Thursday, July 18, 2019

Laws about gay sex in Africa

While many countries have legalized same sex marriages, including South Africa, in the rest of Africa the question is whether engaging in same-sex sex will be legalized.  The Guardian has the story of one step forward and maybe back again in Botswana:

Botswana government to appeal against law legalising gay sex
Attorney general says high court was mistaken in its ruling decriminalising homosexuality

"Botswana’s government will appeal against a high court ruling that decriminalised homosexuality, potentially resuscitating a law that punished gay sex by up to seven years in prison.

"The court’s ruling in June, which was praised by international organisations and activists, meant Botswana joined a handful of African countries that have legalised same-sex relationships.
...
"Same-sex relationships are illegal in more than 70 countries worldwide; almost half of them in Africa, where homosexuality is broadly taboo and persecution is rife.

"Botswana’s ruling came after Kenya’s high court upheld its law banning gay sex, keeping same-sex relations punishable by 14 years in jail, drawing strong criticism from the United Nations and rights activists.

...
Botswana is the latest country in Africa to decriminalise same-sex relations, with Amnesty saying it follows Angola in January, the Seychelles in June 2016, Mozambique in June 2015, and São Tomé and Principe, and Lesotho, in 2012.

South Africa is the only African nation to have legalised gay marriage."

Wednesday, July 17, 2019

Transplantation in China: update

I returned Sunday from a busy and potentially productive trip to China.

Since 2015 it has been illegal in China to use organs from executed prisoners for transplants. The passage of that law was the result of a long struggle between an opaque, often black market system of transplantation, and an emerging transparent system based on voluntary donation.  The transparent system has made, and is continuing to make, enormous strides.

In Shenzhen I visited the China Organ and Transplant Response System (COTRS), run by Dr. Haibo Wang, which organizes and records the data of transplant patients and donors. 

It also collects large amounts of data on all hospital stays at China’s largest hospitals. Together with the National Institute of Health Data Science at Peking University, run by Dr. Luxian Zhang, they are assembling a vast data resource that will have many uses.

In Beijing I also visited the China Organ Transplant Development Foundation, run by Dr. Jeifu Huang, which plays a role in guiding the emerging body of legislation through which transplants are being organized in China with increased transparency.

I also spoke at the Beijing Summit on Health Data Science.

It was a busy week that left me optimistic that we'll see continued big progress in healthcare delivery in China, including but not limited to transplantation.

Some photos were taken...










Tuesday, July 16, 2019

President Trump's Executive Order on kidney care

On July 10, while I was in China, President Trump issued an executive order touching on all aspects of care for kidney patients, including dialysis and transplantation from both deceased and living donors.

Here's the text of that executive order:
Executive Order on Advancing American Kidney Health
 Issued on: July 10, 2019

Because I anticipated being potentially incommunicado when the executive order was announced, I had filed an op-ed article (giving my proxy to my coauthor Greg Segal for any necessary last-minute edits) to be published on CNN's web site, applauding the order:
The Trump administration's organ donation efforts will save lives
By Alvin E. Roth and Greg Segal
Updated 1:20 PM ET, Wed July 10, 2019

As it happens, a reporter for PBS news hour reached me by phone in China, and so I got to chime in in person:
Trump’s plan to combat kidney disease aims to save money and lives. Can it?
Health Jul 10, 2019 4:39 PM EDT


The part of the executive order that touches most closely on my work on kidney exchange is Section 8:

"Sec8.  Supporting Living Organ Donors.  Within 90 days of the date of this order, the Secretary shall propose a regulation to remove financial barriers to living organ donation.  The regulation should expand the definition of allowable costs that can be reimbursed under the Reimbursement of Travel and Subsistence Expenses Incurred Toward Living Organ Donation program, raise the limit on the income of donors eligible for reimbursement under the program, allow reimbursement for lost-wage expenses, and provide for reimbursement of child-care and elder-care expenses."

Regarding deceased donor transplants, Section 7 says

"Sec. 7.  Increasing Utilization of Available Organs.  (a)  Within 90 days of the date of this order, the Secretary shall propose a regulation to enhance the procurement and utilization of organs available through deceased donation by revising Organ Procurement Organization (OPO) rules and evaluation metrics to establish more transparent, reliable, and enforceable objective metrics for evaluating an OPO’s performance.
(b)  Within 180 days of the date of this order, the Secretary shall streamline and expedite the process of kidney matching and delivery to reduce the discard rate.  Removing process inefficiencies in matching and delivery that result in delayed acceptance by transplant centers will reduce the detrimental effects on organ quality of prolonged time with reduced or cut-off blood supply."
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Here is some of the news coverage:
Trump signs executive order revamping kidney care, organ transplantation By Lenny Bernstein July 10 (Washington Post);
Trump signs executive order to transform kidney care, increase transplants 
By Jen Christensen and Betsy Klein, CNN Updated 4:21 PM ET, Wed July 10, 2019
This executive order is well worth supporting, and it will need support to achieve the goals it outlines.  The Secretary of Health and Human Services has been directed to do things in fairly broad terms, and we'll have to watch carefully to see the results, which will be interpreted, contested, and implemented through multiple political/regulatory processess
*************
Regarding removing financial disincentives for kidney (and liver) donors, I'm on the advisory board of the federally funded National Living Donor Assistance Center (NLDAC), which has been able, under very tight constraints, to reimburse some donors for some travel expenses (see related posts here).  A minimalist interpretation/implementation of the Executive Order would be to relax some of the constraints on whose expenses and which expenses can be reimbursed, and to increase NLDAC's budget accordingly.  A more expansive interpretation would be to remove some of those constraints so that no donor would have to pay to rescue someone with kidney failure by donating a kidney.

Monday, July 15, 2019

THE 30TH INTERNATIONAL CONFERENCE ON GAME THEORY at Stony Brook

This long-running game theory conference is now in its 30th year--and some of the old veterans have passed on, but there are lots of young people to keep the field vibrant.

Here's the announcement and (partial) list of participants:

Stony Brook University (July 15 - July 19, 2019)

The full program is here.

I'll be speaking Tuesday at 5:00, on Market Design and Game Theory in a Large World 

Sunday, July 14, 2019

“If we can make the meat without the animal, why wouldn’t we do that?” A future for lab-grown meat

The New Republic looks towards a cruelty free (and maybe animal free) food supply of meat (from an interview with Tyson Foods’ Tom Hayes, who recently resigned as CEO).

The Meat Mogul’s Case For Lab-Grown Beef
 By AMANDA LITTLE

"it was Hayes who made the timeliest and most convincing case for meat alternatives—and cellular meats in particular. 

"He emphasized that the entire “cell-to-fork” process for growing and harvesting lab meats is two to six weeks—a blink of an eye compared with the two and a half years it typically takes to grow cattle from conception to maturity. That represents huge cost and energy savings. Hayes also pointed out that cultured meats eliminate concerns about E. coli and other pathogens that can contaminate animal meat during processing. The single biggest risk in his business, he said, is contamination. A few months after Cargill invested in cell-based meat producer Memphis Meats, it recalled 130,000 pounds of ground beef that had been contaminated with E. coli—a problem that wouldn’t happen with lab-grown meat."

Saturday, July 13, 2019

Litigation financing is no longer so repugnant

Litigation financing has a long history, during much of which it was regarded as repugnant (including a medieval word, "champerty").  But now comes news that the great law and economics scholar, and long-serving but recently retired appellate judge Dick Posner has joined a litigation fin-tech firm. (Does that make him a champion of champerty?  In fact his retirement had to do with his dissatisfaction with the way the courts treat people who can't afford lawyers...)

The American Lawyer has the story:

Posner Casts Lot With Litigation Funding Underdog Legalist
The retired Seventh Circuit jurist has joined Legalist, a San Francisco operation founded by two Harvard dropouts, as an adviser.
By Dan Packer

"Since Richard Posner’s surprise retirement from the U.S. Court of Appeals for the Seventh Circuit in 2017, he’s focused much of his energy on making the justice system more accessible and responsive to pro se litigants.

"That impulse has informed the 80-year-old polymath’s latest move: Posner is entering the world of litigation finance. But he’s not taking a position with one of the giants of the nascent industry. Instead, he’s signed on to serve as an adviser to Legalist, a San Francisco start-up founded by two Harvard undergrads in 2016. 

“The principal motive for my retirement was the failure of the court to treat litigants without financial resources fairly,” Posner said in a statement issued by Legalist. “Litigation finance patches an important hole for businesses with valid claims who lack the funds to hire an attorney.”

Friday, July 12, 2019

Peter Jaworski on paid and unpaid plasma donation in Canada

Peter Jaworski in the Globe and Mail:
There’s a way to avoid blood plasma shortages: pay donors

and on the radio in Calgary (it isn't Peter in the picture:)


Some quotes from the Globe and Mail article:
" Canada collects only about 17 per cent of the plasma necessary to meet domestic demand for immune globulin. Paid donors in the United States are how we meet (and exceed) our country’s demand."

"Only countries that pay donors are self-sufficient in plasma. The rest have to import it from countries that pay. Paid donors in the United States are responsible for more than 60 per cent of the entire world’s plasma used to make plasma medicine."

"In terms of safety, a Health Canada Expert Panel report from May of last year noted that paid plasma is not less safe than unpaid plasma and it is less expensive than trying to recruit and retain unpaid donors. Paying donors is also the most likely way of ensuring security of supply. Paid donations having a negative effect on unpaid blood donations is also unlikely. The United States has more than 800 paid plasma centres, and still has higher blood donation rates than Canada."

"Claims that paid plasma exploits the poor are also mistaken. Pay is about $30 an hour in Canada (it takes 1.5 hours to donate plasma), and represents about 30 per cent of the total revenue from a litre of plasma (a much larger share than profits, which are less than 3 per cent of revenue). That’s a fair deal."

"Opponents also like to point out that plasma collected in the paid plasma centres in Canada is exported, with none of it staying in Canada. That’s true, but it’s true because Canadian Blood Services choose not to buy Canadian plasma in spite of its lower price and domestic origins."

Thursday, July 11, 2019

Plasma shortage alert from the IDF--the Immune Deficiency Foundation

Patients with primary immunodeficiencies don't produce antibodies, and depend on immunoglobulin, one of the primary plasma products produced by donated plasma (the other is albumin, and there are other life-saving and life-improving pharmaceuticals as well).  The IDF is a foundation dedicated to this complex of diseases:

Immune Deficiency Foundation
Dedicated to improving the diagnosis, treatment and quality of life of persons with primary immunodeficiencies

In recent years immunoglobulin has been used around the world to treat other immune deficiency diseases also, as well as to modulate the immune systems of people with auto-immune diseases.

But shortages occur, because the U.S. remains the primary supplier of donated plasma (since it is legal to compensate plasma donors in the U.S., but not everywhere...)

Here's a blog post from John Boyle, the IDF president

Immunoglobulin Product Availability Issues: The Sky Is Not Falling but the World Needs More Plasma
"IDF is working with those who are seeking to increase yields of Ig from plasma, introduce new fractionation technologies, grow plasma donations at collection centers, and more, but those are long term solutions.

"Ultimately, the issue is that the world needs more plasma, and the only good way to make that happen is to collect more plasma. The one thing that we can all do right now is to encourage people to become regular plasma donors if there’s a collection center anywhere near them."
***********

"Biologic" medicines are regulated by the Food and Drug Administration's
Center for Biologics Evaluation and Research (CBER)

"CBER is the Center within FDA that regulates biological products for human use under applicable federal laws, including the Public Health Service Act and the Federal Food, Drug and Cosmetic Act. CBER protects and advances the public health by ensuring that biological products are safe and effective and available to those who need them. CBER also provides the public with information to promote the safe and appropriate use of biological products."

Here is their list of CBER-Regulated Products: Current Shortages
"GAMMAGARD LIQUID® Immune Globulin Infusion (Human) is currently available, though patient shipping schedules may be impacted as continued high demand exceeds production plans and available inventory."
which they attribute to: "Demand increase in the drug or biological product."

Wednesday, July 10, 2019

The Wakley–Wu Lien Teh Prize Essay 2019: telling the stories of Chinese doctors

I'm on my way to China to talk with quite a few Chinese doctors, and so this recent item in The Lancet caught my eye:

The Wakley–Wu Lien Teh Prize Essay 2019: telling the stories of Chinese doctors

"Wu Lien Teh (1879–1960), a Malayan-born Chinese physician, made many firsts in China's medical history. He was one of the first students of Chinese descent to graduate in medicine from the UK's University of Cambridge. Wu published papers in The Lancet and was nominated for the Nobel Prize in Physiology or Medicine. One of the most outstanding of Wu's many contributions to medicine in China and global health was his success in leading the fight against plague in 1910, and his appointment as the chair of the International Plague Conference in 1911.
Wu shared many similarities with Thomas Wakley, the founding Editor of The Lancet. Both were brilliant doctors who also became inspirational social reformers. Wakley started The Lancet to “let in the light” and “cut out the dross”, and Wu founded many modern hospitals, including the Peking University People's Hospital (originally named Peking Central Hospital) in 1918, laboratories, and research institutions in China.
The Lancet has a long commitment to support Chinese doctors and patient care. We receive many submissions on concerns of tense doctor–patient relationships in China, and believe one response to improve the situation of Chinese doctors and these relationships would be to give a voice to Chinese doctors. Therefore, we launch the annual Wakley–Wu Lien Teh Prize in 2019 in honour of these two role models in medicine. We invite essays on any clinical topic of importance to health written in Chinese so that more Chinese doctors can share their stories of medical practice, which we hope will contribute to enhancing patient care in China. The Wakley–Wu Lien Teh Prize will follow The Lancet's annual essay competition, the Wakley Prize,1 and shares many similar standards. The Chinese essay could, like the 2019 Wakley Prize, also be “about the ideas, relationships, experiences, or encounters that make what doctors do meaningful, improved a patient's quality of life, changed doctors’ practice or research, challenged inequities, changed norms, or brought moments of recognition, humour, connection, or learning”.1 Submissions should inform, entertain, and enlighten us, and we expect originality and beautiful writing in Chinese."

Tuesday, July 9, 2019

Monday, July 8, 2019

Congratulations to Yannai Gonczarowski

Yannai Gonczarowski, who will be  a post-doc at Microsoft Research New-England starting this summer, has collected some awards... Here are two announcements:

Dr. Yannai A. Gonczarowski wins the 2019 SIGecom Disseration Award

The 2019 SIGecom Disseration Award is given for an outstanding dissertation in the field of economics and computation

and Yannai Gonczarowski wins Best Paper Award at MATCH-UP 2019


You can find his award talk from EC'19 here:
"Aspects of Complexity and Simplicity in Economic Mechanisms"

And his talk about the gap-year academies redesign here:
"Matching for the Israeli "Mechinot" Gap-Year Programs: Handling Rich Diversity Requirements" with Lior Kovalio, Noam Nisan, and Assaf Romm


HT: Assaf Romm, who writes
"Yannai is possibly one of the best examples of the increasingly large group of CS people who are also "real" market designers. Not only does he have several innovative works on computational and economic aspects of stable matchings (such as their communication complexity, manipulability by coalitions, and strategic simplicity) and auctions, but he is also one of the main forces behind the new redesign of the market for the gap-year academies in Israel. "

Sunday, July 7, 2019

Economics and CS at the Association for Computing Machinery

The special interest group within the association for computing machinery that runs activities related to economics and computation (e.g. the EC conference) has elected some market designers to run the show:

2019 ACM SIGecom Election Results
(For the term of 1 July 2019 – 30 June 2021)
Chair
Nicole Immorlica
Microsoft Research
Email: nicimm@gmail.com

Vice-Chair
Scott Duke Kominers
Harvard University
Email: kominers@fas.harvard.edu

Secretary-Treasurer
Katrina Ligett
The Hebrew University of Jerusalem
Email: katrina@cs.huji.ac.il

Saturday, July 6, 2019

Market design in the May Games and Economic Behavior

I've just gotten around to looking at the May issue of Games and Economic Behavior, and it contains several exciting market design papers.

Chinese college admissions and school choice reforms: An experimental study

Pages 83-100
Download PDF
Abstract
Since 2001, many Chinese provinces have transitioned from a “sequential” to a “parallel” school choice or college admissions mechanism. Inspired by this natural experiment, we evaluate the sequential (immediate acceptance, IA), parallel (PA), and deferred acceptance (DA) mechanisms in the laboratory. We find that participants are most likely to reveal their preferences truthfully under DA, followed by PA and then DA. While stability comparisons also follow the same order, efficiency comparisons vary across environments. Regardless of the metrics, the performance of PA is robustly sandwiched between IA and DA. Furthermore, 53% of our subjects adopt an insurance strategy under PA, making them at least as well off as what they could guarantee themselves under IA. These results help explain the recent reforms in Chinese school choice and college admissions.
*************

Assigning more students to their top choices: A comparison of tie-breaking rules

Pages 167-187
Download PDF
Abstract
School districts that implement stable matchings face various decisions that affect students' assignments to schools. We study the properties of the rank distribution of students with random preferences when schools use different tie-breaking rules to rank equivalent students. Under a single tie-breaking rule, where all schools use the same ranking, a constant fraction of students are assigned to one of their top choices. In contrast, under a multiple tie-breaking rule, where each school independently ranks students, a vanishing fraction of students are matched with one of their top choices. However, if students are allowed to submit only relatively short preference lists under a multiple tie-breaking rule, a constant fraction of students will be matched with one of their top choices, while only a “small” fraction of students will remain unmatched.
****************

Matching with waiting times: The German entry-level labor market for lawyers

Pages 289-313
Download PDF
Abstract
We study the allocation of German lawyers to regional courts for legal trainee-ships. Because of excess demand in some regions lawyers often have to wait before being allocated. The currently used “Berlin” mechanism is not weakly Pareto efficient, does not eliminate justified envy and does not respect improvements. We introduce a mechanism based on the matching with contracts literature, using waiting time as the contractual term. The resulting mechanism is strategy-proof, weakly Pareto efficient, eliminates justified envy and respects improvements. We extend our proposed mechanism to allow for a more flexible allocation of positions over time.

Friday, July 5, 2019

Exchange programs requiring balanced exchange, by Dur and Ünver

Some exchange programs require balance--such as exchanges of students among colleges, e.g. for study abroad.  Here's a paper addressing that in the JPE, with some impossibility results and a constrained optimality approach:

Two-Sided Matching via Balanced Exchange
Umut Mert Dur, North Carolina State University
and
M. Utku Ünver, Boston College and Deakin University
Journal of Political Economy 127, no. 3 (June 2019): 1156-1177.

Abstract  We introduce a new matching model to mimic two-sided exchange programs such as tuition and worker exchanges, in which export-import balances are required for longevity of programs. These exchanges use decentralized markets, making it difficult to achieve this goal. We introduce the two-sided top trading cycles, the unique mechanism that is balanced-efficient, worker-strategy-proof, acceptable, individually rational, and respecting priority bylaws regarding worker eligibility. Moreover, it encourages exchange, because full participation induces a dominant-strategy equilibrium for firms. We extend it to dynamic settings permitting tolerable yearly imbalances and demonstrate that its regular and tolerable versions perform considerably better than models of current practice.
*********

Here's an earlier post about an exchange program of the kind addressed in the paper:

Friday, February 20, 2009

Thursday, July 4, 2019

FUCT up, censorship down in Supreme Court trademark decision

 The WSJ has the story:

Supreme Court Strikes Down Ban on Immoral or Scandalous Trademarks
The decision is a win for California clothing designer’s streetwear brand, FUCT

"The government can’t reject trademarks it deems immoral or scandalous, the Supreme Court ruled Monday.
“The First Amendment does not allow the government to penalize views just because many people, whether rightly or wrongly, see them as offensive,” Justice Elena Kagan, who wrote for the court, said from the bench.
"Two years ago, the court struck down a related provision denying registration to disparaging trademarks, which the government had invoked to cancel the Washington Redskins professional football team’s trademark and to reject an application from the Slants, an Asian-American rock band. The same rationale, said Justice Kagan, required invalidation of the restriction on immoral or scandalous marks: The 1946 trademark law, the Lanham Act, was unconstitutional to the extent it “disfavors certain ideas.”
***************
Earlier related posts:

Sunday, February 19, 2017

Wednesday, July 3, 2019

Lay attitudes towards organ donation from executed prisoners--by Bar-Hillel and Lavee

Here's a new paper reporting a survey, forthcoming in Behavioral Public Policy
Abstract:  A multi-item questionnaire concerning lay people's attitudes toward organ procurement without consent from executed prisoners was given to several hundred respondents. The items ranged from all-out condemnation (“It is tantamount to murder”) to enthusiasm (“It is great to have this organ supply”). Overall, we found two guiding principles upheld by most respondents: (1) Convicts have as much a right to their bodies and organs as other people, so the practice should be judged by the same standards as those that guide organ procurement from any donor. Procuring organs without consent is wrong. (2) Benefiting from those organs should be held to more lenient standards than are demanded for their procurement. So, benefitting from these ill-gotten organs should be tolerated.

Tuesday, July 2, 2019

Sperm donors used to be anonymous. Technology has made that obsolete

Here's a representative story from the NY Times:

Sperm Donors Can’t Stay Secret Anymore. Here’s What That Means.  By Susan Dominus

"To be the biological child of an anonymous sperm donor today is to live in a state of perpetual anticipation. Having never imagined a world in which donors could be tracked down by DNA, in their early years sperm banks did not limit the number of families to whom one donor’s sperm would be sold — means that many of the children conceived have half-siblings in the dozens. There are hundreds of biological half-sibling groups that number more than 20, according to the Donor Sibling Registry, where siblings can find one another, using their donor number. Groups larger than 100, the registry reports, are far from rare.
"Because of the increasing popularity of genetic testing sites like 23andMe, in the past two or three years a whole new category of people, including those who never knew they were conceived via donor insemination, are reaching out to half siblings who may have already connected with others in their extended biological family. 
...
"Over time the adoption movement popularized the principle that individuals had a right to know their biological roots, and lesbian couples and single mothers, dominating ever more of the sperm banks’ market, called for greater transparency. In the early 2000s, California Cryobank offered, for a premium fee, an option for parents to choose a donor who agreed not just to be contacted when the offspring turned 18 but to respond in some fashion (though still anonymously if that was his preference).
By 2010, experts in reproductive technology were starting to note that internet searchability, facial-recognition software and the future of DNA testing would soon render anonymity a promise that the sperm banks could no longer keep. Since 2017, California Cryobank has stopped offering anonymity to its new donors. Donors now must agree to reveal their names to their offspring when they turn 18 and to have some form of communication to be mediated, at first, by the bank."
************

And here's an accompanying story, by a man who has now met and photographed many of his half-sibs.

Monday, July 1, 2019

Markets in pre-owned investment grade sneakers

You didn't know there were investment grade sneakers?  The NY Times brings you up to date:

Buy Low-Tops, Sell High-Tops: StockX Sneaker Exchange Is Worth $1 Billion

"StockX is part of a burgeoning group of online marketplaces that have turned resales of sneakers into a kind of currency — and an increasingly big business. Other sites like GOAT Group, Stadium Goods and Bump, which also resell sneakers, streetwear and other goods, have raised more than $200 million in venture capital funding. On Wednesday, StockX said it had hired a new chief executive to expand its business and garnered a fresh $110 million in financing that values it at more than $1 billion.
...
"Once a bid was accepted, sellers shipped their items to one of StockX’s four authentication centers, which make sure the shoes are not fake brands and then send them to the buyer. StockX makes money by charging sellers a transaction fee.
"The company said its revenue had more than doubled in the last year, with gross product sales topping $100 million a month. It has expanded into streetwear and luxury goods like handbags and has more than 800 employees.

The site does not carry user profiles and ratings, but includes detailed sales and pricing history for each item, making it more like a stock market than eBay. In total, StockX has raised $160 million, with its newest investors including General Atlantic, DST Global and GGV Capital."
*******
Here's the StockX site: BUY AND SELL AUTHENTIC SNEAKERS

Sunday, June 30, 2019

Organ donation by opt-out versus opt-in deceased donor registration (no significant effect on transplants)

In the June issue of Kidney International, there's a meta-study of organ transplantation rates in opt out versus opt in countries, that finds "no significant difference in deceased donation or solid organ transplantation activity between opt-out versus opt-in countries.":

Comparison of organ donation and transplantation rates between opt-out and opt-in systems
Adam Arshad,  Benjamin Anderson, and Adnan Sharif
Kidney International (2019) 95, 1453–1460

Abstract:
Studies comparing opt-out and opt-in approaches to organ donation have generally suggested higher donation and transplantation rates in countries with an opt-out strategy. We compared organ donation and transplantation rates between countries with opt-out versus opt-in systems to investigate possible differences in the contemporary era. Data were analysed for 35 countries registered with the Organisation for Economic Co-operation and Development (17 countries classified as opt-out, 18 classified as opt-in) and obtained organ donation and transplantation rates for 2016 from the Global Observatory for Donation and Transplantation. Compared to opt-in countries, opt-out countries had fewer living donors per million population (4.8 versus 15.7, respectively) with no significant difference in deceased donors (20.3 versus 15.4, respectively). Overall, no significant difference was observed in rates of kidney (35.2 versus 42.3 respectively), non-renal (28.7 versus 20.9, respectively), or total solid organ transplantation (63.6 versus 61.7, respectively). In a multivariate linear regression model, an opt-out system was independently predictive of fewer living donors but was not associated with the number of deceased donors or with transplantation rates. Apart from the observed difference in the rates of living donation, our data demonstrate no significant difference in deceased donation or solid organ transplantation activity between opt-out versus opt-in countries. This suggests that other barriers to organ donation must be addressed, even in settings where consent for donation is presumed.

Large image of Figure 1. 

Saturday, June 29, 2019

Sex related businesses in Japan

Japan is complicated. Here's a story from the Guardian that seems not to involve prostitution, but is nevertheless sex related (and child related).

Schoolgirls for sale: why Tokyo struggles to stop the 'JK business'
The persistent practice of paying underage girls for sex-related services, known in Japan as the ‘JK’ business, has seen charities step in where police have come up short

"Tokyo is famous for its fairly wild red light scene. You can find anything from a handsome man to make you cry and wipe away your tears to a maid to pour your drinks and giggle at your jokes and an encounter in one of the notorious “soapland” brothels.

"You can also pay to spend time with a schoolgirl. Services might include a chat over a cup of tea, a walk in the park or perhaps a photograph – with some places offering rather more intimate options.
...
"The fetishisation of Japanese schoolgirls in Japanese culture has been linked by some academics to a 1985 song called Please Don’t Take Off My School Uniform, released by the female idol group O-nyanko Club, and re-released by no less mainstream a group than AKB48, one of the highest-earning musical performers in Japan and whose single Teacher Teacher sold more than 3m copies in 2018.

"The term “JK business” has become a catch-all for cafes, shops and online agencies which provide a range of “activities”, many of which are not overtly sexual. Young women in school uniforms can be offered for reflexology and massage treatments, photography sessions and “workshops” in which girls reveal glimpses of their underwear as they sit folding origami or creating jewellery.
...
"Japan’s anti-prostitution laws broadly prohibit the sale and purchase of sex, but there are significant loopholes, of which establishments such as soaplands take full advantage. Crucially, in the case of JK businesses, Japan has no specific anti-trafficking laws in place. Ordinarily, a child under 18 involved in sex work is automatically considered trafficked, with harsh penalties for those responsible.

"Pornography laws relating to children are also limited – they do not, for example, cover manga, anime, or virtually created content, allowing games such as 2006’s controversial (and now no longer available) RapeLay, in which the player stalks and attempts to rape a single mother and her two school-age daughters."

Friday, June 28, 2019

Legal brothels and sex trafficking in Germany

Apparently it's hard to staff a really high volume brothel entirely with voluntary sex workers.  The Guardian has the story:

Trouble in Paradise: the rise and fall of Germany's 'brothel king'
Jürgen Rudloff’s chain of ‘wellness spas’ sold sex as a health service for men. But his business model was fatally flawed – as his trial for aiding and abetting trafficking revealed

"Until his dramatic fall from grace, Jürgen Rudloff was the self-proclaimed “brothel king” of Germany. Owner of a chain of clubs he boasted was the “the largest marketplace for sex in Europe”, he was every inch the well-dressed entrepreneur, a regular face on reality TV and chat shows.

"Rudloff is now serving a five-year sentence for aiding and abetting trafficking. His trial laid bare the misery and abuse of women working as prostitutes at his club who, according to court documents, were treated like animals and beaten if they didn’t make enough money. His imprisonment has dismantled the idea of Germany’s “clean prostitution” industry and raised troubling questions about what lies behind the legalised, booming sex trade.

"Prostitution – legalised in Germany in 2002 – is worth an annual €15bn (£13.4bn), and more than a million men visit prostitutes every day. The change in the law led to a rise in “super brothels”, attracting tourists from countries where such establishments are illegal.
...
"The Paradise business model is the same as the hundreds of other “sauna clubs” across Germany – brothel owners provide the premises, and the women are self-employed. Yet Rudloff’s high-volume, low-cost model only works if the supply of women is enough to satisfy demand and bring enough customers through the doors.

"According to court documents, this became a problem for Paradise almost immediately. There weren’t enough women to fill the clubs. So Rudloff’s friends in the industry offered to help him out.

"In 2008, as Rudloff was growing his business, investigators in Augsburg, Bavaria – a hundred miles from Stuttgart – received a tip-off that gangs from the city were trafficking women from eastern Europe, and sending them to work in Paradise. (While prostitution is legal in Germany, pimping and sex trafficking are not.)
...
"Peter Holzwarth, the chief prosecutor at the trial, argued that the owner and management at the clubs were guilty of Organisationsdelikt – aiding and abetting an organisation involved in criminality. “He knew – in the cases brought to court – that the women working at his club were being exploited by pimps,” says Holzwarth. “And he knew the women were trafficked, or rather, he thought that they might be and [still let them work], and that is sufficient for a conviction.”

"The court agreed. Sentencing Rudloff in late February this year, the judge remarked: “A clean brothel of this size is hard to imagine.” He said he hoped the convictions would serve as a warning to the sex industry.
...
"For prosecutors like Holzwarth, Rudloff’s conviction is a warning to those cashing in on Germany’s insatiable demand for commercial sex. “Rudloff’s case was not an isolated incident,” he says. “In my opinion, cooperation between brothel owners and pimps is risky but profitable for both sides. A win-win situation … but the case has had an impact already. I think brothel owners will be more careful about dealing with pimps.”

Thursday, June 27, 2019

Abortions, when abortion was illegal

The Washington Post reprints a concise version of some of its stories from 1966, with stories of successful and unsuccessful illegal abortions:

When abortion was illegal: A 1966 Post series revealed how women got them anyway
Before Roe v. Wade, women died trying to end their pregnancies

"By Elisabeth Stevens


In January 1966, The Washington Post ran a four-part series on how women in the Washington area obtained abortions. At the time, abortion was illegal with few exceptions in the District of Columbia, Maryland and Virginia. Now, nearly a half-century after Roe v. Wade, new abortion restrictions are being imposed in Alabama, Georgia, Missouri, Ohio, Utah and other states. Below is an abridged version of The Post’s four-part series, edited to highlight personal experiences. The original headlines of the series are now subheads for each section.