Later On

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

Archive for September 28th, 2015

The Norman Rockwell idea of a physician is fading fast

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Gina Kolata reports in the NY Times:

A well-to-do cancer patient is nearing the end of her treatments. During an office visit, she says to her doctor, “I can’t thank you enough for the care you provided.”

Should the doctor simply accept the patient’s gratitude — or gently suggest a way for her to show it: “Perhaps you might consider making a donation?”

More and more these days, development offices at major cancer centers are teaching doctors to seize such opportunities to raise money for the medical center or for their own research.

In an unprecedented survey of more than 400 oncologists at 40 leading cancer centers, nearly half said they had been taught to identify wealthy patients who might be prospective donors. A third had been asked to directly solicit donations — and half of them refused. Three percent had been promised payments if a patient donated.

The study, which was published online Monday in The Journal of Clinical Oncology, was conducted by Dr. Reshma Jagsi, a radiation oncologist and ethicist at the University of Michigan, who had grown concerned about the practice and wanted to know more.

Dr. Jagsi said she had sat in on workshops, seminars, training sessions and department meetings that discussed how to identify good prospects for gifts, how to direct grateful patients to the development office, and how to ask them directly if they wanted to donate.

She was uncomfortable with the idea, but she also knew some patients want to donate and are grateful for guidance on how to do it. And she knew medical centers needed money now more than ever. What was the ethical way for doctors to help, she wondered? Or should they stay out of the donation business completely?

She searched the medical literature for studies on the subject and found pretty much nothing, so she decided to conduct her own research.

The issue is “extraordinarily important,” said Arthur L. Caplan, head of the division of medical ethics at NYU Langone Medical Center, adding that he had never seen a paper that examined the issues as thoroughly as Dr. Jagsi’s. “Hopefully, this paper will start a long overdue discussion,” he said.

He ticked off some ethical pitfalls: . . .

Continue reading.

Written by LeisureGuy

28 September 2015 at 5:36 pm

The House That Could Save the World

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Sara Solovitch describes housing done right:

In July, when Portland was sweltering at upwards of 100 degrees, the tenants of The Orchards wondered if they had air conditioning. The temperature in their apartments never rose above 70.

They had all just moved into the newly opened affordable housing project in Hillsboro, a Portland suburb that over the last decade replaced thousands of fruit trees with silicon chip factories. Some of the tenants were workers in those factories. Others were clerks at Costco and nearby supermarkets. As they knew all too well, affordable housing didn’t come with air conditioning. So why were their new homes so comfortable?

The Orchards is an L-shaped building with bare bone apartments that overlook the light rail station. Its lobby is small with two striking features: a glassed display of tree trunks, cross sections of those cut down from those eponymous orchards and marked by fruit typology (Orenco apple, Green Gage plum, Royal apricot) and a five-foot TV screen prominently mounted, with a readout that monitors the minutiae of each apartment’s energy consumption, alerting tenants to the nuances of their neighbors’ electric budgets.

But it’s what you don’t see that makes it so unique. The Orchards is a “Passive House,” currently the largest one in North America. It’s a high performing energy-efficient complex whose 57 apartments stay cool on the hottest days and can be comfortably heated with a hand-held hair dryer on the coldest. Its windows are triple-paned. Its walls and floors are stuffed 11 inches deep with insulation. The ventilation system in the attic acts as the building’s lungs—continually pulling exhaust from every kitchen and bathroom, sucking stale air through a heat exchanger before carrying it to the outside and returning with fresh air.

“Every day I find a new reason to love it,” gushes Georgye Hamlin, whose one-bedroom apartment is as noiseless as a recording studio. “It’s cool, it’s quiet, and I don’t even hear the train. During the heat wave, my girlfriend came over to sleep because it was so cool. Yay for German engineering!”

Passivhaus, a building method developed in Germany in the early 1990s, relies on an airtight envelope—the roof, exterior walls and floors, literally, the physical barrier that separates in from out—to create a building that consumes 80 percent less energy than a standard house.

As translated into English, the term is almost a misnomer. It implies single-family housing, when in fact the approach can be applied to any size building. In Europe, supermarkets, schools, churches, factories and hospitals have been built to passive house standards. The number of certified buildings there exceeds 25,000.

The American market is tiny by comparison. There are about 150 certified houses nationwide and most people, on hearing the term, assume it refers to solar panels. That is now starting to change, along with concern about climate change and a growing understanding that, according to the U.S. Energy Information Administration, houses and other buildings account for 40 percent of all energy consumption and a third of carbon emissions nationally. Widely applied, passive construction could fundamentally alter the world’s carbon balance, but only if it can get over the internecine fights that have torn the concept’s European and North American backers apart.

With the virtuous equation in mind, hundreds of passive houses are now going up around the country—from bland, boxy cubes (like those at The Orchards) to elegant condos and Victorian retrofits. Volunteers for Habitat for Humanity have constructed passive townhouses in Washington, D.C. An ambulance dispatch center in Brooklyn was last year retrofitted to passive standards. An affordable housing project, built for youths aging out of foster care, just opened in Pittsburgh.

Last September, New York Mayor Bill De Blasio released a 35-year plan, One City: Built To Last, for reducing greenhouse gas emissions from the city’s buildings. The report named Passive House construction as a pathway for achieving the city’s goal of 80 percent reduction. It was the only building standard specifically identified in the report, a fact that made architects, builders and public policy experts take notice. In Europe, where all new construction must comply with “Nearly Zero-Energy Buildings” by 2020, passive building is a best building practice.

Then came the news that ground was being broken for the world’s biggest passive house—a 350-unit apartment house, owned by Cornell University on Roosevelt Island in New York City, to be completed by 2017. “This is going to open people’s eyes about what’s possible,” says Ken Levenson, a Brooklyn-based architect who will be working on the Cornell project. “It’s a huge building and it’s significant in terms of its breaking out of a stereotypical low-rise building. And it’s a blue chip customer, with all the associations of Cornell University—plus the fact that it’s being embraced by New York City and the mayor’s office. It changes the conversation in a big way.”

Despite all the talk of “r factors,” kBTUs and “air changes per hour” that breaks out whenever Passive House engineers and designers assemble, the approach’s appeal is its simplicity: Orient a building to . . .

Continue reading.

Written by LeisureGuy

28 September 2015 at 12:33 pm

FBI’s Anti-Encryption Campaign Is a Big Lie

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Jenna McLaughlin reports in The Intercept:

To hear FBI Director James Comey tell it, strong encryption stops law enforcement dead in its tracks by letting terrorists, kidnappers and rapists communicate in complete secrecy.

But that’s just not true.

In the rare cases in which an investigation may initially appear to be blocked by encryption — and so far, the FBI has yet to identify a single one — the government has a Plan B: it’s called hacking.

Hacking — just like kicking down a door and looking through someone’s stuff — is a perfectly legal tactic for law enforcement officers, provided they have a warrant.

And law enforcement officials have, over the years, learned many ways to install viruses, Trojan horses, and other forms of malicious code onto suspects’ devices. Doing so gives them the same access the suspects have to communications — before they’ve been encrypted, or after they’ve been unencrypted.

Government officials don’t like talking about it — quite possibly because hacking takes considerably more effort than simply asking a telecom provider for records. Robert Litt, general counsel to the Director of National Intelligence, recently referred to potential government hacking as a process of “slow uncertain one-offs.”

But they don’t deny it, either. Hacking is “an avenue to consider and discuss,” Amy Hess, the assistant executive director of the FBI’s Science and Technology branch, said at an encryption debate earlier this month.

The FBI “routinely identifies, evaluates, and tests potential exploits in the interest of cyber security,” bureau spokesperson Christopher Allen wrote in an email.

Hacking In Action

There are still only a few publicly known cases of government hacking, but they include examples of phishing, “watering hole” websites, and physical tampering.

Phishing involves an attacker masquerading as a trustworthy website or service and luring a victim with an email message asking the person to click on a link or update sensitive information.

When a high school student made repeated bomb threats in Lacey, Washington, in 2007 — disguising his identity by routing his web traffic through Italy — FBI agents launched a phishing attack using the bureau’s in-house malware by sending a link to a fake news article to his MySpace inbox. When he clicked, he unknowingly installed the malware, which revealed his identity.

This was controversial and received widespread media attention because of the FBI’s choice of a faked news article as their vector of attack. But it also told us two things about FBI hacking: that the FBI has been using that particular kind of malware attack since at least 2007, and that it took the public until 2014 to find out.

A watering hole attack infects a website with malware, so that anyone who visits it is also infected, potentially allowing the attackers to identify and control the visitor’s devices.

In 2013, as part of a child-porn investigation, the FBI seized a large number of web servers and installed malware that reveals personally identifying information of online visitors to several different popular websites, including an email provider. The sites were “Tor hidden service sites,” or sites that reroute web traffic around the globe to cloak their destination. The FBI snuck in a piece of code on every single website hosted by the Freedom Hosting service, directing information about hacked visitors back to a server in northern Virginia.

This watering hole attack landed a large number of people in the FBI’s trap, most of them innocent people who hadn’t committed any crimes. And the FBI never told them about it, because it never subpoenaed their identities — even though their computers had been compromised.

The earliest reported case of the FBI using physical tampering . . .

Continue reading. Lots more.

Written by LeisureGuy

28 September 2015 at 11:47 am

Chicken thoughts: Brining and roasting

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The Wife had dinner with three friends at the Zuni Cafe in San Francisco this past Saturday, and she and one friend chose a Zuni specialty, their roasted chicken (for two—and the other two made the same choice). It’s very tasty—I’ve also had it—and it put me in mind of roasting a chicken.

Zuni brines the chicken, so first I looked at a couple of guides to brining—this one and also the first way (wet brine) mentioned here—and will use ideas from those to brine my chicken, probably overnight. For aromatics I’m thinking garlic, lemon, thyme, and peppercorns.

Then I’ll follow Thomas Keller’s advice to remove the wishbone and truss the chicken well, as seen below. (There was a much better video of how to truss the chicken, but Scripps complained and the video has been taken down. Poo on Scripps.) Note his point on tempering the chicken—i.e., bringing it to room temperature before putting it into the oven so that it will cook evenly. However, I don’t think I’ll be cooking the vegetables with the chicken as he suggests. Instead, I’ll follow Ina Garten’s recipe.

Written by LeisureGuy

28 September 2015 at 11:19 am

Posted in Food, Low carb, Recipes

Learning shaving products

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SOTD 28 Sept 2015

User cgdntx asked an interesting question on Wicked Edge this morning: “When you try a new product, how long do you give it?” He was specifically asking about Mitchell’s Wool Fat shaving soap, which initially some find hard to lather.

I immediately thought of my Apollo Mikron, which initially would give me a lot of nicks. But since I loved the look of the razor, I continued using it, and soon the nicks ceased and now it shaves easily, comfortably, and reliably, never giving me a nick. I was not conscious of whatever changes I made in technique, but it’s quite common for practical skills to be a matter of unconscious learning through practice.

The brush in the photo is another example. I bought it for the beauty of the snakewood handle, and when I got it I was disconcerted by the softness of the knot, and initially was disappointed. But then I reflected that the knot is what it is, and I should learn to use it. It turned out that with very little practice I learned how to load the brush well, and the knot’s soft feel has made it a favorite brush. I knew from the start there had to be a change, but it turned out that what needed changing was not the brush but my attitude toward it. Once I accepted it as a soft brush and learned to use it, the brush became a favorite because of its fine performance and great feel.

So this morning I was planning the use the brush already, and after reading the post, decided that today’s soap would be MWF. I wet the knot well, gave it a good shake, and brushed the soap briskly but (given the brush’s softness) not much firmness. Brisk did the job, though as the brush loaded, the puck seemed too dry, so I added a small driblet of water to the brush and loaded a bit longer.

Ample lather—and a very good lather—and the Merkur white bakelite slant did its usual marvelous job: perfectly BBS in three passes with no problems at all. This razor really is one of the all-time great slants.

A couple of drops of D.R. Harris After Shave Milk, and the week awaits.

Written by LeisureGuy

28 September 2015 at 8:31 am

Posted in Shaving

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