Breast Cancer Prevention: Angelina Jolie and US Health Care

Around 1981, one of my aunts, a pediatrician and physiatrist who is now retired, had a prophylactic bilateral mastectomy, after a second of her four sisters was found to have breast cancer.

Now Angelina Jolie has announced that she decided to do the same, due to having the BRCA1 gene. The autosomal dominant BRCA1 and BRCA2 genes cause a 60 percent risk of breast cancer and also increase the risk of other cancers. See this link from the National Cancer Institute.

What do Angelina Jolie and my aunt (whose name rhymes with Angelina's) have in common as well? They were able to afford surgery that their insurance did not pay for. Currently, Medicare will not cover even the DNA test for BRCA1, much less the prophylactic double mastectomy and the cosmetic bilateral breast implants.

Vireya rhodedendrons

I took these photos earlier this week.  Our vireya rhodedendrons have started flowering again, after a winter's rest.

Natural Kinds, Complexity, and the Particular: Part I

I've recently read Manuel DeLanda's book Intensive Science and Virtual Philosophy (2005).  Recommended. I've been intrigued by how differently Aristotle and DeLanda consider formal causation as a shaping principle in biology.

For the traditional Aristotelian or Thomistic essentialist (AT-E), living things are a combination of matter and form, with the form determining the essence of the living individual, its natural kind.  The form of that individual living substance is the same between individuals of that species, which otherwise may differ in their accidental, non-essential properties. For the AT-E, the mind understands the nature of that species by abstraction within the mind's thoughts, which comes to hold (as a mental property) the same form that makes individuals of that species the species which they are. Thus, for the AT-E, mental representation captures the true or natural essence of the species, its eternal form.

Though useful for taxonomy of species, there was an unfortunate sterility of the AT-E idea of substance when it came to scientific progress which led to its total abandonment in modern biology. The problem was the tendency for the AT-E philosopher's investigation to end once a satisfactory species definition was decided. The essence of a species, to the AT-E theorist, could be completely captured in a concept that is adequate to separate that species from other species.  Thus, the essence of humanity is captured in "rational animal" and the essence of animal itself is that of a mobile life form. Once defined, these concepts tended to be used to represent the species itself, and the other, often unique characteristics of the species were regarded as mere unimportant "accidents." Yet much of modern biology's success lies in its systematic investigation of what are unessential properties to the AT-E theorist. For example, human DNA and its difference from the DNA of, say, a plant, might be a mere distraction from the more important study of essences to the AT-E theorist, yet many useful technologies in modern life depend upon our understanding of the (unimportant to the A-T metaphysician) accident of differences in DNA.

Lest the reader think I am criticizing a mere straw-man position for the AT-E theorist, let me quote Oderberg, a current AT-E philosopher, on the classification of things such as motile bacteria and intelligent non-humans. First, "Secondly, all motile bacteria and archaea, whatever their relation to the kingdom Animalia and whatever their differences from each other, are animals: they can sense their environment and they can move themselves" (David S. Oderberg, Real Essentialism, p. 190). Second, according to Oderberg, "any truly rational animal, if such were metaphysically possible, would still be human" (Oderberg, p. 104).

Why is this disturbing? Oderberg is letting his definitions govern his science instead of using science to better guide his definitions. If things are only truly known via their essences, the definition of the essence, once settled upon, becomes more important than the other properties of an individual, which are considered mere accidents.  Eventually, the biology becomes ignored by the definition maker and his followers, who are then falsely secure that the essence of their derived mental representation tells them all that is essential about a living creature. In this way, metaphysics can be seen, even today, to lead to a kind of scientific doldrums, where classification is all that is required for understanding.

Although Deluze and DeLanda admit formal causes, and see them as fundamental to living things, they do so in an entirely different way, one that does not confuse our mental categories of representation with the actual causes of the natural categories of various living things. In DeLanda, the formal cause of a living being (such as a bacterium, for example) is instead a complex, historical entity of many specific factors, which does not resemble our mental representation or definition of the individual bacterium, and which might in some other context (such as in a computer simulation) produce an entirely different kind of thing, which would be similar to the bacterium only in that mathematical models of its systems would be similar. That way is the way of multiplicities, or "concrete universals," which are mathematical manifolds containing attractors which describe tendencies of systems to take a particular state (Manuel DeLanda, Intensive Science and Virtual Philosophy, p. 22).

Because DeLanda's universals incorporate the mathematically based models of much of modern science, they do not seem to invite a stultifying and distorting reliance on classical definitions that bedevils Oderberg's work.

As such, DeLanda's universals are promising as a basis for the causes of emergence in my emergent neutral monist schema.  More on this in a future post.

Ernst Mayr on species classification in philosophy of biology

The assumptions of population thinking are diametrically opposed to those of the typologist. The populationist stresses the uniqueness of everything in the organic world. What is true for the human species,–that no two individuals are alike, is equally true for all other species of animals and plants ... All organisms and organic phenomena are composed of unique features and can be described collectively only in statistical terms. Individuals, or any kind of organic entities, form populations of which we can determine the arithmetic mean and the statistics of variation. Averages are merely statistical abstractions, only the individuals of which the populations are composed have reality. The ultimate conclusions of the population thinker and of the typologist are precisely the opposite. For the typologist, the type (eidos) is real and the variation. an illusion, while for the populationist the type (average) is an abstraction and only the variation is real. No two ways of looking at nature could be more different.

--In What Evolution is, quoted from 1959.

Aloha Friday: 2013 Merrie Monarch Festival and E Pili Mai

Mili Hokoana English, of Maui, won the Merrie Monarch 50th anniversary hula dance competition yesterday in Hilo.

Merrie Monarch is a yearly hula dance festival here.

Here's a link to a Youtube recording of a different version of the song (Mili's version had two original verses) .

E Pili Mai (Come To Me) - Words by Larry Lindsey Kimura, Music by Cyril Pahinui
ʻAuhea wale ana ʻoe Kuʻu lei o ka pō Pō anu hoʻokahi nō au Sweetheart mine E pili mai Inā ʻo ʻoe a ʻo au ʻIke i ke ahi o Makana He makana ia na ke aloha No na kau a kau ʻO ʻoe aʻo au Sweetheart mine E pili mai	Where are you My sweetheart of the night The night is cold and I am alone Sweetheart mine Come to me If you and I are together We'll know the fires of Makana It would be a gift given of love For all time You and I Sweetheart mine Come to me

Hawai`i newborn hypothyroidism linked to airborne drifting waste from Fukushima disaster

Radioactive I-131 is concentrated in the thyroid gland. This was seen also with Chernobyl, I believe. There are many complicating issues.

See a good analysis of them with Chernobyl here.

Blogger Jan TenBruggencat reports on the Hawaii hypothyroidism (no cancer reported yet though) here.

New Concussion Guidelines: If In Doubt, Sit it Out

"If In Doubt, Sit it Out" was the slogan of an NFL concussion training video a couple of years ago, required viewing for NFL players in view of highly publicized cases of depression and encephalopathy in older American football players. Now, the American Academy of Neurology has endorsed more conservative and stringent handling of concussion at the high school level as well, where there is some evidence players may be even more vulnerable to sequelae of TBI.

The new guidelines are available here.

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A Handout For Sports Personnel:  See also HERE.

 Use this guide to help you evaluate if someone may have a concussion and needs to see a licensed health care provider.*

EVALUATE

Know these signs and symptoms of concussion. Every athlete is unique and may experience different combinations of reactions.

Common Signs of Concussion— Things You Can Observe

• Behavior or personality changes

• Blank stare, dazed look

• Changes to balance, coordination, or reaction time

• Delayed or slowed spoken or physical responses

• Disorientation (confused about time, date, location, game)

• Loss of consciousness (blackout) (occurs in less than 10 percent of people with concussion)

• Memory loss of event before, during, or after injury occurred

• Slurred/unclear speech

• Trouble controlling emotions

• Vomiting

Symptoms of Concussion— Things the Athlete Tells You

• Blurry vision/double vision

• Confusion

• Dizziness

• Feeling hazy, foggy, or groggy

• Feeling very drowsy, having sleep problems

• Headache

• Inability to focus, concentrate

• Nausea (stomach upset)

• Not feeling right

• Sensitivity to light or sound

TAKE ACTION

What should I do if an athlete has a head injury during a game?

Immediately address safety concerns. If the person is unconscious (knocked out), check his or her Airway, Breathing, and Circulation (ABCs).

Airway: Check that the mouth and throat are not blocked

Breathing: Be sure the person is breathing normally

Circulation: Check that the person’s heart is beating regularly

If you suspect the person may have a neck injury or if the person is unconscious:

• Do not move the head, neck, or spine. This could worsen any spinal injury to the neck

• Contact emergency medical services with any concern about breathing, circulation, or spinal injury

• Do not let the athlete return to play until examined and cleared by a licensed health care provider trained in diagnosing and managing concussion

SEEK CARE

What should I do if it appears the athlete has a concussion?

If a concussion is suspected, remove the athlete from play. If a concussion is diagnosed, the athlete should not return to play for the rest of the day.

• Monitor the athlete for the next three to four hours. You may need to monitor for a longer time

• Notify a licensed health care provider trained in diagnosing and managing concussion

• Do not let the athlete return to play until evaluated and cleared by a licensed health care provider trained in diagnosing and managing concussion

When is it okay for the athlete to return to the game?

Clearance from a licensed health care provider trained in diagnosing and managing concussion is needed before allowing the athlete to return to play. The health care provider may:

• Advise the athlete to return to physical activity slowly

• Explain the process for this clearly

• Tell the athlete to increase activity levels carefully, step by step

Remember, if the person has any concussion symptoms, he or she should not advance to the next activity level. Before full return to play, the final activity level should imitate game conditions as much as possible.