Friday, December 31, 2010

Elections 2012 12 Demographics of House Voters Interactive Map Gives Details

Tags: Elections Patchwork Nation Why 12 Different Demographics Vote Republican or Democrat Interactive Map PBS

Those couples who make $250,000 a year know that it is not enough considering the lifestyle they are expected to live and want to lead such as the best schools and ability to save for college. It is even worse because of the financial fraud collapse of the stock market where most had their savings. I suspect many got out by the end of 2008 which hurt them when the uptick started in the spring of 2009. The data indicate that many kept selling as the market went up.

So we have a situation where many families are in bad financial shape even if they still have their insecure jobs. When people are scared, they don’t want change, especially more conservative families. Recent studies show that conservatives have larger Amygdalas so they fear life more than typical Americans. They were also reluctant to take out the risky mortgages so they suffered less than many Americans.

The website that gives us a warehouse of information that will help both Republicans and Democrats plan for 2012. The Republicans will do better in this planning because they have the support of very good Think Tanks supported by billionaires and corporations.

As Senator Schumer (D-NY) suggested the maintaing the tax cuts should go up to $1,000,000 and moved up with inflation. That is the mistake that was made with the tax on incomes over a certain amount taking into account inflation to try to hit excess deductions by the very rich. So it has to be stupidly inactivated year to year until they fix it.

As Obama suggested, a complete overhaul is necessary with serious consultation with reasonable Republicans. In order for a law to stick from administration to administration it must have something important for both parties.

Jim Kawakami, Dec 31, 2010,

Wed, 12/29/2010 - 20:50 | by Dante Chinni

Christmas 2010 is in the past and New Year's is approaching, which means it's time to start thinking about ... 2012.

Yes, Iowa and New Hampshire are more than a year away, but for presidential hopefuls the political calculations are already well underway. For many they started the Wednesday after Election Day 2008.

Tapping into the American electoral zeitgeist is no easy task however and a Patchwork Nation analysis of the vote in 2008 versus 2010 shows just how much the landscape has changed. Both were big change wave elections, but we do not yet know if 2012 will be as charged a political environment.

The Democrats lost ground in all of Patchwork Nation's county types in the 2010 House vote compared to the vote in 2008 -- including the reliably "blue" big city Industrial Metropolis and Campus and Career locales. But most troubling for President Obama and the members of his party would have to be the numbers from the wealthy, largely suburban Monied Burbs.

(You can see a map here of the Democrats 2010 House Vote by county.)

The vote in the Burbs is typically close, but it swung heavily to the Democrats in 2008, when Democratic House candidates won there by 11 percentage points. Those same Burb counties were arguably why Barack Obama won the presidency in 2008 - as we note in the book "Our Patchwork Nation."

In 2010, that margin not only disappeared, the swinging Burbs swung to the GOP. Republican House candidates won the total vote from the Monied Burbs in the midterms - 50 percent to 47 percent. The Burbs -- with 286 counties and 69 million people -- are key to Mr. Obama's chances for reelection and the GOP's hopes of unseating him. The 2010 results seem to show they are very much in play and suggest 2008 may be have been an aberration.

At the very least, the numbers suggest the Democrats have a lot of work to do before 2012:

Voter Support for Democratic House Candidates

Community Type



Point Change

Monied 'Burbs




Minority Central




Evangelical Epicenters




Tractor Country




College and Careers




Immigration Nation




Industrial Metropolis




Boom Towns




Service Center




Empty Nests




Military Bastions




Mormon Outposts








The Biggest Changes

As University of Maryland professor James Gimpel and I write in "Our Patchwork Nation," most of our 12 county types are not up for grabs in election years. It is clear long before the first vote is cast which way they will vote. But the margins in the community types matter and 2010 saw big slips for the Democrats everywhere.

The biggest drop for the Democrats came in the Campus and Career counties. Democrats' House candidates captured 66.2 percent of the vote in those counties in 2008, but only 52.6 percent in 2010 - a drop of 13.6 percentage points. That's not a complete shock. College students were inspired by Mr. Obama's candidacy and are usually not tuned in for midterm elections.

As we heard on our October trip to Bloomington, Ind., home of Indiana University, say "midterms" and students talked about exams not elections. But much of the student vote may return in 2012, if the campus vote still feels excited about President Obama.

There was also a drop in Minority Central -- counties with large black populations -- of more than 10 percentage points for the Democrats. That decline is not hard to understand either. Without the first black president on the ticket to help bring out the African-American vote, the Democratic Party suffered.

But there are more troubling signs for the Democrats in these results, especially in the small town Service Worker Centers, which continue to suffer above-average unemployment.

With many people there living on the margins and often without health insurance, one might think they'd cheer efforts to expand health care coverage, but Democrats were hit hard, seeing an 11.5 percentage-point drop in support in these community types in 2010.

And then there are the worrisome signs for Democrats in the Monied Burbs.

Was it Who Voted or How Many?

For some Democratic supporters, the hope is that the 2010 results were more a sign of a falloff in turnout than anything else. And if the party can get its faithful back to the polls in 2012 all will be well. But the numbers show there may be some serious problems in that thinking.

Comparing the most recent midterm results to 2006 reveals that 2010 was not an especially "low-turnout" election. In fact, the total House votes in 2010 topped total votes in 2006 -- 86 million vs. 80 million. Turnout was higher in 11 of our 12 county types.

Only rural, agricultural Tractor Country counties saw a drop in turnout between 2006 and 2010. As we have noted in the past, those counties have largely avoided the recession. Perhaps voters there felt less "angry" in 2010 than others.

And 2010 voter turnout in House races compared to 2006 was up the most in the Monied Burbs and the more exurban Boom Towns - with about 1.8 million more votes cast in each. In both those county types, Democratic candidates took a big hit in 2010 compared to both 2006 and 2008.

What drove those big changes?

The Boom Towns were hit hard by the foreclosure crisis, as we have noted repeatedly on this blog. The Monied Burbs saw an uncharacteristically big rise in unemployment in the last two years to more than 10 percent in early 2010. Numbers show that may now be in the midst of being reversed -- perhaps time will tell by 2012.

And somewhere in these numbers is the broader message about what to expect from President Obama and the Democrats in the coming year to 18 months.

The Game Plan Going Forward

Republicans and GOP presidential candidates can win without the Monied Burbs. They can't lose them by much, but Republicans have a large enough advantage in other county types to make up the difference and narrowly lose the Burbs. The Democrats more or less must capture the Burbs to win.

Add it all together and it sounds eerily familiar to the world President Bill Clinton faced in 1995 - a president needing to retrench after big losses in the midterms, a need to "triangulate" (if that's what you want to call it) to sway moderate voters without scaring off his base. But there is one critical difference in the present situation -- the economy.

By 1995, the U.S. economy was on the upswing. As 2011 approaches, no one is exactly sure what's happening with the U.S. economy.

And that is the big challenge for the Democrats for 2012. The Monied Burbs, while critical, are also fickle -- more subject to change their votes based on economic shifts.

Ultimately for the Democrats and Mr. Obama, that means it won't just be about creating policies that reach out to those communities without offending more loyal constituencies. It will be about creating policies that work.

And that's something politicians and policymakers from both parties have struggled with since 2008.

Thursday, December 30, 2010

WikiLeaks: Secrets, Free Speech, and the Law, Clint Hendler, CJR

Tags: WikiLeaks Secrets Free Speech The Law CJR Assange Conspiracy Journalists Threatened Stop Free Flow of Information

Not widely publicized is that Wired Magazine editor refuses to release a taped interview that purportedly exonerates Assange from knowing who leaked the information to him. That has been standard policy of Wiki Leaks to never solicit information for years.

Jim Kawakami, Dec 30, 2010,

WikiLeaks: Secrets, Free Speech, and the Law, Clint Hendler, CJR Dec 28, 2010,

Brief Excerpts: … With that dispassionate rendering of events, it’s quite difficult to see significant legal differences between what WikiLeaks has done and what newspaper, television, and magazine reporters do all the time.

To offer one example, think of when The New York Times published cables from the U.S. ambassador to Afghanistan, Karl Eikenberry, in January 2010. That diplomatic cable was more heavily classified than the vast majority obtained by WikiLeaks, but it followed a similar course. It was given to the Times by someone, and the Times published it with some minor redactions—just as WikiLeaks has so far done with the cables.

The United States has never convicted a journalist for publishing classified information—they’ve never even undertaken such a prosecution. Attempts to prosecute non-journalistic third parties for transmitting classified information that they received from government employees have been rare, too—the most prominent case, involving two pro-Israel lobbyists, was brought in 2005 by the Bush administration, and finally fell apart in 2009.

The case drew well-founded concerns that if the two were convicted, it would establish a court precedent that could create something akin to Britain’s Official Secrets Act, which does prohibit the dissemination—and not only the leaking—of some national security secrets. It could mean prohibiting a category of speech—reproducing classified documents, or perhaps even just describing their contents—by persons (journalists, other publishers) who have no official obligation to keep them secret.

The pitfalls of such a law are immediately clear: it would allow journalists to be prosecuted for reporting on classified matters. Large swaths of our government—the State Department, the military, the Department of Energy, the Department of Homeland Security—would immediately become a legal minefield for reporters seeking to give citizens as complete a picture as possible.

So far, the only indications that the government has been serious about its feints towards prosecuting WikiLeaks have been from Assange’s own lawyers, who have said that they expect his indictment under the Espionage Act is “imminent” and that they’ve heard word (through the Swedes, not directly from U.S. sources) that a grand jury has been empanelled to look at the case.

In mid-December, The New York Times reported that the government hoped to sidestep the sticky questions surrounding a charge based on the publication of classified information by instead focusing on Assange’s alleged interactions with Manning, in hopes that they crossed the line into something approaching conspiracy to leak documents.

Conspiracy charges are often nebulous affairs, but again, as Josh Gerstein, a Politico reporter who specializes in legal and transparency issues, pointed out, it’s not so clear that kind of charge wouldn’t also be able to capture traditional national security reporting. While there have been suspicions that WikiLeaks’s interactions with their alleged source crossed some line that would make them less a passive recipient of his information and more of a collaborator in spiriting out the information, there’s been nothing extraordinary publicly offered.

Manning reportedly claimed that Assange had created a special way for him to leak documents, so they wouldn’t be swamped by other submitters to WikiLeaks. If that’s the stiffest kind of cooperation prosecutors find, how legally different would that be from a reporter giving a source their home phone number, or coordinating two free signup e-mail accounts?

Either one of these kinds of prosecutions could have a serious impact on long standing precepts in journalism law. But the presence of WikiLeaks seems likely to shape the law in other ways. The Free Flow of Information Act, the formal name for the federal reporters’ shield law, was closer than ever to passage before the year of WikiLeaks began. The law would have given reporters some protection against being forced to divulge the identity of confidential sources, or information obtained from them, in federal court.

The Obama administration had, after some revisions, agreed to support it, and the House had overwhelmingly passed a version. All that remained was Senate floor passage. A lead lobbyist for the bill told CJR in August that he believed there were “close to seventy” votes in favor of the bill. Even with that filibuster-proof majority, he nonetheless expected that they’d have to face a drawn out cloture process, even if Senate leadership was willing to call a vote on the bill. How many of those votes have evaporated in the climate brought on by WikiLeaks, and how eager was anyone to have that fight? …

Monday, December 27, 2010

Climate Change Why Cooler in Europe and East Coast Fits Warming Model or Not

Tags: Climate Change Predicts Cooling on East Coast and Europe or Not, Judah Cohen

I think Judah Cohen, as bright as he think he is, wrongly states that the climate models do not consider a number of factors including cooling in certain parts of the world. Most of the climate models including the British, American, and Japanese, arguably the best models do not completely agree with each other, but they do predict cooling in the eastern USA and Europe due to Climate Change changing both the flow directions of oceans and jet stream directions.

The central Pacific Ocean warming nearer the equator in recent years has made the so-called seasonal weather effects, a specialty of Cohen’s, to become even more complex. We are now suffering La Nina effects, something Cohen fails to mention in his article, which is now causing heavy rain and snows in the California Mountains and the Cascades in Oregon and Washington, and unprecedented floods in California.

The other factor Cohen does not consider is the Gulf current slow down in the Atlantic, possibly due to Greenland land glaciers melting faster than usual making the ocean less salty. For example, Spain is at the same latitude as New York City, but Europe normally has not suffer the Arctic chills until now. What happened is the Warming Gulf Current flows from the Gulf along the Eastern USA and normally the salty water sinks near Greenland and travels to Europe. About a year ago, I heard the current has slowed by two-thirds and may have slowed even more because the convection process for current flow is no longer operating well in warming Europe.

Remember the film where the Gulf Stream stopped flowing north causing the deep freeze in New York City where the kids had to take refuge and burn books to keep warm.

I am sure Cohen knows more than I do, but perhaps he has a profit motive for his firm which provides the guessing game of seasonal forecasts for corporations by suggesting he is better than the long-term climate models scientists. I go with those keeping quiet now. I hope they speak up. I am just an informed chemist.

Jim Kawakami, Dec 27, 2010,

Climate Change Why Cooler in Europe and East Coast Fits Warming Model or Not

Judah Cohen, NY Times, Dec 25, 2010,

Dr. Judah Cohen, Director of Seasonal Forecasting, joined Atmospheric and Environmental Research, Inc. as a Staff Scientist in 1998. Prior to AER, he spent two years as a National Research Council Fellow at the NASA Goddard Institute for Space Studies after two years as a research scientist at MIT’s Parsons Laboratory. Cohen received his Ph.D. in Atmospheric Sciences from Columbia University in 1994 and has since focused on conducting numerical experiments with global climate models and advanced statistical techniques to better understand climate variability and to improve climate prediction.

In addition to his research interests, as principal scientist, Cohen directs AER’s development of seasonal forecast products for commercial clients who include some of the largest investment firms in the US. He has been interviewed on local and national television, the Wall Street Journal, Boston Globe, and Investor’s Business Daily, among others. His work is highlighted as breakthrough technology by the National Science Foundation (NSF).

Dr. Cohen has a Research Affiliate appointment in the Civil Engineering Department at Massachusetts Institute of Technology (MIT) and is a member of the American Meteorological Society (AMS) and the American Geophysical Union (AGU). He has published over two dozen articles on seasonal forecasting in their journals and others. Most recently, Dr. Cohen was appointed Associate Editor of the Journal of Climate, a peer-reviewed publication of the AMS. He continues to further his research, in addition to directing operational long range forecasting at AER. …

THE earth continues to get warmer, yet it’s feeling a lot colder outside. Over the past few weeks, subzero temperatures in Poland claimed 66 lives; snow arrived in Seattle well before the winter solstice, and fell heavily enough in Minneapolis to make the roof of the Metrodome collapse; and last week blizzards closed Europe’s busiest airports in London and Frankfurt for days, stranding holiday travelers. The snow and record cold have invaded the Eastern United States, with more bad weather predicted.

All of this cold was met with perfect comic timing by the release of a World Meteorological Organization report showing that 2010 will probably be among the three warmest years on record, and 2001 through 2010 the warmest decade on record.

How can we reconcile this? The not-so-obvious short answer is that the overall warming of the atmosphere is actually creating cold-weather extremes. Last winter, too, was exceptionally snowy and cold across the Eastern United States and Eurasia, as were seven of the previous nine winters.

For a more detailed explanation, we must turn our attention to the snow in Siberia.

Annual cycles like El NiƱo/Southern Oscillation, solar variability and global ocean currents cannot account for recent winter cooling. And though it is well documented that the earth’s frozen areas are in retreat, evidence of thinning Arctic sea ice does not explain why the world’s major cities are having colder winters.

But one phenomenon that may be significant is the way in which seasonal snow cover has continued to increase even as other frozen areas are shrinking. In the past two decades, snow cover has expanded across the high latitudes of the Northern Hemisphere, especially in Siberia, just north of a series of exceptionally high mountain ranges, including the Himalayas, the Tien Shan and the Altai.

The high topography of Asia influences the atmosphere in profound ways. The jet stream, a river of fast-flowing air five to seven miles above sea level, bends around Asia’s mountains in a wavelike pattern, much as water in a stream flows around a rock or boulder. The energy from these atmospheric waves, like the energy from a sound wave, propagates both horizontally and vertically.

As global temperatures have warmed and as Arctic sea ice has melted over the past two and a half decades, more moisture has become available to fall as snow over the continents. So the snow cover across Siberia in the fall has steadily increased.

The sun’s energy reflects off the bright white snow and escapes back out to space. As a result, the temperature cools. When snow cover is more abundant in Siberia, it creates an unusually large dome of cold air next to the mountains, and this amplifies the standing waves in the atmosphere, just as a bigger rock in a stream increases the size of the waves of water flowing by.

The increased wave energy in the air spreads both horizontally, around the Northern Hemisphere, and vertically, up into the stratosphere and down toward the earth’s surface. In response, the jet stream, instead of flowing predominantly west to east as usual, meanders more north and south. In winter, this change in flow sends warm air north from the subtropical oceans into Alaska and Greenland, but it also pushes cold air south from the Arctic on the east side of the Rockies. Meanwhile, across Eurasia, cold air from Siberia spills south into East Asia and even southwestward into Europe.

That is why the Eastern United States, Northern Europe and East Asia have experienced extraordinarily snowy and cold winters since the turn of this century. Most forecasts have failed to predict these colder winters, however, because the primary drivers in their models are the oceans, which have been warming even as winters have grown chillier. They have ignored the snow in Siberia.

Last week, the British government asked its chief science adviser for an explanation. My advice to him is to look to the east.

It’s all a snow job by nature. The reality is, we’re freezing not in spite of climate change but because of it. Judah Cohen is the director of seasonal forecasting at an atmospheric and environmental research firm.

Brain Amygdala Much Larger in Highly Social People Like Bill Clinton Why

Tags: Brain Amygdala Much Larger in Highly Social People Chicken or Egg First Growth Brain Parts in Use

What came first, the chicken or the egg. In the last 10-15 years creativity has decreased by 20 percent in Americans. Why? Lack of use of the processing and organization of information during sleep when the brain is often more active than awake? Not enough sleep? Google? Lack of Vitamin D?

Psychologist Lisa Feldman Barrett seems to emphasize the egg where she emphasizes the originally large Amygdala as the reason some have a larger number of social contacts, which she calls friends wrongly, but are more correctly acquaintances such as the people Bill Clinton knows. It has been said that Bill has many acquaintances but no real friends except Hillary. I suspect that having a Rolodex does not mean we have many friends.

It seems that practice makes perfect and like any muscle, repeat use enlarges the Amygdala, something Barrett mentions near the end of the article, but does not really emphasize. I am not sure that it is true, but people in professions that require much thinking tend to have a more prominent prefrontal cortex and those who need to use their memory a lot also tend to have larger hippocampus. Alzheimer’s Disease shrinks the hippocampus as does depression.

Learn to be critical even of writings from prestigious institutions or not and engage your mind to think through what our experts say and whether they have a conflict of interests as we saw in the review of the benefits of Vitamin D3 by the prestigious review panel. Yes, conflicts of interests were rampant.

Jim Kawakami, Dec 27, 2010,


by Sheldon Rampton and John Stauber

Trust Us, We're Experts: How Industry Manipulates Science and Gambles with Your Future

Now In Paperback!
Publisher: Tarcher/Penguin
Bookstore price: $14.95 U.S./$21.99 Canada
ISBN 1-58542-139-1

Social whirl of a life? Thank your amygdala, Ian Sample,, Dec 26, 2010,

Researchers find almond-shaped clump of nerves in brain is larger in more gregarious peoplepastedGraphic_1.pdf

An almond-shaped group of nerves at the base of the brain may be the reason why some people can deal with a varied social life. Photograph: David Job/Getty Images

If your social life is a blur of friends and family, you might want to thank an almond-shaped clump of nerves at the base of your brain.

Researchers have found that part of the brain called the amygdala, a word derived from the Greek for almond, is larger in more sociable people than in those who lead less gregarious lives.

The finding, which held for men and women of all ages, is the first to show a link between the size of a specific brain region and the number and complexity of a person's relationships.

The amygdala is small in comparison with many other brain regions but is thought to play a central role in coordinating our ability to size people up, remember names and faces, and handle a range of social acquaintances.

Researchers at Massachusetts general hospital in Boston used magnetic resonance imaging (MRI) scans to measure the amygdalas of 58 people aged 19 to 83 and found the structure ranged in size from about 2.5 cubic millimetres to more than twice that.

As part of the study, each of the volunteers completed a questionnaire giving the number of people they met on a regular basis. They also commented on the complexity of each relationship. For example, one friend might also be a boss, meaning the person had to adapt their behaviour with the person depending on the nature of their encounter.

The team, led by psychologist Lisa Feldman Barrett, found that participants with larger amygdalas typically had more people in their social lives and maintained more complex relationships.

Those with the smallest amygdalas listed fewer than five to 15 people as regular contacts, while those with the largest amygdalas counted up to 50 acquaintances in their social lives. Older volunteers tended to have smaller amygdalas and fewer people in their social group.

Writing in the journal, Nature Neuroscience, Barrett's team cautions that the finding is only a correlation, meaning they cannot say whether there is a causal link between the size of the amygdala and the richness of a person's social life. However, previous studies with primates show that those that live in large social groups also have bigger amygdalas. "People who have large amygdalas may have the raw material needed to maintain larger and more complex social networks," said Barrett . "That said, the brain is a use it or lose it organ. It may be that when people interact more their amygdalas get larger. That would be my guess.

"It's not that someone with a larger amygdala can do things that someone with a smaller amygdala cannot do. People differ in how well they remember people's names and faces and the situation in which they met them. Someone with a larger amygdala might simply be better at remembering those details," Barrett added.

Previous studies have found that parts of the brain enlarge to cope with more demanding tasks. In 2000, a team of neuroscientists led by Eleanor Maguire at UCL showed that in London taxi drivers, part of the brain called the hippocampus grows to help them remember a mental map of the city.

Barrett's MRI scans revealed no other brain structures that varied in size according to the extent and complexity of a person's social life.

The work builds on previous research by Robin Dunbar, director of social and cultural anthropology at Oxford University, who found a theoretical limit to the number of meaningful relationships a person can maintain. The figure is rough but considered to be about 150.

Barrett did not look at whether amygdala size varied with the number of contacts a person had on social networking websites like Facebook or Twitter, in part because it is unclear whether these require the same cognitive effort to maintain as more traditional relationships.

Barrett's group is now looking at other brain regions to see which others are involved in social behaviour, and how abnormalities or injuries to the brain can impair a person's social life.

Sleep Smart Phone WakeMate Tracks Sleep Patterns Wakeup Alarm Light Sleep

Tags: Wakeup App for Sleeping Alarm Comes when Ready to Wakeup Smart Phones Kindle NY Times

My sleep gets light before I am ready to wakeup. Luckily a couple upstairs gets up about when I do about 9 AM or so. I go to sleep after 1 AM the night before so it seems to be almost enough. Normally I do not need coffee when I get about 9 hours of sleep, a sleep time which use to be the normal for Americans in the past before the Internet era and other modern apps.

Bjornstad is a medical doctor who writes articles time to time for the Register Guard in Eugene. Dr Oz writes a column every Monday which can only be accessed on this improved website by searching for Oz.

Even with the NY Times website, it is not always easy to find articles you might be interested in reading because it is pushed into the background of a very large newspaper. That is why I subscribe.

The new Kindle from is the best selling product in the world now! It is great and may get more people to read and keep authors and book reviewers solvent!

Jim Kawakami, Dec 27, 2010,


New gadget called WakeMate works with a smartphone to track your sleep patterns


The Register-Guard

Published: Monday, Dec 27, 2010 05:00AM Undoubtedly many children found it hard to sleep Friday night, as the popular song goes, because after all, Santa was on his way with lots of toys and goodies on his sleigh.

But in the aftermath of the holiday, with visions of sugar plums no longer dancing in their heads, to borrow from another Christmas classic, most kids are probably back to their regular slumber schedule.

If only many adults could join them, but unfortunately, the alarm clock interrupts the sleep state at the wrong time for many people, who drag themselves out of bed every morning feeling as if they’d never even been there.

Not surprisingly — since most humans spend up to one-third of their lives under the covers — there’s been a lot of scientific research on what disrupts a good night’s sleep and tips for making it more rejuvenating.

And even less surprisingly, in the an-app-for-everything computer age, there are multiple gadgets on the market to help make that happen.

One of the most intriguing choices is called WakeMate, which figures out where you are in your sleep cycle around the time you need to get up and then wakes you at the moment of lightest sleep within a 20-minute time window to give you a chance for a bright-eyed and bushy-tailed start to the day.

The WakeMate does it, according to, by using a special electronic band around the wearer’s nondominant wrist to monitor peaks and troughs in the sleep cycle through a 20-year-old method called “actigraphy.” It sends data from the bracelet to its owner’s smartphone, which issues the wake-up call in the form of an alarm tone or even music.

The application also allows the data to be accumulated by the smartphone to compare nightly “sleep scores” and devise schedules that will lead to more efficient and high-quality sleep.

However, good sleep can be had even by those who don’t carry smartphones, through an understanding of sleep cycles and when best to intercept them.

Modern sleep researchers have known for years that sleep happens in several stages: falling asleep, light sleep, deep sleep and rapid eye movement, or REM sleep, during which dreams occur.

The cycle repeats several times throughout the night, although many researchers say that the dream stage doesn’t happen as often as the others. Instead, the sleep cycle goes from light to deep and back again before hitting REM sleep and then starting over. And, they say, the deepest sleep of the night happens in the first two repetitions of the sleep cycle.

Nor do we dream as often as we might think. The dream, or REM, phase happens only about every hour and a half, lasting at first only about 10 to 20 minutes but lengthening during the night with each cycle. On average, we spend from a fifth to a quarter of the night’s sleep dreaming.

Before the invention of the electroencephalogram in 1929, scientists thought sleep meant the brain was inactive, according to a Harvard Medical School article on sleep patterns. But from then on, it became obvious that the brain remains highly active during sleep — sometimes even more active than when we’re awake.

Different things go on during the different stages of sleep, which is why it matters when a person wakes up. Some parts of the sleep cycle are important for physical regeneration of the body; others help to fix memories and new learning in the brain.

In humans, sleep is determined by a combination of circadian rhythm, the physical and mental need for sleep and the alarm clock. It’s usually the alarm clock that throws things off by interrupting the physical and mental functions controlled by the other two, internal timing devices.

Hence the effort to develop gadgetry such as WakeMate that don’t just cause awakening at a specific moment but try to correlate it with what the body is doing naturally.

British researchers offer additional reasons not only for getting enough sleep but for fine-tuning sleep to correlate with the body’s natural wake-sleep rhythms. Lack of sleep can double the risk of death from cardiovascular disease, they say, as well as create a risk for weight gain, high blood pressure and Type 2 diabetes.

On the mental side, poor sleep patterns are associated with depression, alcoholism and bipolar disorder.

For those reasons, the researchers recommend that children up to 3 years old should sleep as much as 15 hours per day or more; preschoolers need 11 to 13 hours of sleep, while elementary-age children should get nine to 11 hours of sleep daily. Adolescents need as much as 10 hours of sleep, and mature adults should have seven to eight hours or more each day.

Clearly, that doesn’t happen in most people’s frenetic daily schedules, giving rise to electronic aids to try to recapture some of the naturalness of the sleep cycle.

But for those who prefer a less technological approach, the Harvard Medical School’s sleep staff offers some other tips for sleep:

Avoid caffeine, alcohol, nicotine and other chemicals that interfere with sleep four to six hours before bedtime.

Keep the bedroom dark, cool and quiet and well-ventilated, using blackout shades, earplugs or a “white noise” producer if necessary.

Establish a presleep routine that promotes relaxation, such as a warm bath, reading, watching television or doing relaxation exercises. Avoid stressful activities or discussions.

If still awake 20 minutes after going to bed, get up, go to another room and resume relaxing activities until sleepy.

Don’t watch the clock during the night, because being awake and observing the passage of time can be stressful and prevent sleep.

Let natural light into the room first thing in the morning to promote a healthy sleep-waking cycle.

Try to go to bed and get up at the same time each day to help set the body’s internal clock, including on weekends.

Nap, if at all, early in the afternoon and for only a short time, no longer than 30 minutes.

Eat dinner several hours before bedtime and don’t snack before going to bed; if hungry, eat a small amount of fruit or dairy food to avoid causing insomnia or indigestion.

Drink enough fluid before bed to keep from waking up thirsty but not so much as to cause need for urination during the night.

Finish daily exercise at least three hours before bedtime.

Sunday, December 26, 2010

Medicare Voluntary End of Life Planning in Healthcare Bill By Regulation Hooray

Tags: Alzheimer's Excess Proteins Cause Assisted Suicide Meds Diet Causes Medicare End of Life Advice Paid

Derek Humphry who published Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying lives in Oregon where a bill allows physician assisted suicide for patients who have terminal disease within six months. Mormons and Republicans tried to overturn the law, but failed in a second election.

I read recently that we might live longer, but we will live longer with disease, especially Alzheimer’s. Finally the research is shifting towards getting rid of excess proteins early in the disease before severe brain damage occurs.

I suspect that we will find that a combination of a lack of enough vitamin D to keep cells healthy and the many medications we are taking are causing the dementia problem. About 156 pounds yearly of this sugar can’t be good for us.

Sure old age is involved, but I suspect it is not that simplistic. Our diet since the Reagan years and subsidizing of high fructose corn syrup sold widely before it was tested for toxic effects such as causing obesity and likely dementia by the formation of very low density lipoproteins from liver metabolism and excess triglycerides in our Omentum organ due to excess fructose metabolism. Remember one function of vitamin D is to keep genes off or on depending on whether it helps us or not.

Gene caused early Alzheimer’s is due to our body not being able to metabolize very low density lipoproteins. Longer term Alzheimer’s may be caused by a similar mechanism besides medication shutting down the enzyme that gets rid of excess protein. For example, an antihistamine was taken off the market because it blocked the enzyme from forming in our muscles. Perhaps similar molecules have the same effect in our brain.

Jim Kawakami, Dec 26, 2010,

Medicare Voluntary End of Life Planning in Healthcare Bill By Regulation Hooray


Published: December 25, 2010

WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

In the past civilizations allowed sick old people to die. Perhaps they knew something that is lost in our fictitious religious fervor. If we really believe in heaven, why not let the suffering end and allow your loved ones to not suffer anymore.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.

In this case, the administration said research had shown the value of end-of-life planning.

“Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives,” the administration said in the preamble to the Medicare regulation, quoting research published this year in the British Medical Journal.

The administration also cited research by Dr. Stacy M. Fischer, an assistant professor at the University of Colorado School of Medicine, who found that “end-of-life discussions between doctor and patient help ensure that one gets the care one wants.” In this sense, Dr. Fischer said, such consultations “protect patient autonomy.”

Opponents said the Obama administration was bringing back a procedure that could be used to justify the premature withdrawal of life-sustaining treatment from people with severe illnesses and disabilities.

Section 1233 of the bill passed by the House in November 2009 — but not included in the final legislation — allowed Medicare to pay for consultations about advance care planning every five years. In contrast, the new rule allows annual discussions as part of the wellness visit.

Elizabeth D. Wickham, executive director of LifeTree, which describes itself as “a pro-life Christian educational ministry,” said she was concerned that end-of-life counseling would encourage patients to forgo or curtail care, thus hastening death.

“The infamous Section 1233 is still alive and kicking,” Ms. Wickham said. “Patients will lose the ability to control treatments at the end of life.”

Several Democratic members of Congress, led by Representative Earl Blumenauer of Oregon and Senator John D. Rockefeller IV of West Virginia, had urged the administration to cover end-of-life planning as a service offered under the Medicare wellness benefit. A national organization of hospice care providers made the same recommendation.

Mr. Blumenauer, the author of the original end-of-life proposal, praised the rule as “a step in the right direction.”

“It will give people more control over the care they receive,” Mr. Blumenauer said in an interview. “It means that doctors and patients can have these conversations in the normal course of business, as part of our health care routine, not as something put off until we are forced to do it.”

After learning of the administration’s decision, Mr. Blumenauer’s office celebrated “a quiet victory,” but urged supporters not to crow about it.

“While we are very happy with the result, we won’t be shouting it from the rooftops because we aren’t out of the woods yet,” Mr. Blumenauer’s office said in an e-mail in early November to people working with him on the issue. “This regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth.”

Moreover, the e-mail said: “We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded.”

The e-mail continued: “Thus far, it seems that no press or blogs have discovered it, but we will be keeping a close watch and may be calling on you if we need a rapid, targeted response. The longer this goes unnoticed, the better our chances of keeping it.”

In the interview, Mr. Blumenauer said, “Lies can go viral if people use them for political purposes.”

The proposal for Medicare coverage of advance care planning was omitted from the final health care bill because of the uproar over unsubstantiated claims that it would encourage euthanasia.

Sarah Palin, the 2008 Republican vice-presidential candidate, and Representative John A. Boehner of Ohio, the House Republican leader, led the criticism in the summer of 2009. Ms. Palin said “Obama’s death panel” would decide who was worthy of health care. Mr. Boehner, who is in line to become speaker, said, “This provision may start us down a treacherous path toward government-encouraged euthanasia.” Forced onto the defensive, Mr. Obama said that nothing in the bill would “pull the plug on grandma.”

A recent poll by the Kaiser Family Foundation suggests that the idea of death panels persists. In the September poll, 30 percent of Americans 65 and older said the new health care law allowed a government panel to make decisions about end-of-life care for people on Medicare. The law has no such provision.

The new policy is included in a huge Medicare regulation setting payment rates for thousands of services including arthroscopy, mastectomy and X-rays.

The rule was issued by Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services and a longtime advocate for better end-of-life care.

“Using unwanted procedures in terminal illness is a form of assault,” Dr. Berwick has said. “In economic terms, it is waste. Several techniques, including advance directives and involvement of patients and families in decision-making, have been shown to reduce inappropriate care at the end of life, leading to both lower cost and more humane care.”

Ellen B. Griffith, a spokeswoman for the Medicare agency, said, “The final health care reform law has no provision for voluntary advance care planning.” But Ms. Griffith added, under the new rule, such planning “may be included as an element in both the first and subsequent annual wellness visits, providing an opportunity to periodically review and update the beneficiary’s wishes and preferences for his or her medical care.”

Mr. Blumenauer and Mr. Rockefeller said that advance directives would help doctors and nurses provide care in keeping with patients’ wishes.

“Early advance care planning is important because a person’s ability to make decisions may diminish over time, and he or she may suddenly lose the capability to participate in health care decisions,” the lawmakers said in a letter to Dr. Berwick in August.

In a recent study of 3,700 people near the end of life, Dr. Maria J. Silveira of the University of Michigan found that many had “treatable, life-threatening conditions” but lacked decision-making capacity in their final days. With the new Medicare coverage, doctors can learn a patient’s wishes before a crisis occurs.

For example, Dr. Silveira said, she might ask a person with heart disease, “If you have another heart attack and your heart stops beating, would you want us to try to restart it?” A patient dying of emphysema might be asked, “Do you want to go on a breathing machine for the rest of your life?” And, she said, a patient with incurable cancer might be asked, “When the time comes, do you want us to use technology to try and delay your death?”