Emergency Contraception Pills

In the United States, up to 95 percent of teenage pregnancies are unintended. At the same time, at least 40 percent of all pregnancies in the United States are unintended. This can occur when a woman’s regular method of contraception fails or she uses it incorrectly. For example, she might forget to take her birth control pills for two or three days in a row. She might be unable to get her contraceptive injection on time. Her diaphragm might slip, or she and her partner might accidentally tear a condom. Unintended pregnancy can also occur after a couple has had unprotected sex. Finally, unintended pregnancy can occur as a result of rape or sexual assault. In fact, experts estimate that at least 25,000 pregnancies occur each year in the United States as a result of forced sex. There is a contraceptive method that works after unprotected sexual intercourse to prevent pregnancy. This method is known as emergency contraception pills, commonly called the morning-after pill. There are two types of pills:

• Levonorgestrel pills, including the brands Next Choice One Dose and Plan B One-Step. This is a female hormone that prevents ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
• Ulipristal acetate, known by the brand name ella. It’s a non-hormonal pill. It contains ulipristal, a non-hormonal drug that blocks the effects of key hormones necessary for conception.

Anyone — no matter how old you are — can get Plan B One-Step, one brand of emergency contraception, over the counter without a prescription at a drugstore, Planned Parenthood health center, or family planning clinic. Plan B One-Step usually costs about $40-$50, and the generics cost about $35-$45. All other brands of emergency contraception require you get a prescription from a doctor, nurse, or other health care provider if you're 16 or younger. All women need a prescription for ella, regardless of age. Ella can also be ordered through an online prescription service for $59, including shipping. Since emergency contraception works better the sooner you take it, it’s a good idea to get emergency contraception before you need it just in case. That way you’ll have it on hand if an accident happens, and you won’t have to worry about running out to a drugstore or waiting to get an appointment for a prescription.

Both kinds of emergency contraception pills can be used up to five days (120 hours) after unprotected intercourse. You may want to use it if:

• you weren't using any birth control when you had sex
• you forgot to take your birth control pills, patch, ring, or other birth control method
• your partner's condom broke or slipped off
• your partner didn't pull out in time or
• you were forced to have unprotected vaginal sex

In 1997, the U.S. Food and Drug Administration (FDA) recognized the use of oral contraceptives as being safe and effective as emergency contraception. Emergency contraceptive pills are effective in preventing pregnancy after unprotected sex. They are especially effective when begun within 12 to 24 hours after sex. Levonogestrel pills, including the brands Plan B One-Step and Next Choice One Dose, are up to 89 percent effective when taken within 72 hours (three days) after unprotected sex. They prevent pregnancy by temporarily blocking eggs from being produced, by stopping fertilization, or by keeping a fertilized egg from becoming implanted in the uterus. They continue to reduce the risk of pregnancy up to 120 hours (five days) after unprotected sex, but they are less effective as time passes.  Ella is 85 percent effective if taken within 120 hours (five days) after unprotected sex. It stays just as effective as time passes after sex. The morning-after pill will not prevent pregnancy for any unprotected sex you may have after taking the pills. Levonogestrel pills may not work as well for women who have a body mass index (BMI) of more than 25. The IUD or ella are better options for overweight women who need emergency contraception. Plan B One-Step will not affect an existing pregnancy or cause harm to a fetus. Lastly, ella should not be used by women who are already pregnant or suspected to be pregnant.

Side effects are uncommon, and usually stop within a day or two. Possible side effects include:

• an earlier or later, heavier or lighter period than usual
• breast tenderness, dizziness, or headaches, and 
• nausea or vomiting. If you vomit within two hours of taking the pill(s), it won't be effective and you need to take it again.

Frequent use may cause periods to become irregular and unpredictable. Your period also may be heavier, lighter, or more spotty than normal. If you do not get your period in 3 weeks or if you think you might be pregnant after taking ECPs, get a pregnancy test to find out for sure. Emergency contraception should not be used as a form of ongoing birth control because there are other forms of birth control that are a lot more effective and less expensive. Emergency contraception does not protect against sexually transmitted infections! You may want to consider getting tested if there is a possibility that unprotected sex put you at risk. If you’re worried about side effects or have a history of side effects when taking ECP, talk with your health care provider about your concerns. He or she may prescribe additional medicine that can help you prevent or treat side effects, such as nausea, if they occur.

Emergency contraceptive pills are sometimes confused with medical abortion. Whereas mifepristone (RU-486) terminates an existing pregnancy, emergency contraception is effective only before the pregnancy is established (that is, before implantation). If a woman is already pregnant, emergency contraception will not cause an abortion. By contrast, mifepristone is an entirely different medication, unrelated to hormonal contraception. Emergency contraceptive pills do not cause birth defects. Over 40 years experience with oral contraceptives has shown no risk of birth defects if a woman is already pregnant when she takes them. Emergency contraceptive pills are contraindicated for pregnant women only because the medication will not end a pregnancy. Studies of older, higher-dose oral contraceptives have shown that emergency contraception confers no increased risk to an established pregnancy or harm to a developing embryo.

In conclusion, emergency contraception pills are used to help keep a woman from getting pregnant after she has had sex without using birth control or if the birth control method failed. If you are already pregnant, emergency contraception will not work. The sooner you use emergency contraception after unprotected sex, the more likely it will prevent pregnancy. But you must use it correctly. ECPs are only good to protect against one act of unprotected sex. They work by blocking ovulation, but only for a few days, so if you take them and have unprotected sex again afterwards, you’re significantly increasing your risk of a pregnancy. If you have unprotected sex again within a few days of taking the pills, there will be more sperm waiting in the fallopian tubes when the egg is eventually released. It’s important to talk to your doctor if you have an issues or concerns.

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Blogging as a learning tool

With the increased interest in introducing digital literacy skills in the classroom as a means of preparing students for the 21^st century marketplace, our teaching and learning center has had more questions from faculty about using blogs as a teaching tool. Student blogging can be a way to achieve several learning outcomes for a course, as it has been for this class. With these last few weeks I have left at Ohio University, I have found blogging to be an effective learning tool that allows me more control over the course than all my other classes. I think posting a commentary based on the class discussion is the best way to utilize the knowledge gained in class. Blogging encourages creativity and develops vital writing skills. Blogs can be shared and this gives students more incentive to write them and to write them well. Most importantly, one can study for days for an exam and fail for a variety of reasons. But with blogging, I know what is expected of me when writing a blog.

 In a 2013 speech to the American Educational Research Association, Secretary of Education Arne Duncan said that much of the criticism of standardized testing is warranted. “State assessments in mathematics and English often fail to capture the full spectrum of what students know and can do,” he said. “Students, parents, and educators know there is much more to a sound education than picking the right answer on a multiple-choice question.” Standardized tests, by virtue of being multiple-choice, don't allow for students to express themselves. Standardized tests place a heavy weight on students that can lead to anxiety. Test anxiety became such a serious issue that in 2002, California state tests included instructions for teachers on what to do if a student vomits on the test. For students who have to pass a standardized test in order to advance to the next grade or to obtain a diploma, test anxiety can soar. Because anxiety can be so paralyzing, students may forget facts they had memorized or how to perform simple mathematical operations. In this way, the pressure placed on students to perform well ends up impeding the very thing standardized tests is designed to assess: how much students know. On the other hand, blogging reduces that testing anxiety. So while students are cramming for exams and not really even learning, I am stress free and gaining information and technology skills.

Professors should work to discover what it really in their student's minds, to see what all they know or don't know. Yes, our mantra of "studying for exams" has created and nourished a monster—but it's not too late to kill it. Blogging has given me the power to choose my grade, decrease stress, and give me many benefits. I just wish all my teachers would have used this approach.

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GMO - Safe of Unsafe?

There is a great debate going on right now on the subject of genetically modified foods, or GMOs. The development of genetic modification involves inserting a gene from bacteria or a virus (or a gene that helps plants survive the application of highly toxic pesticides) into an organism where it would normally not be found. The idea is to alter the genetic code in plants and animals to make them more productive or resistant to pests or farming techniques, like being doused with chemicals that would ordinarily kill them.

Genetically modified food has quietly become second nature in the U.S. and it may surprise you just how many foods you are eating that you never knew contained a generically modified ingredient. GMO foods have been on the market for nearly 20 years, since 1996. During those years, most of us have eaten GMOs in many foods, from soybeans, beef, dairy products, corn, beets, sugar, cottonseed, and rapeseed. Experts say 60% to 70% of processed foods on U.S. grocery shelves have generically modified ingredients. The U.S. government’s position: genetically engineered crops are safe, resist disease better, and can provide much-needed food in starving nations.

The question is, are GMOs safe for us and the environment? Actually, the answers are not clear. There are raised concerns about GMO foods, and criticized agribusiness for pursuing profit without concern for potential hazards, and the government for failing to exercise adequate regulatory oversight. It seems that everyone has a strong opinion about GMOs. Most concerns about GMOs fall into three categories: environmental hazards, human health risks, and economic concern.

To label or not to label has also been a hot button with consumer advocacy groups. Currently, food companies aren't required by law to label foods containing genetically modified ingredients, so it's no surprise that most Americans don't know they've eaten them. One reason food companies may shy away from labeling genetically modified food is the possibility of consumer rejection. Our country is based on a free market economy. If you are supplying a product and we don't want it, then the market dictates it will go away. This is why the biotech companies and food manufacturers will probably spend over 25 million dollars to prevent the labeling of GMOs. If their products are beneficial and safe, why not label them? Why not be proud of your product? Over 60 countries, including China, label GMOs and some countries ban them. Why can't we have transparency in our food supply?

Genetically modified foods have the potential to solve many of the world's hunger and malnutrition problems, and to help protect and preserve the environment by increasing yield and reducing dependence upon chemical pesticides and herbicides. Yet there are many challenges ahead for governments, especially in the areas of safety testing, regulation, international policy and food labeling. Many people feel that genetic engineering is the inevitable wave of the future and that we cannot afford to ignore a technology that has such enormous potential benefits. However, we must proceed with caution to avoid causing unintended harm to human health and the environment as a result of our eagerness for this powerful technology.

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Risk vs. Risk perception

Risk has been defined in a number of ways, but is often seen as the likelihood that an individual will experience the effect of danger. Every utility – sewerage, water, power, and gas – has a full portfolio of such risks. The less we trust the people who are supposed to protect us, or the people, government or corporate institutions exposing us to risk in the first place, or the people communicating to us about the risk, the more afraid we will be. The more we trust, the less fear we feel. The more we are aware of a risk, the more we are likely to be concerned about it. Concern about child abductions rises when the press is full of coverage of an ongoing case, although the probabilities are the same before that case showed up in the papers and after it is resolved. Can it happen to me? Any risk seems larger if you think you or someone you care about could be a victim. This helps to explain why statistical probability is often an ineffective form of risk communication. A risk of 1 in 1,000,000 can still seem threatening if you think you could be the one. This helps explain why the only acceptable level of risk to many people is zero.

These factors offer powerful insights that help explain why our fears often do not match the facts, and why they may be just as big a risk as the specific hazards about which we are worried. They contribute to potentially dangerous misperceptions of risk, which can lead to unsafe behavioral choices, either when we are more afraid of relatively small risks, or not afraid enough of relatively large ones. For example, many Americans sought a sense of control and safety after 9/11 by driving instead of flying. Air arrivals in Las Vegas were down 6.5% and motor vehicle arrivals were up 7.3% at the end of April 2002. 

People respond to a risk or hazard in ways consistent to their perception of that risk.  It is their perception that influences behavior or action. Understanding public perception of natural hazards is necessary in order to impact hazard preparedness, and can be a problem because residents of at-risk areas often have wrong beliefs about the hazard agent and its impacts, are unaware of available adjustments, and may have invalid beliefs about the effectiveness of the adjustments of which they are aware. Research shows that adaptive actions are motivated by awareness of the hazard, knowledge of how it can affect the community, and feelings of personal vulnerability to the potential consequences.

Peter Sandman breaks his work into three areas: scaring people who are ignoring something that is legitimately dangerous and risky; calming down a person who are freaking out over something that's not risky; and guiding people who are freaking out over something that is legitimately risky. To accomplish all this, Sandman came up with a useful equation: Risk = Hazard + Outrage. Deceptively simple, this formula includes both the objective, technical, measurable component (the "hazard") and the cultural, emotional, personal component (the "outrage" factor, including all levels of fear, anger and general upset). It is possible for the actual hazard to be low and the level outrage to be high however, and vice versa, and each situation requires a completely different approach. "Everything hinges on how elevated the hazard and the level of outrage are," explains Dr. Sandman. "If the level of hazard is low and the level of outrage is also low, there's nothing much going on. People aren't upset, and there's nothing for them to be upset about. This is not much of a business opportunity."

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Harvey W. Wiley

Harvey W. Wiley, M.D., was the original-first at the Food and Drug Administration, where he became known as the “Father of the Pure Food and Drugs Act.” An early pioneer of food chemistry, food toxicology, and food safety, Wiley was born near Kent, Indiana in 1844. He received an undergraduate degree in 1867 from Hanover College and an M.D. from Indiana Medical College in 1871. Shortly after, Wiley accepted a position teaching chemistry at Indiana Medical College. He obtained a B.S. from Harvard in 1873 and then, in 1874, accepted a faculty position in chemistry at Purdue University. With that knowledge he spent his last years at Purdue studying sorghum culture and sugar chemistry, focusing on the adulteration of sugar with glucose, which was also the subject of his first published paper in 1881. Wiley's educational and early professional experiences set the table for his subsequent pioneering efforts in adulterated food products.

In 1883, Wiley was appointed Chief of the U.S. Department of Agriculture's Chemical Division. The division changed its name to the Bureau of Chemistry in 1898, and that is where Wiley conducted his most famous work. He authored early important studies on food adulteration. More significantly, between 1902 and 1907 Wiley directed what would become known as the Poison Squad. Employees of the Bureau of Chemistry and medical students from Georgetown Medical College received free board, eating meals prepared in the bureau's kitchen, during the preparation of which, specific quantities of commonly used chemical preservatives were added to the ingredients. Low paid recent graduates eagerly signed up to join the so-called Poison Squad. The subjects were undergoing medical monitoring – they were required to record their weight, temperature, and pulse rate before each meal and to list what they ate. Then urine and feces samples were collected. Squad members never knew what possible poison they were eating. Still, they all signed waivers absolving the government of liability for possible health impacts.The end result was to determine to what level chemicals were retained, excreted, or changed in their bodies and if any symptoms noted could be attributed to those chemicals. Chemicals used in these experiments included borax, boric acid, copper sulfate, potassium nitrate, saccharin, salicylic acid and salicylates, sulfuric acid and sulfites, benzoic acid and benzoates, and formaldehyde. Wiley was a tireless promoter of food safety.

But there's no doubt that Wiley and his determined volunteers raised public awareness of a risky food supply. That awareness, that growing realization of danger, put intense pressure on the government to fix the problem of contaminated food. Four years after the squads were established, the nation's first law regulating food and pharmaceutical manufacturing went into effect. It was officially known as the Pure Food and Drug Act in 1906. Under Wiley's leadership, the Bureau of Chemistry grew in size and stature after assuming responsibility for enforcement of the 1906 Act.

Wiley was also a prolific writer during his tenure with the Bureau of Chemistry. The Government Printing Office published four of his major studies, including Influence of Food Preservatives and Artificial Colors on Digestion and Health v. Formaldehyde in 1908. Wiley also wrote several books during this time period, including Chemistry and Longevity: Food in its Relation to Individual and National Development. Dr. Wiley retired from the Bureau of Chemistry in 1912 and became director of the Bureau of Foods Sanitation and Health for Good Housekeeping magazine. While working for the magazine, Wiley developed the well-known Good Housekeeping Seal of Approval, which is still in use today. Wiley died on June 30, 1930 at the age of 86. His legacy is still in evidence today in the work of the Food and Drug Administration (FDA) and in the activities of many food and drug toxicologists.

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Exxon Valdez: 20 Years Later, Oil Remains

Four minutes after midnight on March 24, 1989 the Exxon Valdez hit Bligh Reef in Alaska's Prince William Sound. Carrying 1,264,155 barrels of oil bound for Washington, the ship had maneuvered out of the shipping lane to avoid icebergs. The timing of the spill, remote and spectacular location, thousands of miles of rugged and wild shorelines, and the abundance of wildlife combined to make it an environmental and societal disaster well beyond the scope of other spills. Initially, response efforts were aimed at keeping the oil out of critical salmon spawning areas by deploying protective boom at the mouths of several rivers and lagoons. There was also hope that the oil might be kept off of the beaches altogether by skimming it from the water before it came ashore. For several days the oil held offshore in a 20 to 30 mile wide sheen and many separate patches of mousse, or weathered and thickened oil. Unfortunately, the oil skimmers were unable to keep the oil from the beaches. A storm that blew in on the night of April 10 sent the first oil ashore in Kenai Fjords National Park.

In the end, approximately 20 miles of the Kenai Fjords coast received oil. This is about five percent of the total coastline in the park and just a fraction of the total coastline oiled during the disaster. Fortunately, the most sensitive salmon spawning areas in the park did not receive oil. Areas classified as moderately or heavily oiled include Pony Cove, Verdant Cove, Taroka Arm, Black Bay, Beauty Bay, Yalik Bay, and McArthur Pass. Seward became a hub of wildlife treatment shortly after the spill occurred. Facilities were set up for cleaning and caring for sea otters, seabirds, and bald eagles; and volunteers from the local community contributed many hours to this effort. Success rates varied, and many animals could not be saved. One hundred eighty-four sea otters were brought to Seward, and eventually only 19 of these were released back into the wild. Success rates were a bit better with birds. Of 1,088 seabirds brought to Seward, 627 were released. Twenty-two bald eagles arrived alive in Seward, and 13 of these were released. The massive effort to document damage and cleanup oil led to people surveying and walking on beaches that are rarely visited. As a result, many new archeological sites were discovered that were previously unknown to scientists. The documentation of these sites increased our understanding of former human habitation of what is now Kenai Fjords National Park, but also exposed these resources to the potential threat of human disturbance.

Three methods were tried in the effort to clean up the spill: burning, mechanical cleanup, and chemical dispersants. Efforts to save sensitive areas were begun early in the cleanup. Sensitive environments were identified, defined according to degree of cleanup, and then ranked for their priority for cleanup. Seal pupping locations and fish hatcheries were given the highest importance, and for these areas special cleaning techniques were approved. Despite the identification of sensitive areas and the rapid start-up of shoreline cleaning, however, wildlife rescue was slow. Adequate resources for this task did not reach the accident scene quickly enough. Through direct contact with oil or because of a loss of food resources, many birds and mammals died.

20 years after the worst oil spill in U.S. history, huge quantities of oil still coat Alaska’s shores with a toxic glaze.  More than 21,000 gallons of crude oil remain of the 11 million gallons of crude oil that bled from the stranded tanker Exxon Valdez. The spill affected people living in or near the sound economically and culturally. Both the long-term and short-term effects of the oil spill have been studied. Immediate effects included the deaths of 100,000 to as many as 250,000 seabirds, at least 2,800 sea otters, approximately 12 river otters, 300 harbor seals, 247 Bald Eagles, and 22 orcas, and an unknown number of salmon and herring. An 11,000-person crew removed oil from the beaches until 1994, when government officials decided to end the clean up effort. At that time, what was left of the oil was naturally disintegrating at a high rate, and experts predicted it would be gone within a few years. But it turns out that crude oil – especially when it is spilled in a cold region like southeastern Alaska – lingers in the environment for years. According to the Exxon Valdez Oil Spill Trustee Council, the Exxon Valdez oil is decreasing at a rate of 0-4 percent per year. At this rate, the remaining oil will take decades and possible centuries to disappear entirely. To the naked eye, Prince William Sound may appear “normal.”  But if you look beneath the surface, oil continues to contaminate beaches, national parks, and designated wilderness. And as long as the oil is there, it can harm the animals that might come into contact with it. Sea otters once again play in the waters of Alaska’s Prince William Sound, and salmon and some other species have rebounded. But killer whale populations have not recovered, and the huge schools of whirling herring that fed both fisherman and animals have not returned, reminding scientists that nature’s responses are complex and unpredictable.  

As of December 15, 2009, Exxon paid all owed $507.5 million punitive damages, including lawsuit costs, plus interest, which were further distributed to thousands of plaintiffs. The most positive results from the disaster involve oil tanker safety. In 1990, the U.S Congress passed the Oil Pollution Act, setting a schedule for the gradual phase in of a double hull design, providing an additional layer between the oil tanks and the ocean. While a double hull would likely not have prevented the Valdez disaster, a Coast Guard study estimated that it would have cut the amount of oil spilled by 60 percent. The Act set up a liability fund, toughened spill disaster plans, and created a mechanism for citizen-led oversight committees to police safety claims by shippers. Worldwide, the frequency of major accidents in oil shipping has dropped, and insurance experts say safety has improved. The requirement for double-hilled tankers spurred the shipping industry to modernize with much safer ships. 

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Risk assessment vs precautionary principle

Basic risk assessments question, “How much harm is allowable?”

The precautionary approach asks, “How little harm is possible?”

The precautionary principle, generated during the late 1980s as a unifying principle for regulating discharge of hazardous material into the North Sea, has been broadened to include a shifting of the burden of proof to the proponent of a proposed activity, adoption of a more holistic assessment process, and encompassing all environmental management decisions, not just pollution prevention activities. The precautionary principle remains a management philosophy, not a substitute for risk assessment. As the principle has been elaborated recently, it nearly always implies three additional ideas, beyond “harm” and “scientific uncertainty”:

-       The notion of seeking alternatives to harmful technologies,

-       The idea of shifting to proponents of a technology the responsibility for demonstrating its safety, and

-       The goal of transparency and democracy in making decisions about technologies

Taken together, these concepts provide what we believe is a sound overarching approach to assessing and making decisions on products and technologies and other human activities that may impact health or the environment. The precautionary principle represents a paradigm shift in decision-making. It allows for five key elements that can prevent irreversible damage to people and nature:

1.     Anticipatory Action: there is a duty to take anticipatory action to prevent harm. Government, business, and community groups, as well as the general public, share this responsibility.

2.     Right to Know: the community has a right to know complete and accurate information on potential human health and environmental impacts associated with the selection of products, services, operations, or plans. The burden to supply this information lies with the proponent, not with the general public.

3.     Alternatives Assessment: an obligation exists to examine a full range of alternatives and select the alternative with the least potential impact on human health and the environment, including the alternative of doing nothing.

4.     Full Cost Accounting: when evaluating potential alternatives, there is a duty to consider all the reasonably foreseeable costs, including raw materials, manufacturing, transportation, use, cleanup, eventual disposal, and health costs even if such costs are not reflected in the initial price. Short and long-term benefits and time thresholds should be considered when making decisions.

5.     Participatory Decision Process: decisions applying the Precautionary Principle must be transparent, participatory, and informed by the best available science and other relevant information.

Risk assessment is a process to identify potential hazards and analyze what could happen if a hazard occurs. Risk = chance of harmful effects to human health or to ecological systems resulting from exposure to an environmental stressor. Environmental stressor = any physical, chemical, or biological entity that can induce an adverse response. Risk assessment = provides information on potential health or ecological risks. There are many “assets” at risk from hazards. First and foremost, injuries to people should be the first consideration of the risk assessment. Hazard scenarios that could cause significant injuries should be highlighted to ensure that appropriate emergency plans are in place. As you conduct the risk assessment, look for vulnerabilities – weaknesses – that would make as asset more susceptible to damage from a hazard. Vulnerabilities include deficiencies in building construction, process systems, security, protection systems, and loss prevention programs. They contribute to the severity of damage when an incident occurs. 

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Blogging: an effective instructional tool

A class consists of lectures and taking notes. Students then study that material and take an exam to prove how much they paid attention in class. Are those exams really the best way to test one's knowledge? Students zone out during lectures and often forget the information after an exam is taken. Exams and lecturing are not entirely ineffective; however, it is important to consider other methods such as discussion and blogging. Teachers should work to discover what it really in their student's minds, to see what all they know or don't know. Blogging can give students the power to choose their grades, decrease their stress, and give them a number of benefits.  Short for web log, a blog is actually a web page that allows visitors to read and reply to content on varied topics. Blogs work well for students because they can be worked on at virtually any time and in any place with a computer. In addition to providing teachers with an excellent tool for communicating with students, blogs are:

-       Excellent opportunities for students to read and write.

-       Highly motivating to students, especially those who might not become participants in classrooms

-       Effective forums for collaboration and discussion

-       Powerful tools to enable learning or mentoring to occur

Blogs opens the opportunity for students to discuss topics outside of the classroom. Students can post on such topics as journal/diary entries, reflections on their writing process, details on their research projects, commentary on recent events or readings, and drafts for other writing they are doing. With a blog, people have an equal opportunity to share their thoughts and opinions. In a job, your employer is not going to give you a multiple choice test on the meeting this week, but they might ask you to type up meeting minutes or send out a summary email. This is where the practice of blogging becomes very effective. Looking at a larger body of information and being able to produce a summary of that information is a great skill to have that standardized testing will not teach you. Blogging is really most effective with students who are interested in the class, have a willingness to learn, and understand the importance of the discussion of the topic given. Blogs also present, organize and protect student work as digital portfolios. As students realize their efforts will be published, they are typically more motivated to product better writing.  Overall, blogging is a good learning tool in it's own way. Students prefer to do these instead of exams due to the less stress, time consumption, and picking your grade easier. 

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Fukushima Radiation Affecting Americans

The Fukushima disaster in Japan was the world's worst nuclear disaster since Chernobyl in 1986, resulting from the release of radioactive isotopes from the Fukushima Daiichi Nuclear Power Plant after the 2011 earthquake and tsunami. It has brought to the forefront the dangers of worldwide nuclear radiation. Since then, it is estimated that 330 tons of radiation-contaminated water has been leaking into the Pacific Ocean daily. That’s correct, over 300 tons of radiation-contaminated water has been seeping into our oceans every single day for over two years. That’s over 250,000 tons of contaminated water that has now entered the Pacific Ocean. The amount of radioactivity released from Fukushima from other points of comparison yields cause for concern. The release of radioactivity from Fukushima is estimated to be the equivalent of 168 of the atomic bombs dropped on Hiroshima, Japan during World War II. More troubling still is the fact that the Fukushima plant continues to spew out radiation across the northern hemisphere every single day because the reactors have not stabilized. Continuously, leaks in the reactors are being reported, , fish have been found to be contaminated with radiation, U.S. water supply samples are testing positive for radioactive components Iodine-131, Cesium-134 and Cesium -137, and Fukushima children are being diagnosed with thyroid cancer. What prevails is a well-organized camouflage. The public health disaster in Japan, the contamination of water, agricultural land and the food chain, not to mention the broader economic and social implications, have neither been fully acknowledged nor addressed in a comprehensive and meaningful fashion by the Japanese authorities. 

The Japanese government took charge of the Fukushima situation only in August, when Abe finally ordered an intervention. Japan has offered but a few solutions for the persistent radiation leaks, including protective barriers to prevent the flow of contaminated water into the ocean. Japanese government approved a plan to bury refrigeration pipes 100 feet below sea level for about a mile around the radioactive site to essentially freeze the ground to prevent water flow; the job is expected to take 18 months and cost hundreds of millions of dollars. But while Chernobyl and Fukushima were the only two nuclear disasters to measure Level 7 on the International Nuclear Event Scale, Chernobyl only contained 180 tons of nuclear material prior to the catastrophe while Fukushima contained 1,760 tons of nuclear material. Nuclear radiation – which threatens life on planet earth – is not front page news in comparison to the most insignificant issues of public concern, including the tabloid gossip reports on Hollywood celebrities or the local level crime scene. This was an urgent matter two and a half years ago when the leaking first started. And now it’s too late. The world and the entire human race will be greatly affected – and no one is saying anything. We know that Chernobyl did tremendous damage to people in Belarus and Ukraine and now we are seeing it again in Fukushima. Our government hasn’t addressed the topic whatsoever. Obviously, money and keeping face are more important than the lives and wellbeing of millions.

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FDA Approval of Novel Therapeutic Agents

Many patients and physicians assume that the safety and effectiveness of newly approved drugs is well understood by the federal Food and Drug Administration (FDA). The article describes a study of the clinical trial evidence supporting FDA drug approvals, and the authors conclude that the quality of that clinical trial evidence varies widely. The team evaluated the strength of clinical trial evidence supporting FDA approval decisions for new drugs by characterizing key features of efficacy trials, such as trial size, design duration, and end points. FDA approved 188 novel therapeutic agents for 206 indications on the basis of 448 pivotal efficacy trials and that the quality of the clinical trial evidence supporting approval of these drugs varies widely across indications.

Most drugs were approved based on two efficacy trials, but for 74 indications (36.8%), drugs were approved based on only one efficacy trial. Additionally, for 91 indications (45.3%), drugs were approved based solely on trials using surrogate endpoints as their primary outcome. There was also significant reliance on surrogate endpoints, defined as “any endpoint using a biomarker expected to predict clinical benefit.” Trials using surrogate endpoints as their primary outcome formed the exclusive basis of approval for 91 indications (45%) among the study sample. The team also found that only 40% of drug approvals involved a clinical trial that compared a new drug to existing treatment offerings. This is an important step for determining whether the new drug is a better option than existing, older drugs.  Survey data shows that patients expect drugs approved by the FDA to be both safe and effective.

These results are unsurprising because the FDCA (Federal Food, Drug, and Cosmetic Act) specifically authorizes FDA to approve drugs based on clinical trial evidence as such varied quality. Congress has made a policy decisions that FDA should not require that drug approval supported by two trials studying clinical endpoints. The authors suggest that FDA adopt a “life-cycle” approach for drug safety and effectiveness, communicating a therapies risk and benefit information in an updated summary that distinguishes between the types of evidence relied on for initial and continuing approval. It also requires adequate and robust post-market surveillance systems that allow for re-assessments of drug efficacy and safety after launch.

This study is in hopes to educate the public about what kinds of evidence actually support many drug approvals. Its important for patients and practitioners to understand the quality of evidence that supports drug approvals because the quality of that evidence goes to the amount of certainty we should have about the safety and effectiveness of a drugs. This study also increases knowledge about the relative strength of the evidence supporting many drug approvals, it can also enable a more informed debate about whether Congress and FDA have struck the right balance between allowing access to effective drugs for patients who need them, and preventing harms from access to ineffective and unsafe drugs. 

References:

http://jama.jamanetwork.com/article.aspx?articleid=1817794 

http://www.news-medical.net/news/20140122/Study-shows-clinical-trials-used-by-FD-to-approve-new-drugs-vary-widely-in-characteristics.aspx 

http://www.healthnewsreview.org/2014/01/jama-papers-on-the-fda-drugs-and-devices/ 

http://www.sciencedaily.com/releases/2014/01/140121164758.htm

Timothy Leary Changing the World

Dr. Timothy Leary was one of the most prominent figures during the counterculture of the 1960s, and since those times has remained influential on music, pop culture, television, literature and film. His popular slogan, “Turn on, tune in, drop out”, persuaded millions of people to take drugs and explore alternative lifestyles. Leary’s main message – and another one of his famous slogans – was to get people to think for themselves and question authority. It’s a message that’s still relevant today. When LSD was made illegal in 1967, Leary’s went from being an active leader to being mainly a symbol. The government decided that it was going to make an example of Leary in its war against drugs. President Nixon even called him “the most dangerous man in the world.” While making LDS illegal, it didn’t decline the use of the drug, if anything it increased it, but it did change the way the psychedelic movement was developing. The music festivals came to an end mainly because possession of LDS was now a misdemeanor and selling was a felony.

Instead of looking at the medical evidence provided to them, the government made the choice to make LSD illegal based on their fears of the recreational use taking place. Without any real medical reasons to ban such drugs, as well as the possible benefits that increased research could discover, it begs the question why was the government so afraid of what this psychedelic movement might produce? The government was afraid of the radical counter-culture, and their calls to change the establishment. Many people in the government viewed drugs such as marijuana and LSD as the fuel for this counter-culture, so it only would make sense to cut it off as its source.

If our country can legalize alcohol and cigarettes, why not marijuana for recreational use?

Fifty years ago, the idea of marijuana being legalized would have seemed outrageous and impossible to most people. Attitudes regarding marijuana regulation have also changed as some states - Colorado and Washington - have passed their own laws legalizing marijuana for recreational use. If marijuana is legalized in all states, it will dramatically influence the future of American culture, particularly its economic, social and medical structures.  Marijuana smoking, while thought to affect the brain and body many times long after one has stopped using the drug, is generally not any more harmful than alcohol or tobacco if used in moderation. So what’s the problem? Legalization of marijuana would likely mean a lower price of the drug and reducing related crimes. It would also be a source of additional tax revenues and police would be freed up for more serious crimes. The problem is that people are used to thinking that marijuana smoking is “bad.” We have forgotten that drinking used to be “bad”.

Legalizing marijuana will open the door not only to an improved healthcare system, but also to an improved economic and social structure. It also is fulfilling Timothy Leary’s transform America movement. The only question is whether the American people will have the courage to take the risk.

References:

Timothy Leary 

Transform America 

The War On Drugs