Quotulatiousness

January 24, 2015

ArenaNet formally announced first GW2 expansion #GW2HoT

Filed under: Gaming — Tags: , — Nicholas @ 12:28

I just finished watching the ArenaNet livestream from PAX South, where they introduced the first expansion for Guild Wars 2: Heart of Thorns.

Lots of unanswered questions, a few of which are answered in the new FAQ.

Dulfy has the livestream notes if you want to read about what was revealed.

Pairing appropriate cheeses with wines

Filed under: Food, Wine — Nicholas @ 11:24

Wine and cheese are a natural pairing, but finding the right match to optimize the experience may not be as obvious. On Google+, B-Winegrower offers some recommendations:

CheeseWinePairing1Image from B-Winegrower on Google+

Problems besetting the British health system

Filed under: Britain, Bureaucracy, Health — Tags: , , — Nicholas @ 04:00

At Samizdata, Natalie Solent shares a post written by “ARC” discussing why the National Health Service seems to be under such pressure lately:

1) Flow-though is crucial to A&E: you must get people out the back-end of the process to maintain your rate of input to the front-end. However ever-increasing regulations mean a patient without family cannot be released until a boat-load of checks have been done. This is clogging up the back end. It may be preventing the release of a few who had better not be sent home yet (not much and not often, is the general suspicion) but it is definitely delaying hugely processing the release of all others who could be. All this admin takes time and effort — delaying release and also using up time of staff in non-health work — and costs money.

This effect needs to be understood in the context of the 15-years-older story of the destruction of many non-NHS nursing homes by galloping regulation. These homes were mostly owned and operated by senior ex-NHS nurses and provided low-grade post-operative care. The NHS relied on them as half-way houses to get patients out of NHS hospitals when they no longer needed intensive care but were not yet recovered enough to go home. These nurses did not want to spend time form-filling instead of caring for patients, and for each home there was always one of the 1000+ rules that was particularly hard for that given home to meet without vast expense or complication. So they died one by one. The ‘waiting times have increased’ story of Tony Blair’s early-2000 years — “If the NHS were a patient, she’d be on the critical list” — was caused by this and the resultant bed-blocking more than any other one cause.

The problem with waving the regulatory wand to “solve” a problem like this is that it tends to create perverse incentives so that the artificial target can be achieved — like this post from a couple of years back where the regulators dictated a maximum time a patient could be kept waiting for admission to A&E. The reaction of the people running the system was to change the definition of “admission” so that now patients’ timers don’t start running until they’re unloaded from the ambulance … so the end result is people are spending more time in the back of ambulances waiting outside the hospital until there’s an open slot. This meets the artificial target, but creates a worse situation because patients are still waiting as long (or longer), but now they’re also tying up ambulances from attending other emergency situations.

Back to ARC’s list of NHS problems:

2) The new 111 service is sending many more patients to A&E.

2.1) The service’s advice is very risk averse. The people who set up the process were afraid of the consequences of the statistical 1-in-a-million time when anything other than mega-risk-averse advice would see some consequence that would become a major news story blaming them.

2.2) Thanks to the post-1997 reforms, GPs work less hours on-call but the doctors are not just slacking off and doing nothing. The huge growth in regulation means they are in effect putting in as many hours as before, but on form-filling and admin to provide all the info the NHS and other government demand, to ensure they tick every box, etc. The out-of-hours on-call time they used to have is now swallowed by this work. So they are not in fact working less; it is the balance of what they are working on that has changed: less on healthcare, more on admin. Thus 111 must send people to A&E, not an on-call GP (and, of course, fewer on-call GPs mean more people phone 111).

From context, I assume the 111 service is a telephone health advisory service like Telehealth Ontario.

Hey, young’uns? Wanna feel old? It’s over 20 years since Nirvana’s last concert

Filed under: Media, USA — Tags: , — Nicholas @ 02:00

At risk of alienating some of my younger friends — it’s already more than two decades since Nirvana’s final concert:

Yes, it’s been over 20 years now since Nirvana played their last show, and if you’re old enough to have been there, go ahead and take a moment of silence to mourn your lost youth. Given the relative paucity of raw, authentic-sounding guitar rock these days, it’s tempting to romanticize the nineties as halcyon days, but that kind of nostalgia should be tempered by an honest accounting of the tedious flood of grunge-like also-rans the corporate labels released upon us after Nirvana’s mainstream success. In a certain sense, the demise of that band and death of its leader marks the end of so-called “alternative” rock (whatever that meant) as a genuine alternative. After Nirvana, a deluge of growly, angsty, and not especially listenable bands took over the airwaves and festival circuits. Before them — well, if you don’t know, ask your once-hip aunts and uncles.

30,000 lbs of Bananas live

Filed under: Humour, Media — Tags: , — Nicholas @ 02:00

QotD: General Elphinstone in Afghanistan, 1842

Filed under: Asia, Books, Britain, History, Military, Quotations — Tags: , , , — Nicholas @ 01:00

But looking back I can say that, all unwittingly, Kabul and the army were right to regard Elphy’s arrival as an incident of the greatest significance. It opened a chapter: it was a prelude to events that rang round the world. Elphy, ably assisted by McNaghten, was about to reach the peak of his career; he was going to produce the most shameful, ridiculous disaster in British military history.

No doubt Thomas Hughes would find it significant that in such a disaster I would emerge with fame, honour, and distinction — all quite unworthily acquired. But you, having followed my progress so far, won’t be surprised at all.

Let me say that when I talk of disasters I speak with authority. I have served at Balaclava, Cawnpore, and Little Big Horn. Name the biggest born fools who wore uniform in the nineteenth century — Cardigan, Sale, Custer, Raglan, Lucan — I knew them all. Think of all the conceivable misfortunes that can arise from combinations of folly, cowardice, and sheer bad luck, and I’ll give you chapter and verse. But I still state unhesitatingly, that for pure, vacillating stupidity, for superb incompetence to command, for ignorance combined with bad judgement — in short, for the true talent for catastrophe — Elphy Bey stood alone. Others abide our question, but Elphy outshines them all as the greatest military idiot of our own or any other day.

Only he could have permitted the First Afghan War and let it develop to such a ruinous defeat. It was not easy: he started with a good army, a secure position, some excellent officers, a disorganized enemy, and repeated opportunities to save the situation. But Elphy, with the touch of true genius, swept aside these obstacles with unerring precision, and out of order wrought complete chaos. We shall not, with luck, look upon his like again.

George MacDonald Fraser, Flashman, 1969.

Powered by WordPress