Amazon Malaria Initiative

Complaining about _Prescription for a Healthy Nation_
I've seen references to a study mentioned here a million (<-- hyperbole) times: Carnegie Mellon, 276 healthy volunteers, asked about social ties, gave them a rhinovirus. "Within five days, the volunteers with the fewest social ties were about four times as likely to get colds than volunteers with the most social ties, even when the researchers took into account their age, sex, weight, race, and education."

They come to the usual conclusion (social connections make us healthy) but it occurs to me that the fewer people you are close to, the less up-to-date your immune system's firmware is. Of _course_ you're more likely to get sick -- because you haven't experienced that virus or any of its zillion close relatives yet.

Has anyone controlled for that? Do we even know how?

ETA: And on the next page, Robert Putnam is quoted unquestioningly. *sigh* Repeat after me, everyone: Robert Putnam is a Bad Source. Never, ever, ever quote from _Bowling Alone_; it makes you look like an ideologue who cannot be bothered to figure out which sources are not supposed to be quoted when outsiders might be paying attention.

ETAYA: on the subject of monkey see, monkey do and that horrible movie and the resulting incidents involving kids lying down on the highway lines: "Think for a moment of how difficult it would be to persuade anyone, at any age, through any technique of persuasion you can imagine, to lie down in front of a moving car."

I'm a mother. This actually does not even sound difficult to me. I'm thinking these authors must be really young, or way more autistic than even me. (I agree with the point they are making: people do shit they see in movies, which is a problem, given the stuff people show in movies.)

ETA still more: "Because TV programmers want to nail us to the set until the next commercial, they tend to reach for images that are arousing, particularly violence and sex. The formula works, has always worked, and will always work. As media wizard Brandon Tartikoff said, "All of television boils down to excisable elements that you can put in twenty second promos. If you can't have Starsky pull a gun and fire it fifty times a day on promos [because of citizen pressure against violent content], sex becomes your next best handle."

This fully explains in every detail the massive decline in casual violence in children's television shows -- and, for that matter, the drastic reduction in gun battles on police procedurals. [<-- Sarcasm.] The formula actually evolves and, amusingly in contrast to the argument being made, the most sexual and violent shows on television are on channels that don't have ads during the show. (Amirite, all of you Game of Thrones fanatics? You're not sitting through ads.)

ETA file under FFS:

"As advertising philosopher [sic] David Ogilvy wrote, "Give people a taste of Old Crow and tell them it's Old Crow. Then give them another taste of Old Crow, but tell them it's Jack Daniels. Ask them which they prefer. They'll think the two drinks are quite different. They are tasting images."

Really? You're going to silently reproduce the Beam conglomerate vs. the Jack conglomerate without even mentioning that? And on top of that, you're going to compare the cheaper Beam choice to the mid-range Jack choice?

Also, I used to drink Old Crow. It really wasn't bad at all (Maker's Mark obvs better for only a little more money), provided you had the sense to not put ice cubes in it. If you were going to put ice in it, you'd better be mixing it, too. And there's no way in hell you'd be able to serve me the same whisky back to back and tell me it was two different whiskeys. It's been tried.

"In surveys average television viewers say they enjoy watching TV about as much as they enjoy housework and cooking -- enjoy it less, in fact, than working."

And this is how we know that survey instruments are flawed.

Oooh, also, the foot note goes to Putnam's Bowling Alone!!!!! Aaaaargh!

I may have to abandon this book. I _love_ the premise (we should create a bunch of policy -- voluntary programs and regulations and laws -- that makes it easier for everyone to eat somewhat healthier, get a bit more exercise, etc.). But if this is the best argument in favor of that premise, I'm just going to wind up changing my mind, which I have absolutely no intention of doing. I'll go looking for a better argument instead.

I am so disappointed. I am _so_ disappointed.


Still more complaining (really, it's bad enough that I'm reading this -- why are you?):

"Men are now taking in 168 more calories a day than they were thirty years ago, and women are gobbling up 335 calories more." Really? With the gratuitously slanted language by gender? The source is the CDC. I'm sort of wondering how the CDC calculated this, actually.

Source appears to be NHANES. I have no idea if that questionnaire is reasonable.

This says it is (like virtually all questionnaires) not reasonable.

Medscape summary of same:

Complete with critique from Walter Willett. Interestingly, in this case I'm taking the not-Willett side. I think. I could be talked out of it.

Today's Inactivities Include: Being sick, reading about public health
Alas, my son started throwing up at quarter to 4 this morning. Not sure what happened; presumably he ate something (or otherwise something got into his mouth) that was Not Good. He is disturbingly quiet, other than reluctantly getting up to throw up more. I'm giving it another hour or so before I start to panic.

I'm reading Tom Farley and Deborah Cohen's _Prescription for a Healthy Nation_, since Farley had a recent op-ed in the NYT (that was about sodium levels in food, specifically, a topic of interest to me because it drives me nuts how freaking hard it is to find food that isn't insanely high in sodium, and I know from travel in other countries that it doesn't have to be that way. Arguing that adopting policy limits by category/type of food would reduce freedom makes me want to exercise freedom all over the person making the argument. Probably by screaming Right Up In Their Face. You know, freedom of speech.). It is, unfortunately, a really problematic book in a variety of ways, so my love for it is limited, however it is a relatively good piece of advocacy.

Anyway. We know -- and Farley and Cohen lay out some of the numbers -- that if you raise the price of tobacco and alcohol products, they are consumed less. They argue in favor of reducing the price of fruits and vegetables (including prepared ones like salads) and increasing the price of high fat/high sugar ("junk") foods. There is a slight problem here. While it is straight forward to tax stuff, collect the money for the general fund (or even targeted programs of a related nature, say, tax "junk" food to subsidize purchase of fruits and vegetables through SNAP), it is not so obvious how we could reduce the price of fruits and vegetables. I suppose we could provide subsidies to growers? But if you did it by regulating price, you could perversely increase production of high sugar/high fat (if you mandated higher prices, rather than tax, which doesn't seem too likely, it would have the effect of raising still further the profit margin on these items) and decrease production of fruit and veg (by reducing the already slim margin -- even when the margin on fruit and veg looks fat, it rarely is because the volatility associated with harvest is higher than the inputs for high sugar/high fat, altho that, in turn, is partly a result of historic farm policies here in the US).

Pricing is tricky, as the authors learned during an effort to recoup some of the costs of a condom campaign -- usage even at .25 a piece plummeted, which was entirely at odds with what they were attempting to accomplish.

I hope they start talking about advertising at some point. I really do. Because advertising is a huge obstacle for any public health campaign. Altho it is very difficult to deal with, given the aforementioned freedom.

ETA: "In the early 1980s, after years of state "buckle up campaigns that people ignored, seat belt use nationally was an abysmal 14 percent. The idea of requiring people to wear belts seemed ridiculous at first, because people had always had the option to use their seat belts, and the laws would be virtually unenforceable."

Seriously? _Always_ _had_ _the_ _option_? For 20 years, _maybe_, at that point.

Okay, whatev. NY usage went from 20% to 47%. "It wasn't the fear of punishment that made people buckle up, because cops didn't (and in most states legally couldn't) pull people over for not wearing belts it was the statement that the law represented. Buckling up was something people were supposed to do. It was expected, normal, what any regular person did."

Bull shit. I remember the early 1980s. My parents were vocally in favor of mandating new cars having car seat belts, always required that we use them and never let us forget how hard they'd worked to get them into cars. But everyone _else_ I knew started using seat belts after they got an add-on to their ticket for failing to wear a seat belt, or knew someone who did. There was _intense_ "lawyering" around who was required to buckle up and who wasn't and loud arguments in cars on group outings about who was going to pay the ticket if someone did not buckle up who was being told to and who wasn't accustomed to obeying that law. And the extra on the ticket was always mentioned. I also heard a bunch of stories about people getting pulled over with that as the explanation for the pull-over.

I have no mortal clue how the law was written in NY at the time, but given the behavior of law enforcement in NY with respect to other written law, I just don't even see how that would be relevant.

"the seat belt laws didn't always get a smooth ride through state legislatures...Of course it is stupid to drive without seat belts, some protested, but we have no right to force people to be smarter if the only ones they put at risk are themselves"

One of the arguments that I heard a lot in the early 80s did not accept that wearing a seat belt was smart: I heard dozens of people argument, sincerely, at length and volume, that they'd rather be ejected from a vehicle than be hurt by a seat belt. One of the counter arguments, of course, became hey, I don't want you flying around in the car hurting my neck and head, when people were arguing about whether passengers in the back seat needed to wear a seat belt (the rationale being that people riding in the back without a seat belt tend to have lower risk than people in the front with a seat belt, at least according to some statistics being tossed around at the time).

ETAYA: The authors do go on to talk about primary enforcement laws vs. secondary, but even if you have secondary only, you can usually increase a fine for failure to wear seat belts. A deterrent factor unmentioned, but that I remember people using in arguments.

_Reunited_, Pamela Slaton
Subtitled: An Investigative Genealogist Unlocks Some of Life's Greatest Family Mysteries

She apparently has/had a series over on the Oprah Winfrey Network. Even more exciting, apparently the guy she sort-of identified as maybe being her bio-dad (it is a little vague in the book and he isn't identified with a last name, at least not in the version I read) sued her for doing so on a documentary.

I have not been able to figure out how that all turned out; maybe it is still winding its way through court.

I ran across this when I was looking for genealogy memoirs. I think a lot about writing about my genealogical research (because unusual religions! For the win! Also, maternal grandmother child of first cousin marriage. And tons of divorces. Husband of cousin I didn't know I even had getting in touch with me through a mediator. Visiting overseas relatives. Mental illness. There's some great stuff to work with here. Also, a whole lot of people who could hate me forever, if they don't already. So, some risk.) and read other genealogy memoirs to get a better sense of how people approach touchy subjects and what kinds of stories work well even if you aren't personally connected and similar.

Slaton's angle is adoption: she is an adoptee with a complicated family: dead adoptive parents, dead adoptive brother, living full sibling, two living half siblings, living highly-problematic mother, living maybe-dad (description of inconclusive DNA results in the book), etc. After the harrowing adventure of her own family, she adopted (har de har har) adoption reunion/searches as a hobby and then career. It's great stuff and she's clearly developed mad skills, especially when it involves births in New York.

She's a good story teller. She is upbeat, altho she is quite religious and that pervades the book. She has chosen her stories carefully to illustrate more general points/problems associated with the adoption triad (birth family, adoptive family, the adoptee): finding mother, finding father, finding siblings and other family, trying to understand the decisions that were made, managing one's own feelings, the feelings of others in the triad, respecting the wishes of those who don't want to have an ongoing relationship. She also talks about activists pushing for open adoptions and open records, mostly sympathetically altho it is clear that she takes a great deal of pride and finds a lot of satisfaction in working around the barriers associated with closed records.

I'm not directly associated with any adoptions, altho they are certainly present in my extended family (and then there was that mystery cousin thing). But some of what she has to say is generically useful to genealogists, and there's a lot of value in better understanding the world we live in. I do believe what she has to say about the gaps experienced by people who were adopted and who are missing all that information about their biological heritage, even when those same people are adamant about not wanting to pursue that information, often out of love of their real parents.

It is not technical; I wouldn't advocate reading this in search of How Tos, but if you are contemplating researching your own adoption or trying to provide support to someone who is, there is a lot of thoughtful advice about the emotional ramifications.

Daily Activities Include: open gym, McDonald's, scootering, Julie's Place
Today, we scootered and rode bikes around the block. T. wanted me to bring Princess Rainbow Sparkles on the Townie's tray. We looked pretty funny riding around, but had a good time.

R. took A. and T. to open gym. They all went in the van and said they didn't need me, so I stayed home and took care of some things that needed to get done. After the open gym, they drove to McDonald's, where they had chicken nuggets, fries, and white milk. T. also had a chocolate shake.

A. has been watching a lot of Phineas & Ferb on iTunes, and they are both still playing Where's My Water, Where's My Perry, etc.

Later, T. went to Julie's Place, where he only ate a little.

_A Lifelong Journey_, Sarah Russell (kindle)
Subtitled: Staying well with Manic Depression/Bipolar Disorder

This is a collection of responses to a questionnaire by people diagnosed with manic depression/bipolar disorder. The group is from Australia, so the details about the health care system (and the spelling of some words) will be unfamiliar to a United States audience. Because it takes a "wellness" perspective, the responses are about how do people with this diagnosis live their lives and avoid further episodes of their illness (either by reducing the frequency, intensity or both). Almost, but not all, of the respondents are on medication (mostly some form of lithium, altho there is a range of prescriptions used to manage this illness, including some people who only take lithium or anti-psychotics part of the time, or take anti-depressants part of the time because that works best for them, and other strategies as well). All of the respondents are accepting of their diagnosis, altho some of them downplay the seriousness of it.

Many of the people in the book had one or more hospitalizations before they received the correct diagnosis that led to an appropriate treatment strategy that then helped them avoid further hospitalizations. The most common misdiagnoses were for schizophrenia, altho there were some for unipolar depression and other things. The people who had wrong diagnoses were very relieved to finally receive a diagnosis that led to successful treatment.

Some of the people in the book changed careers. Some retired and receive a disability pension. Some were diagnosed quite young and have held a few jobs but not established a career. Some had partners and/or children. Others did not.

It is striking how many of the people describe the great care they take to maintain daily routines and a rhythm to their lives: consistent times getting up and going to bed, activities like exercise, meditation, yoga, etc. to help them maintain perspective and stable mood, relationships they maintain with people who can tell them when they start to "speed up". Overwhelmingly, they have reduced or eliminated their consumption of alcohol and other recreational drugs, and many of them carefully limit caffeine as well. They are cautious about travel across time zones, and they very carefully manage their response to springtime.

This is a wonderful book in that it goes beyond the take-your-medication-or-else approach, while strongly supporting effective medication strategies. It's a rare and useful combination. While some reviewers on Amazon seem to think this book only includes people whose lives were not that disrupted by this illness, a careful reader can clearly see otherwise. Any reader -- whether they have bipolar, know someone who has bipolar, or has an interest in better understanding neurodiversity -- can learn a lot about the importance of self-insight, and developing compensating habits in life to become aware of and effectively deal with stresses before they overwhelm one.

Daily Activities Include: school, parents/kids night out at gym, Red Raven
A. did not have school today. T. had a full day. Today at school, T. had outdoor recess. He says he played by himself. He did not eat his orange for snack (we forgot carrots). He had pizza for lunch. When he got home, he went to get his hair cut. He also scootered a little in the driveway. A. and I scootered around the block. Then, we took A. and T. to Planet Gymnastics for Kids/Parents Nite Out. They got to play for 3 hours and watch Frozen projected on the ceiling. They had a good time. R. and I went to Red Raven where we had a pleasant dinner.

Now we are home, and it is past their bed times, but it was a special night and we all had fun.

_Changing for Good_, Prochaska, Norcross and DiClemente (kindle)
Subtitled: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward

It's not clear exactly when the last substantive revision of this kindle edition occurred. No OCR problems, typos, grammar issues, wtf were apparent in the course of a single read-through. Because the original book dated from the 1990s, the contents are somewhat, er, dated. For example, we have made much more progress towards what they call "social liberation" with respect to smoking, and to a lesser degree with respect to drinking. For example, most indoor and some outdoor public places in the US and many other developed nations are now, by law, smoke-free. Far more people have quit smoking since this book was written, and the phenomenon they describe (of smoking becoming increasingly covert, hidden even from family members) has progressed even further, albeit electronic cigarettes have produced a new wrinkle. Because I've been paying a lot of attention to alcohol portion sizes, the text has a single-alcoholic-serving as 12 oz beer, shot (1.5 oz) serving of spirits (both the same as now) or a 4 oz glass of wine.

Before anyone goes, OMG, do you drink/smoke/have a whatever problem, the answer is, of course I have a whatever problem. Almost everyone has a whatever problem. And this is a systematic way of thinking about whatever problems and what people do about them without involving professional assistance and when that works and, when it doesn't, why. Their theory, the TransTheoretical Model of Change (TTM) is a very 90s, pre-CBT approach to Helping People Help Themselves. Starting from then-current research that indicated that virtually all theoretical approaches in the helping professions (he calls them psychoanalytical theories, and quotes Freud without apology, altho fortunately not often) were roughly equally efficacious. Not too long after the TTM model was devised as a way to map approach to "stage" in the progression of change, the helping professions in general explored and adopted a bunch of Brief/Quick/client-centered approaches to helping -- they are now more or less lumped together as cognitive-behavioral therapies.

In any event, a bunch of people and organizations have adopted TTM as a way to better match therapeutic tools (whether that is consciousness raising or putting together a plan of what to do instead of whatever, or rallying one’s social network to provide support or any number of other things) to where in the change process the complainant/client/patient/addict/etc. is. In general, matching the appropriate tool to the person is a Good Thing; one of the major complaints about TTM is that 6 months out, a lot of people need a fairly significant Readjustment (whether that’s a relapse, or a secondary problem that was why the person had the bad habit in the first place, or one of their coping strategies has gotten out of hand, etc.). TTM is pretty much just like everything else in that respect, offering little more than platitudes about Hey, Lather, Rinse, Repeat.

Many brief, quick, CBT type therapies, however, address the readiness for action problem very differently. If someone is sitting in front of a professional, they are ready for _some_ kind of action; these therapies are much more rigorous about having the client define the goal state. Prochaska et al are here to tell you what your goal state should be, and thus they generate a lot more classic therapeutic resistance. They are _smarter_ about responding to that resistance, but they still generate resistance.

Prochaska et al also stumbled across some perceptual things (like how bad punishment is, how good praise is, ratios of positive to negative statements to be perceived as balancing out as positive, the importance of making a goal more attractive vs. the current state of being less attractive, and having some numbers on that) that are pretty widely recognized by NLP types. In good news, this group of authors is considerably less cult-y than some NLP outfits. In bad news, their therapeutic tricks are a lot sloppier and thus take longer and don’t necessarily “stick” as well.

But if you are looking for a theory of habit change, this is a good one. While the primary focus is on smoking, drinking problems, anger management, exercise/diet/weight control and other health interventions and so forth, you could kind of use it for almost anything. One of the most consistently wonderful things about this book is its honesty about the crankiness of people who are in the process of major self-change, and how a lot of bad habits are the result of people trying to suppress negative emotions or avoid enforcing boundaries, and other things that cause social conflict. They emphasize the importance of developing assertiveness, and recognize that some relationships may need to end (temporarily or permanently) if they are getting in the way of necessary changes.

They do devote a chapter to exploring how to tell when it is time to involve a professional in the change process.

However, I’m going to look around and see if there is anything better out there.

LiveJournal not affected by Heartbleed
theljstaff wrote in news

Dear users,

As you might have heard, a major vulnerability in SSL (the secure channel used for HTTPS) has been detected recently. As many as two thirds of internet sites were affected, including social networks and major web sites.

We are happy to confirm that LiveJournal is not vulnerable and has not been affected at all.

Meanwhile, in the past 12 months we have been working hard to deploy many security features to protect user data.

Nevertheless, even though LiveJournal was not affected by the Heartbleed bug, changing your password is still a good idea, especially if you use similar passwords on other sites whose data may have been compromised. If you haven't changed your password in the last year, we recommend that you do so now.

Daily Activities Include: A.'s half day, no swimming, school, restaurants, no play date
Today, T. had a full day of school. A. had a half day. Her swimming lesson was canceled. She was a few minutes late to school, because she was watching Frozen and wanted to hear the rest of Let It Go. No one else can walk away from that song, so it is unreasonable to ask her to do so.

Today at school, T. refused to eat his apple for snack. It turns out he has been doing this for a few days. We will try carrots tomorrow. No more apples for a while. He had a cheese sandwich for lunch with R. in the cafeteria. He had speech with C. He had outdoor recess. He played with C. (different C.). They played on the slide.

After school, we were supposed to have a visit from S., which they were both excited about. Alas, S. failed to arrive and calls to her went straight to voice mail. We hope she is okay, and just forgot about us or thought she had already canceled to go out of town or something similar. If someone is sick, we hope they recover promptly and completely.

After R. got home, R. and T. went to Julie's Place (where I already had lunch) for dinner. I took A. to Johnny Rockets. Of course, the kids both had chicken tenders and fries, altho I understand T. had juice and R. ordered chocolate milk which she then mostly ignored and T. drank when we brought it home. I had a salad, and some of A.'s chicken.

A. does not have school tomorrow, but T. does. In the evening, they will go to open gym and watch Frozen and eat pizza and popsicles while R. and I go out to dinner. It's a Parents' Night Out thing and we've never been brave enough to try this before so wish us luck.

Daily Activities Include: school, walk, swimming, half day
Today, T. had half day. A. had a full day. I went for a walk. There was snow on the ground from last night. M.'s dog P. had so much fun rolling around in the snow; it was hilarious.

T. came home and we went to the swimming pool where he had his lesson. He is doing really well. He played for a little while after. B. met A. when she came home from school; we drove into the driveway while the van was still there. Then B. took T. to Julie's Place for an early dinner and a hoodsie cup with whipped cream for dessert; he ate everything.

At school today, T. had speech with C. He had Reading Mastery with E. He had indoor recess. He had lunch in the classroom. He says tomorrow he has P.E. with a Mrs. K. who is not E.

A. and T. are both playing Where's My Water 1 or 2. They are having a lot of fun, altho A. keeps making other people play her levels for her.

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