Tuesday, November 21, 2017

TRANSPLANTS - Americans Last?

"Some U.S. Hospitals Don’t Put Americans First for Liver Transplants" by Charles Ornstein (ProPublica) and Lee Zurik (Fox 8 WVUE New Orleans), ProPublica 11/20/2017

At a time when there aren’t enough livers for ailing Americans, wealthy foreigners fly here for transplants.

Earlier this fall, a leader of the busiest hospital for organ transplants in New York state — where livers are particularly scarce — pleaded for fairer treatment for ailing New Yorkers.

“Patients in equal need of a liver transplant should not have to wait and suffer differently because of the U.S. state where they reside,” wrote Dr. Herbert Pardes, former chief executive and now executive vice president of the board at New York Presbyterian Hospital.

But Pardes left out his hospital’s own contribution to the shortage: From 2013 to 2016, it gave 20 livers to foreign nationals who came to the United States solely for a transplant — essentially exporting the organs and removing them from the pool available to New Yorkers.

That represented 5.2 percent of the hospital’s liver transplants during that time, one of the highest ratios in the country.

Little known to the public, or to sick patients and their families, organs donated domestically are sometimes given to patients flying in from other countries, who often pay a premium.  Some hospitals even seek out foreign patients in need of a transplant.  A Saudi Arabian company, Ansaq Medical Co., whose stated aim is to “facilitate the procedures and mechanisms of ‘medical tourism,’” said it signed an agreement with Ochsner Medical Center in New Orleans in 2015.

The practice is legal, and foreign nationals must wait their turn for an organ in the same way as domestic patients.  Transplant centers justify it on medical and humanitarian grounds.  But at a time when President Donald Trump is espousing an “America First” policy and seeking to ban visitors and refugees from certain countries, allocating domestic organs to foreigners may run counter to the national mood.

Even beyond the realm of health care, some are questioning whether foreigners should be able to access limited spots that might otherwise be available to U.S. citizens.  For instance, public colleges compensate for reductions in state funding by accepting more foreign students paying higher tuition, and critics say in-state students are being denied opportunities as a result.

Dr. Sander Florman, director of the transplant institute at the Mount Sinai Hospital in New York, said he struggles with “in essence, selling the organs we do have to foreign nationals with bushels of money.”

Mount Sinai has not performed any transplants on patients who came to this country specifically for that purpose, but it has done so for international patients here for other reasons.

Between 2013 and 2016, 252 foreigners came to the U.S. purely to receive livers at American hospitals.  In 2016, the most recent year for which data is available, the majority of foreign recipients were from countries in the Middle East, including Saudi Arabia, Kuwait, Israel and United Arab Emirates.  Another 100 foreigners staying in the U.S. as non-residents also received livers.

All the while, more than 14,000 people, nearly all of them American citizens, are waiting for liver transplants, a figure that has remained stubbornly high for decades.  By comparison, fewer than 8,000 liver transplants were performed last year in the United States — and that was an all-time high.  The national median wait time for a liver is more than 14 months, and in states like New York, the wait is far longer.  (The wait for livers varies from one state to the next, depending on such factors as the number of organ donors, and the resourcefulness of organ procurement agencies.)

Many patients die before reaching the front of the line.  In 2016, more than 2,600 patients were removed from waiting lists nationally because they either died or were too sick to receive a liver transplant.

Most transplant centers only serve American citizens or residents, either by happenstance or by design.  Foreign transplants are concentrated among a handful of centers, including New York Presbyterian, Memorial Hermann -Texas Medical Center in Houston (31 such transplants from 2013 to 2016), Ochsner (30), and Cleveland Clinic in Ohio (21).

“When you take people from other parts of the world and provide an organ transplant to them rather than someone who’s here, there’s a real cost, there’s a real life that’s lost,” said Jane Hartsock, a visiting assistant professor of medical humanities and health studies at the Indiana University School of Liberal Arts.  Hartsock and her colleagues wrote a journal article published last year saying foreigners should be last in line for a transplant.

New York Presbyterian said it does not advertise its transplant program to foreign patients and that the majority of the transplants it performed on foreign nationals traveling to New York for that reason — 11 of the 20 — were on children under 18.

In a statement, the hospital and its academic partner Columbia University said they follow federal guidelines.  “We strongly support efforts that aim to address the critical issue of equitable distribution of livers for transplant and are working closely with a wide range of stakeholders to help increase the number of organ donor registrations in New York State.”

A spokeswoman for the Cleveland Clinic, Eileen Sheil, said her hospital does not actively seek out foreign national business and has a “thoughtful and ethical approach that is well within the rules and aligned with our overall mission for taking care of patients.” Ochsner similarly said, “patients seek out Ochsner’s expertise because of our relentless commitment to provide the highest-quality, complex care.” Memorial Hermann did not respond to requests for comment.

To be sure, the proportion of available livers that go to foreigners is tiny — slightly less than 1 percent of liver transplants nationwide from 2013 to 16.  The figure appears to be dropping further in 2017.  Even if all recipients were Americans, wait times would still be substantial.  Moreover, foreigners queue up on the waitlist like everybody else — although it may be easier for them, since they aren’t rooted in any particular state, to choose a hospital in an area with a shorter wait, such as Ochsner.  And some Americans discouraged by the lengthy wait in this country have gone abroad for transplants.

The transplant figures in this article do not include transplants involving living donors, meaning a relative or friend who donates part of his or her liver to a patient.  No one interviewed for this story said it is inappropriate for a foreign national to come to the U.S. for a procedure with a living donor.

There’s also an important distinction between giving an organ to a foreigner who happens to be in the U.S. — someone on a student visa or even an undocumented immigrant — and giving one to someone flying over just for surgery.  Someone in the first group would be eligible to donate an organ if something happened to them in this country; someone in the latter group would not because livers must be transplanted quickly and there wouldn’t be enough time to ship them.

“If you live in the United States, no matter what your [citizenship] status is, you could potentially be an organ donor if you get hit by a car or something happens to you,” said Dr. Gabriel M.  Danovitch, medical director of the kidney and pancreas transplant program at Ronald Reagan UCLA Medical Center, who previously led the UNOS international relations committee.  “But if your home is somewhere else, a long way away, there’s no way that you can be a donor or your family or your friends could be donors.

“And in some respects, when you then come to the United States, you are using up a valuable resource that is in great shortage here.”

Foreign patients generally are not entitled to the same discounts as those with private insurance or Medicare, the federal insurance program for seniors and the disabled.  In 2015, for instance, the average sticker price for a liver transplant at New York Presbyterian was $371,203, but the average payment for patients in Medicare was less than one-third of that, $112,469, according to data from the Centers for Medicare and Medicaid Services, which runs Medicare.  In the case of Saudi Arabia, its embassy in Washington often guarantees payment for patients.

The topic is emerging now because the nation’s transplant leaders will meet next month to consider rewriting the rules governing how livers are distributed, giving programs in New York City, Los Angeles, Chicago and other areas greater access to organs from people who die in nearby regions.  The proposal by a committee of the United Network for Organ Sharing, the federal contractor that runs the national transplant system, faces opposition from programs and regions that stand to lose organs.  Pardes’ comments were posted in an online comment forum devoted to the proposal, which does not address the issue of transplants for foreigners.

UNOS said it has worked to get better data on foreigners that receive transplants in this country but ultimately, federal law doesn’t prohibit these transplants.

“This is an individual medical decision that the individual transplant hospital makes,” spokesman Joel Newman said.  “If we addressed citizenship or residency as a particular reason for whether to accept a patient or not, then that would open up the door to lots of other non-medical criteria — religion, race, political preference, any number of things that as a community we have decided from an ethical standpoint not to consider.”

UNOS has the authority to ask questions of transplant centers about surgeries on foreign nationals, but Newman said UNOS committees are still trying to figure out what information they would want, and, in any event, the transplant centers don’t have to answer the questions.

The federal rules governing the transplant system, written more than three decades ago, say organ allocation decisions must be based on medical criteria, which would exclude consideration of a person’s nationality or citizenship.  While centers can perform as many transplants on foreigners as they want, many programs have tried to keep them below 5 percent of all transplants for each organ type.  Until several years ago, 5 percent was the threshold above which UNOS could audit a program.  No programs were ever formally audited, and the cutoff was eventually eliminated.

It’s time to revisit the rules, some lawmakers say.

“As a general rule, you’ve got to take care of Americans first as long as you have more demand than supply,” said Sen. John Kennedy (R-La) whose state is home to Ochsner, a leader in transplants for foreign nationals.  Kennedy said he would favor curbing transplants for foreigners, while creating a national board that could make exceptions.  “But what you don’t want to get into, it seems to me, is subjective areas like well, ‘If this person could live an extra few years, what could they contribute to society?’”

There have been scandals in the past about foreigners and organ transplants.  In 2005, a liver transplant center in Los Angeles shut its doors after disclosing that its team had taken a liver that should have gone to a patient at another hospital and instead had implanted it in a Saudi national.  The hospital said its staff members falsified documents to cover up the incident.

The University of California, Los Angeles, came under fire in 2008 for performing liver transplants on a powerful Japanese gang boss and other men linked to Japanese gangs, and then receiving donations afterward from at least two of the men.  The hospital and its surgeon said they do not make moral judgments about patients.

Further complicating matters is a 2008 document endorsed by transplant organizations around the world, called the Declaration of Istanbul, which seeks to eliminate organ trafficking and reduce transplant tourism internationally.  One concern was that patients went to China and received transplants using organs from prisoners.  (China said it was stopping the practice in 2015, but experts question whether that has happened.) Another concern was that if a country’s wealthiest or most powerful residents could get transplants overseas, its leaders may not have an incentive to set up a system of their own.

The non-binding declaration also says that there should be a ban on “soliciting, or brokering for the purpose of transplant commercialism, organ trafficking, or transplant tourism.” It was endorsed by UNOS and other national transplant groups.

Former Ochsner employees say they recall Saudi nationals coming for transplants, some wealthy and some not.  A New Orleans bar posted a photo on Facebook in 2015 of a young man who brought his mom from Saudi Arabia for a transplant.

Ochsner said in a statement that it was proud of its liver transplant program, which is the nation’s largest.  It said that it is willing to accept donated organs that other centers turn down for medical reasons, expanding its ability to help patients while keeping its survival rate high.  And it noted that the median waiting time for its patients is only 2.1 months, far below the national median.

“UNOS does not have any restrictions preventing transplant for international patients and they are subject to the same guidelines as domestic patients,” the statement said.

Still, many American candidates for livers don’t make Ochsner’s waiting list.  It refused to put Brian “Bubba” Greenlee Jr.  on its list right after Christmas in 2015, because of his “poor insight into his drinking and lack of proper social support,” his medical records show.  He had cirrhosis and died weeks later at age 45.

His sister, Theresa Greenlee-Jeffers, said Ochsner led her brother to believe that he would get a new liver.  Her brother had stopped drinking and she had volunteered to take care of him after a transplant, but then the hospital suddenly reversed course.

“His last Christmas, he was given false hope that he was going to get a transplant.  That’s not OK.  You don’t play with somebody’s emotions like that,” Greenlee-Jeffers said.

Ocshner did not answer questions about Greenlee’s care but said in its statement, “Not every patient is a candidate for transplant.” It said its criteria are similar to those of other liver transplant centers.

“At Ochsner, we are caregivers, dedicated to providing our patients with high-quality care, improved outcomes and the gift of a second chance at life,” its statement said.

Greenlee-Jeffers wonders if Ochsner excluded her brother and other Americans to make room for foreigners willing to pay more.  “It’s not OK,” she said.  “We need to take care of our people here at home first.  We don’t have enough of this to go around.”

CENSORSHIP - At a Public Health Journal?

"Sudden Shift at a Public Health Journal Leaves Scientists Feeling Censored" by Lisa Song, ProPublica 11/20/2017

Claiming overreach by a new publisher, the journal’s editorial board asks for disciplinary action from the National Library of Medicine.

For much of its 22-year existence, few outside the corner of science devoted to toxic chemicals paid much attention to the International Journal of Occupational and Environmental Health.

But now, a feud has erupted over the small academic publication, as its editorial board — the scientists who advise the journal’s direction and handle article submissions — has accused the journal’s new owner of suppressing a paper and promoting “corporate interests over independent science in the public interest.”

More is at stake than just the journal’s direction.

IJOEH is best known for exposing so-called “product defense science” — industry-linked studies that defend the safety of products made by their funders.  At a time when the Trump administration is advancing policies and nominees sympathetic to the chemical industry, the journal seems to be veering in the same direction.

“There are many scientists who work for corporations who are honest scientists,” said David Michaels, the former head of the federal Occupational Safety and Health Administration under President Obama.  “What we’re concerned about here is the ‘mercenary science’ … that’s published purely to influence regulation or litigation, and doesn’t contribute to public health.”

“I think the IJOEH articles were threatening to that whole industry,” said Michaels, now an environmental and occupational health professor at George Washington University.  While Michaels has never served on the journal’s editorial board, he has published an article in the journal and peer-reviewed others.

The journal was one of the relatively few places that provided an outlet for “scientists whose work is independent of the corporations that manufacture chemicals,” he said.  “The silencing of that voice would be a real loss to the field.”

Last Thursday, the journal’s 22-member editorial board, along with eight former board members and the journal’s founding editor-in-chief, wrote a letter to the National Library of Medicine requesting disciplinary action against the academic journal’s new publisher, Taylor & Francis Group.  In particular, they asked the Library of Medicine to rescind the journal’s listing in the Medline index, which could drastically reduce its scientific influence.

Academic journals are often judged by the reputations of those on their editorial boards, and this list includes a Columbia University dean, the president of the International Commission on Occupational Health and a scientist who helped establish the cancer classification system used by the International Agency for Research on Cancer.

UK-based Taylor & Francis, one of the largest publishers of academic journals, acquired IJOEH and 169 other journals in 2015 by purchasing the journal’s original owner and publisher, Maney Publishing.  According to the board’s letter, Taylor & Francis has done the following since taking over:
  • Selected a new editor-in-chief, Andrew Maier, without consulting the editorial board.  Board members said it’s “highly unlikely” that they would have approved of Maier.  Their letter said he had a tendency to reach scientific conclusions “highly sympathetic to parties with an economic interest in favorable outcomes,” which is at odds with the journal’s mission.
  • Withdrew a peer-reviewed article by the journal’s former editor-in-chief David Egilman that criticized Union Carbide Corporation’s efforts to oppose workers’ claims of asbestos exposure.  “Suppression of an accepted paper is a direct assault on academic freedom,” the board members wrote to the Library of Medicine.
  • Flagged three additional studies approved for publication under Egilman as “raising potential concerns,” according to a May 8 email the publisher sent to the board.
A Library of Medicine representative said they’re reviewing the board’s appeal.

Officials at Taylor & Francis declined to speak with ProPublica about the accusations in the letter and did not answer most of the questions we submitted in writing, referring us instead to two emails the publisher sent to the board in May.

In one, Ian Bannerman, manager director of Taylor & Francis Journals, insisted the company had no obligation to consult the board in choosing the journal’s new editor.  “The responsibility for selecting and appointing an Editor-in-Chief lies with Taylor & Francis as the owner of the journal,” he wrote.

In the other, Bannerman responded to a question from the board about the publisher’s plans for “repositioning” the journal by saying Taylor & Francis would aim to boost its online readership, citation levels and “rapidity of publication.”

“We do not see this as ‘repositioning’ the journal as such,” Bannerman wrote, “but we do see it as a change of tack — putting in place long-term plans and goals for the journal’s future development, enhanced by our expertise in marketing, online publishing, and bibliometric analysis.”

A Struggling Endeavor

Joseph LaDou, the founding editor-in-chief of IJOEH, launched the journal in 1995 after years of struggling to publish his own research.  While studying the health hazards of workers making microelectronics for Silicon Valley in the 1980s, he couldn’t find a single U.S. journal to take his paper, he said, and ended up publishing in a Scandinavian public health journal.  So when a Philadelphia-based publisher offered him a chance to start a journal for similar types of studies, he jumped on board.

The journal’s financial situation was always precarious.  LaDou said he put $50,000 to $75,000 of his own money into IJOEH each year.  Egilman, who became editor-in-chief in 2007, said he also paid out of pocket to keep the publication going.  (Both editors worked on the journal part time and earned their income from university positions or from private practice as occupational health experts).

One of the biggest expenses was paying for help writing and editing manuscripts from developing countries, LaDou said.  Among the international studies IJOEH published were a paper on how cooking fuel smoke affects respiratory health for women in Cameroon and another on a worker safety program for stevedores working in Cuba’s Port of Havana.

“I can’t think offhand of [another] pro-worker occupational safety and health journal,” LaDou said.  “Some are better than others — less controlled — but there’s nothing to replace what IJOEH was doing, particularly on an international scale.”

Most occupational health experts work for industry in some way because there’s little independent funding, said Celeste Monforton, an environmental and occupational health lecturer at Texas State University.  There are few academic positions, and the collapse of workers’ unions over the past few decades further decimated the number of labor-related jobs.

“There’s very little investment in occupational health research or looking at exposure to toxics,” said Monforton, who has never published in IJOEH or served on its board.  Most of what’s known about toxics comes from original research funded by the federal government in the 1970s and 1980s, when scientists could coordinate with unions to study large groups of workers, she said.

Those studies focused on long-known hazards such as benzene, asbestos or beryllium, setting the stage for stronger workplace regulations.  The results prompted a backlash from scientists working in “product defense,” who re-analyzed individual studies to conclude the product was less harmful than the government determined, Monforton said.

If journals are judged by the size of their readership, LaDou’s was a perpetual underdog.  “It was never a large subscription,” he said.  “You’re up against such a powerful machine in the industry-supported journals …  I think the reputation of the journal was that of a non-industry publication that was widely respected, but only by a small segment of the readership community.”

Taylor & Francis has finally figured out a way for this journal to make money, he alleged.  “By selling its soul.”

‘A Change of Tack’

In the first months after Taylor & Francis purchased the journal in June 2015, neither the editorial board nor its editor-in-chief noted a major change.

Then, in early 2016, former board member Barry Castleman learned the publisher hadn’t renewed Egilman’s editing contract, which expired in December 2016.

Taylor & Francis hired Maier in early 2017 without consulting board members for their input, as is customary for scientific journals.

Maier is an environmental health professor at the University of Cincinnati and runs a program for research fellows at TERA (Toxicology Excellence for Risk Assessment), a consulting firm that analyzes chemical safety.  TERA often works for industry clients such as the American Chemistry Council.  Concerns about its conflicts of interest gained national attention after President Trump nominated Michael Dourson, TERA’s founder, to lead the Environmental Protection Agency’s chemical safety program.

In 2010, Maier co-authored a study on the risks of diacetyl, a butter flavoring that can cause lung damage in workers.  Maier’s paper recommended an exposure limit of 200 parts per billion — up to 40 times higher than federal guidelines recommend.  Egilman criticized Maier’s results in a 2011 IJOEH paper for not being protective enough.  Maier has said that he has a research partnership with the federal scientists who suggested the lower limit.  “This ongoing close relationship …does not suggest that government parties find my work lacks scientific credibility,” Maier said in a letter to the board.

Egilman said he didn’t expect to continue as editor-in-chief once his contract expired, but he and the board should have helped choose the new editor.

The publisher disagrees.  Bannerman said Taylor & Francis sought advice from “a number of people we know in the field,” including one member of the IJOEH board.  Bannerman explained the conversation with the board member occurred before the publisher began considering Maier.

The dispute over Maier’s hiring was first reported by Retraction Watch, a publication that tracks retractions in the academic publishing world, which went on to publish several items about unrest at the journal this spring.

Maier didn’t respond to a request for comment, but he wrote to the editorial board in May to address their concerns.  He said more than 80 percent of his research funding comes from his university and the government.

“As for the future, I do not suggest any major changes in mission or scope of the journal,” he wrote.  “The same types of scientific articles should continue to find a home in IJOEH.”

‘In-House Review’

Taylor & Francis’ decision in March 2017 to withdraw Egilman’s paper, published about a year earlier, was just as controversial as appointing Maier — possibly more.

Journal publishers rarely interfere in editorial decisions, said Arthur Frank, an IJOEH board member and professor at Drexel University’s School of Public Health.

“I have never, ever been in a setting where the publisher, without engaging the editorial board, made a decision unilaterally to appoint a new editor, and also made decisions to retract an article,” he said.  “Publishers are in the business of printing the journal.  They’re not in the business of deciding what goes into the journal.”

Egilman’s paper critiqued consulting firms that conduct research that attempts to re-create historical worker exposure data for use in toxic tort litigation.  Such studies are expensive and are typically commissioned by companies to defend themselves in court, said Michaels, the former OSHA administrator.

Part of Egilman’s article examined a 2005 study co-authored by consultant Dennis Paustenbach, which simulated historical exposures to conclude that the workers who manufactured Bakelite (an asbestos-containing plastic) for Union Carbide would not have been exposed to asbestos levels that violated health guidelines.  Egilman also focused on Paustenbach’s role in promoting similar types of studies, pointing to a conference speech in which Paustenbach said they often made the difference between winning and losing court cases.

“My point was that OFTEN, litigation in the United States is scientifically unwarranted,” Paustenbach wrote in regards to his speech.  “When anyone is inappropriately accused of a wrongdoing, they deserve a defense …  We are only hired in cases that border on being ‘almost without foundation.’ So it is not surprising that most of our results show that the plaintiff claims are incorrect.”

While Egilman has served as an expert witness for plaintiffs injured by asbestos products — and is well-known for having leaked pharmaceutical company documents to a lawyer representing plaintiffs who alleged an antipsychotic drug gave them diabetes — he has also worked on the defense side.  In his paper’s disclosure, he said he consulted for Union Carbide in the company’s 1984 toxic gas leak that killed thousands of residents in Bhopal, India.

It’s unclear what prompted Taylor & Francis to withdraw Egilman’s paper.

Egilman provided ProPublica with a copy of an August 2016 email a Taylor & Francis employee sent to a third party that said Paustenbach “has been in touch to request that we retract Egilman’s critique article.” It was part of a longer email chain that discussed Paustenbach’s 2005 paper and Egilman’s 2016 paper.

In an email to ProPublica, however, Paustenbach denied requesting the retraction, and copied a Taylor & Francis manager in his response.  Paustenbach said the publisher began considering a withdrawal months before that August 2016 email, and that he had been primarily concerned with correcting falsehoods in Egilman’s paper.

“I have no axe to grind with Dr. Egilman,” Paustenbach said.  “I believe in the importance of a lively discussion of legitimate scientific facts or beliefs.  At times, I find that Dr.  Egilman doesn’t deal in facts …  Egilman’s article was so flawed as to be an embarrassment to any scientist; and perhaps that is why they did not publish it.”

ProPublica reached Sara Shuman, the journal’s former deputy editor who handled the paper’s submission process.  She said Egilman’s paper was peer reviewed by at least two scientists.  The journal uses a double-blind system to ensure that the author and peer reviewers don’t know each others’ identities, and Shuman acted as the intermediary.

Egilman was informed about the decision to withdraw his article in a March 2017 email from the publisher: “Due to an omission of oversight, the manuscript was not subject to our in-house review prior to its publication.  Subsequently we have reviewed the content, and decided to withdraw it from publication.”

In a May 25 email to the board, Bannerman, the Taylor & Francis director, said the paper “was inadvertently published before the review process was completed, and was subsequently decided to be unsuitable for publication.”

The publisher declined to define “in-house review” or comment further.

“We have said all that we can about our reasons for withdrawing this article,” a company spokesperson said.  The company publishes more than 2,500 journals, and our “role is to give the communities these journals serve a voice and a space to engage in debate about their research fields.  We do not have any strategy to align our titles to be for or against any particular agenda.”

Egilman said the publisher never contacted him to discuss their concerns.

Maier, the new editor-in-chief, told the board he wasn’t involved with the decision.  “I have no involvement or decision authority on any manuscripts that were accepted or published prior to my tenure with IJOEH,” he wrote in a letter.

Board members said the incident, compounded by what they considered the unsatisfying explanations for it, had spurred them to action.

“The idea of summarily withdrawing a paper that’s already been reviewed and published without any explanation is outrageous,” said Castleman, the former board member.  “The implication is there was some kind of horrible scientific conduct that must have happened.”

Pressing On

In addition to its complaint to the National Library of Medicine, the board has appealed to the Committee on Publication Ethics, a UK-based charity that sets journal ethics guidelines.

The board’s letter alleged instances in which Taylor & Francis violated COPE guidelines, including one that states, the “relationship of editors to publishers … should be based firmly on the principle of editorial independence.”

COPE’s co-chairman Chris Graf, director of research integrity and publishing ethics at a large journal publisher called Wiley, said COPE doesn’t comment on individual cases.  COPE has no regulatory authority and doesn’t conduct investigations, but can advise publications facing ethical issues.

On Thursday, the president of the Collegium Ramazzini, an international academy of occupational and environmental health experts, said his organization “strongly supports” the board’s letter to the Library of Medicine.  The academy is an invitation-only group of 180 scientists who work to bring public health research to policymakers.  Nearly half of the IJOEH board members are part of the academy, as are Michaels and Monforton.  The group also includes Linda Birnbaum, director of the National Institute of Environmental Health Sciences and former OSHA administrator Eula Bingham.  The organization is named after Bernardino Ramazzini, a 17th-century physician who’s often called the “father of occupational medicine.”

Taylor & Francis has offered to hold a teleconference with the editorial board, but Castleman said the board first wants more answers in writing.

“Had they been more forthcoming, we would have certainly been willing to talk to them,” he said.  “It’s very cumbersome trying to find a convenient time for so many people all over the world to agree to be available for such a conference.  I felt that they were just fobbing us off, stonewalling our plain questions.”

When ProPublica inquired about the status of the three other articles Taylor & Francis had considered withdrawing, the publisher said those studies “are no longer on hold and the authors are aware of their status” — but didn’t explain whether that meant the articles had been withdrawn.  Egilman said one of them was a separate article he wrote on Union Carbide, and that he withdrew that paper from IJOEH two months ago so he could submit it to another journal.  He said something similar had happened to another paper, about cigarette filters that contained asbestos.

Through the tumult, the journal has continued to publish, though the rate has slowed considerably this year.  The IJOEH website shows the journal publishes four issues a year, with 10 to 12 articles per issue.  Yet only five papers have been published in all of 2017.  Three of the five were approved by Egilman and the other two by Maier.  Both are about how employees’ mental health affects stress and well-being.

The journal’s “first full issue of 2017 will be published before the end of the year,” said a Taylor & Francis spokesperson, “with other issues to follow in early 2018.”

Monday, November 20, 2017

OPINION - Shields and Brooks 11/17/2017

"Shields and Brooks on sexual misconduct in politics, Republican tax goals" PBS NewsHour 11/17/2017


SUMMARY:  Syndicated columnist Mark Shields and New York Times columnist David Brooks join Hari Sreenivasan to discuss the week’s news, including allegations of sexual misconduct against and very different responses by Alabama Senate candidate Roy Moore and Sen. Al Franken, President Trump’s criticism of Franken despite his own history being accused by women, plus the GOP tax plans.

Hari Sreenivasan (NewsHour):  But first to the analysis of Shields and Brooks.  That’s syndicated columnist Mark Shields and New York Times columnist David Brooks.

It’s a bit like Groundhog’s Day here.  We’re going the cover some topics you probably have never thought of before, sexual harassment and taxes.  But there are developments, after more and more developments of both of these stories.  And we will get to some more stuff, too.

But this week, we saw new women coming out and alleging sexual misconduct by Roy Moore, some of them underage.  And then we had Al Franken’s behavior in 2006, including a disturbing photograph that nobody can deny.

They are not parallel incidents, but the responses have been very different.

David Brooks, New York Times: Yes, I mean, I guess it’s inevitable, death, taxes, and harassment these days.

It seems to me the one failure that we’re seeing among a lot of people is how partisan the reaction would be, starting with the President.  Sexual harassment is not a Republican thing, or it’s not a Democratic thing.  It’s just a thing.  And it’s amazing how many people are reacting depending on which party the person is in, the guy is in, how their reaction is.

I personally, overall, still think this is a good thing.  Our standards are raising.  People who have done misconduct are being punished, an we’re cleaning out the swamp, as they — we’re supposed to say.

Alongside that, I think it’s important to make some distinctions among the different levels of sin here.  It seems to me what Harvey Weinstein did and what Roy Moore did has the highest level of vileness, and should be career-enders.

Then there are other levels of sin which probably should be career-enders, setting a predatory environment, whether it’s Bill Clinton or the guy — some of the journalists who have been involved.

And then I would put Al Franken so far in a different category, frankly.  What he did was callous and narcissistic and insensitive and just pathetic.  But if it’s one time, and if he can apologize, and then do real penance, my first instinct is that it shouldn’t be a career-ender for him.

Hari Sreenivasan:  But, Mark, oftentimes it’s not one time.  Oftentimes, we start to reveal a pattern of behavior that might be in the background, as more people feel empowered to speak up.

Mark Shields, syndicated columnist:  No, and that’s what we have found so far in these instances.  It’s not usually a single, solitary event.

But I think David makes a very persuasive point about what we have with Roy Moore, quite frankly, the reaction, in the opening news summary, when the governor, Kay Ivey, of Alabama says she has no reason not to believe the women, but she’s still going to vote for Roy Moore.

Now, there is a disconnect there.  And the only explanation can be just blind, unyielding, total partisanship, and I don’t care.

Let’s be very blunt about it.  There were feminists who rallied to Bill Clinton’s support during his long, complicated lying to the American people about a disproportionate power relationship that he had with a 21-year-old intern and adulterous behavior, who rallied to his support because Bill Clinton was pro-choice on abortion.

And there are those now who are ready to skewer Roy Moore — and I’m not going to deny that he needs skewering — for ideological reasons, and because he has proved he’s anti-woman by his political positions.

But if we’re just talking about behavior here, and not blind partisanship, I don’t think that Al Franken’s behavior rises to the level of eviction from the Senate or anything of the sort.

That is not — but for a party that has based an awful lot of its appeal on identity politics, that we are the women’s party, that we believe in women’s rights, that we respect women, and that Republicans don’t, this is a body blow.

And Al Franken has been a major fund-raiser for Democrats, and he has been an aggressive inquisitor on committees and — representing the Democrats.  So, I think it is serious.

I don’t know where it’s going to stop, and — but I think, in the final analysis, we have to come to grips.  It is power.  And it’s been men exercising power, generally speaking, with — almost overwhelmingly speaking, and the women in the position of supplicant, without the resources, without the means of protesting or just bringing to justice to these people.

David Brooks:  If I could add one thing on the — first on the Clinton thing, I think it’s — we just have to look back and say the people who ignored the testimony of Kathleen Willey and Juanita Broaddrick helped set the stage for this.

And the Democrats who defended Clinton in those Clintons, they helped set the atmosphere for what we’re seeing and for the behavior that Harvey Weinstein and the rest can get away with.

The second thing to be said is, there is a word for what defenders of Roy Moore are doing, the people who said they were vote for him nonetheless, and — well, two words.  One word is idolatry, and the other word is heresy, because the people who are putting — who are going to sacrifice morality for politics are making an idol out of politics.

They’re saying politics is higher than morality.  And no honest person can possibly believe that.  And if you’re putting politics above personal morality, above the way we treat each other, above the nature of your own soul, you’re just — you’re making an idol out of it.

And that is the ultimate in heresy.  And to see — I saw a tweet from Franklin Graham, Billy Graham’s son, defending Moore, you know, sort of, oh, they’re all a bunch of hypocrites up there.

It’s just appalling.  It’s just — it’s almost mind-boggling that people who — especially people who have been steeped in any faith could make this kind of fundamental error, which is warned against again and again in the Bible, and to be heretics.  They’re heretics.
Hari Sreenivasan:  Let me ask you if you are surprised about something else that’s happened this week, which is the progress of the Republican tax plan.  Do you think that it — what do you think happens in the Senate?

Mark Shields:  I would say, first of all, I think that Paul Ryan, whom I have criticized, certainly did perform as speaker.  He got it through.  He rallied his Republicans, mostly, to it.

There’s just a couple things about it.  I have been going to Republican Conventions since 1976.  I have heard the party time and again solemnly pledge in its compact and covenant with the American people that we will support and fight for a balanced budget constitutional amendment.

I hope that never appears again, because they have proved that they don’t care about that.  All this tax cut is about, this tax thing, is cutting the corporate rate from 35 percent to 20 percent.  That’s all it is.

Everything else is window dressing.  And there are other factors to it that are important, that touch people’s lives.

And, usually, when there’s a tax cut, there is some behavior is required.  For a charitable deduction, you have to give — make a donation to a charity.  For a child care credit, you have to have a child, and there has to be some — there is nothing required of these corporations.

There is not a nickel they have to spend in investment.  There’s not a nickel they have to spend in retraining.  There’s not a nickel they have to spend in anything for their own workers.

And the idea that they’re going to pass this on and increase wages goes back to John Galbraith’s theory of economics, which is, if you stuff enough oats into the horse, that, eventually, a little will pass through to the road, and the sparrow will be fed.  And I just find it absolutely mind-boggling.

And the only other aspect to it that I found fascinating is the Republican Party that has stood for states’ right, and the states that have actually taxed themselves to improve their education and to improve their health care are going to be punished.

Hari Sreenivasan:  Yes.

Mark Shields:  That’s been in the tax code since 1913 that it was inducted.  They’re going to remove it.

Hari Sreenivasan:  So, David, that analogy of trickle-down economics, I have not heard before.

David Brooks:  Still following the biology of that thing.


David Brooks:  No, I wish it was only a corporate tax cut, because I think there’s a lot of good economic evidence that, if you give corporations tax cuts, they have more cash on hand, they do invest, and that there’s a fair bit of data on this.  And so I wish it were that.

And I think there are other good things in the bill.  Capping the mortgage interest deduction is a good thing.  I think maybe adjusting the state and local taxes is a good thing, because 90 percent of the benefit goes to people making over $100,000 a year.

The problem with it is, first, it explodes the deficit.  Second, it is a raw piece of political exploitation, taking the tax code and benefiting our people, at the expense of blue states.  And we shouldn’t turn the tax code into a spoils system.

And, third, it’s taxes the universities and the nonprofits in a way that I think is unconscionable.  So, I’m against it.  But there are some good things in it.  If they fell back to a corporate tax cut, which had sympathy in the Obama administration, it would be a little happier story.


"How Microsoft’s CEO has ‘hit refresh’ in business and in life" PBS NewsHour 11/17/2017


SUMMARY:  What are the hard questions that CEOs need to grapple with in order to renew and rethink business?  Microsoft CEO Satya Nadella joins Judy Woodruff to discuss his new book, “Hit Refresh,” as well as how he’s learned empathy from being a parent, changes to his perceptions of gender and opportunity and his advocacy for immigrants.

WAR ON ISIS - The Body Count

"Report finds disparities in civilian deaths from U.S.-led ISIS bombing campaign" PBS NewsHour 11/17/2017


SUMMARY:  U.S. bombing played a major role in driving the Islamic State group from cities in Iraq and Syria.  But a report by The New York Times finds that thousands more civilians were killed in those bombing runs than originally admitted by the Pentagon.  Hari Sreenivasan learns more from investigative reporter Azmat Khan.

TAX PLAN - The Republican Grift

  • Noun
  • grift (plural grifts)
  • A confidence game or swindle.
"Who really benefits from GOP’s tax overhaul is battle point as House passes its bill" PBS NewsHour 11/16/2017


SUMMARY:  It's a big step for Republicans' tax overhaul plans, the House voted 227 to 205 to pass its version of the bill.  While a new analysis suggests that the plans would increase taxes for middle and lower-income Americans, Republicans deny that idea.  Lisa Desjardins reports and Judy Woodruff gets perspectives from Rep. Kevin Brady (R-Texas) and Rep. Lloyd Doggett (D-Texas).

TRUMP ADMINISTRATION - Get Ready for 'Trump Network News' 24/7

"How new FCC rules could affect your local news" PBS NewsHour 11/16/2017

aka "Get Ready for State Media (like North Korea)"


SUMMARY:  Longstanding rules that prevented an individual or company from owning broadcast stations and newspapers in the same local market have been abandoned by the FCC.  The sweeping changes come amid wider transformations in the media and digital landscape, and have raised concerns about their impact.  Hari Sreenivasan talks to Keach Hagey of The Wall Street Journal.

TRUMP AGENDA - Consequences of 'America First'

"What limiting foreign trade would mean for the U.S. economy" PBS NewsHour 11/16/2017

My answer, Make America Economic Looser.


SUMMARY:  President Donald Trump ran on a campaign promise that he would “put America first” by pulling out of multilateral trade agreements.  But for many top industries, outsourcing in the global market is essential for business, not to mention vital to Americans’ standard of living.  Is it feasible in the 21st century for America to go it alone?  Economics correspondent Paul Solman reports.

PBS NEWSHOUR - Remembering Gwen, One Year Later

"The words of Gwen Ifill that inspire us every day" PBS NewsHour 11/14/2017


SUMMARY:  Gwen Ifill, an essential member of our NewsHour family, our journalistic North Star, a leader both on-air and off, died one year ago Tuesday.  We remember her with a conversation she had with friend and journalist Michele Norris in 2014.

NEWSHOUR BOOKSHELF - “Where The Past Begins: A Writer’s Memoir”

"How Amy Tan’s family stories made her a storyteller" PBS NewsHour 11/14/2017


SUMMARY:  Amy Tan was going to write a book about writing.  But what came to her mind instead were memories of childhood, reflections on family treasures, photos, documents.  In “Where The Past Begins: A Writer’s Memoir,” Tan explores revelations about her family and how her experiences steered her toward a life as an author.  Tan joins Jeffrey Brown for a conversation.

The Joy Luck Club - Trailer

LAB WORK - After School Club, Rhode Island

"After-school STEM programs inspire kids to keep learning" PBS NewsHour 11/14/2017


SUMMARY:  At an after-school STEM Club in Rhode Island, students are working on an engineering challenge -- because they want to be.  The low-stakes, fun environment offers time for exploration when resources or hands-on activities may be in short supply during school hours, and can help sustain interest as classes get harder.  Special correspondent Lisa Stark of Education Week reports.

NUCLEAR OPTION - Trump Danger?

"Congress questions commander-in-chief’s sole nuclear authority" PBS NewsHour 11/14/2017


SUMMARY:  Senators raised concerns about President Trump's power to launch a nuclear war in a hearing on Tuesday.  U.S. law has long dictated that only a President should carry the responsibility, but that singular authority is now being questioned.  Nick Schifrin takes a look at Congress’ worries and the history of the nuclear command structure.

Nick Schifrin (NewsHour):  The President has the sole authority to launch nuclear weapons.  But that doesn’t mean he can launch a weapon for no reason, whenever he wants, said Duke Professor Peter Feaver, who studied nuclear command for 30 years.

Peter Feaver, Duke Professor:  Where the military wakes up the President and warns him that there is about to be an attack, or that we’re experiencing an attack, he alone would have the authority to make the decision.

But in the other context, where the President is waking up the military, maybe in an extreme funk, saying, I’m angry and I want something done, in that setting, he requires the cooperation of a lot of people.

Nick Schifrin:  That cooperation wouldn’t be forthcoming if his order were illegal, said retired General Robert Kehler, the former head of U.S. Strategic Command.

Gen. Robert Kehler:  The United States military doesn’t blindly follow orders.  A presidential order to employ U.S. nuclear weapons must be legal.  The basic legal principles of military necessity, distinction, and proportionality apply to nuclear weapons, just as they do to every other weapon.

Nick Schifrin:  Maryland Democrat Ben Cardin-

Sen. Ben Cardin:  Do you believe that under — because of legalities, you retain that decision to disobey the commander in chief?

Gen. Robert Kehler:  Yes.  If there is an illegal order presented to the military, the military is obligated to refuse to follow it.

This is something that civilians fail to understand.  Being retired military myself, I know that military personal are obligated to follow all "legal" orders from superiors, BUT are just as obligated to refuse to execute illegal orders (even with the consequences that may come).

U.S. military personal are not robots where anyone can just 'press a button' and say 'kill.'

UCMJ Article 892 - Failure to obey order or regulation

(1) violates or fails to obey any lawful general order or regulation;

(2) having knowledge of any other lawful order issued by a member of the armed forces, which it is his duty to obey, fails to obey the order; or

(3) is derelict in the performance of his duties;

shall be punished as a court-martial may direct.

(Aug. 10, 1956, ch. 1041, 70A Stat. 68.)

ALABAMA GOP - The Albatross Roy More

IMHO:  I find it typical that people tend to disbelieve women who make such allegations against men.  It's the chauvinistic prejudice of a male society.  The women's allegations are credible and Roy More's denial typical.

As for the timing, it's the #MeToo movement that has freed women to face their attackers, which is never easy, the strength given by the numbers.

"GOP candidate Roy Moore faces new allegations, new pressure to quit Senate race" PBS NewsHour 11/13/2017


SUMMARY:  The Senate's top Republican Mitch McConnell told reporters that he believes the women who have accused Roy Moore of inappropriate actions and that Alabama's GOP candidate must step aside.  While the former state Chief Justice insists he is innocent, McConnell’s condemnation comes as another woman has spoken up.  Lisa Desjardins reports that voters appear to have mixed opinions.

Full announcement (34:21)

"What Alabama voters think of the Roy Moore assault allegations" PBS NewsHour 11/13/2017


SUMMARY:  Another woman came forward on Monday to accuse Senate candidate Roy Moore of assaulting her when she was 16, sparking additional political backlash from his own party.  But allegations of sexual misconduct against teenage girls haven’t seemed to shake Moore supporters in his home state.  Judy Woodruff gets an update from Don Dailey of Alabama Public Television.

"The predicament of the Alabama Senate race for Republicans" PBS NewsHour 11/15/2017


SUMMARY:  GOP lawmakers have called for Roy Moore to step aside from the Alabama Senate race amid allegations of sexual misconduct toward teens.  How does that tension fit into a larger party rift?  John Yang talks to Matt Schlapp of the American Conservative Union and Karine Jean-Pierre of MoveOn.org, about what’s at stake with the special election and how the GOP tax reform plans are shaping up.

GREECE - The Brain Drain

"Brain drain and declining birth rate threaten the future of Greece" PBS NewsHour 11/13/2017


SUMMARY:  Seven years since the financial crisis shook Greece, many young people lack opportunity or hope for the future.  Austerity and financial insecurity have pushed the birthrate to all-time lows, and members of the younger generations are leaving Greece for better opportunities elsewhere, leaving experts worried about Greece’s very existence.  Special correspondent Malcolm Brabant reports.

PS:  Note the cats. 😉

Friday, November 17, 2017

RACE IN AMERICA - Walking While Black

"Walking While Black" by Topher Sanders and Kate Rabinowitz (ProPublica) and Benjamin Conarck (Florida Times-Union), ProPublica 11/16/2017

THE JACKSONVILLE SHERIFF’S OFFICE issues hundreds of pedestrian citations a year, drawing on an array of 28 separate statutes governing how people get around on foot in Florida’s most populous city.  There is, of course, the straightforward jaywalking statute, barring people from crossing against a red light.  But in Jacksonville, pedestrians can also be ticketed for crossing against a yellow light, for “failing to cross a street at a right angle,” for not walking on the left side of a road when there are no sidewalks, or alternatively for not walking on a sidewalk when one is available.

The sheriff’s office says the enforcement of the full variety of pedestrian statutes is essential to keeping people alive in a city with one of the highest pedestrian fatality rates in the nation.  The office also says the tickets are a useful crime-fighting tool, allowing officers to stop suspicious people and question them for guns and or drugs.

However, a ProPublica/Florida Times-Union analysis of five years of pedestrian tickets shows there is no strong relationship between where tickets are being issued and where people are being killed.  The number of fatal crashes involving pedestrians, in fact, climbed every year from 2012 to 2016, the most recent years for which complete data is available.

What the analysis does show is that the pedestrian tickets — typically costing $65, but carrying the power to damage one’s credit or suspend a driver’s license if unpaid — were disproportionately issued to blacks, almost all of them in the city’s poorest neighborhoods.  In the last five years, blacks received 55 percent of all pedestrian tickets in Jacksonville, while only accounting for 29 percent of the population.  Blacks account for a higher percentage of tickets in Duval County than any other large county in Florida.

Blacks, then, were nearly three times as likely as whites to be ticketed for a pedestrian violation.  Residents of the city’s three poorest zip codes were about six times as likely to receive a pedestrian citation as those living in the city’s other, more affluent 34 zip codes.

Tickets for some of the less familiar statutes were issued even more disproportionately to blacks.  Seventy-eight percent of all tickets written for “walking in the roadway where sidewalks are provided” were issued to blacks.  As well, blacks accounted for 68 percent of all recipients of tickets issued for “failing to cross the road at a right angle or shortest route.”

John Fitzgerald Kendrick, a truck driver, got out of his truck after encountering Jacksonville sheriff’s officers in April of 2015.  Once out of his truck, he was immediately ordered to the ground by an officer, who pointed a Taser gun at him.  He was arrested and issued a ticket for “walking in the roadway where sidewalks are provided.” Kendrick fought the ticket and it was dismissed by a judge.

Brianna Nonord, 13, wound up in handcuffs and detained by an officer that same month in 2015 after she walked away from an officer trying to write her a ticket for having “failed to cross in a crosswalk” on her way home from school.

Maurice Grant, a lawyer with the federal public defender’s office, was walking near the federal courthouse in May of 2016 when he was cited for crossing against a red light.

The ProPublica/Times-Union analysis also found that the sheriff’s office had issued hundreds of erroneous tickets for crossing the street while not in a crosswalk.  The mistakes, identified by a detailed ProPublica/Times-Union review of the locations where the tickets were given, appear to have resulted from a misunderstanding of the statute on the part of the sheriff’s officers.  The often misapplied crosswalk statute accounted for more tickets than any other, and again, blacks were over-represented in that category of ticket.

In interviews, the sheriff’s department’s second-in-command, Patrick Ivey, said any racial discrepancies could only be explained by the fact that blacks were simply violating the statutes more often than others in Jacksonville.

“Were the citations given in error?” Ivey asked.  “I have nothing to suggest that.  Were they given unjustified?  I have nothing to suggest that.”

In response to the ProPublica/Times-Union findings, Sheriff Mike Williams said, “Let me tell you this: There is not an active effort to be in black neighborhoods writing pedestrian tickets.”

Ivey said stopping people for pedestrian violations as a means for establishing probable cause to search them was also fully justified.

“Shame on him that gives me a legal reason to stop him,” Ivey said.

Lots of police agencies across the country in recent years have been found to have improperly targeted African Americans and other minorities.  The New Jersey State Police profiled minority drivers on the state’s highways.  The New York Police Department’s policy of stop-and-frisk was declared unconstitutional by a federal judge after statistics showed minorities, while making up half the city’s population, accounted for 83 percent of all such encounters with police.  Similar issues with stop-and-frisk practices have surfaced in Milwaukee, Philadelphia and Los Angeles.

Thursday, November 16, 2017

ROBOTS TODAY - What's New Atlas

I know you've seen a robot walk, but have you ever seen one do a backflip?

Monday, November 13, 2017

OPINION - Shields and Brooks 11/10/2017

"Shields and Brooks on Roy Moore's political future, Democrats' Virginia victory" PBS NewsHour 11/10/2017


SUMMARY:  Syndicated Columnist Mark Shields and New York Times columnist David Brooks join Judy Woodruff to discuss the week's news, including accusations that Judge Roy Moore pursued relationships with teens and had sexual contact with a minor decades ago, a wave of Democratic victories in statewide elections, including the Virginia governor's race, and the larger trends facing both parties.

SOUTH AFRICA - Monuments of the Past

"South Africa grapples with contentious reminders of apartheid" PBS NewsHour 11/10/2017


SUMMARY:  Protests in South Africa over a statue of a 19th century diamond magnate and colonial conqueror set off a national debate two years ago about the remnants of apartheid?  As part of his ongoing series, Culture at Risk, Jeffrey Brown reports on the symbols and monuments in South Africa's past that are still being fought over today.

COMBAT PHOTOGRAPHY - Veterans Portrait Project

"Portraits of veterans show us what service looks like" PBS NewsHour 11/10/2017


SUMMARY:  After 10 years as an Air Force combat photographer, Stacy Pearsall sustained an injury that ultimately ended her career.  While receiving medical treatment, she picked up her camera again in order to capture the diversity of the nation's military service members.  Pearsall shares the healing process she experienced in creating the "Veterans Portrait Project."


"This journalist documents forgotten horrors that most news misses" PBS NewsHour 11/9/2017


SUMMARY:  When journalist Anjan Sundaram traveled to Rwanda in 2009, he encountered a repressive government that targeted and imprisoned the journalists he worked with.  His experience opened his eyes to the courage needed to report on the stories and people that can easily hide from the world's collective consciousness.  Sundaram offers his Brief but Spectacular take on covering the forgotten.

FOOD - Where's the Beef (updated)

"Can these mock meat entrepreneurs fool you with a plant-based burger?" PBS NewsHour 11/9/2017


SUMMARY:  As attitudes toward meat-eating shift and climate-conscious consumers experiment with alternatives, investors are throwing their money at mock meat startups that are replicating the smell and texture of a meaty burger.  Economics correspondent Paul Solman explores the emerging technology that might help Americans wean off of their meat habit.

Well, I tried this 'mock beef.'  IMHO, not even close.

NEWSHOUR BOOKSHELF - "You Can't Spell America Without Me"

"When Alec Baldwin plays the president, Trump 'is the head writer'" PBS NewsHour 11/9/2017


SUMMARY:  Alec Baldwin first played then-candidate Donald Trump in October 2016 and assumed the parody would last until the election, but the actor continues to be a recurring guest on Saturday Night Live and an outspoken critic of the President.  Baldwin sits down with Jeffrey Brown to discuss his book, “You Can't Spell America Without Me,” a memoir in which he takes on Trump's voice in a different way.

Jeffrey Brown (NewsHour):  You’re not shy about your own politics.  You’re sort on of the opposite of him on almost every issue.  So should we see this as kind of a political act?

Alec Baldwin, actor:  That’s a fair point, if we were doing a lot of writing.

Trump is the head writer of “SNL” himself.  Nearly 90…

Jeffrey Brown:  In what sense?

Alec Baldwin:  Well, nearly 90 percent of what we say and do are verbatim transcriptions of what Trump has said.  We don’t really have to go very far to find the material.  Trump himself is just spewing it out on a daily basis or a weekly basis.

So it’s not about politics meaning I’m misstating or misquoting things that he said and did.  That’s one of the jokes we told is that Trump would say how he hates the media, and he hates NBC and he hates “SNL,” because I say things, and they repeat it right back to the public, he would say.  They repeat all the things I say.

Of course he’s tormented by the fact that we repeat all the things that he says.

TAX PLAN - Senate vs House

"GOP gears up for intense tax battle as Senate debuts plan" PBS NewsHour 11/9/2017


SUMMARY:  Republicans pushed ahead on their plan for a tax overhaul, with two major developments.  The House Ways and Means Committee passed its sweeping tax bill, while the Senate released their own version.  Lisa Desjardins sits down with Judy Woodruff to discuss how the two bills compare, which GOP senators aren't yet convinced and how Democrats are reacting.

"Outgoing IRS chief 'deeply concerned' about cuts to already strained agency" PBS NewsHour 11/9/2017


SUMMARY:  IRS Commissioner John Koskinen has been a lightning rod for Republican lawmakers who have called for his impeachment and criticized the agency he's been running since 2013.  As one of the last Obama administration holdovers, he'll complete his term this Sunday.  Koskinen sits down with Judy Woodruff to discuss the strains on the IRS and President Trump's controversial tax returns.

GUNS IN AMERICA - Background Checks

"How gun background checks work — and when they don't" PBS NewsHour 11/7/2017


SUMMARY:  New information about the Texas shooter's past behavior reveals he was able to bypass a patchwork of gun laws and purchase the weapon he used to kill 26 people on Sunday.  William Brangham breaks down the complicated landscape of our nation's gun laws.

"Closing gun background check loopholes may be 'common cause' for Democrats and Republicans, says Sen. Chris Murphy" PBS NewsHour 11/7/2017


SUMMARY:  Sen. Chris Murphy (D-Conn) has been one of the most vocal advocates for reforming gun laws since the Sandy Hook tragedy in his own state.  As more becomes known about the man behind the massacre at a Texas church, lawmakers from both sides of the aisle are looking at the background check system, which critics think is broken.  Murphy joins Judy Woodruff to discuss reforms.

TEXAS - Church Murders

"Texas community that's tight-knit 'like family' reels from church murders" PBS NewsHour 11/6/2017


SUMMARY:  The First Baptist Church in the small town of Sutherland Springs was the site of the largest mass shooting in Texas history on Sunday.  Twenty-six-year-old Devin Kelley opened fire during services, killing 26 people and wounding 20.  John Yang speaks with Joey Palacios of Texas Public Radio and Rep. Henry Cuellar (D-Texas) about the how the community is reeling and the investigation into the shooter.

"How are mass killings and domestic violence linked?" PBS NewsHour 11/6/2017


SUMMARY:  The man who shot and killed dozens at a Texas church had been convicted of assaulting his wife and a child, and he may have been motivated by a "domestic situation," say officials.  The latest tragedy underscores a link between mass killings and domestic violence.  John Yang talks with Deborah Epstein of the Georgetown Law Domestic Violence Clinic and James Fox of Northeastern University.

"How the Texas church massacre victims are being remembered" PBS NewsHour 11/8/2017


SUMMARY:  The victims of a deadly church shooting included a grandmother who shielded her grandson from the attack, a cancer survivor and a couple who were visiting the church for the first time.  We remember eight of the victims through the words of their loved ones.


"Trump Recycles Flawed Gun Talking Point" by Robert Farley, FactCheck.org 11/8/2017

President Donald Trump has once again misused the example of Chicago to make a case against gun regulations.

Despite what the president claims, Chicago does not have “the strongest gun laws in our nation.”  It once did, but the laws that gave it that distinction have since been rescinded.  And a spike in homicides occurred after those laws were changed.

Trump also called Chicago “a disaster.”  That's an opinion, but it's worth noting that other cities – some with less stringent gun laws – have higher rates of gun violence.

Experts also warn against cherry-picking cities to score political points, as examples can be found to fit arguments on either side.  They also note that Chicago, which has stricter laws than most cities, is bordered by states that have relatively lax gun laws.  And there is some evidence that most of the guns confiscated from crimes in Chicago come from out of state.

Finally, as we have written before, there is no evidence that gun control laws result in higher murder rates.  In fact, studies suggest the opposite: States with a higher number of firearm restrictions have lower firearm deaths.  But there is only an association between gun control laws and firearm deaths, not a causal relationship, studies show.

Trump's latest comment about Chicago gun crime came when he was asked if he would consider any gun control policies in the wake of the mass shooting at a Texas church on Nov 5.

“I mean, you look at the city with the strongest gun laws in our nation, is Chicago, and Chicago is a disaster,” Trump said during a press conference in Korea on Nov 7.  “It's a total disaster.”

This is a longstanding talking point for Trump, who tweeted in July 2014:

Trump made the same point during the third presidential debate, saying: “In Chicago, which has the toughest gun laws in the United States, probably you could say by far, they have more gun violence than any other city.”

White House Press Secretary Sarah Huckabee Sanders made a similar claim during a press briefing on Oct.  2 after the Las Vegas mass shooting.  “I think if you look to Chicago, where you had over 4,000 victims of gun-related crimes last year, they have the strictest gun laws in the country,” Sanders said.  “That certainly hasn't helped there.”

Here are some facts about gun violence in Chicago and what they say, and don't say, about the role of gun control.

Does Chicago Have 'the Strongest Gun Laws in Our Country'?

Chicago used to have what some considered to be the toughest gun laws in the country.  But not anymore.

In 2010, the U.S. Supreme Court struck down Chicago's handgun ban.  In the year before the court's ruling, Chicago's murder rate in 2009 was 16.1.  The city with the highest murder rate that year was New Orleans at 51.7 murders for every 100,000 people.

And in 2013, Chicago also abolished its requirement that gun owners register their weapons.  The move was made to come into compliance with the state's court-mandated concealed carry law.

“Chicago does have strong municipal laws, but we wouldn't say it has the strongest gun laws in the country, because the strongest regulations in Chicago have been largely implemented by entire states, including New York and California,” Hannah Shearer, a staff attorney and Second Amendment litigation director at the Giffords Law Center to Prevent Gun Violence, told us via email.  “In contrast, the state of Illinois has significantly weaker laws than New York and California, including a shall-issue concealed carry permit system.”

The Law Center to Prevent Gun Violence gave a B+ grade to Illinois in its latest “Gun Law State Scorecard.”  Seven states had a higher grade.


It's true that the total number of murders in Chicago spiked in 2016.  The number of murders recorded that year — 764 — was nearly 58 percent higher than in 2015.  In raw numbers, that was higher than any other major city in the U.S., according to data from the Major Cities Chiefs Association.

But the murder rate in Chicago wasn't the highest.

The per-capita murder rate in Chicago – the number of homicides per 100,000 residents – was 27.9 in 2016.  That's half the rate recorded by St. Louis, at 59.3, which saw 188 murders in 2016.  Among major cities, Chicago's rate was eighth highest in 2016.  (Ninety-three percent of the murders in the city that year involved firearms.)

And again, those high tallies in 2016 came after Chicago did away with its gun registry and ban on handguns.

It should also be noted that the number of homicides in Chicago is trending down so far this year.  According to the Sun-Times, there were 580 homicides in the first 10 months of 2017, down 10 percent from the 644 homicides recorded during the same period in 2016.

Shootings and homicides in Chicago “are still high by urban American standards right now, but the trend appears to be downward,” John Pfaff, a professor of law at Fordham Law School, told us via email.  “There's still two months in the year, but that pushes back against the 'disaster' story.”

Guns Coming from Outside Chicago

Shearer also notes that “Chicago is vulnerable to guns coming in from neighboring states.  A few states bordering Chicago, such as Indiana, have extremely weak gun laws.

A 2017 gun trace report from the Chicago Police Department found that since 2013 the “overwhelming majority” of recovered “crime guns” that were traceable “were originally purchased outside of the city limits and brought into Chicago.”  And the majority were from other states.

Pfaff added the caveat that police could only trace 12,500 of the 28,000 guns seized during the study period, so the origin of most guns could not be determined.

Still, the report suggests that many of the guns used in Chicago crimes come from outside the city — watering down the effectiveness that any local gun laws might have.  And so experts warn it would be unwise to draw definitive conclusions, as the president did, about the effectiveness of gun control efforts in Chicago.

“That is a silly argument,” David Hemenway, director of the Harvard Injury Control Research Center, told us via email.  “That would be similar to someone arguing that pest control doesn't work with an example where only one kitchen is treated in an apartment complex filled with cockroaches.  Chicago is surrounded by easy places for criminals to get guns.  …  There are lots of places where gun control (and pest control) has a much better chance to work and does work.”

Do Stricter Gun Laws Lead to Higher or Lower Homicide Rates?

As for the President's implication that stricter gun laws either don't work or lead to higher rates of homicide, studies suggest that's not the case.  In fact, they show an association, but not a proven causal relationship, between strict gun laws and lower rates of gun violence.

According to the Law Center to Prevent Gun Violence scorecard, seven states graded as having the strongest gun laws also were among those with the lowest gun death rates.

And as we have written before (on several occasions), several studies have shown that states with a higher number of firearm restrictions have lower firearm deaths.  But there is only an association between gun control laws and firearm deaths, not a causal relationship, studies show.  In other words, the studies do not prove that the stricter laws are responsible for lower homicide rates.

It's misleading for Trump to cite Chicago as evidence that gun control laws don't reduce gun violence.  Chicago no longer has “the strongest gun laws in our nation,” and it doesn't have nearly the highest homicide rate among major cities.  Most traceable guns recovered from crimes also come from outside the city limits.

SATIRE - The Trump Presidency

Last Week Tonight with John Oliver (HBO)

Tuesday, November 07, 2017

AMERICA - Addicted to Guns

"What Explains U.S. Mass Shootings?  International Comparisons Suggest an Answer" by Max Fisher and Josh Keller, New York Times 11/7/2017

When the world looks at the United States, it sees a land of exceptions:  a time-tested if noisy democracy, a crusader in foreign policy, an exporter of beloved music and film.

But there is one quirk that consistently puzzles America's fans and critics alike.  Why, they ask, does it experience so many mass shootings?

Perhaps, some speculate, it is because American society is unusually violent.  Or its racial divisions have frayed the bonds of society.  Or its citizens lack proper mental care under a health care system that draws frequent derision abroad.

These explanations share one thing in common:  Though seemingly sensible, all have been debunked by research on shootings elsewhere in the world.  Instead, an ever-growing body of research consistently reaches the same conclusion.

The only variable that can explain the high rate of mass shootings in America is its astronomical number of guns.

What Explains Mass Shootings

The top-line numbers suggest a correlation that, on further investigation, grows only clearer.

Americans make up about 4.4 percent of the global population but own 42 percent of the world's guns.  From 1966 to 2012, 31 percent of the gunmen in mass shootings worldwide were American, according to a 2015 study by Adam Lankford, a professor at the University of Alabama.

Adjusted for population, only Yemen has a higher rate of mass shootings among countries with more than 10 million people — a distinction Mr. Lankford urged to avoid outliers.  Yemen has the world's second-highest rate of gun ownership after the United States.

Worldwide, Mr. Lankford found, a country's rate of gun ownership correlated with the odds it would experience a mass shooting.  This relationship held even when he excluded the United States, indicating that it could not be explained by some other factor particular to his home country.  And it held when he controlled for homicide rates, suggesting that mass shootings were better explained by a society's access to guns than by its baseline level of violence.

What Doesn't:  Crime, Race or Mental Health

If mental health made the difference, then data would show that Americans have more mental health problems than do people in other countries with fewer mass shootings.  But the mental health care spending rate in the United States, the number of mental health professionals per capita and the rate of severe mental disorders are all in line with those of other wealthy countries.

A 2015 study estimated that only 4 percent of American gun deaths could be attributed to mental health issues.  And Mr. Lankford, in an email, said countries with high suicide rates tended to have low rates of mass shootings — the opposite of what you would expect if mental health problems correlated with mass shootings.

Whether a population plays more or fewer video games also appears to have no impact.  Americans are no more likely to play video games than people in any other developed country.

Racial diversity or other factors associated with social cohesion also show little correlation with gun deaths.  Among European countries, there is little association between immigration or other diversity metrics and the rates of gun murders or mass shootings.

A Violent Country

America's gun homicide rate was 33 per million people in 2009, far exceeding the average among developed countries.  In Canada and Britain, it was 5 per million and 0.7 per million, respectively, which also corresponds with differences in gun ownership.

Americans sometimes see this as an expression of deeper problems with crime, a notion ingrained, in part, by a series of films portraying urban gang violence in the early 1990s.  But the United States is not actually more prone to crime than other developed countries, according to a landmark 1999 study by Franklin E. Zimring and Gordon Hawkins of the University of California, Berkeley.

Rather, they found, in data that has since been repeatedly confirmed, that American crime is simply more lethal.  A New Yorker is just as likely to be robbed as a Londoner, for instance, but the New Yorker is 54 times more likely to be killed in the process.

They concluded that the discrepancy, like so many other anomalies of American violence, came down to guns.

More gun ownership corresponds with more gun murders across virtually every axis: among developed countries, among American states, among American towns and cities and when controlling for crime rates.  And gun control legislation tends to reduce gun murders, according to a recent analysis of 130 studies from 10 countries.

This suggests that the guns themselves cause the violence.

Mass Shootings Happen Everywhere

Skeptics of gun control sometimes point to a 2016 study.  From 2000 and 2014, it found, the United States death rate by mass shooting was 1.5 per one million people.  The rate was 1.7 in Switzerland and 3.4 in Finland, suggesting American mass shootings were not actually so common.

But the same study found that the United States had 133 mass shootings.  Finland had only two, which killed 18 people, and Switzerland had one, which killed 14.  In short, isolated incidents.  So while mass shootings can happen anywhere, they are only a matter of routine in the United States.

As with any crime, the underlying risk is impossible to fully erase.  Any individual can snap or become entranced by a violent ideology.  What is different is the likelihood that this will lead to mass murder.

In China, about a dozen seemingly random attacks on schoolchildren killed 25 people between 2010 and 2012.  Most used knives; none used a gun.

By contrast, in this same window, the United States experienced five of its deadliest mass shootings, which killed 78 people.  Scaled by population, the American attacks were 12 times as deadly.

Beyond the Statistics

In 2013, American gun-related deaths included 21,175 suicides, 11,208 homicides and 505 deaths caused by an accidental discharge.  That same year in Japan, a country with one-third America's population, guns were involved in only 13 deaths.

This means an American is about 300 times more likely to die by gun homicide or accident than a Japanese person.  America's gun ownership rate is 150 times as high as Japan's.  That gap between 150 and 300 shows that gun ownership statistics alone do not explain what makes America different.

The United States also has some of the world's weakest controls over who may buy a gun and what sorts of guns may be owned.

Switzerland has the second-highest gun ownership rate of any developed country, about half that of the United States.  Its gun homicide rate in 2004 was 7.7 per million people — unusually high, in keeping with the relationship between gun ownership and murders, but still a fraction of the rate in the United States.

Swiss gun laws are more stringent, setting a higher bar for securing and keeping a license, for selling guns and for the types of guns that can be owned.  Such laws reflect more than just tighter restrictions.  They imply a different way of thinking about guns, as something that citizens must affirmatively earn the right to own.

The Difference Is Culture

The United States is one of only three countries, along with Mexico and Guatemala, that begin with the opposite assumption:  that people have an inherent right to own guns.

The main reason American regulation of gun ownership is so weak may be the fact that the trade-offs are simply given a different weight in the United States than they are anywhere else.

After Britain had a mass shooting in 1987, the country instituted strict gun control laws.  So did Australia after a 1996 incident.  But the United States has repeatedly faced the same calculus and determined that relatively unregulated gun ownership is worth the cost to society.

That choice, more than any statistic or regulation, is what most sets the United States apart.

“In retrospect Sandy Hook marked the end of the US gun control debate,” Dan Hodges, a British journalist, wrote in a post on Twitter two years ago, referring to the 2012 attack that killed 20 young students at an elementary school in Connecticut.  “Once America decided killing children was bearable, it was over.”