The Divide Between Silicon Valley and Washington Is a National-Security Threat

Personnel work at the Air Force Space Command Network Operations and Security Center at Peterson Air Force Base in Colorado.
Personnel work at the Air Force Space Command Network Operations and Security Center at Peterson Air Force Base in Colorado.

Closing the gap between technology leaders and policy makers will require a radically different approach from the defense establishment.

A silent divide is weakening America’s national security, and it has nothing to do with President Donald Trump or party polarization. It’s the growing gulf between the tech community in Silicon Valley and the policy-making community in Washington.

Beyond all the acrimonious headlines, Democrats and Republicans share a growing alarm over the return of great-power conflict. China and Russia are challenging American interests, alliances, and values—through territorial aggression; strong-arm tactics and unfair practices in global trade; cyber theft and information warfare; and massive military buildups in new weapons systems such as Russia’s “Satan 2” nuclear long-range missile, China’s autonomous weapons, and satellite-killing capabilities to destroy our communications and imagery systems in space. Since Trump took office, huge bipartisan majorities in Congress have passed tough sanctions against Russia, sweeping reforms to scrutinize and block Chinese investments in sensitive American technology industries, and record defense-budget increases. You know something’s big when senators like the liberal Ron Wyden and the conservative John Cornyn start agreeing.

In Washington, alarm bells are ringing. Here in Silicon Valley, not so much. “Ask people to finish the sentence, ‘China is a ____ of the United States,’” said the former National Economic Council chairman Keith Hennessey. “Policy makers from both parties are likely to answer with ‘competitor,’ ‘strategic rival,’ or even ‘adversary,’ while Silicon Valley leaders will probably tell you China is a ‘supplier,’ ‘investor,’ and especially ‘potential market.’”

In the past year, Google executives, citing ethical concerns, have canceled an artificial-intelligence project with the Pentagon and refused to even bid on the Defense Department’s Project JEDI, a desperately needed $10 billion IT-improvement program. While stiff-arming Washington, Google has been embracing Beijing, helping the Chinese government develop a more effective censored search engine despite outcries from human-rights groups, American politicians, and, more recently, its own employees. Since the 2016 presidential election, Facebook executives have been apologizing to Congress in public while waging a campaign to deny, delay, and deflect regulation and stifle critics in private.

Former Secretary of Defense Ash Carter, Google’s Eric Schmidt, Amazon’s Jeff Bezos, LinkedIn’s Reid Hoffman, Code for America’s Jen Pahlka, and others have been working hard to bridge the divide, bringing technology innovation to Washington and a sense of national service to the tech industry. But their efforts are nowhere near enough. The rift is real, deep, and a long time coming, because it’s really three divides converging into one.

There is a yawning civil-military relations gap between the protectors and the protected. When World War II ended, veterans could be found in seven out of 10 homes on a typical neighborhood street. Today it’s two. Less than half a percent of the U.S. population serves on active duty. A senior executive from a major Silicon Valley firm recently told us that none of the company’s engineers had ever seen anyone from the military.

It should come as no surprise that when people live and work in separate universes, they tend to develop separate views. The civil-military gap helps explain why many in tech companies harbor deep ethical concerns about helping warfighters kill people and win wars, while many in the defense community harbor deep ethical concerns about what they view as the erosion of patriotism and national service in the tech industry. Each side is left wondering, How can anyone possibly think that way? Asked last week what he would tell engineers at companies like Google and Amazon, Chairman of the Joint Chiefs of Staff General Joseph Dunford said, “Hey, we’re the good guys … It’s inexplicable to me that we wouldn’t have a cooperative relationship with the private sector.”

There’s a training gap between leaders in Washington, who are mostly lawyers struggling to understand recent technological advances, and leaders in Silicon Valley, who are mostly engineers struggling to understand the age-old dynamics of international power politics. Congress has 222 lawyers but just eight engineers. On the Senate Armed Services Committee, it’s even more stark. Of its 25 members, 17 are lawyers and just one is an engineer. (He’s actually the only engineer in the entire Senate.) In the past, policy makers didn’t have to work that hard to understand the essence of breakthrough technologies like the telegraph, the automobile, and nuclear fission. Sure, technology moved faster than policy, but the lag was more manageable. Digital technologies are different, spreading quickly and widely on the internet, with societal effects that are hard to imagine and nearly impossible to contain. Understanding these technologies is far more challenging, and understanding them fast is essential to countering Russia and China.

At the same time, today’s brightest young engineers barely remember 9/11, view the Cold War as ancient history rather than lived experience, and can get computer-science degrees at elite institutions without ever taking a course about cybersecurity or thinking about what is in the national interest. For technologists, technology holds the promise of a brighter future, not the peril of dark possibilities. Their overriding challenge is getting a breakthrough to work, not imagining how it could be used by bad actors in nefarious ways.

The congressional hearings with the Facebook CEO Mark Zuckerberg on April 10 and 11 brought the two perspectives—and the chasm between them—into full view. For the tech community, it was a jaw-dropping moment that revealed just how little members of Congress know about the products and companies that are transforming global politics, commerce, and civil society. Senator Orrin Hatch appeared surprised to learn that Facebook earned the majority of its revenue through ad sales. “How do you sustain a business model in which users don’t pay for your service?” Hatch asked quizzically. “Senator, we run ads,” replied Zuckerberg, his aides grinning behind him. Senator Lindsey Graham asked whether Twitter was the same thing as Facebook. Even Senator Brian Schatz, considered one of Congress’s tech aficionados, didn’t seem to know the difference between social media, email, and encrypted text messaging. As Ash Carter wrote, “All I can say is that I wish members [of Congress] had been as poorly prepared to question me on war and peace in the scores of testimonies I gave as they were when asking Facebook about the public duties of tech companies.”

For the policy-making community, the hearings were a jaw-dropping moment showing just how much naïveté and profits were driving Facebook’s decisions, and just how little Zuckerberg and his team ever considered the possibility that all sorts of bad actors could use their platform in all sorts of very bad ways. In his opening statement, Zuckerberg admitted, “Facebook is an idealistic and optimistic company. For most of our existence, we focused on all of the good that connecting people can do.” Zuckerberg added, “But it’s clear now that we didn’t do enough to prevent these tools from being used for harm.”

The third divide is generational. In Washington, power runs vertically and rests in the hands of gray eminences. In Silicon Valley, power runs horizontally and rests in the hands of wunderkinds and their friends. Steve Jobs was 21 years old when he started Apple with his buddy Steve Wozniak. Bill Gates quit college his junior year to start Microsoft. Zuckerberg launched Facebook in his sophomore dorm room. Larry Page and Sergey Brin were old men, starting Google at the age of 25. In the policy world, 30 years of experience usually makes you powerful. In the technical world, 30 years of experience usually makes you obsolete. Policy makers who think college engineering students should be grateful for the opportunity to shadow them and photocopy during college summers have it all wrong. Interns on Capitol Hill answer phones. Interns at SpaceX launch rockets into orbit. For gray eminences silently lamenting in their Washington corner offices, “Who needs these whiny young Millennials?” the answer is: America does.

It’s hard to overstate just how foreign the worlds of Washington and Silicon Valley have become to each other. At the exact moment that great-power conflict is making a comeback and harnessing technology is the key to victory, Silicon Valley and Washington are experiencing a “policy makers are from Mars, tech leaders are from Venus” moment, with both sides unable to trust or understand each other. Even the dress codes are vexing and perplexing. In the tech industry, adults dress like college kids. Inside the Beltway, college kids dress like adults.

Closing this divide is a national-security imperative. And it requires thinking differently, generating inspiration rather than just regulation, and targeting the leaders of tomorrow, not just the leaders of today.

For starters, the Pentagon needs a messaging overhaul. Stop telling engineering students at top universities, “If you want to make money, go into industry, but if you want a mission bigger than yourself, work for me.” When Admiral Mike Rogers, who led the U.S. Cyber Command and the National Security Agency, gave this standard recruiting pitch to Stanford undergraduates a few years ago, it fell flat. It still does. We recently held a focus group of Stanford computer-science majors. When we tested the message on them, heads started shaking in a Wow, you just don’t get it kind of way. “One of the main reasons people pick companies is they want to do social good,” said  Anna Mitchell, a senior. “People would laugh if the government said the only way to be impactful is to work in government.”

For these students and their peers, the desire for impact is real and deep. They believe that they can achieve large-scale change faster and better outside the government than within it. “A message suggesting a dichotomy of working in companies versus helping your country alienates a good portion of people on the fence,” Michael Karr, a Stanford junior, told us. “If you’re working on autonomous vehicles, you could be saving lives by making cars safer.” So what message does work? Giving them opportunities for impact at scale that don’t take a lifetime of moving up the ladder. Deploying the best young engineers against the toughest challenges, early. Telling them what Kevin tells potential recruits: If you do cyber operations for anyone else, you’ll get arrested. If you do them for me in the Air Force, you’ll get a medal.

The Pentagon also needs to create ambassadors, not lifers. More than getting technical experts into government for their entire careers, we need to get more national-security-minded engineers into tech companies. Winning hearts and minds in the tech world starts early, with new college graduates who are more open to new experiences that can last a lifetime. Imagine a Technology Fellows Program like the White House Fellows program, only younger. It would select the 50 most talented American engineering students graduating from college for a prestigious, one-year, high-impact stint in government service, working directly for senior leaders like the Air Force chief of staff, the secretary of defense, or the commander of U.S. forces in the Middle East.

Tech fellows would work on the most important projects and participate in special programs for their cohort to bond and form a lifelong network. “People really care about their cohort,” said Andrew Milich, a Stanford senior specializing in artificial intelligence. Tech fellows could defer company jobs or take a leave of absence, knowing that all the other fellows would be the best in the world who would also be heading back to industry. The goal isn’t for them to stay in government. The goal is for their government experience to stay with them. As one of our students told us, “Everyone has a friend at Google.” Imagine the ripple effects if these friend networks across the tech industry included tech-fellow alumni.

Doing it right won’t be easy. The Tech Fellows Program would have to be high on prestige and low on bureaucracy. Fellows would need flexibility to select projects that align with their values, not just their expertise. As the sophomore Gleb Shevchuk told us, “There has to be a transparent discussion of ethics. The program has to come off as a program that understands the concerns of people who dislike certain things the government is doing.” Google engineers may object to helping the Pentagon improve its targeting algorithms, but they might jump at the chance to defend U.S. satellites from attacks in space.

In addition, the program would have to reduce logistical pain points dramatically. Tech companies compete aggressively on quality-of-life dimensions for their workforce—locating in cities where top talent wants to live, providing free housing and transportation, and offering exciting programs outside of the job. The Tech Fellows Program would need to do the same. The National Security Agency has cutting-edge technological programs that would be a natural fit for tech fellows, but that’s a hard sell. The hot cities for attracting top engineers include Austin, Seattle, San Francisco, New York, and Denver—but not Fort Meade.

In the longer term, the Pentagon needs a radically new civilian talent model. Programs like the Air Force’s Kessel Run and the Defense Digital Service are breaking new ground to bring technology and tech talent into the Pentagon, but these programs are green shoots surrounded by red tape. Will Roper, the assistant secretary of the Air Force for acquisition, technology, and logistics, and someone who is no stranger to innovating inside the Defense Department, would like to see a much more fluid pathway in and out of industry and government. “I would invest to make the term revolving door superlative instead of pejorative,” he told a Georgetown class. “The people that we want are going to be people in industry that will want to come in and help us, and be able to go back out and come back in and help us, [so] that we’re continually refreshing the ideas, the creative thought … and right now we make it damn difficult to get in and out of government.”

These challenges are substantial, but small steps could have big impact over time. Congress could start by holding hearings with the goal of writing the best proposals into the National Defense Authorization Act this year. And if Congress doesn’t take action, then the Pentagon should, creating a Rapid Capabilities Office dedicated to developing new civilian talent programs, just like it has for developing new technologies.

In 1957, the launch of Sputnik spawned a fear that an underfunded education system had allowed the U.S. to lose its technological advantage to the Soviets. A year after the launch, Congress passed the National Defense Education Act, increasing funding for science, mathematics, and foreign-language education at all levels and allowing for substantially more low-cost student loans. Within a decade, the number of college students in the U.S. had more than doubled, supercharging U.S. breakthroughs in the space race. What our national leaders realized in 1957 is still true today: What people know and how they think are just as important to the nation’s defense as the weapon systems we deploy.

Talking to kids about tragedy is tough task for parents

In this image from the video uplink from the detention center to the courtroom, Dylann Roof appears at a bond hearing Friday, June 19, in South Carolina. Roof is charged with nine counts of murder and firearms charges in the shooting deaths at Emanuel African Methodist Episcopal Church in Charleston, South Carolina on June 17.Not again.

That’s what I and parents across the country say on social media following any large-scale assault on a group of innocent people, especially one involving children.

Aurora. Sandy Hook. Fort Hood. Boston. Washington. And now in Charleston, South Carolina, where a white man walked into a historic African-American church Wednesday evening and opened fire during a Bible study class, killing nine people.

Every tragedy filled with incomprehensible injury sparks nonstop news coverage and a major question for parents: What do we tell our kids?

In 2013, that question plagued parents in the Washington area as their children — from elementary school age on up — were likely to hear about the Washington Navy Yard attacks that unfolded in their backyard and left 12 people dead, as well as the gunman.

After that shooting, Jessica McFadden, a mom of three who lives just outside Washington, said she’d be taking her cues from her children about what to say and when. At the same time, she said she was going to ensure that she and her husband were the first sources of information for their eldest, who was 9 at the time.

“He’s going to hear about it, and I don’t want him to be scared or to feel as if his world is insecure if he hears about it from kids on the bus,” said McFadden, who founded the blog A Parent in Silver Spring.

“So we will be talking about it with him; we will talk about how his school has great safety procedures, how my husband’s office has good safety procedures, how our neighborhood is safe, that this isolated incident shouldn’t make us more fearful in our day to day,” she said.

Sadly, McFadden knows this from experience. A few years ago, McFadden’s husband worked inside the Maryland headquarters for Discovery Communications, where a man armed with a gun took three people hostage before police shot him to death.

“We had to talk about it because other adults that came into our family’s sphere were talking about it, and so we wanted to make sure that we were the sources for the children’s information so that they weren’t overly scared hearing about it kind of secondhand,” she said.

Stephanie Dulli, who lived in Washington with two small boys and an infant daughter at the time of the shooting, initially said she didn’t have any plans to tell her sons what unfolded during the deadly rampage at the Navy Yard. “It would accomplish nothing but creating anxiety, especially for my eldest,” said the host of the blog Stephanie Says.

But she knew there could come a day when her children are older, when sadly, another tragedy could strike and she would definitely have to talk with them about it. It’s not an easy conversation for any parent, but for Dulli, it will be exponentially harder.

Her father was murdered when she was about 2 years old.

“I guess I can only try to do what my mother did. No matter how terrified or scared she was, she never let it affect me,” Dulli said. “I will try to do the same. To explain what happened as clearly as I can, reassure and then show by example that we just have to keep going. I may be terrified to let my child go on the overnight trip, but he will never know that.”

5 tips on talking to kids about scary news

Reassurance is one of the most important things parents can provide children during a time of tragedy, when they fear it could happen to them, said Dr. Glenn Saxe, chairman of the Department of Child and Adolescent Psychiatry at NYU’s Langone Medical Center.

“The first kind of thought and feeling is, ‘Am I safe? Are people close to me safe? Will something happen? Will people I depend on protect me?’ ” said Saxe, who is also director of the NYU Child Study Center.

“You want to be assuring to your child, you want to communicate that you’re … doing everything you can do to keep them safe,” Saxe said. “You also want to not give false assurances, too. And this is also depending on the age of the child. You have to be real about it as well.”

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Sarah Grosjean, who lived in Leesburg, Virginia, about 45 minutes from the Washington tragedy, hoped to arm her then then-5-year-old daughter with information when she talked to her.

“I want to be able to make sure my daughter knows, in the event she’s ever in something like this … how would she react? Would she know what to do?” said Grosjean, founder of the blog Capitally Frugal, who said she’ll be emphasizing how her daughter should listen to the police or teachers in case of an emergency when her mom isn’t around.

Saxe said there are “no hard and fast rules” on the right age to talk to kids about tragedies. He said parents should take into account whether they think their kids will have heard about an event, but — especially for middle and high schoolers — parents should bring the subject up.

“I think the most important thing is that the parent communicates a willingness to talk about this, an openness about it, that parents are really attuned to where their children are in this, even just asking a general question, ‘Have you heard about this?’ and see where your kid goes with that,” Saxe said.

Parents should also be mindful of what images their children are seeing on the news and make sure even older ones, who may be watching the nonstop coverage, aren’t “flooded with images … without any attempt to help make meaning for them or bring perspective to it because that could be very difficult,” Saxe said.

McFadden said she kept the television off immediately after the Navy Yard shootings but followed the latest developments via social media on her laptop. She knew she would be only so prepared when she ultimately had the conversation with her kids.

“One of the biggest questions children ask is why,” she said, “and that’s something that we can’t answer.”

More Alpha-Synuclein in Spinal Fluid Linked to Faster Cognitive Decline

Alpha-synuclein — the protein that clumps in the cells of Parkinson’s patients — is currently the major focus of Parkinson’s biomarker studies. Researchers are analyzing biosamples (spinal fluid, blood, tissue) to make a connection between alpha-synuclein and risk, onset or progression of Parkinson’s disease (PD). The latest findings, published in The American Journal of Pathology, report that patients with higher levels in spinal fluid experienced faster cognitive decline.

In a project funded by The Michael J. Fox Foundation (MJFF), Jing Zhang, MD, PhD, and his team at the University of Washington in Seattle examined samples and data from PD patients obtained in the DATATOP study. Led by the Parkinson’s Study Group in the late 1980s, the deprenyl and tocopherol antioxidative therapy of parkinsonism (DATATOP) study collected samples and clinical data from PD subjects for up to eight years.

In this latest analysis, researchers compared alpha-synuclein levels to scores from tests of cognition, such as verbal learning and memory, visuospatial memory and processing speed, among 304 PD patients. They found that patients with higher levels of alpha-synuclein in spinal fluid had faster cognitive decline.

“This is a surprising conclusion,” says Mark Frasier, PhD, MJFF vice president of research programs. “One would think that people with more cognitive problems would have less alpha-synuclein in spinal fluid because more would be caught up in the brain causing those problems.”

Zhang’s group also reported that while alpha-synuclein levels decreased significantly over two years, that decline could not predict motor symptoms. These findings join a list of observations about how alpha-synuclein in spinal fluid relates to PD. Initial analysis from the MJFF-sponsored Parkinson’s Progression Markers Initiative (PPMI) reported last year that PD patients had lower alpha-synuclein levels in spinal fluid compared to controls. They also found that patients with posture/gait disturbance averaged lower alpha-synuclein than patients with tremor-dominant PD.

Further investigation into alpha-synuclein continues in PPMI and other studies. Zhang and his coauthors cited PPMI as a potential source for validation of their cognition findings. Since PPMI includes healthy controls, researchers could test whether those results are PD-specific or seen in healthy aging adults with cognitive decline, too.

To accelerate research around PD biomarkers, MJFF spearheaded an effort to make data and samples from varied Parkinson’s studies available to investigators. The Foundation also offers funding to use the data and samples, such as to Zhang for the DATATOP analysis.

Cannabis goes on sale in Colorado

David Martinez, manager of 3D Cannabis Center in Denver, on 31 December 2013
Shops selling cannabis have been preparing for a huge influx of customers on their first day of trading

The US state of Colorado is making history by becoming the first to allow stores to sell cannabis.

As many as 30 stores around the state are expected to start selling the drug for recreational purposes from 1 January, dubbed Green Wednesday.

Colorado, along with Washington state, voted to legalise the use and possession of cannabis for people over the age of 21 in November 2012.

Washington is not expected to allow the sale of it until later in 2014.

Colorado and Washington are among 20 states to have approved marijuana use for medical purposes. The drug is still illegal under federal law.

‘Who knows?’

Store owners had stocked up, prepared celebrations and hired extra security in preparation for their opening on Green Wednesday.

“Start Quote

It’s almost the worst of both worlds”

Kevin Sabet Smart Approaches to Marijuana

Under the new law, cannabis will be sold like alcohol. Residents will be able to buy up to one ounce, while those from out of the state can purchase up to a quarter of an ounce.

Cannabis can only be smoked on private premises, with the permission of the owners.

The sale of the drug will be taxed in the same way as alcohol, and state officials have said they expected it to raise millions – the first $40m of which will be used for school construction, The Denver Post reports.

It was not clear exactly how many shops were expected to open on New Year’s Day, though around 30 were listed by The Denver Post.

A total of 136 stores have been given licenses to sell marijuana. Most of the shops are based in Denver. Some communities elsewhere in Colorado have exercised their right not to have the stores.

Supporters of legalising cannabis have praised Colorado’s move.

Rachel Gillette, of the Colorado branch of the National Organization for the Reform of Marijuana Laws, said the state “has found an exit strategy for the failed drug war and I hope other states will follow our lead”.

But critics say it sends the wrong message to the nation’s youth and fear it will lead to serious public health and social problems.

“There will still need to be a black market to serve people who are ineligible to buy on a legal market, especially kids,” said Kevin Sabet of Smart Approaches to Marijuana. “It’s almost the worst of both worlds.”

Report Finds ‘Culture of Resistance’ on Youth Concussion.

Young athletes in the United States face a “culture of resistance” to telling a coach or parent they might have a concussion, according to a new report from the Institute of Medicine and National Research Council. 

The 306-page report, “Sports-Related Concussions in Youth: Improving the Science, Changing the Culture,” was released during a briefing today at the National Academy of Sciences in Washington, DC.

“Even though there is an increased willingness to report a concussion, there is still the desire on the part of the athlete not to report it because they feel they are letting their teammates down; on the part of the coaches because it upsets the team they have on the field, or their own belief that, ‘I had these, I’m okay, it’s just part of the sport’; and on the part of the parents who want to see their children excel and be accepted,” said Robert Graham, MD, chair of the committee that wrote the report.

Attitude Adjustment

Efforts are needed to “change the culture,” said Dr. Graham, who is director of the National Program Office for Aligning Forces for Quality at George Washington University in Washington, DC.

Over 9 months, the committee did a comprehensive review of the literature on concussions in youth sports with athletes aged 5 to 21 years. 

“The findings of our report justify the concerns about sports concussions in young people,” said Dr. Graham. “However, there are numerous areas in which we need more and better data.  Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports,” he added.

The reported number of individuals aged 19 and under treated in US emergency departments for concussions and other nonfatal sports- and recreation-related traumatic brain injuries (TBIs) increased from 150,000 in 2001 to 250,000 in 2009.

“This could possibly be due to an increase in awareness or reporting of concussions,” committee member Tracey Covassin, PhD, director of the undergraduate athletic training program at Michigan State University in East Lansing. “However, we do not know the true incidence of concussions as several concussions go unreported, as well as a lack of consistency in terminology with different studies that have reported different definitions of concussions.”

The committee found that the majority of research into concussions is at the high school and collegiate levels, with very few to no data reported below the high school level.

The committee also found a “shift” in the incidence of concussions, with more reported at the high school level than the collegiate level, Dr. Covassin said.

Football, ice hockey, lacrosse, wrestling, and soccer are associated with the highest rates of reported concussions for male athletes at the high school and college levels, while soccer, lacrosse, and basketball are associated with the highest rates of reported concussions for female athletes at these levels of play.

Limited Evidence Helmets Cut Risk

The committee found little evidence that current sports helmet designs cut the risk for concussions. 

“What the literature tells us is that diffuse brain injuries like concussion are caused by a combination of linear and rotational forces,” explained committee member Kristy Arbogast, PhD, engineering core director, Center for Injury Research and Prevention, Children’s Hospital of Philadelphia in Pennsylvania. “What we do know is that helmets reduce that linear portion. There is limited evidence that they can manage the rotational components of the impact. This is in part due to standards.”

The committee stressed, however, that properly fitted helmets, face masks, and mouth guards should still be used because they reduce the risk for other injuries.

The committee also examined the scientific literature on concussion recognition, diagnosis, and management. They found that the signs and symptoms of concussion are usually placed into 4 categories — physical, cognitive, emotional, and sleep — with patients having 1 or more symptoms from 1 or more categories. 

Most youth athletes with concussion will recover within 2 weeks of the injury, but in 10% to 20% of cases concussion symptoms persist for several weeks, months, or even years. 

Return to Play

The committee advises that a concussed athlete return to play only when he or she has recovered demonstrably and is no longer having any symptoms. An individualized treatment plan that includes physical and mental rest may be beneficial for recovery from a concussion, but current research does not suggest a standard or universal level and duration of rest needed, the committee notes.

Athletes who return to play before complete recovery are at increased risk for prolonged recovery or more serious consequences if they sustain a second concussion. “The evidence is pretty clear” on this, said committee member Arthur Maerlender, PhD, director of pediatric neuropsychological services at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

The literature also suggests that single and multiple concussions can lead to impairments in the areas of memory and processing speed.  However, it remains unclear whether repetitive head impacts and multiple concussions sustained in youth lead to long-term neurodegenerative disease, such as chronic traumatic encephalopathy, the committee said.

It notes, however, that surveys of retired professional athletes provide some evidence that a history of multiple concussions increases risk for depression. In a survey of more than 2500 retired professional football players, approximately 11% reported having clinical depression. “Very little” research has evaluated the relationship between concussions and suicidal thoughts and behaviors, the committee notes.

In youth sports, several organizations have called for a “hit count” to limit the amount of head contact a player receives over a given amount of time. Although this concept is “fundamentally sound,” the committee found that implementing a specific threshold for the number of impacts or the magnitude of impacts per week or per season is without scientific basis.

The committee calls for establishing a national surveillance system to accurately determine the number of sports-related concussions, identify changes in the brain following concussions in youth, conduct studies to assess the consequences and effects of concussions over a life span, and evaluate the effectiveness of sports rules and playing practices in reducing concussions. 

Splenda Causing Leukemia in Mice.

 The Center for Science in the Public Interest is urging caution in the use of the artificial sweetener Splenda.

A food safety advocacy group has downgraded its rating for sucralose, the artificial sweetener better known as Splenda, from “safe” to “caution” in its chemical guide to food additives.

The Washington-based Center for Science in the Public Interest announced Wednesday that it had long rated sucralose as “safe” but is now categorizing it with a ”caution,” pending peer review of an unpublished study by an independent Italian lab that found the sweetener caused leukemia in mice.
Previously, the only long-term animal-feeding studies were done by sucralose’s manufacturers, the CSPI said.

Other artificial sweeteners such as saccharinaspartame andacesulfame potassium have received the center’s lowest rating, “avoid.”

Rebiana, a natural high-potency sweetener obtained from the plant stevia, is considered “safe” by the CSPI, though it says the sweetener needs better testing.

Sucralose may prove to be safer than saccharin, aspartame, and acesulfame potassium, but the forthcoming Italian study warrants careful scrutiny before we can be confident that the sweetener is safe for use in food,” said CSPI Executive Director Michael F. Jacobson.

Despite concerns about artificial sweeteners, the CSPI says that drinking diet soda is better than sugar-carbonated soda, which it says “poses greater risks such as obesity, diabetes heart disease, gout and tooth decay.”

In order to avoid the risks of both sugars and non-caloric sweeteners, the CSPI is encouraging people to switch to water, seltzer water, flavored unsweetened waters, seltzer mixed with some fruit juice or unsweetened iced tea.

Sources: Raw For Beauty

Washington State Cancer Patients Found To Be At Greater Risk For Bankruptcy Than People Without A Cancer Diagnosis.


Much has been written about the relationship between high medical expenses and the likelihood of filing for bankruptcy, but the relationship between receiving a cancer diagnosis and filing for bankruptcy is less well understood. We estimated the incidence and relative risk of bankruptcy for people age twenty-one or older diagnosed with cancer compared to people the same age without cancer by conducting a retrospective cohort analysis that used a variety of medical, personal, legal, and bankruptcy sources covering the Western District of Washington State in US Bankruptcy Court for the period 1995–2009. We found that cancer patients were 2.65 times more likely to go bankrupt than people without cancer. Younger cancer patients had 2–5 times higher rates of bankruptcy than cancer patients age sixty-five or older, which indicates that Medicare and Social Security may mitigate bankruptcy risk for the older group. The findings suggest that employers and governments may have a policy role to play in creating programs and incentives that could help people cover expenses in the first year following a cancer diagnosis.


Cancer diagnosis puts people at greater risk for bankruptcy.

Study also shows younger cancer patients are most vulnerable to financial stress

People diagnosed with cancer are more than two-and-a-half times more likely to declare bankruptcy than those without cancer, according to a new study from Fred Hutchinson Cancer Research Center. Researchers also found that younger cancer patients had two- to five-fold higher bankruptcy rates compared to older patients, and that overall bankruptcy filings increased as time passed following diagnosis.

The study, led by corresponding author Scott Ramsey, M.D., Ph.D., an internist and health economist at Fred Hutch, was published online on May 15 as a Web First in the journal Health Affairs. The article will also appear in the journal’s June edition.

Ramsey and colleagues, including a chief judge for a U.S. Bankruptcy Court, undertook the research because the relationship between receiving a cancer diagnosis and bankruptcy is less well understood than the much-studied link between high medical expenses and likelihood of bankruptcy filing.

“This study found strong evidence of a link between cancer diagnosis and increased risk of bankruptcy,” the authors wrote. “Although the risk of bankruptcy for cancer patients is relatively low in absolute terms, bankruptcy represents an extreme manifestation of what is probably a larger picture of economic hardship for cancer patients. Our study thus raises important questions about the factors underlying the relationship between cancer and financial hardship.”

For this study, researchers analyzed data from a population-wide registry of individuals over age 21 who lived in western Washington and who were diagnosed with cancer between Jan. 1, 1995 and Dec. 31, 2009. They were compared to a randomly sampled age-, sex-, and ZIP code-matched population of people without cancer. Cancer cases were identified using the Cancer Surveillance System of Western Washington, a population-based cancer registry based at Fred Hutch that is part of the National Cancer Institute’s Surveillance Epidemiology and End Results Program (SEER).

The cancer and control cohorts were both linked with the records of the U.S. Bankruptcy Court for the Western District of Washington. The court serves 19 counties in western Washington, including all 13 counties represented in the Cancer Surveillance System of Western Washington. Researchers included Chapter 7 or Chapter 13 bankruptcy filings only.

“This is the strongest evidence we have between a disease and risk for severe financial distress,” Ramsey said. “I’ve not seen other studies that linked databases of this quality.”

Ramsey directs the Hutchinson Institute for Cancer Outcomes Research (HICOR), which is dedicated to health economics and cancer outcomes research. Its mission is to improve the efficiency and effectiveness of cancer prevention, early detection and treatment to reduce the economic and human burdens of cancer. HICOR is believed to be the first of its kind among comprehensive cancer centers nationwide.

Among the study’s key findings:

  • Between 1995 and 2009 there were 197,840 people in western Washington who were diagnosed with cancer and met the inclusion criteria for the study. Of those, 4,408 (2.2 percent) filed for bankruptcy protection after diagnosis. Of the matched controls who were not diagnosed with cancer, 2,291 (1.1 percent) filed for bankruptcy.
  • Compared to cancer patients who did not file for bankruptcy, those who did were more likely to be younger, female and nonwhite. The youngest age groups had up to 10 times the bankruptcy rate as compared to the older age groups. The authors noted that because cancer is generally a sudden and unexpected event, the risk of bankruptcy is influenced by factors such as debt load before diagnosis, assets, presence and terms of health and disability insurance, number of dependent children, and incomes of others in the household at the time of the cancer diagnosis.

“The youngest groups in the study were diagnosed at a time when their debt-to-income ratios are typically highest — often unavoidably, because they are paying off student loans, purchasing a home, or starting a business,” the authors wrote. “All working-age people who develop cancer face loss of income and, in many cases, loss of employer-sponsored insurance, both of which can be devastating for households in which the patient is the primary wage earner.”

In contrast, people age 65 or older generally have Medicare insurance and Social Security benefits. These older people are likely to have more assets and possibly more income than working-age people. “However, it is likely that having stable insurance (specifically, coverage not tied to employment) plays a major role in mitigating the risk of bankruptcy for those over age sixty-five,” the authors wrote.

  • The proportion of cancer patients who filed for bankruptcy within one year of diagnosis was 0.52 percent, compared to 0.16 percent within one year for the control group. For bankruptcy filings within five years of diagnosis, the proportion of cancer patients was about 1.7 percent, compared to 0.7 percent for the control group.
  • The incidence rates for bankruptcy at one year after diagnosis for the cancers with the highest overall incidence rates, stated as rates per 1,000 person years from diagnosis, were as follows: thyroid, 9.3; lung, 9.1; uterine, 6.8; leukemia/lymphoma, 6.2; colorectal, 5.9; melanoma, 5.7; breast, 5.7; and prostate. 3.7. The incidence rate for all cancers combined was 6.1. (Person-years takes into account the number of people in the study and the amount of time each person spent in the study.)

The high bankruptcy incidence rate for those with thyroid cancer may be because thyroid cancer affects younger women more often than other cancers do according to the researchers. “Compared to men, younger women are more likely to live in single-income households and to have lower wages and lower rates of employment, and therefore less access to high-quality health insurance – leaving them more financially vulnerable,” the authors wrote.

Source: Fred Hutchinson Cancer Research Center



Ex-Microsoft manager plans to create first U.S. marijuana brand.


A former Microsoft executive plans to create the first U.S. national marijuana brand, with cannabis he hopes to eventually import legally from Mexico, and said he was kicking off his business by acquiring medical pot dispensaries in three U.S. states.

Jamen Shively, a former Microsoft corporate strategy manager, said he envisions his Seattle-based enterprise becoming the leader in both recreational and medical cannabis – much like Starbucks is the dominant name in coffee, he said.

Shively, 45, whose six years at Microsoft ended in 2009, said he was soliciting investors for $10 million in start-up money.

The use, sale and possession of marijuana remains illegal in the United States under federal law. Two U.S. states have, however, legalized recreational marijuana use and are among 18 states that allow it for medical use.

“It’s a giant market in search of a brand,” Shively said of the marijuana industry. “We would be happy if we get 40 percent of it worldwide.”

A 2005 United Nations report estimated the global marijuana trade to be valued at $142 billion.

Washington state and Colorado became the first two U.S. states to legalize recreational marijuana when voters approved legalization in November.

Shively laid out his plans, along with his vision for a future in which marijuana will be imported from Mexico, at a Thursday news conference in downtown Seattle.

Joining him was former Mexican President Vicente Fox, a longtime Shively acquaintance who has been an advocate of decriminalizing marijuana. Fox said he was there to show his support for Shively’s company but has no financial stake in it.

“What a difference it makes to have Jamen here sitting at my side instead of Chapo Guzman,” said Fox, referring to the fact he would rather see Shively selling marijuana legally than the Mexican drug kingpin selling it illegally. “This is the story that has begun to be written here.”

Shively told Reuters he hoped Fox would serve an advisory role in his enterprise, dubbed Diego Pellicer after Shively’s hemp-producing great grandfather.

The sale of cannabis or marijuana remains illegal in much of the world although countries mainly in Europe and the Americas have decriminalized the possession of small quantities of it. A larger number of countries have decriminalized or legalized cannabis for medical use.


Shively acknowledges that his business plans conflict with U.S. federal law and are complicated by regulations in both Washington state and Colorado. He said he is interested in buying dispensaries that comply with local and state rules and are less likely to attract the scrutiny of authorities.

“If they want to come talk to me, I’ll be delighted to meet with them,” he said of federal officials. “I’ll tell them everything that we’re doing and show them all our books.”

Washington state’s marijuana consultant, Mark Kleiman, said he was skeptical of Shively’s plans, and feared that the businessman is seeking to profit off others’ addiction.

“It’s very hard for me to understand why anybody seriously interested in being in the marijuana business, which after all is against the federal law, would so publicly announce his conspiracy to break that law,” said Kleiman, a professor of public policy at the University of California, Los Angeles.

Emily Langlie, spokeswoman for the U.S. Attorney’s Office in Seattle, referred questions to the Department of Justice headquarters. Department officials did not immediately return calls seeking comment.

Washington state Representative Reuven Carlyle, a Seattle Democrat, sees promise in Shively’s initiative. Any industry emerging from the shadows will inevitably undergo consolidation – and thereby simplify the task of regulators, he said.

“The fact that an entrepreneur is publicly pushing the envelope around a branding and value-based pricing opportunity, I would say that’s in the water in Seattle,” said Carlyle, chairman of the House Finance Committee. “That’s in our DNA … We could have predicted that as much as the rain.”

Shively said he has already acquired the rights to the Northwest Patient Resource Center, a medical marijuana operation that includes two Seattle store fronts. He added that he was close to acquiring another dispensary in Colorado, as well as two more each in Washington state and California, with the owners given the option to retain a stake in their businesses.

“We’ve created the first risk-mitigated vehicles for investing directly in this business opportunity,” he said.

Shively said he ultimately plans to create separate medical and recreational-use marijuana brands. Shively said he also plans to launch a study of the effectiveness of concentrated cannabis oil in the treatment of cancer and other illnesses.

Source: Yahoo news


Pertussis on the Rise.

Pertussis reached epidemic proportions in Washington State in 2012, apparently because of waning immunity in individuals who received acellular vaccines during childhood.

Pertussis incidence has been increasing since mid-2011 in the state of Washington. The number of cases reported in early 2012 — 2520 — was 1300% higher than the number during the same period in 2011. Rates were highest among infants aged <1 year, children aged 10 years, and adolescents fully vaccinated with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. Incidence among Hispanics was more than twice that among non-Hispanics (53.1 vs. 24.6 cases per 100,000 population).

A total of 2069 cases were confirmed by laboratory testing (83%) or epidemiologic linking (17%). Multitarget polymerase chain reaction (PCR) assays, performed on 193 specimens in which Bordetella DNA had been detected by PCR, identified B. pertussis in 175 (91%) and B. parapertussis in 11 (6%). Thirty (55%) of the 55 isolates subjected to pulsed-field gel electrophoresis represented the four most commonly identified profiles in the CDC’s national database.

Valid vaccination history was available for 91% of the patients aged 3 months to 19 years. Seventy-six percent of the patients aged 3 months to 10 years were up to date with childhood diphtheria and tetanus toxoids and acellular pertussis doses; 43% of those aged 11 to 12 years and 77% of those aged 13 to 19 years had received the Tdap vaccine recommended for older children and adults.

Although the incidence of pertussis nationwide in early 2012 was far lower than that in Washington State (4.2 vs. 37.5 cases per 100,000), it also peaked among infants and among children aged 10, 13, and 14 years. Across the U.S., the case fatality rate showed a slight decrease from the previous decade.

Comment: Acellular vaccines replaced the older whole-cell products because of adverse events associated with the latter. It now appears that protection by the acellular vaccines, although lasting several years, may wane, leaving large populations unprotected against pertussis. Nonetheless, vaccination and revaccination remain the primary shields against infection.

Source: Journal Watch Infectious Diseases.