Later On

A blog written for those whose interests more or less match mine.

Archive for November 12th, 2013

Beware partial transcripts from Darrell Issa

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Steve Benen writes at MSNBC:

For reporters covering Capitol Hill, there are two phrases that should immediately raise red flags when put in the same sentence: “partial transcript” and “House Oversight Committee.”

Republicans on this committee got into quite a bit of trouble in this area during the Clinton era, and now that Rep. Darrell Issa (R-Calif.) holds the gavel, reporters have been fed half-truths through “partial transcripts” over and over again.

And yet, some keep falling for the same trick. Last night, it was CBS News.

CBS News has learned that the project manager in charge of building the federal health care website was apparently kept in the dark about serious failures in the website’s security…. The project manager testified to congressional investigators behind closed doors, but CBS News has obtained the first look at a partial transcript of his testimony.

Henry Chao, HealthCare.gov’s chief project manager at the Centers for Medicare and Medicaid Services (CMS), gave nine hours of closed-door testimony to the House Oversight Committee in advance of this week’s hearing. In excerpts CBS News has obtained, Chao was asked about a memo that outlined important security risks discovered in the insurance system.

Based on the “partial transcript” from Issa’s committee, Chao didn’t know about a Sept. 3 memo on website problems identified by another official at the Centers for Medicare and Medicaid Services. Confronted with the document, the partial transcript shows Chao saying, “I just want to say that I haven’t seen this before.”

The CBS report sounds troubling, right? Probably, at least until one picks up the phone to ask Democrats on the committee whether the CBS report is accurate

I talked to a Democratic staffer this morning about the partial transcript and the aide said Issa’s staff “basically sandbagged this witness with a document he had never seen before and then failed to inform him that it has nothing to do with parts of the website that launched on October 1. In fact, it relates to a function of the website that is not currently active and won’t be until the spring of 2014. Rather than seeking out the truth, this press release tries to scare the public by capitalizing on confusion caused by the Chairman’s own staff.”

Oh. So, when Republicans and CBS suggest the project manager in charge of building the federal health care website was apparently kept in the dark about serious failures in the website’s security, they’re leaving out pretty much every relevant detail that points in a more accurate direction.

The Democratic staffer added that even when this part of the website is active, it “will not submit or share personally identifiable information,” but rather, will only include “insurance information plan data.”

Let’s say this again: beware of partial transcripts from Issa’s office. They keep pulling this trick; there’s no reason anyone should keep falling for it.

The report does not say whether the gullible CBS reporter was Lara Logan or not.

Written by LeisureGuy

12 November 2013 at 11:58 am

Posted in Congress, GOP, Healthcare

Reducing harm from alcohol

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David Nutt writes in The Guardian (emphasis added):

enjoying a seasonal drink at a Christmas party without the risk of a hangover the next day, or being able then to take an antidote that would allow you to drive home safely. It sounds like science fiction but these ambitions are well within the grasp of modern neuroscience.

Alcohol is both one of the oldest and most dangerous drugs, responsible for about 2.5 million deaths worldwide, which is more than malaria or Aids. The reasons for this are well known: alcohol is toxic to all body systems, and particularly the liver, heart and brain. It makes users uninhibited, leading to a vast amount of violence and is also quite likely to cause dependence, so about 10% of users get locked into addiction. If alcohol was discovered today it could never be sold as it is far too toxic to be allowed under current food regulations, let alone pharmaceutical safety thresholds. In this health-conscious age, it is odd that these aspects of alcohol are rarely discussed.

The only proven way to reduce alcohol harms is to limit consumption through increased pricing and limiting availability. Most governments have shied away from this because of public opinion and fears of lost tax income – the notable exception being Scotland with its minimum pricing strategy. An alternative strategy that offers greater health benefits would be to make a safer version of alcohol.

We know that the main target for alcohol in the brain is the neurotransmitter system gamma aminobutyric acid (Gaba), which keeps the brain calm. Alcohol therefore relaxes users through mimicking and increasing the Gaba function. But we also know that there are a range of Gaba subsystems that can be targeted by selective drugs. So in theory we can make an alcohol surrogate that makes people feel relaxed and sociable and remove the unwanted effects, such as aggression and addictiveness.

I have identified five such compounds and now need to test them to see if people find the effects as pleasurable as alcohol. The challenge is . . .

Continue reading.

The boldfaced paragraph is why I support marijuana legalization, particularly since data show that people use less alcohol when marijuana is available.

Written by LeisureGuy

12 November 2013 at 11:36 am

Again we see the importance of the microbiome

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This time in hyenas rather than humans. Tracy Vince has the report in The Scientist:

Symbiotic bacteria that populate the scent glands of hyenas seem to aid chemical communication among the scent-marking mammals, according to a study published in the Proceedings of the National Academy of Sciences today (November 11). Michigan State University’s Kevin Theis and his colleagues, who had previously shown that hyena social groups harbor unique communities of bacteria that produce signature smells, used next-generation sequencing to investigate the microbes found in the scent glands of wild spotted and striped hyenas. They found that the bacterial communities were dominated by fermentive species and that microbial profiles between spotted and striped hyenas differed.

“It’s an extremely important study showing the role of bacteria mediating interactions between mammals,” Penn State University’s David Hughes, who not involved in the work, told LiveScience. “Only now are we discovering the role of what we think of as inconsequential passengers—the bacteria—and how important they are.”

Theis told Nature that his team was somewhat surprised by the bacterial communities it found. “The diversity of the bacteria is enough to potentially explain the origin of these [scent] signals,” he said.

In their paper, the researchers suggested that their bacteria-based fermentation hypothesis of chemical communication may be “prove broadly applicable among scent-marking mammals.”

Written by LeisureGuy

12 November 2013 at 11:27 am

Posted in Science

Simple Things You Can Do Today That Will Make You Happier, Backed By Science

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Interesting article by Belle Beth Cooper:

Happiness is so interesting, because we all have different ideas about what it is and how to get it. It’s also no surprise that it’s the Nr.1 value for Buffer’s culture, if you see ourslidedeck about it. So naturally we are obsessed with it.

I would love to be happier, as I’m sure most people would, so I thought it would be interesting to find some ways to become a happier person that are actually backed up by science. Here are ten of the best ones I found.

1. Exercise more – 7 minutes might be enough
You might have seen some talk recently about the scientific 7 minute workout mentioned in The New York Times. So if you thought exercise was something you didn’t have time for, maybe you can fit it in after all.

Exercise has such a profound effect on our happiness and well-being that it’s actually been proven to be an effective strategy for overcoming depression. In a study cited in Shawn Achor’s book, The Happiness Advantage, three groups of patients treated their depression with either medication, exercise, or a combination of the two. The results of this study really surprised me. Although all three groups experienced similar improvements in their happiness levels to begin with, the follow up assessments proved to be radically different:

The groups were then tested six months later to assess their relapse rate. Of those who had taken the medication alone, 38 percent had slipped back into depression. Those in the combination group were doing only slightly better, with a 31 percent relapse rate. The biggest shock, though, came from the exercise group: Their relapse rate was only 9 percent!

You don’t have to be depressed to gain benefit from exercise, though. It can help you to relax, increase your brain power and even improve your body image, even if you don’t lose any weight.

study in the Journal of Health Psychology found that people who exercised felt better about their bodies, even when they saw no physical changes:

Body weight, shape and body image were assessed in 16 males and 18 females before and after both 6 × 40 mins exercise and 6 × 40 mins reading. Over both conditions, body weight and shape did not change. Various aspects of body image, however, improved after exercise compared to before.

We’ve explored exercise in depth before, and looked at what it does to our brains, such as releasing proteins and endorphins that make us feel happier, as you can see in the image below.

2013-11-11-brain-thumb2.  . . .

Continue reading.

Written by LeisureGuy

12 November 2013 at 11:17 am

The long-term human cost of waging war

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First is the human cost in the countries we choose to invade—Vietnam, Iraq, Afghanistan. And then there’s the human cost to our troops: deaths, which now are less frequent than in past wars, and disabilities, both physical and psychological (PTSD). Josh Eidelson in Salon interviews Ann Jones about her new book:

War zone journalist and humanitarian aid volunteer Ann Jones is the author of eight books on war trauma, violence against women, and Afghanistan. She recently spoke with Salon about her latest, the newly released “They Were Soldiers: How the Wounded Return From America’s Wars – The Untold Story” (a Dispatch Books project for Haymarket Books). “The sort of post-deployment crime waves are pretty, pretty frightening,” she said. A condensed version of our conversation follows.

Your book is subtitled “How the Wounded Return From America’s Wars – the Untold Story.” What’s the untold part here?

I sort of don’t like those, you know, claims. But I understand that as far as we know, nobody has written in such detail about the step-by-step treatment of soldiers who have been injured in these wars. And it took me a year to get the permission to embed and make these Medevac flights with the wounded and hang out in the hospitals and see what is going on. So that part of witnessing what happens to the patients, and also the tremendous effect this has on the medical staff that is caring for them — that part of the story has not been reported before.

There’s another part of the book, the last chapter, that is about what happens when many of the soldiers come home and fall into, shall we say, risky and dangerous and often deadly behavior. Both a lot of family violence — a lot of them kill their wives or their girlfriends or their children. A lot of them, quite surprisingly to me, kill other soldiers. Many of them kill perfect strangers. And of course a great number of them kill themselves. And then there’s the drinking and drugging and all of that that goes on. And I think that the press has been remiss in putting that all together.

But what I found was that smaller local papers all over the country have been reporting on the things that were happening in their local area. And when those localities are close to military bases there are reporters that start putting this together, and the sort of post-deployment crime waves are pretty, pretty frightening. And the New York Times has put together some of those stories, but I think they got a lot of pushback — you know, “That’s not very complimentary to our veterans who have done so much for our country.” So they kind of seem to have given up on that. But the statistics keep mounting.

And your reporting on what you’re calling a “crime wave” – how much did that come from interviews that you did, or local press reports, or government statistics?

I’ve written about it before, and have done interviews about it before. But when I started looking into it again for this book, there was just too much of it for me to go around the country and report on all of this myself. And so in that particular chapter of the book, I depend very much on these small local papers all over the country who are sending out their reporters to get the facts … It’s very important documentation that we wouldn’t know about if it weren’t for all those local reporters out there.

And what’s the nature of the connection you’re suggesting between violence in war and violence at home?

Well, this is the connection that’s been pretty well established in past wars, but it seems to be even more extreme in these wars. And I think probably part of that has to do with the extent to which these people are doped up with drugs that aren’t doing them any good. But there are several different kinds of connections that have been pretty well established by researchers, psychiatrists and so on working with veterans. One is this inability to fit into their own families again, and the kind of hyper-explosiveness that comes out in family violence. And so there is a great deal of wife-beating, sexual assault of wives and girlfriends, and the murder of wives and girlfriends. Because often both partners in a relationship are in the military, often male soldiers are murdering their partners who are also soldiers. This has something to do with the whole macho ethos of the military, because rates of domestic violence have always been much higher in the military population than among civilians.

And a great deal of effort has gone into trying to get the military to institute effective programs to deal with domestic violence, but they’ve never really done it. They’ve made gestures and they’ve instituted some reforms which civilian experts in domestic violence recommended against. And so the results have not been good.

And then the other typical behavior that results in trouble is that guys who’ve been in combat especially tend to come back and engage in very risky behavior. And I don’t know if this is an adrenaline hangover or what. A great number of returning soldiers are killed in single-car crashes, or even more so in motorcycle accidents at a rate much higher than the civilian population. And then there’s getting into bar fights and attacking other guys and so on, and it goes on and on. And then there is quite a lot of this soldiers murdering other soldiers. And I think there are a lot of them who come back and haven’t gotten out of combat mode, and they just kind of carry on. In fact this is especially associated with certain bases … So the Pentagon is well aware of this but they don’t seem to know what to do about it.

And what is it that you think should be done? . . .

Continue reading.

Written by LeisureGuy

12 November 2013 at 11:13 am

Posted in Books, Military

Thom Hartmann: Libertarians are pushing us over a cliff

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UPDATE: Democracy Now! also interviews Thom Hartmann.

Alex Halperin interviews Thom Hartmann in Salon:

Brace yourself. Thom Hartmann has bad news. His new book “The Crash of 2016” is self-explanatory but understated. The great recession? As he sees it that that that was a tremor before the big one. It’s coming and just one of the causes might be the unregulated derivatives market measured in hundreds of trillions of dollars, several times as much as the conventional global economy.

Thom Hartmann talked to Salon about how conservative “predators” got out of control, Enron’s ugly legacy and why he’s optimistic. Gluttons for punishment can find an excerpt from the book here.

This interview has been edited for space and clarity.

What is the plot to destroy America? There have been lots of them.

From the beginning of our republic there has been this debate. There have been these dueling visions of what America should be. In some ways it’s an analogue of what ended up being the Whig Federalist vs. the Democratic Republican debates, which is should we have a country that is governed by a wise few, because the masses can’t really be trusted or should we have a country that is governed from the bottom up. This debate has taken a lot of different forms and morphed into a variety of political positions, but that’s the essential battle.

That’s the plot, as it were, on the one hand a group of ideologues concerned that you can’t trust the masses and on the other hand you have the kind of Rooseveltian notion that society should be for all the people and all the people should be able to participate in the society whether it’s through a union or with the democratic process.

There’s two groups that are driving this thing that I describe as the plot. First is the [conservative] ideologues but then there’s also a group of predators who use that rhetoric and that ideology to set up a situation where they can enrich themselves at the expense of everyone else. So the rhetoric has been used to deconstruct the protections for our economy and our middle class that kept our nation stable from the 40s through the 80s.

Then the predators stepped in and said lets take that a step further and blow up Glass – Steagall and put in the Futures Modernization Act so we can have unregulated derivatives, create a 800 trillion dollar market when the whole world’s GDP is only 65 trillion dollars. It’s really the predators that have always brought down our country, but they’ve hid behind ideology that is actually a legitimate ideology.

You’re talking about conservative ideology?

One might call it conservative ideology but I’m not even sure Barry Goldwater would recognize it. Maybe libertarian ideology is a better word for it.

What enabled this ideology to reach what you’re arguing is a dangerous point? There have always been predators.

That’s the second major point of the book. You have to go back to a quote that has been attributed to various people, “When the last man that remembers the horrors of the last great war dies, the next great war becomes inevitable.” When we forget the history to paraphrase Sir Edmund Burke, we are doomed to repeat it. And it takes about 80 years for that to happen. Roughly 90 years ago we saw the election of Warren Harding on a platform, his slogan was “More business in government, less government in business.” He dropped the tax rate, deregulated banks, deregulated pretty much everything. It was this huge bubble in the 20s that crashed in 1929.

If you go back 80 years before that you see the big battles over regulation and deregulation of the 1840s and 1850s that led to the crash of 1857 that arguably led to the Civil War. And if you go back 80 years before that, you see there were somewhat similar economic debates.

Roughly every 80 years we kind of forget about economic bubbles, make the same mistakes, and those mistakes lead to economic disaster, which typically leads to a war. And I’m saying we’re 80 years out from the last one and we’re making the same mistakes.

We’ve just had a severely bad recession as well as quite a few wars, why aren’t those having any the effect you say crises have – a corrective effect? . . .

Continue reading.

Written by LeisureGuy

12 November 2013 at 10:48 am

Posted in Books, Business

Elizabeth Warren seems to be doing good things

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I am so glad that we have Elizabeth Warren for a Senator. David Dayen shows why:

If asked, Americans of all political persuasions will say overwhelmingly that they prefer “tougher rules” for Wall Street. But what does that actually mean?

You can frame this conventionally: supporting regulators, punishing rules violators, mopping up 2008-style disasters to limit the damage and attempting to prevent such chaos from happening again. But by “tougher rules,” maybe Americans are really signaling a vague but persistent dissatisfaction with an economy that has become dominated by the financial sector. And you can see within that how transforming banking back to its traditional purpose — as a conduit for putting capital in the hands of worthwhile business ventures and driving shared prosperity — would be one antidote to an unequal society full of financial titan gatekeepers, who confiscate a giant share of the money flowing through the system.

Sen. Elizabeth Warren — in many ways the avatar of a new populist insurgency within the Democratic Party that seeks to combine financial reform and economic restoration — will speak later today in Washington at the launch of a new report that marks a key new phase in this movement. Released by Americans for Financial Reform and the Roosevelt Institute – and called “An Unfinished Mission: Making Wall Street Work for Us” — the report is a revelation, because it finally invites fundamental discussions about these issues. Its 11 chapters from some of the leading thinkers on financial reform do look back at the successes and failures of the signal financial reform law of this generation, the Dodd-Frank Act. But the report also weaves in a story about how we can reorient finance as a complement to the real economy, rather than its overriding force. Mike Konczal, a fellow at the Roosevelt Institute and the co-editor of the report, tells Salon, “The financial sector is still eating up a lot of GDP [gross domestic product], and it’s not clear what we’re getting out of it. We want to get the conversation at that level.”



This report fills in the details, creating definable action items and goals that could serve as a marker for legislative and regulatory action, as well as primaries in the next several election cycles.

The roots of this conversation go back decades, if not hundreds of years. One of the report’s authors, John Parsons of MIT, notes that the debate over whether to force derivative trades — the bets on top of bets that helped accelerate and magnify the financial crisis — into central and transparent clearinghouses dates back to the Minneapolis Grain Exchange of 1896. The concept of a fiduciary standard, which states that anyone offering advice on investment strategies should act in the interests of their individual clients rather than trying to enrich themselves, was initially settled in the Investment Advisors Act of 1940.  Even Ben Bernanke last week drew parallels between the 2008 crisis and the Panic of 1907, which led to the creation of the Federal Reserve.

In the past few decades, Wall Street has devised financial “innovations” with the primary purpose of outpacing regulatory reach, surmounting decades-old reforms. This frees non-bank financial firms from oversight by the watchdogs, and allows them to accumulate risk in search of greater profits. For example, Marcus Stanley of Americans for Financial Reform looks at shadow banking, the lending markets that “convert illiquid, risky, long-term assets into ‘safe,’ liquid short-term securities.” This creates an illusion of safety and puts massive amounts of money outside the New Deal-era regulatory apparatus, where the firms involved don’t have requirements to carry capital to guard against inevitable losses, for example. In 2008, the breakdown of parts of the shadow banking system made it impossible for large financial actors to access short-term funding, turning a downturn into a crisis.

While shadow banking does not have access to the public safety net (things like bank deposit insurance, or access to Federal Reserve liquidity programs), in reality it is hooked into mega-banks inside the safety net. AIG was bailed out because its counterparties were corporations like Goldman Sachs and JPMorgan Chase, determined to be too big to fail. So you have the worst of all possible worlds; a giant alternative banking system not subject to any of the rules that limit risk, vulnerable to old-style bank runs, but able to get government relief if their gambles turn sour. You get privatized profits and socialized losses. You also create more fragility in the system, because shadow banking involves multiple links from borrower to lender, and as Stanley told Salon, “Each link in the chain is another opportunity to lie about what’s inside the loan.”

There are two ways to look at this problem. One is seen in the way Dodd-Frank tried, with varying success, to bring New Deal-era structures to the broader financial sector, pulling systemically important activities like insurance and hedge funds under a regulatory regime. Unfortunately, the maddening complexity of financial innovations generates uncertainty over what really falls under the rules, giving Wall Street and compliant regulators the opportunity to take advantage of loopholes. Orderly liquidation authority, the new measures for regulators to wind down large financial institutions, is so full of holes, argues Stephen Lubben of Seton Hall University, that it could quickly devolve into “a bailout in all but name.” Regulators have not even begun to reckon with large elements of the system, like money market funds or the overnight “repo” markets, which made significant contributions to the financial crisis. “Many of the conditions that helped cause the 2008 crisis persist,” writes Jennifer Taub of Vermont Law School in one of the report’s chapters.

The other way to deal with financial innovations is . . .

Continue reading.

Written by LeisureGuy

12 November 2013 at 10:44 am

The war-crime cover-up worked

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That’s the good news, in a way. The bad news is that covering up such things tends to increase the frequency, so that when it finally does come up, it’s discovered that the problem is MUCH larger than people at first thought—cf. rape in the military, which also greatly increased thanks to cover-ups. A cover-up indicates that the action is acceptable within the culture—otherwise there would be accountability and punishment. If those are missing, then the practice continues and often grows.

Here’s the report in Rolling Stone on the alleged war crimes, and Reuters today reports:

Afghanistan’s intelligence service has abandoned its investigation into the murder of a group of civilians after being refused access to U.S. special forces soldiers suspected of involvement, according to a document obtained by Reuters.

Seventeen men disappeared after being detained in U.S. raids in Wardak province between October 2012 and February 2013. Bodies of 10 of the men were found by residents in shallow graves within several hundred metres of the U.S. soldiers’ base.

Mystery surrounding their deaths has added tension to U.S.-Afghan ties already strained over delays to a proposed security pact designed to define the future of U.S. troops after most foreign forces leave the country by the end of next year.

In the report authored by Afghanistan’s National Directorate of Security (NDS) intelligence agency, investigators said they had asked the United States for access to three U.S. Green Berets and four Afghan translators working with them but were rebuffed.

“Despite many requests by NDS they have not cooperated. Without their cooperation this process cannot be completed,” said the report, which was originally published on Sept. 23.

U.S. military officials were not immediately available for comment but they have long said the Green Berets did not take part in, or turn a blind eye to, illegal killings in Wardak.

Under current rules, Afghan authorities have no right to charge U.S. military personnel with crimes as they are immune from Afghan law under a decade-old military agreement.

Access to the American soldiers would have allowed NDS to establish if accusations put forward by Zakeria Kandahari, an Afghan translator working with the Green Berets, had substance. . .

Continue reading.

Written by LeisureGuy

12 November 2013 at 10:29 am

A constructive response to a teen suicide epidemic

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Teen suicide epidemics are not unknown: it a very difficult age, and one suicide can spark a series of copycat suicides. In ancient Greek, one city-state had a series of suicides of adolescent women. Their response was to announce that suicides would be exhibited nude in the public square, and that ended it. A more constructive approach was taken by the citizens (not the community leaders) in Indian Valley CA as reported in Yes! magazine by Jane Braxton Little:

During the long, hard winter of 2011, the bleakest moment for Indian Valley, Calif., came with the chilling news of a sixth youth suicide. Ethan Elzea, then a reclusive 12-year-old, could name all of the dead boys: Rodney, Nate, Joaquin, Nick, Robby, Miko. But the shot that killed Nate Cunningham came closest to his heart.

Ethan, who confesses to having suicidal thoughts himself as early as the fourth grade, had followed Nate around their northern Sierra Nevada community like a little brother. They swam together and canoed in Lake Almanor. Ethan looked up to Nate, a counselor and fellow Native American. The relationship offered him respite from their home community, where racial tension and bullying are widespread.

“He was someone I could talk to,” says Ethan, now 15, slender and serious. The string of suicides—all of which occurred during a two-year period—sent him into a devastating depression. He brooded about violence, including the death of his sister’s cat, killed with a baseball bat. “I was angry at everything around me,” he says, his voice low and guarded. “I basically hit rock bottom.” For a few seconds Ethan’s eyes go dark and furious behind his maroon-rimmed glasses.

The six teen suicides shook Ethan’s rural community like an earthquake. Home to ranchers, loggers, and retirees, it is a place where almost everyone knows everyone else, often across several generations. The dead boys were sons of Indian Valley. Some were gentle, others pranksters. Some played sports, others dabbled in music. All but one were Maidu Indians, and all came from two-parent households where drugs, alcohol, and domestic violence had been longstanding problems. All had been exposed to bullying, and they knew each other well.

The community waited in stunned silence for some response from local social service providers. Greenville High School offered one day of grief counseling after the death of the oldest boy, a non-Native who had been out of school for several years, and the Maidu education center held a day-long gathering with healers and dancers. That was it. No discussion for parents, no suicide prevention training for teachers, nothing to kick-start the painful process of healing.

A close-knit community of 3,000 residents, Indian Valley had rallied together after forest fires, floods, and the threatened closure of the area’s only high school. The suicides, however, seemed to drive people into isolation. No one talked openly about them, says Susie Wilson, a lifelong resident whose husband, brother, and several close friends had killed themselves in years past. “It was as if we were all frozen in fear.”

Ethan was lucky. Though reticent himself, he comes from a talkative family. They hold weekly meetings—no electronics, no telephones—and discuss everything from daily chores to thoughts of death.

“If you talk about things, they don’t seem so bad,” says his sister Cassy, 18. “And maybe you can stop someone from committing suicide,” adds Haylee, 14.

This was the hope that inspired their mother, Marsha Ebersole, to team up with Wilson. Compelled by a yearning to spark community discussion about what was happening, the women took what now seems like an obvious first step: They held a public meeting. The gathering, in January 2012, drew about 85 people, a high turnout for any local event in January. The county director of mental health attended along with parents, Maidu elders, educators, and the Plumas County sheriff. . .

Continue reading.

In my experience, convening an ad hoc meeting of people affected by something can be surprisingly useful. I once worked as director of admissions at a college that did not accept transfers: everyone started as a freshman, regardless of previous college work. (The reason is that the college consisted of a four-year unified program, and it worked only if students began at the beginning.) The effect of this policy is that the each class suffered irreversible shrinkage over the four years: inevitably some students would drop out or transfer to another college, and the class would shrink. Occasionally a student who had dropped out would return, but never in significant numbers to make a difference in class size.

The college’s total enrollment was limited, so I quickly realized that if I could retain more of the students, the freshman classes could become smaller (because more upperclassmen remained in the program). That would greatly ease my job—getting a full number of qualified applicants was difficult—so I took a special interest in reducing attrition.

I called a meeting of people affected: the treasurer, the dean, the two assistant deans, the college nurse, the college psychiatrist, myself. I don’t recall whether I also included the director of athletics (the college did not play intercollegiate sports, but the intramural sports program involved a lot of the students).

The first surprise was that many of these had not met each other. Uh-oh. We did talk about why students were leaving—the dean does an exit interview—and we explored that for a while. The psychiatrist noted that the reasons the students gave may well not be the true reasons, and that in some cases they may not even know why: they just know they want to leave.

One concrete suggestion came from our realizing that parents might well fear that the college, which offered a very strong liberal arts program that included four years of math and four years of lab science among other things, would not enable their children to get a job. I could practically hear, “But what are you going to do with that degree?” being asked repeatedly, with the question more frequent each year, as graduation approached.

So we created the office of college vocational counselor: a person who would start discussing possible career directions and opportunities with students from the time they arrive, meeting occasionally with each to discuss career options and requirements, put students in touch with alumni in various careers to get their perspective, present information on appropriate graduate programs, and so on. The idea was to provide the student with solid information to respond to the question: when asked, s/he could describe the process of finding a good career path and preparing themselves for it.

That was not the only idea that arose, but probably the major change. Whether because of that or because of the many minor changes, attrition dropped sharply. Within a couple of years, I was able to cut the size of the entering freshman class by 20% because we were retaining so many more upperclassmen. I think also the students felt more assured by the information they received and felt better about their choice of college.

The point is that if you convene a group of people with an interest in a given problem, you often will discover surprising solutions. Getting different perspectives together with a focus on the problem does indeed produce results.

Written by LeisureGuy

12 November 2013 at 9:59 am

Posted in Daily life

Wonderful send-off for the last remaining “Dambuster”

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Harold Jellicoe Percival served as ground crew on the famous Dambusters raids carried out in May 1943 by the 617 Squadron and depicted in the (highly recommended) movie The Dambusters. He died recently at the age of 99, and because he had a quiet life, the funeral home feared that few would attend his funeral, so they put a little ad in the paper:

Harold Jellicoe Percival, who was known as Coe, served as ground crew on the famous Dambusters raids carried out in May 1943 by 617 Squadron.

Mr Percival, who died last month aged 99, never married or had children.

The funeral home organising the service put an advert in a newspaper appealing for people to attend.

The Reverend Alan Clark, who conducted the service, said: “We marvel at the power of the printed word, whether on paper or screen.”

Mr Percival’s nephew, Andrew Colyer-Worrsall, said the attendance was “just remarkable”.

“He was a quiet man, he was an ordinary man who did his duty and served in the war and to see so many people turn up, it’s just overwhelming,” he said.”I can only say thank you so much to everybody.

“We thought there would just be two or three of us, so to see this many hundreds of people turn up is stunning.”

Mr Percival, who lived in Penge, south London, before joining Bomber Command, died in Alistre Lodge Nursing Home in Lytham St Annes in Lancashire.

Nursing home manager Lorraine Holt told BBC News she had been inundated with responses from people after the advert was reposted on social media sites.

“Late last night, we had a call from a soldier on leave from Afghanistan who said he wanted to attend.

“Then an 80-year-old lady from London who served in the RAF called us to say she was attending.

“The response has been absolutely incredible.”

The RAF Association Leyland branch, said they had also helped to ensure Mr Percival’s funeral on Monday was well attended.

The association’s standard bearer Stuart Dagger said: “We are saying goodbye to a hero.”The Dambusters March played as Mr Percival’s coffin was carried into Lytham Park Crematorium at 11:00 GMT on Armistice Day. . .

Continue reading.

Written by LeisureGuy

12 November 2013 at 8:59 am

Posted in Daily life

Why doctors cover up their colleagues’ medical mistakes

with 3 comments

It’s very hard to ferret out bad doctors because doctors cover up for their incompetent colleagues. [After all, the only people hurt are the patients, right? And when another doctor sees the patient, the damage has already been done, so reporting their colleague’s mistake will just rock the boat, so better to keep silent. On think it over (see comment to this post), that seemed gratuitously snarky. Apologies. – LG] Marshall Allen has the story in ProPublica:

Patients don’t always know when their doctor has made a medical error. But other doctors do.

A few years ago I called a Las Vegas surgeon because I had hospital data showing which of his peers had high rates of surgical injuries – things like removing a healthy kidney, accidentally puncturing a young girl’s aorta during an appendectomy and mistakenly removing part of a woman’s pancreas.

I wanted to see if he could help me investigate what happened. But the surgeon surprised me.

Before I could get a question out, he started rattling off the names of surgeons he considered the worst in town. He and his partners often had to correct their mistakes — “cleanup” surgeries, he said. He didn’t need a database to tell him which surgeons made the most mistakes.

By some estimates, medical errors are one of the leading causes of death in the United States. Physicians often see the mistakes made by their peers, which puts them in a sticky ethical situation: Should they tell the patient about a mistake made by a different doctor? Too often they do not.

A new report in The New England Journal of Medicine, “Talking With Patients About Other Clinicians’ Errors,” suggests it’s a common problem.

The report’s lead author, Dr. Thomas Gallagher, an internist and professor at the University of Washington School of Medicine, said he conducted a survey of doctors in which more than half said that, in the prior year, they identified at least one error by a colleague. (The survey, unrelated to the NEMJ report, did not ask what the doctors did about it, Gallagher said.)

There’s wide agreement in the medical community that doctors have an ethical duty to disclose their own errors to patients, Gallagher said. But there’s been less discussion about what physicians should do when they discover that someone else’s mistake.

For the NEJM report, Gallagher led a team of 15 experts who discussed the problem. They identified many reasons why doctors may want to stay silent about errors by their peers.

One is that doctors depend on each other for business. So a physician who breaks the code of silence may become known as a tattler and lose referrals, a financial penalty. Or maybe they aren’t sure exactly what happened to the patient and don’t want to take the time to try and unravel it. In some cases, issues related to cultural differences, gender, race and seniority come into play.

The report notes that doctors also may be wary of becoming entangled in a medical malpractice case, or of causing a colleague to face legal consequences.

Dr. Brant Mittler, a cardiologist who now works as a medical malpractice attorney in Texas, told me that he frequently saw errors made by other physicians during almost four decades in medicine.

Mittler remembers a scan read by a radiologist that said a patient had an “ejection fraction” — the amount of blood pumped by the heart with each beat — of zero. But that would only be possible if the patient was dead, he said. He noted the error to the radiologist, who thanked him.

Many times Mittler stayed quiet, he said. He saw many errors reading electrocardiograms at a 500-bed hospital in San Antonio. He said he didn’t know the details of each case, so he couldn’t tell if the errors affected the outcome for the patient. But he did not go to the other doctors to point out the errors — there would have been hostility if he had, he said.

“There’s not a culture where people care about feedback,” Mittler said. “You figure that if you make them mad they’ll come after you in peer review and quality assurance. They’ll figure out a way to get back at you.”

Gallagher said physicians experience the normal range of human emotions when they find a colleague’s error. They wonder if they can keep it to themselves or whether they’re compelled to tell someone. Or they consider what they would want to happen if they had made the error.

That results in too much leniency toward mistakes, he said.

The bottom line: . . .

Continue reading. There’s more. In particular, findings from the ProPublica Patient Harm Questionnaire are discussed.

It strikes me in particular that the elevation of doctors—especially, say, surgeons—to a God-like status that enables their ego open the gates to their id and refuse to countenance correction or feedback is the root of the problem. A doctor gets enough deference from nurses that in time doctors see that as their due and start to demand deference—and not just from nurses. And without corrective feedback, it’s very easy to drift off course. In fact, Chris Argyris looking at another group insulated from feedback by their own power and the deference of others, CEOs, found that often they had an explicit code of conduct that diverged sharply from the code of conduct expressed by their actions. They were totally unaware of this, because of course they had a clear reason in mind that justified each action, and those around them were fearful of pointing out the discrepancies.

Written by LeisureGuy

12 November 2013 at 7:59 am

Posted in Business, Medical

Very smooth shave, a few tenterhooks

with one comment

SOTD 12 Nov 2013

Very nice result, but the R41 does tend to give me a bit of the heebie-jeebies. The key is to use a much shallower angle than I normally use, and the shave went well with no nicks. But I would not call it a comfortable, carefree shave.

But first, the lather. (Important to remember.) The banded equivalent of the Pro 48 has a different feel. It did seem to break in faster. I don’t know quite how to describe the difference: it’s softer but as though the knot were not quite so dense—it is in fact equally dense, I think, but perhaps the bristles feel thinner? At any rate, it’s a good brush and breaks in very quickly, whereas the Pro 48 takes a bit longer. I like both brushes.

Dr. Selby is a concentrated (3x!) shaving cream. I at first thought it had to be a soap because I was under the illusion that the differences were: creams=soft, soaps=hard. But then there are many soft soaps around (Cella, Vitos, Virgilio Valobra, and the like), and there are some quite firm creams (Coates Limited Edition, for one). Dr. Selby takes the cream to a new level of firmness, but it still a cream: the difference between soap and cream is in the formulation (cream being more detergent like) and not in the firmness. This is definitely a shaving cream, just hard as most soaps.

And it makes a dynamite lather. Quite wonderful stuff. The lid, as you see, acts also as a little stand for the bowl. This is one of several shaving creams that I think shaving-soap guys should try.

The shave went well, as I hinted: no nicks, smooth finish, and a good splash of Musgo Real aftershave to wrap things up.

In answering a question for a WEdger, I found this page of Mühle products. Take a look at some of those razors and brushes. Why don’t we have those available in the US? Some razors in particular look stunning.

Written by LeisureGuy

12 November 2013 at 7:44 am

Posted in Shaving

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