Buy diflucan online australia

We live in unprecedented buy diflucan online australia times. But what makes them without parallel is not the current diflucan crisis nor the continued problems facing minorities in our institutions. Rather, it’s that for the first time, the problems of accessibility, rights and freedoms are now invading privileged spaces buy diflucan online australia.

There can be no ‘getting back to normal’, because ‘normal’ only ever benefited the white, Western, patriarchal, abled and cis ideals. For many, the world is buy diflucan online australia not suddenly on fire. It has long been burning.The present diflucan lays bare systemic prejudice against the most vulnerable among us.

We at Medical Humanities, with our focus on global health and social justice, welcome discussion about how the crisis has disproportionately affected racial and fiscal minorities, those from the disabled community, those who are LGBTQA+ and other vulnerable groups. What we focus on here, now, can lead to greater accessibility and equity in the future.In this expanded issue, we offer some of the incredible work being done across the field of medical humanities prior to the antifungal medication crisis, and we are already reviewing articles on the role of health humanities during the diflucan buy diflucan online australia. The process of academic publishing tends not to lend itself to immediacy, however, and the challenges of diflucan means greater pressure on everyone, from the authors to the reviewers and readers.To remedy this, we at Medical Humanities have been increasing the work on our blog platform, a place where content can be quickly updated, and where conversations can occur among readers and writers.

We openly invite submissions concerning the diflucan, as well as topics relevant to our buy diflucan online australia wider CFP (call for posts/papers) this year on social justice and health, to both blog and journal. We will do our best to expedite. Finally, we have also been addressing social justice and access in our podcast, where we interviewed disability activist Alice Wong and most recently Dr Oni Blackstock, primary care physician and HIV specialist in New York.

We hope buy diflucan online australia to have many more on these critical subjects.We wish all of you good health and safety and know that many of you are yet on the front lines. Thank you for being part of the community of Medical Humanities.IntroductionMinecraft is a computer game with no specific goals to accomplish. The gameworld consists of three-dimensional (3D) cubes buy diflucan online australia and objects which the player (Steve) can mine and build into infinitely complex (and logically impossible) structures.

Steve sometimes encounters other characters (‘mobs’), such as animals and hostile creatures. He can ‘spawn’ and destroy them. While it looks like a harmless game of logical construction, it conveys some buy diflucan online australia worryingly delusive ideas about the real world.

The difference between real and imagined structures is at the heart of the age-old debate around categorising mental disorders.Classification in mental health has had various forms throughout history. Mack and colleagues set out a history buy diflucan online australia of psychiatric classification beginning in 2600 BC with Egyptian references to melancholia and hysteria. Through the Ancient Greeks with Hippocrates’ phrenitis, mania, melancholia, epilepsy, hysteria and Scythian disease.

Through the Renaissance period. Through to 19th-century psychiatry featuring Pinel (known as the first psychiatrist), Kraepelin (known for observational classification) and Freud (known for classifying neurosis and psychosis).1Although the history of psychiatric classification identifies some common trends such as the labels ‘melancholia’ and ‘hysteria’ which have survived millennia, the label ‘depression’ is relatively new buy diflucan online australia. The earliest usage noted by Snaith is from 1899.

€˜in simple pathological depression…the patient exhibits a growing indifference to his buy diflucan online australia former pursuits…’.2 Snaith noted that early 20th-century psychiatrists like Adolf Meyer hoped that ‘depression’ would come to encompass a broad category under which descriptions of subtypes would emerge. This did not happen until the middle of the 20th century. With the publication of the sixth International Classification of Diseases (ICD) in 1948 and the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 and their subsequent revisions, the latter half of the 20th century has seen depression subtype labels proliferate.

In their study of the social determinants of diagnostic labels in depression, McPherson and Armstrong illustrate how the codification of depression subtypes in the latter half of the 20th century has been shaped by the evolving context of psychiatry, including power struggles within the profession, a move to community care and the development of psychopharmacology.3During this period, McPherson and Armstrong describe how subsequent versions of the DSM served as battlegrounds for professional disputes and philosophical quarrels around categorisation of mental buy diflucan online australia disorders. DSM I and DSM II have been described as products of an American Psychiatric Association dominated by psychoanalytic psychiatrists.4 DSM III and DSM III-R have been described as a radical rejection of psychoanalytic thinking, a ‘neo-Kraepelinian revolution’, a reference to the observational descriptive techniques of 19th-century psychiatrist Emil Kraepelin who classified mental disorders into two broad categories. €˜dementia praecox’ and ‘manic-depression’.5 DSM III was seen by buy diflucan online australia some as a turning point in the use of the medical model of mental illness, through provision of specific inclusion and exclusion criteria, and use of field trials and a multiaxial system.6 These latter technocratic additions to psychiatric labelling served to engender a much closer alignment between psychiatry, science and medicine.The codification of mental disorders in manuals has been described by Thomas Schacht as intrinsic to the relationship between science and politics and the way in which psychiatrists gain significant social power by aligning themselves to science.7 His argument drew on Szasz, who saw the mental health establishment as a therapeutic state.

Zimbardo, who described psychiatric care as a controlling force. And Foucault, who described the categorisation of the mentally ill as a force for isolating ‘the other’. Diagnostic critique has been further developed through a cultural relativist lens in that what Western psychiatrists classify as a depression is constructed differently in other cultures.8 Considering these limitations, some critics have gone so far as to argue that psychiatric diagnostic systems should be abolished.9Yet architects of DSM manuals have worked hard to ensure the buy diflucan online australia technology of classification is regarded as genuine scientific activity with sound roots in philosophy of science.

In their philosophical defence of DSM IV, Allen Frances and colleagues address their critics under the headings ‘nominalism vs realism’, ‘empiricism vs rationalism’ and ‘categorical vs dimensional’.10 The implication is that there are opposing stances in which a choice must be made or a middle ground forged by those reasonable enough to recognise the need for pragmatism in the service of clinical utility. The nominalism–realism buy diflucan online australia debate is illustrated using as metaphor three different stances a cricket umpire might take on calling strikes and balls. The discussion sets out two of these as extreme views.

€˜at one extreme…those who take a reductionistically realistic view of the world’ versus ‘the solipsistic nominalists…might content that nothing exists’. Szasz, who is characterised as buy diflucan online australia holding particularly extreme views, is named as an archetypal solipsist. There is implied to be a degree of arrogance associated with this view in the illustrative example in which the umpire states ‘there are no balls and there are no strikes until I call them’.

Frances therefore sets up a means of grouping two kinds of people as philosophical extremists who can be dismissed, while avoiding addressing the philosophical problems they pose.Frances provides little if any justification for the middle ground stance, ‘There are balls buy diflucan online australia and there are strikes and I call them as I see them’, other than to focus on its clinical utility and the lack of clinical utility in the alternatives ‘naïve realism’ and ‘heuristically barren solipsism’. The natural conclusion the reader is invited to reach is that a middle ground of a heuristic concept is naturally right because it is not extreme and is naturally useful clinically, without specifying in what way this stance is coherent, resolves the two alternatives, and in what way a heuristic construct that is not ‘real’ can be subject to scientific testing.Similarly, in discussing the ‘categorical vs dimensional’, Frances promotes the ‘prototype approach’. Those holding opposing views are labelled as ‘dualists’ or ‘dichotomisers’.

The prototypical approach is again put forward as a clinically useful middle ground buy diflucan online australia. Illustrations are drawn from natural science. €˜a triangle buy diflucan online australia and a square are never the same’, inciting the reader to consider science as value-free.

The prototypical approach emerges as a natural solution, yet the authors do not address how a diagnostic prototype resolves the issues posed by the two alternatives, nor how a prototype can be subjected to natural science methods.The argument presented here is not a defence of solipsism or dualism. Rather it aims to illustrate that if for pragmatic purposes clinicians and policymakers choose to gloss over the philosophical flaws in classification practices, it is then risky to move beyond the heuristic and apply natural science methods to these constructs adding multiple layers of technocratic subclassification. Doing so is buy diflucan online australia more like playing Minecraft than cricket.

The National Institute for Health and Care Excellence (NICE) guideline for depression is taken as an example of the philosophical errors that can follow from playing Minecraft with unsound heuristic devices, specifically subcategories of persistent forms of depression. As well as serving a clinical purpose, diagnosis in medicine is a way of allocating resources for insurance companies and constructing clinical buy diflucan online australia guidelines, which in turn determine rationing within the National Health Service. The consequences for recipients of healthcare are therefore significant.

Clinical utility is arguably not being served at all and patients are left at risk of poor-quality care.Heterogeneity of persistent depressionAndrea Jobst and colleagues note that ‘because of their chronic clinical course, approximately 40% of CD [chronic depression] patients also fulfil criteria for TRD [treatment resistant depression]…usually defined by the number of non-successful biological treatments’.11 This position is reflected in the DSM VAmerican Psychiatric Association (2013), the European Psychiatric Association (EPA) guidance and the ICD-11(World Health Organisation, 2018), which all use a ‘persistent’ depression category, acknowledging a loosely defined mixed group of long-term, difficult-to-treat depressive conditions, often associated with dysthymia and comorbid common mental disorders, various personality traits and psychosocial disability.In contrast, the NICE 2018 draft guideline separates treatments into those for ‘new episodes’ of depression. €˜further-line’ treatment of buy diflucan online australia depression (equivalent to TRD), CD and ‘depression with co-morbidities’. The latter is subdivided into treatments for ‘complex depression’ and ‘psychotic depression’.

These categories and subcategories introduce an unfortunate sense of certainty as though these labels represent buy diflucan online australia real things. An analysis follows of how these definitions play out in terms of grouping of randomised controlled trials in the NICE evidence review. Specifically, the analysis reveals the overlap between populations in trials which have been separated into discrete categories, revealing significant limitations to the utility of the category labels.The NICE definition of CD requires trial samples to meet the criteria for major depressive disorder (MDD) for 2 years.

Dysthymia and buy diflucan online australia double depression (MDD superimposed on dysthymia) were included. If 75% of the trial population met these criteria, the trial was reviewed in the CD category.12 The definition of TRD (or ‘further-line treatments’) required that the trial sample had demonstrated a ‘limited response to previous treatment’ and randomised to the further-line treatment at this point. If 80% of the trial buy diflucan online australia participants met these criteria, it was reviewed in the TRD category.13 Complex depression was defined as ‘depression co-existing with personality disorder’.

To be classed as complex, 51% of trial participants had to have personality disorder (PD).14It is immediately clear from these definitions that there is a potential problem with attempting to categorise trial populations into just one of these categories. These populations are likely to overlap, whether or not a trial protocol sets out to explicitly record all of this information. The analysis below will illustrate this using examples from within the NICE buy diflucan online australia review.Cataloguing complexity in trial populationsWithin the category of further-line treatments (TRD), 64 trials were reviewed.

Comparisons within these trials were further subcategorised into ‘dose escalation strategies’, ‘augmentation strategies’ and ‘switching strategies’. In drilling down by way of illustration, this analysis considers the 51 trials in the augmentation strategy evidence review buy diflucan online australia. Of these, two were classified by the reviewers as also fulfilling the criteria for CD but were not analysed in the CD category (Study IDs.

Fonagy 2015 and Kocsis 200915). About half of the trials (23/51) did not report the mean duration of episode, meaning buy diflucan online australia that it is not possible to know what percentage of participants also met the criteria for CD. Of trials that did report episode duration, 17 reported a mean duration longer than 24 months.

While the standard deviations varied in size or were unreported, the mean indicates a good likelihood that a significant proportion of the participants across these 51 trials met the criteria for CD.Details of baseline employment, trauma history, suicidality, physical comorbidity, axis I comorbidity and PD (all clinical indicators of complexity, severity buy diflucan online australia and chronicity) were not collated by NICE. For the present analysis, all 51 publications were examined and data compiled concerning clinical complexity in the trial populations. Only 14 of 51 trials report employment data.

Of those that do, buy diflucan online australia unemployment ranges from 12% to 56% across trial samples. None of the trials report trauma history. About half of the trials (26/51) excluded buy diflucan online australia people who were considered a suicide risk.

The others did not.A large proportion of trials (30/51) did not provide any data on axis 1 comorbidity. Of these, 18 did not exclude any diagnoses, while 12 excluded some (but not all) disorders. The most common diagnoses excluded were psychotic disorders, substance or alcohol abuse, and bipolar disorder (excluded in 26, 25 and 23 trials, buy diflucan online australia respectively).

Only 7 of 51 trials clearly stated that all axis 1 diagnoses were excluded. This leaves only 13 buy diflucan online australia studies providing any data about comorbidity. Of these, 9 gave partial data on one or two conditions, while 4 reported either the mean number of disorders (range 1.96–2.9) or the percentage of participants (range 68.1–96.7) with any comorbid diagnosis (Nierenberg 2003a, Nierenberg 2006, Watkins 2011a, Town 201715).The majority of trials (46/51) did not report the prevalence of PD.

Many stated PD as an exclusion criterion but without defining a threshold for exclusion. For example, PD could be excluded if it buy diflucan online australia ‘impacted’ the depression, if it was ‘significant’, ‘severe’ or ‘persistent’. Some excluded certain PDs (such as antisocial or borderline) and not others but without reporting the prevalence of those not excluded.

In the five trials where prevalence was clear, prevalence ranged from 0% (Ravindran 2008a15), where all PDs were excluded, buy diflucan online australia to 87.5% of the sample (Town 201715). Two studies reported the mean number of PDs. 2.0 (Nierenberg 2003a) and 0.85 (Watkins 2011a15).The majority of trials (43/51) did not report the prevalence of physical illness.

Many stated illness as an exclusion criterion, but the buy diflucan online australia definitions and thresholds were vague and could be interpreted in different ways. For example, illness could be excluded if it was ‘unstable’, ‘serious’, ‘significant’, ‘relevant’, or would ‘contraindicate’ or ‘impact’ the medication. Of the eight trials reporting information about physical health, there was a wide variation buy diflucan online australia.

Four reported prevalence varying from 7.6% having a disability (Eisendrath 201615) to 90.9% having an illness or disability (Town 201715). Four used scales of physical health. Two indicating mild problems (Nierenberg 2006, Lavretsky buy diflucan online australia 201115) and two indicating moderately high levels of illness (Thase 2007, Fang 201015).The NICE review also divided trial populations into a dichotomy of ‘more severe’ and ‘less severe’ on the grounds that this would be a clinically useful classification for general practitioners.

NICE applied a bespoke methodology for creating this dichotomy, abandoning validated measure thresholds in order first to generate two ‘homogeneous’ groups to ‘facilitate analysis’, and second to create an algorithm to ‘read across’ different measures (such as the Beck Depression Inventory, the Hamilton Rating Scale for Depression (HRSD) and the Montgomery-Asberg Depression Rating Scale).16 Examining trials which use more than one of these measures reveals problems in the algorithm. Of the 51 trials, there are 6 instances in which the study population falls into NICE’s more severe category according to one measure buy diflucan online australia and into the less severe category according to another. In four of these trials, NICE chose the less severe category (Souza 2016, Watkins 2011a, Fonagy 2015, Town 201715).

The other two trials were designated more severe (Barbee 2011, Dunner 200715). Only 17 of 51 trials reported two or more depression scale measures, leaving much unknown about buy diflucan online australia whether other study populations could count as both more severe and less severe.Absence of knowledge or knowledge of absence?. A key philosophical error in science is to confuse an absence of knowledge with knowledge of absence.

It is likely that some of the study populations deemed lacking in complexity buy diflucan online australia or severity could actually have high degrees of complexity and/or severity. Data to demonstrate this may either fall foul of a guideline committee decision to prioritise certain information over other conflicting information (as in the severity algorithm). The information may be non-existent as it was not collected.

It may buy diflucan online australia be somewhere in the publication pipeline. Or it may be sitting in a database with a research team that has run out of funds for supplementary analyses. Wherever those data are or are not, their absence from buy diflucan online australia published articles does not define the phenomenology of depression for the patients who took part.

As a case in point, data from the Fonagy 2015 trial presented at conferences but not published reveal that PD prevalence data would place the trial well within the NICE complex depression category, and that the sample had high levels of past trauma and physical condition comorbidity. The trial also meets the guideline criteria for CD according to the guideline’s own appendices.17 Reported axis 1 comorbidity was high (75.2% had anxiety disorder, 18.6% had substance abuse disorder, 13.2% had eating disorder).18 The mean depression scores at baseline were 36.5 on the Beck Depression Inventory and 20.1 on the HRSD (severe and very severe, respectively, according to published cut-off scores). NICE categorised this population as less severe TRD, buy diflucan online australia not CD and not complex.Notes1.

Avram H. Mack et buy diflucan online australia al. (1994), “A Brief History of Psychiatric Classification.

From the Ancients to DSM-IV,” Psychiatric Clinics 17, no. 3. 515–9.2.

R. P. Snaith (1987), “The Concepts of Mild Depression,” British Journal of Psychiatry 150, no.

3. 387.3. Susan McPherson and David Armstrong (2006), “Social Determinants of Diagnostic Labels in Depression,” Social Science &.

Gerald N. Grob (1991), “Origins of DSM-I. A Study in Appearance and Reality,” The American Journal of Psychiatry.

421–31.5. Wilson M. Compton and Samuel B.

Guze (1995), “The Neo-Kraepelinian Revolution in Psychiatric Diagnosis,” European Archives of Psychiatry and Clinical Neuroscience 245, no. 4. 198–9.6.

Gerald L. Klerman (1984), “A Debate on DSM-III. The Advantages of DSM-III,” The American Journal of Psychiatry.

539–42.7. Thomas E. Schacht (1985), “DSM-III and the Politics of Truth,” American Psychologist.

Theurer (2018), “Psychiatry Should Not Seek Mechanisms of Disorder,” Journal of Theoretical and Philosophical Psychology 38, no. 4. 189–204.9.

Sami Timimi (2014), “No More Psychiatric Labels. Why Formal Psychiatric Diagnostic Systems Should Be Abolished,” Journal of Clinical and Health Psychology 14, no. 3.

208–15.10. Allen Frances et al. (1994), “DSM-IV Meets Philosophy,” The Journal of Medicine and Philosophy.

A Forum for Bioethics and Philosophy of Medicine 19, no. 3. 207–18.11.

Andrea Jobst et al. (2016), “European Psychiatric Association Guidance on Psychotherapy in Chronic Depression Across Europe,” European Psychiatry 33. 20.12.

National Institute for Health and Care Excellence (2018), Depression in Adults. Treatment and Management. Draft for Consultation, https://www.nice.org.uk/guidance/gid-cgwave0725/documents/full-guideline-updated, 507.13.

Ibid., 351–62.14. Ibid., 597.15. Note that in order to refer to specific trials reviewed in the guideline, rather than the full citation, the Study IDs from column A in appendix J5 have been used.

See www.nice.org.uk/guidance/gid-cgwave0725/documents/addendum-appendix-9 for details and full references.16. National Institute for Health and Care Excellence (2018), Depression in Adults. Treatment and Management.

Second Consultation on Draft Guideline – Stakeholder Comments Table, https://www.nice.org.uk/guidance/gid-cgwave0725/documents/consultation-comments-and-responses-2, 420–1.17. National Institute for Health and Care Excellence (2018), Depression in Adults, appendix J5.18. Peter Fonagy et al.

(2015), “Pragmatic Randomized Controlled Trial of Long-Term Psychoanalytic Psychotherapy for Treatment-Resistant Depression. The Tavistock Adult Depression Study (TADS),” World Psychiatry 14, no. 3.

312–21.19. American Psychological Association (2018), Clinical Practice Guideline for the Treatment of Depression in Children, Adolescents, and Young, Middle-aged, and Older Adults. Draft.20.

Jacqui Thornton (2018), “Depression in Adults. Campaigners and Doctors Demand Full Revision of NICE Guidance,” BMJ 361. K2681..

Where can i buy diflucan

Diflucan
Sporanox
Without prescription
Yes
100mg
Best price in USA
150mg 20 tablet $55.00
100mg 10 tablet $70.00
Generic
Yes
No
Best price for brand
Yes
Yes
Prescription is needed
Yes
No

Clinical guidelines play an where can i buy diflucan increasingly important role in care of patients with cardiovascular disease http://leafyourmark.com/?page_id=2. Approaches to guideline development reflect the need to integrate a complex and ever-expanding evidence base with new treatment options and clinical expertise to formulate recommendations that then can be implemented both by individual healthcare providers and across healthcare systems. All guidelines for a specific disease condition start with the same evidence base, yet guidelines are developed in many different ways, by many different organisations, often addressing the same or overlapping types of cardiovascular disease, typically leading to at least subtle (and sometimes major) divergences in the resultant recommendations.Professional society recommendations, such as those generated by the European Society of Cardiology (ESC) and by the American Heart Association/American College of Cardiology (AHA/ACC), predominate, but many geographic regions have their own guidelines, tailoring recommendations to specific regional requirements.1 Government agencies and insurance providers also generate guidelines either directly in published documents or indirectly by restricting reimbursement. Online medical textbooks, such as Up-to-Date, attempt to integrate and reconcile recommendations from multiple guideline sources, filling any gaps in clinical management with recommendations based on clinical expertise alone where can i buy diflucan. Another approach is to convene an independent group of experts to address new practice changing evidence rapidly, focusing on a specific question, such as the BMJ Rapid Recs or Magic Evidence my latest blog post Ecosystem Foundation.2 3Why are there so many guidelines?.

What are the limitations of our current approach?. How can we optimise guideline development to where can i buy diflucan improve care of patients with cardiovascular disease?. All guidelines share two common purposes. First, to review, assess quality, summarise and interpret the published evidence base, and second, to provide clear recommendations for patient management.

Clinical guidelines play an increasingly important role http://howyouruletheworld.com/can-casual-fridays-exist-an-entrepreneurial-perspective/ in care of patients with cardiovascular disease buy diflucan online australia. Approaches to guideline development reflect the need to integrate a complex and ever-expanding evidence base with new treatment options and clinical expertise to formulate recommendations that then can be implemented both by individual healthcare providers and across healthcare systems. All guidelines for a specific disease condition start with the same evidence base, yet guidelines are developed in many different ways, by many different organisations, often addressing the same or overlapping types of cardiovascular disease, typically leading to at least subtle (and sometimes major) divergences in the resultant recommendations.Professional society recommendations, such as those generated by the European Society of Cardiology (ESC) and by the American Heart Association/American College of Cardiology (AHA/ACC), predominate, but many geographic regions have their own guidelines, tailoring recommendations to specific regional requirements.1 Government agencies and insurance providers also generate guidelines either directly in published documents or indirectly by restricting reimbursement. Online medical textbooks, such as Up-to-Date, attempt to integrate and reconcile recommendations from multiple guideline sources, filling any gaps in clinical management with recommendations based on clinical expertise alone buy diflucan online australia.

Another approach buy diflucan online usa is to convene an independent group of experts to address new practice changing evidence rapidly, focusing on a specific question, such as the BMJ Rapid Recs or Magic Evidence Ecosystem Foundation.2 3Why are there so many guidelines?. What are the limitations of our current approach?. How can we optimise guideline development to improve care of patients with cardiovascular disease? buy diflucan online australia. All guidelines share two common purposes.

First, to review, assess quality, summarise and interpret the published evidence base, and second, to provide clear recommendations for patient management.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

Diflucan nystatin

We’ve had our fill of the politics this time, http://o-e.me/contact-form-1/ no diflucan nystatin matter what position one may favor. Whether voters choose to vote for Trump on the basis of emotion or reason, they will be better able to articulate the reasons, or rationalizations, for their choice. This should give pollsters better data to make a more accurate prediction.One of the most impressive, disturbing works of science journalism I’ve encountered is Anatomy of an Epidemic. Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in diflucan nystatin America, published in 2010. In the book, which I review here, award-winning journalist Robert Whitaker presents evidence that medications for mental illness, over time and in the aggregate, cause net harm.

In 2012, I brought Whitaker to my school to give a talk, in part to check him out. He struck me as diflucan nystatin a smart, sensible, meticulous reporter whose in-depth research had led him to startling conclusions. Since then, far from encountering persuasive rebuttals of Whitaker’s thesis, I keep finding corroborations of it. If Whitaker is right, modern psychiatry, together with the pharmaceutical industry, has inflicted iatrogenic harm on millions of people. Reports of surging mental distress during the diflucan have me thinking diflucan nystatin once again about Whitaker’s views and wondering how they have evolved.

Below he answers some questions. €”John Horgan
 Horgan. When and why did you start reporting diflucan nystatin on mental health?. Whitaker. It came about in a very roundabout way.

In 1994, I had co-founded a publishing company called CenterWatch diflucan nystatin that covered the business aspects of the “clinical trials industry,” and I soon became interested in writing about how financial interests were corrupting drug trials. Risperdal and Zyprexa had just come to market, and after I used a Freedom of Information request to obtain the FDA’s review of those two drugs, I could see that psychiatric drug trials were a prime example of that corruption. In addition, I had learned of NIMH-funded research that seemed abusive of schizophrenia patients, and in 1998, I co-wrote a series for the Boston Globe on abuses of patients in psychiatric research. My interest diflucan nystatin was in that broader question of corruption and abuse in research settings, and not specific to psychiatry. At that time, I still had a conventional understanding of psychiatric drugs.

My understanding was that researchers were making great advances in understanding mental disorders, and that they had found that schizophrenia and depression were due to chemical imbalances in the brain, which psychiatric medications then put back in balance. However, while reporting that series, I stumbled upon studies that didn’t make sense to me, for they belied what I knew diflucan nystatin to be “true,” and that was what sent me down this path of reporting on mental health. First, there were two studies by the World Health Organization that found that longer-term outcomes for schizophrenia patients in three “developing” countries were much better than in the U.S. And five other “developed” countries. This didn’t really make sense to me, and diflucan nystatin then I read this.

In the developing countries, they used antipsychotic drugs acutely, but not chronically. Only 16 percent of patients in the developing countries were regularly maintained on antipsychotics, whereas in the developed countries this was the standard of care. That didn’t fit diflucan nystatin with my understanding that these drugs were an essential treatment for schizophrenia patients. Second, a study by Harvard researchers found that schizophrenia outcomes had declined in the previous 20 years, and were now no better than they had been in the first third of the 20th century. That didn’t fit with my understanding that psychiatry had made great progress in treating people so diagnosed.

Those studies led to my questioning the story that our society told about those we call “mad,” and I got a diflucan nystatin book contract to dig into that question. That project turned into Mad in America, which told of the history of our society’s treatment of the seriously mentally ill, from colonial times until today—a history marked by bad science and societal mistreatment of those so diagnosed. Horgan. Do you still see yourself as a journalist, or are diflucan nystatin you primarily an activist?. Whitaker.

I don’t see myself as an “activist” at all. In my own writings, and in the webzine I direct, Mad in America, I think you’ll diflucan nystatin see journalistic practices at work, albeit in the service of an “activist” mission. Here is our mission statement. €œMad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.” Thus, our starting point is that “change” is needed, and while that does have an activist element, I diflucan nystatin think journalism—serving as an informational source—is fundamental to that effort.

As an organization, we are not asserting that we have the answers for what that change should be, which would be the case if we were striving to be activists. Instead, we strive to be a forum for promoting an informed societal discussion about this subject. Here’s what we diflucan nystatin do. We publish daily summaries of scientific research with findings that are rarely covered in the mainstream media. You’ll find, in the archives of our research reports, a steady parade of findings that counter the conventional narrative.

For instance, there are reports of how diflucan nystatin the effort to find genes for mental disorders has proven rather fruitless, or of how social inequalities trigger mental distress, or of poor long-term outcomes with our current paradigm of care. And so forth—we simply want these scientific findings to become known.
We regularly feature interviews with researchers and activists, and podcasts that explore these issues. We launched MIA Reports as a showcase for our print journalism. We have published in-depth diflucan nystatin articles on promising new initiatives in Europe. Investigative pieces on such topics as compulsory outpatient treatment.

Coverage of “news” related to mental health policy in the United States. And occasional reports on how the mainstream media is covering mental diflucan nystatin health issues. €¨We also publish blogs by professionals, academics, people with lived experience, and others with a particular interest in this subject. These blogs and personal stories are meant to help inform society’s “rethinking” of psychiatric care. All of these efforts, I think, fit within the framework of “journalism.” However, I do understand diflucan nystatin that I am going beyond the boundaries of usual “science journalism” when I publish critiques of the “evidence base” related to psychiatric drugs.

I did this in my books Mad in America and Anatomy of an Epidemic, as well as a book I co-wrote, Psychiatry Under the Influence. I have continued to do this with MIA Reports. The usual practice in “science journalism” is to look to the “experts” in the field diflucan nystatin and report on what they tell about their findings and practices. However, while reporting and writing Mad in America, I came to understand that when “experts” in psychiatry spoke to journalists they regularly hewed to a story that they were expected to tell, which was a story of how their field was making great progress in understanding the biology of disorders and of drug treatments that—as I was told over and over when I co-wrote the series for the Boston Globe—fixed chemical imbalances in the brain. But their own science, I discovered, regularly belied the story they were telling to the media.

That’s why I turned to focusing on the story that could be dug out from a critical look at their own scientific literature diflucan nystatin. So what I do in these critiques—such as suicide in the Prozac era and the impact of antipsychotics on mortality—is review the relevant research and put those findings together into a coherent report. I also look at research cited in support of mainstream beliefs and see if the data, in those articles, actually supports the conclusions presented in the abstract. None of this is really that difficult, and yet I know it is unusual for a journalist diflucan nystatin to challenge conventional “medical wisdom” in this way. Horgan.

Anatomy of an Epidemic argues that medications for mental illness, although they give many people short-term reliefs, cause net harm. Is that a fair summary? diflucan nystatin. Whitaker. Yes, although my thinking has evolved somewhat since I wrote that book. I am more convinced diflucan nystatin than ever that psychiatric medications, over the long term, cause net harm.

I wish that weren’t the case, but the evidence just keeps mounting that these drugs, on the whole, worsen long-term outcomes. However, my thinking has evolved in this way. I am not so sure any diflucan nystatin more that the medications provide a short-term benefit for patient populations as a whole. When you look at the short-term studies of antidepressants and antipsychotics, the evidence of efficacy in reducing symptoms compared to placebo is really pretty marginal, and fails to rise to the level of a “clinically meaningful” benefit. Furthermore, the problem with all of this research is that there is no real placebo group in the studies.

The placebo group is composed of patients who have been diflucan nystatin withdrawn from their psychiatric medications and then randomized to placebo. Thus, the placebo group is a drug-withdrawal group, and we know that withdrawal from psychiatric drugs can stir myriad negative effects. A medication-naïve placebo group would likely have much better outcomes, and if that were so, how would that placebo response compare to the drug response?. In short, research on diflucan nystatin the short-term effects of psychiatric drugs is a scientific mess. In fact, a 2017 paper that was designed to defend the long-term use of antipsychotics nevertheless acknowledged, in an off-hand way, that “no placebo-controlled trials have been reported in first-episode psychosis patients.” Antipsychotics were introduced 65 years ago, and we still don’t have good evidence that they work over the short term in first episode patients.

Which is rather startling, when you think of it. Horgan. Have any of your critics—E. Fuller Torrey, for example—made you rethink your thesis?. Whitaker.

When the first edition of Anatomy of an Epidemic was published (2010), I knew there would be critics, and I thought, this will be great. This is just what is needed, a societal discussion about the long-term effects of psychiatric medications. I have to confess that I have been disappointed in the criticism. They mostly have been ad hominem attacks—I cherry-picked the data, or I misunderstood findings, or I am just biased, but the critics don’t then say what data I missed, or point to findings that tell of medications that improve long-term outcomes. I honestly think I could do a much better job of critiquing my own work.

You mention E. Fuller Torrey’s criticism, in which he states that I both misrepresented and misunderstood some of the research I cited. I took this seriously, and answered it at great length. Now if your own “thesis” is indeed flawed, then a critic should be able to point out its flaws while accurately detailing what you wrote. If that is the case, then you have good reason to rethink your beliefs.

But if a critique doesn’t meet that standard, but rather relies on misrepresenting what you wrote, then you have reason to conclude that the critic lacks the evidence to make an honest case. And that is how I see Torrey’s critique. For example, Torrey said that I misunderstood Martin Harrow’s research on long-term outcomes for schizophrenia patients. Harrow reported that the recovery rate was eight times higher for those who got off antipsychotic medication compared to those who stayed on the drugs. However, in his 2007 paper, Harrow stated that the better outcomes for those who got off medication was because they had a better prognosis and not because of negative drug effects.

If you read Anatomy of an Epidemic, you’ll see that I present his explanation. Yet, in my interview with Harrow, I noted that his own data showed that those who were diagnosed with milder psychotic disorders who stayed on antipsychotics fared worse over the long term than schizophrenia patients who stopped taking the medication. This was a comparison that showed the less ill maintained on antipsychotics doing worse than the more severely ill who got off these medications. And I presented that comparison in Anatomy of an Epidemic. By doing that, I was going out on a limb.

I was saying that maybe Harrow’s data led to a different conclusion than he had drawn, which was that the antipsychotic medication, over the long-term, had a negative effect. After Anatomy was published, Harrow and his colleague Thomas Jobe went back to their data and investigated this very possibility. They have subsequently written several papers exploring this theme, citing me in one or two instances for raising the issue, and they found reason to conclude that it might be so. They wrote. €œHow unique among medical treatments is it that the apparent efficacy of antipsychotics could diminish over time or become harmful?.

There are many examples for other medications of similar long-term effects, with this often occurring as the body readjusts, biologically, to the medications.” Thus, in this instance, I did the following. I accurately reported the results of Harrow’s study and his interpretation of his results, and I accurately presented data from his research that told of a possible different interpretation. The authors then revisited their own data to take up this inquiry. And yet Torrey’s critique is that I misrepresented Harrow’s research. This same criticism, by the way, is still being flung at me.

Here is a recent article in Vice which, once again, quotes people saying I misrepresent and misunderstand research, with Harrow cited as an example. I do want to emphasize that critiques of “my thesis” regarding the long-term effects of psychiatric drugs are important and to be welcomed. See two papers in particular that take this on (here and here), and my response in general to such criticisms, and to the second one. Horgan. When I criticize psychiatric drugs, people sometimes tell me that meds saved their lives.

You must get this reaction a lot. How do you respond?. Whitaker. I do hear that, and when I do, I reply, “Great!. I am so glad to know that the medications have worked for you!.

€ But of course I also hear from many people who say that the drugs ruined their lives. I do think that the individual’s experience of psychiatric medication, whether good or bad, should be honored as worthy and “valid.” They are witnesses to their own lives, and we should incorporate those voices into our societal thinking about the merits of psychiatric drugs. However, for the longest time, we’ve heard mostly about the “good” outcomes in the mainstream media, while those with “bad” outcomes were resigned to telling their stories on internet forums. What Mad in America has sought to do, in its efforts to serve as a forum for rethinking psychiatry, is provide an outlet for this latter group, so their voices can be heard too. The personal accounts, of course, do not change the bottom-line “evidence” that shows up in outcome studies of larger groups of patients.

Unfortunately, that tells of medications that, on the whole, do more harm than good. As a case in point, in regard to this “saving lives” theme, this benefit does not show up in public health data. The “standard mortality rate” for those with serious mental disorders, compared to the general public, has notably increased in the last 40 years. Horgan. Do you see any promising trends in psychiatry?.

Whitaker. Yes, definitely. You have the spread of Hearing Voices networks, which are composed of people who hear voices and offer support for learning to live with voices as opposed to squashing them, which is what the drugs are supposed to do. These networks are up and running in the U.S., and in many countries worldwide. You have Open Dialogue approaches, which were pioneered in northern Finland and proved successful there, being adopted in the United States and many European countries (and beyond.) This practice puts much less emphasis on treatment with antipsychotics, and much greater emphasis on helping people re-integrate into family and community.

You have many alternative programs springing up, even at the governmental level. Norway, for instance, ordered its hospital districts to offer “medication free” treatment for those who want it, and there is now a private hospital in Norway that is devoted to helping chronic patients taper down from their psychiatric medications. In Israel, you have Soteria houses that have sprung up (sometimes they are called stabilizing houses), where use of antipsychotics is optional, and the environment—a supportive residential environment—is seen as the principal “therapy.” You have the U.N. Special Rapporteur for Health, Dainius Pūras, calling for a “revolution” in mental health, one that would supplant today’s biological paradigm of care with a paradigm that paid more attention to social justice factors—poverty, inequality, etc.—as a source of mental distress. All of those initiatives tell of an effort to find a new way.

But perhaps most important, in terms of “positive trends,” the narrative that was told to us starting in the 1980s has collapsed, which is what presents the opportunity for a new paradigm to take hold. More and more research tells of how the conventional narrative, in all its particulars, has failed to pan out. The diagnoses in the Diagnostic and Statistical Manual (DSM) have not been validated as discrete illnesses. The genetics of mental disorders remain in doubt. MRI scans have not proven to be useful.

Long-term outcomes are poor. And the notion that psychiatric drugs fix chemical imbalances has been abandoned. Ronald Pies, the former editor in chief of Psychiatric Times, has even sought to distance psychiatry, as an institution, from ever having made such a claim. Horgan. Do brain implants or other electrostimulation devices show any therapeutic potential?.

Whitaker. I don’t have a ready answer for this. We have published two articles about the spinning of results from a trial of deep-brain stimulation, and the suffering of some patients so treated over the long-term. Those articles tell of why it may be difficult to answer that question. There are financial influences that push for published results that tell of a therapeutic success, even if the data doesn’t support that finding, and we have a research environment that fails to study long-term outcomes.

The history of somatic treatments for mental disorders also provides a reason for caution. It’s a history of one somatic treatment after another being initially hailed as curative, or extremely helpful, and then failing the test of time. The inventor of frontal lobotomy, Egas Moniz, was awarded a Nobel Prize for inventing that surgery, which today we understand as a mutilation. It’s important to remain open to the possibility that somatic treatments may be helpful, at least for some patients. But there is plenty of reason to be wary of initial claims of success.

Horgan. Should psychedelic drugs be taken seriously as treatments?. Whitaker. I think caution applies here too. Surely there are many risks with psychedelic drugs, and if you were to do a study of first-episode psychosis today, you would find a high percentage of the patients had been using mind-altering drugs before their psychotic break—antidepressants, marijuana, LSD and so forth.

At the same time, we’ve published reviews of papers that have reported positive results with use of psychedelics. What are the benefits versus the risks?. Can possible benefits be realized while risks are minimized?. It is a question worth exploring, but carefully so. Horgan.

What about meditation?. Whitaker. I know that many people find meditation helpful. I also know other people find it difficult—and even threatening—to sit with the silence of their minds. Mad in America has published reviews of research about meditation, we have had a few bloggers write about it, and in our resource section on “non-drug therapies,” we have summarized research findings regarding its use for depression.

We concluded that the research on this is not as robust as one would like. However, I think your question leads to this broader thought. People struggling with their minds and emotions may come up with many different approaches they find helpful. Exercise, diet, meditation, yoga and so forth all represent efforts to change one’s environment, and ultimately, I think that can be very helpful. But the individual has to find his or her way to whatever environmental change that works best for them.

Horgan. Do you see any progress toward understanding the causes of mental illness?. Whitaker. Yes, and that progress might be summed up in this way. Researchers are returning to investigations of how we are impacted by what has “happened to us.” The Adverse Childhood Experiences study provides compelling evidence of how traumas in childhood—divorce, poverty, abuse, bullying and so forth—exact a long-term toll on physical and mental health.

Interview any group of women diagnosed with a serious mental disorder, and you’ll regularly find accounts of sexual abuse. Racism exacts a toll. So too poverty, oppressive working conditions, and so forth. You can go on and on, but all of this is a reminder that we humans are designed to respond to our environment, and it is quite clear that mental distress, in large part, arises from difficult environments and threatening experiences, past and present. And with a focus on life experiences as a source of “mental illness,” a related question is now being asked.

What do we all need to be mentally well?. Shelter, good food, meaning in life, someone to love and so forth—if you look at it from this perspective, you can see why, when those supporting elements begin to disappear, psychiatric difficulties appear. I am not discounting that there may be biological factors that cause “mental illness.” While biological markers that tell of a particular disorder have not been discovered, we are biological creatures, and we do know, for instance, that there are physical illnesses and toxins that can produce psychotic episodes. However, the progress that is being made at the moment is a moving away from the robotic “it’s all about brain chemistry” toward a rediscovery of the importance of our social lives and our experiences. Horgan.

Do we still have anything to learn from Sigmund Freud?. Whitaker. I certainly think so. Freud is a reminder that so much of our mind is hidden from us and that what spills into our consciousness comes from a blend of the many parts of our mind, our emotional centers and our more primal instincts. You can still see merit in Freud’s descriptions of the id, ego and superego as a conceptualization of different parts of the brain.

I read Freud when I was in college, and it was a formative experience for me. Horgan. I fear that American-style capitalism doesn’t produce good health care, including mental-health care. What do you think?. Whitaker.

It’s clear that it doesn’t. First, we have for-profit health-care that is set up to treat “disease.” With mental-health care, that means there is a profit to be made from seeing people as “diseased” and treating them for that “illness.” Take a pill!. In other words, American-style capitalism, which works to create markets for products, provides an incentive to create mental patients, and it has done this to great success over the past 35 years. Second, without a profit to be made, you don’t have as much investment in psychosocial care that can help a person remake his or her life. There is a societal expense, but little corporate profit, in psychosocial care, and American-style capitalism doesn’t lend itself to that equation.

Third, with our American-style capitalism (think neoliberalism), it is the individual that is seen as “ill” and needs to be fixed. Society gets a free pass. This too is a barrier to good “mental health” care, for it prevents us from thinking about what changes we might make to our society that would be more nurturing for us all. With our American-style capitalism, we now have a grossly unequal society, with more and more wealth going to the select few, and more and more people struggling to pay their bills. That is a prescription for psychiatric distress.

Good “mental health care” starts with creating a society that is more equal and just. Horgan. How might the antifungal medication diflucan affect care of the mentally ill?. Whitaker. That is something Mad in America has reported on.

The diflucan, of course, can be particularly threatening to people in mental hospitals, or in group homes. The threat is more than just the exposure to the diflucan that may come in such settings. People who are struggling in this way often feel terribly isolated, alone, and fearful of being with others. antifungal medication measures, with calls for social distancing, can exacerbate that. I think this puts hospital staff and those who run residential homes into an extraordinarily difficult position—how can they help ease the isolation of patients even as they are being expected to enforce a type of social distancing?.

Horgan. If the next president named you mental health czar, what would be at the top of your To Do list?. Whitaker. Well, I am pretty sure that’s not going to happen, and if it did, I would quickly confess to my being utterly unqualified for the job. But from my perch at Mad in America, here is what I would like to see happen in our society.

As you can see from my answers above, I think the fundamental problem is that our society has organized itself around a false narrative, which was sold to us as a narrative of science. In the early 1980s, we began to hear that psychiatric disorders were discrete brain illnesses, which were caused by chemical imbalances in the brain, and that a new generation of psychiatric drugs fixed those imbalances, like insulin for diabetes. That is a story of an amazing medical breakthrough. Researchers had discovered the very chemicals in our brain that cause madness, depression, anxiety or ADHD, and they had developed drugs that could put brain chemistry back into a normal state. Given the complexity of the human brain, if this were true, it would arguably be the greatest achievement in medical history.

And we understood it to be true. We came to believe that there was a sharp line between the “normal” brain and the “abnormal” brain, and that it was medically helpful to screen for these illnesses, and that psychiatric drugs were very safe and effective, and often needed to be taken for life. But what can be seen clearly today is that this narrative was a marketing story, not a scientific one. It was a story that psychiatry, as an institution, promoted for guild purposes, and it was a story that pharmaceutical companies promoted for commercial reasons. Science actually tells a very different story.

The biology of psychiatric disorders remains unknown. The disorders in the DSM have not been validated as discrete illnesses. The drugs do not fix chemical imbalances but rather perturb normal neurotransmitter functions. And even their short term efficacy is marginal at best. As could be expected, organizing our thinking around a false narrative has been a societal disaster.

A sharp rise in the burden of mental illness in our society. Poor long-term functional outcomes for those who are continuously medicated. The pathologizing of childhood. And so on. What we need now is a new narrative to organize ourselves around, one steeped in history, literature, philosophy, and good science.

I think step one is ditching the DSM. That book presents the most impoverished “philosophy of being” imaginable. Anyone who is too emotional, or struggles with his or her mind, or just doesn’t like being in a boring environment (think ADHD) is a candidate for a diagnosis. We need a narrative that, if truth be told, can be found in literature. Novels, Shakespeare, the Bible—they all tell of how we humans struggle with our minds, our emotions and our behaviors.

That is the norm. It is the human condition. And yet the characters we see in literature, if they were viewed through the DSM lens, would regularly qualify for a diagnosis. At the same time, literature tells of how humans can be so resilient, and that we change as we age and move through different environments. We need that to be part of a new narrative too.

Our current disease-model narrative tells of how people are likely going to be chronically ill. Their brains are defective, and so the therapeutic goal is to manage the symptoms of the “disease.” We need a narrative that replaces that pessimism with hope. If we embraced that literary understanding of what it is to be human, then a “mental health” policy could be forged that would begin with this question. How do we create environments that are more nurturing for us all?. How do we create schools that build on a child’s curiosity?.

How do we bring nature back into our lives?. How do we create a society that helps provide people with meaning, a sense of community, and a sense of civic duty?. How do we create a society that promotes good physical health, and provides access to shelter and medical care?. Furthermore, with this conception in mind, individual therapy would help people change their environments. You could encourage walks in nature.

Recommend volunteer work. Provide settings where people could go and recuperate, and so forth. Most important, in contrast to a “disease-based” paradigm of care, a “wellness-based” paradigm would help people feel hopeful, and help them find a way to create a different future for themselves. This is an approach, by the way, that can be helpful to people who have suffered a psychotic episode. Soteria homes and Open Dialogue are “therapies” that strive to help psychotic patients in this manner.

Within this “wellness” paradigm of care, there would still be a place for use of medications that help people feel differently, at least for a time. Sedatives, tranquilizers, and so forth. And you would still want to fund science that seeks to better understand the many pathways to debilitating mood states and to “psychosis”—trauma, poor physical health, physical disease, lack of sleep, setbacks in life, isolation, loneliness, and yes, whatever biological vulnerabilities that may be present. At the same time, you would want to fund science that seeks to better understand the pillars of “wellness.” Horgan. What’s your utopia?.

Whitaker. My “utopia” would be a world like the one I just described, based on a new narrative about mental illness, rooted in an understanding of how emotional we humans are, of how we struggle with our minds, and of how we are built to be responsive to our environments. And that really is the mission of Mad in America. We want it to be a forum for creating a new societal narrative for “mental health.” Further Reading. Can Psychiatry Heal Itself?.

Are Psychiatric Medications Making Us Sicker?. Meta-Post. Posts on Mental Illness Meta-Post. Posts on Brain Implants Meta-Post. Posts on Psychedelics Meta-Post.

Posts on Buddhism and Meditation See also “The Meaning of Madness,” a chapter in my free online book Mind-Body Problems.1970 Sweet Suburbia “Massive movement from central cities to their suburbs, a population boom in the West and Southwest, and a lower rate of population growth in the 1960's than in the 1950's are the findings that stand out in the preliminary results of the 1970 Census as issued by the U.S. Bureau of the Census. The movement to the suburbs was pervasive. Its extent is indicated by the fact that 13 of the 25 largest cities lost population, whereas 24 of the 25 largest metropolitan areas gained. Washington, D.C., was characteristic.

The population of the city changed little between 1960 and 1970, but the metropolitan area grew by 800,000, or more than 38 percent.” 1920 Air Cargo “The proposed machine, known as the ‘Pelican Four-Ton Lorry,' is a colossal cantilever monoplane designed for two 460-horse-power Napier engines. Its cruising speed is 72 miles per hour. Its total weight is to be 24,100 pounds. The useful load is four tons, with sufficient fuel for the London-Paris journey. Most interesting of all, however, is the novel system of quick loading and unloading which has been planned.

This permits handling of shipments with the utmost speed, and is based on a similar practice in the motor truck field. Idle airplanes mean a large idle capital, hence the designers plan to keep the airplane in the air for the greater part of the time.” Don't Try This Anywhere “Dr. Charles Baskerville points out that while the data thus far obtained on chlorine and influenza do not warrant drawing conclusions, such facts as have been established would indicate to the medical man the advisability of trying experimentally dilute chlorinated air as a prophylactic in such epidemics as so-called influenza. Dr. Baskerville determined to what extent workers in plants where small amounts of chlorine were to be found in the atmosphere were affected seriously by influenza.

Many of those from whom information was requested expressed the opinion that chlorine workers are noticeably free from colds and other pneumatic diseases.” 1870 The Rise of Telegraphy “The rapid progress of the telegraph during the last twenty-five years has changed the whole social and commercial systems of the world. Its advantages and capabilities were so evident that immediately on its introduction, and demonstration of its true character, the most active efforts were made to secure them for every community which desired to keep pace with the advances of modern times. The Morse or signal system seemed for a time to be the perfection of achievement, until Professor Royal E. House astonished the world with his letter printing telegraph. Now, almost every considerable expanse of water is traversed, or soon will be, by the slender cords which bind continents and islands together and practically bring the human race into one great family.” The Transport of Goods 1887.

Cargo ship launched as Golconda had room for 6,000 tons of cargo, loaded and unloaded by crane and cargo nets, and 108 passengers. Credit. Scientific American Supplement, Vol. XXIII, No. 574.

January 1, 1887 Oxcarts, railroad cars and freight ships can be loaded and unloaded one item at a time, but it is more efficient to handle cargo packed into “intermodal shipping containers” that are a standardized size and shape. Our October 1968 issue noted that a “break-bulk” freighter took three days to unload, a container ship less than one (including loading new cargo). Air transport became a link in this complex system, but the concept in the 1920 illustration shown is a little ahead of its time. These days air cargo (and luggage) makes abundant use of “unit load devices,” cargo bins shaped to fit the fuselage of specific aircraft models.The items below are highlights from the free newsletter, “Smart, useful, science stuff about antifungal medication.” To receive newsletter issues daily in your inbox, sign-up here. Are you in need of a “dose of optimism” about the diflucan, at least in the U.S.?.

Check out this 10/12/20 story at The New York Times by by Donald McNeil Jr., who has covered infectious diseases and epidemics for many years. McNeil notes the 215,000 people in the U.S. Dead so far from the novel antifungals, as well as the estimates that the figure could go as high as 400,000 before this era draws to a close. But here is some of the good news that he tallies. 1) mask-wearing by the public is “widely accepted”.

2) the development of treatments to protect against antifungals and of treatments for antifungal medication are proceeding at record speed. 3) “experts are saying, with genuine confidence, that the diflucan in the United States will be over far sooner than they expected, possibly by the middle of next year”. And 4) fewer infected people die today than did earlier this year, even at nursing homes. About 10 percent of people in the U.S. Have been infected with the diflucan so far, according to the U.S.

Centers for Disease Control, the story states. €œdiflucans don’t end abruptly. They decelerate gradually,” McNeil writes. A 10/14/20 story by Carl Zimmer for The New York Times puts into context three late-stage (Phase 3 safety and effectiveness) antifungal medication experiments that have been paused in recent weeks due to illness among some study participants. Pauses in treatment studies — in this case Johnson &.

Johnson’s treatment candidate and AstraZeneca’s treatment candidate — are “not unusual,” the story states, partly because the safety threshold is extremely high for a product that, if approved, could be given to millions or billions of people. But pauses are rare in treatment studies — in this case Eli Lilly’s monoclonal antibody cocktail drug. Once a drug or treatment experiment (trial) is paused, a safety board determines whether the ill participant was given the new product or a placebo. If it was the placebo, the study can resume. If not, the board looks deeper into the case to determine whether or not the illness is related to the drug or treatment.

If a clear connection is discovered, “the trial may have to stop,” Zimmer writes. Dr. Eric Topol at Scripps Research is quoted in the piece as saying he is “still fairly optimistic” about monoclonal antibody treatments for antifungal medication. The safety-related pauses of all three experiments are “an example of how things are supposed to work,” says Dr. Anna Durbin of Johns Hopkins Bloomberg School of Public Health in the story.

The top of a story at The Washington Post features an instructive interactive that sketches “Scienceville,” a fictional place where “politicians and public health officials use every tool at their disposal to contain the antifungals.” It basically shows how genetic analysis and tracing of viral strains found in a frequently and widely tested population could help officials control outbreaks of antifungals. Then the 10/13/20 text story below, by Brady Dennis, Chris Mooney, Sarah Kaplan, and Harry Stevens, focuses on the details of such a “genomic epidemiology” approach and describes some real-life efforts under way, primarily in the UK, to implement the approach. The U.S. Has not been able to effectively use the approach, in part because genetic sequencing of viral strains “has largely been left up to states and individual researchers, rather than being part of a coordinated and well-funded national program,” the story states. The rise in antifungals s in the U.S.

Is now driven by “small gatherings in people’s homes,” according to officials with the U.S. Centers for Disease Control, reports Carolyn Crist for WebMD (10/14/20). People should continue to wear face masks and to practice social distancing “since most people have still not been exposed to the antifungals worldwide," the researchers suggest, Crist writes.

This didn’t really make sense to me, and buy diflucan online australia then I read this. In the developing countries, they used antipsychotic drugs acutely, but not chronically. Only 16 percent of patients in the developing countries were regularly maintained on antipsychotics, whereas in the developed countries this was the standard of care. That didn’t fit with my understanding that these drugs were an buy diflucan online australia essential treatment for schizophrenia patients.

Second, a study by Harvard researchers found that schizophrenia outcomes had declined in the previous 20 years, and were now no better than they had been in the first third of the 20th century. That didn’t fit with my understanding that psychiatry had made great progress in treating people so diagnosed. Those studies led to my questioning the story that our society told about those we call “mad,” and I got a book contract to dig into that buy diflucan online australia question. That project turned into Mad in America, which told of the history of our society’s treatment of the seriously mentally ill, from colonial times until today—a history marked by bad science and societal mistreatment of those so diagnosed.

Horgan. Do you still see yourself as a journalist, or are you buy diflucan online australia primarily an activist?. Whitaker. I don’t see myself as an “activist” at all.

In my own writings, and in the webzine I direct, Mad in America, I think you’ll see journalistic practices at work, albeit in the service of an “activist” mission buy diflucan online australia. Here is our mission statement. €œMad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as buy diflucan online australia well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.” Thus, our starting point is that “change” is needed, and while that does have an activist element, I think journalism—serving as an informational source—is fundamental to that effort.

As an organization, we are not asserting that we have the answers for what that change should be, which would be the case if we were striving to be activists. Instead, we strive to be a forum for promoting an informed societal discussion about this subject. Here’s what we do buy diflucan online australia. We publish daily summaries of scientific research with findings that are rarely covered in the mainstream media.

You’ll find, in the archives of our research reports, a steady parade of findings that counter the conventional narrative. For instance, there are reports of how the effort to find genes for mental disorders has proven rather fruitless, or of how social inequalities trigger mental distress, or of poor buy diflucan online australia long-term outcomes with our current paradigm of care. And so forth—we simply want these scientific findings to become known.
We regularly feature interviews with researchers and activists, and podcasts that explore these issues. We launched MIA Reports as a showcase for our print journalism.

We have buy diflucan online australia published in-depth articles on promising new initiatives in Europe. Investigative pieces on such topics as compulsory outpatient treatment. Coverage of “news” related to mental health policy in the United States. And occasional reports on buy diflucan online australia how the mainstream media is covering mental health issues.

€¨We also publish blogs by professionals, academics, people with lived experience, and others with a particular interest in this subject. These blogs and personal stories are meant to help inform society’s “rethinking” of psychiatric care. All of these efforts, I think, fit within the framework of “journalism.” However, I do understand that I am going beyond buy diflucan online australia the boundaries of usual “science journalism” when I publish critiques of the “evidence base” related to psychiatric drugs. I did this in my books Mad in America and Anatomy of an Epidemic, as well as a book I co-wrote, Psychiatry Under the Influence.

I have continued to do this with MIA Reports. The usual practice in “science journalism” buy diflucan online australia is to look to the “experts” in the field and report on what they tell about their findings and practices. However, while reporting and writing Mad in America, I came to understand that when “experts” in psychiatry spoke to journalists they regularly hewed to a story that they were expected to tell, which was a story of how their field was making great progress in understanding the biology of disorders and of drug treatments that—as I was told over and over when I co-wrote the series for the Boston Globe—fixed chemical imbalances in the brain. But their own science, I discovered, regularly belied the story they were telling to the media.

That’s why I turned to focusing on the story buy diflucan online australia that could be dug out from a critical look at their own scientific literature. So what I do in these critiques—such as suicide in the Prozac era and the impact of antipsychotics on mortality—is review the relevant research and put those findings together into a coherent report. I also look at research cited in support of mainstream beliefs and see if the data, in those articles, actually supports the conclusions presented in the abstract. None of this is really that difficult, and yet I know it buy diflucan online australia is unusual for a journalist to challenge conventional “medical wisdom” in this way.

Horgan. Anatomy of an Epidemic argues that medications for mental illness, although they give many people short-term reliefs, cause net harm. Is that a fair summary? buy diflucan online australia. Whitaker.

Yes, although my thinking has evolved somewhat since I wrote that book. I am buy diflucan online australia more convinced than ever that psychiatric medications, over the long term, cause net harm. I wish that weren’t the case, but the evidence just keeps mounting that these drugs, on the whole, worsen long-term outcomes. However, my thinking has evolved in this way.

I am not so sure any more that the medications provide buy diflucan online australia a short-term benefit for patient populations as a whole. When you look at the short-term studies of antidepressants and antipsychotics, the evidence of efficacy in reducing symptoms compared to placebo is really pretty marginal, and fails to rise to the level of a “clinically meaningful” benefit. Furthermore, the problem with all of this research is that there is no real placebo group in the studies. The placebo group is composed of patients who have been withdrawn buy diflucan online australia from their psychiatric medications and then randomized to placebo.

Thus, the placebo group is a drug-withdrawal group, and we know that withdrawal from psychiatric drugs can stir myriad negative effects. A medication-naïve placebo group would likely have much better outcomes, and if that were so, how would that placebo response compare to the drug response?. In short, research on the short-term effects of psychiatric drugs is buy diflucan online australia a scientific mess. In fact, a 2017 paper that was designed to defend the long-term use of antipsychotics nevertheless acknowledged, in an off-hand way, that “no placebo-controlled trials have been reported in first-episode psychosis patients.” Antipsychotics were introduced 65 years ago, and we still don’t have good evidence that they work over the short term in first episode patients.

Which is rather startling, when you think of it. Horgan. Have any of your critics—E. Fuller Torrey, for example—made you rethink your thesis?.

Whitaker. When the first edition of Anatomy of an Epidemic was published (2010), I knew there would be critics, and I thought, this will be great. This is just what is needed, a societal discussion about the long-term effects of psychiatric medications. I have to confess that I have been disappointed in the criticism.

They mostly have been ad hominem attacks—I cherry-picked the data, or I misunderstood findings, or I am just biased, but the critics don’t then say what data I missed, or point to findings that tell of medications that improve long-term outcomes. I honestly think I could do a much better job of critiquing my own work. You mention E. Fuller Torrey’s criticism, in which he states that I both misrepresented and misunderstood some of the research I cited.

I took this seriously, and answered it at great length. Now if your own “thesis” is indeed flawed, then a critic should be able to point out its flaws while accurately detailing what you wrote. If that is the case, then you have good reason to rethink your beliefs. But if a critique doesn’t meet that standard, but rather relies on misrepresenting what you wrote, then you have reason to conclude that the critic lacks the evidence to make an honest case.

And that is how I see Torrey’s critique. For example, Torrey said that I misunderstood Martin Harrow’s research on long-term outcomes for schizophrenia patients. Harrow reported that the recovery rate was eight times higher for those who got off antipsychotic medication compared to those who stayed on the drugs. However, in his 2007 paper, Harrow stated that the better outcomes for those who got off medication was because they had a better prognosis and not because of negative drug effects.

If you read Anatomy of an Epidemic, you’ll see that I present his explanation. Yet, in my interview with Harrow, I noted that his own data showed that those who were diagnosed with milder psychotic disorders who stayed on antipsychotics fared worse over the long term than schizophrenia patients who stopped taking the medication. This was a comparison that showed the less ill maintained on antipsychotics doing worse than the more severely ill who got off these medications. And I presented that comparison in Anatomy of an Epidemic.

By doing that, I was going out on a limb. I was saying that maybe Harrow’s data led to a different conclusion than he had drawn, which was that the antipsychotic medication, over the long-term, had a negative effect. After Anatomy was published, Harrow and his colleague Thomas Jobe went back to their data and investigated this very possibility. They have subsequently written several papers exploring this theme, citing me in one or two instances for raising the issue, and they found reason to conclude that it might be so.

They wrote. €œHow unique among medical treatments is it that the apparent efficacy of antipsychotics could diminish over time or become harmful?. There are many examples for other medications of similar long-term effects, with this often occurring as the body readjusts, biologically, to the medications.” Thus, in this instance, I did the following. I accurately reported the results of Harrow’s study and his interpretation of his results, and I accurately presented data from his research that told of a possible different interpretation.

The authors then revisited their own data to take up this inquiry. And yet Torrey’s critique is that I misrepresented Harrow’s research. This same criticism, by the way, is still being flung at me. Here is a recent article in Vice which, once again, quotes people saying I misrepresent and misunderstand research, with Harrow cited as an example.

I do want to emphasize that critiques of “my thesis” regarding the long-term effects of psychiatric drugs are important and to be welcomed. See two papers in particular that take this on (here and here), and my response in general to such criticisms, and to the second one. Horgan. When I criticize psychiatric drugs, people sometimes tell me that meds saved their lives.

You must get this reaction a lot. How do you respond?. Whitaker. I do hear that, and when I do, I reply, “Great!.

I am so glad to know that the medications have worked for you!. € But of course I also hear from many people who say that the drugs ruined their lives. I do think that the individual’s experience of psychiatric medication, whether good or bad, should be honored as worthy and “valid.” They are witnesses to their own lives, and we should incorporate those voices into our societal thinking about the merits of psychiatric drugs. However, for the longest time, we’ve heard mostly about the “good” outcomes in the mainstream media, while those with “bad” outcomes were resigned to telling their stories on internet forums.

What Mad in America has sought to do, in its efforts to serve as a forum for rethinking psychiatry, is provide an outlet for this latter group, so their voices can be heard too. The personal accounts, of course, do not change the bottom-line “evidence” that shows up in outcome studies of larger groups of patients. Unfortunately, that tells of medications that, on the whole, do more harm than good. As a case in point, in regard to this “saving lives” theme, this benefit does not show up in public health data.

The “standard mortality rate” for those with serious mental disorders, compared to the general public, has notably increased in the last 40 years. Horgan. Do you see any promising trends in psychiatry?. Whitaker.

Yes, definitely. You have the spread of Hearing Voices networks, which are composed of people who hear voices and offer support for learning to live with voices as opposed to squashing them, which is what the drugs are supposed to do. These networks are up and running in the U.S., and in many countries worldwide. You have Open Dialogue approaches, which were pioneered in northern Finland and proved successful there, being adopted in the United States and many European countries (and beyond.) This practice puts much less emphasis on treatment with antipsychotics, and much greater emphasis on helping people re-integrate into family and community.

You have many alternative programs springing up, even at the governmental level. Norway, for instance, ordered its hospital districts to offer “medication free” treatment for those who want it, and there is now a private hospital in Norway that is devoted to helping chronic patients taper down from their psychiatric medications. In Israel, you have Soteria houses that have sprung up (sometimes they are called stabilizing houses), where use of antipsychotics is optional, and the environment—a supportive residential environment—is seen as the principal “therapy.” You have the U.N. Special Rapporteur for Health, Dainius Pūras, calling for a “revolution” in mental health, one that would supplant today’s biological paradigm of care with a paradigm that paid more attention to social justice factors—poverty, inequality, etc.—as a source of mental distress.

All of those initiatives tell of an effort to find a new way. But perhaps most important, in terms of “positive trends,” the narrative that was told to us starting in the 1980s has collapsed, which is what presents the opportunity for a new paradigm to take hold. More and more research tells of how the conventional narrative, in all its particulars, has failed to pan out. The diagnoses in the Diagnostic and Statistical Manual (DSM) have not been validated as discrete illnesses.

The genetics of mental disorders remain in doubt. MRI scans have not proven to be useful. Long-term outcomes are poor. And the notion that psychiatric drugs fix chemical imbalances has been abandoned.

Ronald Pies, the former editor in chief of Psychiatric Times, has even sought to distance psychiatry, as an institution, from ever having made such a claim. Horgan. Do brain implants or other electrostimulation devices show any therapeutic potential?. Whitaker.

I don’t have a ready answer for this. We have published two articles about the spinning of results from a trial of deep-brain stimulation, and the suffering of some patients so treated over the long-term. Those articles tell of why it may be difficult to answer that question. There are financial influences that push for published results that tell of a therapeutic success, even if the data doesn’t support that finding, and we have a research environment that fails to study long-term outcomes.

The history of somatic treatments for mental disorders also provides a reason for caution. It’s a history of one somatic treatment after another being initially hailed as curative, or extremely helpful, and then failing the test of time. The inventor of frontal lobotomy, Egas Moniz, was awarded a Nobel Prize for inventing that surgery, which today we understand as a mutilation. It’s important to remain open to the possibility that somatic treatments may be helpful, at least for some patients.

But there is plenty of reason to be wary of initial claims of success. Horgan. Should psychedelic drugs be taken seriously as treatments?. Whitaker.

I think caution applies here too. Surely there are many risks with psychedelic drugs, and if you were to do a study of first-episode psychosis today, you would find a high percentage of the patients had been using mind-altering drugs before their psychotic break—antidepressants, marijuana, LSD and so forth. At the same time, we’ve published reviews of papers that have reported positive results with use of psychedelics. What are the benefits versus the risks?.

Can possible benefits be realized while risks are minimized?. It is a question worth exploring, but carefully so. Horgan. What about meditation?.

Whitaker. I know that many people find meditation helpful. I also know other people find it difficult—and even threatening—to sit with the silence of their minds. Mad in America has published reviews of research about meditation, we have had a few bloggers write about it, and in our resource section on “non-drug therapies,” we have summarized research findings regarding its use for depression.

We concluded that the research on this is not as robust as one would like. However, I think your question leads to this broader thought. People struggling with their minds and emotions may come up with many different approaches they find helpful. Exercise, diet, meditation, yoga and so forth all represent efforts to change one’s environment, and ultimately, I think that can be very helpful.

But the individual has to find his or her way to whatever environmental change that works best for them. Horgan. Do you see any progress toward understanding the causes of mental illness?. Whitaker.

Yes, and that progress might be summed up in this way. Researchers are returning to investigations of how we are impacted by what has “happened to us.” The Adverse Childhood Experiences study provides compelling evidence of how traumas in childhood—divorce, poverty, abuse, bullying and so forth—exact a long-term toll on physical and mental health. Interview any group of women diagnosed with a serious mental disorder, and you’ll regularly find accounts of sexual abuse. Racism exacts a toll.

So too poverty, oppressive working conditions, and so forth. You can go on and on, but all of this is a reminder that we humans are designed to respond to our environment, and it is quite clear that mental distress, in large part, arises from difficult environments and threatening experiences, past and present. And with a focus on life experiences as a source of “mental illness,” a related question is now being asked. What do we all need to be mentally well?.

Shelter, good food, meaning in life, someone to love and so forth—if you look at it from this perspective, you can see why, when those supporting elements begin to disappear, psychiatric difficulties appear. I am not discounting that there may be biological factors that cause “mental illness.” While biological markers that tell of a particular disorder have not been discovered, we are biological creatures, and we do know, for instance, that there are physical illnesses and toxins that can produce psychotic episodes. However, the progress that is being made at the moment is a moving away from the robotic “it’s all about brain chemistry” toward a rediscovery of the importance of our social lives and our experiences. Horgan.

Do we still have anything to learn from Sigmund Freud?. Whitaker. I certainly think so. Freud is a reminder that so much of our mind is hidden from us and that what spills into our consciousness comes from a blend of the many parts of our mind, our emotional centers and our more primal instincts.

You can still see merit in Freud’s descriptions of the id, ego and superego as a conceptualization of different parts of the brain. I read Freud when I was in college, and it was a formative experience for me. Horgan. I fear that American-style capitalism doesn’t produce good health care, including mental-health care.

What do you think?. Whitaker. It’s clear that it doesn’t. First, we have for-profit health-care that is set up to treat “disease.” With mental-health care, that means there is a profit to be made from seeing people as “diseased” and treating them for that “illness.” Take a pill!.

In other words, American-style capitalism, which works to create markets for products, provides an incentive to create mental patients, and it has done this to great success over the past 35 years. Second, without a profit to be made, you don’t have as much investment in psychosocial care that can help a person remake his or her life. There is a societal expense, but little corporate profit, in psychosocial care, and American-style capitalism doesn’t lend itself to that equation. Third, with our American-style capitalism (think neoliberalism), it is the individual that is seen as “ill” and needs to be fixed.

Society gets a free pass. This too is a barrier to good “mental health” care, for it prevents us from thinking about what changes we might make to our society that would be more nurturing for us all. With our American-style capitalism, we now have a grossly unequal society, with more and more wealth going to the select few, and more and more people struggling to pay their bills. That is a prescription for psychiatric distress.

Good “mental health care” starts with creating a society that is more equal and just. Horgan. How might the antifungal medication diflucan affect care of the mentally ill?. Whitaker.

That is something Mad in America has reported on. The diflucan, of course, can be particularly threatening to people in mental hospitals, or in group homes. The threat is more than just the exposure to the diflucan that may come in such settings. People who are struggling in this way often feel terribly isolated, alone, and fearful of being with others.

antifungal medication measures, with calls for social distancing, can exacerbate that. I think this puts hospital staff and those who run residential homes into an extraordinarily difficult position—how can they help ease the isolation of patients even as they are being expected to enforce a type of social distancing?. Horgan. If the next president named you mental health czar, what would be at the top of your To Do list?.

Whitaker. Well, I am pretty sure that’s not going to happen, and if it did, I would quickly confess to my being utterly unqualified for the job. But from my perch at Mad in America, here is what I would like to see happen in our society. As you can see from my answers above, I think the fundamental problem is that our society has organized itself around a false narrative, which was sold to us as a narrative of science.

In the early 1980s, we began to hear that psychiatric disorders were discrete brain illnesses, which were caused by chemical imbalances in the brain, and that a new generation of psychiatric drugs fixed those imbalances, like insulin for diabetes. That is a story of an amazing medical breakthrough. Researchers had discovered the very chemicals in our brain that cause madness, depression, anxiety or ADHD, and they had developed drugs that could put brain chemistry back into a normal state. Given the complexity of the human brain, if this were true, it would arguably be the greatest achievement in medical history.

And we understood it to be true. We came to believe that there was a sharp line between the “normal” brain and the “abnormal” brain, and that it was medically helpful to screen for these illnesses, and that psychiatric drugs were very safe and effective, and often needed to be taken for life. But what can be seen clearly today is that this narrative was a marketing story, not a scientific one. It was a story that psychiatry, as an institution, promoted for guild purposes, and it was a story that pharmaceutical companies promoted for commercial reasons.

Science actually tells a very different story. The biology of psychiatric disorders remains unknown. The disorders in the DSM have not been validated as discrete illnesses. The drugs do not fix chemical imbalances but rather perturb normal neurotransmitter functions.

And even their short term efficacy is marginal at best. As could be expected, organizing our thinking around a false narrative has been a societal disaster. A sharp rise in the burden of mental illness in our society. Poor long-term functional outcomes for those who are continuously medicated.

The pathologizing of childhood. And so on. What we need now is a new narrative to organize ourselves around, one steeped in history, literature, philosophy, and good science. I think step one is ditching the DSM.

That book presents the most impoverished “philosophy of being” imaginable. Anyone who is too emotional, or struggles with his or her mind, or just doesn’t like being in a boring environment (think ADHD) is a candidate for a diagnosis. We need a narrative that, if truth be told, can be found in literature. Novels, Shakespeare, the Bible—they all tell of how we humans struggle with our minds, our emotions and our behaviors.

That is the norm. It is the human condition. And yet the characters we see in literature, if they were viewed through the DSM lens, would regularly qualify for a diagnosis. At the same time, literature tells of how humans can be so resilient, and that we change as we age and move through different environments.

We need that to be part of a new narrative too. Our current disease-model narrative tells of how people are likely going to be chronically ill. Their brains are defective, and so the therapeutic goal is to manage the symptoms of the “disease.” We need a narrative that replaces that pessimism with hope. If we embraced that literary understanding of what it is to be human, then a “mental health” policy could be forged that would begin with this question.

How do we create environments that are more nurturing for us all?. How do we create schools that build on a child’s curiosity?. How do we bring nature back into our lives?. How do we create a society that helps provide people with meaning, a sense of community, and a sense of civic duty?.

How do we create a society that promotes good physical health, and provides access to shelter and medical care?. Furthermore, with this conception in mind, individual therapy would help people change their environments. You could encourage walks in nature. Recommend volunteer work.

Provide settings where people could go and recuperate, and so forth. Most important, in contrast to a “disease-based” paradigm of care, a “wellness-based” paradigm would help people feel hopeful, and help them find a way to create a different future for themselves. This is an approach, by the way, that can be helpful to people who have suffered a psychotic episode. Soteria homes and Open Dialogue are “therapies” that strive to help psychotic patients in this manner.

Within this “wellness” paradigm of care, there would still be a place for use of medications that help people feel differently, at least for a time. Sedatives, tranquilizers, and so forth. And you would still want to fund science that seeks to better understand the many pathways to debilitating mood states and to “psychosis”—trauma, poor physical health, physical disease, lack of sleep, setbacks in life, isolation, loneliness, and yes, whatever biological vulnerabilities that may be present. At the same time, you would want to fund science that seeks to better understand the pillars of “wellness.” Horgan.

What’s your utopia?. Whitaker. My “utopia” would be a world like the one I just described, based on a new narrative about mental illness, rooted in an understanding of how emotional we humans are, of how we struggle with our minds, and of how we are built to be responsive to our environments. And that really is the mission of Mad in America.

We want it to be a forum for creating a new societal narrative for “mental health.” Further Reading. Can Psychiatry Heal Itself?. Are Psychiatric Medications Making Us Sicker?. Meta-Post.

Posts on Mental Illness Meta-Post. Posts on Brain Implants Meta-Post. Posts on Psychedelics Meta-Post. Posts on Buddhism and Meditation See also “The Meaning of Madness,” a chapter in my free online book Mind-Body Problems.1970 Sweet Suburbia “Massive movement from central cities to their suburbs, a population boom in the West and Southwest, and a lower rate of population growth in the 1960's than in the 1950's are the findings that stand out in the preliminary results of the 1970 Census as issued by the U.S.

Bureau of the Census. The movement to the suburbs was pervasive. Its extent is indicated by the fact that 13 of the 25 largest cities lost population, whereas 24 of the 25 largest metropolitan areas gained. Washington, D.C., was characteristic.

The population of the city changed little between 1960 and 1970, but the metropolitan area grew by 800,000, or more than 38 percent.” 1920 Air Cargo “The proposed machine, known as the ‘Pelican Four-Ton Lorry,' is a colossal cantilever monoplane designed for two 460-horse-power Napier engines. Its cruising speed is 72 miles per hour. Its total weight is to be 24,100 pounds. The useful load is four tons, with sufficient fuel for the London-Paris journey.

Most interesting of all, however, is the novel system of quick loading and unloading which has been planned. This permits handling of shipments with the utmost speed, and is based on a similar practice in the motor truck field. Idle airplanes mean a large idle capital, hence the designers plan to keep the airplane in the air for the greater part of the time.” Don't Try This Anywhere “Dr. Charles Baskerville points out that while the data thus far obtained on chlorine and influenza do not warrant drawing conclusions, such facts as have been established would indicate to the medical man the advisability of trying experimentally dilute chlorinated air as a prophylactic in such epidemics as so-called influenza.

Dr. Baskerville determined to what extent workers in plants where small amounts of chlorine were to be found in the atmosphere were affected seriously by influenza. Many of those from whom information was requested expressed the opinion that chlorine workers are noticeably free from colds and other pneumatic diseases.” 1870 The Rise of Telegraphy “The rapid progress of the telegraph during the last twenty-five years has changed the whole social and commercial systems of the world. Its advantages and capabilities were so evident that immediately on its introduction, and demonstration of its true character, the most active efforts were made to secure them for every community which desired to keep pace with the advances of modern times.

The Morse or signal system seemed for a time to be the perfection of achievement, until Professor Royal E. House astonished the world with his letter printing telegraph. Now, almost every considerable expanse of water is traversed, or soon will be, by the slender cords which bind continents and islands together and practically bring the human race into one great family.” The Transport of Goods 1887. Cargo ship launched as Golconda had room for 6,000 tons of cargo, loaded and unloaded by crane and cargo nets, and 108 passengers.

Credit. Scientific American Supplement, Vol. XXIII, No. 574.

January 1, 1887 Oxcarts, railroad cars and freight ships can be loaded and unloaded one item at a time, but it is more efficient to handle cargo packed into “intermodal shipping containers” that are a standardized size and shape. Our October 1968 issue noted that a “break-bulk” freighter took three days to unload, a container ship less than one (including loading new cargo). Air transport became a link in this complex system, but the concept in the 1920 illustration shown is a little ahead of its time. These days air cargo (and luggage) makes abundant use of “unit load devices,” cargo bins shaped to fit the fuselage of specific aircraft models.The items below are highlights from the free newsletter, “Smart, useful, science stuff about antifungal medication.” To receive newsletter issues daily in your inbox, sign-up here.

Are you in need of a “dose of optimism” about the diflucan, at least in the U.S.?. Check out this 10/12/20 story at The New York Times by by Donald McNeil Jr., who has covered infectious diseases and epidemics for many years. McNeil notes the 215,000 people in the U.S. Dead so far from the novel antifungals, as well as the estimates that the figure could go as high as 400,000 before this era draws to a close.

But here is some of the good news that he tallies. 1) mask-wearing by the public is “widely accepted”. 2) the development of treatments to protect against antifungals and of treatments for antifungal medication are proceeding at record speed. 3) “experts are saying, with genuine confidence, that the diflucan in the United States will be over far sooner than they expected, possibly by the middle of next year”.

And 4) fewer infected people die today than did earlier this year, even at nursing homes. About 10 percent of people in the U.S. Have been infected with the diflucan so far, according to the U.S. Centers for Disease Control, the story states.

€œdiflucans don’t end abruptly. They decelerate gradually,” McNeil writes. A 10/14/20 story by Carl Zimmer for The New York Times puts into context three late-stage (Phase 3 safety and effectiveness) antifungal medication experiments that have been paused in recent weeks due to illness among some study participants. Pauses in treatment studies — in this case Johnson &.

Johnson’s treatment candidate and AstraZeneca’s treatment candidate — are “not unusual,” the story states, partly because the safety threshold is extremely high for a product that, if approved, could be given to millions or billions of people. But pauses are rare in treatment studies — in this case Eli Lilly’s monoclonal antibody cocktail drug. Once a drug or treatment experiment (trial) is paused, a safety board determines whether the ill participant was given the new product or a placebo. If it was the placebo, the study can resume.

If not, the board looks deeper into the case to determine whether or not the illness is related to the drug or treatment. If a clear connection is discovered, “the trial may have to stop,” Zimmer writes. Dr. Eric Topol at Scripps Research is quoted in the piece as saying he is “still fairly optimistic” about monoclonal antibody treatments for antifungal medication.

The safety-related pauses of all three experiments are “an example of how things are supposed to work,” says Dr. Anna Durbin of Johns Hopkins Bloomberg School of Public Health in the story. The top of a story at The Washington Post features an instructive interactive that sketches “Scienceville,” a fictional place where “politicians and public health officials use every tool at their disposal to contain the antifungals.” It basically shows how genetic analysis and tracing of viral strains found in a frequently and widely tested population could help officials control outbreaks of antifungals. Then the 10/13/20 text story below, by Brady Dennis, Chris Mooney, Sarah Kaplan, and Harry Stevens, focuses on the details of such a “genomic epidemiology” approach and describes some real-life efforts under way, primarily in the UK, to implement the approach.

The U.S. Has not been able to effectively use the approach, in part because genetic sequencing of viral strains “has largely been left up to states and individual researchers, rather than being part of a coordinated and well-funded national program,” the story states. The rise in antifungals s in the U.S. Is now driven by “small gatherings in people’s homes,” according to officials with the U.S.

Centers for Disease Control, reports Carolyn Crist for WebMD (10/14/20). People should continue to wear face masks and to practice social distancing “since most people have still not been exposed to the antifungals worldwide," the researchers suggest, Crist writes. A newly developed test can detect antifungals in 5 minutes, reports Robert F. Service at Science (10/8/20).

The test relies on CRISPR gene-editing technology, for which Jennifer Doudna of the University of California, Berkeley, and Emmanuelle Charpentier of the Max Planck Unit for the Science of Pathogens won the Nobel Prize in Chemistry earlier this month. Doudna heads up the work that led to this new 5-minute CRISPR test for the antifungals. By comparison, it can take a day or more to get back standard antifungals test results, the story states. Donald G.

McNeil Jr. At The New York Times has written a guide to distinguishing common cold, flu, and antifungal medication symptoms (10/3/20). A major difference between having a cold and having the flu is that "Flu makes you feel as if you were hit by a truck,” McNeil quotes experts as saying. The symptom that best distinguishes antifungal medication from flu is loss of your sense of smell — strong smells don’t register, he writes.

But many flu and antifungal medication symptoms overlap, the story states. The most common symptoms for antifungal medication are a high fever, chills, dry cough and fatigue. For flu, it’s a fever, headaches, body aches, sore throat, runny nose, stuffed sinuses, coughing and sneezing, the story states. Dr.

Anthony Fauci’s three daughters do not plan to visit him for Thanksgiving to avoid potentially transmitting the new antifungals to their parents, reports Ralph Ellis at WebMD. The story includes holiday traveling and visiting tips from a pulmonary critical care doctor at the University of Washington Medical Center who “believes traveling for the holidays is risky.” The tips include ensuring you have no antifungal medication-like symptoms two weeks before traveling, getting tested before traveling, quarantining in a hotel for at least 48 hours before visiting with loved ones, traveling by car, and cutting down on “close contact and talking without a mask” (10/9/20). Adele Chapin has written a guide for reducing kids’ risk of catching and spreading antifungals at the playground. The 10/8/20 piece in The Washington Post makes the usual recommendations for mask-wearing, hand-washing, hand-sanitizer, disinfecting wipes, and distancing.

It quotes a Children’s National Hospital pediatrician advises against gloves, because “people wearing them often touch their faces, which defeats the purpose.” The piece also recommends visiting playgrounds at less busy times and choosing playgrounds with more than one play structure, which makes it easier for kids to distance from one another. A story by Carl Zimmer for The New York Times beautifully describes and illustrates some of the amazing imaging work that scientists have done to study the structure of antifungals and how it infects our cells and multiplies (10/9/20). For starters, check out a mesmerizing video about a quarter of the way down-page that simulates spike proteins (complex molecules) doing a “molecular dance” on the diflucan membrane. The video (just one of several in this stunning piece) is part of research by a computational biophysicist at the Max Planck Institute of Biophysics and colleagues.

The spikes appear to shimmy, which “increases the odds of encountering the protein on the surface of our cells it uses to attach,” the researchers suspect, Zimmer writes. You might enjoy, “A letter of recommendation in the age of Zoom,” by Matt Cheung, for McSweeney’s (10/14/20)..

Where can you buy diflucan

Researchers have studied human kidney best online diflucan cells in the lab to examine the effects of antifungal medication on kidney where can you buy diflucan health. The findings appear in an upcoming issue of JASN.Many individuals who develop antifungal medication also experience kidney damage, but it's unclear if this is a direct result of viral or a consequence of another condition or the body's response to the . To investigate, a where can you buy diflucan team led by Benjamin Dekel, MD, PhD (Sheba Medical Center, in Israel) cultivated human kidney cells in lab dishes and infected them with the diflucan that causes antifungal medication.The researchers found that although the diflucan that causes antifungal medication could enter, infect, and replicate in human adult kidney cells, this did not typically lead to cell death. Prior to , the cells contained high levels of interferon signaling molecules, and the stimulated an inflammatory response that increased these molecules.

In contrast, of kidney cells deficient in such molecules resulted in cell death, suggesting a protective effect.The cells in these experiments were grown as a three-dimensional spheroid that imitates the healthy kidney or as a two-dimensional layer that mimics the cells of an acutely injured kidney. Cells that mimicked an acutely injured kidney were more prone to and additional injury but not cell death."The data indicate that it is unlikely that the diflucan is a primary cause where can you buy diflucan of acute kidney injury seen in antifungal medication patients. It implies that if such injury takes place in the kidney by any cause, the diflucan might jump on the wagon to intensify it. Therefore, if we're able to limit the common scenario of acute kidney injury in the first place, then there might be the possibility to minimize potential damage caused by the diflucan," Dr.

Dekel explained.Study co-authors from the Sheba Medical Center and the Israel Institute for Biological Research include Dorit where can you buy diflucan Omer, PhD, Oren Pleniceanu, MD, PhD, Yehudit Gnatek, MSc, Michael Namestnikov, Osnat Cohen-Zontag, PhD, Sanja Goldberg, PhD, Yehudit Eden Friedman, MD, Nehemya Friedman, PhD, Michal Mandelboim, PhD, Einat B. Vitner, PhD, Hagit Achdout, PhD, Roy Avraham, PhD, Eran Zahavy, PhD, Tomer Israely, PhD, and Haim Mayan, MD.Disclosures. Dr. Dekel is a co-founder and shareholder at KidneyCure Ltd.

Story Source. Materials provided by American Society of Nephrology. Note. Content may be edited for style and length..

Researchers have studied human kidney cells in the lab to buy diflucan online australia examine the effects of antifungal medication browse around this web-site on kidney health. The findings appear in an upcoming issue of JASN.Many individuals who develop antifungal medication also experience kidney damage, but it's unclear if this is a direct result of viral or a consequence of another condition or the body's response to the . To investigate, a team led by Benjamin Dekel, MD, PhD (Sheba Medical Center, in Israel) cultivated human kidney buy diflucan online australia cells in lab dishes and infected them with the diflucan that causes antifungal medication.The researchers found that although the diflucan that causes antifungal medication could enter, infect, and replicate in human adult kidney cells, this did not typically lead to cell death.

Prior to , the cells contained high levels of interferon signaling molecules, and the stimulated an inflammatory response that increased these molecules. In contrast, of kidney cells deficient in such molecules resulted in cell death, suggesting a protective effect.The cells in these experiments were grown as a three-dimensional spheroid that imitates the healthy kidney or as a two-dimensional layer that mimics the cells of an acutely injured kidney. Cells that mimicked an acutely injured kidney were more buy diflucan online australia prone to and additional injury but not cell death."The data indicate that it is unlikely that the diflucan is a primary cause of acute kidney injury seen in antifungal medication patients.

It implies that if such injury takes place in the kidney by any cause, the diflucan might jump on the wagon to intensify it. Therefore, if we're able to limit the common scenario of acute kidney injury in the first place, then there might be the possibility to minimize potential damage caused by the diflucan," Dr. Dekel explained.Study co-authors from the Sheba Medical Center and the Israel Institute for Biological Research include Dorit Omer, PhD, Oren Pleniceanu, MD, PhD, Yehudit Gnatek, MSc, Michael Namestnikov, Osnat Cohen-Zontag, PhD, Sanja Goldberg, PhD, Yehudit Eden Friedman, MD, Nehemya Friedman, PhD, buy diflucan online australia Michal Mandelboim, PhD, Einat B.

Vitner, PhD, Hagit Achdout, PhD, Roy Avraham, PhD, Eran Zahavy, PhD, Tomer Israely, PhD, and Haim Mayan, MD.Disclosures. Dr. Dekel is a co-founder and shareholder at KidneyCure Ltd.

Story Source. Materials provided by American Society of Nephrology. Note.

Content may be edited for style and length..

Diflucan for strep throat

India's National Health Authority seeks comments on UHI projectThe National Health Authority of India is seeking comments from the public on its proposed Unified Health Interface project, which is envisioned to be an diflucan for strep throat open, interoperable platform connecting digital additional reading health solutions.Ahead of the implementation of the National Digital Health Mission (NDHM), the agency has released a consultation paper outlining the UHI's prospective design, scope and role. In a statement, the NHA said it wanted to ensure the project is designed and developed in a "collaborative and consultative manner".A news report noted that patients and providers are presently required to use the same applications to avail and provide digital health services, respectively. The UHI project, whose design is similar to the Unified Payments Interface ecosystem for digital payments, is intended to create an open network where patients and providers diflucan for strep throat can discover, book, pay and fulfil various digital health services, such as teleconsultations, across applications.The NDHM, which was piloted last year in August across six union territories, aims to transform the way digital health services are rendered in India.

"NDHM is endeavouring to make digital public goods for the healthcare industry to make it more accessible, affordable and efficient. To facilitate this, we are diflucan for strep throat taking a consultative approach to develop the National Digital Health Ecosystem," NHA CEO Dr Ram Sewak Sharma said. The NHA is receiving comments and feedback via email until 23 August.

Over 100,000 bookings made on first-day rollout of Book My treatment in New ZealandNew Zealand's national vaccination booking system went online this week, diflucan for strep throat enabling 105,811 bookings on its first day. This latest count brings the total number of future bookings via the Book My treatment system to nearly 950,000, the Health Ministry claimed. Above seven diflucan for strep throat in 10 seniors have either been vaccinated or are already scheduled for inoculation, it added.

In a statement, New Zealand's Director-General of Health Ashley Bloomfield noted that the rollout of the system on 28 July was a "resounding success". All 20 District Health Boards in the country are using the Book My treatment system which the government developed using diflucan for strep throat the Salesforce Skedulo plugin to integrate with the National antifungal medication Immunisation Register. The booking system is also backed by a dedicated national call centre.

Indonesia's Health Ministry eyes nationwide health data integrationIndonesia's Ministry of Health is working towards integrating citizen's health data across platforms for improving diflucan for strep throat the quality of public health.The plan, according to Health Minister Budi Gunadi Sadikin, is to combine data from routine public health checks in hospitals and digital treatment platforms, medicines and records of health activities from smartwatches. He was cited in a news report as saying that artificial intelligence will be used to create a security mechanism or sandbox that can store the data of 200 million Indonesians. Minister Sadikin said the government will first diflucan for strep throat craft standard requirements to enable clinicians access to people's health data.

According to the news report, the initiative was inspired by the use of Big Data and IoT in creating new treatments and drugs. Taiwan's epidemiological investigation platform goes liveThe Centres for Disease Control of diflucan for strep throat Taiwan has announced the launch of the Central Epidemic Command Centre's latest platform to keep track of emerging antifungal medication cases in the country.The Epidemiological Investigation Assistance platform launched early in the week is a system that shows hotspot areas, tracks locations under investigation, and uses a contract tracing text messaging service. In a statement, Taiwan's CDC said the platform is strictly used by authorised personnel who are conducting epidemiological surveillance in local governments.

The system's launch follows the relaxed enforcement of antifungal medication restrictions in the country as cases continue diflucan for strep throat to fall. Taiwan lowered its epidemic alert level from 3 to 2, which allows the gathering of 50 people indoors and 100 people outdoors, among other guidelines.With its relatively small population, Taiwan has recorded above 15,600 antifungal medication cases and 787 deaths. It has so diflucan for strep throat far administered 7.58 million doses of treatment against the disease.

NZHIT presses government to invest in digital health tech researchDigital health industry group New Zealand Health IT has urged the government to prioritise investing in digital health technology research for disease monitoring, among other concerns.In managing health crises like antifungal medication, the country "needs to buy into digital tools", the organisation said. It noted that during the diflucan, digital technology has supported the country's ability to assess the impact diflucan for strep throat of policies targeted at social distancing, thus fostering evidence-based action. "We should revisit past lessons and take strategic action.

We need to invest in digital technology to prepare for future health crises diflucan for strep throat. Our response to the global health crisis demonstrated the vital importance of a strong and vibrant research sector," NZHIT General Manager Ryl Jensen said.NZHIT's appeal comes following the Health Ministry's latest investment in research on some of the country's biggest health concerns, including cancer, diabetes, and heart disease. In a statement, Jensen made the case for supporting research in digital technologies in the healthcare system.She noted that digital health data research can drive the development of predictive models that can quickly identify high-risk patients, as well as present multi-variable patient-specific factors to support and enhance clinical decision making.Jensen also said that research into health data science is a "key tool" to enhance care systems and develop new products, which will provide consumers with new means to improve their own health and wellbeing..

India's National Health Authority seeks comments on UHI projectThe National Health Authority of India is seeking comments from the public on its proposed Unified Health Interface project, which is envisioned to be an open, interoperable platform connecting digital health solutions.Ahead of the implementation of the National http://www.securityresources.com/how-to-buy-lasix/ Digital Health Mission (NDHM), the buy diflucan online australia agency has released a consultation paper outlining the UHI's prospective design, scope and role. In a statement, the NHA said it wanted to ensure the project is designed and developed in a "collaborative and consultative manner".A news report noted that patients and providers are presently required to use the same applications to avail and provide digital health services, respectively. The UHI project, whose design is similar to the Unified Payments Interface ecosystem for digital payments, is intended to create an open network where patients and providers can discover, book, pay and fulfil various buy diflucan online australia digital health services, such as teleconsultations, across applications.The NDHM, which was piloted last year in August across six union territories, aims to transform the way digital health services are rendered in India. "NDHM is endeavouring to make digital public goods for the healthcare industry to make it more accessible, affordable and efficient. To facilitate buy diflucan online australia this, we are taking a consultative approach to develop the National Digital Health Ecosystem," NHA CEO Dr Ram Sewak Sharma said.

The NHA is receiving comments and feedback via email until 23 August. Over 100,000 bookings made on first-day rollout of Book My treatment in New ZealandNew Zealand's national vaccination booking system went online this week, buy diflucan online australia enabling 105,811 bookings on its first day. This latest count brings the total number of future bookings via the Book My treatment system to nearly 950,000, the Health Ministry claimed. Above seven buy diflucan online australia in 10 seniors have either been vaccinated or are already scheduled for inoculation, it added. In a statement, New Zealand's Director-General of Health Ashley Bloomfield noted that the rollout of the system on 28 July was a "resounding success".

All 20 District Health Boards in the country are using the Book My buy diflucan online australia treatment system which the government developed using the Salesforce Skedulo plugin to integrate with the National antifungal medication Immunisation Register. The booking system is also backed by a dedicated national call centre. Indonesia's Health Ministry eyes nationwide health data integrationIndonesia's Ministry of Health is working towards integrating citizen's health data across platforms for improving the quality of public health.The plan, according to Health Minister Budi Gunadi Sadikin, is to combine data buy diflucan online australia from routine public health checks in hospitals and digital treatment platforms, medicines and records of health activities from smartwatches. He was cited in a news report as saying that artificial intelligence will be used to create a security mechanism or sandbox that can store the data of 200 million Indonesians. Minister Sadikin buy diflucan online australia said the government will first craft standard requirements to enable clinicians access to people's health data.

According to the news report, the initiative was inspired by the use of Big Data and IoT in creating new treatments and drugs. Taiwan's epidemiological investigation platform goes liveThe Centres for Disease Control of Taiwan has announced the launch of the Central Epidemic Command Centre's latest platform to keep track of emerging antifungal medication cases in the country.The Epidemiological Investigation Assistance platform launched early in the buy diflucan online australia week is a system that shows hotspot areas, tracks locations under investigation, and uses a contract tracing text messaging service. In a statement, Taiwan's CDC said the platform is strictly used by authorised personnel who are conducting epidemiological surveillance in local governments. The system's launch follows the relaxed enforcement of antifungal medication restrictions in the country buy diflucan online australia as cases continue to fall. Taiwan lowered its epidemic alert level from 3 to 2, which allows the gathering of 50 people indoors and 100 people outdoors, among other guidelines.With its relatively small population, Taiwan has recorded above 15,600 antifungal medication cases and 787 deaths.

It has so far administered 7.58 million doses of treatment buy diflucan online australia against the disease. NZHIT presses government to invest in digital health tech researchDigital health industry group New Zealand Health IT has urged the government to prioritise investing in digital health technology research for disease monitoring, among other concerns.In managing health crises like antifungal medication, the country "needs to buy into digital tools", the organisation said. It noted that during the diflucan, digital technology buy diflucan online australia has supported the country's ability to assess the impact of policies targeted at social distancing, thus fostering evidence-based action. "We should revisit past lessons and take strategic action. We need to invest in digital technology to buy diflucan online australia prepare for future health crises.

Our response to the global health crisis demonstrated the vital importance of a strong and vibrant research sector," NZHIT General Manager Ryl Jensen said.NZHIT's appeal comes following the Health Ministry's latest investment in research on some of the country's biggest health concerns, including cancer, diabetes, and heart disease. In a statement, Jensen made the case for supporting research in digital technologies in the healthcare system.She noted that digital health data research can drive the development of predictive models that can quickly identify high-risk patients, as well as present multi-variable patient-specific factors to support and enhance clinical decision making.Jensen also said that research into health data science is a "key tool" to enhance care systems and develop new products, which will provide consumers with new means to improve their own health and wellbeing..

How long after taking diflucan will itching stop

But then the hotel where he works how long after taking diflucan will itching stop closes its doors, and with his job at risk, Andy starts wondering how serious the threat from the new diflucan really is. No one he knows has died, after all. A colleague posts an article about the antifungal medication “scare” having been created by Big Pharma in collusion with corrupt politicians, which jibes with Andy's distrust of government. His Web search how long after taking diflucan will itching stop quickly takes him to articles claiming that antifungal medication is no worse than the flu.

Andy joins an online group of people who have been or fear being laid off and soon finds himself asking, like many of them, “What diflucan?. € When he learns that several of his new friends are planning to attend a rally demanding an end to lockdowns, he decides to join them. Almost no one at the massive how long after taking diflucan will itching stop protest, including him, wears a mask. When his sister asks about the rally, Andy shares the conviction that has now become part of his identity.

antifungal medication is a hoax. This example illustrates a minefield of cognitive how long after taking diflucan will itching stop biases. We prefer information from people we trust, our in-group. We pay attention to and are more likely to share information about risks—for Andy, the risk of losing his job.

We search for and remember things that fit well with what how long after taking diflucan will itching stop we already know and understand. These biases are products of our evolutionary past, and for tens of thousands of years, they served us well. People who behaved in accordance with them—for example, by staying away from the overgrown pond bank where someone said there was a viper—were more likely to survive than those who did not. Modern technologies how long after taking diflucan will itching stop are amplifying these biases in harmful ways, however.

Search engines direct Andy to sites that inflame his suspicions, and social media connects him with like-minded people, feeding his fears. Making matters worse, bots—automated social media accounts that impersonate humans—enable misguided or malevolent actors to take advantage of his vulnerabilities. Compounding the problem is the proliferation of how long after taking diflucan will itching stop online information. Viewing and producing blogs, videos, tweets and other units of information called memes has become so cheap and easy that the information marketplace is inundated.

Unable to process all this material, we let our cognitive biases decide what we should pay attention to. These mental shortcuts how long after taking diflucan will itching stop influence which information we search for, comprehend, remember and repeat to a harmful extent. The need to understand these cognitive vulnerabilities and how algorithms use or manipulate them has become urgent. At the University of Warwick in England and at Indiana University Bloomington's Observatory on Social Media (OSoMe, pronounced “awesome”), our teams are using cognitive experiments, simulations, data mining and artificial intelligence to comprehend the cognitive vulnerabilities of social media users.

Insights from psychological studies on the evolution of information conducted at Warwick inform the computer models developed at Indiana, and how long after taking diflucan will itching stop vice versa. We are also developing analytical and machine-learning aids to fight social media manipulation. Some of these tools are already being used by journalists, civil-society organizations and individuals to detect inauthentic actors, map the spread of false narratives and foster news literacy. Information Overload The glut of information has generated intense competition for people's attention how long after taking diflucan will itching stop.

As Nobel Prize–winning economist and psychologist Herbert A. Simon noted, “What information consumes is rather obvious. It consumes the attention of its recipients.” One of the first how long after taking diflucan will itching stop consequences of the so-called attention economy is the loss of high-quality information. The OSoMe team demonstrated this result with a set of simple simulations.

It represented users of social media such as Andy, called agents, as nodes in a network of online acquaintances. At each time how long after taking diflucan will itching stop step in the simulation, an agent may either create a meme or reshare one that he or she sees in a news feed. To mimic limited attention, agents are allowed to view only a certain number of items near the top of their news feeds. Running this simulation over many time steps, Lilian Weng of OSoMe found that as agents' attention became increasingly limited, the propagation of memes came to reflect the power-law distribution of actual social media.

The probability that a how long after taking diflucan will itching stop meme would be shared a given number of times was roughly an inverse power of that number. For example, the likelihood of a meme being shared three times was approximately nine times less than that of its being shared once. Credit. €œLimited individual attention and online virality of low-quality information,” By Xiaoyan Qiu et how long after taking diflucan will itching stop al., in Nature Human Behaviour, Vol.

1, June 2017 This winner-take-all popularity pattern of memes, in which most are barely noticed while a few spread widely, could not be explained by some of them being more catchy or somehow more valuable. The memes in this simulated world had no intrinsic quality. Virality resulted purely from the statistical consequences of information proliferation in a social network of agents how long after taking diflucan will itching stop with limited attention. Even when agents preferentially shared memes of higher quality, researcher Xiaoyan Qiu, then at OSoMe, observed little improvement in the overall quality of those shared the most.

Our models revealed that even when we want to see and share high-quality information, our inability to view everything in our news feeds inevitably leads us to share things that are partly or completely untrue. Cognitive biases how long after taking diflucan will itching stop greatly worsen the problem. In a set of groundbreaking studies in 1932, psychologist Frederic Bartlett told volunteers a Native American legend about a young man who hears war cries and, pursuing them, enters a dreamlike battle that eventually leads to his real death. Bartlett asked the volunteers, who were non-Native, to recall the rather confusing story at increasing intervals, from minutes to years later.

He found that as time passed, the how long after taking diflucan will itching stop rememberers tended to distort the tale's culturally unfamiliar parts such that they were either lost to memory or transformed into more familiar things. We now know that our minds do this all the time. They adjust our understanding of new information so that it fits in with what we already know. One consequence how long after taking diflucan will itching stop of this so-called confirmation bias is that people often seek out, recall and understand information that best confirms what they already believe.

This tendency is extremely difficult to correct. Experiments consistently show that even when people encounter balanced information containing views from differing perspectives, they tend to find supporting evidence for what they already believe. And when people with how long after taking diflucan will itching stop divergent beliefs about emotionally charged issues such as climate change are shown the same information on these topics, they become even more committed to their original positions. Making matters worse, search engines and social media platforms provide personalized recommendations based on the vast amounts of data they have about users' past preferences.

They prioritize information in our feeds that we are most likely to agree with—no matter how fringe—and shield us from information that might change our minds. This makes us easy how long after taking diflucan will itching stop targets for polarization. Nir Grinberg and his co-workers at Northeastern University recently showed that conservatives in the U.S. Are more receptive to misinformation.

But our own analysis of consumption of low-quality information on Twitter shows that the vulnerability applies to both sides of the political spectrum, and no one can fully how long after taking diflucan will itching stop avoid it. Even our ability to detect online manipulation is affected by our political bias, though not symmetrically. Republican users are more likely to mistake bots promoting conservative ideas for humans, whereas Democrats are more likely to mistake conservative human users for bots. Credit how long after taking diflucan will itching stop.

Filippo Menczer Social Herding In New York City in August 2019, people began running away from what sounded like gunshots. Others followed, some shouting, “Shooter!. € Only later did they learn that how long after taking diflucan will itching stop the blasts came from a backfiring motorcycle. In such a situation, it may pay to run first and ask questions later.

In the absence of clear signals, our brains use information about the crowd to infer appropriate actions, similar to the behavior of schooling fish and flocking birds. Such social conformity is pervasive how long after taking diflucan will itching stop. In a fascinating 2006 study involving 14,000 Web-based volunteers, Matthew Salganik, then at Columbia University, and his colleagues found that when people can see what music others are downloading, they end up downloading similar songs. Moreover, when people were isolated into “social” groups, in which they could see the preferences of others in their circle but had no information about outsiders, the choices of individual groups rapidly diverged.

But the how long after taking diflucan will itching stop preferences of “nonsocial” groups, where no one knew about others' choices, stayed relatively stable. In other words, social groups create a pressure toward conformity so powerful that it can overcome individual preferences, and by amplifying random early differences, it can cause segregated groups to diverge to extremes. Social media follows a similar dynamic. We confuse popularity with quality and end up copying the behavior we how long after taking diflucan will itching stop observe.

Experiments on Twitter by Bjarke Mønsted and his colleagues at the Technical University of Denmark and the University of Southern California indicate that information is transmitted via “complex contagion”. When we are repeatedly exposed to an idea, typically from many sources, we are more likely to adopt and reshare it. This social bias is further amplified by what how long after taking diflucan will itching stop psychologists call the “mere exposure” effect. When people are repeatedly exposed to the same stimuli, such as certain faces, they grow to like those stimuli more than those they have encountered less often.

Credit. Jen Christiansen how long after taking diflucan will itching stop. Source. Dimitar Nikolov and Filippo Menczer (data) Such biases translate into an irresistible urge to pay attention to information that is going viral—if everybody else is talking about it, it must be important.

In addition to showing us items that conform with our views, social media platforms such as Facebook, Twitter, YouTube and Instagram place popular content at the top of our screens and show us how many people have liked and shared how long after taking diflucan will itching stop something. Few of us realize that these cues do not provide independent assessments of quality. In fact, programmers who design the algorithms for ranking memes on social media assume that the “wisdom of crowds” will quickly identify high-quality items. They use how long after taking diflucan will itching stop popularity as a proxy for quality.

Our analysis of vast amounts of anonymous data about clicks shows that all platforms—social media, search engines and news sites—preferentially serve up information from a narrow subset of popular sources. To understand why, we modeled how they combine signals for quality and popularity in their rankings. In this model, agents with limited attention—those who see only a given number of items at the top of their news feeds—are how long after taking diflucan will itching stop also more likely to click on memes ranked higher by the platform. Each item has intrinsic quality, as well as a level of popularity determined by how many times it has been clicked on.

Another variable tracks the extent to which the ranking relies on popularity rather than quality. Simulations of this model reveal that such algorithmic bias typically suppresses the quality of memes even in how long after taking diflucan will itching stop the absence of human bias. Even when we want to share the best information, the algorithms end up misleading us. Echo Chambers Most of us do not believe we follow the herd.

But our confirmation bias leads us to follow others who how long after taking diflucan will itching stop are like us, a dynamic that is sometimes referred to as homophily—a tendency for like-minded people to connect with one another. Social media amplifies homophily by allowing users to alter their social network structures through following, unfriending, and so on. The result is that people become segregated into large, dense and increasingly misinformed communities commonly described as echo chambers. At OSoMe, we explored how long after taking diflucan will itching stop the emergence of online echo chambers through another simulation, EchoDemo.

In this model, each agent has a political opinion represented by a number ranging from −1 (say, liberal) to +1 (conservative). These inclinations are reflected in agents' posts. Agents are also influenced by the opinions they see in their news how long after taking diflucan will itching stop feeds, and they can unfollow users with dissimilar opinions. Starting with random initial networks and opinions, we found that the combination of social influence and unfollowing greatly accelerates the formation of polarized and segregated communities.

Indeed, the political echo chambers on Twitter are so extreme that individual users' political leanings can be predicted with high accuracy. You have the how long after taking diflucan will itching stop same opinions as the majority of your connections. This chambered structure efficiently spreads information within a community while insulating that community from other groups. In 2014 our research group was targeted by a disinformation campaign claiming that we were part of a politically motivated effort to suppress free speech.

This false charge spread virally mostly in the conservative echo chamber, whereas debunking articles by fact-checkers were found mainly in the liberal community how long after taking diflucan will itching stop. Sadly, such segregation of fake news items from their fact-check reports is the norm. Social media can also increase our negativity. In a how long after taking diflucan will itching stop recent laboratory study, Robert Jagiello, also at Warwick, found that socially shared information not only bolsters our biases but also becomes more resilient to correction.

He investigated how information is passed from person to person in a so-called social diffusion chain. In the experiment, the first person in the chain read a set of articles about either nuclear power or food additives. The articles were designed to be balanced, containing as much positive information (for example, about less carbon pollution or longer-lasting food) as negative information (such as risk of meltdown how long after taking diflucan will itching stop or possible harm to health). The first person in the social diffusion chain told the next person about the articles, the second told the third, and so on.

We observed an overall increase in the amount of negative information as it passed along the chain—known as the social amplification of risk. Moreover, work by Danielle how long after taking diflucan will itching stop J. Navarro and her colleagues at the University of New South Wales in Australia found that information in social diffusion chains is most susceptible to distortion by individuals with the most extreme biases. Even worse, social diffusion also makes negative information more “sticky.” When Jagiello subsequently exposed people in the social diffusion chains to the original, balanced information—that is, the news that the first person in the chain had seen—the balanced information did little to reduce individuals' negative attitudes.

The information that had passed through people not only had become more negative but also was more resistant to updating how long after taking diflucan will itching stop. A 2015 study by OSoMe researchers Emilio Ferrara and Zeyao Yang analyzed empirical data about such “emotional contagion” on Twitter and found that people overexposed to negative content tend to then share negative posts, whereas those overexposed to positive content tend to share more positive posts. Because negative content spreads faster than positive content, it is easy to manipulate emotions by creating narratives that trigger negative responses such as fear and anxiety. Ferrara, now at the University of Southern California, and his how long after taking diflucan will itching stop colleagues at the Bruno Kessler Foundation in Italy have shown that during Spain's 2017 referendum on Catalan independence, social bots were leveraged to retweet violent and inflammatory narratives, increasing their exposure and exacerbating social conflict.

Rise of the Bots Information quality is further impaired by social bots, which can exploit all our cognitive loopholes. Bots are easy to create. Social media platforms provide so-called application how long after taking diflucan will itching stop programming interfaces that make it fairly trivial for a single actor to set up and control thousands of bots. But amplifying a message, even with just a few early upvotes by bots on social media platforms such as Reddit, can have a huge impact on the subsequent popularity of a post.

At OSoMe, we have developed machine-learning algorithms to detect social bots. One of how long after taking diflucan will itching stop these, Botometer, is a public tool that extracts 1,200 features from a given Twitter account to characterize its profile, friends, social network structure, temporal activity patterns, language and other features. The program compares these characteristics with those of tens of thousands of previously identified bots to give the Twitter account a score for its likely use of automation. In 2017 we estimated that up to 15 percent of active Twitter accounts were bots—and that they had played a key role in the spread of misinformation during the 2016 U.S.

Election period how long after taking diflucan will itching stop. Within seconds of a fake news article being posted—such as one claiming the Clinton campaign was involved in occult rituals—it would be tweeted by many bots, and humans, beguiled by the apparent popularity of the content, would retweet it. Bots also influence us by pretending to represent people from our in-group. A bot only has to follow, like and retweet someone in how long after taking diflucan will itching stop an online community to quickly infiltrate it.

OSoMe researcher Xiaodan Lou developed another model in which some of the agents are bots that infiltrate a social network and share deceptively engaging low-quality content—think of clickbait. One parameter in the model describes the probability that an authentic agent will follow bots—which, for the purposes of this model, we define as agents that generate memes of zero quality and retweet only one another. Our simulations show that these how long after taking diflucan will itching stop bots can effectively suppress the entire ecosystem's information quality by infiltrating only a small fraction of the network. Bots can also accelerate the formation of echo chambers by suggesting other inauthentic accounts to be followed, a technique known as creating “follow trains.” Some manipulators play both sides of a divide through separate fake news sites and bots, driving political polarization or monetization by ads.

At OSoMe, we recently uncovered a network of inauthentic accounts on Twitter that were all coordinated by the same entity. Some pretended to be pro-Trump supporters of the Make America Great Again how long after taking diflucan will itching stop campaign, whereas others posed as Trump “resisters”. All asked for political donations. Such operations amplify content that preys on confirmation biases and accelerate the formation of polarized echo chambers.

Curbing Online Manipulation Understanding our cognitive biases how long after taking diflucan will itching stop and how algorithms and bots exploit them allows us to better guard against manipulation. OSoMe has produced a number of tools to help people understand their own vulnerabilities, as well as the weaknesses of social media platforms. One is a mobile app called Fakey that helps users learn how to spot misinformation. The game simulates a social media news feed, showing actual articles from low- how long after taking diflucan will itching stop and high-credibility sources.

Users must decide what they can or should not share and what to fact-check. Analysis of data from Fakey confirms the prevalence of online social herding. Users are more likely to share low-credibility articles when they believe that many other people have shared how long after taking diflucan will itching stop them. Another program available to the public, called Hoaxy, shows how any extant meme spreads through Twitter.

In this visualization, nodes represent actual Twitter accounts, and links depict how retweets, quotes, mentions and replies propagate the meme from account to account. Each node has a color representing how long after taking diflucan will itching stop its score from Botometer, which allows users to see the scale at which bots amplify misinformation. These tools have been used by investigative journalists to uncover the roots of misinformation campaigns, such as one pushing the “pizzagate” conspiracy in the U.S. They also helped to detect bot-driven voter-suppression efforts during the 2018 U.S.

Midterm election how long after taking diflucan will itching stop. Manipulation is getting harder to spot, however, as machine-learning algorithms become better at emulating human behavior. Apart from spreading fake news, misinformation campaigns can also divert attention from other, more serious problems. To combat such manipulation, we have recently developed how long after taking diflucan will itching stop a software tool called BotSlayer.

It extracts hashtags, links, accounts and other features that co-occur in tweets about topics a user wishes to study. For each entity, BotSlayer tracks the tweets, the accounts posting them and their bot scores to flag entities that are trending and probably being amplified by bots or coordinated accounts. The goal is to enable reporters, civil-society organizations and how long after taking diflucan will itching stop political candidates to spot and track inauthentic influence campaigns in real time. These programmatic tools are important aids, but institutional changes are also necessary to curb the proliferation of fake news.

Education can help, although it is unlikely to encompass all the topics on which people are misled. Some governments and social media platforms are also trying to clamp down on online how long after taking diflucan will itching stop manipulation and fake news. But who decides what is fake or manipulative and what is not?. Information can come with warning labels such as the ones Facebook and Twitter have started providing, but can the people who apply those labels be trusted?.

The risk that such measures could deliberately or how long after taking diflucan will itching stop inadvertently suppress free speech, which is vital for robust democracies, is real. The dominance of social media platforms with global reach and close ties with governments further complicates the possibilities. One of the best ideas may be to make it more difficult to create and share low-quality information. This could involve adding friction by forcing people to pay how long after taking diflucan will itching stop to share or receive information.

Payment could be in the form of time, mental work such as puzzles, or microscopic fees for subscriptions or usage. Automated posting should be treated like advertising. Some platforms are already using friction in the form how long after taking diflucan will itching stop of CAPTCHAs and phone confirmation to access accounts. Twitter has placed limits on automated posting.

These efforts could be expanded to gradually shift online sharing incentives toward information that is valuable to consumers. Free communication is not free how long after taking diflucan will itching stop. By decreasing the cost of information, we have decreased its value and invited its adulteration. To restore the health of our information ecosystem, we must understand the vulnerabilities of our overwhelmed minds and how the economics of information can be leveraged to protect us from being misled.Ice skating, ice fishing, snowmobiling.

These iconic winter activities are how long after taking diflucan will itching stop a way of life for many cold-climate communities. But in some regions, they may be on thin ice—literally. New research suggests that winter drownings increase with rising winter temperatures. The warmer the air, the more likely it is that someone will fall through an unstable how long after taking diflucan will itching stop sheet of ice.

That means drownings could increase in cold countries as the climate continues to heat up, the study’s authors warn. Published yesterday in the journal PLOS ONE, the research documents more than 4,000 wintertime drowning incidents from 10 cold-climate countries across the Northern Hemisphere, including the United States, Canada, Finland, Sweden, Russia and Germany. In some countries, how long after taking diflucan will itching stop the data spanned several decades. When analyzed alongside monthly winter climate data, several patterns emerged.

In general, drownings were rare in temperatures below 14 degrees Fahrenheit and above freezing—times when lake ice is at its most stable or when it melts away. They increased sharply how long after taking diflucan will itching stop as temperatures began to approach the freezing point. Drowning rates tended to be highest at the beginning and end of winter—March or April in most of the 10 countries—when the weather is likely to be warmer. The study shows that there’s a statistical relationship between winter temperatures and winter drownings—it doesn’t necessarily prove that the temperatures are the cause.

But the how long after taking diflucan will itching stop researchers suggest that ice thickness is the most likely explanation. As temperatures rise, lake ice becomes less stable and less safe for sport or recreation. That means rising winter temperatures could be a safety risk in cold climates, the authors suggest. The study involved an international group of researchers working together to investigate the links between climate change, lake ice how long after taking diflucan will itching stop and human communities.

The group had begun to look into the implications for winter recreation and cultural events, like ice fishing tournaments, when they realized that winter drownings might be worth investigating. €œThis group of collaborators, we had a call every month,” said Sapna Sharma, the study’s lead author and a researcher at York University in Canada. €œI remember saying to the group, ’Hey, we had a really tragic drowning through ice on a lake just north of how long after taking diflucan will itching stop Toronto where I live.’” Collaborators in the United States and Sweden said similar incidents had occurred recently in their communities as well. The group began to wonder if there were any connections between winter drownings and winter weather.

Their findings suggest that cold-climate communities may wish to reassess the ways they regulate or communicate about winter recreation. While drownings how long after taking diflucan will itching stop did generally increase as winter temperatures approached freezing, the rate of drownings still varied widely from one country to the next. The researchers noted that in countries with stringent rules about winter recreation—local laws in Italy, for instance, prohibit ice fishing and other activities—drownings were far less frequent. On the other hand, the number of drowning incidents tended to be higher in places where winter activities have strong cultural ties, such as Indigenous communities in northern Canada.

The researchers suggest that these communities may be at higher risk as winter temperatures how long after taking diflucan will itching stop rise. The study provides a human angle to a phenomenon scientists are already tracking. Thinning and melting winter lake ice is already an expected consequence of climate change. Last year, a study in Nature Climate Change suggested that just a how long after taking diflucan will itching stop few degrees of warming could cause thousands of lakes across the Northern Hemisphere to go from freezing reliably each winter to freezing only some of the time.

Sharma also led that study. €œI think if I could make one recommendation, it would be to incorporate winter safety and winter ice safety into swimming lessons for children and teens,” Sharma suggested. In general, she said, raising awareness about the dangers of warming winters is key how long after taking diflucan will itching stop to helping keep communities safe. €œIt will just make more people aware that climate is changing, and it’s not happening just for the polar bears or for hurricane strength—it’s happening within our backyards and the lakes and rivers and creeks that we might spend time on in the winters,” she said.

€œAnd we need to adapt our behavior and our decisionmaking on whether a body of water is safe to use.” Reprinted from Climatewire with permission from E&E News. E&E provides daily coverage of essential energy and environmental news at www.eenews.net.One of astronomy’s most renowned telescopes—the 305-metre-wide radio telescope at Arecibo, Puerto how long after taking diflucan will itching stop Rico—is permanently closing. Engineers cannot find a safe way to repair it after two cables supporting the structure suddenly and catastrophically broke, one in August and one in early November. It is the end of one of the most iconic and scientifically productive telescopes in the history of astronomy—and scientists are mourning its loss.

€œI don’t know what to say,” says Robert how long after taking diflucan will itching stop Kerr, a former director of the observatory. €œIt’s just unbelievable.” “I am totally devastated,” says Abel Mendéz, an astrobiologist at the University of Puerto Rico in Arecibo who uses the observatory. The Arecibo telescope, which was built in 1963, was the world’s largest radio telescope for decades and has historical and modern importance in astronomy. It was the site from which astronomers sent an interstellar radio message in 1974, in case any extraterrestrials might hear it, and where the first known extrasolar planet was discovered, in how long after taking diflucan will itching stop 1992.

It has also done pioneering work in detecting near-Earth asteroids, observing the puzzling celestial blasts known as fast radio bursts, and studying many other phenomena. All of those lines of investigation are now shut down for good, although limited science continues at some smaller facilities at the Arecibo site. Assessing the damage The cables that broke helped support a 900-tonne platform of scientific instruments, which hangs above the main how long after taking diflucan will itching stop telescope dish. The first cable smashed panels at the edge of the dish, but the second tore huge gashes in a central portion of it.A high-resolution satellite image, produced at Nature’s request by Planet, an Earth-observing company, shows the extent of the damage wrought by the second cable.

The green of the vegetation below shows through large holes in the dish. A second photograph, released this week by observatory how long after taking diflucan will itching stop officials, also reveals the destruction. They are the only public glimpses of the damage to date. If any more cables fail—which could happen at any time—the entire platform could crash into the dish below.

The US National Science Foundation (NSF), which owns Arecibo Observatory, is working on how long after taking diflucan will itching stop plans to safely lower the platform down in a controlled fashion. But those plans will take weeks to develop, and there’s no telling whether the platform might crash down uncontrollably in the meantime. €œEven attempts at stabilization or at testing the cables could result in accelerating the catastrophic failure,” said Ralph Gaume, the NSF’s head of astronomy, at a 19 November media briefing. So NSF how long after taking diflucan will itching stop decided to close the Arecibo dish permanently.

€œThis decision is not an easy one to make, but safety is the number-one priority,” said Sean Jones, head of NSF’s mathematical and physical sciences directorate. The closure is likely to come as a shock to the wider astronomical community. €œLosing the Arecibo Observatory would be a how long after taking diflucan will itching stop big loss for science, for planetary defense, and for Puerto Rico,” said Desireé Cotto-Figueroa, an astronomer at the University of Puerto Rico at Humacao, in an email prior to the announced closure. NSF officials insist that the cable failures came as a surprise.

After the first, engineering teams spotted a handful of broken wires on the second cable, which was more crucial to holding up the structure, but they did not see it as a major problem because the weight it was carrying was well within its design capacity. €œIt was not seen as an immediate threat,” says Ashley Zauderer, programme manager for Arecibo how long after taking diflucan will itching stop at the NSF. Over the years, external review committees have highlighted the ongoing need to maintain the telescope’s ageing cables. Zauderer said that maintenance had been completed according to schedule.

Before this year, the last major cable problems at the observatory were in January 2014, when a magnitude-6.4 earthquake caused damage to another of the main cables, how long after taking diflucan will itching stop which engineers repaired. The ageing structure has suffered other shocks in recent years, including Hurricane Maria in 2017 and a series of smaller earthquakes in January of this year. There is no estimate yet on the cost of decommissioning the telescope. A legendary site Some how long after taking diflucan will itching stop of the observatory’s scientific projects may be able to be transferred to other facilities, Gaume said—and that he expects scientists to propose where to shift their research to.

Science does continue at other portions of the Arecibo observatory, which encompasses more than the 305-metre dish. They include two lidar facilities that shoot lasers into the atmosphere to study atmospheric phenomena. Arecibo had how long after taking diflucan will itching stop been regularly upgraded, with several new instruments slated to be installed in the coming years. €œThe telescope is in no way obsolete,” says Christopher Salter, an astronomer at the National Radio Astronomy Observatory in Green Bank, West Virginia, who worked at Arecibo for years.

The observatory is also a major science-educational centre for Puerto Rico, fostering the careers of many astronomers and engineers. And it has become a part of the pop culture lexicon, featuring in major movies such as Contact, based on a Carl Sagan novel, and the James Bond film GoldenEye.

When one buy diflucan online australia opines on Facebook that diflucan fears are overblown, Andy dismisses the idea at first. But then the hotel where he works closes its doors, and with his job at risk, Andy starts wondering how serious the threat from the new diflucan really is. No one he knows has died, after all. A colleague buy diflucan online australia posts an article about the antifungal medication “scare” having been created by Big Pharma in collusion with corrupt politicians, which jibes with Andy's distrust of government. His Web search quickly takes him to articles claiming that antifungal medication is no worse than the flu.

Andy joins an online group of people who have been or fear being laid off and soon finds himself asking, like many of them, “What diflucan?. € When he learns that several of his new friends are planning to attend a rally demanding an end to lockdowns, he decides to join buy diflucan online australia them. Almost no one at the massive protest, including him, wears a mask. When his sister asks about the rally, Andy shares the conviction that has now become part of his identity. antifungal medication is a hoax buy diflucan online australia.

This example illustrates a minefield of cognitive biases. We prefer information from people we trust, our in-group. We pay attention to and are more likely to share information buy diflucan online australia about risks—for Andy, the risk of losing his job. We search for and remember things that fit well with what we already know and understand. These biases are products of our evolutionary past, and for tens of thousands of years, they served us well.

People who behaved in accordance with them—for example, by staying away from the overgrown pond bank where someone said there was a viper—were buy diflucan online australia more likely to survive than those who did not. Modern technologies are amplifying these biases in harmful ways, however. Search engines direct Andy to sites that inflame his suspicions, and social media connects him with like-minded people, feeding his fears. Making matters worse, bots—automated social media accounts that impersonate humans—enable misguided or malevolent actors to take advantage of his vulnerabilities buy diflucan online australia. Compounding the problem is the proliferation of online information.

Viewing and producing blogs, videos, tweets and other units of information called memes has become so cheap and easy that the information marketplace is inundated. Unable to buy diflucan online australia process all this material, we let our cognitive biases decide what we should pay attention to. These mental shortcuts influence which information we search for, comprehend, remember and repeat to a harmful extent. The need to understand these cognitive vulnerabilities and how algorithms use or manipulate them has become urgent. At the University of Warwick in England and at Indiana University Bloomington's Observatory on Social Media (OSoMe, pronounced “awesome”), our buy diflucan online australia teams are using cognitive experiments, simulations, data mining and artificial intelligence to comprehend the cognitive vulnerabilities of social media users.

Insights from psychological studies on the evolution of information conducted at Warwick inform the computer models developed at Indiana, and vice versa. We are also developing analytical and machine-learning aids to fight social media manipulation. Some of these tools are already being used by journalists, civil-society organizations and individuals to detect inauthentic actors, buy diflucan online australia map the spread of false narratives and foster news literacy. Information Overload The glut of information has generated intense competition for people's attention. As Nobel Prize–winning economist and psychologist Herbert A.

Simon noted, “What information consumes is buy diflucan online australia rather obvious. It consumes the attention of its recipients.” One of the first consequences of the so-called attention economy is the loss of high-quality information. The OSoMe team demonstrated this result with a set of simple simulations. It represented users of social media such as Andy, called agents, as nodes buy diflucan online australia in a network of online acquaintances. At each time step in the simulation, an agent may either create a meme or reshare one that he or she sees in a news feed.

To mimic limited attention, agents are allowed to view only a certain number of items near the top of their news feeds. Running this simulation over many time steps, Lilian Weng of OSoMe found that as agents' attention became increasingly limited, the propagation of buy diflucan online australia memes came to reflect the power-law distribution of actual social media. The probability that a meme would be shared a given number of times was roughly an inverse power of that number. For example, the likelihood of a meme being shared three times was approximately nine times less than that of its being shared once. Credit buy diflucan online australia.

€œLimited individual attention and online virality of low-quality information,” By Xiaoyan Qiu et al., in Nature Human Behaviour, Vol. 1, June 2017 This winner-take-all popularity pattern of memes, in which most are barely noticed while a few spread widely, could not be explained by some of them being more catchy or somehow more valuable. The memes in buy diflucan online australia this simulated world had no intrinsic quality. Virality resulted purely from the statistical consequences of information proliferation in a social network of agents with limited attention. Even when agents preferentially shared memes of higher quality, researcher Xiaoyan Qiu, then at OSoMe, observed little improvement in the overall quality of those shared the most.

Our models revealed that even when we want to see buy diflucan online australia and share high-quality information, our inability to view everything in our news feeds inevitably leads us to share things that are partly or completely untrue. Cognitive biases greatly worsen the problem. In a set of groundbreaking studies in 1932, psychologist Frederic Bartlett told volunteers a Native American legend about a young man who hears war cries and, pursuing them, enters a dreamlike battle that eventually leads to his real death. Bartlett asked the volunteers, who were non-Native, buy diflucan online australia to recall the rather confusing story at increasing intervals, from minutes to years later. He found that as time passed, the rememberers tended to distort the tale's culturally unfamiliar parts such that they were either lost to memory or transformed into more familiar things.

We now know that our minds do this all the time. They adjust our understanding of new information so that it fits in with what buy diflucan online australia we already know. One consequence of this so-called confirmation bias is that people often seek out, recall and understand information that best confirms what they already believe. This tendency is extremely difficult to correct. Experiments consistently show that even when people encounter balanced information containing views from differing perspectives, they tend to find supporting evidence for what they already buy diflucan online australia believe.

And when people with divergent beliefs about emotionally charged issues such as climate change are shown the same information on these topics, they become even more committed to their original positions. Making matters worse, search engines and social media platforms provide personalized recommendations based on the vast amounts of data they have about users' past preferences. They prioritize information in our feeds that we are most likely to agree with—no matter how buy diflucan online australia fringe—and shield us from information that might change our minds. This makes us easy targets for polarization. Nir Grinberg and his co-workers at Northeastern University recently showed that conservatives in the U.S.

Are more buy diflucan online australia receptive to misinformation. But our own analysis of consumption of low-quality information on Twitter shows that the vulnerability applies to both sides of the political spectrum, and no one can fully avoid it. Even our ability to detect online manipulation is affected by our political bias, though not symmetrically. Republican users are more likely to mistake bots promoting conservative ideas for buy diflucan online australia humans, whereas Democrats are more likely to mistake conservative human users for bots. Credit.

Filippo Menczer Social Herding In New York City in August 2019, people began running away from what sounded like gunshots. Others followed, buy diflucan online australia some shouting, “Shooter!. € Only later did they learn that the blasts came from a backfiring motorcycle. In such a situation, it may pay to run first and ask questions later. In the absence of clear buy diflucan online australia signals, our brains use information about the crowd to infer appropriate actions, similar to the behavior of schooling fish and flocking birds.

Such social conformity is pervasive. In a fascinating 2006 study involving 14,000 Web-based volunteers, Matthew Salganik, then at Columbia University, and his colleagues found that when people can see what music others are downloading, they end up downloading similar songs. Moreover, when people were isolated into “social” buy diflucan online australia groups, in which they could see the preferences of others in their circle but had no information about outsiders, the choices of individual groups rapidly diverged. But the preferences of “nonsocial” groups, where no one knew about others' choices, stayed relatively stable. In other words, social groups create a pressure toward conformity so powerful that it can overcome individual preferences, and by amplifying random early differences, it can cause segregated groups to diverge to extremes.

Social media follows a similar dynamic buy diflucan online australia. We confuse popularity with quality and end up copying the behavior we observe. Experiments on Twitter by Bjarke Mønsted and his colleagues at the Technical University of Denmark and the University of Southern California indicate that information is transmitted via “complex contagion”. When we are repeatedly exposed to an idea, buy diflucan online australia typically from many sources, we are more likely to adopt and reshare it. This social bias is further amplified by what psychologists call the “mere exposure” effect.

When people are repeatedly exposed to the same stimuli, such as certain faces, they grow to like those stimuli more than those they have encountered less often. Credit buy diflucan online australia. Jen Christiansen. Source. Dimitar Nikolov and Filippo Menczer (data) Such biases translate into an irresistible urge to pay attention to information that is going buy diflucan online australia viral—if everybody else is talking about it, it must be important.

In addition to showing us items that conform with our views, social media platforms such as Facebook, Twitter, YouTube and Instagram place popular content at the top of our screens and show us how many people have liked and shared something. Few of us realize that these cues do not provide independent assessments of quality. In fact, programmers who design the algorithms for ranking buy diflucan online australia memes on social media assume that the “wisdom of crowds” will quickly identify high-quality items. They use popularity as a proxy for quality. Our analysis of vast amounts of anonymous data about clicks shows that all platforms—social media, search engines and news sites—preferentially serve up information from a narrow subset of popular sources.

To understand why, we modeled how they combine signals for quality and popularity in their buy diflucan online australia rankings. In this model, agents with limited attention—those who see only a given number of items at the top of their news feeds—are also more likely to click on memes ranked higher by the platform. Each item has intrinsic quality, as well as a level of popularity determined by how many times it has been clicked on. Another variable tracks the extent to which the ranking relies on popularity rather buy diflucan online australia than quality. Simulations of this model reveal that such algorithmic bias typically suppresses the quality of memes even in the absence of human bias.

Even when we want to share the best information, the algorithms end up misleading us. Echo Chambers Most of us do not buy diflucan online australia believe we follow the herd. But our confirmation bias leads us to follow others who are like us, a dynamic that is sometimes referred to as homophily—a tendency for like-minded people to connect with one another. Social media amplifies homophily by allowing users to alter their social network structures through following, unfriending, and so on. The result buy diflucan online australia is that people become segregated into large, dense and increasingly misinformed communities commonly described as echo chambers.

At OSoMe, we explored the emergence of online echo chambers through another simulation, EchoDemo. In this model, each agent has a political opinion represented by a number ranging from −1 (say, liberal) to +1 (conservative). These inclinations are reflected in agents' buy diflucan online australia posts. Agents are also influenced by the opinions they see in their news feeds, and they can unfollow users with dissimilar opinions. Starting with random initial networks and opinions, we found that the combination of social influence and unfollowing greatly accelerates the formation of polarized and segregated communities.

Indeed, the political echo chambers on Twitter are buy diflucan online australia so extreme that individual users' political leanings can be predicted with high accuracy. You have the same opinions as the majority of your connections. This chambered structure efficiently spreads information within a community while insulating that community from other groups. In 2014 our research group was targeted by buy diflucan online australia a disinformation campaign claiming that we were part of a politically motivated effort to suppress free speech. This false charge spread virally mostly in the conservative echo chamber, whereas debunking articles by fact-checkers were found mainly in the liberal community.

Sadly, such segregation of fake news items from their fact-check reports is the norm. Social media can also increase our buy diflucan online australia negativity. In a recent laboratory study, Robert Jagiello, also at Warwick, found that socially shared information not only bolsters our biases but also becomes more resilient to correction. He investigated how information is passed from person to person in a so-called social diffusion chain. In the experiment, the first person in the chain read a set of articles about either nuclear power buy diflucan online australia or food additives.

The articles were designed to be balanced, containing as much positive information (for example, about less carbon pollution or longer-lasting food) as negative information (such as risk of meltdown or possible harm to health). The first person in the social diffusion chain told the next person about the articles, the second told the third, and so on. We observed an overall increase in the amount of negative information as it passed buy diflucan online australia along the chain—known as the social amplification of risk. Moreover, work by Danielle J. Navarro and her colleagues at the University of New South Wales in Australia found that information in social diffusion chains is most susceptible to distortion by individuals with the most extreme biases.

Even worse, social diffusion also makes negative information more “sticky.” When Jagiello subsequently exposed people in the social diffusion buy diflucan online australia chains to the original, balanced information—that is, the news that the first person in the chain had seen—the balanced information did little to reduce individuals' negative attitudes. The information that had passed through people not only had become more negative but also was more resistant to updating. A 2015 study by OSoMe researchers Emilio Ferrara and Zeyao Yang analyzed empirical data about such “emotional contagion” on Twitter and found that people overexposed to negative content tend to then share negative posts, whereas those overexposed to positive content tend to share more positive posts. Because negative content buy diflucan online australia spreads faster than positive content, it is easy to manipulate emotions by creating narratives that trigger negative responses such as fear and anxiety. Ferrara, now at the University of Southern California, and his colleagues at the Bruno Kessler Foundation in Italy have shown that during Spain's 2017 referendum on Catalan independence, social bots were leveraged to retweet violent and inflammatory narratives, increasing their exposure and exacerbating social conflict.

Rise of the Bots Information quality is further impaired by social bots, which can exploit all our cognitive loopholes. Bots are easy to create buy diflucan online australia. Social media platforms provide so-called application programming interfaces that make it fairly trivial for a single actor to set up and control thousands of bots. But amplifying a message, even with just a few early upvotes by bots on social media platforms such as Reddit, can have a huge impact on the subsequent popularity of a post. At OSoMe, we have developed machine-learning algorithms to detect social buy diflucan online australia bots.

One of these, Botometer, is a public tool that extracts 1,200 features from a given Twitter account to characterize its profile, friends, social network structure, temporal activity patterns, language and other features. The program compares these characteristics with those of tens of thousands of previously identified bots to give the Twitter account a score for its likely use of automation. In 2017 we estimated that up to 15 percent of active Twitter accounts were bots—and that they had played a key role in the spread of misinformation during the buy diflucan online australia 2016 U.S. Election period. Within seconds of a fake news article being posted—such as one claiming the Clinton campaign was involved in occult rituals—it would be tweeted by many bots, and humans, beguiled by the apparent popularity of the content, would retweet it.

Bots also influence us by pretending to represent people buy diflucan online australia from our in-group. A bot only has to follow, like and retweet someone in an online community to quickly infiltrate it. OSoMe researcher Xiaodan Lou developed another model in which some of the agents are bots that infiltrate a social network and share deceptively engaging low-quality content—think of clickbait. One parameter in the model describes the probability that an authentic agent will follow bots—which, for the purposes of this model, we define as agents that generate memes of zero buy diflucan online australia quality and retweet only one another. Our simulations show that these bots can effectively suppress the entire ecosystem's information quality by infiltrating only a small fraction of the network.

Bots can also accelerate the formation of echo chambers by suggesting other inauthentic accounts to be followed, a technique known as creating “follow trains.” Some manipulators play both sides of a divide through separate fake news sites and bots, driving political polarization or monetization by ads. At OSoMe, we recently uncovered a network of buy diflucan online australia inauthentic accounts on Twitter that were all coordinated by the same entity. Some pretended to be pro-Trump supporters of the Make America Great Again campaign, whereas others posed as Trump “resisters”. All asked for political donations. Such operations buy diflucan online australia amplify content that preys on confirmation biases and accelerate the formation of polarized echo chambers.

Curbing Online Manipulation Understanding our cognitive biases and how algorithms and bots exploit them allows us to better guard against manipulation. OSoMe has produced a number of tools to help people understand their own vulnerabilities, as well as the weaknesses of social media platforms. One is a mobile app called Fakey buy diflucan online australia that helps users learn how to spot misinformation. The game simulates a social media news feed, showing actual articles from low- and high-credibility sources. Users must decide what they can or should not share and what to fact-check.

Analysis of data from Fakey confirms the buy diflucan online australia prevalence of online social herding. Users are more likely to share low-credibility articles when they believe that many other people have shared them. Another program available to the public, called Hoaxy, shows how any extant meme spreads through Twitter. In this visualization, nodes represent actual Twitter accounts, and links depict how retweets, quotes, buy diflucan online australia mentions and replies propagate the meme from account to account. Each node has a color representing its score from Botometer, which allows users to see the scale at which bots amplify misinformation.

These tools have been used by investigative journalists to uncover the roots of misinformation campaigns, such as one pushing the “pizzagate” conspiracy in the U.S. They also helped to detect bot-driven voter-suppression efforts buy diflucan online australia during the 2018 U.S. Midterm election. Manipulation is getting harder to spot, however, as machine-learning algorithms become better at emulating human behavior. Apart from spreading fake news, misinformation campaigns can also divert attention buy diflucan online australia from other, more serious problems.

To combat such manipulation, we have recently developed a software tool called BotSlayer. It extracts hashtags, links, accounts and other features that co-occur in tweets about topics a user wishes to study. For each entity, BotSlayer tracks the tweets, the accounts posting them and their bot scores to flag entities that are trending and probably being buy diflucan online australia amplified by bots or coordinated accounts. The goal is to enable reporters, civil-society organizations and political candidates to spot and track inauthentic influence campaigns in real time. These programmatic tools are important aids, but institutional changes are also necessary to curb the proliferation of fake news.

Education can help, although it is unlikely to encompass all buy diflucan online australia the topics on which people are misled. Some governments and social media platforms are also trying to clamp down on online manipulation and fake news. But who decides what is fake or manipulative and what is not?. Information buy diflucan online australia can come with warning labels such as the ones Facebook and Twitter have started providing, but can the people who apply those labels be trusted?. The risk that such measures could deliberately or inadvertently suppress free speech, which is vital for robust democracies, is real.

The dominance of social media platforms with global reach and close ties with governments further complicates the possibilities. One of the best ideas may be to make it more difficult to create and buy diflucan online australia share low-quality information. This could involve adding friction by forcing people to pay to share or receive information. Payment could be in the form of time, mental work such as puzzles, or microscopic fees for subscriptions or usage. Automated posting buy diflucan online australia should be treated like advertising.

Some platforms are already using friction in the form of CAPTCHAs and phone confirmation to access accounts. Twitter has placed limits on automated posting. These efforts could be expanded to gradually shift online sharing incentives toward information buy diflucan online australia that is valuable to consumers. Free communication is not free. By decreasing the cost of information, we have decreased its value and invited its adulteration.

To restore the health of our information buy diflucan online australia ecosystem, we must understand the vulnerabilities of our overwhelmed minds and how the economics of information can be leveraged to protect us from being misled.Ice skating, ice fishing, snowmobiling. These iconic winter activities are a way of life for many cold-climate communities. But in some regions, they may be on thin ice—literally. New research buy diflucan online australia suggests that winter drownings increase with rising winter temperatures. The warmer the air, the more likely it is that someone will fall through an unstable sheet of ice.

That means drownings could increase in cold countries as the climate continues to heat up, the study’s authors warn. Published yesterday in the journal PLOS ONE, the research documents more than 4,000 wintertime drowning incidents from buy diflucan online australia 10 cold-climate countries across the Northern Hemisphere, including the United States, Canada, Finland, Sweden, Russia and Germany. In some countries, the data spanned several decades. When analyzed alongside monthly winter climate data, several patterns emerged. In general, drownings were rare in temperatures below 14 degrees Fahrenheit and above freezing—times when lake ice is at its most buy diflucan online australia stable or when it melts away.

They increased sharply as temperatures began to approach the freezing point. Drowning rates tended to be highest at the beginning and end of winter—March or April in most of the 10 countries—when the weather is likely to be warmer. The study buy diflucan online australia shows that there’s a statistical relationship between winter temperatures and winter drownings—it doesn’t necessarily prove that the temperatures are the cause. But the researchers suggest that ice thickness is the most likely explanation. As temperatures rise, lake ice becomes less stable and less safe for sport or recreation.

That means rising winter temperatures could buy diflucan online australia be a safety risk in cold climates, the authors suggest. The study involved an international group of researchers working together to investigate the links between climate change, lake ice and human communities. The group had begun to look into the implications for winter recreation and cultural events, like ice fishing tournaments, when they realized that winter drownings might be worth investigating. €œThis group of buy diflucan online australia collaborators, we had a call every month,” said Sapna Sharma, the study’s lead author and a researcher at York University in Canada. €œI remember saying to the group, ’Hey, we had a really tragic drowning through ice on a lake just north of Toronto where I live.’” Collaborators in the United States and Sweden said similar incidents had occurred recently in their communities as well.

The group began to wonder if there were any connections between winter drownings and winter weather. Their findings suggest that cold-climate communities may buy diflucan online australia wish to reassess the ways they regulate or communicate about winter recreation. While drownings did generally increase as winter temperatures approached freezing, the rate of drownings still varied widely from one country to the next. The researchers noted that in countries with stringent rules about winter recreation—local laws in Italy, for instance, prohibit ice fishing and other activities—drownings were far less frequent. On the buy diflucan online australia other hand, the number of drowning incidents tended to be higher in places where winter activities have strong cultural ties, such as Indigenous communities in northern Canada.

The researchers suggest that these communities may be at higher risk as winter temperatures rise. The study provides a human angle to a phenomenon scientists are already tracking. Thinning and melting winter lake ice is already an expected consequence of climate buy diflucan online australia change. Last year, a study in Nature Climate Change suggested that just a few degrees of warming could cause thousands of lakes across the Northern Hemisphere to go from freezing reliably each winter to freezing only some of the time. Sharma also led that study.

€œI think if I could make one recommendation, it would be to incorporate winter safety and winter ice safety into swimming lessons for children and buy diflucan online australia teens,” Sharma suggested. In general, she said, raising awareness about the dangers of warming winters is key to helping keep communities safe. €œIt will just make more people aware that climate is changing, and it’s not happening just for the polar bears or for hurricane strength—it’s happening within our backyards and the lakes and rivers and creeks that we might spend time on in the winters,” she said. €œAnd we need to adapt our behavior and our decisionmaking on whether a buy diflucan online australia body of water is safe to use.” Reprinted from Climatewire with permission from E&E News. E&E provides daily coverage of essential energy and environmental news at www.eenews.net.One of astronomy’s most renowned telescopes—the 305-metre-wide radio telescope at Arecibo, Puerto Rico—is permanently closing.

Engineers cannot find a safe way to repair it after two cables supporting the structure suddenly and catastrophically broke, one in August and one in early November. It is buy diflucan online australia the end of one of the most iconic and scientifically productive telescopes in the history of astronomy—and scientists are mourning its loss. €œI don’t know what to say,” says Robert Kerr, a former director of the observatory. €œIt’s just unbelievable.” “I am totally devastated,” says Abel Mendéz, an astrobiologist at the University of Puerto Rico in Arecibo who uses the observatory. The Arecibo telescope, which was built in 1963, was the world’s largest radio telescope for decades and has historical buy diflucan online australia and modern importance in astronomy.

It was the site from which astronomers sent an interstellar radio message in 1974, in case any extraterrestrials might hear it, and where the first known extrasolar planet was discovered, in 1992. It has also done pioneering work in detecting near-Earth asteroids, observing the puzzling celestial blasts known as fast radio bursts, and studying many other phenomena. All of those lines of investigation are now buy diflucan online australia shut down for good, although limited science continues at some smaller facilities at the Arecibo site. Assessing the damage The cables that broke helped support a 900-tonne platform of scientific instruments, which hangs above the main telescope dish. The first cable smashed panels at the edge of the dish, but the second tore huge gashes in a central portion of it.A high-resolution satellite image, produced at Nature’s request by Planet, an Earth-observing company, shows the extent of the damage wrought by the second cable.

The green of the vegetation below shows through large holes in the dish buy diflucan online australia. A second photograph, released this week by observatory officials, also reveals the destruction. They are the only public glimpses of the damage to date. If any more cables fail—which could happen at any buy diflucan online australia time—the entire platform could crash into the dish below. The US National Science Foundation (NSF), which owns Arecibo Observatory, is working on plans to safely lower the platform down in a controlled fashion.

But those plans will take weeks to develop, and there’s no telling whether the platform might crash down uncontrollably in the meantime. €œEven attempts at stabilization buy diflucan online australia or at testing the cables could result in accelerating the catastrophic failure,” said Ralph Gaume, the NSF’s head of astronomy, at a 19 November media briefing. So NSF decided to close the Arecibo dish permanently. €œThis decision is not an easy one to make, but safety is the number-one priority,” said Sean Jones, head of NSF’s mathematical and physical sciences directorate. The closure is likely to come as a shock to the wider astronomical community.

€œLosing the Arecibo Observatory would be a big loss for science, for planetary defense, and for Puerto Rico,” said Desireé Cotto-Figueroa, an astronomer at the University of Puerto Rico at Humacao, in an email prior to the announced closure. NSF officials insist that the cable failures came as a surprise. After the first, engineering teams spotted a handful of broken wires on the second cable, which was more crucial to holding up the structure, but they did not see it as a major problem because the weight it was carrying was well within its design capacity. €œIt was not seen as an immediate threat,” says Ashley Zauderer, programme manager for Arecibo at the NSF. Over the years, external review committees have highlighted the ongoing need to maintain the telescope’s ageing cables.

Zauderer said that maintenance had been completed according to schedule. Before this year, the last major cable problems at the observatory were in January 2014, when a magnitude-6.4 earthquake caused damage to another of the main cables, which engineers repaired. The ageing structure has suffered other shocks in recent years, including Hurricane Maria in 2017 and a series of smaller earthquakes in January of this year. There is no estimate yet on the cost of decommissioning the telescope. A legendary site Some of the observatory’s scientific projects may be able to be transferred to other facilities, Gaume said—and that he expects scientists to propose where to shift their research to.

Science does continue at other portions of the Arecibo observatory, which encompasses more than the 305-metre dish. They include two lidar facilities that shoot lasers into the atmosphere to study atmospheric phenomena. Arecibo had been regularly upgraded, with several new instruments slated to be installed in the coming years. €œThe telescope is in no way obsolete,” says Christopher Salter, an astronomer at the National Radio Astronomy Observatory in Green Bank, West Virginia, who worked at Arecibo for years. The observatory is also a major science-educational centre for Puerto Rico, fostering the careers of many astronomers and engineers.