Shakespeare's Sister asks that one caption the photo of Heimat Security Secretary Certoff.

Ports don't need security, landmarks need security. What a pretty neck. Care for a nice fat rat?

Posted by EBW at 10:33 PM | Permalink | Comments (0) | TrackBacks (0)

Riverbend's posted another gem on life under the puppets.

Read it.

Posted by EBW at 08:10 PM | Permalink | Comments (0) | TrackBacks (0)

My last two posts have been about things I do not care about. It is now time to turn to a subject, the civil justice system, about which I care deeply.

Kevin Drum recently wrote about a new study of medical malpractice claims. The study appeared in the May 11, 2006 New England Journal of Medicine. The abstract is here. The press release is here. News reports are here and here. I have not been able to locate the full study free on-line (it will be free at the NEJM site when it is 6 months old). If someone were to email me a copy of the full report, I'd never tell.

I want tohighlight one specific aspect of the study for further discussion in another post, but for now, let’s look at the methodology and the general findings.

The methodology looks quite appropriate. From the abstract:

Trained physicians reviewed a random sample of 1452 closed malpractice claims from five liability insurers to determine whether a medical injury had occurred and, if so, whether it was due to medical error. We analyzed the prevalence, characteristics, litigation outcomes, and costs of claims that lacked evidence.

The research team from Harvard School of Public Health (HSPH) and Brigham and Women's Hospital focused on litigation-prone specialties. From the press release:

The authors reviewed 1,452 closed claims from five malpractice insurance companies across the country. They focused on four clinical categories: surgery, obstetrics, medication and missed or delayed diagnosis, areas that collectively account for about 80% of all malpractice claims filed in the U.S. Specialist physicians in each of these clinical areas reviewed the claims and the associated medical records to determine whether the plaintiff had sustained an injury from care. If an injury had occurred, the physicians judged how likely it was to have been due to medical error.

Other details about the methodology:

The companies provided insurance coverage for 33,000 physicians, 61 acute care hospitals--including 35 academic medical centers--and 428 outpatient facilities.

Claims were reviewed by board-certified physicians, fellows or final year surgical residents. The claims were reviewed for adverse outcome as well as for medical error, which was defined using this definition from the Institute of Medicine: "the failure of a planned action to be completed as intended (i.e., error of planning) or the use of a wrong plan to achieve an aim (i.e., error of planning)."

Claims were scored using a six-point confidence scale, with six indicating virtual assurance that an adverse outcome was secondary to one or more medical errors. Claims that received scores of four or higher were identified as involving medical error.

That strikes me as a very good design for the study. It would tend to put some potentially viable claims in the non-injury category (e.g. cases in which received a "causation score” of 3) but the burden of proof is on the plaintiff so that seems appropriate. The study also may suffer from the fact that the reviewers knew the outcome of the claim when deciding how to characterize it. Blind review would be better. I do not know how the reviewers resolved disputes about whether or not a medical error caused injury and whatever process they used is a potential source of bias. It is also not clear to me that injury secondary to medical error (the standard used by the reviewers) is precisely the same as negligence although it seems pretty close. Finally, the study may suffer from bias in the selection of claims to review. All in all, though, the study design seems very good to me.

The key findings include the following.

Virtually all (97%) of the claimants had suffered harm. The vast majority (80%) suffered significant harm (39% significant disability, 15% major disability, 26% death). Only a tiny percentage (0.4%) of total claims resulted in compensation paid to a claimant without a physical injury.

The justice system reached the correct result (payment or no payment) in the eyes of the researchers in 73% of the claims. Of claims decided incorrectly, 10% involved claims made in the absence of medical error causing injury and 16% involved failure of payment despite injury due to medical error. In other words, a medical malpractice claimant is more likely to lose despite injuries caused by medical error than to win without injuries caused by medical error.

Those results should dispel the notion that litigation is a lottery in which evidence of medical error and damages is meaningless. Of course, that has always been apparent to anyone who looked. If the results were truly random, why would doctors and insurers spend lots of money on lawyers, adjusters, depositions, experts, discovery, and trials? It would just be wasted money, eh? That said, I can not say that I am impressed with 73% accuracy of the civil justice system on a crude measure such as paid or not paid. I think the system should be able to achieve 85-95% accuracy without breathing hard.

As should come as no surprise to anyone, the defendants win the majority (79%) of medical malpractice trials. That is not surprising as the insurance companies are far more likely to make reasonable settlement offers if liability is clear. In essence, for most claims, the insurance companies decide which ones get tried and which one do not. It should come as no surprise that they win most of the ones they select.

Finally, it should come as no surprise that the costs of litigating med mal cases are high. The stakes are high in many such cases, the experts are both necessary and expensive, and cost of trial presentation is unusually high. That is a recipe for large litigation costs. In fact, I was surprised that the administrative costs for a med mal case proceeding to trial were only $113,000. I have spent more than that to prepare and present non-medical cases a number of times and the figure quoted purports to be for both sides.

The one finding that jumped out at me was that the reviewers found no medical error in 37% of claims. I think that is an important finding that can point the way to needed reforms. Alas, this post is already overlong so that must be the subject of my next one.

Posted by Dwight Meredith at 03:42 PM | Permalink | Comments (0) | TrackBacks (0)

by James Ryan, USMA '62, founder, West Point Grads Against the War

Mister Bush, you deserve a good reaming for your performance at the United States Military Academy graduation on Saturday. Post around to my room for some character guidance.

Come in, wackhead. Slam up against that wall! Suck up that capacious gut! Shoulders back! Pop up that puny chest! Fingers along the seams of your trousers! You want to be our big buddy, Mister? What's that? I can't hear you. . . . Sound off, dumbsmack! Yes, you say? Yes, what? That's an incomplete statement, beanhead. Tack a "sir" at the end. That's better.

So you think you can be our big buddy by spouting some cadet slang in a speech? One hour here at Hudson High, and you're falling out, acting like an upper classman. That's pathetic behavior, Mister Bush. This is one place where you have to earn privileges, Mister! You got that? You think all we care about up here is war? From your speech one would think so. You must love yakking about IEDs, convoy operations, and running checkpoints. There is so much more going on up here, mister, and you make us out to be cannon fodder. So run your feeble neck in another notch for that.

You must be corrected about this place, West Point. It's not a "tin school." That's just a joke, and not one for either you or Rumsfeld to crack wise about. West Point is supposed to develop military leadership to provide expertise in the increasingly complex world of geopolitics. Rumsfeld's wishful thinking and arrogance swept all that away. His (and your) tragically flawed, ego-driven ideology trumped empirical, professional judgment and leadership. Over a score of generals walked rather than bow their necks under the deceitful yoke of Rumsfeld. And then you ended up with the likes of Tommy "We Don't Do Body Counts" Franks. But now he IS counting bodies . . . those of our own troops. "What we're talking about is neither 2,400, 24,000 or 240,000 lives," the dismissive Franks said at a recent NRA bash, adding paradoxically, "It [terrorism] doesn't have anything to do with politics." Does this make you feel proud, Mister Bush? To have people like this develop policies for the United States of America? When you get back to DC, you tell Rumsfeld to drive around to our room, and we'll explain a few things to him too.

We pay attention to everything up here at West Point, Mister Bush. Even the fact that you told the same joke about giving cadets amnesty that you told four years ago. You should be more respectful of West Point, Mister Bush. That seems to be a pattern in your behavior, smackhead. Telling the same stories over and over. And you throw around the names of old grads like Eisenhower and Bradley, using them to somehow justify what you and your big buddies in DC have done to the world. What do you know about Eisenhower or Bradley? You might get away with that stuff in the oval office, but not up here. Not at West Point. You got that, wack? You got that loud and clear, beansmack? Good. Retain same. Fop

The Long Gray Line spans the generations, mister. Its spirit fills the geographic, intellectual, and moral space that is West Point. The old grads are always there. Mister Bush, you want to buy this place? No? Well stop gawking! Keep those slimy eyeballs straight ahead. Pick a spot on the opposite wall and examine it! You never said anything about what those old grads said. You just got the cadets' attention by saying the words, Eisenhower and Bradley, but then that was the idea, wasn't it? Then you launched into how President Truman did this, that, and the other thing. You even pulled a Winston Churchill with your "never back down . . . never give in . . . never accept anything less than a complete victory" routine. It reminded many of us of that "mission accomplished" crud that you blabbed off the coast of San Diego a few years ago. Just who are you, Mister Bush? Makes cadets wonder whether there's anything inside that fine civilian suit of yours? You read me, Mister Bush?

Do you remember what you said here at the Academy four years ago? About pre-emptive action? Do you know what Dwight Eisenhower said about that much earlier? Don't hem and haw, Mister Bush. Here at West Point there are only three answers for smacks like you: Yes sir. No sir. No excuse sir. Remember that! And remember this!
And his fellow classmate from the class of 1915, the class the stars fell on, Omar Bradley was even clearer. "Wars can be prevented just as surely as they can be provoked," he said, "and we who fail to prevent them must share the guilt for the dead."

You feel like sharing any of that responsibility, any of that guilt, Mister Bush? Your decision, your deceit-filled decision, to attack Iraq has cost tens of thousands of lives. What do you have to say about that? It seems to us that you have to watch your language, Mister Bush. I mean you still maintain that Saddam Hussein had weapons of mass destruction and that he was somehow responsible for 9/11. Your evasions and quibbling and lies have cost the world dearly. Cram your neck in, Mister Bush. And you implied as much again in your speech at West Point:

"On September the 11th, 2001, we saw that the problems originating in a failed and oppressive state 7,000 miles away could bring murder and destruction to our country."

Which country might that have been, Mister Bush? No specification followed. Rack your neck in further for another gross deception!

Four years ago, you were introduced to the graduating class of 2002 as "a man who exemplifies the West Point motto of Duty, Honor, Country." That now revolts some graduates of West Point. At West Point, we uphold the Cadet Honor Code . . . a cadet will not lie cheat or steal or tolerate those who do. Mister Bush, it seems to us that you and your ilk have done exactly the opposite. (Keep that chin firmly in!) And you are still, cooking up war stories, unalloyed of truth, further proving, if such were still necessary, that lying, even under your combat imaginings, jeopardizes the lives of fighting men and women. And Saturday you told the graduating cadets that "the war began on my watch but it's going to end on yours." Perhaps you would like to correct that statement? Perhaps consider adding what is now widely known, that the assault on Iraq began premised on lies. That it is illegal. That these lies have severely dissipated the capability, morale, and reputation of United States military forces, and the United States of America. And that the young men and women of West Point in this year's graduating class may also be soon at risk for crimes against the Geneva Convention. And that you don't give a damn for anything we just said.

Would you like to make a statement, Mister Bush?

Posted by EBW at 10:04 PM | Permalink | Comments (7) | TrackBacks (0)

It was Col. Gregory Watt who lead a three-week military investigation and apparently found that 24 unarmed Iraqis -- including women and children -- were murdered by 12 members of the U.S. Marines from the 3rd Battalion, 1st Marine Regiment, 1st Marine Division.

Posted by EBW at 09:53 PM | Permalink | Comments (0) | TrackBacks (0)

MB's kicking off a "how many are in for an eagle" fund and levee raising over at Draft Gore 2008 PAC. I'm fond of rare coins. Its a platonic relationship, the closest I've come to holding rare coins was in Munich, when an elderly White Russian woman spilled her store of Athena's silver owls into my hands -- which just about stopped my heart. Warfare does odd things to national collections, even the Romanoff's.

If you don't happen to have a 1914 Indian Head Eagle lying about the house, please use something more prosaic to let MB know the count and therefore, the amount, of support Al has circa End of May / Start of June in this minor arm of the spiral galaxey known as the blogosphere (y!sctp!).

Posted by EBW at 12:21 PM | Permalink | Comments (0) | TrackBacks (0)

Q Can you give us a readout on the President's meeting this morning with the Iraq experts?

MR. SNOW: Yes. Oh, my goodness, I forgot to bring the list. But actually -- do you have the list, Fred? Yes, it was an interesting meeting. What you ended up having was -- I've got all the names but one written down here. We had Wayne Downing, Barry McCaffrey, Michael Vickers, Amir Taheri, Fouad Ajami and Raad Alkadiri. And you had a combination there of military men and also scholars who are students of Iraq. And it was an interesting discussion that touched upon cultural issues, on political issues, on the state of affairs in Iraq. You had a number of people who've been there recently, General McCaffrey having returned just last month from his latest visit. Fouad Ajami last year had the occasion to sit down and speak with the Ayatollah Sistani, Ali al Sistani.

The President wanted to hear about that. And what he really wanted first was to get their honest opinions -- and, again, these were honest opinions -- about how things are going in Iraq, about the status and viability of the government, and what the United States needs to do on the way forward. The one thing that was of mutual agreement is that, number one, this is an important enterprise, and number two, that we can and will win it. But those are sort of the general outlines of the conversation.

I'm so glad Amir Taheri was there as an Iraqi expert. If he were there as an Iranian expert, he might have fabricated something important.

He's the guy who fabricated the "Jewish badges" nonsense mid-month.

Posted by EBW at 12:10 PM | Permalink | Comments (0) | TrackBacks (0)

I may have an actual substantive post later today, but in the meantime, here are a few more things I do not care about:

12) Paris Hilton. I didn't even see the video. I didn't see the Pamela Anderson one either.

13) The Bush twins. It is not their fault their dad is a lousy President. They have a life to live. Let them live it. They have no more of an obligation to join the armed forces than anyone else. Chelsea Clinton, too.

14) Whether or not Barry Bonds took steroids. He was a great player before his head grew to massive proportions and a great player after. He deserves to be in Cooperstown regardless.

15) Whether Al Gore spent a whole summer or part of a summer in France in 1962.

16) How Hillary (or Nancy Pelosi or Condi Rice or any other female political figure) wears her hair or what she wears. It is the quality of mind and character that is important.

17) Cat Blogging.

18) What any horoscope says.

19) Lynn Cheney's purple prose. She wrote a lousy novel. So what? My efforts at writing fiction are not likely to be mistaken for Faulkner either.

20) Any award handed out by Andrew Sullivan.

21) Opus Dei and the Priory of Sion.

22) Where Jimmy Hoffa is buried.

23) What happened in Aruba a year ago.

24) Mel Kiper's analysis of the NFL draft. Is any television more boring that the later rounds of the NFL draft? Yes, the NBA draft lottery. The early rounds of the national spelling bee are far more compelling

25) The alleged war against Christmas. If one were so inclined, would it be possible to avoid being told "Merry Christmas?"

26) Daily fluctuations in the stock market. I am intensely interested in longer term trends.

27) Left Behind. I don't even read The Slacktivist's posts about the books and I love nearly everything Fred writes.

Posted by Dwight Meredith at 09:27 AM | Permalink | Comments (7) | TrackBacks (0)

The EU's highest court has just struck down the legal basis for the two decisions of the Councile of the European Commission which lead to the provisioning of passenger personal data by Air Carriers operating flights originating in the EU to the US.

Skilling and Lay last week. Ashcroft this week.

Posted by EBW at 08:07 AM | Permalink | Comments (0) | TrackBacks (0)

The spruce-fir coniferous boreal forest that replaces the mixed stands of pine species and yellow birch, sugar maple, and American beech, which in turn replaces the mixed pine and white and black oak stands of the Piedmont broadleaf forest, has been present at and above the 6,000 foot level of southern Appalachias since the retreat of the Wisconsin ice sheet, 14,000 years ago.

In a uniform mixing model of global warming, the contour that demarks the spruce-fir and mixed pine and deciduous species forests will, as global temperatures rise, simply move upwards, like the sea levels at Diego Garcia and Bikini Atoll, until the last spruce-fir climbs into the clouds, like the woman who decended from the sky land on the root of a turnip in Siksika legend, in reverse.

I don't know that a uniform mixing model of global warming will be supported by data. I do know tree stress when I see it, and I saw a lot of it today in the spruce-fir stock at the top of the highest peak east of the Rockies. Dew and ice collected at the summit has had pH values as low as 2.1.

The primary cause is atmospheric sulfur dioxide (SO2) and nitrogen oxides (NOx), of which 2/3 of all SO2 and 1/4 of all NOx comes from burning coal by electrical utilities.

The Clean Air Act isn't simply some aesthetic fashion statement. Slowing the rate of increase of atmospheric carbon loading isn't made more trivial by taking the northern and eastern forests out for a century long non-reproductive stress test via acidification on the conifers and ozone on the broadleaf species. Thats a lot of carbon dioxide not taken out of the atmosphere.

Posted by EBW at 07:56 PM | Permalink | Comments (0) | TrackBacks (0)

I am feeling a bit grouchy this morning so I thought it might be appropriate to list some of the things I do not care about:

1) The Dixie Chicks. They dissed Bush and did or did not apologize. They will be played on country radio stations or maybe not. Whatever.

2) The sex life of Bill and/or Hillary Clinton. If I am going to care about anyone's sex life it will be ours.

3) American Idol. Some guy I never heard of from around here (Greensboro) got jobbed so some guy I never heard of from Alabama won. Can Keith Olbermann's producers now please allow him to cover some other story? And by the way, just who the heck is Simon and why do we care what he says?

4) Lost (Sorry Deb). They just had their two-hour season finale and I am pretty sure they are still lost. I am interested in why the network executives at ABC do not produce a show to follow "Lost" called "Found."

5) What any politician has on their I-Pod. Maybe I am just jealous because I don't have an I-Pod or maybe I have morphed into a curmudgeon in my old age. Now you kids get off my lawn.

6) Yearly Kos. Do they provide child care for autistic kids? I do hope everyone has a good time.

7) Jonah Goldberg. He is Oakland. No there there. Hugh Hewitt, too.

8) How many pounds Pat Robertson can leg press. I also do not care about Robertson's weather reports from God. I am interested in the fact that a nut bar like Robertson could finish second in the 1988 Iowa Republican Presidential Caucuses.

9) Howard Fineman's critique of any candidate's wardrobe choices.

10) Joe Biden's doomed efforts to become President. Please spare us even one more Biden appearance on Meet the Press.

11) Tom Cruise and Angelina Jolie's baby. Or maybe it was Britney Spears' baby. Or maybe Brad Pitt was involved somehow. I just can't keep up with it all. I am sure it was all explained on Oprah but I don't care about her, either.

Should I care about any of that? What do you not care about?

Posted by Dwight Meredith at 12:02 PM | Permalink | Comments (8) | TrackBacks (0)

It is indeed a noble cause.

Okay folks, here's the deal. DM is at 408,273 visits, which is 10,794 shy of the vaunted 419,067 milestone I want to reach by my third blogversary on June 14th. Sadly, that will require an average of 600 daily visits, and I'm currently clocking in at 549 a day, so it looks like the goal is juuuuuust out of reach. Unless...

So please tell all your friends to visit.

Barry Bonds may be at 715 but imagine the glory of being the 419,067 person to visit NTodd. It would be a "brush with greatness" moment.

Posted by Dwight Meredith at 10:25 AM | Permalink | Comments (1) | TrackBacks (0)

I could write something in memory of people I know who've spent part of, or the end of, their lives in uniform or employed by the Department of Defense. But that wouldn't "honor" them. That kind of writing is best be done in peace-time. When memory is unconflicted by the present.

This morning north of Kabul, two uniformed US service personel were involved in a traffic accident. The brakes on a truck in a convoy failed, and a civilian was killed and six others injured, two of them greviously. Stones were thrown at the foreign soldiers, and the foreign soldiers shot their way out of the crowded accident site, killing four more civilians with gunfire.

An Agence France Press witness recounts what he saw as follows:

La foule en colère a commencé à lancer des pierres sur les soldats américains, qui se sont réfugiés dans leurs véhicules et ont commencé à rouler vers la foule en faisant feu, tuant au moins quatre personnes. J'ai vu deux personnes tuées par balles juste à côté de moi. Les véhicules ont forcé leur passage dans la foule en tirant.

Last week John Murtha and Jack Warner got around to expressing a desire to know what happened at Haditha, Iraq, on the 19th of November. So did I, ten weeks ago, a day after Time broke the story. The Time exclusive is here: pages 1 | 2 | 3 | 4 |.

Recall: An officer, and a gentleman by Act of Congress, from 19 November 2005, until 10 January 2006, reported for the record that the Iraqis killed at Haditha had been killed by an insurgent bomb. Ltc. Barry Johnson wrote me 10 weeks ago that he wasn't the unnamed infantry colonel who conducted the February, 2006 investigation, which changed the story from "killed by an insurgent bomb" to "collateral damage", and that he won't answer further questions, except from accredited journalists.

Friday's decision by the California Court of Appeals doesn't make us "journalists", nor does it compell Barry Johnson or his superiors to cooperate with a present, or eventual, civilian oversight review of the events of 19 November 2005 at Haditha, and any subsequent events, intended to disclose, or obscure, prior events. But there will be an eventual, civilian oversight review, and one or more commissions may be surrendered.

The writing that is best done in war-time is oversight writing. When the present is unconflicted by memory.

Posted by EBW at 08:28 AM | Permalink | Comments (0) | TrackBacks (0)

According to Joseph Ratzinger, who was able to utter the word, it was a band of criminals, not the German people. He went on, Germans were victims at Auschwitz too. He cited his predecessor, Karol Wojtyla, who was unable to utter the word, converting the dead via "Golgotha of the modern world", and who spoke of "six million Polish POWs", without mentioning that the majority of them were Jews.

Today Joseph Ratzinger shared his religious vision. The National Socialists, hostile to Christianity, sought to destroy European Jewery, witnesses of God, because the National Socialists sought to kill God.

That lets Europe since the 10th century off the hook.

The German Communists and Socialists, the German clerics, Catholic and Lutheran, the German homosexuals, Polish Soldiers and Officers, Polish Jews, Hungarian and MittleEuropa Romani and Jews, French and Italian Jews, Romani, and homosexuals, Russian and Ukranian partisans, Jews, Romani, and homosexuals, ... The European Civil Wars of 1914-1918, 1917-1921, and 1936-1939, 1939-1945 are simply amazing.

What is not 60 years past is attempting to hang the "anti-Semite" red jacket on scholarship critical of the policies of the Likud Party, which is after all, a political party, not the mystical union of all Jews, or all Jews who shared Pinsker's and Hershel's and others ideals of Zionisms.

Larry Franklin was charged with espionage. The AIPAC pursues interests independent from, and obviously contrary to, the interests of even the Bush Regime. Attempting to think critically about Israel and the United States isn't anti-Semite, or un-American.

Pretending that Christian Europe doesn't have a historic problem with European Jewery (and European Romani, and for the 20th century, European Moslems) is anti-sensical, and in particular, that genocide wasn't committed by some states of MittleEuropa in the 40's, not just some gangsters, now that is wicked anti-Semite.

The moody youth styling in the HJ threads in the photo is Joseph Ratzinger in 1943.

Meanwhile, in Krakow, were our slightly deranged ex-landlady lives, the photographs and personal details of over 20 individuals -- most of them living, studying and working in Krakow, academics from the Jagiellonian University, students of the city's colleges and members of Krakow's feminist and gay organizations, are published on the neo-facist website redwatch.info. Redwatch has also published a number of photos which show the ordinary people who participated in Krakow's March of Tolerance in April 2006. The website encourages everyone to assault those people physically and gives all the details by which the human rights' activists can be recognized -- including the clothes they were and the pubs and cafes they usually go to.

Last week a man named Maciek had a significant portion of 30cm of edged steel pushed into his back, and was then kicked on the ground by his assailants, who may have had said something critical of his politics while they tried to kill him.

Maciek is a Jew. He lived. His attackers are in fact members of a small gang. Their imperviousness to prosecution -- the .info registry is in Canada under ICANN jurisdiction, the "domains by proxy" registrar (GoDaddy), is in Arizona, also under ICANN jurisdiction, the 66.33.192.0/19 CIDR allocated by ARIN, is also under ICANN jurisdiction, and the hosting operator Dreamhost is in Brea, under California jurisdiction, as is ICANN, a 501(c)(3) incorporated in California -- is not "small gang". It is something else.

Posted by EBW at 07:43 PM | Permalink | Comments (1) | TrackBacks (0)

From the Telegraph:

The measles virus has been found in the guts of children with a form of autism, renewing fears over the safety of the MMR jab.

American researchers have revealed that 85 per cent of samples taken from autistic children with bowel disorders contain the virus. The strain is the same as the one used in the measles, mumps and rubella triple vaccine.

I haven't read the study and have generally been agnostic about any relationship between the MMR and autism (perhaps because my son does not fit the profile for a MMR/autism link and I have not looked that hard at the subject). I have no doubt that the new study will spark renewed debate on the subject.

On the heavy metals front, the New Scientist reports:

Urine samples from hundreds of French children have yielded evidence for a link between autism and exposure to heavy metals. If validated, the findings might mean some cases of autism could be treated with drugs that purge the body of heavy metals.

Samples from children with autism contained abnormally high levels of a family of proteins called porphyrins, which are precursors in the production of haem, the oxygen-carrying component in haemoglobin. Heavy metals block haem production, causing porphyrins to accumulate in urine. Concentrations of one molecule, coproporphyrin, were 2.6 times as high in urine from children with autism as in controls.

Once again, I haven't seen the actual study but if it supports the news report, the controversy over a heavy metal (including mercury)/autism link will increase in intensity.

It should be noted at this point that thinking about autism as if it is one phenomenon with only one cause is likely to be wrong. It is far more likely that the set of behaviors that we call autism results from a variety of several (many?) combinations of genetic predisposition and environmental triggers. There may be several (many?) types of autism each with its own etiology. The MMR study noted above, for instance, apparently looked at a sub-group of autistics who suffered from bowel disorders. Looking at sub-groups is a very good idea. If we identify the sub-groups, it is much easier to design early diagostic tests, treatments, and cures.

Perhaps one of the reasons that epidemiology has not yet confirmed the results of bench science regarding the relationship between possible environmental triggers and autism is that epidemiology has a harder time identifying ten causes each affecting smaller populations that one cause affecting a larger group.

Posted by Dwight Meredith at 09:50 AM | Permalink | Comments (0) | TrackBacks (0)