A Lifesaving Checklist

Monday, December 31st, 2007

Atul Gawunde once again writes about A Lifesaving Checklist, but this time he writes about how the government shut down the lifesaving program:

A year ago, researchers at Johns Hopkins University published the results of a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves.

The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.

Yet this past month, the Office for Human Research Protections shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.

Scents & Sensibility

Monday, December 31st, 2007

In Scents & Sensibility, Sarah Chayes explains the difficulties she faced getting any kind of aid to start her exotic fragrance business in Afghanistan:

Andres suggested I turn instead to the Alternative Livelihoods Program (ALP). Funded by USAID, the project is, according to the agency’s Web site, a “major component of the U.S. and Government of Afghanistan’s comprehensive Counter-Narcotics Strategy.” The idea behind ALP is to compete with the ubiquitous opium poppy by promoting other ways for rural folk to make a living. The match seemed perfect. Our cooperative’s main objective was to find new, profitable uses for more of southern Afghanistan’s traditional agricultural and botanical products. The more reliably farmers could earn money from legal crops—especially ones with a higher market value than wheat or watermelons—the less likely they were to have recourse to risky and religiously taboo opium. Full of hope, I approached ALP.

As I was to learn over the next two bewildering years, the Alternative Livelihoods Program exemplifies the disturbing evolution of the international development industry. With neither the staff nor the mobility to carry out or even fully monitor the projects it supports, USAID acts strictly as a moneybag. Though it does fund nonprofit, nongovernmental organizations dedicated to humanitarian action, many American development dollars go to huge for-profit companies that have adapted over recent decades to capture the manna. Chemonics, which landed the contract for ALP in the southern region of Afghanistan—known, inevitably, by the clumsy ALP/S— is one of these.

Chemonics’ initial contract provided for $119 million, for use in three Afghan provinces over a four-year period. Roughly one year after the contract became official in early 2005, Chemonics had spent only a tiny percentage of its authorization, and a large part of that on its own start-up costs. Earlier this year, at its well-equipped building in Kandahar, guarded around the clock by a private security detail, I counted 10 brand-new SUVs. And yet, until this year, ALP/S was hardly visible in Kandahar, and only rarely had an international presence here. According to a former worker on the project, international employees can earn up to about $180,000 a year—plus 35 percent hazard pay, 35 percent “post differential,” and 20 percent for working Saturdays. But USAID, the former worker said, pays the company some $500,000 to $600,000 for each of them. Little surprise that Afghans wonder where the development dollars are going.

My initial contacts with ALP/S in May 2005 were warm, if a trifle confusing. The members of the agribusiness team were enthusiastic but unsure of how they could help. They kept inviting me to lunch at the German restaurant around the corner from their office, as though such charity could replace substantive help. What I needed was money—something they had plenty of. A year’s start-up funding would have been perfect, $50,000 or $70,000, until sales kicked in. The ALP/S workers said they couldn’t give grants and told me to write up a business plan.

Estimate is the word, a euphemism for “shot in the dark.” I was, like many business-plan authors, making it up. But by the end of June, I had submitted my 15-page document, and it included soap formulas, a list of raw materials and products, a description of likely markets and marketing strategies, and a schedule of production activities, both daily and seasonal. Its projections have proved quite accurate, at least in terms of raw-materials costs and margins. Even the monthly operating costs have checked out.

However, at my next meeting with the ALP/S team in Kabul, applause did not break out. “It needs more numbers,” commented one team member. I asked what kind of numbers; he could not specify. A Chemonics bigwig, in Afghanistan on a different project, volunteered to build me a spreadsheet. “It would be good if you could show yourself breaking even within six months,” he advised. A few days later, he e-mailed me an opus. Fourteen screens long on my laptop, in a rainbow of colors, it began with “Production Coefficients,” then scrolled through equipment procurement, loan-repayment summaries, sales figures, labor costs, packaging and shipping costs, and cash-flow statements. It took me two weeks, full-time, just to fill in the cells with real numbers. And I have a master’s degree from a U.S. university. I began to wonder how Afghan entrepreneurs would ever be able to negotiate such requirements.

Sometimes my numbers puzzled Chemonics personnel. Why had I altered the working hours per person for October? Answer: October that year was when Ramadan fell. No one is going to make an Afghan work more than four hours a day during Ramadan. Similar questions arose when purchases of pomegranates were entered only for October and November. Pomegranates are fruit, I explained. They have a growing season. It’s not like supermarkets in the West, stocked all year long.

The expectation that a start-up business, located in one of the most volatile and dangerous cities on Earth, should break even within six months seemed excessive. In any case, the ALP/S agribusiness team greeted the spreadsheet with a snort. “We don’t need anything like that. He just loves to cook up these spreadsheets,” they remarked of their colleague. I was stunned, but not ungrateful for the thought process this task had imposed. And I started over on a different type of business plan.

Costco Starts a Barroom Brawl

Monday, December 31st, 2007

Costco Starts a Barroom Brawl — by looking to bypass the alcohol distribution system, which exists for largely political reasons:

One of the perceived social ills inspiring Prohibition was the owning of bars by brewers. To the Anti-Saloon League and like-minded groups, this arrangement promoted alcoholism. They made the case so effectively that, even after Prohibition was lifted in 1933, most states insisted on keeping alcohol makers far away from alcohol sellers. The favored solution: a three-tier distribution system requiring manufacturers to sell to wholesalers, and wholesalers to sell to retailers.

That structure is still in place in most states today. But a closely watched federal court case filed in Seattle is now challenging the three-tier regime as outdated and anticompetitive. In 2006 Issaquah (Wash.)-based club store Costco Wholesale (COST) won an antitrust lawsuit challenging its home state’s three-level arrangement. The state then appealed, arguing that the 21st Amendment ending Prohibition gave states the authority over alcohol regulation.

The Ninth Circuit Court of Appeals is expected to rule on the case soon — a decision that could have widespread ramifications for every group with a stake in the beer and wine industry. Brewers and wineries nationwide could eventually gain the power to sell their products directly to retailers. Distributors and state tax collectors, meanwhile, could lose substantial revenues. The Costco case could “radically change the rules of the game,” says George Hancock, chairman of Pyramid Breweries, a craft beer brewer in Seattle.

A Tale of Two Town Houses

Sunday, December 30th, 2007

In A Tale of Two Town Houses, Virginia Postrel explains how real estate may be as important as religion in explaining the infamous gap between red and blue states:

In 2000, my husband and I moved out of our mid-1970s three-bedroom town house in Los Angeles and into a brand-new three-bedroom town house in Uptown Dallas. At the time, the two were worth about the same, but the Dallas place was 1,000 square feet bigger. We’ve moved back to L.A., and we’re glad we kept our old house. Over the past seven years, its value has roughly doubled. By contrast, we sold our Dallas place for $6,500 less than we paid for it.

It’s not that we bought into a declining Dallas neighborhood: Uptown is one of the hottest in the city, with block upon block of new construction. But the supply of housing in Dallas is elastic. When demand increases, because of growing population or rising incomes, so does the amount of housing; prices stay roughly the same. That’s true not only in the outlying suburbs, but also in old neighborhoods like ours, where dense clusters of town houses and multistory apartment buildings are replacing two-story fourplexes and single-family homes. It’s easy to build new housing in Dallas.

Not so in Los Angeles. There, increased demand generates little new supply. Even within zoning rules, it’s hard to get permission to build. When a local developer bought three small 1920s duplexes on our block, planning to replace them with a big condo building, neighbors campaigned to stop the proj­ect. The city declared the charming but architecturally undistinguished buildings historic landmarks, blocking demolition for a year. The developer gave up, leaving the neighborhood’s landscape — and its housing supply — unchanged. In Los Angeles, when demand for housing increases, prices rise.

Dallas and Los Angeles represent two distinct models for successful American cities, which both reflect and reinforce different cultural and political attitudes. One model fosters a family-oriented, middle-class lifestyle — the proverbial home-centered “balanced life.” The other rewards highly productive, work-driven people with a yen for stimulating public activities, for arts venues, world-class universities, luxury shopping, restaurants that aren’t kid-friendly. One makes room for a wide range of incomes, offering most working people a comfortable life. The other, over time, becomes an enclave for the rich. Since day-to-day experience shapes people’s sense of what is typical and normal, these differences in turn lead to contrasting perceptions of economic and social reality. It’s easy to believe the middle class is vanishing when you live in Los Angeles, much harder in Dallas. These differences also reinforce different norms and values — different ideas of what it means to live a good life. Real estate may be as important as religion in explaining the infamous gap between red and blue states.

Persistence of Myths Could Alter Public Policy Approach

Sunday, December 30th, 2007

Persistence of Myths Could Alter Public Policy Approach — because people forget silly details like which points are true and which are false:

The federal Centers for Disease Control and Prevention recently issued a flier to combat myths about the flu vaccine. It recited various commonly held views and labeled them either “true” or “false.” Among those identified as false were statements such as “The side effects are worse than the flu” and “Only older people need flu vaccine.”

When University of Michigan social psychologist Norbert Schwarz had volunteers read the CDC flier, however, he found that within 30 minutes, older people misremembered 28 percent of the false statements as true. Three days later, they remembered 40 percent of the myths as factual.

Younger people did better at first, but three days later they made as many errors as older people did after 30 minutes. Most troubling was that people of all ages now felt that the source of their false beliefs was the respected CDC.

The psychological insights yielded by the research, which has been confirmed in a number of peer-reviewed laboratory experiments, have broad implications for public policy. The conventional response to myths and urban legends is to counter bad information with accurate information. But the new psychological studies show that denials and clarifications, for all their intuitive appeal, can paradoxically contribute to the resiliency of popular myths.

People, of course, believe all kinds of crazy things — that Saddam was behind the 9/11 attacks, that it was an inside job, etc. — and that has been a big concern for years:

As early as 1945, psychologists Floyd Allport and Milton Lepkin found that the more often people heard false wartime rumors, the more likely they were to believe them.

The research is painting a broad new understanding of how the mind works. Contrary to the conventional notion that people absorb information in a deliberate manner, the studies show that the brain uses subconscious “rules of thumb” that can bias it into thinking that false information is true. Clever manipulators can take advantage of this tendency.

The experiments also highlight the difference between asking people whether they still believe a falsehood immediately after giving them the correct information, and asking them a few days later. Long-term memories matter most in public health campaigns or political ones, and they are the most susceptible to the bias of thinking that well-recalled false information is true.

You have to wonder how humanity got this far:

Furthermore, a new experiment by Kimberlee Weaver at Virginia Polytechnic Institute and others shows that hearing the same thing over and over again from one source can have the same effect as hearing that thing from many different people — the brain gets tricked into thinking it has heard a piece of information from multiple, independent sources, even when it has not. Weaver’s study was published this year in the Journal of Personality and Social Psychology.

The experiments by Weaver, Schwarz and others illustrate another basic property of the mind — it is not good at remembering when and where a person first learned something. People are not good at keeping track of which information came from credible sources and which came from less trustworthy ones, or even remembering that some information came from the same untrustworthy source over and over again. Even if a person recognizes which sources are credible and which are not, repeated assertions and denials can have the effect of making the information more accessible in memory and thereby making it feel true, said Schwarz.

Experiments by Ruth Mayo, a cognitive social psychologist at Hebrew University in Jerusalem, also found that for a substantial chunk of people, the “negation tag” of a denial falls off with time. Mayo’s findings were published in the Journal of Experimental Social Psychology in 2004.

“If someone says, ‘I did not harass her,’ I associate the idea of harassment with this person,” said Mayo, explaining why people who are accused of something but are later proved innocent find their reputations remain tarnished. “Even if he is innocent, this is what is activated when I hear this person’s name again.

“If you think 9/11 and Iraq, this is your association, this is what comes in your mind,” she added. “Even if you say it is not true, you will eventually have this connection with Saddam Hussein and 9/11.”

Mayo found that rather than deny a false claim, it is better to make a completely new assertion that makes no reference to the original myth. Rather than say, as Sen. Mary Landrieu (D-La.) recently did during a marathon congressional debate, that “Saddam Hussein did not attack the United States; Osama bin Laden did,” Mayo said it would be better to say something like, “Osama bin Laden was the only person responsible for the Sept. 11 attacks” — and not mention Hussein at all.

The psychologist acknowledged that such a statement might not be entirely accurate — issuing a denial or keeping silent are sometimes the only real options.

So is silence the best way to deal with myths? Unfortunately, the answer to that question also seems to be no.

Another recent study found that when accusations or assertions are met with silence, they are more likely to feel true, said Peter Kim, an organizational psychologist at the University of Southern California. He published his study in the Journal of Applied Psychology.

Myth-busters, in other words, have the odds against them.

The rumor research I was already aware of was the basic law of rumor going back to WWII:

Allport and Postman called their most far-reaching assertion “the basic law of rumor.” It declared that rumor strength (R) will vary with the importance of the subject to the individual concerned (i) times the ambiguity of the evidence pertaining to the topic at hand (a), or R ? i × a.


Saturday, December 29th, 2007

Chuck Squatriglia calls the Aerocivic “ugly as sin”:

There’s no two ways about it — this car is ugly as sin and as rough as a shipping pallet. But that doesn’t matter because it gets 95 mpg.

Its owner, known only as “basjoos,” says he spent $400 building “Aerocivic” in his yard using things you can get at hardware and art supply stores. That pretty much invalidates auto industry arguments about it being difficult and costly to build super fuel-efficient cars. It also makes him a contender for the Automotive X-Prize, a $10 million challenge to build the first 100-mpg car.

According to a thread over at Ecomodder.com, basjoos started with a 1992 Honda Civic CX that already got about 50 mpg or so. He used aluminum, Coroplast and Lexan to improve the aerodynamics of the car, dropping the drag coefficient from 0.34 to 0.17. Although the car looks like it would be pushed all over the place, if not blow apart entirely, in a stiff breeze, basjoos claims it’s smooth to 90 mph and will top 100 mph. He says it gets 95 mpg up to 65 mph before fuel economy begins to fall as speed increases.

Granted, the Civic is a lightweight car with a small engine and a lot of the improvement in basjoos’ fuel economy can be attributed to his hypermiler driving style. But AeroCivic is still an impressive accomplishment, and Ron Cogan of Green Car Journal and GreenCar.com tells us automakers will be building cars a lot like it in order to meet the new 35 mpg fuel economy standard.

High-fat, high-carb meals more harmful to obese

Saturday, December 29th, 2007

High-fat, high-carb meals more harmful to obese:

Dr. Paresh Dandona and colleagues from Kaleida Health in Buffalo, New York looked at inflammation and oxidative stress, which occurs when levels of normal byproducts of metabolism known as free radicals exceed the body’s ability to neutralize them.

In previous research they found that obese individuals have higher levels of oxidative stress and inflammation than normal-weight individuals. They also demonstrated that eating a high-fat, high-carb meal increased oxidative stress and inflammation in normal-weight people.

To test whether these increases might be greater in obese people, Dandona and his team had 10 normal-weight and 8 obese people eat a 1,800-calorie meal consisting of a large hamburger, a large serving of fries, a large cola, and a slice of apple pie.

Both groups showed increases in oxidative stress two hours after eating the meal. By three hours, oxidative stress had returned to baseline levels in the normal-weight individuals, but it continued to climb in the obese individuals. The same pattern was seen for inflammation.

“If obese people who already have oxidative and inflammatory stress take the same meal, they get far greater and more prolonged levels of oxidative and inflammatory stress,” Dandona told Reuters Health. “Since oxidative and inflammatory stress predispose you to atherosclerosis (hardening of the arteries), heart attack and stroke, this risk is far greater in obese people.”

In another study, Dandona and his colleagues demonstrated that a high-fruit, high-fiber meal with the same calorie content as the fast food meal tested in the current study produced no increase in oxidative or inflammatory stress.

The findings provide yet more evidence that people should avoid high-fat, high carb fast food meals and consume as much fruit and vegetables as possible, Dandona said.

Hello Kitty turns attention to young men

Saturday, December 29th, 2007

It’s amazing how much a nation’s character can change in a few generations. Hello Kitty turns attention to young men:

The cute cuddly white cat from Japan’s Sanrio Co., usually seen on toys and jewelry for girls and young women, will soon don T-shirts, bags, watches and other products targeting young men, company spokesman Kazuo Tohmatsu said Friday.
The usual bubble-headed shape of Hello Kitty was slightly changed for a more rugged, cool look to appeal to men in their teens and early 20s.

For example, a picture of the cat on a $36 black T-shirt has the words, “hello kitty,” instead of the usual dots for the eyes and nose.

Hello Kitty is one of mascot-obsessed Japan’s biggest “character” hits, decorating everything from a humble eraser to a $48,000 diamond necklace.

Fish oil capsules pack same omega-3 punch as fish

Saturday, December 29th, 2007

Fish oil capsules pack same omega-3 punch as fish:

To investigate, Harris and his team had 11 women eat two servings of tuna or salmon each week, while an additional 12 women took in the same amount of omega-3s, an estimated 485 milligrams daily, in capsule form.

After 16 weeks, the amount of omega-3 fatty acids in the red blood cells of women in both groups had risen by 40 percent to 50 percent, while omega-3s in the plasma (the cell-free, liquid portion of the blood) had risen by 60 percent to 80 percent.

“We went into the project assuming that fish would be better, based on some previous literature from other people,” Harris noted in an interview. Based on the current findings, he added, “it doesn’t make any difference whether you get your omega 3 fatty acids from a concentrate in a capsule or in fish — they have the same effect on enriching the tissues with omega 3.”

Nevertheless, Harris said, he would encourage people to eat fish rather than relying on fish oil capsules. “Fish of course brings with it proteins and minerals and other factors that are good for our health that the capsules don’t bring, but we weren’t able to measure any of those things,” he said.

Top 10 Color Classical Reproductions

Saturday, December 29th, 2007

This list of the Top 10 Color Classical Reproductions shows what some of those beautiful white marble works really looked like:

When we think of statues and buildings of the classical period, we tend to imagine white marble; scientists in recent years have discovered that it is in fact most likely that many of the buildings and statues were painted and probably adorned with jewelry. The Vatican Museum has recently put on an exhibition of some of the most famous antiquities from the era with reproductions painted as close to the originals as they can – this is possible because many statues contain trace amounts of pigment from their original coats of paint.

Snorting a Brain Chemical Could Replace Sleep

Saturday, December 29th, 2007

Snorting a Brain Chemical Could Replace Sleep:

A nasal spray containing a naturally occurring brain hormone called orexin A reversed the effects of sleep deprivation in monkeys, allowing them to perform like well-rested monkeys on cognitive tests.

I’d like to perform like a well-rested monkey. Here’s more:

The study, published in the Dec. 26 edition of The Journal of Neuroscience, found orexin A not only restored monkeys’ cognitive abilities but made their brains look “awake” in PET scans.

Siegel said that orexin A is unique in that it only had an impact on sleepy monkeys, not alert ones, and that it is “specific in reversing the effects of sleepiness” without other impacts on the brain.

Such a product could be widely desired by the more than 70 percent of Americans who the National Sleep Foundation estimates get less than the generally recommended eight hours of sleep per night (.pdf).

The research follows the discovery by Siegel that the absence of orexin A appears to cause narcolepsy. That finding pointed to a major role for the peptide’s absence in causing sleepiness. It stood to reason that if the deficit of orexin A makes people sleepy, adding it back into the brain would reduce the effects, said Siegel.

Lovin’ It All Over

Friday, December 28th, 2007

George Will talks about the amazing economic engine that is McDonald’s, in Lovin’ It All Over:

McDonald’s exemplifies the role of small businesses in Americans’ upward mobility. The company is largely a confederation of small businesses: 85 percent of its U.S. restaurants — average annual sales, $2.2 million — are owned by franchisees. McDonald’s has made more millionaires, and especially black and Hispanic millionaires, than any other economic entity ever, anywhere.

McDonald’s has 14,000 restaurants in America and an additional 17,000 in 117 other countries. The company will add 1,000 others in 2008, more than 90 percent of them abroad. Such is the power of the McDonald’s brand, 48 percent of the people of India were aware of McDonald’s before it opened its first restaurant on the subcontinent.

Airport Security Study

Friday, December 28th, 2007

Bruce Schneier notes that a new study concludes that airport security isn’t helping:

A team at the Harvard School of Public Health could not find any studies showing whether the time-consuming process of X-raying carry-on luggage prevents hijackings or attacks.

They also found no evidence to suggest that making passengers take off their shoes and confiscating small items prevented any incidents.
The researchers said it would be interesting to apply medical standards to airport security. Screening programs for illnesses like cancer are usually not broadly instituted unless they have been shown to work.

Of course, the TSA has things completely backwards and doesn’t seem to realize that confiscating millions of lighters from innocent people is a security failure:

“Even without clear evidence of the accuracy of testing, the Transportation Security Administration defended its measures by reporting that more than 13 million prohibited items were intercepted in one year,” the researchers added. “Most of these illegal items were lighters.”

Top 10 Scientific Breakthroughs of 2007

Friday, December 28th, 2007

Aaron Rowe of Wired lists the Top 10 Scientific Breakthroughs of 2007:

10. Transistors Get Way Smaller

In the race to make computers faster, chipmakers rely on exotic new materials. In January, Intel announced that the element hafnium and some new metal alloys will allow them to make the millions of switches on their microprocessors far smaller. Gordon Moore, co-founder of the company and father of the law that bears his name, called it the biggest change in transistor technology since the 1960s. The tremendous accomplishment allows Intel to squeeze features on each chip down to 45 nanometers from the current standard of 65 nanometers. But the greatest benefit may be an increase in energy efficiency. That improvement comes along with the hafnium alloys that will prevent electricity from leaking across the tiny switches.

Intel started using the technology, codenamed Penryn, in November in high-end servers. Home users can expect the chips in early 2008.

9. Scientists Clone Rhesus Monkey to Produce Stem Cells

At Oregon Health and Science University, Shoukhrat Mitalipov and his team cloned a Rhesus Monkey and used the resulting embryo to create stem cells. Until then, the impressive feat had been performed only with mice.

In November, the team reported in Nature a surprising key to their success: avoiding ultraviolet light and dyes — tools that are almost always used in cloning experiments — because they can damage delicate cells.

Stem cells could be used to repair nearly any damaged organ, but they are useless if they upset the immune system. By cloning sick patients and using cells derived from their own bodies, doctors could skirt problems similar to those experienced by people with organ transplants. But some say the No. 1 discovery on our list makes cloning unnecessary. Nonetheless, some scientists, including stem-cell researchers at Harvard, say cloning is still necessary.

Regular flu vaccine may help against H5N1

Friday, December 28th, 2007

Regular flu vaccine may help against H5N1:

Ordinary seasonal flu vaccines may provide a small amount of protection against bird flu, Italian researchers reported on Wednesday.

Their study is among the first to support the idea that getting an annual flu shot may help people’s bodies fight off the H5N1 virus, which has killed 210 people in 13 countries and infected 341.

Cristiana Gioia, Maria Capobianchi and colleagues at the National Institute for Infectious Diseases Lazzaro Spallanzani in Rome tested the blood of 42 volunteers who had been vaccinated against seasonal influenza.

In the laboratory, they added H5N1 virus to the blood and found that in some of the volunteers immune system proteins called antibodies acted against the bird flu virus.

They also found a few immune cells called CD4 T-cells seemed to recognize and act against H5N1 virus “and seasonal vaccine administration enhanced the frequency of such reactive CD4 T-cells,” they wrote in the journal Emerging Infectious Diseases.

“Our findings indicate that seasonal vaccination can raise neutralizing immunity against (H5N1 avian influenza) virus,” the researchers concluded.

This could help explain why H5N1, which only rarely affects people, is even rarer among the elderly, Gioia’s team wrote.

“This finding may be explained by hypothesizing that older people, although not previously exposed to H5N1 subtype, may have gained protective immunity by previous infections sustained by circulating influenza virus strains,” they wrote.