The Outlook Is Bleak

by krm | Thursday, December 1, 2016 - 6:00 AM

America is losing the fight against HIV/AIDS. Last year, CDC leaders summarized the evidence in the New England Journal of Medicine . The most compelling data show that for the last 20 years the annual number of new HIV infections in the United States has stayed the same , at approximately 45,000 cases. The long-range plan for control of HIV infection is to identify new cases as quickly as possible and provide the patients with medications that will reduce their viral load to a level that will render them non-infectious. Successful treatment reduces the chance of sexual transmission not to zero, but to a very low rate. But CDC data show that only about 30% of the estimated 1.2 million persons living with HIV infection in the United States have reached the desired low viral load. Many complex reasons account for this, but the conclusion is clear, HIV control efforts are not working well enough to bring the epidemic under control.

It is important to understand that CDC has no authority over implementation of HIV control measures. The states hold this authority, and implement HIV and other sexually transmitted diseases (STD) control measures through their state and...Read More

The Value of Pain?

by krm | Wednesday, November 30, 2016 - 6:00 AM

One of the interesting things I learned while researching my book, was the way our conception of pain has changed over time.

Prior to 1900, pain was viewed as an immediate and short-lived response to an injury or illness – the body’s emergency warning system that burned bright and then burned out. Once the injury healed or the illness was cured, (or the body just got used to it, whichever came first), the pain, so the thinking went, disappeared. There was no framework or lexicon for chronic pain, especially in the absence of injury or objectively verifiable disease.

Today, hospitals and clinics are overrun with patients struggling with a growing variety of chronic pain conditions. Indeed the number one cause of Social Security Disability Insurance (SSDI) today is chronic pain. Compare this with the 1980’s, when the leading causes of disability were heart disease and cancer. Furthermore, pain today need not be caused by an injury or illness. Pain can be its own disease. A growing list of chronic pain conditions has emerged for which there is limited understanding and no obvious medical antecedent: fibromyalgia, complex regional pain syndrome, pelvic pain syndrome, etc.

Another aspect...Read More

The book as an interactive device: Media doesn’t always need to be digital

by krm | Tuesday, November 29, 2016 - 6:00 AM

The traditional media used in education has at least one major Achilles heel. No matter how well produced and instructional the content may be, the learning experience is primarily passive and the extent to which learners can control the flow of that content is limited. For the broadcast media of radio and television, the situation is much worse in the case of the as the only opportunity for viewer agency is to turn it on or off. When the content is recorded and made locally accessible, a viewer can replay segments of the instruction as many times as needed, that control significantly increases, but overall, the instructional experience is not as optimal as it could be. This is because the media is inherently linear, designed to be consumed in a straight line from beginning to end.

This serious limitation of traditional linear media weighs heavily on instructors looking to create a more effective learning experience. A novel or movie may depend on this linearity to convey the narrative arc, which is essential to its form, but this can present an impediment to more instructional kinds of media. One way to overcome those limitations is...Read More

Hoax: Franklin's Forgery

by krm | Thursday, November 24, 2016 - 6:00 AM

The following is an excerpt from chapter nine of Gregory Dowd's latest book, Groundless: Rumors, Legends, and Hoaxes on the Early American Frontier .

Late in the Revolutionary War, in Passy, France, [Benjamin] Franklin lifted his pen in a most extraordinary effort at what today’s intelligence community would call “disinformation.” He sought to encourage support for the American position in the treaty negotiations. Between April 18 and April 22, 1782, he printed a broadsheet, a phony “Supplement” to the Boston Independent Chronicle , complete with advertisements, and he provided for its circulation around Europe, partly by enclosing the broadsheet with his correspondence. The “Supplement’s” main “item” was a purportedly intercepted message, sent, the item alleged, by an agent among the Seneca Indians and intended for the British governor of Canada. This message and the strange freight that accompanied it had been captured by a New England captain while raiding the Indians, or so Franklin fabricated the events. A portion of the message read:

At the request of the Senneka Chiefs, I send herewith to your Excellency, under the care of James Boyd, eight packs of Scalps, cured, dried,...Read More

Irish Romanticism and Climate Change

by krm | Wednesday, November 23, 2016 - 6:00 AM

Like many of my friends and neighbors in Spokane, Washington this summer, I have been preoccupied with a second consecutive year of major wildfires. We have endured prolonged stretches where the Air Quality Index has been deemed “unhealthy” or even “hazardous.” For me, the smoke has been an inconvenience, but for others it has meant tragedy-- lost property and even lost lives. The Spokane Reservation, home to the Spokane tribe of Native Americans, has seen 10% of its 13,000 acres engulfed in the flames. In nearby Wellpinit, firefighters have used so much water that residents must rely on bottled water for drinking and washing. Elsewhere, another 70,000 acre fire is moving ominously towards the Hanford Nuclear Reactor.

While 2016 has beaten out 2015 worldwide as the hottest summer on record, serious environmental discussions have been conspicuously absent from the U. S. Presidential campaign.

I take refuge in the work of the Irishwoman Mary Tighe (1772-1810), one of the most insightful writers on environmental issues in her day. She understood the long arc of history in the natural world and the way humankind can be terribly short-sighted. For example, in “Written at Rossana, Nov r 18. 1799,” she asks:...Read More