These are all the Blogs posted on Saturday, 14, 2012.
Saturday, 14 July 2012
To Smoke or Not To Smoke
Despite the rapid decline in prevalence of smoking in the general population, it remains the most important cause of preventable death in the western world. But is smoking itself preventable by therapeutic intervention? Indeed, is smoking a disease that doctors could or should prevent and treat? If you accept the National Institute of Health’s definition of addiction as a chronic, relapsing brain disease, the answer is yes. But the NIH’s philosophy is dubious, to say the least.
All round the world, telephone help-lines have been established to assist smokers to abandon the habit. But do they do any good, other than provide a certain amount of employment to those who man them (not to be underestimated in these hard economic times)?
A paper in the British Medical Journal for April 28 suggests an answer, and there are no prizes for guessing what it is. The answer, in a word, is no.
The authors of the paper wanted to see whether more intensive and “proactive” advice (we’ll call you regularly, to chivvy you along), with or without the offer of free nicotine patches, would improve the rate of smoking cessation as compared with “standard support and advice.”
Interestingly, of the first 75,272 callers to the help line after the researchers started to recruit their subjects, only 5355 (7 percent) were even willing to state a date by which they intended to quit or try to quit. And of those, only 2,591 were eligible and willing to take part in the trial. Bear in mind that those who called the help line in the first place were not necessarily representative of smokers as a whole.
The trial subjects were divided into four groups, those who had standard support and advice, those who had standard support and advice plus the offer of free nicotine patches, those who were given enhanced telephone support, and those who were given enhanced telephone support plus the offer of free nicotine patches. Seventy percent of those who offered free nicotine patches took the offer up.
The results were not encouraging.
The rates of cessation were very low at six months. They were slightly (though not significantly lower) in those offered enhanced support by comparison with standard support, and those offered nicotine patches were lower still. Moreover, the rates of cessation were half of the self-reported rate when measured objectively by the level of exhaled carbon monoxide — in other words, about half those who self-reported cessation were not telling the truth.
Overall, about 8 percent of the people enrolled in the trial had quit smoking at six months, 6.6 percent of those offered patches, and 9.4 percent not offered patches. When one considers that only 3.44 percent of people who called the help line were willing even to enter the trial, this is not impressive: not more than 0.28 percent of the people who first called.
Personally I do not find this in the least surprising. It is mistaken to treat a voluntary behavior as if it were a disease, and then try to “treat” it. The editorial that accompanied the research paper, written by an Australian professor of public health and a director of a center for “behavioral research, was rather saddened by the result. “Although motivation to quit by itself is often insufficient too, most ex-smokers finally seem to quit without professional or pharmaceutical assistance.”
In other words, people who say they want to quit don’t always mean it; but millions have meant it, and have succeeded, no thanks to doctors. And those doctors who simply told their patients to “pull yourself together” were actually right by comparison with those who held that addiction to smoking was a chronic relapsing brain disease. They had a much more sophisticated grasp of the human condition.
First published in PJMedia.
Posted on 07/14/2012 7:47 AM by Theodore Dalrymple
Saturday, 14 July 2012
Lee Smith On Obama's Fantasy World
From The Weekly Standard:
Obama's Fantasy World
July 23, 2012,
The White House wants you to know there’s much more to Obama’s foreign policy than meets the eye. Sure, it might seem that the president has lost the thread, and that America’s interests are suffering in the Persian Gulf, the eastern Mediterranean, Europe, and Africa, just to name a few. But there’s a secret world—details of which are regularly leaked to the media—where the reality is supposedly different. Here the Obama administration is—according to the Obama administration—conducting a robust foreign policy, racking up victory after victory and confounding our foes on a regular basis. You just don’t know about it because Obama wants it that way, nice and quiet. Subtlety, after all, is the signature of smart power.
You might think, for example, that Obama has rolled over on Iran, and that he will allow the mullahs and the Revolutionary Guards Corps to get the bomb. But in the secret world, the president has engineered a clandestine cyber campaign against Iran’s nuclear facilities that will continue to frustrate the regime’s plans. In the secret world, the administration has intelligence operatives on the ground in Syria coordinating with rebel forces and regional allies to bring down Bashar al-Assad. Russian president Vladimir Putin may seem to display open contempt for Obama—but in the secret world, the Russian reset will soon pay rich dividends.
This secret world, not to put too fine a point on it, is a fantasy. In the real world, there are clandestine actions, to be sure, but the bulk of foreign policy—trade, diplomacy, and war—is conducted openly. Unlike an iceberg, foreign policy is almost all visible. This is especially true of the United States, an enormous power projecting global influence whose smallest movements and offhand remarks are monitored closely by all. Around the world, lives may depend on a decision made in the White House. When the United States is inert, as it is with the current administration, when it is not doing anything to secure its interests, its inaction is obvious to friends and enemies alike.
The administration’s campaign of leaks, in short, is political theater. So what is the driving principle of Obama’s foreign policy?
In the White House’s hesitancy in acting to topple American adversary, and Iranian ally, Bashar al-Assad, Weekly Standard contributing editor Reuel Marc Gerecht sees evidence of an “administration trying not to commit itself.” Indeed, lack of commitment would appear to describe Obama’s foreign policy in its entirety. Ambivalence has been elevated to a guiding principle.
Perhaps the most instructive example is Turkey, whose prime minister, Recep Tayyip Erdogan, is said to be one of Obama’s closest confidants among world leaders. He earned his place on Obama’s speed dial because the administration believed that Islamists were poised to inherit the political order of the Middle East, and that Turkey’s Islamist premier would be well placed to help coordinate the White House’s outreach—in Egypt, Tunisia, and Libya, among other places. It is because the administration saw Ankara as a useful strategic partner that it tried to pressure Israel to apologize to Turkey for killing nine terrorists aboard the Turkish-flagged Mavi Marmara, dispatched in May 2010 to break the maritime blockade of Gaza.
The Turks never received their apology, but Erdogan won a role as the administration’s proxy on Syria policy—until Assad illuminated the limits of Ankara’s power and Erdogan turned against the Syrian president. Turkish diplomats have sought U.S. support to bring down Assad, while Turkish military planners are said to be explaining to their U.S. peers exactly how they’d do it—if the Americans were only on board. But Turkish efforts to convince the White House to join in a project that would advance U.S. interests have been in vain. Obama won’t do it. So the Turks, as well as other regional partners, are spinning their wheels without the backing of their superpower ally.
Much has been made of the Obama team’s tough-minded political cutthroats, but they’re all deployed against Mitt Romney. When it comes to foreign policy, the White House rolls over. It’s not just that Putin and Iran’s Supreme Leader Ali Khamenei might be a little rougher around the edges than Chicago political bosses, but that Obama himself is not that hardy. Over the course of a very brief political career, he has always had the wind at his back—thanks in large part to an admiring press corps, which has now also proved to be a willing accomplice in crafting the fairy tale of Obama’s secret foreign policy cunning.
The real issue then is this: Why has the administration felt the need to project a world of exciting secret images on the blank screen of his foreign policy? That is, who is the administration defending itself against? Whose criticism are they trying to blunt? Republican opponents, to be sure, as well as the party’s candidate—but more significantly the large part of the American public that expects leadership from its commander in chief. Obama’s handlers are busy behind the curtains making it look like he is a decisive leader because they fear the judgment that will be rendered on the president if the public sizes him up correctly: a character study in ambivalence, a man who can’t commit.
Posted on 07/14/2012 12:47 PM by Hugh Fitzgerald
Saturday, 14 July 2012
More Than 50 Billion Dollars Officially Wasted By Americans In Iraq
The article is of interest, but also a little beside the point. The main point is this: ALL of the money spent or currently committed to be spent, as a result of the Iraq War, was wasted -- or wasted unless one correctly defines "victory" as an end result that weakens the Camp of Islam. And that weakening of the Camp of Islam was set in motion by the capture of Saddam Hussein, the killing of his two sons, the capture or killing of almost all of the major figures in his regime. In other words, by early 2004 the conditions for that victory were set in motion, and the American troops should have left, promptly, then. Power had passed to the Shi'a from the Sunni Arabs. That was it.
It took another eight years, and 1.5 trillion dollars more, for the Americans to leave. Why?
From The Huffington Post:
WASHINGTON — After years of following the paper trail of $51 billion in U.S. taxpayer dollars provided to rebuild a broken Iraq, the U.S. government can say with certainty that too much was wasted. But it can't say how much.
In what it called its final audit report, the Office of the Special Inspector General for Iraq Reconstruction Funds on Friday spelled out a range of accounting weaknesses that put "billions of American taxpayer dollars at risk of waste and misappropriation" in the largest reconstruction project of its kind in U.S. history.
"The precise amount lost to fraud and waste can never be known," the report said.
The auditors found huge problems accounting for the huge sums, but one small example of failure stood out: A contractor got away with charging $80 for a pipe fitting that its competitor was selling for $1.41. Why? The company's billing documents were reviewed sloppily by U.S. contracting officers or were not reviewed at all.
With dry understatement, the inspector general said that while he couldn't pinpoint the amount wasted, it "could be substantial."
Asked why the exact amount squandered can never be determined, the inspector general's office referred The Associated Press to a report it did in February 2009 titled "Hard Lessons," in which it said the auditors – much like the reconstruction managers themselves – faced personnel shortages and other hazards.
"Given the vicissitudes of the reconstruction effort – which was dogged from the start by persistent violence, shifting goals, constantly changing contracting practices and undermined by a lack of unity of effort – a complete accounting of all reconstruction expenditures is impossible to achieve," the report concluded.
In that same report, the inspector general, Stuart Bowen, recalled what then-Defense Secretary Donald H. Rumsfeld asked when they met shortly after Bowen started in January 2004: "Why did you take this job? It's an impossible task."
By law, Bowen's office reports to both the secretary of defense and the secretary of state. It goes out of business in 2013.
Bowen's office has spent more than $200 million tracking the reconstruction funds, and in addition to producing numerous reports, his office has investigated criminal fraud that has resulted in 87 indictments, 71 convictions and $176 million in fines and other penalties. These include civilians and military members accused of kickbacks, bribery, bid-rigging, fraud, embezzlement and outright theft of government property and funds.
Much, however, apparently got overlooked. Example: A $35 million Pentagon project was started in December 2006 to establish the Baghdad airport as an international economic gateway, and the inspector general found that by the end of 2010 about half the money was "at risk of being wasted" unless someone else completed the work.
Of the $51 billion that Congress approved for Iraq reconstruction, about $20 billion was for rebuilding Iraqi security forces and about $20 billion was for rebuilding the country's basic infrastructure. The programs were run mainly by the Defense Department, the State Department and the U.S. Agency for International Development.
A key weakness found by Bowen's inspectors was inadequate reviewing of contractors' invoices.
In some cases invoices were checked months after they had been paid because there were too few government contracting officers. Bowen found a case in which the State Department had only one contracting officer in Iraq to validate more than $2.5 billion in spending on a DynCorp contract for Iraqi police training.
"As a result, invoices were not properly reviewed, and the $2.5 billion in U.S. funds were vulnerable to fraud and waste," the report said. "We found this lack of control to be especially disturbing since earlier reviews of the DynCorp contract had found similar weaknesses."
In that case, the State Department eventually reconciled all of the old invoices and as of July 2009 had recovered more than $60 million.
The report touched on a problem that cropped up in virtually every major aspect of the U.S. war effort in Iraq, namely, the consequences of fighting an insurgency that proved more resilient than the Pentagon had foreseen. That not only made reconstruction more difficult, dangerous and costly, but also left the U.S. military unprepared for the grind of multiple troop deployments, the tactics of an adaptable insurgency and the complexity of battlefield wounds. It also left the U.S. government short of the expertise it needed to monitor contractors.
Although the audit was labeled as final, a spokesman for Bowen's office, Christopher M. Griffith, said several more will be done to provide additional details on what the U.S. got for its reconstruction dollars and what was wasted.
Posted on 07/14/2012 1:05 PM by Hugh Fitzgerald
Saturday, 14 July 2012
Defecting Syrian Ambassador To Baghdad, A Sunni, Now In Qatar, Attacks Maliki
DUBAI: Syria's former ambassador in Baghdad, Nawaf Fares, criticised Iraqi premier in an interview broadcast Saturday, saying Nuri al-Maliki's stance towards Damascus was "contradictory" to the truth.
"I personally reproach the (Iraqi) prime minister on his stance which is contradictory to the truth," Fares, who defected earlier this week, told Doha-based Al-Jazeera television channel.
"He knows very well what (Syrian President) Bashar al-Assad had done to him and to all of Iraq and to (Muslim) Shia specifically, Fares said, adding that Assad has "killed thousands" by opening "the doors for Al-Qaeda" militants to carry out bombings across Iraq.
Iraq had repeatedly accused Damascus in the past of letting Sunni insurgents and arms transit through Syria for carrying out attacks inside the country, especially during the brutal sectarian conflict that erupted after US-led forces toppled Saddam Hussein's regime.
But since the uprising against Assad -- who belongs to the Alawite minority sect which is an offshoot of Shia Islam -- Iraq's Shiite-led government has called for non-interference in Syria and has opposed arming the rebels.
Baghdad's stance was similar to that of Syria's other Shiite ally Iran which Fares accused of "putting pressures" on Maliki's government.
"Iran must not support a tyrant and dictator who is killing his own people, regardless of its interests," Fares told Al-Jazeera in Qatar, where he has fled.
Western countries and the Syrian opposition accuse Iran of providing military support to the regime in Syria, where more than 17,000 people have been killed since March 2011 according to activists. Tehran denies the charge.
When asked on UN-Arab League envoy Kofi Annan's bid to shore Iran's support for his tattered peace plan, Fares said: "Iran is part of the problem, how could it be part of the solution?"
"The Syrian revolt will win despite Iran and all countries backing the tyrant" whom Fares described as "Syria's former president who is now a criminal and a killer."
Fares, the first Syrian ambassador to defect to the opposition, was widely seen as a regime hardliner and his decision, announced on Al-Jazeera on Wednesday, was surprising.
Syrian foreign ministry had said Fares, who hails from a prominent Sunni tribe from eastern Syria, had been dismissed and would be prosecuted.â€‘
Posted on 07/14/2012 1:17 PM by Hugh Fitzgerald
Saturday, 14 July 2012
Lawless Sinai, With Islam As Its Codex Sinaiticus
From The Washington Post:
In Egypt's Sinai desert, Islamic militants gaining new foothold
RAFAH, Egypt — Vast areas of Egypt’s Sinai desert have descended into lawlessness in recent months, providing fertile ground for small cells of extremist militants that have emerged from the shadows and quietly established training camps near the Israeli border, according to Bedouin elders and security experts.
The militants include men who have fought in Afghanistan and Pakistan in recent years, as well as Islamists who were released from prison after the 2011 popular revolt that toppled President Hosni Mubarak and drove much of his potent security apparatus underground.
The only thing that kept us looking over our shoulders was the prospect of getting kidnapped
Drawing little notice during a period of dramatic developments in Cairo, the militants have become increasingly bold and visible amid a broader breakdown of security in the strategically important desert, a buffer zone between Israel and Egypt. The eclipse of authority has also given rise to Sharia courts run by Islamic scholars who settle disputes according to Islamic law.
The Egyptian government’s failure to restore order in the Sinai has unnerved Israel, in part because of a recent attack on an Israeli border post. Some local residents worry that Israel might ultimately respond unilaterally, a prospect that alarms those who survived successive wars in the Sinai between the neighbors in the 1960s and 1970s.
“In one year, this could all become extremely dangerous,” said Nassar Abu Akra, a merchant and elder in the area who fears that the rise of a violent militant movement could spark a crushing response from Israel. “If Israel responds to protect its land, it would be a disaster — a massacre. Even normal people, not just jihadis, would fight and die if Israelis came back.”
U.S. officials have grown increasingly concerned about deteriorating security in the Sinai. The subject is all but certain to come up during Secretary of State Hillary Rodham Clinton’s visit to Cairo this weekend, particularly because two U.S. citizens were reportedly kidnapped in the area Friday.
The Sinai peninsula was contested territory for much of the past century, largely because it is a gateway to the Suez Canal, which connects the Mediterranean Sea and Red Seas. Israeli forces occupied the Sinai in 1956 and 1967 and fought a war against Egyptian troops in the following decade. Egypt regained full control of the Sinai after the 1979 peace treaty brokered by the United States.
A U.S. Army battalion consisting of several hundred soldiers is stationed in the Sinai as part of an international peacekeeping force.
In the recent turmoil, militants have been carrying out attacks on lightly armed police officers in recent months and have repeatedly bombed the pipeline that carries natural gas to Israel. Bedouin tribesmen with grievances against the state, meanwhile, have kidnapped foreign tourists and international peacekeepers. Drug runners and human smugglers have also seized the moment, making both lucrative trades increasingly violent.
Soon after Egyptians rose up in Cairo in late January 2011 against Mubarak’s authoritarian regime, residents in northern Sinai went on a looting rampage, burning police stations and other symbols of a state that became despised for the heavy hand of its security forces and the few services it offered to the residents of the impoverished, barren area.
Posted on 07/14/2012 3:55 PM by Hugh Fitzgerald