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Thursday, August 18, 2011

Russia's $165,000 per night space hotel

Russia's planned Commercial Space Station hotel may be a steal at $165,000 per night, but you may want to consider the $410,000 travel costs.

Russia's planned Commercial Space Station hotel may be a steal at $165,000 per night, but you may want to consider the $410,000 travel costs. Photo: Orbital Technologies SEE ALL 78 PHOTOS

Best Opinion: Nation, Business Insider

The image: Russian company Orbital Technologies wants to take luxury hotels to new hights — orbiting 217 miles above the Earth — by 2016. The proposed Commercial Space Station (CSS) would house seven guests in four cabins, including such space luxuries as precooked gourmet meals, sealed showers, and spectacular views of the home planet (see images below). Though the accommodations are more likely to evoke a high-tech dentist's office more than a chic Miami getaway, the space hotel will be "far more comfortable" than the even more spartan International Space Station, says Orbital chief executive Sergei Kostenko.

The reaction: "Russia may have lost the first space race to America," but it's dead set on winning the space-hotel race, says M.O. in Pakistan's The Nation. If you're lucky enough to make the trip, though, be aware that "aside from the spectacular view, there’s not much else to do, so you'd be wise to take a good book." Lucky, indeed, say Linette Lopez and Dina Spector in Business Insider. At about $165,000 per person for a five-night stay, and $410,000 for the trip up there on a Russian Soyuz rocket, "experiencing the final frontier from your bedroom window... won't be cheap."

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Eat Like a Foodie at Home, Without Breaking Your Budget

Just because you enjoy great food doesn't mean you have to spend a lot of money dining out or buying upscale foods for delicious meals at home. With the advice of some noted chefs and food writers, you can elevate the level of your home-cooked meals even while working with a tight grocery budget, producing feasts that wow for just a few dollars per serving.

We'll show you where to shop and what to stock in your pantry to maximize your dollars-to-enjoyment ratio. We'll also show you how to save more on buying meat (often the most expensive part of the meal) and techniques and recipes for cooking up some exquisite dishes. Note: you don't have to consider yourself a "foodie" to use these suggestions—all you need to bring is a desire for great food.

Learn Techniques to Make the Most Out of Your Meals

Some cooking techniques like braising and slow cooking are very cost-effective and simple, producing flavorful meals; you can tenderize extremely tough—and inexpensive—cuts of meat with these techniques.

Make the Most Out of Cheap Proteins

The biggest cost savings you find may be on proteins, especially with today's rising meat prices. If you're not a vegetarian, the meat portion of the meal could very well make up the majority of your grocery budget (thus, it also follows that you can make the most out of your food budget by switching to a flexitarian diet or just eating a meat-less meal every once in a while).

Learning a few cooking techniques to enhance even cheap cuts of meat can help you turn a $5 steak into a $50 steak, so to speak:

Slow cooking: Even if you don't decide to hack your slow cooker into an off-the-charts sous vide cooker, a slow cooker can make even the toughest of meats tender and tastier. (Apparently you can also hack a beer cooler into a sous vide cooker.) Plus, the hands-off approach of using a slow cooker also means you can get flavor-packed meals without a lot of effort. You don't want just an everyday slow cooker meal though: foodie recipe search engine Punchfork can help you find more advanced slow cooker meals to make at home, like this carnitas recipe from TheKitchn that uses an inexpensive cut of pork: place a 6-8 pound pork butt (a.k.a., pork shoulder) in the slow cooker with some spices and tomato and orange juice and 8 hours later, you've got tender meat that falls off the bone.

Braising: Deb Perelman of the beautiful Smitten Kitchen food blog suggests we embrace braising. Cooked low and slow, ribs, briskets, pork shoulders, and so on "make incredible flavor-packed, stewy meals that can easily be spooned into tacos/served over rice or egg noodles and stretched to feed you for a week." Want recipes? Try Deb's knee-weakening braised beef short ribs or other braised recipes. Don't know what braising is? Previously mentioned cooking video library Cookblast has some videos and recipes for this slow cooking technique.

Salting: That $5 steak that tastes like it came from the very expensive steakhouse? It's all about salt. Basically, salt your steak like crazy at least 40 minutes before cooking (wash the salt off before) for the juiciest steak you've every made. You can intensify the flavor of all of your meats with wet and dry brining techniques—basically using salt to enhance the flavor of your meats by immersing them in a salty solution or just applying a dry salt rub directly.

How to Save on Proteins

With the techniques above you can make cheaper cuts of meat, like pork shoulder, taste extraordinary, but here's how to save even more:

Process your meat yourself: For the most savings, buy your meat (and other foods) minimally processed. Serious Eats' James Kenji Lopez-Alt (who forever transformed my steak-cooking technique and subsequent lifelong enjoyment) says that his biggest tip is:

Buy your meat in the least processed form possible and learn how to do some very minimal butchering yourself. So don't buy boneless skinless chicken breasts. If you want them, buy a whole chicken, which ends up costing about the same price as you'd pay for its breasts alone, but then you end up with chicken leg meat for a whole extra meal, as well as a carcass with which you can make stock. Three meals for the price of one, and all you've got to do is learn how to break down a chicken.

Buying and learning how to cook cheaper cuts of meat is very useful as well. Pork shoulder, for example, to me tastes a hundred times better than a pork chop. You just have to be willing to cook it a little longer. It takes well to methods like braising, slow roasting, or grinding into mince.

He also recommends buying a meat grinder, because not only will it give you the freshest tasting burgers, it lets you use up leftover scraps of meat you'd normally throw out. (Ready to take the plunge? Serious Eats shows you how to buy, use, and care for a meat grinder and what to do once you've got one.)

Cheaper cuts: Katerina, who writes the Daily Unadventures in Cooking blog says that:

One of the well kept secrets of foodies is that the cheaper the cut of meat, the harder to cook but the more the flavour. Lamb shanks and neck? Pork belly? Octopus? Short ribs? As proteins, they all represent a cheap way to impress guests at home if you are willing to take the time to properly cook them.

For example, if you have some cheap pork shoulder, TheKitchn managing editor Faith Durand says you can really maximize the flavor of it by grilling before braising.

Clay Dunn, who writes the popular and informative Bitten Word blog with partner Zach Patton, generously offered these two preparation techniques:

One of the best, most versatile and most affordable cuts of meat you can find is a skirt steak. You can often grab it for about $2 per serving. Another plus: It's also one of the easiest cuts of meat to cook. Amp up the flavor by rubbing the steak with instant espresso powder and some cayenne pepper. Then just sear it in a stovetop pan over high heat for a couple minutes per side, let it rest for several minutes, and slice it against the grain. You can stretch your protein dollar even further by incorporating the skirt steak into a steak salad: It's fantastic tossed with fresh dark lettuces, green beans and a sweet vinaigrette.

Another favorite inexpensive protein of ours is chicken thighs. They're tasty and succulent — way more flavorful than white-meat breasts. And you can frequently find chicken thighs for about a dollar per serving. We always by these instead of chicken breasts. Sear them on all sides in hot oil, toss some chopped onions and fresh tomato into the pan, and throw the whole thing in a 375-degree oven for 16-18 minutes to roast. Delicious! Maximize the flavor — and your budget — even more by stirring in a few fresh basil leaves, chopped, right before you serve.

Buy from a farm directly: Brian Lee, who runs the EatDrinkMadison dining guide says you can save a lot of money by purchasing a side or ¼ beef (100 lbs.) from a farm. You'll need a separate freezer, most likely, or someone to share with you, but you can get quality, ethically-raised beef for between $3.50-$5.50 per pound from the farm versus three times that much or more from Whole Foods.

How to Save on Fresh Produce

Speaking of Whole Foods, you don't really need to shop there for any or all of your choice foods. Farmer's markets, or greenmarkets, offer fresh-from-the-farm foods, and as mentioned here at Lifehacker previously, shopping later in the day at a farmer's market can save you some extra cash. (Dunn said you can find some really great deals at farmer's markets if you buy the fruits and vegetables at the peak of the season—you could get a pint of berries for a third of what it would cost you at the grocery store.)

Joining a CSA (community supported agriculture) group may likewise be a worthwhile investment where you get a load of in-season veggies and/or fruits (or even eggs and flowers) for about $20-$50 a month.

Canning, freezing, and even layering in salt can extend your food's life as well.

Perelman also reminds us that good looks don't always matter when it comes to your fruits and veggies:

Don't be afraid of ugly produce (in fact, be more suspicious of the overly pretty stuff and what has to be added to the soil to get blemish free beauties); ugly tomatoes make great sauce

To get the most bang for your organic buck, you can also focus your spending on just those organic foods most prone to pesticide (e.g., with this organic food buying cheat sheet). If your main reason for buying organic is to avoid pesticides, foods like avocado and bananas, which have thick peels that aren't eaten, can be bought safely non-organic. Peppers, celery, peaches, apples, strawberries and other fruits and vegetables with thin or edible skins are better organic options.

Of course, you can also save a lot of money by starting your own vegetable garden, if you have the space. Cheap Vegetable Gardener has a chart of the most profitable vegetables/herbs to grow yourself. (Previously mentioned tools like Smart Gardener can help you set this up and grow your own food successfully even if you don't have a green thumb.)

Where to Buy Other Quality Food for Cheap

Beyond fresh produce and meats, you can save a whole lot more by shopping in unconventional places.

Look to ethnic grocery stores for better deals on spices, for example, or just the international aisle of your main grocery store, Dunn advises.

Online shops let you find specialty foods that you couldn't find in brick-and-mortar stores. International food market places like Foodzie, Zingerman's and Import Food offer specialty ingredients that can elevate your dish. As CNN reports, most foodmakers will also ship direct to you, for even more savings:

A pound of Humboldt Fog goat's-milk cheese, ordered off Zingerman's, will run you $35; the same amount from the cheesemaker, Cypress Grove, is $20.

How to Stock Your Gourmet Pantry/What to Buy

Sometimes, all it takes is that one key ingredient—a unique sauce or a condiment—to make your meal extraordinary. Investing your food money wisely lets you scrimp on some expensive items (like meats) while still getting a lot of flavor from your meal.

Stephanie Trahd at artisan foods marketpace Fooducopia says "It's much more affordable to take a cheaper cut of meat and dress it with a gourmet steak wash, than it is to buy a filet and only be able to afford a parsley garnish!"

Likewise, Chef Mark Estee, owner of Moddy's Bistro and Lounge and Burger Me in Truckee, CA, reminds us that having great staples in your pantry is important because "bad quality in, bad quality out." The staples he suggest you invest in: extra virgin olive oil, balsamic vinegar, sea salts, chutneys, and mustards.

Durand adds to the list nut oils like hazelnut and roasted walnut oil for delicious salads, and really likes this smoked olive oil featured on TheKitchn. (When cooking, stick to cheap olive oil to save cash, but for salads or drizzling over food, you may actually taste the difference in a higher-quality oil.)

Keeping basics in stock will also help you avoid the dine-out/take-out bug. Lopez-Alt says he always has on hand a collection of Chinese, Japanese, and South East Asian condiments and sauces ready to go, so all he has to do for a quick and savory meal is pick up a protein and boil some rice.

I'm with Perelman on splurging on milk, eggs, produce and meat; it's worth the extra cost to us to buy ethically raised and cleanly produced foods. But even then, you can still save even on organic produce, grass-fed beef, free-range eggs and the like using some of the shopping tips above.

Favorite Versatile, Inexpensive Meals

When asked what their most delicious yet cheap meals were, our food sources had so many great suggestions:

How to Get More Value Out of Your Wines

If you agree with the old Andre Simon quote that "Food without wine is a corpse; wine without food is a ghost," you'll probably want some good vino with your home-cooked meal. For many people, a wine store filled with bottles upon bottles of wines of varying prices can be overwhelming.

Jsaon Mancebo, who writes the 20 Dollar Wine Blog, said the best strategy is to develop a relationship with a wine monger at a smaller wine shop, so he/she can get to know your style, palate, and price ranges. Regionally speaking:

The usual suspects for bargains in the past 10 years or so are Australia, Chile and Argentina, but recent economics make Spain, Portugal and even Italy VERY attractive now. Great Rioja, Alentejo and Barolo are certainly within reach! If you're normally only a red wine fan, try some rose' from Provence or white from the Langhe. There's lots to explore and great stuff to pair with the dishes you create!

Though you can find good wines at $10 or below, they're not as easy (i.e., super-easy) to find at $20. The sweet spot, Mancebo says, may be about $15-17.

I also like Lopez-Alt's answer: "It's the summer. I like having inexpensive, easy-to-drink wines, like a nice cold vinho verde."

"Foodie" Meals at Home: In a Nutshell

To sum up, you can save more but still get a lot of value and tastiness out of the foods you buy and make at home. The basic guidelines:

  • Buy from less conventional/mass marketplaces. Explore ethnic markets, farmer's markets, and grow your own if you can
  • Buy as much as you can whole and unprocessed
  • Learn how to preserve your foods (e.g., how to store food properly in the freezer and fridge or food preservation techniques)
  • Use all parts of the food if possible. Use chicken bones to make stock, toast pumpkin seeds, etc.
  • Splurge on items that will enhance the rest of the meal and where a little will go a long way. Or focus on one quality ingredient in each dish.

Doing this may increase the quality of your meals at home to the point where you might even prefer dining in rather than out. Bon appetit!

Got your own tips for increasing the foodieness of your homecooked meals (on a budget)? We're all ears in the comments.
Photo by benicce / Shutterstock.

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Over career, most doctors in US will face lawsuit

By Chelsea Conaboy

Most doctors in America will be sued at some point during their career, a Harvard study released yesterday in the New England Journal of Medicine has found. Physicians who perform high-risk procedures, including neurosurgeons and obstetricians, face a near certainty of being named in a malpractice case before they reach age 65.

Yet a relatively small number of claims, about 22 percent, result in payments to patients or their families.

Authors of the study, which examined 15 years of data, said it highlights the need for changes in malpractice law so that doctors and patients can resolve disputes before they resort to litigation, which often costs both parties money and heartache.

“Doctors get sued far more frequently than anyone would have thought, and in some specialties, it’s extremely high,’’ said Amitabh Chandra, an economist and professor of public policy at the Harvard Kennedy School and an author of the study. “In some sense, the payment is the least important part, because you can insure against it, but you can’t insure against the hassle cost.’’

The study looked at claims data for nearly 41,000 physicians from 1991 to 2005. The researchers found that 7.4 percent of physicians had a malpractice claim against them each year and that 1.6 percent had a claim that led to a payment each year.

The likelihood and outcome of lawsuits varied considerably across specialties. But the fact that even doctors in low-risk areas of practice, such as family medicine, had a 75 percent chance of being sued during their career is cause for concern, Chandra said.

Every time doctors are sued they face lost income from the time they spend out of the office fighting the case, said Dr. Alan Woodward, a retired emergency physician who is chairman of the Massachusetts Medical Society’s committee on professional liability. The threat to their reputation is a cause of major stress, and the anxiety can compromise the care they provide to other patients, he said.

Fear of lawsuits drives many physicians to practice defensive medicine - ordering more diagnostic tests than necessary, for example - or to retire early, Woodward said. And when doctors fear legal retribution, they are less likely to share information, with patients or internally.

“It creates a culture of secrecy and fear,’’ he said.

The small number of successful malpractice cases does not mean most are frivolous, said Chandra. It can be difficult to prove that an injury resulted from an avoidable error in patient care, he said.

“Many of us are coming to the conclusion that litigation is not the answer,’’ Chandra said.

Woodward met with Chandra yesterday and discussed the study, which included researchers from Harvard-affiliated Massachusetts General Hospital, the Rand Institute, and the University of Southern California. Woodward said it provides more evidence that government regulations should encourage doctors to talk openly with patients, apologize when warranted, and offer compensation when appropriate.

Some advocates, including the consumer group Health Care for All, have been trying for at least four years to get a law passed in Massachusetts making such apologies inadmissible in court; such laws exist in many other states. The hope is that doctors will feel more secure in talking about a patient’s care and even admitting an error. The patient could still pursue a case based on the medical evidence.

Previous studies have shown that patients are less likely to sue when they receive an apology and explanation from their doctor.

Brian Rosman, research director of Health Care for All, said everyone will benefit if patient-doctor communication is divorced from legal proceedings. That would allow doctors and hospitals to deal more directly with the root cause of an error.

“Fixing this problem can also improve the quality of care,’’ he said.

The medical society has been working with Beth Israel Deaconess Medical Center, using a $273,782 federal grant, to design a plan for a system that would encourage apologies and compensation, when justified, in Massachusetts. The plan is set to be released this fall.

The group has interviewed dozens of people representing patients, hospitals, the legal community, and doctors.

Woodward said that nearly universal support exists for a system that encourages doctors to apologize.

Woodward said the medical society, along with the hospital and other partners, have applied for a three-year grant of about $3 million to create pilot projects at Baystate Health in Western Massachusetts and Beth Israel Deaconess and to launch a statewide campaign educating patients and doctors.

He is also working with lawmakers to draft legislation requiring malpractice cases to go through a six-month vetting period in which the physicians would share all pertinent medical records with the patient and analyze whether an avoidable error occurred.

Litigation plays an important role in exposing errors and getting patients the help they need, said medical malpractice lawyer Jeffrey Catalano, vice president of the Massachusetts Bar Association. But, he said, it is often inefficient.

He supports what is referred to as the apology law.

“The devil’s in the details, but it has a lot of promise,’’ said Catalano, who represents patients.

Catalano said out-of-court reviews should be overseen by a third-party attorney and that patients’ lawyers should be allowed to participate to ensure their clients’ rights are protected.

Chandra and his coauthor, Dr. Anupam B. Jena of Mass. General, said they hope their study will dispel the fear that many doctors have of big payouts. Their study found just 66 claims that resulted in payments exceeding $1 million. Average claims by specialty ranged from $117,832 in dermatology to $520,923 in pediatrics.

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Monday, July 11, 2011

Food Surprise! Subsidizing Healthy Food Helps Kids Lose Weight

overweight
It seems obvious to anyone who's ever paid money for something: Make things cheaper, especially things people absolutely need, and you'll sell more of them. And yet it seems the U.S. government has yet to grasp that lesson. For decades now, America has been struggling with rising obesity, but rather than invest in subsidizing healthy foods for citizens, the government has instead dumped tens of billions of dollars into corn subsidies. What that's done is give rise to vast stockpiles of corn syrup, corn chips and soda, all on the taxpayer's dime. Whereas more than $15 billion in subsidies went to corn, cotton, rice, wheat and soybeans in 2009, only $825 million went to fruits and vegetables. We're not just getting fat, we're paying to do so out of both hands (once with our taxes and once at the store).

A new report (PDF) from the U.S.D.A.'s Economic Research Service outlines exactly how damaging these subsidies are on America's children. Working on behalf of Michelle Obama's "Let's Move" campaign against youth obesity, a team was able to ascertain that just a 10-percent decrease in the price of lowfat milk for one quarter was associated with a .35-percent drop in children's BMIs. Similarly, lowering the cost of dark green vegetables by 10 percent saw a .28-percent BMI drop. And the effect worked both ways: When the price of sweets fell, BMIs increased.Link

It's important to note that BMI is often attacked as a bad way to measure a person's health, but until there's a better metric that can be applied generally in these types of studies, BMI will have to do. Also, if you're thinking that a .35-percent drop doesn't seem like a lot of weight, you're right. But it's an important start, and one whose impact could be larger if we enacted subsidies cutting health-food prices by more than just 10 percent.

Let this be a reminder that poor people, who are more overweight than the wealthy, shouldn't be written off as pigs who stuff their kids full of empty calories every night. The simple fact is that unhealthy food costs less, and cost is of primary importance when you're on a very limited budget.

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Opposites attract? Apparently not, according to study

  • Partners are drawn to individuals in a similar 'league' and of the same desirability

By Daily Mail Reporter


When it comes to love, there are no hard and fast rules though many people follow the age-old theory that opposites attract.

But now a study has found that more often that not, similarity rules the day.

Researchers at Berkeley found that people are drawn to potential romantic partners if they are of their own or similar league and desirability, which they called the 'matching hypothesis'.

Hot: The Berkeley study found that the more popular the individual the more a similarly popular individual would be attracted to them

Hot: The Berkeley study found that the more popular the individual the more a similarly popular individual would be attracted to them

Of course personality traits and common interests play a factor but for that instant attraction, like is drawn towards like, putting paid to the phrase, 'You're out of my league'.

For their research, the authors of the study turned - as most singletons do today - to online dating sites.

They measured the popularity of more than 3,000 heterosexual users of a site and looked at the popularity of each.

Popularity was defined by the number of opposite-sex individuals who had sent unsolicited messages to a user.

Findings: The authors of the study said individuals on the dating market will assess their own self-worth and select partners whose social desirability equals their own

Findings: The authors of the study said individuals on the dating market will assess their own self-worth and select partners whose social desirability equals their own


Analyses indicated that high-popularity users contacted other popular users at a rate greater than would be expected by chance.

Similarly, the less popular users of the site also contacted other low-popularity users.

The researchers then conducted a follow-up study of more than a million users and found a similar result - when it comes to dating, potential mates stick to someone in their own league.

Like attracts like: Couples are said to be attracted to each other due to their level of desirability

Like attracts like: Couples are said to be attracted to each other due to their level of desirability

The authors found that: 'Individuals onLink the dating market will assess their own self-worth and select partners whose social desirability approximately equals their own. LinkLink

'Using data collected in the laboratory and from users of a popular online dating site, the authors found evidence for matching based on self-worth, physical attractiveness, and popularity, but to different degrees and not always at the same stage of the dating process.

'The most striking prediction is that undesirable individuals will choose undesirable partners.'


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News of the World's best ever front pages Read more: http://www.asylum.co.uk/2011/07/08/news-of-the-world-best-front-pages/#ixzz1Rm8UZqBO

By Sam Parker

News of the World front pages

Last week, James Bond baddie Rupert Murdoch and his evil henchman James Murdoch surprised us all by announcing that today will be the last time ever that the News of the World goes to print.

In the wake of still-growing phone-hacking scandal, the News International overlords decided the popular rag's time was up, while cLinkuriously standing by Rebekah Brooks, the woman who presided over the whole messy business in the first place.

And so, as 200 largely blameless journalists, sales people, designers and finance staff walk the plank to save their superiors, we take a moment to celebrate the News of the World's most memorable front page splashes.

From celebrity sex scandals to sporting corruption via loads of stuff that made the royal family whince, we might not have always liked what it had to say but nothing raised our eyebrows quite like the News of the World. Click below for our highlights.

In Defense of Antidepressants

Leo Jung

IN terms of perception, these are hard times for antidepressants. A number of articles have suggested that the drugs are no more effective than placebos.

Last month brought an especially high-profile debunking. In an essay in The New York Review of Books, Marcia Angell, former editor in chief of The New England Journal of Medicine, favorably entertained the premise that “psychoactive drugs are useless.” Earlier, a USA Today piece about a study done by the psychologist Robert DeRubeis had the headline, “Antidepressant lift may be all in your head,” and shortly after, a Newsweek cover piece discussed research by the psychologist Irving Kirsch arguing that the drugs were no more effective than a placebo.

Could this be true? Could drugs that are ingested by one in 10 Americans each year, drugs that have changed the way that mental illness is treated, really be a hoax, a mistake or a concept gone wrong?

This supposition is worrisome. Antidepressants work — ordinarily well, on a par with other medications doctors prescribe. Yes, certain researchers have questioned their efficacy in particular areas — sometimes, I believe, on the basis of shaky data. And yet, the notion that they aren’t effective in general is influencing treatment.

For instance, not long ago, I received disturbing news: a friend had had a stroke that paralyzed the right side of his body. Hoping to be of use, I searched the Web for a study I vaguely remembered. There it was: a group in France had worked with more than 100 people with the kind of stroke that affected my friend. Along with physiotherapy, half received Prozac, and half a placebo. Members of the Prozac group recovered more of their mobility. Antidepressants are good at treating post-stroke depression and good at preventing it. They also help protect memory. In stroke patients, antidepressants look like a tonic for brain health.

When I learned that my friend was not on antidepressants, I suggested he raise the issue with his neurologists. I e-mailed them the relevant articles. After further consideration, the doctors added the medicines to his regimen of physical therapy.

Surprised that my friend had not been offered a highly effective treatment, I phoned Robert G. Robinson at the University of Iowa’s department of psychiatry, a leading researcher in this field. He said, “Neurologists tell me they don’t use an antidepressant unless a patient is suffering very serious depression. They’re influenced by reports that say that’s all antidepressants are good for.”

Critics raise various concerns, but in my view the serious dispute about antidepressant efficacy has a limited focus. Do they work for the core symptoms (such as despair, low energy and feelings of worthlessness) of isolated episodes of mild or moderate depression? The claim that antidepressants do nothing for this common condition — that they are merely placebos with side effects — is based on studies that have probably received more ink than they deserve.

The most widely publicized debunking research — the basis for the Newsweek and New York Review pieces — is drawn from data submitted to the Food and Drug Administration in the late 1980s and the 1990s by companies seeking approval for new drugs. This research led to its share of scandal when a study in The New England Journal of Medicine found that the trials had been published selectively. Papers showing that antidepressants work had found their way into print; unfavorable findings had not.

In his book “The Emperor’s New Drugs: Exploding the Antidepressant Myth,” Dr. Kirsch, a psychologist at the University of Hull in England, analyzed all the data. He found that while the drugs outperformed the placebos for mild and moderate depression, the benefits were small. The problem with the Kirsch analysis — and none of the major press reports considered this shortcoming — is that the F.D.A. material is ill suited to answer questions about mild depression.

As a condition for drug approval, the F.D.A. requires drug companies to demonstrate a medicine’s efficacy in at least two trials. Trials in which neither the new drug nor an older, established drug is distinguishable from a placebo are deemed “failed” and are disregarded or weighed lightly in the evaluation. Consequently, companies rushing to get medications to market have had an incentive to run quick, sloppy trials.

Often subjects who don’t really have depression are included — and (no surprise) weeks down the road they are not depressed. People may exaggerate their symptoms to get free care or incentive payments offered in trials. Other, perfectly honest subjects participate when they are at their worst and then spontaneously return to their usual, lower, level of depression.

THIS improvement may have nothing to do with faith in dummy pills; it is an artifact of the recruitment process. Still, the recoveries are called “placebo responses,” and in the F.D.A. data they have been steadily on the rise. In some studies, 40 percent of subjects not receiving medication get better.

The problem is so big that entrepreneurs have founded businesses promising to identify genuinely ill research subjects. The companies use video links to screen patients at central locations where (contrary to the practice at centers where trials are run) reviewers have no incentives for enrolling subjects. In early comparisons, off-site raters rejected about 40 percent of subjects who had been accepted locally — on the ground that those subjects did not have severe enough symptoms to qualify for treatment. If this result is typical, many subjects labeled mildly depressed in the F.D.A. data don’t have depression and might well respond to placebos as readily as to antidepressants.

Nonetheless, the F.D.A. mostly gets it right. To simplify a complex matter: there are two sorts of studies that are done on drugs: broad trials and narrow trials. Broad trials, like those done to evaluate new drugs, can be difficult these days, because many antidepressants are available as generics. Who volunteers to take an untested remedy? Research subjects are likely to be an odd bunch.

Narrow studies, done on those with specific disorders, tend to be more reliable. Recruitment of subjects is straightforward; no one’s walking off the street to enter a trial for stroke patients. Narrow studies have identified many specific indications for antidepressants, such as depression in neurological disorders, including multiple sclerosis and epilepsy; depression caused by interferon, a medication used to treat hepatitis and melanoma; and anxiety disorders in children.

New ones regularly emerge. The June issue of Surgery Today features a study in which elderly female cardiac patients who had had emergency operations and were given antidepressants experienced less depression, shorter hospital stays and fewer deaths in the hospital.

Broad studies tend to be most trustworthy when they look at patients with sustained illness. A reliable finding is that antidepressants work for chronic and recurrent mild depression, the condition called dysthymia. More than half of patients on medicine get better, compared to less than a third taking a placebo. (This level of efficacy — far from ideal — is typical across a range of conditions in which antidepressants outperform placebos.) Similarly, even the analyses that doubt the usefulness of antidepressants find that they help with severe depression.

In fact, antidepressants appear to have effects across the depressive spectrum. Scattered studies suggest that antidepressants bolster confidence or diminish emotional vulnerability — for people with depression but also for healthy people. In the depressed, the decrease in what is called neuroticism seems to protect against further episodes. Because neuroticism is not a core symptom of depression, most outcome trials don’t measure this change, but we can see why patients and doctors might consider it beneficial.

Similarly, in rodent and primate trials, antidepressants have broad effects on both healthy animals and animals with conditions that resemble mood disruptions in humans.

One reason the F.D.A. manages to identify useful medicines is that it looks at a range of evidence. It encourages companies to submit “maintenance studies.” In these trials, researchers take patients who are doing well on medication and switch some to dummy pills. If the drugs are acting as placebos, switching should do nothing. In an analysis that looked at maintenance studies for 4,410 patients with a range of severity levels, antidepressants cut the odds of relapse by 70 percent. These results, rarely referenced in the antidepressant-as-placebo literature, hardly suggest that the usefulness of the drugs is all in patients’ heads.

The other round of media articles questioning antidepressants came in response to a seemingly minor study engineered to highlight placebo responses. One effort to mute the placebo effect in drug trials involves using a “washout period” during which all subjects get a dummy pill for up to two weeks. Those who report prompt relief are dropped; the study proceeds with those who remain symptomatic, with half getting the active medication. In light of subject recruitment problems, this approach has obvious appeal.

Dr. DeRubeis, an authority on cognitive behavioral psychotherapy, has argued that the washout method plays down the placebo effect. Last year, Dr. DeRubeis and his colleagues published a highly specific statistical analysis. From a large body of research, they discarded trials that used washouts, as well as those that focused on dysthymia or subtypes of depression. The team deemed only six studies, from over 2,000, suitable for review. An odd collection they were. Only studies using Paxil and imipramine, a medicine introduced in the 1950s, made the cut — and other research had found Paxil to be among the least effective of the new antidepressants. One of the imipramine studies used a very low dose of the drug. The largest study Dr. DeRubeis identified was his own. In 2005, he conducted a trial in which Paxil did slightly better than psychotherapy and significantly better than a placebo — but apparently much of the drug response occurred in sicker patients.

Building an overview around your own research is problematic. Generally, you use your study to build a hypothesis; you then test the theory on fresh data. Critics questioned other aspects of Dr. DeRubeis’s math. In a re-analysis using fewer assumptions, Dr. DeRubeis found that his core result (less effect for healthier patients) now fell just shy of statistical significance. Overall, the medications looked best for very severe depression and had only slight benefits for mild depression — but this study, looking at weak treatments and intentionally maximized placebo effects, could not quite meet the scientific standard for a firm conclusion. And yet, the publication of the no-washout paper produced a new round of news reports that antidepressants were placebos.

In the end, the much heralded overview analyses look to be editorials with numbers attached. The intent, presumably to right the balance between psychotherapy and medication in the treatment of mild depression, may be admirable, but the data bearing on the question is messy.

As for the news media’s uncritical embrace of debunking studies, my guess, based on regular contact with reporters, is that a number of forces are at work. Misdeeds — from hiding study results to paying off doctors — have made Big Pharma an inviting and, frankly, an appropriate target. (It’s a favorite of Dr. Angell’s.) Antidepressants have something like celebrity status; exposing them makes headlines.

It is hard to locate the judicious stance with regard to antidepressants and moderate mood disorder. In my 1993 book, “Listening to Prozac,” I wrote, “To my mind, psychotherapy remains the single most helpful technology for the treatment of minor depression and anxiety.” In 2003, in “Against Depression,” I highlighted research that suggested antidepressants influence mood only indirectly. It may be that the drugs are “permissive,” removing roadblocks to self-healing.

That model might predict that in truth the drugs would be more effective in severe disorders. If antidepressants act by usefully perturbing a brain that’s “stuck,” then people who retain some natural resilience would see a lesser benefit. That said, the result that the debunking analyses propose remains implausible: antidepressants help in severe depression, depressive subtypes, chronic minor depression, social unease and a range of conditions modeled in mice and monkeys — but uniquely not in isolated episodes of mild depression in humans.

BETTER-DESIGNED research may tell us whether there is a point on the continuum of mood disorder where antidepressants cease to work. If I had to put down my marker now — and effectively, as a practitioner, I do — I’d bet that “stuckness” applies all along the line, that when mildly depressed patients respond to medication, more often than not we’re seeing true drug effects. Still, my approach with mild depression is to begin treatments with psychotherapy. I aim to use drugs sparingly. They have side effects, some of them serious. Antidepressants help with strokes, but surveys also show them to predispose to stroke. But if psychotherapy leads to only slow progress, I will recommend adding medicines. With a higher frequency and stronger potency than what we see in the literature, they seem to help.

My own beliefs aside, it is dangerouLinks for the press to hammer away at thLinke theme that antidepressants are placebos. They’re not. To give the impression that they are is to cause needless suffering.

As for my friend, he had made no progress before his neurologists prescribed antidepressants. Since, he has shown a slow return of motor function. As is true with much that we see in clinical medicine, the cause of this change is unknowable. But antidepressants are a reasonable element in the treatment — because they do seem to make the brain more flexible, and they’ve earned their place in the doctor’s satchel.

Peter D. Kramer is a clinical professor of psychiatry at Brown University.

Original here

Thursday, February 11, 2010

Strangest McFoods from Around the World

McDonald’s is, at this point in American history, ubiquitous. You can’t swing a dead Fry Guy in the U.S. without hitting a McDonaldland. This isn’t only well-known; it’s part of their corporate identity right on their signage: billions and billions served (they’ve stopped counting, by the way—which sort of sucks, really).

What’s perhaps less known is that McDonald’s is ubiquitous worldwide. It’s not just Americans who are lovin’ it. But since tastes in fast food differ from place to place? So does the McFood being offered. And sometimes—at least to American eyes? The menu gets pretty odd.

10. McHomard (Canada)


Canadians are generally seen as a fairly even-tempered lot. But just try to take away this lobster-roll Mickey-D’s style (homard is French for lobster), and watch them Canadians kick some McAss. They say you can get this in Maine, too—but really, is Maine all that different from Canada? Let’s not split hairs, people.

9. Maharaja Mac (India)


Cows are sacred to the Hindi in India—and not in the same way that beef is sacred to the American dinner plate. So to avoid rioting in the Bangladesh streets, McDonald’s there came up with a new versions of the Big Mac: the McMutton. When that didn’t take, they tried chicken, and called in the Maharajah Mac (and no actual Maharajahs were harmed in the making of this Mac). So: Big Mac, hold the sacrilege.

8. Pasta Zoo Happy Meal (Australia)


The weird thing about this Australian kids’ meal wasn’t that it included animal-shaped pasta, or even that there were specifically ten pieces of pasta in each pack. (Okay, that’s a little anal, but whatever.) The really disturbing thing was the sauce, which they called Zoo Goo. I’m sorry, but…what? I’ve been to many zoos, and there’s no goo that I’ve seen there that I’d want anywhere near my pasta.

7. Greek Mac (Greece)


File this one under “barely even trying”. If you stick the innards of a Big Mac into a pita, does that mean that it’s Greek? I guess the special sauce is made from yogurt, but no feta? And the burgers are still crappy Mcpatties? I guess some disappointment is universal.

6. Bacon Potato Pie (Asia)


Pies at McDonald’s are normally limited to dessert items: their traditional apple, if you’re lucky, a specialty pie like cherry or blueberry, or pumpkin for the holidays. But ask for a pie in parts of Asia, and you’ll get something that tastes like either a deep fried pirogue, or an incomplete shepherd’s pie.

5. McMollettes (Mexico)


An English Muffin topped with refried beans, cheese, and salsa. I’m sorry, is this a Mexican dish, or something from a trailer park?

4. KiwiBurger (New Zealand)


This burger doesn’t sound so strange—beef patty, tomato, fried egg—until you get down to the last ingredient: beetroot. If someone asked me “hey, is there any veggie you don’t want to try on your burger?” “Beetroot” would be right up there. Just in case, I’d also not like the following on my burger: grass, corn husks, or orange rind.

3. My Poutine (Canada)


Everyone has their own idea of what’s good on French fries: ketchup, mayonnaise, ranch dressing, chili and cheese, even mustard. But in Quebec, they add cheese curds, and top it off with brown gravy. What’s more annoying than all that is the fact that they refer to it with the added possessive “My”. And honestly, I want no part of curds and gravy, thanks. Don’t try to drag me into that mess.

2. Koroke Burger (Japan)


This Japanese entry sort of defies the idea of “burger”. If it’s on a bun, and that’s all the sandwich shares with a hamburger, is it still a burger? If I put tuna salad on a bun, does that make it a burger? I don’t think so. Likewise, this concoction of mashed potato, shredded cabbage, and katsu sauce just doesn’t seem like a burger to me. It seems like a “here’s some crap I found in my fridge” sandwich (which is pretty much what I lived on in college).

1. Mega Mac (China, Ireland, Serbia, Japan, Turkey, Malaysia, Singapore and Thailand)

Okay, suddenly the Koroke Burger seems more logical. At least it’s probably semi-healthy. This monster is just a super-sized double-meat Big Mac, which means that the weirdest thing about it is that it’s not widely available in the States. And seriously, no more talk about how being stupid-obese is a peculiarly American deal, okay?

Original here

Porsche 911 GT3 R hybrid

By Stephen Dobie

Porsche 911 GT3 R Hybrid

Porsche is taking a hybrid version of its 911 supercar to the 2010 Geneva motor show. It’s no ordinary 911, either – it’s the GT3 R racing car, perhaps the last place you’d expect to find a green-pleasing powertrain.

Not that this one’s particularly green, of course. A 473bhp 4-litre flat-six engine powers the rear wheels, while two electric motors (each developing around 80bhp) power the front axle, effectively making this a four-wheel-drive GT3.

Those motors are powered by an electric flywheel generator, which is charged up by regenerative braking each time the driver slows. And rather than cutting in automatically during the drive (or indeed race) cycle, the electric power is made available KERS-style, as the racing driver requires it for a six to eight second boost.

The 911’s hybrid system is also intended to increase fuel efficiency. Ideal, really, as the car’s first big race with be May’s Nurburgring 24-hour race. And for Porsche, it really is about the taking part rather than the winning: racing the hybrid GT3 R will be ‘a ‘racing laboratory’ that will provide invaluable knowledge and insight on the subsequent use of hybrid technology in road-going Porsche sports car’.

A road-going hybrid version of the next 911, then? Certainly sounds like it…

Original here

Tesla CEO Takes Private Jet as Company Takes Public Loan

By Chuck Squatriglia

musk_f

The CEO of Tesla Motors, which has received a fat federal loan, flew to Washington, D.C., aboard a private jet at least 12 times in the past 14 months. Although it isn’t unusual for CEOs to jet around on corporate planes, Elon Musk did so not long after lawmakers berated the heads of the Big Three automakers for doing the same thing while seeking a government bailout.

PeHub.com, citing FAA records, says Musk flew to Washington aboard his Dassault Falcon 900 on June 15, 2009 — one week before the Department of Energy agreed to lend the company $465 million to help build the Model S sedan, and two weeks after Tesla took over paying the plane’s operating costs. Those costs came to $175,000 in the second half of last year, according to the paperwork Tesla filed with the Securities and Exchange Commission ahead of an impending IPO.

The Silicon Valley automaker lost $31.5 million in the first nine months of 2009. Although the company has been steadily cutting its losses, it has lost $236.4 million since its founding in 2003. Tesla turned its first and only profit in July, 2009 but said in the Form S-1 filed with the SEC: “We expect the rate at which we will incur losses to increase significantly in future periods from current levels.” The same document notes Musk is taking $1 a year in salary.

Since Tesla started footing the bill, Musk’s plane has flown to Washington five other times, including one flight this year. Four of those flights were made after the feds approved the loan but before they finalized it. PeHub did not list the remaining six flights it claims Musk made since the beginning of 2009.

As PeHub notes, there’s nothing odd about the CEOs of tech firms billing their companies when flying in their jets. But PeHub quotes one venture capitalist who says it is highly unusual for the CEO of a startup to do so.

“It’s really not normal. and I don’t think it’s actually right,” said Ho Nam of Altos Ventures, which does not have a stake in Tesla. “It’s okay to expense what it would have cost to fly commercial, but the difference should be covered by the person using it. It’s really about the culture and the message it sends to the rest of the company.”

Tesla spokesman Ricardo Reyes said the company does not own a jet but pays for expenses incurred when Musk and other employees fly.

“Tesla has no corporate jet,” he said in an email. “When traveling on business, Elon and other Tesla employees have used his private airplane, especially for urgent or unscheduled travel, other times they fly coach. Tesla has paid for expenses such fuel charges and landing fees on some of the trips.”

Musk may have done nothing wrong. There’s nothing wrong with someone as busy as Musk — who runs three companies — flying around on a private jet. And some of those flights may have involved business related to Musk’s other ventures, Space-X and Solar City. But to have Tesla Motors foot the bill for any flights pertaining to its business while taxpayers underwrite the Model S is a colossal PR blunder.

Just ask Rick Wagoner, Alan Mulally and Robert Nardelli.

Faulkner Link to Plantation Diary Discovered

By PATRICIA COHEN

The climactic moment in William Faulkner’s 1942 novel “Go Down, Moses” comes when Isaac McCaslin finally decides to open his grandfather’s leather farm ledgers with their “scarred and cracked backs” and “yellowed pages scrawled in fading ink” — proof of his family’s slave-owning past. Now, what appears to be the document on which Faulkner modeled that ledger as well as the source for myriad names, incidents and details that populate his fictionalized Yoknapatawpha County has been discovered.

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Southern Historical Collection/Library of the University of North Carolina at Chapel Hill

Francis Terry Leak’s diary was read by Faulkner. A page from 1856 records a slave sale.

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Times Topics: William Faulkner

Associated Press

William Faulkner at his home near Oxford, Miss., in 1950.

The original manuscript, a diary from the mid-1800s, was written by Francis Terry Leak, a wealthy plantation owner in Mississippi whose great-grandson Edgar Wiggin Francisco Jr. was a friend of Faulkner’s since childhood. Mr. Francisco’s son, Edgar Wiggin Francisco III, now 79, recalls the writer’s frequent visits to the family homestead in Holly Springs, Miss., throughout the 1930s, saying Faulkner was fascinated with the diary’s several volumes. Mr. Francisco said he saw them in Faulker’s hands and remembers that he “was always taking copious notes.”

Specialists have been stunned and intrigued not only by this peephole into Faulkner’s working process, but also by material that may have inspired this Nobel-prize-winning author, considered by many to be one of the greatest American novelists of the 20th century.

“I think it’s one of the most sensational literary discoveries of recent decades,” said John Lowe, an English professor at Louisiana State University who is writing a book on Faulkner. He was one of a handful of experts who met Dr. Francisco at the hand-hewn log house in Holly Springs last month. There they saw the windowpane where a cousin, Ludie Baugh, etched the letters L-U-D-I-E into the glass while watching Confederate soldiers march by — a scene that appears in several Faulkner works.

During the gathering Dr. Francisco, known in childhood as Little Eddie, described how Faulkner stood in front of that window and said, “ ‘She’s still here,’ like she was a ghost,” Professor Lowe recalled.

Dr. Francisco, speaking by telephone from his home in Atlanta, remembered hearing Faulkner rant as he read Leak’s pro-slavery and pro-Confederacy views: “Faulkner became very angry. He would curse the man and take notes and curse the man and take more notes.”

Sally Wolff-King, a scholar of Southern literature at Emory University who uncovered the connection between the author and the journal, called it “a once-in-a-lifetime literary find.”

“The diary and a number of family stories seem to have provided the philosophical and thematic power for some of his major works,” she added.

Names of slaves owned by Leak — Caruthers, Moses, Isaac, Sam, Toney, Mollie, Edmund and Worsham — all appear in some form in “Go Down, Moses.” Other recorded names, like Candis (Candace in the book) and Ben, show up in “The Sound and The Fury” (1929) while Old Rose, Henry, Ellen and Milly are characters in “Absalom, Absalom!” (1936). Charles Bonner, a well-known Civil War physician mentioned in the diary, would also seem to be the namesake of Charles Bon in “Absalom.”

Scholars found Faulkner’s decision to give his white characters the names of slaves particularly arresting. Professor Wolff-King said she believes he was “trying to recreate the slaves lives and give them a voice.”

Dr. Francisco says he is still very uncomfortable that his family’s connection to Faulkner has come to light. “I wouldn’t have done it at all,” he said about publicizing the diary. “My wife urged me until I finally did it,” he said of Anne Salyerds Francisco, his wife of 50 years. “She pushed and Sally pulled.”

“There were long-repressed things that Faulkner uncovered that I didn’t know were in the family,” Dr. Francisco explained, adding that his father never talked about Leak and his slave-owning past. “I just bottled all that up and forgot about it.”

Dr. Francisco said that neither he nor his father ever read much of Faulkner’s work, including “Go Down, Moses.”

“I tried to read that book years ago,” he said, “but I got so angry I threw it across the room, and it stayed there for months.” He said he now might give it another go.

The mothers of Faulkner and of Dr. Francisco’s father were close. The boys went to each other’s childhood birthday parties. Later they double dated and became hunting and drinking buddies, remaining friends until their 40s, when they drifted apart, a situation probably encouraged by Mr. Francisco’s wife, who did not approve of Faulkner’s drinking, smoking and cursing.

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Erik S. Lesser for The New York Times

Edgar Wiggin Francisco III, above, with a typescript of an old family diary. As a boy, he used to see William Faulkner reading the original.

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Times Topics: William Faulkner

Erik S. Lesser for The New York Times

Sally Wolff-King, a Faulkner scholar who bases some of her new research on the diary.

Professor Wolff-King had been working on a book about people who knew Faulkner and ended up connecting with Dr. Francisco because he was an alumnus of Emory. When she visited his home in Atlanta, his wife suggested he show the professor a typescript copy of the ledger. Included was a facsimile of a page that listed dollar amounts paid for individual slaves.

“At that moment I realized this diary may not only have influenced the ledger and slave sale record in ‘Go Down, Moses’ but also likely served an important source for much of William Faulkner’s work,” said Professor Wolff-King, who has spent 30 years studying the writer.

A short preview of her findings is in the fall 2009 issue of The Southern Literary Journal; her book “Ledgers of History: William Faulkner, an Almost Forgotten Friendship, and an Antebellum Diary,” is due out in June from Louisiana State University Press.

Professor Lowe reviewed the manuscript before publication. To protect against leaks the editor arranged a meeting in a coffee shop. “He gave me the manuscript in a plain brown wrapper, and I was sworn to secrecy,” he said.

“I was electrified when I was reading it,” he said. “Faulkner had a very intense and intellectual relationship with Dr. Francisco’s father,” which seems to have formed “the basis of some of the conversations you find in ‘Absalom, Absalom!’ and ‘Go Down, Moses.’ ”

The Leak papers are not unfamiliar to scholars. The family donated the journal, which includes the plantation accounts as well as descriptive sections, to the University of North Carolina in 1946 and received a typescript copy of the material that runs 1,800 pages. The original documents have been used by Southern economists and social historians for their insights into Mississippi’s plantation life, but no one has previously been aware that Faulkner, who died in 1962, had any connection to them.

Professor Wolff-King argues that elements and terms from the diary repeatedly surface in Faulkner’s work, including the ticking sound of a watch that Quentin Compson is obsessed with in “The Sound and the Fury”; descriptions of building a plantation match Thomas Sutpen’s in “Absalom, Absalom!”

Noel Polk, the editor of The Mississippi Quarterly and among the deans of Faulkner scholars, said, “I was surprised at the discovery of what is so clearly a major piece of information about his life, and maybe his work.”

He and others said it was still too early for them to gauge just how significant the diary is without reading Professor Wolff-King’s book and examining the ledgers themselves, especially when it comes to the more common details about the antebellum and Civil War eras.

“Almost every document that you can come up with that Faulkner used is interesting, but the question is what do you do with it,” Judith L. Sensibar, whose biography “Faulkner and Love: The Women Who Shaped His Art” was published last year. What does it tell us, for instance, about his “obsession with the ways in which slavery has disfigured the lives of both the slaves and their masters?” she asked.

Although literary experts have been taken aback by this unexpected find, Faulkner more than anyone would have understood how the past can unpredictably poke its nose into the present.

Original here

Sunday, December 20, 2009

“Do I have the right to refuse this search?”

Today’s guest author is Deirdre Walker. She retired recently as the Assistant Chief of the Montgomery County, Maryland, Department of Police. She spent 24 years as a police officer.

“Do I have the right to refuse this search?”

This is a question I heard many times during my law enforcement career. Often my answer was no. But occasionally it would be “yes,” followed by an admonition to have a good day.

For the last half of my career, I would have documented each interaction, whether or not it involved an arrest. I would have written down the nature and length of the interaction, the gender, race, and age of the person, and the outcome of the contact (arrest, citation, etc.).

I carry the baggage of this history with me as I’ve traveled over the last eight years, mindlessly placing my luggage on the conveyer belt and removing my shoes for TSA inspection.

Recently, something changed.

Within the last few months, I have been singled out for “additional screening” roughly half the time I step into an airport security line. On Friday, October 9, as I stepped out of the full-body scanning device at BWI, I decided I needed more information to identify why it is that I have become such an appealing candidate for secondary screening.

Little did I know this would be only the first of many questions I now have regarding my airport experiences.

Over these last few months, I have grown increasingly frustrated with what I view as an unjustifiable intrusion on my privacy. It was not so much the search (then) as it was the embarrassment of being singled out, effectively being told “You are different,” but getting no explanation as to why.

That frustration has been tempered by a combination of my desire to be a good citizen, and my empathy for the TSA screeners. These folks, after all, are merely doing what we, the American traveling public, have permitted and now expect them to do.

I am left to wonder whether my own passive acceptance of these evolving search procedures has contributed to a potentially fatal dichotomy: what we allow TSA screeners to do in order to maximize efficiency and enhance our perception of safety, or what we really need them to do in order to preserve our rights and dignity and enhance our actual safety.

We have asked TSA to find the tools terrorists use and prevent both from boarding a passenger plane. We have unintentionally created an agency that now seeks efficiency and compliance more than any weapon or explosive.

While returning my computer and shoes to their proper places, I watched the screening line at BWI. I thought about the haphazard events surrounding the security screening process. As I watched the screening officers, I wondered what information drives their decisions. Left only to my observations, I concluded that their decisions were entirely random, and likely based upon three criteria: passenger load, staffing, and whim.

I was left to conclude that I am not screened because I look like a terrorist. I am routinely screened because I look like someone who will readily comply. I decided then that my next invitation to enjoy additional screening would be met with more inquiry.

I did not have wait very long. On my return through Albany to BWI — Surprise! – I got “randomly selected” for additional screening.

This time, I was “invited” to step into one of the explosive detection machines, commonly referred to as a “puffer machine.” The traveller is exposed to short, intense bursts of air, which are then, supposedly, analyzed for trace residue.

I read an article awhile ago that suggested these machines are entirely ineffective. I have subsequently observed that they now sit idle at many airports where they were originally installed (Tampa International, for example). In recently renovated airports (San Jose) they have not been installed. At some other airports (like BWI), they have been replaced by the body-scanning technology.

When notified by the cheerful screener that I had been selected for additional screening (the screener’s tone reminded my of the announcer who tells the contestant that she has just won a TV on the Price is Right), I stepped reluctantly toward the machine and asked her quietly whether I had the right to refuse the search. I did not want to become a spectacle, or have to rent a car and drive back to Maryland.

The screeners face dropped and she appeared stunned, as if my question had been received like a body-blow. She asked me to repeat what I said, and I repeated my inquiry regarding whether or not I had the right to refuse this search, especially since it was my understanding that the equipment did not work. She responded defensively, “It sounds an alarm!”

What followed is what I can only describe as a process that left me with more questions and a hunger for something we need and something that has apparently been missing from TSA procedures since September 12, 2001: Data.

It is, again, important to note my general respect for the front line TSA screeners — with the exception of those screeners who feel that it is necessary to yell at people. In my experience as a cop, as a supervisor and as a manager, I know that yelling at people is the one method guaranteed to ensure sub-par performance and a collapse of any semblance of cooperation.

My motivation to write this piece is first, to vent, but then to take a stab at the windmill that has grown from flawed processes to become a barrier to achieving the real mission and ultimate goal: Passenger safety.

I believe, fundamentally, that our collective compliance with the current screening procedures has served only to undermine TSA, and has denied our screeners the tools they need to correct their course.

After realizing I was serious about refusing to step into the puffer machine, I was told that I would be subjected to a “full-body pat-down” and that all of my “stuff would be fully searched.”

I shrugged and waited while the screeners figured out what to do next. One of the screeners said “Who is the supervisor? Notify a supervisor.” I waited two to three minutes with two female screeners. I was then approached by a uniformed screener and the following exchange took place.

“She refused the puffer. We are supposed to notify a supervisor. You’re a supervisor, right?”

Apparently reminded of his role, the subordinate screener then said “We’re notifying you.” She said nothing further. The supervisor then informed me that if I did not step into the “puffer” I would be subjected to a full body-pat-down, that I would be “wanded” and that all of my belongings would be fully searched by hand.

By this time, my belongings had already passed through the x-ray and sat oddly unattended on the belt. They had aroused no suspicion, either as they passed through the x-ray or as they sat completely unattended. I thought it odd that my initial refusal to be subjected to the ‘puffer’ now rendered the x-ray examination effectively flawed. I was being cajoled and was then offered the opportunity to change my mind, which, again, I thought rather odd. If I posed such a risk by refusing the secondary screening, why would that risk be now mitigated, if only I were to change my mind?

I did not change my mind. So, I stepped between two glass walls and was subjected to what my police training would allow me to conclude was a procedural vacuum.

I had been told repeatedly I would be subjected to a “pat-down.” I correctly suspected otherwise. During the course of my police career, I have conducted many pat-downs on the street. The Supreme Court has described pat downs as a cursory check of the outer clothing of a person by a police officer, upon articulable suspicion that the officer’s safety is at risk of being compromised. My department’s procedure indicated that this pat-down was to be conducted with an open hand, gently patting the outer clothing of an individual, for purposes of officer safety only, with the goal of detecting weapons. In other words, it is not a search.

What happened to me in Albany was not the promised “pat-down.” It was a full search conducted in full public view. It was also one of the most flawed searches I have ever witnessed.

From the outset, it was very clear that the screener would have preferred to be anywhere else. She acted as if she was afraid of me, though given that I had set myself apart as apparently crazy, perhaps I cannot blame her. With rubber-gloved hands she checked my head, my arms, my legs, my buttocks (and discovered a pen that had fallen into one of my pockets) and even the bottom of my feet. Perhaps in a nod to decorum, she did not check my crotch, my armpits or either breast area.

Here was a big problem: an effective search cannot nod to decorum.

These three areas on a woman, and the crotch area of men, offer the greatest opportunity to seclude weapons and contraband. Bad guys and girls rely on the type of reluctance displayed by this screener to get weapons and drugs past the authorities. We train cops to realize that their life depends upon the ability to compartmentalize any apprehension about the need to lift and separate. Fatal consequences can and do result when officers fail to detect a secreted weapon which is later used against them.

At the Albany airport, I was left to wonder what kind of training the screener received. I was forced to conclude the answer might be “none.” At a minimum, she needs re-training, assuming there is any policy or training that governs searches. Further, after being repeatedly informed that I would be “wanded” by the metal detector in addition to the ‘pat-down,’ I was not.

Had I actually intended to move contraband past the screening point, my best strategy would have been to refuse secondary screening.

I am also forced to conclude that the purpose of the “pat-down” was not to actually interdict contraband. In my case, I believe I was subjected to a haphazard response in order to effectively punish me for refusing secondary screening and to encourage a different decision in the future.

All of this is admittedly subjective, based on my perceptions at the time. What is also entirely subjective is identifying which travelers are selected for secondary screening.

This is where I find myself now obsessing over TSA policy, or its apparent lack. Every one of us goes to work each day harboring prejudice. This is simply human nature. What I have witnessed in law enforcement over the course of the last two decades serves to remind me how active and passive prejudice can undermine public trust in important institutions, like police agencies. And TSA.

Over the last fifteen years or so, many police agencies started capturing data on police interactions. The primary purpose was to document what had historically been undocumented: informal street contacts. By capturing specific data, we were able to ask ourselves tough questions about potentially biased-policing. Many agencies are still struggling with the answers to those questions.

Regardless, the data permitted us to detect problematic patterns, commonly referred to as passive discrimination. This is a type of discrimination that occurs when we are not aware of how our own biases affect our decisions. This kind of bias must be called to our attention, and there must be accountability to correct it.

One of the most troubling observations I made, at both Albany and BWI, was that — aside from the likely notation in a log (that no one will ever look at) — there was no information captured and I was asked no questions, aside from whether or not I wanted to change my mind.

Given that TSA interacts with tens if not hundreds of millions of travelers each year, it is incredible to me that we, the stewards of homeland security, have failed to insist that data capturing and analysis should occur in a manner similar to what local police agencies have been doing for many years.

Some might argue that the potential for intrusion is not the same between police and TSA. I believe my experience this past weekend demonstrates otherwise. Currently, there is no way to know whether a certain male screener routinely identifies predominantly women for additional screening. There is no way to identify whether a Latino screener routinely isolates African-Americans, or vice versa. To assert that the screeners are highly trained and do not engaged in this type of discrimination, whether passive or active, is unsupportable because there is no data. You simply cannot solve problems that you do not want to identify.

Finally, I am most concerned about the “random” nature of my repeated selection for secondary screening. If there is no discrimination at work, and my selection is entirely random, then we have yet another, and probably more significant problem.

For years in policing, we relied on random patrols to curb crime. We relied upon this “strategy” until someone went out and captured some data, and did a study that demonstrated conclusively that random patrols do not work (Kansas City Study).

As police have employed other types of “random” interventions, as in DWI checkpoints, they have had to develop policies, procedures and training to ensure that the “random” nature of these intrusions is truly random. Whether every car gets checked, or every tenth car, police must demonstrate that they have attempted to eliminate the effects of active and passive discrimination when using “random” strategies. No such accountability currently exists at TSA.

As I left the screening check point in Albany, I looked over a few feet and observed an elderly Asian couple talking to “my” supervisor. I unashamedly eavesdropped.

I heard the man say that his wife had not been told that the machine would blow air and that she had been quite startled. The woman said she should have been informed and the supervisor agreed. He said he would speak to the screener (but again, who knows whether he actually did).

Then the man said “And she should have been told she can refuse.” The bells in my head were deafening.

I believe what we have here is the beginning of the end of complacency. It is now apparent to me that in the haste to ensure compliance with procedures that are inconsistent if not inarticulable, TSA has hastened the likelihood of failure. If we do not insist that TSA work to create articulable policies that make sense, procedures that are explicit and consistent and training that supports both, then we are complicit in what will inevitably be an ultimate compromise of TSA.

That compromise may come in the form of terrorist attack, or it may come in the form of a collapse of public support. Either or both are inevitable. Either or both are preventable.