Oxford University Press's Blog, page 947
May 8, 2013
This is your brain on food commercials…
Gooey chocolate and scoops of mouth-watering chocolate ice cream. Steaming hot golden French fries. Children see thousands of commercials each year designed to increase their desire for foods high in sugar, fat, and salt like those mentioned above. Yet, we know almost nothing about how this advertising onslaught might be affecting the brain.
A recent study in Social Cognitive and Affective Neuroscience conducted by researchers from the University of Michigan, Oregon Research Institute, and Yale University starts to uncover how the brain responds to food commercials in teens. Thirty adolescents visited a lab to watch a typical television show that included commercial breaks composed of frequently advertised food (e.g., McDonald’s, Wendy’s) and non-food commercials (e.g., AT&T, Ford). But unlike a typical TV viewing experience, these participants had their brain response measured in a functional magnetic resonance imaging (fMRI) scanner.
While watching the food commercials, regions of the brain linked with reward, attention, and cognition were more active for all participants. After completing the fMRI scan, teens also remembered the food commercials better than the non-food commercials. Why does this matter? It appears that food advertisements (by far the most frequently marketed product to this age group) are better at getting into the mind and memory of kids. This makes sense because our brains are hard-wired to get excited in response to delicious foods. When these calorie-laden products are combined with $1 billion dollars’ worth of marketing by the food and beverage industry, it creates a potent combination.
Surprisingly, healthy-weight teens had greater brain activity in regions associated with reward and attention than obese adolescents. Why might this be? The study suggests that obese adolescents may have been trying to control their response to the food commercials, which might have altered the way their brain responded.
Yet, what happens after obese teens come into contact with more and more food cues later that day? Their self-control might decline in the face of an environment that pushes consumption of high-calorie foods. If a teen is stressed, hungry, or depressed, his or her willpower might be even more likely to falter. The healthy-weight adolescents might also be impacted by how their brain responds to food commercials, but the consequences might not be apparent immediately. A number of brain regions that were more responsive in the lean adolescents during the food commercials have been linked with future weight gain. It will be important to explore how brain responses to food marketing might be related to increased risk of obesity in the future.
This research highlights the possible ways that food advertising may affect younger generations. How do we prevent food advertisers from being the major driver of what our kids eat? We can rely solely on parents to police what teenagers buy or attempt to educate children about how advertising might impact them. We also may need to set guidelines that prevent marketers from aggressively targeting kids with commercials for unhealthy foods. The road ahead is not without challenges, but action must be taken to turn back the tide of childhood obesity.
Dr. Ashley N. Gearhardt is an assistant professor of psychology at the University of Michigan. Her work focuses on the overlap between addictive and eating behaviors, as well as the role of the environment in obesity. Gearhardt is a co-author of the study ‘Relation of Obesity to Neural Activation in Response to Food Commercials‘, which is published by the journal Social Cognitive and Affective Neuroscience.
Social Cognitive and Affective Neuroscience (SCAN) provides a home for the best human and animal research that uses neuroscience techniques to understand the social and emotional aspects of the human mind and human behavior.
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Image credit: French fries. By dja65, via iStockphoto
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May 7, 2013
Advice from the CDC on travel and H7N9
Avian influenza. H7N9. Bird flu. If you are planning a trip to China, these phrases might have you concerned. There are still many uncertainties regarding the new influenza A (H7N9) virus: it isn’t clear where the virus started or how people are getting sick, and a vaccine is not yet available. Amid these unanswered questions, it’s not surprising that many travelers are doubting their plans. You may find yourself wondering if travel to China is still safe, or if you should cancel your trip.
Travelers should be aware that the Centers for Disease Control and Prevention (CDC) is not recommending against travel to China at this time. Currently no sustained person-to-person spread of the H7N9 virus has been found. So, while public health officials will continue closely monitoring the situation and working to determine how the virus is spreading, travelers don’t need to cancel their trips at this time.
However, travelers and their physicians should take this opportunity to remember that healthy behaviors are always important, especially while traveling. CDC is repeating its standard advice to travelers and Americans living in China to follow good hand hygiene and food safety practices and to avoid contact with animals. Simple actions like staying away from animals, eating food that is fully cooked, and washing your hands often can go a long way toward preventing illness (including H7N9). Travelers should also see a doctor right away if they become sick with fever, coughing, or shortness of breath during or after travel to China.
It’s important for travelers to remember that, although new illnesses like H7N9 make it into the news, any international travel can pose a health risk if you aren’t prepared. If you are planning an international trip, you should visit your doctor at least 4-6 weeks before your trip. You may need vaccines or medicine to stay healthy while traveling and your doctor can advise you on actions you can take while you are overseas to make sure your trip is safe and healthy.
For the most up-to-date information for travelers from the CDC regarding H7N9, see the CDC Travel Notice. CDC will also provide updated information on the H7N9 situation as it becomes available. For more information on healthy travel, please visit the CDC travel website and follow them on Twitter @CDCtravel.
Megan Crawley O’Sullivan, MPH is a Health Communications Specialist in the Travelers’ Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention.
The new 2014 edition of CDC Health Information for International Travel (commonly known as The Yellow Book) will be released later this year by Oxford University Press.
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Getting from “is” to “ought” near the end of life
There is a saying in ethics: you can’t get an “ought” from an “is.” Descriptions of the world as it is do not reveal truths about the world as it ought to be. Even when descriptions of real-world conditions suggest that something is seriously wrong — that our actions are causing unintended and avoidable harms to ourselves, to others, to our common environment — reaching agreement on how we ought to change our thinking and our behavior, and then putting these changes into practice, is hard. Efforts at reform may fail again and again, but we need “is” to understand how to get to “ought.” In health care work, describing and reflecting on current conditions can shed light on persistent ethical challenges. Palliative care workers who focus on the relief of suffering and other goals central to the care of the sick observe and experience many such challenges daily.
In the United States each year, 2.5 million people die. Because cause of death is often a condition typically associated with age, Medicare billing-code data offers a reliable way to understand where older people were, day by day, as they approached the end of their lives. A recent article by Joan M. Teno, health services researcher at Brown University, and her team, published in JAMA in February 2013 and subsequently picked up by the media, compared samples of Medicare patients who died in 2000, 2005, and 2009. Each sample included nearly 300,000 patients, all of whom had a medical diagnosis of cancer, chronic obstructive pulmonary disease, or dementia for the final six months prior to death. This data suggests that these patients were hospice-eligible and their deaths were not unexpected.
Digging into the data, the researchers found that over the course of this nine-year period the percentage of patients who died in hospice increased. However, these hospice referrals tended to come only after dying patients had spent time in the intensive care unit. That is, the intensity of treatment near the very end of life first spiked sharply upward. As Teno and her co-authors explain, “Site of death, as noted on a death certificate, only provides information on where a person was at the moment of death,” while understanding the end of life as an “experience” involves looking at all places of care, the transitions between these places, and when and why these transitions occurred. They conclude that, even with more frequent referrals to hospice and the expansion of palliative care programs in hospitals over the period they studied, “the notion that there is a trend toward less aggressive care” may be unfounded.
Reading Joan Teno’s careful research and analysis in this article and others, I am reminded of the technique of Jan van Eyck, the 15th century northern European painter who was the first master of the new medium of oil painting. Analysis of van Eyck’s works reveal that he applied layer upon layer of translucent paint to create the impression of light that shapes space and reveals surface and texture. (The Getty Museum has created this public website of images from its recent documentation of van Eyck’s “Ghent Altarpiece.”) It was not a quick or simple way to work, but it built up the light. So, too, does the science that describes, day by day, layer by layer, the complexity of the end of life in our society, and that suggests the complexity of the work needed to change this experience. If the picture that emerges from this study — of the ICU as the route to hospice — troubles us, are we willing to think and act differently? And how much earlier in the journey?
Nancy Berlinger is a research scholar at The Hastings Center. With Bruce Jennings and Susan M. Wolf, she is the author of The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life: Revised and Expanded Second Edition (Oxford University Press, 2013). Learn more at HastingsCenterGuidelines.org.
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Image credit: Nursing home corridor by Thomas Bjørkan (Own work). Creative commons licensce via Wikimedia Commons.
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The limits of American power, a historical perspective
Just when, where, why, and how should American power be used? Current assumptions about the near omnipresence—though far from omnipotence—of US power, its influence and its reach are now shaky. Yet these same assumptions coexist alongside widely shared views that such power could and should be used. Perspectives on the application of US power are hotly contested—ranging from the advocacy of using force and providing “lethal aid” to revolutionaries in Syria, to the idea of strategic (née preemptive) bombing of nuclear facilities in Iran. Only idealistic aims—e.g. humanitarian intervention and foreign aid—in the use of power are generally acceptable. Indeed, even as the President and Secretary of Defense aver that “all options are being evaluated,” they do not “foresee boots on the ground.” These choices reflect recent developments. Such alternatives simply did not exist for most of US history. Nor, of course, did the nation always hold the power it possesses today.
For the majority of American history weakness, not strength—and certainly not “power” as we understand it now—defined how American policymakers, thinkers, activists, military leaders, and citizens tended to understand their nation’s place in the world. Protecting the state, not using scarce power or resources abroad, and holding European—especially British—encroachment as far off as possible, were the preferred military and diplomatic strategies of US leaders and citizens through the late nineteenth century and, for many, well into the twentieth century.
Three policy pillars in American foreign relations are the foundation for past as well as present considerations of whether and how to deploy US power. The premise for all three was an understanding of weakness, what we might term cautious realism coupled to a vision of isolation, which sought to stay out of power politics, foreign wars, and binding international treaties and regimes.
George Washington in his Farewell Address of 1796 designed this architecture: “to steer clear of permanent alliances with any portion of the foreign world.” Yet even before that speech, Washington had established the nation’s neutrality as a formal policy tradition with the Proclamation of Neutrality (1793) and the Neutrality Act (1794). These neutrality declarations ran contrary to the alliance with France, which had helped win the Revolutionary War. They officially distanced the US from allies and enemies alike and asserted the guiding principle that America would pursue “a conduct friendly and impartial towards the Belligerent powers.” Washington’s Farewell Address, partly written by Alexander Hamilton along with James Madison and read in Congress almost every year until quite recently, set the explicitly isolationist tone. It aimed to recognize the nation’s limited power in order to nurture the safety and progress of the state (and hence, national power one might say). These, in turn, became the basis for virtually all subsequent invocations of a “tradition” in American foreign relations. Washington built on this notion of the new nation as neutral and impartial when he put forward the classic formulation:
The great rule of conduct for us, in regard to foreign nations, is in extending our commercial relations, to have with them as little political connection as possible…. Europe has a set of primary interests, which to us have none, or a very remote relation. Hence she must be engaged in frequent controversies the causes of which are essentially foreign to our concern…. Therefore, it must be unwise in us to implicate ourselves, by artificial ties, in the ordinary vicissitudes of her politics, or the ordinary combinations and collisions of her friendships or enmities.
These Washingtonian principles did not turn the nation away from the world. Instead, the ideas formed the crux of foreign policy realism and argued for a cautious sense of America’s place in the world and for choosing “war or peace, as our interest, guided by justice, shall counsel.” Washington took into account the inherent fragility of American power and the nation’s precarious place in the world, emphasizing America’s distant geographical position as a key to strategic separation and as a brake on involvement in Europe’s hazardous political system. These views were then established as precedent by John Adams and reaffirmed by Thomas Jefferson, who allayed the fears of many Federalists when he underscored a shared set of Washingtonian-Adamsian foreign policy principles in his own inaugural address in 1801.
Jefferson asserted this ideal as “peace, commerce, and honest friendship with all nations, entangling alliances with none.” Jefferson held a clear belief grounded on the practicality of a type of isolation: enter no enduring alliances with the Old World and steer clear of Europe’s petty squabbles. Jefferson’s daring and farsighted purchase of the Louisiana Territory in 1803 propelled the great mission of continental expansion and improvement, doubling the nation’s territory. And of course the Purchase limited the amount of North American land that European powers could claim or conquer. When regarded in this light, his unilateralist efforts were consistent with the idea of isolation as a guarantee toward maintaining and protecting national sovereignty—of giving the weak, fledgling nation time to develop and grow while avoiding entanglements such as those that Ben Franklin derisively termed Europe’s “romantick Continental Connections.”
A circumspect view of American power still was evident in 1823, when President James Monroe pronounced his doctrine. An ambitious articulation of American hemispheric power, the Monroe Doctrine evolved as the guiding view for later foreign policy advocates of interventionism as well as isolationism, many of whom agreed that unilateral involvement across the Americas was perfectly legitimate, but that beyond the Western Hemisphere the nation should avoid foreign wars and the corruptions of particularly Old World political intrigues. Monroe centered this argument on what he saw as an obvious fact: “With the movements in this hemisphere we are of necessity more immediately connected,” and therefore he declared that “we should consider any attempt on their part to extend their system to any portion of this hemisphere as dangerous to our peace and safety.”
Thus, in three bold strokes, Washington, Jefferson, and Monroe laid out the essential isolationist mode of thinking about their young nation’s most advantageous relationship to the world. As we will be discussing at the Oregon State University American Military and Diplomatic History Conference today, 7 May 2013, these arguments became the benchmarks that a broad range of subsequent politicians, thinkers, and citizens later had to confront as they built their own cases for engagement abroad and justified their developing visions of internationalism. One point is clear about interpreting the meaning of their words in their own time. This dedicated triad of America’s founders articulated a commerce-first form of unilateralism and a sense of cautious realism, which at its most fundamental level sought to protect their young, weak nation by favoring isolation from almost all entangling alliances as well as conflicts abroad, particularly those involving Europe.
Americans today debate possible new interventions, withdrawals, disputes over what does and does not constitute a “red line,” and other applications of power abroad in light of enormous geopolitical changes and challenges. Let the debate consider the long history of cautious realism, the recognition of the limits to power, and the concern about the unintended consequences of foreign policy adventurism. The history cannot be blinked away. It is central to American diplomatic and military policy.
Christopher McKnight Nichols is a professor at Oregon State University and a Senior Editor for the Oxford Encyclopedia of American Military and Diplomatic History. View the Melbourne launch of the Encyclopedia, or attend the American Military and Diplomatic History conference at Oregon State University on 7 May 2013.
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Image credit: USA at night. Image by 1xpert, iStockphoto.
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International humanitarianism in the United States
Each year on 8 May, the Red Cross and Red Crescent societies of dozens of nations unite in celebration of World Red Cross/Red Crescent Day. This global event observes the birthday of Henry Dunant, one of the founders of the International Committee of the Red Cross and Red Crescent (ICRC), and commemorates the humanitarian principles that this organization represents. This year’s Red Cross Day is a particularly noteworthy occasion for the year 2013 marks the 150th anniversary of the ICRC’s founding.
This 8 May 2013, the American Red Cross (ARC) will join 186 other national societies in marking this momentous occasion and honoring the ICRC’s sesquicentennial. This probably comes as little surprise: after all, the ARC is an important and influential humanitarian organization, both domestically and globally. And yet, this has not always been the case. It was not until 1881, 18 years after the ICRC’s creation, that US citizens formed their own national Red Cross society. Only in the early 20th century, moreover, did the ARC come to be recognized as a major international war and disaster relief society. The story of these developments — of the creation of the American Red Cross and its path to becoming the official voluntary aid association of the United States — is an important part of the history of US international engagement, and of its evolution at the turn of the last century.
This process began in 1859, when a young Swiss citizen named Henry Dunant observed a bloody battle in Solferino, Italy and witnessed the horrors of wartime suffering firsthand. The experience convinced him of the necessity of establishing permanent associations of humanitarian volunteers, ready to provide neutral medical care on the battlefield whenever the need arose. These ideas started coming to fruition when, in February 1863, Dunant met with four fellow Swiss citizens in Geneva to develop an organization dedicated to the relief of wounded soldiers. The result of their meeting would be the formation of the International Committee of the Red Cross. The ICRC’s founding members lobbied for two goals: the creation of Red Cross societies in every nation and the passage of new international laws to protect both wounded soldiers and aid workers. By August 1864, their mission had achieved considerable success. In Geneva, representatives from twelve nations signed a treaty to establish international standards for wartime humanitarianism, the First Geneva Convention. In the ensuing months and years, additional countries would become signatories as well.
Jean Henri Dunant (1828-1910), Swiss author and philanthropist, founder of the Red Cross society. Image courtesy of the Library of Congress.
In 1864, the ICRC’s leaders invited the United States to participate in this fledgling international humanitarian movement. However, the US government demurred. Preoccupied with the nation’s ongoing Civil War, policymakers had their hands full with domestic concerns. Yet even after the Civil War came to an end, US diplomatic officials chose not to follow the growing number of nations that had signed the Geneva Treaty. Citing longstanding precedents in US foreign policy, dating back to the 18th century, government officials declared it best for the United States to avoid entering any entangling political alliances with Europe.
Not all Americans agreed with this decision. Several former members of the U.S. Sanitary Commission, an agency that provided aid to sick and wounded Union soldiers during the US Civil War, lobbied the government to join the International Red Cross Movement. Beginning in the early 1870s, so did an American woman named Clara Barton. Barton had served as a volunteer during the Civil War, helping to deliver medical supplies to Union field hospitals and to identify wounded and dead soldiers. After the Civil War ended, she traveled to Europe to rest and recover. Soon, however, she became involved again in war relief. After the outbreak of the Franco-Prussian War, Barton volunteered with the newly formed ICRC to assist its medical aid efforts. It was there that she met Dunant and became inspired by his international humanitarian mission.
Clara Barton, (1821-1912), president of the American Red Cross from 1882 until 1904. Image courtesy of The Library of Congress.
In 1873, Barton returned to the United States and began to lobby against the U.S. government’s policy of non-engagement. For nearly a decade, she led a twin crusade for US ratification of the Geneva Convention and the formation of an American Red Cross society. Eventually, Barton achieved both of her goals. In May 1881, she and fifty-one other US citizens drafted and signed a charter to create the American Association of the Red Cross. The next year, in the spring of 1882, the United States joined a growing body of nations — in Europe and throughout the world — in ratifying the Geneva Convention. US government officials had come to see signing the Geneva Convention as compatible and consistent with US foreign policy goals. As Secretary of State James G. Blaine put it, the American tradition of non-entanglement in foreign political affairs “was not meant to ward off humanity.” Thus, in the early 1880s, the United States became a belated entrant into the world’s foremost international humanitarian movement.
The ARC remained quite limited, in terms of its membership, finances, and power, for several decades to come. It was not until 1900 that the US Congress granted the organization its federal charter. Although President William Howard Taft designated the agency as the “official volunteer aid department of the United States” in 1911, it was only during the First World War — fifty years after the First Geneva Convention — that the ARC began to attain broad popular support and financial stability. It took US entry into the conflict, in April 1917, for the ARC to truly solidify its status as the recognized face of American humanitarian aid.
American Red Cross Parade, Birmingham, Alabama. Birmingham View Company., 05/21/1918. Image courtesy of the U.S. National Archives.
Despite this slow progress, the creation of the American Red Cross and the subsequent US ratification of the Geneva Convention in the early 1880s marked a major milestone in the histories of US humanitarianism and international cooperation. On 8 May, as the world unites in celebration of the 150th anniversary of the ICRC, it is worth taking a moment to remember how the United States and its citizens came to see relieving the suffering of others as a national and an international obligation.
Julia F. Irwin is an Assistant Professor of History at the University of South Florida. She specializes in the history of U.S. relations with the 20th century world, with a particular focus on the role of humanitarianism in U.S. foreign affairs. She is the author of Making the World Safe: The American Red Cross and a Nation’s Humanitarian Awakening . Her current research focuses on the history of U.S. responses to global natural disasters.
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Beatlemania
Fifty years ago, in March of 1963, The Beatles released their first album entitled Please Please Me. While the music partly based on British folk and popular forms—including skiffle and music-hall styles—American rock ’n’ roll was by far their dominant resource. The album quickly dominated the British charts and led the group to a path of superstardom that changed the world forever.
To celebrate the release on this monumental album, Oxford Bibliographies has released an extensive bibliography on The Beatles with chapters on the early years of in Liverpool and Hamburg, Beatlemania, individual studies of John, Paul, George, and Ringo. In addition to the new bibliography article, Oxford Music Online has a comprehensive collection of articles on the fab four, with articles on each Beatles album. Each article talks about the history of the album, its creation and the impact it made on the music world. To celebrate Beatlemania, it’s now time for a quiz…
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Developed cooperatively with scholars and librarians worldwide, Oxford Bibliographies offers exclusive, authoritative research guides. Combining the best features of an annotated bibliography and a high-level encyclopedia, this cutting-edge resource guides researchers to the best available scholarship across a wide variety of subjects.
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May 6, 2013
Give weight-loss diets a rest
A respected cardiologist of our acquaintance recently confessed that he often tells his patients to lose weight. This may sound like good advice, but he knows better. Scores of clinical studies show that heavier patients with heart disease are, on average, less likely to die than thinner ones. Furthermore, weight loss efforts are typically counterproductive. Our cardiologist friend knows the studies but can’t quite bring himself to let go of the association between weight and health. He is not alone. In fact, the pervasive clinical and cultural bias against fat and fat people distorts medical practice, despite mounting evidence that human metabolic function is far more complex than previously understood.
Weight Loss Advertisement from Woman Beautiful Magazine, November 1908 via Library of Congress
It is true that heavier individuals are more likely to develop heart disease on average than are thinner patients, although it is not clear that being heavier causes heart disease. It may be that some related factor or factors — such as diet, exercise, stress, socio-economic status or a combination of these — causes both increased weight and makes one susceptible to heart disease.
That said, a growing body of evidence has shown that, among people who already have heart disease, heavier patients are less likely to die. This is so counter-intuitive that medical researchers refer to this burgeoning body of research as “reverse epidemiology” or the “obesity paradox.”
A recent study has shown that this “obesity paradox” holds for Type II Diabetes as well. Granted, people in the general population are more likely to develop Type II Diabetes in the first place if they are heavier, although the causal pathways remain unknown. However, among those who develop Type II Diabetes, many are in the “normal weight” category. Furthermore, among Type II Diabetes patients, the heavier ones are less likely to die than their thinner counterparts.
In the general population, heavier body mass is indeed associated with cardiometabolic abnormalities (i.e., high blood pressure, triglycerides, cholesterol, glucose, insulin resistance and inflammation). However, even here, the association is far from perfect. Specifically, almost one quarter of “normal weight” people — or 16 million Americans — have metabolic abnormalities, whereas more than half of “overweight” and almost one third of “obese” people — or 56 million Americans — have normal profiles, according to a 2008 study. We are beginning to understand that it is not the quantity but rather the quality of fat in our bodies that predicts cardiovascular risk; the unseen fat deeply embedded in our internal organs, known as visceral adipose tissue, is the type of fat most likely to lead to cardiometabolic abnormalities while visible fat beneath our skin may be more metabolically benign.
These studies belie the idea that heavier or bigger bodies are automatically diseased bodies and that weight loss is a panacea. When we further consider that 90-95% of dieters end up regaining what they lose, and that use of diet drugs or supplements may be particularly dangerous in patients with heart disease, the insistence on weight loss is more puzzling.
Rubber Reducing Garment advertising, Woman Beautiful Magazine, November 1908. via Library of Congress
“It took a lot of self-discipline, but I finally gave up dieting,” quips a popular Facebook posting. This post is funny because it inverts the common assumption that dieting requires discipline and is a virtuous endeavor. Indeed, being fat is still widely regarded as evidence of the sins of sloth and gluttony, despite — or perhaps because — of growing talk of “obesity” as a medical problem and public health crisis. It is this conviction that being fat is morally wrong that makes it hard for doctors, as well as ordinary people, to give up dieting and dieting advice. This is all the more true in times and places, like the contemporary United States, where the socially and economically privileged tend to be thin and the disadvantaged are more likely to be heavy.
Especially distressing are studies showing that many medical professionals regard their heavy patients as lazy and non-compliant. A recent study showed that doctors treat their heavy patients with less empathy and compassion than their thinner peers. In extreme cases, convinced that excess weight is responsible for ill health and that weight loss is the solution, doctors may not conduct necessary diagnostic exams that would have pointed to the underlying cause of illness.
It is time that medical professionals give up the focus on fat. This won’t be easy; the belief that if overweight and obese patients lost weight they would be healthier is deeply embedded in both our popular and our medical culture. Yet, there is a better way. Rather than focusing on outward appearance, it would be infinitely more productive and accurate to talk about cardiometabolic risk and to recognize that there are both metabolically-healthy and metabolically-unhealthy individuals in all categories of weight. Instead of promoting weight loss, doctors should emphasize that patients of all sizes incorporate physical activity and a balanced diet into their lives. Several studies have shown that physically fit “obese” individuals have lower incidence of heart disease and mortality from all causes than do sedentary people of “normal” weight. Similarly, a recent clinical trial published in the New England Journal of Medicine showed that adopting a Mediterranean diet reduced cardiovascular risk without inducing weight loss. The sixth of May is International No-Diet Day and a good time for doctors and patients alike to give up their unhealthy focus on weight loss.
Abigail C. Saguy, PhD is Associate Professor and Vice Chair of Sociology at UCLA and author of What’s Wrong with Fat? (Oxford, 2013).Tamara B. Horwich, MD, MS is a UCLA cardiologist who has published research on the link between body mass and mortality among heart disease patients.
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Adopt the Marketplace Fairness Act
The Marketplace Fairness Act, now being debated in the US Senate, is a rare phenomenon: a bill with strong bi-partisan support and an accurate title. The Act would indeed establish fairness in the marketplace by imposing on out-of-state internet and mail order sellers the same sales tax withholding requirements now imposed only on in-state brick-and-mortar businesses. The Senate and then the House should adopt the Marketplace Fairness Act so that the President can sign it into law.
In 1992, the US Supreme Court in Quill Corporation v. North Dakota held that a state cannot require out-of-state sellers to collect sales taxes when such sellers ship goods into the state since such out-of-state sellers have no physical presence in the state. Quill Corporation conducted a classic mail order business in North Dakota. Quill sold office and equipment supplies to North Dakota customers, but had no salespersons, stores or other physical presence in North Dakota. Quill Corporation advertised in North Dakota, mailed catalogs and flyers to North Dakota households, and shipped purchased goods to North Dakota customers via mail or common carrier.
Since Quill Corporation had no in-state physical presence, the US Supreme Court ruled, North Dakota could not require Quill to collect sales tax from North Dakota customers on such customers’ purchases. However, the Court made clear, Congress can change this result by federal legislation authorizing states to impose sales tax withholding obligations on out-of-state sellers.
Since Quill, online commerce has burgeoned in important measure because out-of-state internet firms need not collect sales taxes while stores with in-state presence must. This unfairly disadvantages both ma-and-pa in-state stores which must collect sales taxes and so-called click-and-brick sellers like Staples.com and Walmart.com which, because of their in-state stores, must collect sales taxes on their internet sales. In contrast, online and mail order sellers which eschew such in-state stores can effectively sell sales tax-free since, under current law, such sellers cannot be required to collect sales taxes because they are not physically present in the state.
This situation is neither fair nor efficient. Technically, purchasers of online and mail order merchandise must on their own pay taxes on their purchases from out-of-state firms. In practice, the states cannot collect and enforce taxes on most online and mail order purchases. This disadvantages in-state businesses which must collect sales taxes while their internet and mail order competitors need not.
The Marketplace Fairness Act would overturn Quill for large internet and mail order sellers. The Act would thereby put sellers on the proverbial level playing field by authorizing states to require out-of-state sellers like Quill Corporation to collect sales taxes even when such sellers lack in-state physical presence.
Some opponents characterize the Act as establishing a new tax. Some opponents also argue that the Act would impose an unfair burden on small businesses. Neither argument is correct.
Internet and mail order buyers have always owed taxes on their purchases. Such buyers have generally been unaware of or have ignored their obligation to pay taxes on their purchases from out-of-state sellers. The Marketplace Fairness Act would put buyers from mail order and electronic sellers in the same position as persons who purchase from in-state brick-and-mortar stores, that is to say, subject to sales tax withholding by the seller.
Moreover, the Act would only permit states to impose sales tax collection responsibility on internet and mail order firms with at least one million dollars in out-of-state sales. Truly small businesses would, per the Quill, still enjoy immunity from tax collection responsibilities on their out-of-state sales as long as they have no physical presence in the taxing state.
Some states will use the revenues they collect under the Act to balance their budgets. Others will use those revenues to lower their respective sales tax rates. Each state should be free to decide for itself.
The Marketplace Fairness Act is long overdue. It is neither fair nor efficient to require brick-and-mortar sellers to collect sales taxes while their on-line and mail order competitors effectively sell sales tax-free. By overturning Quill, the Act would indeed establish tax fairness in the marketplace.
Edward A. Zelinsky is the Morris and Annie Trachman Professor of Law at theBenjamin N. Cardozo School of Law of Yeshiva University. He is the author of The Origins of the Ownership Society: How The Defined Contribution Paradigm Changed America. His monthly column appears here.
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Image Credit: President Obama’s address to a joint session of Congress by Lawrence Jackson. Public domain via Wikimedia Commons.
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Why do we have a Heart Failure Awareness Day?
How would you feel if you were told you had heart failure? Once you had recovered from the shock, what are the questions you’d ask? European Heart Failure Awareness Days aim to combat all those blank looks in doctors’ offices.
So you have heart failure and now you have to live with it. But you’re not alone; millions of people out there have heart failure. That’s millions of people who struggle to make their daily lives just a bit better every day. And it’s possible. That’s another aim of the Awareness Days — making people’s lives better every day.
Anybody can get heart failure in many different circumstances, though it is most common in older people. Heart failure is a serious medical condition but it doesn’t mean that your heart is going to stop; it means that your heart is finding it difficult to pump your blood round your body to meet the needs of your daily activities. This means that you can have heart failure for a long time and live with it to the best of your ability.
It is with this in mind that the Heart Failure Association of the European Society of Cardiology initiated the first Heart Failure Awareness Day in 2010. The lack of knowledge among doctors as well as the general public concerned heart failure specialists who were looking for a way to access potential sufferers, help those already with the condition as well as their families, and inform local doctors and nurses. As a result, they turned to local heart failure organisations which are usually linked to national cardiac societies. Read the report from the very first Awareness Day.
Since then, the event has grown dramatically. Where at first a hospital in one country held an open house and a newspaper in another country published an article, now the Awareness Days have a huge variety of events from experienced organisers who plan countrywide to newcomers who start small but with big ambitions.
This year, countries all over Europe will hold their events on one or more days over the weekend of 10-12 May. The Heart Failure Association offers a basic structure for events and has created a poster and comprehensive leaflets that can be translated and tailored for each country. Organisers can also download a web banner for their local websites. In order to reach the maximum of people, the Association has created an exhaustive patient information website, translated into six languages.
Some countries organise walks, others hold public events where blood pressure readings are done. Informational leaflets are given out and medical staff give talks on heart failure. Most organisations contact local newspapers and television and radio stations to reach a wider audience.
Alongside newcomers Cyprus, the former Yugoslav republic of Macedonia, and Belarus — all enthusiastically preparing their events and media campaigns — the Russian Federation organisers have extended the dates of their Awareness Days so that they can cover their vast territory. In one month, they will go to 30 cities and try to reach over 20,000 patients. Germany has spread its awareness day programme over 16 hospitals, introduced a public cooking programme on The Mediterranean Kitchen, arranged an art competition in regional schools on the subject “My heart – A technical miracle,” and created a walk-through artery for their visitor health screenings. In the UK, the Awareness Day events are very much nurse-run. Read what is happening around Europe on 10-12 May 2013.
Those who are aware of the problem and closest to their patients are working hard to see that the message gets out to those with the condition and those who live with sufferers: find out all you can about heart failure; you’ll feel better, prolong your life, and enjoy it more. This is the essence of the Awareness Day campaigns. Europe has woken up and is taking up the challenge by spreading the word.
Anya Creaser works for the Heart Failure Association, a registered branch of the European Society of Cardiology. With Prof Petar Seferovic, Coordinator of the HFA Committee for National Heart Failure Societies, she has coordinated the Awareness Days since the inception in 2010.
Oxford University Press is supporting Heart Failure Awareness Day with resources from across the press and blog posts on the subject.
The European Journal of Heart Failure, edited by Professor Dirk van Veldhuisen, is the International Journal of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure.
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Image credit: Male anatomy of human organs in x-ray view. Image by janulla, iStockphoto.
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Preparing for ESIL 2013
In April 2013, OUP attended the American Society of International Law’s annual conference in Washington, DC. Now, it is the turn of the society’s European counterpart, the European Society of International Law (ESIL).
The 2013 ESIL Research Forum, to be held in Amsterdam on 23-25 May, will gather delegates from all corners of the globe to discuss the key issues and challenges that affect international lawyers today.
The European Society of International Law was formed in 2001 by the original editors of the European Journal of International Law, out of a need to develop a “general European network to bring together and to develop deeper understanding among all of those working in the field of international law, be they government officials, diplomats, legal advisers in international organizations, academics, or practising lawyers.” The society hosts a variety of events including its biennial conference, which takes place every other year. For those years inbetween it is the turn of the Research Forum, which is now in its fifth year.
The theme of this year’s Forum is law as a profession, which will be articulated through an exploration of the different roles carried out by international lawyers, ranging from the international lawyer as judge to the international lawyer as academic. What challenges do these lawyers face? And how will they be overcome? ESIL 2013 will attempt to answer these questions through a jam-packed few days of plenary sessions, panel discussions, workshops, and keynote addresses. Three ESIL interest groups will also convene the day before the Forum opens. These are: the International Business and Human Rights Interest Group; International Economic Law Interest Group and the Law of the Sea Interest Group. Visit the conference website for further details.
Here are some of the highlights:
On arrival, make sure you attend the welcome addresses at the Opening Ceremony, all of which are being delivered by OUP authors: Laurence Boisson de Chazournes, Elies van Sliedregt, and Andre Nollkaemper
Many of our authors will be moderating, participating, and presenting at this year’s event. Check out the programme for further details/
Some of the sessions will be streamed online, so you don’t have to be at the conference to enjoy all it has to offer.
On Friday, ESIL will host the Gala Dinner — a lovely way to round off a busy day at the Forum.
No doubt you will be busy most days attending sessions, catching up with colleagues, and browsing the exhibition stands. However, if you do have some down time, ensure you take the time to explore Amsterdam, the host city of this year’s event. Why not take a boat cruise along the canal or visit the newly re-opened Van Gogh Museum? Or if you are feeling particularly energetic, perhaps take a bike ride around the city to view the sights?
While at the Forum, don’t forget to visit us at the OUP stand to browse our latest books and perhaps pick up a journal or two. Be sure to follow the #ESIL2013 hashtag for the latest updates. We look forward to seeing you there!
Katherine Marshall is Marketing Executive for Academic Law titles at Oxford University Press.
Oxford University Press is a leading publisher in Public International Law, including the Max Planck Encyclopedia of Public International Law, latest titles from thought leaders in the field, and a wide range of law journals and online products. We publish original works across key areas of study, from humanitarian to international economic to environmental law, developing outstanding resources to support students, scholars, and practitioners worldwide.
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Image credit: Amsterdam by JORGE A. RAMOS C. Creative Commons License via Wikimedia Commons
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