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March 2023

Merit and Diversity

Merit and Diversity

            Robert A. Levine

Today’s world is increasingly complex and competitive, and can be expected to remain so. National economies are under constant pressure to provide more and better products, both for export and internal consumption. For America to thrive in this challenging landscape, we must be certain that the best and the brightest among us are given the opportunity to fully maximize their intellectual potential to advance science, industry and medicine. This means that the top sources of higher education, both in undergraduate and graduate programs, must be available to the most intelligent strata of young Americans to help them fully grow their knowledge base and skills. Having finished with these programs, they should be welcomed into prime academic positions to teach new students and carry on novel research in all fields, and industrial companies to develop new products.

Given the nation’s history of slavery and discrimination directed against Blacks and Latinos, the above schema presents some ethical questions. Though not a homogeneous group, our Asian population appears to have few problems in progressing without special governmental, legal or institutional help. Indeed, they are quite successful academically as well as in the fields of endeavor they choose. In fact, because they are so proficient academically, many of the elite schools appear to manifest bias against them, restricting the number of Asian students they admit, even though their qualifications surpass many non-Asians who gain entry. Some meritorious white students are also denied entry to elite schools in the name of diversity- admittance of Black and Latino students whose qualifications are not as strong as those Asians and whites who are rejected. Many institutions are no longer requiring SATs or ACTs to help decide on admissions, as the results would tend to work against minority applicants and perhaps limit diversity. This is also a strike against merit based admissions.

There is no question that Blacks and Latinos have suffered from centuries of bias and discrimination from the dominant white population in America. Their education has been inferior, their housing and health care sub-par, their job opportunities and wealth accumulation wanting in comparison to whites. With bias undoubtedly playing a role, there are higher rates of alcoholism, drug addiction and gun violence among these minority populations. An important factor however, in these epidemics of violence and addiction is parental neglect and youngsters who are raised in families with absent fathers. Some of these children have neither father nor mother present and are raised by grandmothers or other family members.

Early interactions between parents and infants are essential in children’s learning, and those lacking in early parental instruction and nurturing start school already behind their classmates. Unfortunately, most of these deprived children never seem to catch up to their peers, many of them dropping out and not graduating from high school.

To help children who begin school behind, Head Start and pre-Head Start programs were initiated, to introduce these children to a learning environment and to some degree of discipline. Some schools have also made arrangements for tutoring at all levels and in different subjects for those students who are not learning at grade level or above. The various programs and tutoring has been helpful in many cases and these children may be performing adequately to even exceptionally well. It is not only minority students who are aided by these special programs, but poor white students who come from disadvantaged backgrounds. However, the students who seem to do best are those who have parental involvement, with parents reinforcing the value of any academic achievements.

The support and special programs are a necessity to help minority and impoverished white students maximize their academic potential and contribute to society. But admission to elite colleges should be on the basis of merit and not to promote diversity alone. Those who are not the best, can go to lower level colleges, community colleges, or even into apprenticeship programs. And those students in college who are not exceptional academically should not be admitted to elite graduate schools just to promote diversity.

The same holds true for important or intellectually demanding jobs. These should also be offered on the basis of merit and not just for a diverse workplace. Eventually, with the various special programs and tutoring in the public schools, more diverse classes will be admitted to elite colleges on the basis of merit. Likewise, graduate schools and jobs will also be apportioned on the basis of merit and will reflect diversity. But merit should be the decisive factor.

www.robertlevinebooks.com

Buy The Uninformed Voter on Amazon and Barnes and Noble


Merit and Diversity

Merit and Diversity

            Robert A. Levine

Today’s world is increasingly complex and competitive, and can be expected to remain so. National economies are under constant pressure to provide more and better products, both for export and internal consumption. For America to thrive in this challenging landscape, we must be certain that the best and the brightest among us are given the opportunity to fully maximize their intellectual potential to advance science, industry and medicine. This means that the top sources of higher education, both in undergraduate and graduate programs, must be available to the most intelligent strata of young Americans to help them fully grow their knowledge base and skills. Having finished with these programs, they should be welcomed into prime academic positions to teach new students and carry on novel research in all fields, and industrial companies to develop new products.

Given the nation’s history of slavery and discrimination directed against Blacks and Latinos, the above schema presents some ethical questions. Though not a homogeneous group, our Asian population appears to have few problems in progressing without special governmental, legal or institutional help. Indeed, they are quite successful academically as well as in the fields of endeavor they choose. In fact, because they are so proficient academically, many of the elite schools appear to manifest bias against them, restricting the number of Asian students they admit, even though their qualifications surpass many non-Asians who gain entry. Some meritorious white students are also denied entry to elite schools in the name of diversity- admittance of Black and Latino students whose qualifications are not as strong as those Asians and whites who are rejected. Many institutions are no longer requiring SATs or ACTs to help decide on admissions, as the results would tend to work against minority applicants and perhaps limit diversity. This is also a strike against merit based admissions.

There is no question that Blacks and Latinos have suffered from centuries of bias and discrimination from the dominant white population in America. Their education has been inferior, their housing and health care sub-par, their job opportunities and wealth accumulation wanting in comparison to whites. With bias undoubtedly playing a role, there are higher rates of alcoholism, drug addiction and gun violence among these minority populations. An important factor however, in these epidemics of violence and addiction is parental neglect and youngsters who are raised in families with absent fathers. Some of these children have neither father nor mother present and are raised by grandmothers or other family members.

Early interactions between parents and infants are essential in children’s learning, and those lacking in early parental instruction and nurturing start school already behind their classmates. Unfortunately, most of these deprived children never seem to catch up to their peers, many of them dropping out and not graduating from high school.

To help children who begin school behind, Head Start and pre-Head Start programs were initiated, to introduce these children to a learning environment and to some degree of discipline. Some schools have also made arrangements for tutoring at all levels and in different subjects for those students who are not learning at grade level or above. The various programs and tutoring has been helpful in many cases and these children may be performing adequately to even exceptionally well. It is not only minority students who are aided by these special programs, but poor white students who come from disadvantaged backgrounds. However, the students who seem to do best are those who have parental involvement, with parents reinforcing the value of any academic achievements.

The support and special programs are a necessity to help minority and impoverished white students maximize their academic potential and contribute to society. But admission to elite colleges should be on the basis of merit and not to promote diversity alone. Those who are not the best, can go to lower level colleges, community colleges, or even into apprenticeship programs. And those students in college who are not exceptional academically should not be admitted to elite graduate schools just to promote diversity.

The same holds true for important or intellectually demanding jobs. These should also be offered on the basis of merit and not just for a diverse workplace. Eventually, with the various special programs and tutoring in the public schools, more diverse classes will be admitted to elite colleges on the basis of merit. Likewise, graduate schools and jobs will also be apportioned on the basis of merit and will reflect diversity. But merit should be the decisive factor.

www.robertlevinebooks.com

Buy The Uninformed Voter on Amazon and Barnes and Noble


What's Going On With

What’s Going On With Putin?

                        Robert A. Levine, M.D.  March 8, 2023

I am a retired neurologist. Last week, I watched a five to ten second video of President Putin’s meeting with Lukashenko in a villa outside of Moscow online. Instead of being seated behind a table which would hide his lower body, he was in a chair with nothing blocking his legs. During the period he was visible, constant movements of both legs were noted in an asynchronous fashion. One might call these “restless legs,” but medically they looked like a syndrome called akathisia or psychomotor restlessness. Minimal movements of the hands and fingers were also noted.

Akathisia is most often caused by an adverse reaction to drugs, particularly with anti-psychotic medications. However, other drugs can also be responsible less often, including antidepressants such as tricyclic medications (nortriptyline and amitriptyline) and (SSRIs) selective serotonin uptake inhibitors (Prozac, Zoloft, Paxil, Celexa, Lexapro). In addition, calcium channel blockers (Cardizem), which are utilized for high blood pressure can rarely produce akathisia. Even if Putin is taking anti-psychotic medications, it does not indicate he is psychotic as some physicians may also prescribe these drugs for anxiety. And he may be taking anti-depressants or calcium channel blockers and having an adverse response, though akathisia is seen uncommonly with these compounds.

The National Library of Medicine of the NIH also mentions that akathisia can be seen with anti-emetic drugs (Compazine), drugs for vertigo, sedatives used for anesthesia, and abuse of cocaine.

Other considerations besides akathisia for Putin’s leg movements include the possibility of a tardive dyskinesia which can also occur with the above medications, or when they are withdrawn. However, movements of the arms and facial tics are present more often with tardive dyskinesia than mainly leg movements.

Less likely possibilities are that Putin has a neurodegenerative disorder or a movement disorder such as Parkinson’s or one of its associated syndromes. There are medications that can treat akathisia, but Putin may not even be aware of his problem or may not want any additional medications. And the treatments are not always successful. Those used include mirtazapine, beta blockers and anticholinergic compounds. The mechanism in the brain that produces akathisia is uncertain, but may have to do with dopamine or other neurotransmitters, and an imbalance between neurotransmitter systems, such as dopamine and acetylcholine. A blockage of dopamine type 2 receptors is also a consideration. There are no specific laboratory tests that can help with the diagnosis of akathisia. It is merely a diagnosis made by observation.

Patients with akathisia usually feel restless with a need to move. They may also feel subjectively uncomfortable. The akathisia may be short lasting or may persist indefinitely, even after the precipitating medications are withdrawn and treatment is initiated. We don’t know how long Putin has had these movements as there have not been videos of him with his legs exposed. Usually, he has been seen sitting at a long table, with his advisors or guests at the far end. There have been suggestions that this was a manifestation of paranoia, as Putin was afraid of catching Covid or of being assassinated. But perhaps this was related to his akathisia.

As far as we know, Putin is cognitively intact, but it would be helpful if his physicians told the world what is going on since he is the leader of a powerful nation with nuclear weapons. However, Putin wants to project an aura of strength and determination to the world and certainly does not want it known that he has an illness of any sort or is taking medications on a regular basis. In an autocratic state, the leader controls the release of all information, particularly those of a personal nature.

www.robertlevinebooks.com

Buy The Uninformed Voter on Amazon or Barnes and Noble


What's Going On With

What’s Going On With Putin?

                        Robert A. Levine, M.D.  March 8, 2023

I am a retired neurologist. Last week, I watched a five to ten second video of President Putin’s meeting with Lukashenko in a villa outside of Moscow online. Instead of being seated behind a table which would hide his lower body, he was in a chair with nothing blocking his legs. During the period he was visible, constant movements of both legs were noted in an asynchronous fashion. One might call these “restless legs,” but medically they looked like a syndrome called akathisia or psychomotor restlessness. Minimal movements of the hands and fingers were also noted.

Akathisia is most often caused by an adverse reaction to drugs, particularly with anti-psychotic medications. However, other drugs can also be responsible less often, including antidepressants such as tricyclic medications (nortriptyline and amitriptyline) and (SSRIs) selective serotonin uptake inhibitors (Prozac, Zoloft, Paxil, Celexa, Lexapro). In addition, calcium channel blockers (Cardizem), which are utilized for high blood pressure can rarely produce akathisia. Even if Putin is taking anti-psychotic medications, it does not indicate he is psychotic as some physicians may also prescribe these drugs for anxiety. And he may be taking anti-depressants or calcium channel blockers and having an adverse response, though akathisia is seen uncommonly with these compounds.

The National Library of Medicine of the NIH also mentions that akathisia can be seen with anti-emetic drugs (Compazine), drugs for vertigo, sedatives used for anesthesia, and abuse of cocaine.

Other considerations besides akathisia for Putin’s leg movements include the possibility of a tardive dyskinesia which can also occur with the above medications, or when they are withdrawn. However, movements of the arms and facial tics are present more often with tardive dyskinesia than mainly leg movements.

Less likely possibilities are that Putin has a neurodegenerative disorder or a movement disorder such as Parkinson’s or one of its associated syndromes. There are medications that can treat akathisia, but Putin may not even be aware of his problem or may not want any additional medications. And the treatments are not always successful. Those used include mirtazapine, beta blockers and anticholinergic compounds. The mechanism in the brain that produces akathisia is uncertain, but may have to do with dopamine or other neurotransmitters, and an imbalance between neurotransmitter systems, such as dopamine and acetylcholine. A blockage of dopamine type 2 receptors is also a consideration. There are no specific laboratory tests that can help with the diagnosis of akathisia. It is merely a diagnosis made by observation.

Patients with akathisia usually feel restless with a need to move. They may also feel subjectively uncomfortable. The akathisia may be short lasting or may persist indefinitely, even after the precipitating medications are withdrawn and treatment is initiated. We don’t know how long Putin has had these movements as there have not been videos of him with his legs exposed. Usually, he has been seen sitting at a long table, with his advisors or guests at the far end. There have been suggestions that this was a manifestation of paranoia, as Putin was afraid of catching Covid or of being assassinated. But perhaps this was related to his akathisia.

As far as we know, Putin is cognitively intact, but it would be helpful if his physicians told the world what is going on since he is the leader of a powerful nation with nuclear weapons. However, Putin wants to project an aura of strength and determination to the world and certainly does not want it known that he has an illness of any sort or is taking medications on a regular basis. In an autocratic state, the leader controls the release of all information, particularly those of a personal nature.

www.robertlevinebooks.com

Buy The Uninformed Voter on Amazon or Barnes and Noble