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Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art … – Dove Medical Press
Posted: June 29, 2017 at 11:47 pm
Marco Solmi,1,2 Andrea Murru,3 Isabella Pacchiarotti,3 Juan Undurraga,4,5 Nicola Veronese,2,6 Michele Fornaro,7,8 Brendon Stubbs,2,911 Francesco Monaco,2 Eduard Vieta,3 Mary V Seeman,12 Christoph U Correll,13,14 Andr F Carvalho2,15
1Neuroscience Department, University of Padua, 2Institute for Clinical Research and Education in Medicine, Padua, Italy; 3Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clnic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; 4Department of Psychiatry, Faculty of Medicine, Clnica Alemana Universidad del Desarrollo, 5Early Intervention Program, J. Horwitz Psychiatric Institute, Santiago, Chile; 6National Research Council, Ageing Section, Padua, 7Laboratory of Molecular and Translational Psychiatry, Department of Neuroscience, School of Medicine, University Federico II, Naples, Italy; 8New York State Psychiatric Institute, Columbia University, New York, NY, USA; 9Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 10Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, 11Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK; 12Institute of Medical Science, Toronto, ON, Canada; 13Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, 14Department of Psychiatry and Molecular Medicine Hempstead, Hofstra Northwell School of Medicine, Hempstead, NY, USA; 15Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Cear, Fortaleza, Cear, Brazil
Abstract: Since the discovery of chlorpromazine (CPZ) in 1952, first-generation antipsychotics (FGAs) have revolutionized psychiatric care in terms of facilitating discharge from hospital and enabling large numbers of patients with severe mental illness (SMI) to be treated in the community. Second-generation antipsychotics (SGAs) ushered in a progressive shift from the paternalistic management of SMI symptoms to a patient-centered approach, which emphasized targets important to patients psychosocial functioning, quality of life, and recovery. These drugs are no longer limited to specific Diagnostic and Statistical Manual of Mental Disorders (DSM) categories. Evidence indicates that SGAs show an improved safety and tolerability profile compared with FGAs. The incidence of treatment-emergent extrapyramidal side effects is lower, and there is less impairment of cognitive function and treatment-related negative symptoms. However, treatment with SGAs has been associated with a wide range of untoward effects, among which treatment-emergent weight gain and metabolic abnormalities are of notable concern. The present clinical review aims to summarize the safety and tolerability profile of selected FGAs and SGAs and to link treatment-related adverse effects to the pharmacodynamic profile of each drug. Evidence, predominantly derived from systematic reviews, meta-analyses, and clinical trials of the drugs amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, sertindole,ziprasidone, CPZ, haloperidol, loxapine, and perphenazine, is summarized. In addition, the safety and tolerability profiles of antipsychotics are discussed in the context of the behavioral toxicity conceptual framework, which considers the longitudinal course and the clinical and therapeutic consequences of treatment-emergent side effects. In SMI, SGAs with safer metabolic profiles should ideally be prescribed first. However, alongside with safety, efficacy should also be considered on a patient-tailored basis. Keywords: antipsychotics, side effects, tolerability, safety, psychosis, psychiatry
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
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’50s musical lightens up Bolingbrook summer stage – Chicago Tribune
Posted: at 11:46 pm
Sandwiched between a dense Tennessee Williams play and an ultra-spooky Halloween thriller comes a laugh-a-minute summer musical.
Bolingbrook's Theatre-on-the-Hill is staging "How to Succeed in Business Without Really Trying" July 7-23 at the Bolingbrook Performing Art Center's outdoor stage. Performances are at 8 p.m. Fridays and Saturdays and 7 p.m. Sundays.
The troupe staged "A Streetcar Named Desire" in the spring and this fall plans to do an immersive stage adaptation of "Night of the Living Dead."
Theatre-on-the-Hill President Michael Fudala is directing the musical, which features a score by score by Frank Loesser of "Guys and Dolls" fame. Loesser is a hero of Fudala's, he said.
"It is a wonderfully biting satire of big business that is based on a book of the same name that came out in 1952," he said. "It is all over the top, tongue-in-cheek, politically incorrect. This came out in '61 as a stage play, won seven Tony awards, won a Grammy for best album and won the Pulitzer for drama one of only eight musicals ever to win a Pulitzer. And it happens to be, in my humble opinion, probably the funniest musical ever."
It plays off all the stereotypes we "know and love to hate" in the business world, he said.
"It charts the rise of J. Pierrepont Finch, who starts as a window washer and with the help of this handy little book, 'How to Succeed in Business Without Really Trying,' and rises to become the chairman of the board in a very short period of time," he said.
As Chairman of the Board at the World-Wide Wicket Company, Finch's morally-questionable business practices jeopardize not only his career but also his romance with secretary Rosemary Pilkington (Rachel Banda of Bolingbrook and Claire Diamond of Lockport).
Characters include company boss J. B. Biggley (Andrew Philippides of Bolingbrook), Biggley's nephew Bud Frump (Chris Tinoco of Bolingbrook and Kush Soni of Naperville) and Biggley's mistress Hedy LaRue (Melaura Rice of Bolingbrook and Abby Williams of Aurora). Famous songs include "I Believe in You," "Been a Long Day," and "Brotherhood of Man."
"As usual, we have just a phenomenal cast," Fudala said. "I'm always impressed with the level of talent that we have come out, even for the lesser known (musical) I mean, it was really popular in its day, but it's been 50 years. It was re-done in the '90s with Matthew Broderick and there was a revival in 2011 with Daniel Radcliffe as the main character."
He was inspired to do this show by those revivals, particularly by Rob Ashford's choreography and direction, he said.
"I've loved this show forever. I've done it once in the '90s and (while) I don't like to repeat myself, this one is so good," he said. "It has brilliant singing and brilliant dancing. It's really an ensemble piece."
J. Pierrepont Finch is played by Bolingbrook High School sophomore Spencer Avery of Bolingbrook.
"He came to us a few years back when we did 'Spamalot' and he was still in grade school and his level of maturity and understanding of British humor knocked my socks off," Fudala said. "And in the intervening years, he has really matured vocally as well. I can't say enough about the kid. He is destined to go on to bigger things."
Fudala is anxious for audiences to see the musical. It's the perfect cure for any lingering summertime blues, he said.
"I really thought everyone could use a few laughs and this is funny from beginning to end," he said. "Something lighthearted, something you don't have to think too hard about. It's the funniest musical of all time."
Annie Alleman is a freelance writer for the Naperville Sun.
When: July 7-23
Where: Bolingbrook Performing Arts Center 375 W. Briarcliff, Bolingbrook
Tickets: $17
Information: 630-908-2538; facebook.com/Theatre-on-the-Hill-117023365025544/
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ASK DOG LADY: A crated dog may be a happy dog – The Salem News
Posted: at 11:46 pm
Dear Dog Lady,
I love dogs. In fact, I love dogs so much that I don't own one. I have a house with a small yard, and I refuse to get a dog until I have a yard with space for him to enjoy his life. Unfortunately, you and many of your readers seem intent on having a dog whether it's good for the dog or not.
In a recent column, you responded to a woman whose dog was chewing everything in the house. Your advice to her was to keep the dog confined in a crate, in a room or behind a gate.
Consider the quality of life for this dog that nature designed to run and roam free. He will be severely confined inside a crate, or at best in a room, for the vast majority of his day, with at best an hour of exercise walking on a leash. This is a lifestyle we reserve for our worst criminals in solitary confinement.
A: Your well-reasoned letter makes perfect sense for you and your non-existent dog. However, for other people and their real and beloved pets, your prison scenario isnt the case. Many dogs are quite happy to be contained in crates or cages (the politically incorrect term for dog enclosures). These are the animals safe houses for peaceful, solitary confinement. Crates are also effective house-training tools.
In my response to the woman whose dog chewed everything, you might have also seen the sharp finger wag at the woman who had not properly trained her dog. We humans are responsible for our dogs success. We train them to live with us. We are the dunces if they flunk. Through their domesticated natures, dogs want to please us by fitting in. We should not fail them.
You are to be complimented for deciding your lifestyle cannot support a dog. You have thought it all out and you have made a good decision for you. Others would naturally disagree.
Dear Dog Lady,
All but one of my/our six dogs had been lucky happenings. I found one without having had to search. The latest, a rescue, was a dear but had health problems and the veterinarian couldnt help. I wonder where to begin looking for another? Now that I am old, I hope to find a small animal I will be able to lift without pain, and one that is more couch potato than border collie. Do you advise local shelters? National searches via the web? Newspaper ads? Theres luck, of course.
A: Local shelters are a good place to start, especially if you visit first and tell the staff about the sort of dog you seek. I love your description of more couch potato than border collie, which describes your ideal pet succinctly. If you make a connection with a shelter, perhaps make a donation, they will keep your request in mind. Naturally, theres always luck. Dogs come into peoples lives in the strangest and most wonderful ways. Keep your eyes open. Your heart sounds ready.
Monica Collins offers advice on pets, life and love. Ask a question or make a comment at askdoglady@gmail.com.
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Wikipedia Against Censorship – Harvard Magazine
Posted: at 11:45 pm
If you tried to search for Emma Watsons Wikpedia page in Iran in 2013, you wouldnt have been able to find it; the article was one of 963 blocked by the government. This tidbit about the Harry Potter actress is found in a 2013 University of Pennsylvaniareport on Irans censorship of Wikipedia. Researchers at Harvards Berkman Klein Center for Internet & Society recently built on this publication by analyzing censorship of the site in 15 countries since 2014. In a report published in May, they found that censorship of Wikipedia has declined since then due to the sites new security measures.
In fact, they discovered that only three countries blocked access to parts of Wikipedia during the duration of the study: China and Uzbekistan were blocking the Chinese- and Uzbek-language versions of Wikipedia (read more coverage of censorship in China, and its use of fake social media posts to influence public opinion). Thailand had once blocked the Yiddish versionmost likely a weird misconfiguration, says Justin Clark, a software developer at the center and the principal author of the report. They derived their results partly by analyzing data from the Wikimedia Foundation (Wikipedias parent organization) that showed when people load Wikipedia articles, and partly from 41 servers located in different countries around the world that tried to load Wikipedia and could determine if the website was blocked.
Clark says there are multiple reasons for the changing levels of censorship. The first is Wikipedias transition from HTTP to HTTPS. HTTP (hypertext transfer protocol) guides the way a websites data is sent to a browser. Because the connection is unencrypted, however, other people can intercept that connection and see the data being sent. In HTTPS, the s stands for secure; the major difference between the two protocols is that HTTPS encrypts the data being communicated.
Wikipedias transition affected the way countries could block access, Clark explains. With HTTP, a country could block an individual Wikipedia article. But with HTTPS, the country needs to choose between blocking every article or none. Countries are choosing the latter. As the report states: Russia once again blacklisted Wikipedia over a single cannabis-related article, but the ban was reversed less than 24 hours later.
Monitoring censorship of Wikipedia matters because Wikipedia is one of the most prominent, and most important, sites out there, says Rob Faris, the research director at the center, who also worked on the report. How countries treat Wikipedia, he continues, is indicative of how important Internet freedom is not only to them, but also to the rest of the world. Clark adds that understanding the information controls imposed on the Internet is important for allowing an informed citizenry to emerge.
As the first complete empirical deep dive into incidents of the blocking of Wikipedia projects around the world, Faris says, the report will inform future research as other investigators follow its methods. He also notes that accessing Wikipedia server data is novel. Such research paves the way for examining global Internet outages, Clark says, especially those deliberately caused by countries during elections or protests. He adds that after the study concluded, China blocked access to Wikipedia in additional languages spoken there, and Turkey in all languages, so the Berkman Klein Center will continue to monitor Wikipedia around the world.
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New Berkman Klein Center study examines global internet censorship – Harvard Law School News
Posted: at 11:45 pm
Credit: Berkman Klein Center
A sharp increase in web encryption and a worldwide shift away from standalone websites in favor of social media and online publishing platforms has altered the practice of state-level internet censorship and in some cases led to broader crackdowns, a new study by the Berkman Klein Center for Internet & Society at Harvard University finds.
The Shifting Landscape of Global Internet Censorship, released today, documents the practice of internet censorship around the world through empirical testing in 45 countries of the availability of 2,046 of the worlds most-trafficked and influential websites, plus additional country-specific websites. The study finds evidence of filtering in 26 countries across four broad content themes: political, social, topics related to conflict and security, and internet tools (a term that includes censorship circumvention tools as well as social media platforms). The majority of countries that censor content do so across all four themes, although the depth of the filtering varies.
The study confirms that 40 percent of these 2,046 websites can only be reached by an encrypted connection (denoted by the HTTPS prefix on a web page, a voluntary upgrade from HTTP). While some sites can be reached by either HTTP or HTTPS, total encrypted traffic to the 2,046 sites has more than doubled to 31 percent in 2017 from 13 percent in 2015, the study finds. Meanwhile, and partly in response to the protections afforded by encryption, activists in particular and web users in general around the world are increasingly relying on major platforms, including Facebook, Twitter, Medium, and Wikipedia.
These trends have created challenges for state internet censors operating filters at national network levels. When an entire website is encrypted, it is not easy to detect and selectively block a particular dissidents page on Facebook or troublesome history lesson on Wikipedia. So unless a platform agrees to remove content, a country must either block the whole site, or allow everything through.
Twenty years ago the webs infrastructure was truly distributed; visiting a web site could mean corresponding with a server in a university, a private home, or a business anywhere in the world. Today, content and services are increasingly hosted among a handful of cloud providers, says Jonathan Zittrain, professor of computer science and George Bemis Professor of International Law at Harvard University and a co-founder of the Berkman Klein Center. That may have helped standardize the rollout of encryption for day-to-day communication over the web, while at the same time placing the major providers under increasing pressure to shape and censor their services by governments in markets where providers wish to have a strong physical presence.
In some respects, the shift may be reducing the blocking of communications. For example, in 2011, Saudi Arabia was blocking individual Wikipedia entries (such as one describing the theory of evolution); and individual Twitter accounts such as that of Egyptian activist Wael Ghonim, with nearly 2.8 million followers, and the human rights advocate Gamal Eid, the director of a Cairo-based regional human rights NGO. But today both of those sites use HTTPS, making such censorship practices difficult. While Saudi Arabia vigorously censors many types of content, it doesnt block Wikipedia or Twitter, which in effect allows these critics to be heard in the Kingdom.
But in other contexts, the shift has been followed by broader crackdowns. For example, in recent years Medium, the online publishing platform, has become popular among activists in Egypt. But in June 2017, Egypt blocked Medium, effectively censoring not only the activists content but also millions of other articles on the site. Similarly, Malaysia blocked Medium in January 2016 after the company refused to take down articles about a government corruption case.
And in April of 2017, Turkey blocked all of Wikipedia because censors could not block (or convince Wikipedia to remove) entries asserting that Turkey sponsored terrorist organizations. This left Turkeys population without any access to Wikipedias 290,000 Turkish-language entries. Tech companies are on the front lines; to an ever-greater extent they serve as the principal guardians of freedom of expression online around the world, says Rob Faris, a co-author of the report and research director at the Berkman Klein Center.
Among the reports many other findings is that governments are increasingly blocking content from other governments, not merely blocking internal dissidents and other non-state actors. This is particularly evident in the MENA (Middle East and North Africa) countries.
In a related trend, the MENA region is also experiencing a rise in shared internet censorship practices among allied nations. For example, Saudi-allied countries have begun to block the same websites originating from Qatar. State internet censorship practices are increasingly intertwined with intraregional political dynamics, says Helmi Noman, a report co-author and research affiliate at the Berkman Klein Center. The regional political tensions and conflicts and political alliances around them give rise to bloc-centered similar internet censorship policies, he says. As a result, more states now ban content originating from or affiliated with rival states.
Of course, governments have other means at their disposal to suppress online speech, including arresting dissidents, pressuring companies to take down content, and shaping online narratives by launching disinformation campaigns on social media platforms.
The Berkman Klein Center report is the latest of several studies and media reports from the past year documenting global censorship practices. Governments have also blocked encrypted mobile messaging apps like WhatsApp and Viber that allow users to spread information quickly and securely, and even shut all internet access within national borders at certain times.
Regimes that aggressively filter the internet typically use third parties usually private companies that specialize in selling filtering technologies to detect and carry out content blocking. State censors have extended the reasons and rationales for internet censorship. The fight against terrorism has provided one justification for expanding political censorship, and states have exploited this to target political speech they find offensive. More recently, state censors have started using claims of fake news as motive to censor the internet.
For more information and to download a copy of the report, visit the Berkman Klein Center website.
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A libertarian leader can save the GOP from white nationalism – The Diamondback
Posted: at 11:45 pm
Ever since William F. Buckleys death, commentators spanning the political spectrum have searched for someone to succeed the conservative intellectual leader and National Review founder.
Most recently, Washington Post columnist George Will decried the scowling primitives who populate the conservative intelligentsia and pined for a Buckley figure someone who can, with vigor and high spirits, fashion conservative thought into coherent ideology.
Will is right that conservatism needs a intellectual leader in Buckleys mold, but not for the reasons political writers often advance. I especially want to separate my motivation from the mass of left-of-center writers who are suckers for Buckley.
Many liberals bemoan the loss of educated, well-spoken conservatives and the rise of unsophisticated rage-mongers. They claim that if the GOP only had more intellectual heft, it would be compassionate and measured. Many center-left folks admire Buckley for cosmetic reasons: Because he defended conservative ideology with eloquence and literary charm, he deserves our esteem.
This is silly. Conservatism doesnt need a Buckley figure because Buckley used big words. And heaps of evidence undermine the claim that intelligence inspires virtue just look at Mitch McConnell! When it comes to the lives of Americans, it doesnt matter whether the leader of the conservative intellectual movement has the vocabulary of President Trump or William Shakespeare.
No, conservatism needs an intellectual leader because, without one, it will be dominated by white identity politics. Within the conservative movement, there has always been a tension between free-market devotion and the defense of white identity. For many decades, the Republican party was the party of small government and libertarian economics. But beneath the surface was a torrent of racial resentment and fear; its no accident that the GOP won back the South after Lyndon Johnson signed the Civil Rights Act.
Buckley created a free-market orthodoxy to which conservative politicians adhered for years. In the inaugural issue of National Review, Buckley wrote, The competitive price system is indispensable to liberty and material progress. From Barry Goldwater to Paul Ryan, Republican leaders were forced to praise the wisdom of markets and criticize progressive government projects.
This devotion to markets restrained the worst impulses of white identity politics. To be sure, racism and libertarian economics sometimes work in tandem, such as in Reaganite attacks on Welfare Queens.
But the most destructive forms of white supremacy rely on state intervention in the economy. In his classic piece for The Atlantic, The Case for Reparations, Ta-Nehisi Coates details how governments created housing policies that denied equal economic opportunity for black people.
Pure libertarianism despises state-sanctioned racial inequality; consequently, its role in conservative orthodoxy kept white nationalism in check. Trumps 2016 campaign revealed a conservatism without libertarianism.
In 2016, Trump campaigned without the burden of free-market ideology. He promised massive government projects to benefit his followers. He promised to seize power from urban cosmopolitan elites, and return it to the forgotten men and women of our country.
It doesnt take much imagination to see this rhetoric as welcoming a redistribution campaign: take wealth from urban minorities and give it back to white folks. Trump campaigned as Robin Hood for white people.
A big caveat: Im not claiming Buckley was innocent on race issues. He once defended segregation by arguing that the claims of civilization supersede those of universal suffrage. However, Buckley did insist on free-market orthodoxy and defend conservatism against racial loonies like Pat Buchanan. For decades, commitment to libertarian economics restrained the worst racial instincts of American conservatives.
In conservatism, the absence of free-market values attracts unabashed white nationalism. Im no libertarian, but white identity politics is the most pernicious force in American life. We should cheer anything that diminishes its clout. Whoever steps into Buckleys role Nebraska Sen. Ben Sasse, libertarian economist Tyler Cowen and The Federalist publisher Ben Domenech are candidates faces a mountainous challenge. Libertarianism is on the retreat, and Trumps 21st century white nationalism has the power to devour our politics.
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New Hampshire Now Has Third Sitting Libertarian Party Legislator – Reason (blog)
Posted: at 11:45 pm
As of this week, New Hampshire has three sitting Libertarians in its House of Representatives. First elected in 2016 as a Republican, Brandon Phinney, representing wards 4 and 5 in the city of Rochester, announced he's joining Caleb Dyer (former Republican) and Joseph Stallcop (former Democrat) as Libertarians, giving the L.P. a three-man caucus. (In the 1990s for a period there were four sitting Libertarians in the New Hampshire House.)
Libertarian Party
"The Libertarian Party platform gives us, as legislators, the best possible framework to expand social freedoms, support a free-market economy, and ensure the checks and balances on government power are enforced," Phinney said in the Libertarian Party's press release announcing the switch.
Phinney works for the Carroll County Department of Corrections. (Being one of the 400 members of the New Hampshire House is a part-time job.) "We do what we can to rehabilitate offenders, implement new programming in the county to help addicts get treatment, and we manage inmate behavior," he described his day job in a phone interview this week after he announced his move to the Libertarian Party.
His work in corrections "has given me inspiration as far as government's role in policing" and led him to realize "we need to be ending the drug war. I know the system is broken. I know there are people in jail who don't need to be there."
Before running for office last year, Phinney had been deployed for a year to the United Arab Emirates with the New Hampshire Army National Guard working as a construction engineer.
He has also been slightly famous in atheist circles for being a rare out-and-proud atheist politician. Phinney himself doesn't like to make too much of that, and points out that it isn't his atheism per se but his atheism combined with his previous GOP membership that made it seem like news, since Republicans "have a tradition of being faith-based." (He even once sang for a metal band named Godcrusher.)
Phinney says his initial attraction toward government work came from "issues in the past with the family court system" and a desire to reform such policies in a more father-friendly direction, though he doesn't want to discuss his personal specifics and says they are not currently an active problem in his life.
The issues he likes to front and center as a legislator that he discussed in our phone interview include some that fit well with the Libertarian Party platformsuch as marijuana legalizationand some that don'tlike increasing state programs for veterans. But he describes his overarching way of judging proposed legislation as having "three criteria, which are, will [a bill] expand government growth? Will it have a burden on taxpayers? And is it in the interest of freedom?"
Like fellow L.P. convert Stallcop, the former Democrat, Phinney at first considered running as an independent but found the ballot access issues too troublesome and thought the Republicans were the major party that were "closest to what I felt." He has since realized that the Republican platform didn't "actually represent what I thought should be the role of government in our lives."
He quickly found caucusing with the GOP wearying and "stopped going" to the meetings; "every time something controversial came up they wanted the Party to vote united." Phinney didn't always want to go along with their desires but "they didn't want to hear" any dissent from the Party line.
He says his friend Dyer helped him see the way clear to the L.P. switch. He'd been thinking about it since February and knew for weeks before the official announcement he intended to do it. The only Republican he informed beforehand was Gov. Chris Sununu, during a conversation over why he, Phinney, was not going to be able to vote for the budget the Republicans proposed since it raised spending too much. The $11.7 billion budget will put state spending on an "unsustainable" course, Phinney believes. (He found Sununu "nonjudgmental, understanding of why I felt that way" about the Party switch.)
Like Dyer, Phinney is also confident many other New Hampshire House members are philosophically more compatible with the L.P. than the two major parties, but are afraid to make the switch out of fear of losing re-election, a fear he hopes he and Dyer can prove groundless in 2018. His own town of Rochester, he says, tends to "lean purple" and he hopes name recognition from retail politicking and his incumbency will make the L.P. switch irrelevant to his constituents. Even running as a Republican he says his constituents "knew I have these philosophies, they get it, no problem."
Although he has a tendency to stutter and thus found door-to-door contact with voters sometimes nerve-wracking, Phinney says it's essential to winning in New Hampshire's small districts. He won his first race with 2,323 votes, only 117 votes more than a Democrat who Phinney says didn't even campaign. He does not yet know who, if anyone, he'll be running against next year from the two major parties. He advises would-be voters to look beyond Party labels and "see how I voted. That's what actually matters. If I voted in your best interest, keep me in. If I haven't, vote me out."
Fear of a Libertarian New Hampshire
Phinney has lived in New Hampshire since the late 1990s, predating the Free State Project, which advocates the libertarian-minded moving to New Hampshire to sway its politics in a liberty direction. While Phinney thinks it's a "great idea to get people who want to minimize the scope and power of government to come to this state" he has no specific opinion about anything any given Free Stater has said or done. He is aware that some New Hampshire residents "view them in a not-so-favorable light. I personally don't have an opinion as long as they are not hurting anyone."
The FSP's existence helps draw out concerns that make political progressives unhappy with the thought of libertarians in their midst. The folks at FreeKeene, not institutionally affiliated with the FSP, recently summed up a 90-minute anti-libertarian presentation by Zandra Rice Hawkins of the group Granite State Progress.
Hawkins is trying to get her fellow citizens of New Hampshire to believe the FSP's mission involves attempted secession from the U.S. (it does not), to worry that the FSP's internal communal self-help and attempts to help their communities' food needs are just sinister cover for their radical mission of dismantling government, and to condemn them for their alleged connection to the national website CopBlock which encourages keeping an eye on and curbing the power of police to harass citizens.
Compare those fears with how Phinney expects to guide his future as a state representative, believing that all he and his fellow Libertarians are "trying to do is minimize government interference in lives and businesses and just try to keep as much money in people's pockets" as possible.
To many Americans, that sounds like common sense. To those living in quivering fear of a Libertarian New Hampshire in which people might just, to sum up some of Hawkins' worries, keep a watchful eye on police, act undignified in court, pay other people's parking meters, or advocate for legalization of drugs and prostitution, it sounds like something that requires organized opposition, including trying to keep a public record of Free State Project associates involved in New Hampshire politics. She is especially worried that some of them even fly under the Democratic Party's banner.
As the recent moves of Phinney, Dyer, and Stallcop to the Libertarian Party show, the libertarian-minded certainly can keep using major party labels if they wish. But in New Hampshire, they may not have to. The electoral success or failure of Dyer and Phinney in 2018 will tell.
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New Hampshire Now Has Third Sitting Libertarian Party Legislator - Reason (blog)
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What Do ‘Women in Liberty’ Want? Five Female Libertarians Discuss – Reason (blog)
Posted: at 11:45 pm
Why aren't there more female libertarians? Is it because biology dictates that ladies love the state?
These are the sorts of tedious questions women in the "liberty movement" field at far too many events. So when some of us gathered last week at "Porcfest"formally the Porcupine Freedom Festival, an annual campground conference and party put on by the Free State Projectwe used a "Women in Liberty" panel to deconstruct myths about male dominance in liberty circles, the incompatibility of libertarianism and feminism, and libertarians' ability to make "emotional arguments."
Reason's Melissa Mann, along with libertarian activist and writer Avens O'Brien, Kat Murti of the Cato Institute and Feminists for Liberty, and Free the People CEO Terry Kibbe joined in a panel I moderated. Friends in the audience took video of the hour-long panel, which I have cobbled together. My editing skills might be sub-par, but my wise and off-the-cuff co-panelists make it worth your while anyway.
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What Do 'Women in Liberty' Want? Five Female Libertarians Discuss - Reason (blog)
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How doctors get sucked into inappropriate care – 6minutes
Posted: at 11:44 pm
Frailty in old age is similar to cancer in that it may be terminal, writes intensive care specialist Professor Ken Hillman in his new book, A Good Life to the End.*
Doctors are able to predict the likelihood of survival for elderly individuals and groups of patients with some accuracy. However, this does not seem to influence the use of inappropriate and aggressive medical care, writes Professor Hillman.
He says patient safety includes managing the dying and frail safely, not just preventing potentially preventable adverse events.
He is concerned that fighting old age and frailty with drugs and complex interventions is an expensive and largely ineffective exercise.
The inference is that frailty may be avoidable or even curable. Apart from giving false hope, it reinforces the current complicity between modern medicine and our society, inferring that all things are treatable or even curable.
He raises the prospect of frailty assuming a medical life of its own, with specific diagnostic criteria and an assumption that it can be treated.
We may gradually lose sight of the inevitability of frailty and be blinded by the prospect of immortality, he writes.
However, as the palliative care approach gains traction, he says a new system could look something like this:
*From A Good Life to the End by Ken Hillman. Published by Allen & Unwin. In stores now. RRP: $29.99
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How doctors get sucked into inappropriate care - 6minutes
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The Only Way To Stop The Machines From Taking Over Is Getting … – The Federalist
Posted: at 11:43 pm
With yesterdays futuristic technologies increasingly becoming todays product announcements, the progress of science seems unstoppable. Mark OConnells excellent new book To Be a Machine: Adventures Among Cyborgs, Utopians, Hackers, and the Futurists Solving the Modest Problem of Death follows the authors interactions and interviews with self-professed transhumanists.
This eclectic collection of scientists, tech giants, journalists, and enthusiasts are prophets of a coming post-human species that embraces technology as the means to transcend present biological and psychological limitations. The book itself is masterfully and humorously written, and gives the reader a thorough introduction to the ideas and people behind the transhumanist movement.
The book serves a more important purpose than simply describing transhumanism, however: OConnells interactions with transhumanists show that modern man is not prepared to argue against transhumanism. He must either accept it or find a theological alternative.
It seems that, sociologically speaking, transhumanism springs from the same part of man that desires to create religion. Man fears death, so must overcome it in some way. From this fear, the social scientists tell us, man creates fantasies about deities and paradises, resurrection and glorification. In its own way, transhumanism becomes religious insofar as it represents another in a long line of sets of belief adopted by man in hopes of overcoming his mortality. This time, man seeks help not from mystical transcendent beings but from his own will, instantiated in technology.
Some religious sects like Mormonism have made a place for transhumanist ideas, but transhumanists like Max More have made clear that traditional Christian doctrine and transhumanism are largely incompatible, given the difficulty of reconciling both sets of claims. However, on at least one point, the transhumanist and the Christian agree: death is an enemy to be conquered. The Christian New Testament claims the last enemy that shall be destroyed is death. Transhumanists concur, and propose that if death can be conquered through technology, death should be conquered through technology.
I am not a scientist. I lack the knowledge to tell scientists who advocate transhumanist ideas that they are wrong about what technology can accomplish. When non-experts like myself grapple with the transhumanist ideas, we traffic in intuitions and philosophies about consciousness, personality, death, and what it means to be human, rather than in scientific arguments.
This is true of OConnell as well. In his research, OConnell encounters scientists who tell him that living to extreme ages will be possible soon, within his and his childs lifetime. Some subjects interviewed even theorize that eventually we could theoretically upload consciousness and become more machine than man. OConnell clearly sees the progression from the thought of men like Thomas Hobbes to the ideas of transhumanism. Hobbes saw man as fundamentally an organic machine, so there seems to be no reason that machine could not be upgraded.
Despite hearing the arguments and understanding their source, OConnell refuses to accept transhumanism. This is not because he thinks transhumanist ideals are unachievable, but because he cannot stomach the idea of living forever, or being himself in any other physical form. He ultimately objects not to the practicality of the transhumanist project but to the propriety of it.
OConnells resistance to transhumanism culminates in a fascinating exchange in the book where OConnell is forced to defend death and mortality as preferable to eternal life and vitality. He mounts standard arguments: Lifes brevity is what gives it value. Impending death makes our continued existence meaningful in some way. Also, life sucks; why extend it?
OConnells transhumanist companions deftly deflect his objections. There [is] no beauty in finitude, they say. They argue that OConnells qualms come from an essential human need to grapple with death and somehow justify it as good so we can avoid constant dread and despair. And, OConnell admits, the transhumanists are right. There is something palpably absurd about defending death as some sort of human good.
Despite conceding the point, OConnell concludes the book by restating his rejection of transhumanism, and the reader is left wondering why. If the transhumanists are correct in theorizing that our continued acceptance of death is just an evolutionary symptom of a disease that can and will be cured, what possible reason could we have to deny the inevitable?
In a poignant scene in the book, OConnells child begins to wrestle with mortality following the death of his grandmother. The boy is comforted when he learns that his father is writing a book on people who are trying to create a world in which people no longer have to die. What comfort is there to offer if we are to reject both religion and transhumanism? What compelling reason do we have to embrace despair when technology offers hope?
Simply put, defending death is a lost cause. Even if, as OConnell theorizes, the idea of meaning [is] itself an illusion, a necessary human fiction, man has continued maintaining that illusion for millennia and seems to persist in preferring life to death. Unless OConnell and others like him are prepared and able to convince the bulk of humanity that death is a happy end to be embraced, not fought against, it seems a choice has presented itself. This choice is between different religions that offer escape from death. Transhumanism offers the materialist a religion through which to conquer death; other religions offer the same to those who have faith in gods other than technology.
Will OConnell and others who reject both transhumanism and other religions refuse anti-aging treatments if they become available? Will they abstain from extending their lives, if given the choice? Only time, the one thing transhumanism cannot hope to overcome, will tell.
Philip is a senior political philosophy student at Patrick Henry College in Purcellville, VA, and will begin graduate study at the University of Wisconsin-Madison in the fall
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The Only Way To Stop The Machines From Taking Over Is Getting ... - The Federalist
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