In Part I, we discussed in general terms some of the shortcomings I encountered in many of the grant proposals submitted during my stint as a grant reviewer for the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control (NCIPC) in the years 2002-2004 . There is no reason to believe that these epidemiologic and scientific shortcomings have been addressed and corrected in subsequent years. And from the outset, let me state that the problems do not lie with the methodology of the peer review process, but rather with the misuse of statistics and the lack of science in many, if not most, of the grant proposals. The methodology of grant review calls for the evaluation of research aims and long-term objectives, significance and originality, as well as research design. These are appropriate criteria, but perhaps, for improvement, an additional criterion should be added: Show me the science!
In Part I, we also stressed the fact that statistics are not science, and cannot prove cause and effect relationships . Yet statistics are a very useful tool of science that when properly applied establish correlations as to disease processes. And...
During the years 2002-2004, I served in the Injury Research Grant Review Committee (IRGRC, more recently the "Initial Review Group") of the Centers for Disease Control and Prevention (CDC) - more specifically, the National Center for Injury Prevention and Control (NCIPC).
I participated not only in the major meetings in Atlanta, but also in on-site reviews and inspections of Injury Research Centers (IRG) reviewing thousands of pages of grant applications requesting funding for medical and public health scientific research proposals. I have deliberately let some time elapse before writing this analysis with the purpose of being able to take a step back and write from a distance, objectively.
I should also inform the reader that I must write in generalities, for I cannot disclose by CDC rules specific details of any grant proposal requesting funding, or discuss the content of the review of any specific grant application in which I participated or that came to my knowledge while working at the CDC in the capacity of grant reviewer. This secrecy seems, in retrospect, even more stringent than those that were in place at Los Alamos during the Manhattan Project! So my...
I wholeheartedly agree and applaud your momentous editorial in November 2006 (I am now in standing ovation), pointing out with pinpoint accuracy the differences and defining characteristics between personal leadership and collective consensus building.
However, apparently you and I, and other neurosurgeons who believe in stoic leaders, the power of the individual mind, personal will, fortitude, and moral courage, are now seemingly a minority, going against an oceanic current, a progressive (socialistic) wave of pragmatic followers bent on establishing consensus down a predetermined path.
We are told almost daily by the mass media in the United States that people dislike gridlock and that consensus is a way to stop political gridlock and move forward. Yet, to our founding fathers, gridlock was the very strong medicine needed then (and still needed today) against the malady of3 runaway government---the checks and balances of a republican form of government---to protect dissenting minorities from passionate, tyrannical majorities.
However, consensus builders do as they have been instructed to do by those above who pull the strings from behind the curtain. They...
The media's ecstatic jubilation over the death of Gen.Augusto Pinochet on 12/10/06, including the AP report "Death of Pinochet shakes the nation" by Eduardo Gallardo, does not surprise me. What still amazes me is not only the blatantly biased, one-sided reporting of his "brutal" 17-year rule, but also the lack of sensitivity for those who lived under and supported him, and now mourn his death. The elitism is also apparent: The Chileans, who mourn him, are not only given short shrift, but do not know for a fact that he saved them from communism, but only "believe" he did so!
With great reluctance, this same writer (who also reported and gloated over Pinochet's travails in England a few years ago) intimates that his government "laid the groundwork for South America's most stable economy." The fact is that Gen. Pinochet also saved Chile from becoming another Cuba by deposing Socialist President Salvador Allende, who was planning his own communist coup in 1973. Gen. Pinochet may have had the secret help of the US, but he openly had the support of the Chilean housewives, who went in the streets of Santiago protesting Allende's rule banging their pots and pans.
In a memorable editorial, Frank Davidoff, M.D., Editor of the Annals of Internal Medicine (AIM) and Robert D. Reinecke, M.D. of the Jefferson Medical College called for a 28th Amendment to the U.S. Constitution to establish universal health care as a right.(1) It was promulgated in a "Dear Health Care Colleague" letter by Ira Hellander, M.D., Executive Director of Physicians for a National Health Program (PNHP; a group calling for socialized medicine in the U.S.).(2) The Amendment read in part, "All citizens and other residents of the United States shall have equal access to basic and essential health care."
And it should be affirmed that the re-election of President Bush in 2004, a Republican president who has expressed his support for Health Savings Accounts (HSAs) and free market reforms to improve access to and the quality of American medicine, has not squashed the efforts of many of his opponents who want to impose socialized medicine in the United States by trumpeting the concept of medical care as a right.
But is medical care really a basic human right? Does an individual have a right to health care? Let's assert categorically that health care is not a...
Over the next three to four years, during President George W. Bush's second term in office, we can expect the United States Congress to continue to move in the direction of improving access and quality of medical care via the implementation of affordable, free market solutions, particularly Health Savings Accounts (HSAs).
Strengthened by his re-election with a popular majority, a decisive and final victory in the Electoral College, as well as an increase in the already present majorities in both the U.S. House of Representatives and Senate---President Bush should be able to move decisively to free American medicine from the bureaucratic red tape that has been gradually suffocating the American health care delivery system for the last several decades.
Nevertheless, it will not be an easy task! Impediments remain, not only political opposition by liberal Democrats, who want to continue to travel down the same road of bigger government and ever greater government dependency, but also the bureaucratic inertia characteristic of Washington.
Moreover, President Bush and Congress still have to deal with the problem of the American legal system and the persisting,...
Even though politicians and some historians in both America and Europe have likened the French and American Revolutions, these two landmark events of world history were as dissimilar as the men who forged them.
The American Revolution (1775-1783) was a war for independence from England, a war for self-governance, as well as a thunderous political event that led to the affirmation of the Natural Rights of men namely, life, liberty, property and the pursuit of happiness. The American Civil War (1861-1865) freed the black slaves and extended civil rights that had been denied them since their arrival in chains to the New World.
Ordered liberty and self-determination enshrined in the American constitutional republic would endure and guide these United States of America through the turbulence of the last 200 years into the 21st century.
On the other side of the coin, the epochal episodes of the French Revolution, the storming of the Bastille (July 14, 1789), the fall of the monarchy (August 10, 1792), etc., were merely preludes to mob violence, the September Massacres (1792), the Reign of Terror and...
The Brave Girondins
Unfortunately, in her book, Radicals -- Politics and Republicanism in the French Revolution, Prof. Leigh Ann Whaley seems to admire the most radical Jacobins and by bringing down the reputation of the brave Girondins, she hopes to bring all the radicals of the French Revolution to the same level. No easy task! And so it was the Girondins' fault that they were executed. The purged Girondin Deputies had been "intransigent" and had acted "illegally," rising against the National Convention, as if this violated legislature was acting lawfully and with legitimate authority. It did not. Anarchy and tyranny had become the order of the day in France, and the Jacobin fanatics without the Girondin opposition were now unopposed and free to begin the Reign of Terror.
Even if the Girondins had been lawfully executed, as Prof. Whaley suggests, for rising against the Convention, what can be said then about the extermination of the aristocrats, the monarchists, the clergy, the Feuillants (constitutional monarchist), and later, Danton himself, the titan of the Revolution, and his friends (the "indulgents")? Why were all of these citizens and factions...
The Founding Fathers in their wisdom established a Constitutional Republic with a federal system in which each and every state, large and small, has a major stake in the election of the chief executives, the President and Vice President, of the United States of America.
This federal system incorporated an enduring system of checks and balances, separation of powers, limited government, and indirect representation. Within this conceptual framework, the Electoral College has served us well for over two centuries. What is the Electoral College? It's the body of electors chosen by the citizens of each state to elect the President and Vice President of these United States. The number of electors equals the number of U.S. senators (two) and U.S. Representatives for each particular state, and thus represents not only the wishes of the citizens but also the interests of the states.
These slates of electors are pledged to cast their ballots for a presidential ticket (e.g., Democrat or Republican). The national ticket getting the majority of Electoral College votes wins the election.
While other nations from so-called People's Republics and...
Seventy-eight-year-old Cuban dictator Fidel Castro, dressed in his usual olive green fatigues, tripped and fell fracturing his left knee and sustaining a hairline fracture of the upper right arm Wednesday, October 20, 2004. He had just finished giving a speech at a graduation ceremony in Santa Clara when the incident happened.
Security personnel rushed to his rescue to help him up. Shortly after, Fidel spoke briefly and stated that he was still "all in one piece." Sweating profusely, he added that he will do all that he could to get well soon, "but as you can see I can still talk."
Three years ago he fainted after having given a long speech under the hot sun. At his age, it may be that these episodes are the secondary manifestations of more serious conditions such as advanced cerebral arteriosclerosis and insufficient cerebral circulation, presenting clinically as a condition medically referred to as transient ischemic attacks (TIAs). If this is the case, you can be sure that the medical condition of the Maximum Leader will remains a closely guarded secret.
If hardening of his arteries and associated formation of cholesterol plaques (cerebral...