the time. You design a diet for each person that is within their means and that matches their particular needs. I may want to configure a house with oak and marble; it won't happen on a pine-and-formica budget.

The Budget Diet

In the spirit of cooking on a budget, here's one dietitian's "grocery list to help you cut food prices while you boost nutrition."
________¹ Less Than 1% of American Cropland Is Organic

The photo is from the cover of David Shipler's book, The Working Poor: Invisible in America. Not a book I've read but it's on my list:

"Shipler shows how liberals and conservatives are both partly right – that practically every life story contains failure by both the society and the individual. Braced by hard fact and personal testimony, he unravels the forces that confine people in the quagmire of low wages. And unlike most works on poverty, this book also offers compelling portraits of employers struggling against razor-thin profits and competition from abroad."

Dr. Cinque: "The Sensible, Sane Way To Optimize Your Blood Sugar"

I enjoy reading Dr. Cinque's blog. I don't always agree with him but about diet we're on the same page.

In his latest post, Carbs And Blood Sugar, he questions Drs. Mercola and Rosedale's* advice to eat little-to-no foods that contain primarily carbohydrates. This would have one eliminate foods such as apples, yams, squash, rice, potatoes, corn, bananas, etc. He does not, however recommend "eating nothing but starches and fruits and vegetables, as per McDougall or Esselstyn. Healthy fats are just as good for you as healthy starches, and I am for moderation with both. To demonize carbs or fats is extreme, and I mean really bizarre."

He's funny! He wraps up:

"Find a good balance of protein, fats, and carbs in your diet; go for quality in all the foods that you eat; keep an eye on your total caloric intake, and cut out every single junk food; and also stay as physically active as possible. Also, try to avoid snacking. Eat your meals and "fast" in-between meals. That's the sensible, sane way to optimize your blood sugar."

Seems sensible to me.
________* I'm not familiar with Mercola and Rosedale; I'm just paraphrasing Cinque.

Bird Of Prey

A falcon or a hawk?


________Photo by Aidan Finn

Fallout from Japan's Disasters

I received an email this morning from a gentleman concerned about the fallout from Japan's triple earthquake, tsunami, and nuclear power plant disasters. He sent this article:

The Death Of The Pacific Ocean, Fukushima Debris Soon To Hit American Shores

That pile of debris, made up of cars, trucks, boats, refrigerators, television sets, furniture, all laced with toxic chemicals is due to begin hitting Hawaii this winter (according to NOAA) and the US West Coast several months after that:

Japan Tsunami Debris Floating Toward Hawaii, Huffington Post, October 25, 2011

The National Oceanic and Atmospheric Administration (NOAA, under the Department of Commerce, an agency that Texas Governor and Republican Presidential aspirant Rick Perry would eliminate) offered this map of movement of debris from the tsunami. (Year 1 = red; Year 2 = orange; Year 3 = yellow; Year 4 = light blue; Year 5 = violet.) Looks like it's moving a little faster than this.


________
The following are recent events related to Fukushima's radiation leakage:

400,000 cans of baby formula recalled:
Japanese Tests Find Radiation In Infant Food, New York Times, December 6, 2011

"Traces of radioactive cesium thought to be from the crippled Fukushima Daiichi nuclear power plant were detected in Japanese baby formula on Tuesday as concerns about food safety continue almost nine months after the accident.
...
Since the Fukushima Daiichi plant was heavily damaged by the tsunami that followed the March 11 earthquake, radioactive particles have made their way into vegetables, beef, fish and the nation’s staple, rice."

New leakage of radioactive gas, indicating that nuclear fission has resumed - on its own - in a reactor close to shutdown:
Japan Nuclear Crisis: Xenon Detected At Fukushima Plant, BBC, November 2, 2011

Revised estimates of radiation release:
Fukushima Nuclear Plant Released Far More Radiation Than Government Said, Scientific American, October 25, 2011

Banned beef shipments:
Japan Bans Fukushima Beef Shipments, BBC, July 19, 2011

"The initial discovery of contaminated beef was traced back to farms near the Fukushima power plant, but more recent discoveries are from farms as far as 100km (70 miles) away."

Maybe the world is better off with fewer regulations? Presidential aspirant Rick Perry is also advocating for the abolishment of the Department of Energy, which houses the National Nuclear Security Administration.
________The photo, from the US Navy, shows the debris off Japan's coast shortly after the tsunami.

Men And Sheds

Professor Alan White, whose analysis on men, health, and sheds appeared in the British Medical Journal last week, says that for men, working in a shed can relieve stress, lower blood pressure, and boost self-esteem ... adding years to their lives.

"Men find doing things relaxing, and that in itself is good for their health."

Europe’s Men Need Their own Health Strategy, BMJ, 29 November 2011

What are men doing in sheds?

The Telegraph says they're banging nails, welding metal, shaping wood, and disassembling/reassembling cars.
The Daily Mail says they're doing crossword puzzles.

Maybe women have already found their sheds?

"At any given age, men are still more likely than women to die from most of the leading causes, and in the European Union men have more than twice as many deaths a year as women throughout the working ages (15-64 years)."

________

Corrupted Research (Repost)

This is a repost from May 2009.
________
When a former editor-in-chief of The New England Journal of Medicine, says:

"It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine."

It's worth paying attention.

That quotation is by former NEJM editor Dr. Marcia Angell from her review of three recent books which (including one she authored herself) shine a light on the influence businesses, in this case drug companies, have on research that appears in even the most respected, peer-reviewed science and medical journals ... and how businesses influence the behavior of medical professionals, in all fields - healthcare, research, academia, and government.

Here's her review:
Drug Companies & Doctors: A Story of Corruption, New York Review of Books, January 2009.

I'll list the books she was reviewing because I think their titles help tell the story:

• "Side Effects: A Prosecutor, A Whistleblower, And A Bestselling Antidepressant On Trial"
  by Alison Bass
  
  This is the story of pharmaceutical giant GlaxoSmithKline, who "buried evidence that its top-selling antidepressant, Paxil, was ineffective and possibly harmful." GSK agreed to settle charges of consumer fraud for $2.5 million - their cost for doing business, since Paxil continued to bring in about $3 billion a year.
  
  
• "Our Daily Meds: How The Pharmaceutical Companies Transformed Themselves Into Slick Marketing Machines And Hooked The Nation On Prescription Drugs"
  by Melody Petersen
  
  The story of how drug companies engage in "disease-mongering," convincing prospective patients and their doctors "that they have medical conditions that require long-term medical treatment." Here, Pfizer pled guilty for illegally marketing Neurontin, laying out $430 million to resolve the charges. Again, this was just the cost of doing business, since Neurontin, which was initially approved to treat epilepsy, continued to bring in billions annually - for precisely the off-market uses Pfizer illegally advanced, "bipolar disease, post-traumatic stress disorder, insomnia, restless legs syndrome, hot flashes, migraines, tension headaches, and more."
  
  
• "Shyness: How Normal Behavior Became A Sickness"
  by Christopher Lane
  
  This is another story of disease-mongering: Drug makers creating diagnoses for which drug intervention is not indicated (e.g. the diagnosis of "social anxiety disorder" for shyness), let alone adequately researched, yet proceeding to aggressively market their drugs anyway.

________
Selling Pills On Inference Instead Of Science

The field of psychiatry is particularly vulnerable to disease-mongering since diagnoses are largely subjective. However, Senator Charles Grassley, who exposed damaging conflicts-of-interest in the psychiatry field, has shifted his attention to the cardiology field - where cocktails of powerful drugs are being peddled without the backing of convincing published scientific evidence. (The polypill for heart disease comes to mind. It's an untested pill containing a statin, ACE inhibitor, diuretic, aspirin, and others.)

Ways Industries Corrupt Research

There are many ways that industries influence research. One is by suppressing unfavorable results of industry-sponsored studies. Here's an example using antidepressants:

"Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive."
- Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy, NEJM, 2008

Other ways include:

• Setting up trials that are all but certain to show market worth, e.g. by comparing your drug to a placebo instead of to another similarly-classed drug.
  
  
• Writing a paper that shifts focus away from a drug's poorly substantiated primary effect to a peripheral effect that appears more favorable.
  
  
• Reanalyzing data from published studies, that is, performing a "meta-analysis," where included studies can be cherry-picked, or statistical analyses performed to deemphasize negative findings (i.e. broadening confidence intervals).

Dr. Angell says that "many reforms would be necessary to restore integrity to clinical research and medical practice. ... Many would involve changes in the FDA." I hope the new FDA Commissioner makes these reforms part of her agenda.
________

The Laptop With The Mostest

We bought a new laptop. It came bundled with a lot of bloatware. These two bits of free software were enormously helpful:

PC Decrapifier, which helped me to remove a lot of pre-loaded and unwanted programs that were souring my fresh-out-the-box new-computer experience.

Malwarebytes, which found a trojan on a new computer I hadn't even used yet. In the blink of an eye it was gone.

Both programs are free for the basic version, easy to install, and don't, that I know, deposit any dregs on your hard drive. I've used Malwarebytes in addition to McAfee Antivirus and Webroot's Spy Sweeper for about 5 years and it always finds things these two don't.
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