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	<title>DrugMonkey</title>
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	<description>biomedical research, just another job...</description>
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		<title>DrugMonkey</title>
		<link>http://drugmonkey.wordpress.com</link>
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		<item>
		<title>On blogging</title>
		<link>http://drugmonkey.wordpress.com/2012/01/24/on-blogging/</link>
		<comments>http://drugmonkey.wordpress.com/2012/01/24/on-blogging/#comments</comments>
		<pubDate>Tue, 24 Jan 2012 18:56:57 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[BlogBlather]]></category>

		<guid isPermaLink="false">http://drugmonkey.wordpress.com/?p=907</guid>
		<description><![CDATA[You know you are doing your proper job as a blogger when SiteMeter shows you a bunch of folks on the site for 20-40 min plus, just waiting around to enjoy the comment fireworks.<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=907&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>You know you are doing your proper job as a blogger when SiteMeter shows you a bunch of folks on the site for 20-40 min plus, just waiting around to enjoy the comment fireworks.</p>
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		<slash:comments>0</slash:comments>
	
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			<media:title type="html">drugmonkey</media:title>
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		<title>SciAm bloggers get pizzaid!</title>
		<link>http://drugmonkey.wordpress.com/2012/01/19/sciam-bloggers-get-pizzaid/</link>
		<comments>http://drugmonkey.wordpress.com/2012/01/19/sciam-bloggers-get-pizzaid/#comments</comments>
		<pubDate>Thu, 19 Jan 2012 21:31:45 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[BlogBlather]]></category>

		<guid isPermaLink="false">http://drugmonkey.wordpress.com/?p=904</guid>
		<description><![CDATA[A tweet from one @robinlloyd99 indicates that the pay structure worked out for the Scientific American blogs runs a fixed $200 per month. .@BoraZ: some networks pay more to those who bring more traffic. @sciam network doesn&#8217;t. same monthly pay for every blogger. $200 Not too shabby. I may have reached that in one or [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=904&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>A tweet from one <a href="https://twitter.com/#!/robinlloyd99/status/160074593887977474" target="_blank">@robinlloyd99 </a>indicates that the pay structure worked out for the <a href="http://blogs.scientificamerican.com/" target="_blank">Scientific American blogs </a>runs a fixed $200 per month.</p>
<blockquote><p><em>.<a href="https://twitter.com/#%21/BoraZ" rel="nofollow"><s>@</s><strong>BoraZ</strong></a>: some networks pay more to those who bring more traffic. <a href="https://twitter.com/#%21/sciam" rel="nofollow"><s>@</s><strong>sciam</strong></a> network doesn&#8217;t. same monthly pay for every blogger. $200</em></p></blockquote>
<p>Not too shabby. I may have reached that in one or two big months at Scienceblogs.com but for the most part the paystructure there was running maybe $100-$150 per month for the DM blog, which was right around 20% or so down the traffic list. So the vast majority of Sb bloggers were not making anything near what SciAm blogs is paying. Including Sb escapees such as <a href="http://blogs.scientificamerican.com/compound-eye/" target="_blank">Myrmecos</a>, <a href="http://blogs.scientificamerican.com/scicurious-brain/" target="_blank">SciCurious</a> and <a href="http://blogs.scientificamerican.com/doing-good-science/" target="_blank">Aunt Janet</a>.</p>
<p>&nbsp;</p>
<p>This is fantastic.</p>
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		<slash:comments>0</slash:comments>
	
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			<media:title type="html">drugmonkey</media:title>
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		<item>
		<title>PIs on screen</title>
		<link>http://drugmonkey.wordpress.com/2012/01/05/pis-on-screen/</link>
		<comments>http://drugmonkey.wordpress.com/2012/01/05/pis-on-screen/#comments</comments>
		<pubDate>Thu, 05 Jan 2012 09:08:23 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[Mentoring]]></category>

		<guid isPermaLink="false">https://drugmonkey.wordpress.com/?p=701</guid>
		<description><![CDATA[The Professor guy in Congo really didn&#8217;t seem too broken up about his postdoc getting ripped apart by beasts. People complain about maniacal slave driver bosses like MooMing Poo and Scott Kern but c&#8217;mon&#8230;could be worse.<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=701&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>The Professor guy in <em>Congo</em> really didn&#8217;t seem too broken up about his postdoc getting ripped apart by beasts. People complain about maniacal slave driver bosses like MooMing Poo and Scott Kern but c&#8217;mon&#8230;could be worse.</p>
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			<media:title type="html">drugmonkey</media:title>
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		<title>The end of an era</title>
		<link>http://drugmonkey.wordpress.com/2011/09/15/the-end-of-an-era/</link>
		<comments>http://drugmonkey.wordpress.com/2011/09/15/the-end-of-an-era/#comments</comments>
		<pubDate>Thu, 15 Sep 2011 21:31:05 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[Day in the life of Drugmonkey]]></category>

		<guid isPermaLink="false">http://drugmonkey.wordpress.com/?p=475</guid>
		<description><![CDATA[Not Found The requested URL /drugmonkey/ was not found on this server. Apache/2.2.3 (Red Hat) Server at scienceblogs.com Port 80<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=475&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<h1><strong>Not Found</strong></h1>
<p>The requested URL /drugmonkey/ was not found on this server.</p>
<hr />
<p><em>Apache/2.2.3 (Red Hat) Server at scienceblogs.com Port 80</em></p>
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		<slash:comments>4</slash:comments>
	
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			<media:title type="html">drugmonkey</media:title>
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		<title>Mentoring and the publication racket</title>
		<link>http://drugmonkey.wordpress.com/2011/09/10/mentoring-and-the-publication-racket/</link>
		<comments>http://drugmonkey.wordpress.com/2011/09/10/mentoring-and-the-publication-racket/#comments</comments>
		<pubDate>Sun, 11 Sep 2011 05:20:54 +0000</pubDate>
		<dc:creator>bikemonkey</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">https://drugmonkey.wordpress.com/2011/09/10/mentoring-and-the-publication-racket/</guid>
		<description><![CDATA[Whether I think it sad or not, it is true. From postdocs to grad students to rotation students, summer interns and technicians&#8230; The best thing to do as a mentor is to make sure they are on projects which earn them an authorship, preferably sooner rather than later. Learning a bunch of stuff is comparatively [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=474&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>Whether I think it sad or not, it is true. From postdocs to grad students to rotation students, summer interns and technicians&#8230;</p>
<p>The best thing to do as a mentor is to make sure they are on projects which earn them an authorship, preferably sooner rather than later.</p>
<p>Learning a bunch of stuff is comparatively less important.</p>
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			<media:title type="html">bikemonkey</media:title>
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		<item>
		<title>A reaction to the racial disparity in NIH grant success rates</title>
		<link>http://drugmonkey.wordpress.com/2011/09/06/a_reaction_to_the_racial_dispa/</link>
		<comments>http://drugmonkey.wordpress.com/2011/09/06/a_reaction_to_the_racial_dispa/#comments</comments>
		<pubDate>Tue, 06 Sep 2011 21:54:32 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[Careerism]]></category>
		<category><![CDATA[Grant Review]]></category>
		<category><![CDATA[NIH]]></category>
		<category><![CDATA[Tribe of Science]]></category>
		<category><![CDATA[Underrepresented Groups]]></category>

		<guid isPermaLink="false">http://drugmonkey.wordpress.com/2011/09/06/a_reaction_to_the_racial_dispa/</guid>
		<description><![CDATA[in which a picture is worth a thousand words&#8230;. but you need to go read the post by Hermitage. Also, here&#8217;s a link to the Chronicle bit on the disparity in undergraduate scholarship awards mentioned in the post at The Hermitage. White students make up 62 percent of full-time students enrolled in four-year colleges but [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=903&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>in which a picture is worth a thousand words&#8230;.<br />
<a href="http://scientopia.org/blogs/thehermitage/2011/09/06/in-which-hermitage-is-a-pissy-black-person/"><img src="http://scientopia.org/blogs/thehermitage/files/2011/09/the-negro-community-frowns-upon-your-shenanigans1.jpg"></a><br />
but you need to <a href="http://scientopia.org/blogs/thehermitage/2011/09/06/in-which-hermitage-is-a-pissy-black-person/">go read the post by Hermitage</a>.<br />
Also, here&#8217;s a link to the Chronicle bit on the <a href="http://chronicle.com/blogs/ticker/white-students-receive-disproportionate-share-of-merit-aid-report-finds/35888">disparity in undergraduate scholarship awards</a> mentioned in the post at The Hermitage.</p>
<blockquote><p><em>White students make up 62 percent of full-time students enrolled in four-year colleges but receive 76 percent of institutional merit scholarships; and white students are 40 percent more likely to receive private scholarships than minority students are.</em></p></blockquote>
<p>And the <a href="http://nexus.od.nih.gov/all/2011/08/18/new-nih-study-on-diversity">OER Rock Talk blog thread on the racial disparity</a> continues&#8230;</p>
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		<title>On the perceptions of well intentioned people regarding the NIH&#8217;s little diversity whoopsie</title>
		<link>http://drugmonkey.wordpress.com/2011/08/26/on_the_perceptions_of_well_int/</link>
		<comments>http://drugmonkey.wordpress.com/2011/08/26/on_the_perceptions_of_well_int/#comments</comments>
		<pubDate>Fri, 26 Aug 2011 23:54:33 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[Grant Review]]></category>
		<category><![CDATA[NIH]]></category>
		<category><![CDATA[Underrepresented Groups]]></category>

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		<description><![CDATA[If there is one item that is way up there on the list of things that discourage black scientists (right behind the data that illustrate the disparity) it is the reflexive denial by non-blacks that there could possibly be any racism at work.
<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=902&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><span style="float:left;padding:5px;"><img src="http://scienceblogs.com/drugmonkey/image/bicyclingadvertcloseup-125.jpg" width="125" height="112" /><br /><font size="-2"><em><b>BikeMonkey Guest Post</b></em></font></span><em></em>Believe you me, it does not escape my attention that instead of working on my grant that is due in approx one month&#8217;s time, I am talking about the <a href="http://www.sciencemag.org/content/333/6045/1015">Ginther et al report</a>. No, I am not <em>obligated</em> to say jack squatte about it. These little distractions are optional. As is the mentoring &#8220;tax&#8221; that the senior author of that report, Raynard Kington, <a href="http://www.wbur.org/npr/139748454/black-researchers-getting-fewer-grants-from-nih">discussed</a>. Likewise participation in the well-intentioned &#8220;enhance the diversity&#8221; efforts of our Universities and professional societies. Yet&#8230;here we are.<br />
The DM has been <a href="http://www.michaeleisen.org/blog/?p=476#comment-40834">taking</a> a few whacks at what appears to be the <a href="http://www.michaeleisen.org/blog/?p=476">reasonably well-intentioned musings</a> of one Michael Eisen. I am fascinated by the latter&#8217;s defensive comment:</p>
<blockquote><p><em>But I&#8217;m shocked at how many people leapt to the immediate conclusion that the peer review system penalizes applications from black PIs when we know that black scientists face all sorts of other obstacles that both discourage them from entering the field in the first place and make it more difficult for them once they are here. I just felt it was pretty naive on the NIHs part to expect anything different &#8211; as if they thought the things they were doing to promote the careers of black scientists had actually solved all the problems they face. And then to look at the data and cry racism is just making the problem even worse by both discouraging black scientists from joining the field and making it harder for them to recruit people once there here. </em></p></blockquote>
<p>&#8220;<em>leapt to the immediate conclusion</em>&#8220;. &#8220;<em>cry racism</em>&#8220;. Yes, perhaps I should reconsider the &#8220;well-intentioned&#8221; bit. These are stock in trade phrasings of anti-affirmative action people.</p>
<p><span id="more-902"></span><br />
Dr. Eisen has gone astray. If you actually read what the Ginther report chose to look at for their analyses, and barring that read the Tabak and Collins executive summary, it is entirely obvious that these descriptions are inaccurate. The authors went to great lengths to try to address some of the more obvious questions that were only secondarily or tertiarily linked to the race of the PI. Even in the proposals for future study and review, Tabak and Collins bent over backward to cover the &#8220;disparities in education and research opportunities&#8221; that might be the true causal agent.<br />
So why is it Dr. Eisen&#8217;s perception that the NIH went jumping to racial conclusions?</p>
<blockquote><p><em>So, if I don&#8217;t believe peer review is pervasively racist, but I believe the data in the paper, I have to believe instead that NIH study sections find that grant applications from black scientists are &#8211; on average &#8211; marginally less impressive than those of their comparably experienced and accomplished white colleagues. </em></p></blockquote>
<p>Because his posed theoretical is likely not so theoretical. He is highly invested in the denial of racism in the peer review process. I&#8217;d like to point out to him that this may possible conflict with another of his stated goals:</p>
<blockquote><p><em>Rather than discouraging aspiring black scientists by portraying a field filled with insurmountable obstacles, we should emphasize that biomedical science offers them the opportunity to be judged not by the color of their skin, but by the content of their R01 application.</em></p></blockquote>
<p>If there is one item that is way up there on the list of things that discourage black scientists (right behind the data that illustrate the disparity) it is the reflexive denial by non-blacks that there could possibly be any racism at work. For those who have made their <strike>peace</strike> detente with the underlying, long established, subtle and hard to reverse discrimination realities, I&#8217;d hazard that this <em>denial</em> is in fact much more of a discouraging stimulus.<br />
Look, I&#8217;m not suggesting that the NIH needs to only pursue implicit racial bias in the minds of the study section members. The many goals and hypotheses that are on the table are admirable and have a chance of payoff. But they should not shy away from the possibility that there is bias at the level of peer review <em>either</em>.</p>
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		<title>Your Grant in Review: Productivity on Prior Awards</title>
		<link>http://drugmonkey.wordpress.com/2011/08/26/your_grant_in_review_productiv/</link>
		<comments>http://drugmonkey.wordpress.com/2011/08/26/your_grant_in_review_productiv/#comments</comments>
		<pubDate>Fri, 26 Aug 2011 17:06:14 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[Ask DrugMonkey]]></category>
		<category><![CDATA[Careerism]]></category>
		<category><![CDATA[Grant Review]]></category>
		<category><![CDATA[Grantsmanship]]></category>

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		<description><![CDATA[Better to have produced papers on topics far afield, than not to have published anything at all due to your original Aims being a dry well.
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			<content:encoded><![CDATA[<p>A commenter named ES over at writedit&#8217;s blog <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13253">asked</a>:</p>
<blockquote><p><em> I am wondering if I can conduct unfunded research projects using my current RO1 support since I have more experience and more publications on these unfunded projects. In contrast, testing our hypothesis proposed in my funded RO1 is practically not promising. If I decided to do something else which was not originally proposed in my funded RO1, how can I renew my funded RO1 or submit the report down the road.</em></p></blockquote>
<p>and <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13270">expands upon the theme</a>:</p>
<blockquote><p><em>the issue here is that my unfunded and funded project are total irrelevant. It is almost impossible to convert my unfunded project to something which is even close to the funded project. Can I do whatever Science takes me to with the unfunded project, and submit the unfunded project as new applications later, instead of renewal of my RO1? Will this cause a bad record for my academic career?</em></p></blockquote>
<p>There was also a related query from <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13299">Saheli</a> in that thread:</p>
<blockquote><p><em>2. Should the renewal reflect a substantial continuity to the current grant?<br />
3. What the ingredients of a successful renewal?</em></p></blockquote>
<p>The question from ES led to some startlingly bad advice.</p>
<p><span id="more-901"></span><br />
<a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13258">writedit</a>: <em>&#8220;you run the risk of not being funded again (&amp; not just in your attempt to renew the R01).&#8221;</em><br />
<a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13274">cc</a>: <em>&#8220;i would not change anything without discussing w/project officer, who should want to see the best science come forward.&#8221;</em><br />
The real howler, was in <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13310">this one from writedit</a>:</p>
<blockquote><p><em>I would hope at the very least that PIs who spend their grant $ on other projects have presented them to their peers and received some feedback on feasibility, suggested tweaks, etc. &#8230; the refinements a PI might not make on his/her own without going through the proposal process. Funds are too tight and the margin of error too small (in terms of available funds for re-dos), methinks, to wing it on one&#8217;s own.</em></p></blockquote>
<p>Although <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13259">CPP </a>and <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13329">BM</a> are all over it in the comments, I thought I had a contribution.<br />
The core question here is how will the reviewers of your current grant application view your record of accomplishment on your <em>prior </em>grant awards.<br />
I submit to you that in most cases there is a cascade of preferences that is approximately ordered as follows.<br />
1) Did you knock our socks off? This could be amazing ELEVENTY type findings, GlamourPub record (whether &#8220;expected&#8221; for your lab or not), unbelievably revolutionary advances, etc. If you have a record* of this, nobody is going to think twice about what your Aims may have been. Probably won&#8217;t even give a hoot whether your work is a close match** to the funding IC, for that matter.<br />
2) Were you <em>productive</em>? Even if you didn&#8217;t WOW the world, if you&#8217;ve pumped out a respectable number of papers that have some discernible impact on a scientific field, you are in good shape. The more, the merrier. If you look &#8220;fabulously productive&#8221; and have contributed all kinds of interesting new science on the strength of your award(s), this is going to go down like gangbusters with the review panels. At this level of accomplishment you&#8217;d probably be safest at least be doing stuff that is vaguely in line with the IC that has funded your work. But even so, and related to ES&#8217;s query,<em> better to have produced papers on topics far afield, than not to have published anything at all due to your original Aims being a dry well. </em><br />
3) Were you productive in addressing your overall goals? This is an important distinction from the Specific Aims. It is not necessary, in my view, that you hew closely to Aims first dreamed up 7 years prior to the conclusion of the actual study. But if you have moderate, or disappointing, productivity it is probably next most-helpful that you have published work related to the overall theme of the project. What was the big idea? What was mentioned in the first three sentences of your Specific Aims page? If you have published work related to this broad picture, that&#8217;s good.<br />
4) Did you address your original Specific Aims? Now true, this can be a big obsession of certain reviewers. Not saying it isn&#8217;t a good idea to have papers that you can connect clearly to your prior Aims. This is particularly important for a competitive renewal application. I place this far down the list however, to emphasize my usual theme: <em>A grant is not a <u>contract</u></em>. It is quite natural in the course of actual science that you will change your approaches and priorities for experiments. Maybe you&#8217;ve been beaten to the punch. Maybe your ongoing studies tell you that your original predictions were bad and you need to go in a whole new direction. Maybe the field as a whole has moved on. With that said, however, you will make it easier on your advocate reviewers if you have addressed your Aims. And since by that I mean <em>with published papers</em>, this is where you need to think hard about your tactical decisions. You might want to squeeze a drop out of a dry well to meet the &#8220;addressed Aims&#8221; criterion but maybe that money, effort and time would be better spent on a new direction which will lead to three pubs instead of one? I&#8217;d go with the latter, personally.<br />
Circling back to <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13310">writedit&#8217;s absurd comment</a>, I want to emphasize that deciding tactics is the normal daily business of the scientist who heads a research group and manages research funds. Where the most useful, interesting and productive science lies is on <em>you </em>to decide, PI. You don&#8217;t require &#8220;the proposal process&#8221; or the input of formal peer review to determine how to do your science! I mean sure, we all may seek advice from colleagues about planned experiments and all. But there is nothing magical about proposal review in a NIH study section that will be able to help you make <em>ongoing </em>tactical decisions within the scope of conducting the actual work related to your funded 5yr plan.<br />
With respect to the conflation of your ability to get a favorable review of a competing continuation and new projects, I emphasize for <a href="http://writedit.wordpress.com/nih-paylines-resources/#comment-13270">ES&#8217;s question</a> that these are <em>very </em>different questions. It is absolutely ok to fail to submit a competing continuation for one project that went badly in preference to submitting a new project. This will not lead to a &#8220;bad record for (your) academic career&#8221;. It is preferable, yes, to renew some of your projects. This is because of some old school thinking and grant award experiences. But times have changed and the thinking needs to change with it. In terms of priorities, this comes down the list behind, you guessed it, <em>productivity</em>.<br />
The bottom line is, you should worry first about the publications and your substantive contribution to a subfield of science. Be a <em>scientist</em>. Don&#8217;t march in lock step to a plan laid out in a grant proposal if it is not leading you anywhere useful.<br />
__<br />
*one shot wonder GlamourPub may not be enough but an amazing bit of scientific advance may very well be the ticket.<br />
**of course this works best for the basic research stuff. The more basic you are, the better you can argue that starting with Aims in National Institute X&#8217;s wheelhouse led inexorably to findings more relevant to National Institute Y.</p>
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		<title>Polling Returns Without Review</title>
		<link>http://drugmonkey.wordpress.com/2011/08/26/polling-returns-without-review/</link>
		<comments>http://drugmonkey.wordpress.com/2011/08/26/polling-returns-without-review/#comments</comments>
		<pubDate>Fri, 26 Aug 2011 16:44:18 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[Scientific Publication]]></category>

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			<content:encoded><![CDATA[<a href="http://polldaddy.com/poll/5455133">Take Our Poll</a>
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		<title>Home Birther Logic. or &#8220;Logic&#8221; actually</title>
		<link>http://drugmonkey.wordpress.com/2011/08/24/home-birther-logic-or-logic-actually/</link>
		<comments>http://drugmonkey.wordpress.com/2011/08/24/home-birther-logic-or-logic-actually/#comments</comments>
		<pubDate>Thu, 25 Aug 2011 00:08:34 +0000</pubDate>
		<dc:creator>drugmonkey</dc:creator>
				<category><![CDATA[AntiFeministAsshole]]></category>
		<category><![CDATA[FWDAOTI]]></category>

		<guid isPermaLink="false">http://drugmonkey.wordpress.com/?p=469</guid>
		<description><![CDATA[Riddle me this. For background, Isis the Scientist started some shit by posting Your Home Birth is Not a Feminist Statement which sounds totally noncontroversial right from the start. But since it reviewed some data on home birth suggesting up to 37% of planned home births result in emergency hospital visits and noting as much [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=drugmonkey.wordpress.com&amp;blog=762913&amp;post=469&amp;subd=drugmonkey&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>Riddle me this.</p>
<p>For background, Isis the Scientist started some shit by posting</p>
<p style="text-align:center;"><a href="http://isisthescientist.com/2011/08/23/your-home-birth-is-not-a-feminist-statement/" target="_blank">Your Home Birth is Not a Feminist Statement</a></p>
<p>which sounds totally noncontroversial right from the start. But since it reviewed <a href="http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS000293781000671X.pdf" target="_blank">some data on home birth</a> suggesting up to 37% of planned home births result in emergency hospital visits and noting as much as a 0.3% uptick in the neonatal death rate, well, the home birth fans went shitnutz.</p>
<p>One can only hope that <a href="http://skepticalob.blogspot.com/2011/08/mother-of-dead-baby-asks-why-does-there.html" target="_blank">this homebirth person</a> who had one kid die, one need resuscitation and still can&#8217;t understand why anyone would think she&#8217;s high risk is rare. Very rare.</p>
<p>Kate Clancy, for whom I have a great deal of respect on most issues, has <a href="http://blogs.scientificamerican.com/context-and-variation/2011/08/24/why-do-those-who-advocate-home-birth-feel-the-way-they-do/" target="_blank">a somewhat reasonable post up</a> on the motivations for home birther fanaticism. </p>
<p>And these motivations are key, I agree. Because these motivations are driving otherwise reasonable people into a frenzy of woo based illogic that is really something to see. </p>
<p>There is one particular bit of thinking that I cannot for the life of me grasp. I&#8217;m going to pick on <a href="http://editedscientist.wordpress.com/2011/08/24/homebirth-vs-hospital-birth/" target="_blank">this post from homebirthercurious Dr.B</a> </p>
<blockquote><p><em>Hospitals are clearly equipped for dealing with the worst case scenarios. But it also seems that they are big fans of unnecessary interventions. </em></p></blockquote>
<p>but really it pops up everywhere. Such as on the <a href="http://twitter.com/#!/drugmonkeyblog/status/106219639280893952" target="_blank">Twitts</a>:</p>
<blockquote><p><em>Given that it&#8217;s kinda a one way trip, how does one determine this? RT @DrSnit: @drisis I don&#8217;t see your blog about unnecessary c-sections</em></p></blockquote>
<p><a href="http://twitter.com/#!/drugmonkeyblog/status/106221576206303233" target="_blank">and</a></p>
<blockquote><p>
<em>absent evidence of convenience scheduling, you simply have no idea what the &#8220;unnecessary&#8221; rate actually IS. No way to tell. @DrSnit</em></p></blockquote>
<p>Right? RIGHT??????</p>
<p>In birthing, the only way to know if a procedure was &#8220;unnecessary&#8221; or &#8220;necessary&#8221; is to either do it or not do it and figure out if the bad consequence is prevented, ameliorated or unaffected. And unfortunately you only get one try for each case study. Which means that you cannot actually know for sure for any particular case whether the procedures were in fact &#8220;necessary&#8221;. </p>
<p>Amirite? </p>
<p>Please explain to me, homebirther fans who wield the &#8220;unnecessary intervention&#8221; cudgel, exactly how you can determine which procedures were and were not necessary <em>in advance</em>. Because I am missing your logic here. </p>
<p>Look, science-based and/or evidence-based medicine recognizes that in the cases that are interesting*, there is rarely such a thing as a clear cut 100% accurate prediction of the future. What there <em>is</em> are probability distributions. If the kid&#8217;s heart rate slows down by such and such, the damn cord is wrapped around it&#8217;s neck X% of the time. Or, when the kid is in breech, Y% of the time the delivery ain&#8217;t going well. </p>
<p>Which always leaves some percentage of the time that everything is going to be fine and dandy. </p>
<p>Between fine-and-dandy land and 100% of births, however, you are playing with the health, well-being and even viability of a new human being. And this, mind you, is just for the stuff we can actually detect with high confidence is an adverse effect on the child. Dying is a pretty good one there, also hypoxia induced brain damage. </p>
<p>We do not know, however, if there are more subtle effects. Maybe you knock 5 pts off the kid&#8217;s IQ because you insist on laboring too long for &#8220;the experience&#8221;. Maybe you bathe that little wackaloon in hormonal responses that produce a raft of a subtle effects on development? Or maybe the child&#8217;s innate stress responses set a different stage. Who knows? Me, I&#8217;m betting on the side of smooth deliveries. Relatively rapid appearance of the kid once the laboring commences is my preference. </p>
<p>This last part is <em>MY</em> version of birth woo.  I&#8217;d rather not take chances. </p>
<p>__<br />
*i.e., debatable.</p>
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