Senior Women Web

Author: SeniorWomenWeb

  • Ferida Wolff’s Backyard Series: Tomatoes For All

    We planted a variety of tomatoes this year – cherry, beefsteak, and heirloom varieties. They are all growing nicely, thriving in the heat/rain cycles. Some of them have grown to an incredible size, which thrills me.Tomato munched
     
    I was watching one as it got bigger and started turning a deep shade of red. It was ripening so sweetly. I could imagine how it would taste. The day I went out to pick it, though, I had a shock; a quarter of the tomato was eaten into. I could see the seeds. The juice dripped from the opening and I could smell the fresh tomato aroma. I mourned the loss of such a beauty.
     
    There was another tomato on the vine that was just starting to ripen. I didn’t want the same thing to happen so I placed a cage around that section of the plant.  But when I went to check on it the next day, the cage was lifted out of its moorings and the tomato had been nibbled on.
     
    Was it a wascally wabbit that was getting into the garden or a sneaky squirrel? I was talking to a man who had a vegetable garden and he said that groundhogs, in particular, loved tomatoes. I occasionally saw a groundhog around but not lately.
     
    I needed a plan. While I love letting the tomatoes ripen on the vine, I decided to pick them when they were partially red, before the creatures got into them, and to let them ripen the rest of the way on my kitchen counter. So far that is working. We ate one of our tomatoes yesterday and it was absolutely delicious! I can’t blame the outside critters for digging in.
     
    I know that everyone needs to eat and I don’t mind sharing but I would like some produce for myself, too. Next year I will plan differently, perhaps setting aside a small plot for the local scavengers; this year I will just enjoy what I can and at least take pleasure in knowing that my tomatoes are making a party for many mouths.
     
    Here are some ways to discourage squirrels, and I imagine other critters, from chomping on your tomatoes. Some are practical, others tongue-in-cheek:  http://www.mnn.com/your-home/organic-farming-gardening/stories/7-ways-to-keep-squirrels-from-eating-your-tomatoes    
     

    Editor’s Note: We, too, in California planted tomatoes both of the cherry variety and smaller size full-size from a nursery named Sweetwater Nursery  near the capitol of California, Sacramento that provides plants to our supermarket.  The description of their nursery includes:

    Since 1977, Sweetwater Nursery has been whole-heartedly dedicated to providing organic herb, vegetable and flowering plant starts.  To preserve biodiversity they specialize in both traditional and heirloom varieties well suited to particular microclimates.  Most of the varieties they grow have been trialed on their certified organic farm in Sebastopol, California.  They operate their business using sustainable practices, including: Sweetwater's logo

    • Using biodiesel to fuel their delivery trucks
    • Using solar power to run the nursery
    • Earth friendly pots
    • Growing much of their seed on their organic farm

     Their cherry tomatoes and tarragon … superb.

  • Drug Giants Brawl Over Copycat Drugs: Which States Adopted Notification Requirements

    By Michael Ollove, Staff Writer, Stateline*

    The year 2013 began with the promise of a state-by-state, coast-to-coast battle between the makers of brand-name medications derived from living organisms — known as biologics — and those who to make and sell copies of those drugs.

    The battle has turned into a rout, at least for now. In state after state, the brand-name makers — led by the pharmaceutical giants Amgen and Genentech — have been unable to convince state legislatures to require pharmacists to notify doctors (and sometimes patients) when they substitute generics for brand-name biologic drugs. Manufacturers of copies fiercely opposed such a requirement, which they said would put them at a competitive disadvantage.porin

    Notification measures died in Arizona, Arkansas, Colorado, Indiana, Illinois, Maryland, Mississippi, Nevada, Texas and Washington.

    Oregon, Utah and Virginia all adopted notification requirements, but with sunsetting provisions that will take effect before any of the knock-offs reach the market. Only one state, North Dakota, passed the measure the brand-name manufacturers sought.

    “State legislators accepted that there was absolutely no need to push this type of legislation” said Brynna Clark, senior director of state affairs for the Generic Pharmaceutical Association, which took the lead in organizing the effort against notification requirements. “Nobody’s hair was on fire.”

    Measures are still alive in California, where the prospects for passage look bright, and in Pennsylvania and Massachusetts.

    Two Years Away

    Most believe it will be at least two years before any copies of biologics receive approval from the Food and Drug Administration (FDA). But the skirmishes in 18 states this year give a sense of the high stakes involved.

    Biologics already account for roughly a quarter of the $320 billion spent annually on medications in the U.S., according to IMS Health, and biologic medicines are expected to command ever larger portions of the prescription drug marketplace. The Congressional Budget Office has estimated that substituting biologic doppelgangers for brand names would reduce federal Medicaid and Medicare spending by $25 billion over 10 years.  The CBO estimates that total federal spending on prescription drugs during the same period will total $500 billion.

    The Affordable Care Act calls for an abbreviated approval process for the biologic copies, as a means to promote competition and reduce costs. While the federal government will determine whether particular biosimilars are interchangeable with the originals, it will be up to the states to determine the exact policies regarding substitutions.

    Companies that make the copies say their products should be treated no differently than generic chemical drugs. By state law, pharmacists can (and in some cases, must) substitute cheaper generics for brand-name medications once the original patent has expired, unless otherwise directed by the doctor or, in some states, the patient.

    Complex Substances

    But, there are big differences between copying chemical drugs and copying biologic drugs.

    Until the 1970s, virtually all manufactured medicines were derived from chemicals. They are sometimes called “small molecule” drugs because they are composed of relatively few atoms and have stable, well-defined chemical structures, making it relatively easy to produce exact duplicates.

  • CultureWatch Reviews: Hilary Mantle’s Bring Up the Bodies and Rowling’s (a.k.a. Galbraith) The Cuckoo’s Calling

    In This Issue

    Fraught with danger and intrigue, Ms. Mantel gives us a view into the complex, brilliant mind of Thomas Cromwell, and deftly enables us to follow his reasoning and machinations as he strives to do his master’s work, that of Henry VIII.  If you have not read Ms. Mantel’s earlier book, Wolf Hall, you will benefit greatly from tackling it before moving on to Bring up the Bodies.  When J. K. Rowling delivers the mystery series in the future based on The Cuckoo’s Calling characters, it will provide readers with some very satisfying hours — or, as a friend says about her love of crime fiction, some delectable “comfort food of the mind.” So, after selling more than half a billion volumes of Harry Potter, does Rowling deserve our attention in her new literary adventure? No question about it, she does.

    Bring Up the Bodies
    by Hilary Mantel, © 2012
    Published by Henry Holt & Co., LLC New York; hardcover: 407 pp

    This review comes with a caveat: if you have not read Ms. Mantel’s earlier book, Wolf Hall, you will benefit greatly from tackling it before moving on to Bring up the Bodies. Mantel has ten or eleven earlier novels to her credit, but it is the most recent two that won the Man Booker Prize*, Wolf Hall in 2009 and Bring up the Bodies in 2012. Mantel is the first woman to have twice won that prestigious prize .

    The central character of both novels is Thomas Cromwell. Wolf Hall takes Cromwell from his early teenage years when he ran away from his abusive father, through his years as a mercenary, and his years of self-education among the money lenders of Europe, to his return to England, and his employment by the ill-fated Cardinal Wolsey. Bring up the Bodies chronicles the years of Cromwell’s steady rise to become Henry VIII’s trusted right hand in the King’s single-minded pursuit of Anne Boleyn.

    Unless you are a much hardier soul than this reviewer, neither book is the kind of novel you can read in one, excited swoop. Both are hard to put down, but they are full of so much information and so much intricate plotting (plotting not only by the 16th century court, but by the author herself) that one must simply take breathing spells to absorb the information, sort out the characters, and at times figure out the prose.

    About the latter: Ms. Mantel is occasionally careless of the references for her pronouns. In Wolf Hall, the reader is often confused as to which character “He” refers. The preceding sentence or paragraph may be about someone else, but the “he” you read may well mean Cromwell, and having to pause to figure that out was a decided annoyance. Apparently, Bring up the Bodies was in the hands of a different proof reader or editor, because rather more often, this go ‘round, Mantel offers us: “He, Cromwell,” so that we may re-orient ourselves.

    All of which is, believe me, a minor annoyance in a fascinating read. In addition to recounting the historical facts, Ms. Mantel has, with a remarkably even hand, offered us well fleshed out, fully human characters. Her research has been prodigious, but – and this is, after all, a novel – she has moved smoothly beyond mere recorded facts (of which there are plenty), avoiding the usual, cookie-cutter version of history. Her characters are complex and believable, right down the line, from the powerful rulers of England to the smallest of servants.  We don’t just see the machinations and power struggles necessary for survival: we understand why a person might have needed to equivocate and bargain in order to survive in the ruthless political maneuverings of the times.

    The intrigues with which Thomas dealt included enacting directives from Henry VIII (including those which separated the English church from Rome, an action previously unthinkable, and very disruptive to the general public); bargaining with ambassadors from the Pope, the Emperor, and the King of France; giving aid and advice to Bishop Cranmer; arranging Henry’s divorce from Katherine of Aragon; dealing with the entire self-promoting tribe of Boleyns, never mind Anne Boleyn herself; serving as the king’s go-between to Jane Seymour and her family. Keep in mind that all of the foregoing needed to be handled smoothly around the ordinary demands of his several official duties.

  • Conserving and Sharing Music Heritage from the Golden Age of the American Town Band

    Ocean Park Oak Bluffs, Martha's Vineyard

    They are the BandMusic PDF Library, conservators and stewards of our band music heritage from the time of John Philip Sousa, Karl L. King, Henry Fillmore and all the other great composers who were active during the Golden Age of the American Town Band. Our special focus is public domain music from the 1880s through 1922.

    Ocean Park bandstand, Oak Bluffs, Martha’s Vineyard, Massachusetts; Wikimedia Commons

    Beginnings

    Music from this time period was donated to North Royalton (Ohio) Community Band — boxes and boxes and boxes of time-worn, brown-edged sheet music. Most pages were too fragile to hand out so we decided to scan the music. Once everything was scanned, the next logical step was to share it with other bands. Just in time, our first webmaster, Graham Nasby, stepped up and agreed to create a library website and host it. The Library became a non-profit corporation in 2006.

    Evolution

    BandMusic PDF Library has been online since February 2006. Our first thought was to have about 50 pieces online — mostly marches and a few dances. That number soon surpassed the 100 mark. Fast forward a few years and we’ve passed 3,000 titles, with no end in sight.  And now the rich library holdings include marches of every description, all kinds of dances, ragtime, major period concert works, and solos with band accompaniment for a wide variety of instruments including voice.  All three websites that formerly contained our music are now rolled into one.

    With this much music online, our former plan of operation has become unworkable. The current plan is to post everything, then go through and make as many pieces playable as possible. This will necessitate filling in missing pages and transposing Piccolo and Horn parts to modern keys.

    The Scout Report notes:  * “A summer band concert in a white gazebo is always a highlight of small town life. The BandMusic PDF Library might just inspire such a musical gathering, as they offer up hundreds of pieces of band music at no charge. On their homepage, visitors can find Featured Content, such as the complete score for the Bacchanal from Samson and Delilah and the band music transcription of Verdi’s Luisa Miller. Moving along, visitors can use the Search the Library link to look for pieces of interest, or they can just browse around by title, genre, composer, publisher, year, or keyword. Also, the Wish List contains items that the site is looking for, and perhaps a kind visitor can provide them with access to a copy so that others might enjoy said work.”

    Frequently Requested Titles
    A Curated List 

    •  Alte Kameraden (Old Comrades) Teike, Martin Tousignant, editor
    •  American Festival Overture, Wm. F. Kretschmer
    •  American Patrol, F.W. Meacham
    •  Amidst Thunder of Cannons, J.C. Heed, edited by Marc Oliver
    •  Aroldo, Overture to, Giuseppe Verdi
    •  Barber of Seville, arranged by M.C. Meyrelles
    •  Carmen, George Bizet, arranged by V.F. Safranek
    •  Colonel Bogey, Kenneth J. Alford
    •  Coronation March, G. Meyerbeer
    •  Dance of the Hours, A. Ponchielli
    •  Die Frau Meisterin, Franz von Suppe 
           – Continued on CODA page

    *From The Scout Report, Copyright Internet Scout 1994-2013. https://www.scout.wisc.edu/
    Thanks to the BandMusic site for additional information.
     

  • Transportation Security: TSA Could Strengthen Oversight of Allegations of Employee Misconduct

    screening at denver

    An overhead view of the security screening area at Denver International Airport, Wikimedia Commons

    What GAO Found

    In July 2013, US GAO (Government Accountability Office) reported that TSA investigated and adjudicated approximately 9,600 cases of employee misconduct from fiscal years 2010 through 2012, according to TSA employee misconduct data that we analyzed. Two offense categories accounted for about half of all cases — (1) attendance and leave, which accounted for 32 percent; and (2) screening and security, which accounted for 20 percent. Charges for screening and security-related incidents pertain to violating standard operating procedures, including not conducting security or equipment checks, and allowing patrons or baggage to bypass screening. TSA developed a Table of Offenses and Penalties that delineates common employee charges, along with a suggested range of penalties. Of the cases that we analyzed, 47 percent resulted in letters of reprimand, which describe unacceptable conduct that is the basis for a disciplinary action; 31 percent resulted in suspensions of a definite duration; and 17 percent resulted in the employee’s removal from TSA. The remaining cases covered a variety of outcomes, including suspensions of an indefinite duration.

    In the July 2013 report, GAO found that TSA has taken steps to help manage the investigations and adjudications process, such as creating OPR in 2010 to provide greater consistency in misconduct penalty determinations and providing training for TSA staff at airports responsible for investigating and adjudicating allegations of employee misconduct. While TSA has taken these steps, GAO reported weaknesses in four areas related to monitoring of employee misconduct cases: (1) verifying that TSA staff at airports comply with policies and procedures for adjudicating misconduct, (2) recording case information on all adjudication decisions, (3) tracking the time taken to complete all phases of the investigations and adjudications process, and (4) identifying allegations not adjudicated by the agency.

    Why GAO Did This Study

    This testimony discusses the findings of GAO’s report issued yesterday assessing the Transportation Security Administration’s (TSA) efforts to address employee misconduct. TSA employs approximately 56,000 transportation security officers (TSO) and other TSA personnel to ensure the security of the traveling public at more than 450 TSA-regulated airports nationwide. News stories in recent years have highlighted several high-profile allegations of misconduct by TSA employees, including TSOs being involved in theft and drug-smuggling activities, as well as circumventing mandatory screening procedures for passengers and baggage. For example, in 2011, a TSO at the Orlando International Airport pleaded guilty to federal charges of embezzlement and theft for stealing more than 80 laptop computers and other electronic devices, valued at $80,000, from passenger luggage. TSOs engaging in misconduct raise security concerns because these employees are charged with helping to ensure the security of our nation’s aviation system.

    The process of addressing TSA employee misconduct involves various components within the Department of Homeland Security (DHS). For example, depending on the facts and circumstances of a case, the DHS Office of Inspector General (OIG), TSA Office of Inspection (OOI), or TSA Office of Security Operations (OSO) may conduct an investigation into allegations of TSA employee misconduct. OSO generally adjudicates cases at airports — that is, determines whether the evidence is sufficient to propose and sustain a charge of misconduct and determines the appropriate penalty.

    The Office of Professional Responsibility (OPR), an independent office that TSA established in 2010 to provide greater consistency in misconduct penalty determinations, adjudicates a more specialized set of cases, such as misconduct involving senior-level TSA employees at airports and other locations. The testimony this morning will address the key findings from the report on TSA’s efforts to address employee misconduct that we issued yesterday. Specifically, like the report, the statement will address (1) data on TSA employee misconduct cases and (2) TSA efforts to manage and oversee the investigations and adjudications process.

    For more information contact Steve Lord at (202) 512-4379 or lords@gao.gov.

    The US Government Accountability Office (GAO) is an independent, nonpartisan agency that works for Congress. Often called the “congressional watchdog,” GAO investigates how the federal government spends taxpayer dollars. The head of GAO, the Comptroller General of the United States, is appointed to a 15-year term by the President from a slate of candidates Congress proposes. Gene L. Dodaro became the eighth Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO) on December 22, 2010, when he was confirmed by the United States Senate

  • Hopper Drawing at the Whitney Museum of American Art: “It took me ten years to get over Europe”

    (through October 6, 2013)

     By Val CastronovoEarly Sunday Morning

    Edward Hopper,Early Sunday Morning, 1930. Oil on canvas, 35 3/16 × 60 1/4 in. (89.4 × 153 cm). Whitney Museum of American Art, New York; purchase with funds from Gertrude Vanderbilt Whitney. © Heirs of Josephine N. Hopper, licensed by the Whitney Museum of American Art, New York

    Think Edward Hopper (1882-1967) and think Nighthawks, Early Sunday Morning, New York Movie — all masterpieces that have transcended the realm of fine art and seeped into the popular culture.  These and so much more can be found in an illuminating show at the Whitney, which focuses on this 20th century American artist’s drawings — the studies that preceded, and served as a walk-up to, his iconic oil paintings.

    Hopper’s widow (and frequent model) Josephine Nivison Hopper bequeathed some 2,500 drawings to the Whitney in 1970.  More than two hundred are on display in the current show, billed as the first major museum exhibition devoted to the artist’s drawings.  They flank the paintings, and they illustrate the creative process. 

    Hopper worked out themes in black chalk, and he saved everything, rarely selling or exhibiting his works on paper.  He referred back to the drawings when he wanted to tackle a favorite motif — a road, a bedroom, an urban street, building or architectural detail.

    A student at the New York School of Art from 1900 to 1906, Hopper trained with American realist painter Robert Henri and studied alongside George Bellows and Rockwell Kent, the latter dubbing him “the John Singer Sargent” of the class because of his obvious skills as a draftsman.

    He spent the early part of his career working as a commercial illustrator, a profession that he loathed.   He wanted to draw what he wanted to draw and didn’t like having the subject dictated to him.  But sales of his paintings — especially those from a 1924 watercolor show at the Frank K.M. Rehn Galleries — eventually led to financial security, and he was able to devote himself entirely to his art (that is, the art that he wanted to pursue) in the mid-1920s.

    After three trips to Paris between 1907 and 1910 to paint the café culture and the river Seine, Hopper took a studio in Greenwich Village at 3 Washington Square North, where he lived and worked for the rest of his life (he also kept a studio in Truro, on Cape Cod in Massachusetts).  He drew inspiration for his urban landscapes from the streets and architecture of New York City, which he prowled from his home base in the Village. 

    He was especially intrigued by Greenwich Avenue, a street a few blocks from Washington Square that sliced through the city’s grid in a diagonal direction, thereby forming triangular wedges with its streets.  The buildings situated on these wedges (and the Flatiron Building some ten blocks north) parallel the shape and form of the diner in Nighthawks (1942), probably Hopper’s most famous work, on loan here from The Art Institute of Chicago.

    The Whitney Museum’s curators did some important archival research and pinpointed the specific downtown New York locales that inspired not just Nighthawks but also Early Sunday Morning (1930) — a depiction of a low-rise, two-story red brick building on a commercial stretch on 7th Avenue, between 15th and 16th streets, long since demolished. 

  • Plastic Surgery, Attractiveness and Average Number of ‘Years Saved’: 3.1

     No Consistent Improvement in Attractiveness

     A study suggests that after aesthetic facial plastic surgery the average number of apparent “years saved” (true age minus guessed age) was 3.1 years but there was only an insignificant increase in attractiveness scores, according to a report published by JAMA Facial Plastic Surgery, a JAMA Network publication.Nose surgery

    Patients seek out aesthetic facial surgery to look younger and more attractive but there is minimal literature about the effect of the surgery on perceived age and attractiveness, according to the study background.

     A. Joshua Zimm, M.D., of the Lenox Hill Hospital and Manhattan Eye, Ear & Throat Institute of North Shore-LIJ Health System, New York, and colleagues quantitatively evaluated the degree of perceived age change and improvement in attractiveness following surgical procedures.

    Independent raters examined preoperative and postoperative photographs of 49 patients who underwent aesthetic facial plastic surgery between July 2006 and July 2010 at a private practice in Toronto, Canada. The photographs were shown to 50 blind raters. Patients in the study ranged in age from 42 to 73 years at the time of surgery with an average age of 57 years.

    On average, raters estimated their patients’ ages to be about 2.1 years younger than their chronological age before surgery and 5.2 years younger than their chronological age after surgery. The average overall years saved following surgery was 3.1 years, according to the results. There also was a small and insignificant increase in attractiveness scores in postprocedural photographs, the results indicate.

     “In conclusion, the subjective nature of facial rejuvenation surgery presents a challenge in the assessment of successful results,” the study concludes. “Given the limitations of the attractiveness component of this study as described herein, further investigation is warranted to verify these findings.”

    Objective Assessment of Perceived Age Reversal and Improvement in Attractiveness After Aging Face Surgery

  • Summer Cookies: Aunt Rickie’s Icebox, Mom”s Iced Orange Drop, Aunt Myrtle’s Ginger and Jean’s Oatmeal Chocolate Chip

    By Margaret CullisonChatham Beach, MA

    Cookie lovers probably would agree that nothing makes lazy summer afternoons more pleasant than relaxing on the porch or shaded patio with a plate of cookies and sweet mint ice tea. Children come home from swimming or playing ball with ravenous appetites, and they like a cold glass of milk with their cookies. Such afternoon cookie breaks are the essence of easy summertime living.

    In the days before air conditioning, cookies had to be baked in the cool early morning hours before the house got too hot. In even earlier times, homes had a separate summer kitchen for this purpose. Today we can indulge the urge to bake cookies any time of day, because air-conditioned houses quickly neutralize the oven’s heat.

    I took for granted the cookies my mother made when I was a kid and asked her to buy chocolate-covered marshmallow cookies from the grocery store. She did, just once, probably hoping that reverse psychology would help me see the truth that store-bought cookies aren’t as good as homemade. Gradually I did realize that chocolate marshmallow cookies are among the lower forms of commercially-made cookie products. But I’ll still eat them, on occasion, when will power weakens.

    In her cookbook, Mom included a selection of cookie recipes that she’d gathered from many sources, as people who love to cook do. Some came from relatives or family friends, and tasting these cookies still evokes memories of these people, the ones I knew as well as those I only heard about from my parents.

    One of the mainstays of Mom’s cookie production was ice box cookies. The very word icebox says old-fashioned, and this recipe is old. It came from mother’s Great Aunt Rickie who lived in Scribner, Nebraska, a farming community almost 100 miles from Mom’s hometown in southwest Iowa.

    Each summer my mother’s family traveled by car to see Aunt Rickie and Uncle Albert, and these visits were among the highlights of Mom’s childhood. An automobile trip of that distance was a more rigorous adventure in the early 1900s than it is today, certainly not a one-day excursion. The family would stay in Scribner for several days, re-establishing connections in the village where Mom’s father grew up. Aunt Rickie and Uncle Albert had no children of their own, but they were as devoted as grandparents to Mom and her siblings.

    Aunt Rickie added caraway seeds to these icebox cookies in keeping with her German heritage. I’ve liked the taste of caraway since childhood, and Mom continued to make these cookies for me after I’d grown up, when I came home for summer visits with my sons. Because of the generous amount of butter called for in this recipe, the cookies have a crunchy, shortbread-like consistency. It makes a fine sugar cookie, but I prefer the added flavors of caraway or cinnamon and almond.
     
    One great advantage to refrigerator cookies is that you can bake one roll at a time, keeping the remaining dough wrapped in foil, in the refrigerator, for up to one week. These cookies also freeze well.

    Aunt Rickie’s Ice Box Cookies

    2 cups butter
    2 cups sugar
    6 cups flour
    1 tablespoon vanilla
    1 egg
    1/2 teaspoon salt
     
    Cream butter and sugar; add eggs, vanilla and dry ingredients.

    If adding flavor variations, divide the dough in half. Thoroughly mix in ground almonds and cinnamon to one half and caraway seeds to the other. Form dough into two-inch rolls and refrigerate.

    When dough is cold, cut into ¼ inch slices, working with only one roll at a time. Keep the remaining dough in the refrigerator. Bake on greased cookie sheets at 350 degrees until lightly browned.

    My Note: As is typical of old recipes, precise amounts for the added ingredients are not given. I suggest starting with ½ tablespoon of caraway seeds for one half of the recipe and 1/3 teaspoon cinnamon and ½ cup ground almonds for the other half, adding more if desired. The recipe makes about 120.

  • “Too Much Medicine”: Overdiagnosed and Overtreated, A Scientific Panel Recommends Personalized Cancer Strategies

    By Elizabeth Fernandez

    To address the growing problem of people being overdiagnosed and overtreated for cancer, a group of scientists convened by the National Cancer Institute and chaired by a UC San Francisco breast cancer expert is proposing a major update of the way the nation approaches diseases now classified as “cancer.”

    The “Viewpoint” article was published online on July 29 in the Journal of the American Medical Association.  When cancer screening programs were widely initiated three decades ago, medical knowledge of the disease was more simplistic. The intent was to detect cancer at its earliest stages to reduce illness and mortality, but in fact early diagnosis has not led to a proportional decline in serious disease and death, the scientists write in the JAMA commentary.Instead, screening programs are identifying not only malignant cancers, but also slow-growing, low-risk lesions, and sweeping them into the same treatment process. As a result, patients are being diagnosed and treated for forms of cancer that might never actually harm them – a phenomenon that’s been termed overdiagnosis, which translates to “too much medicine.”Now, with the advancement of scientific understanding of the biology of cancer, the authors say it is time for significant changes in practice and policy.“By recognizing that cancer is not one disease, but a number of different diseases, we can individualize our treatment based on biology and avoid overtreatment,” said panel chair Laura J. Esserman, MD, MBA, director of the Carol Franc Buck Breast Care Center at the UCSF Helen Diller Family Comprehensive Cancer Center. 

    “The goal going forward is to personalize screening strategies, and focus screening policies on the conditions that are most likely to result in aggressive illness and death”.

    — Laura J. Esserman, MD, MBA

    The authors recommend creation of a new classification for tumors that are indolent (unlikely to cause patients harm). For example, ductal carcinoma of the breast – currently considered the earliest form of breast cancer – would no longer be called cancer. The authors also call for the formation of registries for lesions with low potential for malignancy, and for a multidisciplinary approach across pathology, imaging, surgery and other medical specialties “to revise the taxonomy of lesions now called cancer.”The key, they say, is to improve screening strategies to avoid overtreating tumors that would not be lethal, or that would not even have come to medical attention.The JAMA article is comprised of recommendations from a working group formed last year during a meeting convened by the National Cancer Institute. The group was charged with developing a strategy to improve current approaches to cancer screening and prevention. 

    Laura J. Esserman. MD, MBA

    “Although our understanding of the biology of cancer has changed dramatically, perceptions on the part of the public, and among many physicians, have not yet changed,” Esserman said. “Cancer is still widely perceived as a diagnosis with lethal consequences if left untreated.”The commentary was co-written by Ian M. Thompson, MD, professor at the University of Texas Health Science Center at San Antonio; and Brian Reid, MD, PhD, director of the Seattle Barrett’s Esophagus Program and member of the Human Biology Division at the Fred Hutchison Cancer Research Center in Seattle. The three authors served as chairs of the NCI working group.An internationally known leader in the field of breast cancer, Esserman, a UCSF professor of surgery and radiology, is leading an effort to change the delivery of breast cancer services and the information systems used to support both research and patient care.

    Overdiagnosis Occurs Across Many Medical Conditions

    Overdiagnosis is occurring across many medical conditions, but is particularly common in breast cancer, lung cancer, prostate, thyroid cancer and melanoma, said the authors.

    They cite DCIS, or ductal carcinoma of the breast, and Barrett’s esophagus as illustrations of how the detection and surgical removal of what have been called precancerous lesions have failed to lead to lower rates of invasive cancer.

  • Nationwide Operation: Targeting Commercial Child Sex Trafficking

    During the past 72 hours, the FBI; its local, state, and federal law enforcement partners; and the National Center for Missing and Exploited Children (NCMEC) conducted Operation Cross Country VII, a three-day enforcement action to address commercial child sex trafficking throughout the United States. The operation included enforcement actions in 76 cities across 47 FBI divisions nationwide and led to the recovery of 105 children who were being victimized through prostitution. Additionally, 159 pimps were arrested on state and federal charges.Innocence Lost

    “Child prostitution remains a persistent threat to children across America,” said Ron Hosko, assistant director of the FBI’s Criminal Investigative Division. “This operation serves as a reminder that these abhorrent crimes can happen anywhere, and the FBI remains committed to stopping this cycle of victimization and holding the criminals who profit from this exploitation accountable.”

    Operation Cross Country is part of the Innocence Lost National Initiative that was established in 2003 by the FBI’s Criminal Investigative Division, in partnership with the Department of Justice and NCMEC, to address the growing problem of child prostitution.

    “Operation Cross Country demonstrates just how many of America’s children are being sold for sex every day, many on the Internet,” said John Ryan, CEO of NCMEC. “We’re honored and proud to partner with the FBI, which has taken the lead in tackling this escalating problem.”

    To date, the FBI and its task force partners have recovered more than 2,700 children from the streets. The investigations and subsequent 1,350 convictions have resulted in lengthy sentences, including 10 life terms and the seizure of more than $3.1 million in assets.

    Task force operations usually begin as local enforcement actions that target truck stops, casinos, street “tracks,” and websites that advertise dating or escort services, based on intelligence gathered by officers working in their respective jurisdictions. Initial arrests are often violations of local and state laws relating to prostitution or solicitation. Information gleaned from those arrested frequently uncovers organized efforts to prostitute women and children across many states. FBI agents further develop this evidence in partnership with US Attorney’s Offices and the US Department of Justice’s Child Exploitation and Obscenity Section so that prosecutors can help bring federal charges in those cities where child prostitution occurs.

    The Innocence Lost National Initiative brings state and federal law enforcement agencies, prosecutors, and social service providers from across the country to NCMEC for training.

    The FBI thanks the its local, state, and federal law enforcement partners representing more than 230 separate agencies who participated in Operation Cross Country VII and their ongoing enforcement efforts.

    The following list denotes FBI divisions, not necessarily actual cities, where juveniles were recovered and pimps were arrested.