Later On

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

Archive for July 6th, 2022

New (and safe) way for police to stop fleeing cars

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In the recent past, police have used PIT (Pursuit Intervention Technique) to stop fleeing cars. (You can see this technique in action by searching YouTube on (say) “pit maneuver.”) PIT is a risky maneuver that can send the pursued car spinning out of control and even flipping, endangering the occupants and those in other cars that might be hit by the out-of-control car or that might lose control in trying to avoid it. 

Written by Leisureguy

6 July 2022 at 10:14 pm

The odd logic of a Pro-Lifer

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From a Facebook post by Girl du Jour:

Pro Lifer: Well the mother should just give the baby up for adoption if she doesn’t want the baby
Me: So who will adopt the baby?
PL: I don’t know there’s lots of couples who want to adopt
Me: Do you know any couple who is waiting to adopt?
PL: Um well not personally but like I know there’s lots of people waiting to adopt.
Me: Do you know what a domestic adoption costs?
PL: I don’t know. $15,000 maybe?
Me: The average cost of domestic adoption in the United States is $70,000 if you go through a private agency.
PL: Oh I didn’t realize it was that much
Me: Yep it’s really expensive. It can be more if you want a newborn straight from the hospital. Up to $120,000.
PL: Well all life is precious.
Me: it really is. I’ve adopted through foster care and am currently a licensed foster parent. Would you be interested in becoming a foster parent yourself?
PL: Oh no I couldn’t do it.
Me: Why not?
PL: It would just be too much for me right now.
Me: Why is that?
PL: It would be too hard to handle all the issues that came with it. I’ve heard horror stories.
Me: Yep it can be extremely difficult. But what if I told you that you were required by law to become a foster parent?
PL: what?
Me: what if you had to become a foster parent by law?
PL: they would never do that. That would never happen.
Me: Well, if a woman is forced to bear a child she doesn’t want, and she goes ahead and has that child, someone has to care for the child either through adoption or foster care. You have to do one of those two things.
PL: But I don’t want any more kids.
Me: So you don’t want someone forcing you to have a child in your home that you don’t want or aren’t able to care for?
PL: no, that’s not my job to raise someone else’s child.

There it is, folks. Have the baby, but we don’t want anything to do with it afterwards.
But, let’s ban abortion…

And some statistics include in the post:

Texas: 47,913 children in foster care as of 2020
California: 55,539 children in foster care as of 2022
Florida: 30,000 children in foster care as of 2021
Virginia: 5,240 children in foster care as of 2021
Montana: 3,456 children in foster care as of 2020
Alaska: 2,939 children in foster care as of 2021
Alabama: 5,682 children in foster care as of 2019
Arizona: 13,329 children in foster care as of 2019
Arkansas: 4,123 children in foster care as of 2019
Colorado: 4,824 children in foster care as of 2019
Connecticut: 3,882 children in foster care as of 2019
Delaware: 577 children in foster care as of 2019
Georgia: 12,888 children in foster care as of 2019
Hawaii: 1,604 children in foster care as of 2019
Idaho: 1,740 children in foster care as of 2019
Illinois: 16,565 children in foster care as of 2019
Indiana: 16,023 children in foster care as of 2019
Iowa: 5,943 children in foster care as of 2019
Kansas: 8,001 children in foster care as of 2019
Kentucky: 9,113 children in foster care as of 2019
Louisiana: 3,929 children in foster care as of 2019
Maine: 2,083 children in foster care as of 2019
Maryland: 3,689 children in foster care as of 2019
Massachusetts: 9,831 children in foster care as of 2019
Michigan: 11,438 children in foster care as of 2019
Minnesota: 8,261 children in foster care as of 2019
Mississippi: 4,011 children in foster care as of 2019
Missouri: 12,654 children in foster care as of 2019
Nebraska: 3,238 children in foster care as of 2019
Nevada: 4,515 children in foster care as of 2019
New Hampshire: 1,211 children in foster care as of 2019
New Jersey: 4,431 children in foster care as of 2019
New Mexico: 2,324 children in foster care as of 2019
New York: 15,606 children in foster care as of 2019
North Carolina: 11,025 children in foster care as of 2019
North Dakota: 1,468 children in foster care as of 2019
Ohio: 15,710 children in foster care as of 2019
Oklahoma: 8,301 children in foster care as of 2019
Oregon: 6,922 children in foster care as of 2019
Pennsylvania: 14,912 children in foster care as of 2019
Puerto Rico: 2,579 children in foster care as of 2019
Rhode island: 2,196 children in foster care as of 2019
South Carolina: 4,497 children in foster care as of 2019
South Dakota: 1,703 children in foster care as of 2019
Tennessee: 8,893 children in foster care as of 2019
Utah: 2,335 children in foster care as of 2019
Vermont: 1,226 children in foster care as of 2019
Washington: 10,151 children in foster care as of 2019
West Virginia: 7,211 children in foster care as of 2019
Wisconsin: 7,626 children in foster care as of 2019
Wyoming: 984 children in foster care as of 2019
District of Columbia: 653 children in foster care as of 2019

Written by Leisureguy

6 July 2022 at 6:47 pm

Covey’s method in practice

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I came across a post on Facebook, and it struck me as an excellent illustration of Covey’s first 3 habits:

1. Be proactive
2. Begin with the end in mind
3. First things first

And I see a bit of habit 4 (“Think win/win”) in addition. (You can read more about the habits in this post.) Specifically, the driver focused on his circle of influence and did not spend time on his circle of concern — that is, he focused on things he could control directly or through direct influence.

Here’s the post:

I was waiting in line for a ride at the airport. When a cab pulled up, the first thing I noticed was the taxi was polished to a bright shine. Smartly dressed in a white shirt, black tie, and freshly pressed black slacks, the cab driver jumped out and rounded the car to open the back passenger door for me.
He handed me a laminated card and said, “I’m Wasu, your driver. While I’m loading your bags in the trunk, I’d like you to read my mission statement.”

Taken aback, I read the card. It said, “Wasu’s Mission Statement: To get my customers to their destination in the quickest, safest, and cheapest way possible in a friendly environment.”

This blew me away. Especially when I noticed the inside of the cab matched the outside. Spotlessly clean!

As he slid behind the wheel, Wasu said, :Would you like a cup of coffee? I have a thermos of regular and one of decaf.”

I said jokingly, “No, I’d prefer a soft drink.”

Wasu smiled and said, “No problem. I have a cooler up front with regular and Diet Coke, lassi, water, and orange juice.”

Almost stuttering, I said, “I’ll take a lassi since I’ve never had one before.”

Handing me my drink, Wasu said, “If you’d like something to read, I have Good Housekeeping magazine, Reader’s Digest, The Bible, and a Travel + Leisure magazine.”

As we were pulling away, Wasu handed me another laminated card, “These are the stations I get and the music they play, if you’d like to listen to the radio.

And as if that weren’t enough, Wasu told me he had the heater on and asked if the temperature was comfortable for me.

Then he advised me of the best route to my destination for that time of day. He also let me know he’d be happy to chat and tell me about some of the sights or, if I preferred, to leave me with my own thoughts.

“Tell me, Wasu,” I was amazed and asked him, “have you always served customers like this?”

Wasu smiled into the rear view mirror. “No, not always. In fact, it’s only been in the last two years. My first five years driving, I spent most of my time complaining like all the rest of the cabbies do. Then I heard about power of choice one day.

“Power of choice is that you can be a duck or an eagle. If you get up in the morning expecting to have a bad day, you’ll rarely disappoint yourself. Stop complaining! Don’t be a duck. Be an eagle. Ducks quack and complain. Eagles soar above the crowd.

“That hit me right,” said Wasu. He continued and said, “It is about me. I was always quacking and complaining, so I decided to change my attitude and become an eagle. I looked around at the other cabs and their drivers. The cabs were dirty, the drivers were unfriendly, and the customers were unhappy. So I decided to make some changes. I put in a few at a time. When my customers responded well, I did more.”

“I take it that has paid off for you,” I said.

‘It sure has,” Wasu replied. “My first year as an eagle, I doubled my income from the previous year. This year, I’ll probably quadruple it. My customers call me for appointments on my cell phone or leave a message on it.”

Wasu made a different choice. He decided to stop quacking like ducks and start soaring like eagles. I hope we all decide to soar like an eagle and not quack like a duck.

I could not find a link to the specific post, but that’s the text. And the mission statement idea is directly from Covey’s Habit 2.

Written by Leisureguy

6 July 2022 at 12:15 pm

When prestigious journals publish bad science

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The video is worth watching, but there’s also a transcript, which begins:

A series of articles published in the Annals of Internal Medicine culminated in a recommendation suggesting people keep eating their red and processed meat. Nutrition researchers savaged these articles. The chair of the nutrition department at Harvard called it “a very irresponsible public health recommendation,” and the past Harvard nutrition chair was even less restrained. “It’s the most egregious abuse of data I’ve ever seen,” said Walter Willett, “There are just layers and layers of problems.” Let us start to pick through these layers.

The first of several serious weaknesses was that the analyses and recommendations were largely based on the so-called GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation), which I talked about in my last video. The authors erred in applying the GRADE tool, since that was designed for drug trials.

GRADE automatically scores observational studies as “low- or very-low” scores for “certainty of evidence,” which is exactly what you want when you’re evaluating evidence from drug trials. You want a randomized double-blind, placebo-controlled trial to prove the drug’s risks and benefits. However, the infeasibility for conducting randomized clinical trials on most dietary, lifestyle, and environmental exposures makes the criteria inappropriate in these areas, since it would involve controlling people’s daily diet and following them for decades.

“You can’t do a double-blinded placebo-controlled trial of red meat and other foods on heart attacks or cancer. “For dietary and lifestyle factors, it’s impossible to use the same standards for drug trials.” Imagine telling one group of people to smoke a pack of cigarettes every day for the next 20 years to prove that cigarettes cause lung cancer. And how could you make it double-blind—have the control group smoke placebo cigarettes?

Yet, in the meat papers, they were downgrading studies due to lack of blinding. Well duh, in nutritional trials how are you going to blind people to the facts of what they’re eating? GRADE is just the wrong tool for diet studies. In fact, . . .

Continue reading.

Written by Leisureguy

6 July 2022 at 11:04 am

Cavendish and the RazoRock BBS razor

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I used my Plisson synthetic with Phoenix Artisan’s Cavendish in the CK-6 formulation, and what a great lather it made. I like the Cavendish fragrance a lot, and the lather was redolent of it — and also thick and creamy, providing excellent glide and superb skin conditioning.

I have the “Standard” BBS — the stainless version of the Baby Smooth. The razor also comes in “A” and “AS” versions (more efficient) as well as an open-comb version. I like this razor a lot, and it delivered a completely smooth result, comfortable, easily, and trouble-free.

A splash of Phoenix Artisan Cavendish aftershave (with a couple of squirts of Hydrating Gel) and the day begins. The aftershave has the same fine fragrance as the soap — “Dark Kentucky & Burley Tobacco, Cherry Wood, Vanilla Bean, Cedar, Sweet Northern Grass Tree Resin, Tobacco Absolute, Leather & a kiss of Smoke” — and interesting ingredients:

Denatured Alcohol, Essential/Fragrance Oils, Rose Water, Aloe Vera, Vegetable Glycerin, Sweet Northern Grass Tree Resin, Tobacco Absolute [plus 2 squirts Grooming Dept Hydrating Gel – LG]

The tea this morning is Murchie’s Royal Grey: “Currants and cream with a twist of bergamot, a modern take on the timeless Earl Grey.” 

On the Cavendish aftershave page:

This my friends, is the Original Pipe Tobacco Scent Shave Product! It’s true, the 2nd scent I ever made and a personal favorite, being that Cavendish is/was always my favorite blend to puff…The Earl Grey of Pipe Tobacco! 

Written by Leisureguy

6 July 2022 at 9:56 am

Posted in Caffeine, Shaving

An obstetrician has some specific questions regarding how to follow new anti-abortion laws

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Natalie M. Gregory, MD, an obstetrician in South Carolina, asked some specific questions that illustrate the difficulties in following the new anti-abortion laws in her state. Via a Facebook post:

I am a Fellow of the American College of OBGYN and a graduate of MUSC School of Medicine. I was trained to practice evidence-based medicine. As a Board Certified OBGYN, I am tested with oral and written exams, reviewed by peers, and expected to maintain Continuing Medical Education (CME) in my field of study. I am to use my training to uphold the Hippocratic Oath and obey the laws of our state and our nation while keeping the best interest of the patient as the priority.

I believe the following are not political decisions but rather are private matters between a patient and her physician. Because I have been trained to be prepared for any situation, please consider the following situations and help me to make most appropriate decisions. I have many questions.

1) Ectopic or tubal pregnancy with a fetal heartbeat seen. In this situation, without the possibility of fetal survival, there are 2 options: surgery to remove the pregnancy or medications to stop the growth and thus abort the abnormal gestation. With Senate Bill 1, the standard of care would not be options, however, withholding treatment would be considered malpractice and would be expected to end with hemorrhage, transfusion, loss of fertility or hysterectomy, and possibly death. What should I say to the family? What is the route to obtain permission if she is has internal bleeding and is unstable or unconscious? Can a judge allow it? Is her consent not enough? Will my malpractice insurance company defend me if I disobey the law and remove the tube? What about if I disobey the evidence I have been tested on and the standard of care? Will they continue to insure me? Without malpractice insurance I cannot practice.

2) Molar pregnancy at 9 weeks with fetal heartbeat. This is a genetically abnormal pregnancy with proliferation of placental-type tissue but can be associated with an abnormal fetus, sometimes with a heartbeat. It cannot end with a viable fetus and is genetically abnormal. The standard of care, treatment with a dilation and curettage, would be illegal under Senate Bill 1 and the patient would eventually hemorrhage, require transfusions, lose her uterus and potential for childbearing, and she would die. This is a condition that is curable but not without proper treatment. This bill sets the medical field back decades if not centuries. Do I wait until she hemorrhages, knowing there is no chance of survival of the fetus? Is her life worth less than this pregnancy? Does she not get another chance for a healthy child? Whom shall I contact to obtain approval for this patient’s survival? What if no one answers or the contact is unavailable? I ask because these things happen in the middle of the night.

3) Fetal Anencephaly. This is a condition in which the fetal brain does not form correctly or at all. At times brainstem function can allow a live birth but typically death follows soon after delivery. What do I tell the parents who see the concern on my face when I see the ultrasound? Do I tell them there are no options except waiting for the baby to be born and die? What if she requires a cesarean and suffers complications impairing her fertility? What if she suffers a pulmonary embolism during pregnancy, a known risk? What if she is nearing the end of her reproductive years and wants to try again for a healthy baby but her “clock is running out”? May I offer the standard of care? Is it more humane to end the pregnancy early in the gestation or to experience a neonatal loss? Who gets to make this decision and what are their priorities? Who do I call in the middle of the night? What if she is hemorrhaging and a decision must be made quickly? I take call shifts of 24 hours and my partners and I always have a physician available for our patients. Will there be someone is the legislature available like I am, at any time of day or night? What about Christmas morning? Will there be a hotline or a pager system?

4) Preterm Premature Rupture of Membranes. When this occurs prior to viability or around 23 weeks, the standard of care is to deliver with surgery or induction of labor. Both would be illegal under Senate Bill 1. The alternative is to manage expectantly, the fancy way of saying we let nature take its course. If some fluid reaccumulates, then there is the possibility of staying pregnant long enough for development to continue to viability. If the fluid continues to leak, the fetal lungs will not develop and there is no chance of survival after birth. More likely, an infection will develop that can rapidly spread into the maternal circulation. Treatment with antibiotics is insufficient without delivery as there is poor penetration across the placental barrier. Without delivery, mothers can die of systemic infection. Delivery, however, risks my career. Do I offer delivery, which is the standard of care? What if the fetus still has a heartbeat but the mother is unable to consent? Is the fetal life more precious than maternal life? Do I wait until her blood pressure drops and she can’t respond to me? Whom shall I call to get approval? What are the patient’s rights concerning the confidentiality of her situation? Does HIPAA apply?

5) Cervical cancer diagnosed in a woman with a pre-viable pregnancy. Termination with subsequent treatment of the cancer with surgical removal, chemotherapy and/or radiation provides the best chance of maternal survival. Morbidity and mortality are increased without immediate treatment. Should I tell her she has a better chance of survival if she moved to another state where evidence-based medical decisions are possible? What if she has other children and she is the primary care provider? What is the process for her to secure childcare if she is unable to care for the children while she undergoes palliative therapy? Can her family weigh in on their desire for their loved one to be valued for more than her womb? Who do I call if she has legal questions? Will there be a hotline?

6) Pregnancies that are the result of rape and/or incest. This bill requires the woman to file a police report and allows the hospital to violate HIPAA laws and file a report for her. Her options would be to carry the pregnancy or file a report. What if filing a report means her ex would get arrested and she needs his child support for the other children? What if filing a report means getting taken from your home and placed in foster care at age 17? Many women choose not to file reports and I do not know their reasons. It does not concern me caring for their medical needs. Again, who is on this rape and incest approval committee and how do I reach them 24/7?

I ask that you help guide me to provide the care that you would want for yourself or your wife, your daughter, your granddaughter. Please remember that pregnancy, for women, is a risky endeavor. We risk our lives for this. Respect us enough to know how to navigate our healthcare decisions with our doctors and families. And respect me and my profession enough to allow us to care for our patients without having our hands tied by these laws.”

Natalie Gregory, MD, FACOG
Mount Pleasant, SC

I hope that the legislators who drafted and voted for South Carolina’s anti-abortion law will individually respond, both publicly and to the doctor, to provide their answers to the very real questions she has asked. Unfortunately, however, I believe that they will ignore the questions and run from any reporter who conveys one of the questions. Those voting for the bill lack a sense of responsibility; they are interested in making a political statement and they care nothing about the real-world outcomes when their political fantasies are made real.

I imagine that if you pinned down one of the legislators and demanded an answer to these questions. he would say that he cannot answer because he is not a medical doctor and lacks the knowledge and experience to make such vital medical decisions — but of course he did make a vital medical decision when he voted to ban all abortions. – Update: It occurs to me that this is a good example of the Dunning-Kruger effect: legislators so ignorant of medical knowledge that they were supremely confident in making a (universal) medical decision, completely unaware of their ignorance. Requiring them to answer Dr. Gregory’s questions, on the record, might help them realize what they have done.

Another piece worth reading: a column by Rebecca Solnit that appeared in the Guardian three years ago.

Written by Leisureguy

6 July 2022 at 7:22 am

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