Longread #205 -- Ignoring the Science on Mammograms -- 11/30/12

Yesterday's longread looked at new approaches to improve the efficiency of medical care in the U.S. It focused largely on proposals to improve patient-doctor communication in ways that increase the use of palliative care in lieu of expensive, ineffective, and aggressive cancer treatments near the end of life. As explained in that article, reforming the system was at odds with the financial incentives for oncologists, many of whom garner their largest percentage of income through drug prescriptions.

Today's longread looks at a similar issue but at the opposite end of the cancer continuum: early detection. A central theory that has guided many years of cancer research and clinical practice is the idea that earlier detection of cancer means better outcomes for patients. While this is true on a general level (an earlier stage cancer almost always has a better prognosis), the challenge lies in finding tests that work effectively for early detection. Mammograms, which have become a staple of preventive medicine for women over age 40, are imperfect in this regard. While the research results are more complicated than this article implies, much of the opposition to changes to mammogram screening guidelines (such as those two years ago that suggested a starting age of 50 instead of 40) is based on what the author calls the "mammogram economy." This isn't to say that we should do away with screening mammography altogether, but we should do our best to let science guide us toward standards that both reduce costs and improve the well-being of patients.

For anyone interested in the research that has been done on mammograpy as a screening tool for breast cancer, here are some useful links:

• National Cancer Institute breast cacner screening summary: http://www.cancer.gov/cancertopics/pdq/screening/breast/Patient/page1/AllPages
• NCI breast cancer screening summary for health professionals (this is much more technical but goes through the studies one-by-one): http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional/page1/AllPages
• US Preventive Services Task Force (USPSTF) recommendations: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

"Ignoring the Science on Mammograms" by David H. Newman, M.D.
Published in the New York Times, November 28, 2012
http://well.blogs.nytimes.com/2012/11/28/ignoring-the-science-on-mammograms/

Eric

Longread #204 -- Against the Odds -- 11/29/12

The rising costs of medical care in the U.S. are one of the biggest challenges to our country's long-term financial picture. For years, health care costs have been rising although with limited demonstrated benefits to the overall health of Americans. Virtually everyone agrees that the system is broken, but of course, there is tremendous disagreement about how to fix it. This longread looks at one initiative being conducted at Stanford to identify key areas where costs can be reduced without negatively affecting the quality of care. The most frustrating aspect of this story is how bottom lines become prioritized over the health of patients and the long-term health of the medical care system. Nevertheless, the concept behind this initiative is important and may likely help lead us toward positive solutions to the looming health care crisis.

"Against the Odds" by Kris Newby
Published in the Stanford Medicine Magazine, Fall 2012
http://stanmed.stanford.edu/2012fall/article3.html?src=longreads

Eric

Longread #203 -- The Plot Against Occupy -- 11/28/12

Criticisms of U.S. counter-terrorism policies are certainly not new. Especially since the start of the "War on Terrorism," analysts have exposed ways in which the efforts of U.S. agencies were ineffectual, racist, and threatening to fundamental civil liberties. This article extends these critiques of the FBI and the broader practices of U.S. counter-terrorism. First, the article points out that the reaches of these agencies has expanded to include targeting virtually any groups with strong dissenting voices such as the Occupy movement. Second, the tactics used to foil supposed terrorist plots reek of entrapment. The end result is counter-terrorism missions that not only chill free expression but that also spur on the terrorist acts that are supposedly being prevented. These policies may create positive headlines for law enforcement, but an informed analysis reveals they are probably doing nothing to make us safer.

"The Plot Against Occupy" by Sabrina Rubin Erdely
Published in Rolling Stone, September 17, 2012
http://www.rollingstone.com/culture/news/the-plot-against-occupy-20120926?print=true&src=longreads

Eric

Longread #202 -- Cuba's New Now -- 11/27/12

Even though the Cold War has been over for more than two decades, Cuba remains a pariah in the eyes of the U.S. During this time, though, Cuba has undergone significant changes as a result of the resignation of Fidel Castro and the changing dynamics of international politics and economics. This article looks at the complex challenges facing Cuba as a country as well as everyday Cubans who struggle with the day-to-day challenges of a country in an ambiguous state of change.

"Cuba's New Now" by Cynthia Gorney
Published in National Geographic, November 2012
http://ngm.nationalgeographic.com/2012/11/new-cuba/gorney-text?src=longreads

Eric

Longread #201 -- Rethinking the Computer -- 11/26/12

With our society's growing reliance on technology, the issues of computer and network security have become increasingly important. It seems that every few months there is another major security flaw that is exploited to expose the confidential information of governments, corporations, or individuals. This longread looks at a computer scientist who is rethinking the entire paradigm of the computer to try to identify long-term solutions to ensure cyber-security.

"Killing the Computer to Save It" by John Markoff
Published in the New York Times, October 29, 2012
http://www.nytimes.com/2012/10/30/science/rethinking-the-computer-at-80.html?src=dayp&pagewanted=all&_r=0

Eric

Longread #200 -- A Soldier of Kindness -- 11/21/12

Today's longread is one of the more moving pieces that I have read recently. As we approach tomorrow's Thanksgiving holiday, stories of people like Army Lt. Col. David Cabrera remind me of how important it is to be thankful and to turn that gratitude into meaningful and positive interactions with other people.

Happy Thanksgiving!

"As first military social work officer killed in action, Army Lt. Col. David Cabrera was a ‘soldier of kindness’" by Jim Sheeler

Published in the Washington Post, November 8, 2012

http://www.washingtonpost.com/lifestyle/magazine/as-first-military-social-work-officer-killed-in-action-army-lt-col-david-cabrera-was-a-soldier-of-kindess/2012/11/02/0dce8cf4-e1a6-11e1-98e7-89d659f9c106_print.html

Eric

Longread #199 -- The GOP & Demographics -- 11/20/12

Now that a few weeks have passed since the elections, analysts have had more time to break down what happened and predict how national politics may evolve over the coming years. One of the biggest issues that has been discussed is the need for the GOP to reach out to minority voters with a specific emphasis placed on Latino voters. In this longread, Nate Cohn, a former debater at my alma mater of Whitman College, breaks down why a focus on reaching out to Latino voters won't be enough to overcome the challenges facing the Republican Party.

"The GOP’s Challenge Extends Beyond Hispanics and Immigration Reform" by Nate Cohn
Published by the New Republic, November 15, 2012
http://www.tnr.com/blog/electionate/110159/the-gops-challenge-extends-beyond-hispanics-and-immigration-reform#

Eric

Longread #198 -- The Truth About Brining Turkey -- 11/19/12

I'm on vacation this week but still want to post some Thanksgiving-themed longreads. The best way to cook a turkey is a matter of considerable debate. In today's longread, we turn to science as J. Kenji López-Alt offers his insightful take on the question of brining. I'm not sure he will win over people who have been brining for years and years, but he does make a compelling case.

"Food Lab: The Truth About Brining Turkey" by J. Kenji López-Alt

Published on Serious Eats, November 5, 2012

http://www.seriouseats.com/2012/11/the-food-lab-the-truth-about-brining-turkey-thanksgiving.html

Eric

Longread #197 -- The Luxury Repo Men -- 11/16/12

I've certainly posted plenty of articles on this blog related to the housing bubble, unsustainable debt for American families, and the resulting foreclosure crisis. This longread takes a slightly different angle and looks at luxury repo men -- the people who track down high-value assets of wealthy people who have stopped paying their bills.

Hope you enjoy the article. Happy Friday!

"The Luxury Repo Men" by Matthew Teague
Published in Business Week, October 25, 2012
http://www.businessweek.com/printer/articles/78322-the-luxury-repo-men

Eric

Longread #196 -- Paradise With An Asterisk -- 11/15/12

As short days and cold, rainy weather descends on Seattle, I have found myself daydreaming a lot recently about finding a tropical beach and relaxing in the sunshine. In some ways, Bikini Atoll is the exact type of place where I would want to be. Unfortunately, this tropical paradise was subject to years of American nuclear testing with substantial impacts on the local environment. More problematic than the environmental problems, though, is how the people native to Bikini Atoll were treated during this period. In some ways reminiscent of the transgressions made in the name of "Manifest Destiny" in the colonization of the American west, native Bikinians were relocated on multiple occasions, permanently altering the social and cultural fabric of the Bikinian people. This longread examines how the U.S. quest for nuclear weapon supremacy turned Bikini Atoll into a paradise with an asterisk.

"Paradise With An Asterisk" by S.C. Gwynne
Published in Outside Magazine, October 17, 2012
http://www.outsideonline.com/outdoor-adventure/nature/Paradise-With-An-Asterisk.html?page=all

Eric

Longread #195 -- As Not Seen on TV -- 11/14/12

I have a soft spot for "Diners, Drive-Ins, and Dives," but I think Guy Fieri bit off more than he could chew (da-dun-CHING) with his enormous new restaurant in New York. Enjoy this hilarious review that is as over-the-top and bombastic as Guy himself.

"As Not Seen on TV" by Pete Wells
Published in the New York Times, November 13, 2012
http://www.nytimes.com/2012/11/14/dining/reviews/restaurant-review-guys-american-kitchen-bar-in-times-square.html?pagewanted=2&_r=0&smid=tw-share&pagewanted=all

Eric

Longread #194 -- Monopoly is Theft -- 11/13/12

There's not a lot for me to write about this longread. It is a fascinating article about the history of Monopoly (the board game) and its relationship to the anti-capitalist movement in the United States. It is a remarkable story that basically serves as its own case-in-point.

"Monopoly is Theft" by Christopher Ketcham
Published in Harper's, October 19, 2012
http://harpers.org/blog/2012/10/monopoly-is-theft/?single=1&src=longreads

Eric

Longread #193 -- General Failure -- 11/12/12

Even though today isn't a business day for me, I'm going to go ahead and post a longread. The reason that I'm not working is because yesterday was Veteran's Day, and I want to take this opportunity to thank everyone who has served on behalf of the U.S. So many people have made sacrifices in the name of our country, and to me, that is all the more reason why we should strive to make this country as great as it can be. Hopefully in that process we can move toward a world where we will no longer need so many people to serve in the military but instead to serve in other capacities (education, health, etc.).

Since this holiday is about the military, though, I thought this longread was appropriate. It is critical of the leadership in today's Army, arguing that the culture of promotion does not properly reward the most effective leaders. While it may seem odd to post an article critical of the military on this holiday, it is an important discussion and one should never confuse constructive criticism with a lack of respect.

"General Failure" by Thomas Ricks
Published in the Atlantic, November 2012
http://www.theatlantic.com/magazine/archive/2012/11/general-failure/309148/?single_page=true

Eric

Longread #192 -- A Violent Prone, Poor People Zone -- 11/9/12

When most Americans think of Somalia, they likely think of Somali pirates or of the story of the American military operations there that inspired the film 'Black Hawk Down.' What most people, myself included, have no awareness of is the tremendous refugee crisis associated with violence, poverty, and famine in Somalia. This has spilled over to Kenya where refugees flee to large refugee camps as well as to slums near Nairobi. This longread provides a chilling account of life in Somalia and life for the refugees who have fled. It is troubling for so many reasons ranging from the degree of poverty to the pervasiveness of violence to the deplorable treatment of women. Normally on Fridays I try to post a fun longread, and this is definitively not one of those. Nevertheless, it is an important and eye-opening piece.

"A Violent Prone, Poor People Zone" by Tom Sleigh
Published in the Virginia Quarterly Review, Winter 2012
http://www.vqronline.org/articles/2012/winter/sleigh-florio-poor-zone/?src=longreads&buffer_share=5f767

Eric

Longread #191 -- The Slow Death of Public Higher Education -- 11/8/12

A huge part of the recently-concluded elections was about the proper role of government in society. On many issues ranging from health care to the economy to social issues like women's rights, the question of the government's proper role has been hotly contested. It is important to note that these debates are important not just at the federal level but also with state and local governments. One major issue for state governments is about the accessibility of higher education. This longread investigates the higher education system of the state of California and how it has changed since Ronald Reagan instituted a new approach as the state's governor. It is a depressing look at how one of the key tools for social mobility, innovation, and economic growth can be systematically eroded in ways that, not surprisingly, benefit certain private interests.

"From Master Plan to No Plan: The Slow Death of Public Higher Education" by Aaron Bady and Mike Konczal
Published in Dissent Magazine, Fall 2012
http://www.dissentmagazine.org/article/from-master-plan-to-no-plan-the-slow-death-of-public-higher-education?src=longreads

Eric

Longread #190 -- Big Sugar's Sweet Little Lies -- 11/7/12

Well, after a long election cycle, you're probably either celebrating or sulking today. For many Americans, either emotion pushes one toward sugary treats and comfort foods. It is commonly reported that there is an obesity and diabetes problem in America, but identifying the causes and possible solutions to this problem is a more hotly contested topic. As with many issues, we rely on science to help us understand why these health challenges have grown so substantially over the past decades. Unfortunately, as this article documents, groups with vested interests in the composition of the American diet, such as the sugar lobby, have systematically worked to avoid, confuse, and suppress attempts at objective science. It's an appalling story that reflects a troubling willingness to sacrifice the interests of the public for corporate bottom lines.

For more on this topic, make sure to read a past longread -- Longread #32 -- Is Sugar Toxic?

"Big Sugar's Sweet Little Lies" by Gary Taubes and Cristin Kearns Couzens
Published in Mother Jones, November/December 2012
http://www.motherjones.com/environment/2012/10/sugar-industry-lies-campaign?src=longreads

Eric

Longread #189 -- Who Fracked Mitt Romney -- 11/6/12

At long last, the polls will close today for the U.S. Presidential election. More money has been spent in this election cycle than any before it, and much of that money has come from extremely wealthy people with a huge stake in the election's outcome. One such individual is Harold Hamm, an oil baron and top energy adviser to Mitt Romney who also happens to be one of America's richest and most powerful businessmen. While the political connections in this story are absolutely important, so too are the social and environmental ramifications of the type of rapid oil field development that Hamm's company, Continental Resources, is undertaking. Given that even a second Obama Administration is likely to move forward with this kind of oil exploration, recognition of these issues is essential to try to create proper oversight and regulation.

"Who Fracked Mitt Romney?" by Josh Harkinson
Published in Mother Jones, October 29, 2012
http://www.motherjones.com/print/198461

Eric

Longread #188 -- The Fifty-Nine Story Crisis -- 11/5/12

Sometimes it seems as though our society is in a constant state of scandal. Whether it's corruption in politics, cheating in sports, or the illicit activities of the rich and famous, there seems to be a never-ending stream of indiscretions that come to light. These scandals are often shocking and represent and unbelievable idiocy or hubris or disregard for others. Furthermore, attempts to cover things up often lead to a web of lies that generate even further outrage.

As a result of this pervasiveness of scandal, I found this longread to be immensely refreshing to read. It tells the story of a famous engineer who blew the whistle on himself and took responsibility to fix a problem rather than try to cover it up. This story is a recognition that when finger-pointing, buck-passing, and covering-up are set aside, even difficult situations can be resolved quickly, amicably, and in a way that benefits the best interest of all parties involved.

"The Fifty-Nine Story Crisis" by Joe Morgenstern
Published in the New Yorker, May 29, 1995
http://people.duke.edu/~hpgavin/ce131/citicorp1.htm

Eric

Longread #187 -- Chore List of Champions -- 11/2/12

As I embark on a short vacation, I thought I'd share a lighter longread. This is from a contract that Kurt Vonnegut wrote with his pregnant wife. While this theme has certainly been played out by comics, sitcoms, and many other media over the years, it's still makes for a pretty good laugh.

Happy Friday!

"Chore List of Champions" by Kurt Vonnegut
Published in Harper's, September 2012. Originally written January 26, 1947.
http://harpers.org/archive/2012/09/chore-list-of-champions/

Eric

Longread #186 -- The Company That Spooked the World -- 11/1/12

I took a class in college about the "politics of place," and we analyzed the myriad ways that places become defined and imbued with meaning. One interesting element of our discussions was how globalization and the growth of multinational corporations altered the landscape of how national sovereignty and global capitalism interact. As the global economy has become more interconnected and complex, it creates more situations in which the imperatives of the economy and the imperatives of security do not align.

This article demonstrates an interesting example of this with the case of the Chinese technology company Huawei. On one hand, Huawei manufactures quality products at a low cost, enabling companies that rely on their technology to be more efficient and profitable. On the other hand, concerns about the relationship between Huawei and the Chinese government has raised concern about installing the company's products for important infrastructure.

Thank you to my friend Ross who shared this article with me and whose company helped provide some information to the Economist for this piece.

"The company that spooked the world"
Published in The Economist, August 4, 2012
http://www.economist.com/node/21559929

Eric