Later On

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Archive for March 6th, 2017

The US seems to have gone crazy

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Kamili Hinkson reports for CBC News:

A Canadian woman travelling on a Canadian passport says she was turned away at the U.S. border and told she needed a valid immigrant visa to enter the country.

Manpreet Kooner, 30, is a Canadian citizen who was born to Indian parents in Canada and raised here. She now lives in Montreal’s LaSalle borough with her fiancé and works in a science lab at a local college.

She told CBC she was on her way from Montreal to a spa in Vermont for a day trip with two friends, who are both white, Sunday afternoon. They never made it.

Kooner said she was held at the border for six hours before being turned away.

At one point, she said, a border agent told her: “‘I know you may feel like you’ve been Trumped,'” an apparent reference to U.S. President Donald Trump.

Trump’s January executive order barring citizens from seven majority-Muslim countries from entering the country was later blocked in U.S. courts, but has touched off legal battles and confusion around the world.

Kooner was told to apply for the visa at the U.S. Embassy in Ottawa. She went to the embassy Monday morning but was told they couldn’t help her, and that she would need to talk to U.S. Customs and Border Protection.

“I’m speechless,” she said. “There are no answers.”

In a statement, U.S. Customs and Border Patrol (CBP) said it does not discuss individual cases, but that those who present themselves at ports of entry must prove they fulfill admission requirements, and that admission to the U.S. is at the discretion of the border officers.

The statement also says CBP adopted a policy in 2014 that “prohibits the consideration of race or ethnicity in law enforcement, investigation, and screening activities, in all but the most exceptional circumstances.”

Kooner’s story is the latest in a string of recent tales involving Canadian travellers scrutinized or turned away by U.S. border agents.

Last month, for instance, a woman from the Montreal suburb of Brossard said she was denied entry after being fingerprinted, photographed and questioned in detail about her religion and her views on Trump.

Kooner was reluctant to attribute her situation to racism, but said friends who have reached out to her say that could be the case.

“People have said we need to take that into account here, because unfortunately, yeah, my skin colour is brown,” she said.

Told she needed an immigrant visa

Kooner said this summer, her mother was turned away at the border as well, but wasn’t told why. Kooner said she was told her mother’s issues wouldn’t impact her.

She first had trouble getting into the U.S. last December, before Trump took office. She was with friends and her fiancé when her car was pulled over for what she was told was a random check, she said.

She was made to fill out a number of forms, but was eventually told there was a problem with the computer system and they should return the next morning.

When they went back, she was let through without any problems.

She said that when she tried to cross Sunday, at Highgate Springs, Vt., an agent checked her passport and said they needed to ask her additional questions.

The agent mentioned that she had been stopped in December and asked why she was trying to go through again, Kooner said.

She said she told them she’s a Canadian citizen, has no criminal record and, before December, never had any issues crossing the border.

She also said she was fingerprinted and photographed, and signed a form to withdraw her application for entry to the United States.

Though she was told there are no flags on her file, a border agent advised her not to fly to the U.S. without a visa, Kooner said.

The reference to Trump came as the agent was explaining the reasons why she was refused entry, she said. . .

Continue reading.

Written by LeisureGuy

6 March 2017 at 7:57 pm

Sam Sifton’s Picadillo

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And right after that previous post. I made this recipe tonight. My notes:

I tried to substitute dried salami for dried chorizo to save a trip to Whole Foods. It did not work. Use dried chorizo, although I use 5 oz, not 2 oz.

I use 8 cloves garlic: you must let minced or crushed garlic sit 15 minutes before cooking (to preserve nutrients that would otherwise be destroyed by heat), so peeling garlic and mincing it is the first step in the recipe.

I use ground beef that was 80% lean. I think next time I will go with 85% lean if they have it, or 90% lean if they don’t.

I used canned whole San Marzano tomatoes, 28 oz can. Don’t forget to DRAIN the tomatoes. I did.

I used plain raisins, not Sultanas.

Olive should be salad olives, which are small.

Very tasty dish. No rice: low-carb.

Written by LeisureGuy

6 March 2017 at 7:05 pm

the best books on Eating Meat (Carnivorism)

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Fivebooks.com interviews Louise Gray:

You’ve just published a book called The Ethical Carnivore. What does it mean to be an ‘unethical carnivore?’

Well, to me, being an unethical carnivore means just stuffing your face with meat without caring where it comes from. Being an ethical carnivore means trying only to eat meat that you understand comes from a good source. I tried to define it in my book by saying that ethics is the effort to live a good life. My question was how can we ensure the meat we eat does not harm the environment and comes from animals that have lived a good life?

I know to some people that can sound a little wishy-washy, but I was aiming the book at the majority of people in this country. I accept that people eat meat; I myself was a carnivore. Those who are vegetarian have already made their choice, so I wanted to talk to the carnivores about how they could be more ethical. And I wanted to make it realistic, so you have to leave room for trying your best and not always being perfect—the occasional drunken kebab. I believe that is the way to make a difference, by giving people an opportunity to try their best.

In the book, you spend some time discussing the capacity of different animals, with molluscs at one end of the spectrum, to feel pain. Is this the main moral or ethical issue that we need to consider?

No, I think it’s a lot more complex. For a start, how do we judge the pain of other animals? You mentioned molluscs—there is still ongoing research into whether these particular animals can even feel pain. I think you have to always consider that, but also look at the wider impacts, such as upon the environment.

In the book, for example, I write about scallop dredging on the west coast of Scotland. This is not just affecting the molluscs but the wider marine ecosystem as all the coral and other life on the seabed is ploughed up just for the scallops. So, I would argue in this case the question of the environmental impact is worth considering as well as the ability of the animal to feel pain.

The other question to ask is how does the processing of that animal affect the humans around them. For example, you might choose free-range organic chickens because the animals are better cared for, but if they’re being processed in a factory where people are being treated appallingly, then isn’t there a moral question about the labour that was used to get that meat to your table? Between the animal being born, or hatching, and getting to your plate, there are so many questions to consider in terms of ethics.

It can halt you in your tracks and make you think ‘I won’t bother’. But I think asking questions and trying to understand is a good start. There are a lot of grey areas, I don’t see how you can have black and white answers when it comes to something so complex.

Would a simpler answer be instead of us tearing our hair out over the ethics of meat-eating, to not eat any meat at all?

Yep, that’s the easiest answer. I have enormous respect for people who choose to be vegan. They are undeniably having a lighter impact on the planet because it generally takes less energy, and therefore fewer greenhouse gas emissions, to produce plant-based foods than meat. There are also fewer concerns about welfare, the wider environment and labour. I would say that one of the big discoveries from the book is people often expect vegans to be very extreme and to lecture everyone else, but actually I’ve had some really nice responses to the book from people who choose to eat no animal products. They want to encourage more people to think about what they eat and welcome any effort in that direction. They understand that a clear message in the book is that if you are desperately worried about the environment, then one of the simplest things you can do is eat less meat.

You mentioned one non-environmental impact as being to do with labour and the first book that you’ve chosen, The Jungle by Upton Sinclair (1906)—a novel that portrays the working conditions of those in the meat-packing industry at the turn of the twentieth century—deals with this labour question. It touches on immigration, and class, and many issues beyond that of eating meat. Why have you chosen to start here?

One interesting thing with this book is that while there are lots of animals in it—and they’re being tortured horribly, literally being skinned alive in the background of many, many scenes in the novel—it’s what’s happening to the humans that is so terrible, and that’s what you’re left with, especially reading it now. When it first came out, people were really shocked by what went into their meat, and I think people would read it now and think things are a bit better, and they probably are… but when you think about it we had the horsemeat scandal a few years ago, a lot of what happens in meat factories is still unknown to us.

I think sometimes when we discuss meat-eating, we talk about the suffering of the animals, we even talk about the environment, but we often forget to talk about the people and I think that’s really important: the people who do it on your behalf are worth considering.

When you were writing The Ethical Carnivore, you went into slaughterhouses and onto fishing boats and spent a lot of time with people who are at the coalface of producing meat, often on industrial scales. How do you think that affects the people who do it, and do you think they have to become blind to some of these issues to be able to work in that industry?

I think they have to process those issues, but they shouldn’t be blind to them. All of the places I went to were in the UK which meant they were really highly regulated. Also, I would say they were probably quite good abattoirs because they were allowing a journalist in—I wasn’t undercover, I was being quite open about what I was doing. So those people weren’t blind to the issues because they had to be very good at what they did in order to keep their job.

In one abattoir, the slaughter-men who were doing the killing had trained for seven years on all the floors, and so I don’t think they’re blind to it. They have to be trained in all of the welfare stuff and they have to care for the animals because they’re being filmed. They have CCTV in most abattoirs in the UK and there’s a big campaign to get CCTV in all abattoirs—I don’t know why the government will not legislate on this as it protects the abattoirs as well. If they are doing a good job it should not be a threat to them.

“They had to control their emotions, otherwise they couldn’t do the job”

When I interviewed slaughtermen and -women they were aware of what they were doing, that they were killing a beautiful animal. They admitted that they had to control their emotions, otherwise they couldn’t do the job, but also said they were keenly aware of ensuring the animal had a quick death. They were proud of doing a job well. I think it also becomes part of your lifestyle, often there are whole families working in these industries. It is normalised in the sense it is part of your life and that’s just how things are.

One of the most interesting interviews I did was with Temple Grandin, an animal behaviourist. She’s audited a lot of abattoirs, and she said that the majority really care about their jobs and do it well but yes, like anything, there are a few bad apples. She admits it and is trying to redesign the industry, so that those kind of people are weeded out.

Publication of The Jungle caused public outrage, and as a result new legislation was brought in in the United States, the Meat Inspection Act. Do you think that the public want to know about what happens in their slaughterhouses?

I guess a few people don’t because I’ve had quite violent reactions to my book by people who often eat meat and really don’t want to know. It’s almost like they feel it’s a personal affront, that they’re being attacked when I start telling them where meat comes from. I try to be delicate because I can sort of understand that it is quite upsetting for people. But the majority of people absolutely do want to know because they want to know it is being done right.

I think [most] people do want to know, but you have to contextualise it. The first time I went to an abattoir to write about it, I was traumatised. It is a death factory, there is no way of getting around that. But you have to put it in context if you really want to understand, so I think people should know about the whole picture—another reason I wrote the book. You need quite a lot of education because you have to think about how the animals are bred and how they’re treated as well as how they are killed. I think that should probably be part of school education. We should know where our food comes from, otherwise we’re susceptible to the kinds of things that happened in The Jungle, or the horsemeat scandal, because people are getting away with stuff where no one’s wanting to loo

Your second book, Ruth Harrison’s Animal Machines (1964), revealed the indignities and the suffering of animals in industrialised agriculture. What impact did the book have?

It was like Upton Sinclair’s but in the UK. It led to the UK government changing the law—the 1968 Agriculture (Miscellaneous Provisions) Act and also the European Convention for the Protection of Animals Kept for Farming Purposes. Ultimately it led to the ‘five freedoms’, which vets had been working on, being brought into law. These summarised animal welfare as freedom from hunger and thirst, from discomfort, from pain, injury or disease, from fear and distress and, most controversially, the freedom to express most normal behaviours.

What I liked about Ruth Harrison was that . . .

Continue reading.

Written by LeisureGuy

6 March 2017 at 6:34 pm

The quiet medical heroism of incremental care

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From an excellent article by Atul Gawande in the New Yorker (but you really should read the whole thing);

He showed me studies demonstrating that states with higher ratios of primary-care physicians have lower rates of general mortality, infant mortality, and mortality from specific conditions such as heart disease and stroke. Other studies found that people with a primary-care physician as their usual source of care had lower subsequent five-year mortality rates than others, regardless of their initial health. In the United Kingdom, where family physicians are paid to practice in deprived areas, a ten-per-cent increase in the primary-care supply was shown to improve people’s health so much that you could add ten years to everyone’s life and still not match the benefit. Another study examined health-care reforms in Spain that focussed on strengthening primary care in various regions—by, for instance, building more clinics, extending their hours, and paying for home visits. After ten years, mortality fell in the areas where the reforms were made, and it fell more in those areas which received the reforms earlier. Likewise, reforms in California that provided all Medicaid recipients with primary-care physicians resulted in lower hospitalization rates. By contrast, private Medicare plans that increased co-payments for primary-care visits—and thereby reduced such visits—saw increased hospitalization rates. Further, the more complex a person’s medical needs are the greater the benefit of primary care.

I finally had to submit. Primary care, it seemed, does a lot of good for people—maybe even more good, in the long run, than I will as a surgeon. But I still wondered how. What, exactly, is the primary-care physician’s skill? I visited Asaf’s clinic to see.

The clinic is in the Boston neighborhood of Jamaica Plain, and it has three full-time physicians, several part-timers, three physician assistants, three social workers, a nurse, a pharmacist, and a nutritionist. Together, they get some fourteen thousand patient visits a year in fifteen clinic rooms, which were going pretty much non-stop on the day I dropped by.

People came in with leg pains, arm pains, belly pains, joint pains, head pains, or just for a checkup. I met an eighty-eight-year-old man who had survived a cardiac arrest in a parking lot. I talked to a physician assistant who, in the previous few hours, had administered vaccinations, cleaned wax out of the ears of an elderly woman with hearing trouble, adjusted the medications of a man whose home blood-pressure readings were far too high, and followed up on a patient with diabetes.

The clinic had a teeming variousness. It didn’t matter if patients had psoriasis or psychosis, the clinic had to have something useful to offer them. At any given moment, someone there might be suturing a laceration, lancing an abscess, aspirating a gouty joint, biopsying a suspicious skin lesion, managing a bipolar-disorder crisis, assessing a geriatric patient who had taken a fall, placing an intrauterine contraceptive device, or stabilizing a patient who’d had an asthma attack. The clinic was licensed to dispense thirty-five medicines on the premises, including steroids and epinephrine, for an anaphylactic allergic reaction; a shot of ceftriaxone, for newly diagnosed gonorrhea; a dose of doxycycline, for acute Lyme disease; or a one-gram dose of azithromycin for chlamydia, so that someone can directly observe that the patient swallows it, reducing the danger that he or she will infect someone else.

“We do the things you really don’t need specialists for,” a physician assistant said. And I saw what a formidably comprehensive range that could be. Asaf—Israeli-born and Minnesota-raised, which means that he’s both more talkative and happier than the average Bostonian—told me about one of his favorite maneuvers. Three or four times a year, a patient comes in with disabling episodes of dizziness because of a condition called benign positional vertigo. It’s caused by loose particles of calcified debris rattling around in the semicircular canal of the inner ear. Sometimes patients are barely able to stand. They are nauseated. They vomit. Just turning their head the wrong way, or rolling over in bed, can bring on a bout of dizziness. It’s like the worst seasickness you can imagine.

“I have just the trick,” he tells them.

First, to be sure he has the correct diagnosis, he does the Dix-Hallpike test. He has the patient sit on the examination table, turns his head forty-five degrees to one side with both hands, and then quickly lays him down flat with his head hanging off the end of the table. If Asaf’s diagnosis is right, the patient’s eyes will shake for ten seconds or so, like dice in a cup.

To fix the problem, he performs what’s known as the Epley maneuver. With the patient still lying with his head turned to one side and hanging off the table, Asaf rotates his head rapidly the other way until his ear is pointed toward the ceiling. He holds the patient’s head still for thirty seconds. He then has him roll onto his side while turning his head downward. Thirty seconds later, he lifts the patient rapidly to a sitting position. If he’s done everything right, the calcified particles are flung through the semicircular canal like marbles out a chute. In most cases, the patient feels better instantly.

“They walk out the door thinking you’re a shaman,” Asaf said, grinning. Everyone loves to be the hero. Asaf and his colleagues can deliver on-the-spot care for hundreds of conditions and guidance for thousands more. They run a medical general store. But, Asaf insisted, that’s not really how primary-care clinicians save lives. After all, for any given situation specialists are likely to have more skill and experience, and more apt to follow the evidence of what works. Generalists have no advantage over specialists in any particular case. Yet, somehow, having a primary-care clinician as your main source of care is better for you.

Asaf tried to explain. “It’s no one thing we do. It’s all of it,” he said. I found this unsatisfying. I pushed everyone I met at the clinic. How could seeing one of them for my—insert problem here—be better than going straight to a specialist? Invariably, the clinicians would circle around to the same conclusion.

“It’s the relationship,” they’d say. I began to understand only after I noticed that the doctors, the nurses, and the front-desk staff knew by name almost every patient who came through the door. Often, they had known the patient for years and would know him for years to come. In a single, isolated moment of care for, say, a man who came in with abdominal pain, Asaf looked like nothing special. But once I took in the fact that patient and doctor really knew each other—that the man had visited three months earlier, for back pain, and six months before that, for a flu—I started to realize the significance of their familiarity.

There’s a lot more at the link.

Written by LeisureGuy

6 March 2017 at 2:43 pm

Posted in Medical

Tricking

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Written by LeisureGuy

6 March 2017 at 2:34 pm

Posted in Daily life, Video

Jennifer Rubin, conservative Republican blogger, provides an outline for Congress to do its job

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From her column today:

Ironically, Republicans need only do their job in a conscientious and constitutionally sound manner. Doing that, you see, amounts to defiance and repudiation of the Trump-Bannon alternative political universe. Republicans, for example:

  • Could demand FBI Director James Comey testify under oath as to the falsity of Trump’s bugging charge, and then instruct the intelligence committees not to expend time or resources on the allegation absent a showing of proof from the White House;
  • Require by legislation that all senior executive branch employees, including the president, disclose tax returns for the preceding 10 years and identify transactions exceeding $1 million (including sales, loans, partnerships) with foreign nationalists (America First, the president keeps telling us);
  • Open a serious and comprehensive investigation of potential emoluments clause violations by the president;
  • Call current and former Trump aides, including Michael T. Flynn, Paul Manafort, Carter Page and Michael Cohen (who apparently was not acting in a legal capacity subject to attorney-client privilege, but in a business capacity) to get to the bottom of the Russia connections. Federal law, by the way, does not recognize an accountant-client privilege, so nothing bars Congress from obtaining testimony from Trump’s financial managers.
  • Call Eric Trump and Donald Trump Jr. to testify about their statements and connections, past and present, to Russian oligarchs.

If only Congress would work up the courage to do these simple steps.

Written by LeisureGuy

6 March 2017 at 1:46 pm

Lawfare note on investigating the alleged Obama wiretapping order

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Paul Rosenzweig has an interesting note in Lawfare:

esterday, I wrote about the strategy and tactics for investigating the Trump/Russia connection.  As you may imagine, I got a number of responses which are unpublishable in these pages.  To my surprise, however, at least two lawyers whom I respect asked a question of the form “what about investigating the Obama wiretap order” and suggesting, implicitly, that my failure to include an investigative plan for that allegation was evidence of incompleteness, if not bias.  Because they were serious questions (unlike some of the other inquiries I got!) I thought I would treat the suggestion with respect and answer more fully.  I would not include the Obama/Wiretap allegation in a Russia/Trump investigative plan for at least three independent reasons:

1) The investigations are not really connected.  As discussed yesterday, there is a plausible (albeit unproven and perhaps unprovable) overarching thesis of investigation to the Russia/Trump allegations—namely that the allegations of influence, contacts, and cover-up are directly derived from allegations of counter-intelligence influence.  This may or may not be true—but as a thesis for investigation it has coherence.  The Obama/Wiretap allegations don’t fit into the thesis—rather they are completely disconnected from it and therefore not well-suited to inclusion in the investigative plan.  NOTE:  This is not to say that the two are factually completely disconnected—indeed the alleged wiretap was (if it happened) probably in service of one of the Russia/Trump investigations identified and likely was targeted at the Russian end of the conversation (as seems to be the case with General Flynn’s ill-fated calls to the Ambassador).  Rather, this is to say that the motivations are unrelated, if not completely opposed to one another and thus don’t fit into the same strategic investigation, even if we credit the allegations.

2) Unlike the Russia/Trump allegations, the Obama/Wiretap allegation is simply not credible.  As noted, there is significant doubt that such a wiretap order was even entered.  Its origins appear to lie in a conspiracy theory without any factual basis.  For me (and here I speak personally) the allegation is of a piece with the suggestion that there were 3-5 million illegal votes; that Ted Cruz’s family was involved in the JFK murder; and that President Obama was not born in Hawaii.

Still, to honor the request, if this were, in fact, my investigation, the thesis for this investigation would NOT be “the government got a wiretap order, that authorized an interception which may have involved someone at Trump Tower.”  For if that were the allegation it would have no legs—after all the lawful issuance of a warrant authorizing interception is … well … legal authorization.  The thesis would, instead, have to be either: a) that in securing the warrant the warrant applicant knowingly lied to the court; or b) that no warrant was applied for or received but interception nonetheless occurred.  And to give credence to President Trump’s suggestion there would have to be a subsidiary thesis that these occurred because President Obama directly or indirectly ordered them to happen.  Had any of this actually happened it would be a plausible criminal case.

The investigative plan would be simple — get copies of any and all FISA and Title III applications and orders relating to Russia and or President Trump issued in the last 2 years.  Review same.  Interview FBI agents assigned to any cases relating to such orders.  Interview IT service providers for Trump Tower.  All of the evidence that relates to these allegations is presumably within the United States and readily available.  All of which brings me to the third factor:

3) Since the allegation is of misconduct by the former President, the current President and/or the Congress are well-situated to investigate.  There is no formal conflict of interest and thus no need for an independent investigation.  . .

Continue reading.

Written by LeisureGuy

6 March 2017 at 1:32 pm

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