Quotulatiousness

January 25, 2015

Prescribing modern drugs for Richard III

Filed under: Britain, Health, History, Science — Tags: , , , — Nicholas @ 02:00

In Richard Lehman’s BMJ journal review, there was an amusing bit of interest to Ricardians:

King Richard III of England was 32 when he died at Bosworth and then famously suffered the indignity of being buried in a Leicester car park. I think I probably drew your attention to this account of his post-mortem examination when it appeared online last September. Had Richard III been spared avoidable mortality in the form of a bashed-in skull and a spear through his spine, he would probably have needed a walking frame by the age of 70. He was never in the best shape:

I, that am curtail’d of this faire Proportion,
Cheated of Feature by dissembling Nature,
Deform’d, unfinish’d, sent before my time
Into this breathing World, scarse halfe made up,
And that so lamely and unfashionable,
That dogges bark at me, as I halt by them.

(from The Tragedy of Richard the Third: with the Landing of Earle Richmond , and the Battell of Boʃworth Field by Wm Shakespeare c.1592, First Folio text 1623)

With his nasty scoliosis and his habit of moving around castles with smoky rooms and no hand rails on the stairs, Richard III would have needed an OT assessment and a dosset box containing all the drugs which are now compulsory for elderly people in the UK:

simvastatin 40mg to add 2 days to life and cause muscle aches
tramadol 50mg to fail to ease pain & cause dependency, falls, confusion
naproxen 500mg to cause GI bleeds and fluid retention
furosemide 20mg to reduce fluid retention due to naproxen
omeprazole 20mg to prevent GI bleeds, encourage C diff
senna 7.5mg to counter tramadol constipation
citalopram 20mg to cause serotonin syndrome with tramadol
trazodone 50mg for agitation due to serotonin, to worsen it & cause falls
gababentin MR 800mg to see if it will help pain
paracetamol 500mg because it hasn’t helped the pain
tamsulosin 400mcg for nocturia due to age and furosemide
lisinopril 5mg for “grade 2 CKD” due to furosemide & naproxen
Seretide inhaler for low FEV1 due to scoliosis
etc.

My kingdom for a bit of horse-sense.

January 24, 2015

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.

January 21, 2015

“Sir, please put the Sriracha down. Now!”

Filed under: Cancon, Health, USA — Tags: , — Nicholas @ 04:00

Megan McArdle worries that the otherwise welcome introduction of spice to the awesomely bland North American diet of yesteryear may have gone just a tad too far:

It has come to my attention that some of you are becoming unable to eat good food unless it is spiced to within an inch of its life.

I’ve been noticing this for a while. It started with friends who put hot sauce on everything, even on dishes that were perfectly good without hot sauce. With dinner party hosts who proudly declared that the secret to good cooking was just to douse something in Cajun spices until you noticed the powder forming drifts on the side of the pan. With people who reported that an Asian restaurant was “good” because it had left their taste buds numb for hours.

Then, during the holiday season, I saw a Slate food writer declare that American apple pie is not as good as French apple pie because it is “bland and goopy,” and I began to suspect that something had gone seriously wrong with our food culture. When I saw an article on restaurant chefs who are daring to bring back prime rib, I became sure of it.

I’m as excited as anyone about the majestic spread of foreign food throughout our nation’s urban downtowns, its strip malls and cookbook aisles, its fruited plains and amber waves of grain. I can’t think of a national cuisine I don’t like, and that includes foods that will sear the taste buds off a water buffalo’s tongue at 20 feet.

I love me some spices … but I also like the idea of not feeling my tongue in pain for hours after I’ve finished eating my meal.

January 10, 2015

Living with diphallia

Filed under: Health, Randomness — Tags: , — Nicholas @ 04:00

BBC Newsbeat on the plight of a poor American boy who lives a secret life due to his rare diphallia condition:

A man with two penises has been speaking to Newsbeat about living with the condition.

Known only as Triple D, the 25-year-old from the east coast of America claims to have had 1,000 sexual partners.

He suffers from diphallia which is a rare condition where a male is born with two penises.

According to a report by the BMJ — the global healthcare knowledge provider — one-in-five million males in the world are born this way.

[…]

Triple D describes himself as “very much bisexual” and has been in polyamorous relationships — sexual or romantic relationships that are not exclusive to one person.

He says his longest relationship was with a couple.

Everyday things like buying underwear are an issue — so he tells Newsbeat he doesn’t wear any.

Both penises are fully functioning. “I can urinate and ejaculate through both at the same time,” he explains.

“Entering into the porn industry has crossed my mind. I knew people who worked in the sex industry and some of them knew what I had, some had heard what I had.

“Nobody had seen it. I remember thinking about it but I don’t want to become a novelty. My dignity is priceless.”

Newsbeat has seen photographs which support Triple D’s claims but cannot independently verify his identity.

The four kinds of healthcare spending

Filed under: Bureaucracy, Business, Economics, Government, Health, USA — Tags: , , , — Nicholas @ 03:00

Megan McArdle explains why healthcare costs more than you think it should:

Milton Friedman famously divided spending into four kinds, which P.J. O’Rourke once summarized as follows:

  1. You spend your money on yourself. You’re motivated to get the thing you want most at the best price. This is the way middle-aged men haggle with Porsche dealers.
  2. You spend your money on other people. You still want a bargain, but you’re less interested in pleasing the recipient of your largesse. This is why children get underwear at Christmas.
  3. You spend other people’s money on yourself. You get what you want but price no longer matters. The second wives who ride around with the middle-aged men in the Porsches do this kind of spending at Neiman Marcus.
  4. You spend other people’s money on other people. And in this case, who gives a [damn]?

Most health-care spending in the U.S. falls into category three. In theory, the people who are funding our expenses — the proverbial middle-aged men in Porsches, except that they’re actually insurance executives and government bureaucrats — have every incentive to step in, cut up the charge cards, and substitute a gift-wrapped box of Hanes briefs with the comfort-soft waistband. In practice, legislators frequently intervene to stop them from exercising much cost-control. The managed care revolution of the 1990s died when patients complained to their representatives, and the representatives ran down to their offices to pass laws making it very hard to deny coverage for anything anyone wanted. Medicare cost-controls, such as the famed Sustainable Growth Rate, fell prey to similar maneuvers. The only system that exhibits sustained cost control is Medicaid, because poor people don’t vote, or exit the system for better insurance.

The result is a system where everyone complains that we spend much too much on health care — and the very same people get indignant if anyone suggests that they, personally, should maybe spend a little bit less. Everyone wants to go to heaven — but nobody wants to die.

Unfortunately, this is what cost-control actually looks like, which is to say, like people not being able to spend as much on health care. Oh, to be sure, we could achieve this end differently — instead of asking patients to pay a modest share of their own costs (the article suggests that this amount is less than 10 percent, in the case of Harvard professors) — we could simply set a schedule of covered treatment, and deny patients access to off-schedule treatments, or even better, not even tell them that those treatments exist. But people don’t like that solution either, which is why medical dramas are filled with rants about insurers who won’t cover procedures, and the law books are filled with regulations that sharply curtail the ability of insurers to ration care. And the third option, refusing to pay top-dollar for care, would be a bit tricky for Harvard to implement, given that they run exactly the sort of high-cost research facilities that help drive health-care costs skyward. Nor do I really think that the angry professors would be mollified by being given a cheap insurance package that wouldn’t let them go see the top-flight specialists their elite status now entitles them to access.

Instead, they persist in our mass delusion: that there is some magic pot of money in the health-care system, which can be painlessly tapped to provide universal coverage without dislocating any of the generous arrangements that insured people currently enjoy. Just as there are no leprechauns, there is no free money at the end of the rainbow; there are patients demanding services, and health-care workers making comfortable livings, who have built their financial lives around the expectation that those incomes will continue. Until we shed this delusion, you can expect a lot of ranting and raving about the hard truths of the real world.

January 9, 2015

Scott Adams can predict your diet success rate

Filed under: Health, Randomness — Tags: , , — Nicholas @ 02:00

No, he really can:

I can accurately predict whether you will meet your weight loss goals by the way you talk about it.

I mean that literally. I think I could devise a controlled experiment in which I pick weight-loss winners and losers in advance based on nothing but a transcript of folks talking about their fitness goals.

I’ll give you some examples. What follows is a list of things you will hear from people that have no legitimate chance of losing weight and keeping it off. Yes, your thing is probably on this list and it pisses you off to see it. But stay with me and I’ll change your life by the end of this post.

Here’s what people say when they are preparing to fail at a weight-loss strategy.

“I need to exercise more.”

“I’m counting calories.”

“I have a cheat day coming.”

“I’m watching my portions.”

“I’m doing a cleanse.”

“I’m trying the (whatever) diet plan.”

Ten years ago I would have said everything on the list is a common-sense way to lose weight. But science has since shown otherwise. I’ll go through them one at a time.

January 6, 2015

The amazing – and scary – power of testosterone

Filed under: Health, Science — Tags: , , , , — Nicholas @ 02:00

A throw-away comment on the experiences of female-to-male transgender people by Scott Alexander:

… I could hunt down all of the stories of trans men who start taking testosterone, switch to a more male sex drive, and are suddenly like “OH MY GOD I SUDDENLY REALIZE WHAT MALE HORNINESS IS LIKE I THOUGHT I KNEW SEXUAL FRUSTRATION BEFORE BUT I REALLY REALLY DIDN’T HOW DO YOU PEOPLE LIVE WITH THIS?”

The author of the last link has this to say about the impact of testosterone on his life:

One of the most interesting things about the effects of testosterone and trans men is that we have something else to compare it to. Non-trans men do not. And non-trans women do not, which is why I wrote the post “It’s the Testosterone: What Straight Women Should Know.”

When I started testosterone a dozen years ago, I expected my sex drive to increase. The “horror” stories are a part of trans man lore, passed down from generation to generation as we all gear up for male adolescence, no matter how old we are, and take out a line of credit at the adult toy store.

And it did increase, within about four days of my first shot, and I basically squirmed a lot for two years before I got used to it. But I was planning for that. Here are the things that took me by surprise:

> It became very focused on one thing – the goal, the prize, the end. That doesn’t mean that I was not able to “make love.” What it does mean is that there was a madness to my method, because it was goal-oriented. There was a light at the end of the tunnel. There was a pot of gold at the end of the rainbow. There was an unguarded hoop just waiting for a slam dunk – score!

> It became very visual. I saw it, I wanted it – whatever it was. This was a new experience for me, because, in the past, I had not been aroused so much by pictures and body parts (or pictures of body parts) as I had been by words – erotic descriptions, stories, and things said to me.

> It became very visceral – instinctual – with a need to take care of it. It had very little to do with romance or even an attraction that made sense intellectually. You’re hungry, you eat. There was a matter-of-factness about it, especially when I was by myself. Hmm … peanut butter sandwich sounds good. Okay, done. Let’s move on.

And from the linked post:

Whenever I speak at a college class (which I did this week), I inevitably get the question about testosterone and sex drive (because college kids are still young enough to be thinking about sex most of the time).

And I tell them the truth, which is that, at least for me and most guys I know, testosterone sends your sex drive straight through the roof and beyond the stratosphere. NASA should honestly use it for fuel to get those rockets (which are really just larger-than-life phallic symbols) to the moon. It is a very powerful aphrodisiac, and way better than oysters, which tend to be slimy.

Testosterone not only increased my sex drive ten-fold, but changed the nature of it as well. It became less diffuse and more goal-oriented, which is probably how the word “score” entered the sexual lexicon. It also, in certain situations, became less about any other person and more about me.

December 31, 2014

The psychological value of online gaming

Filed under: Gaming, Health, Technology — Tags: , , , — Nicholas @ 11:17

At Massively, Andrew Ross talks to the lead author on a recent paper that — unlike the pop-psych headlines in the newspapers — shows a much more positive side to gamers and online gaming:

Every time we talk about scientific research on Massively, readers argue that results from game studies should be “obvious” and are a waste of time/money or that everyone knows MMOs are filled with anti-social trolls. Kowert told me that game studies are “not unique in these criticisms,” though “they may seem stronger within this field due to the perceived frivolity of games and gaming as a field of study”:

    Even though gaming continues to grow in importance and popularity within society, there is still so much that remains unknown about how and why people are using this medium and what are its potential uses and effects (both positive and negative). For example, it has long been assumed that online game players are all reclusive, overweight, lonely, teenage males. This is reflected in the cultural stereotype of the group as seen in the news media and popular culture (Make Love, Not Warcraft, anyone?).

In her paper Reconsidering the Stereotype of Online Gamers, Kowert and her colleagues examined the validity of these stereotypes. As we discussed yesterday, the results proved that the opinions people hold about gamers don’t quite match the media’s stereotypes, even among non-gamers. Without research, we wouldn’t have this information, and for me as a gamer, it’s encouraging to know that times are changing. Plus, it gives you ammo when Uncle Frank tries to put down your hobby this holiday season.

During my examination of the research into online games and real world friendships among emotionally sensitive users, I realized I could see myself in the findings. As a child, I was very shy; part of the problem was that I didn’t know how to react to people’s emotions. One article about social gaming and lonely lives argued that people who game a lot can sometimes have trouble connecting with non-gamers. Many “enthusiastic hobbyists” also have this issue, whether their hobby is sports or soap operas or games.

Kowert says this is correct to an extent; we’ve all met the hardcore sports fans who spouts sports jargon. “There is some uniqueness in the social profile of individuals who choose to exclusively engage in hobbyist activities that are mediated by technology, such as online games,” Kowert told me. “For instance, you state that you were shy as a child and preferred standing in the background rather than diving right into new social situations. Knowing this about yourself, you may have been more apprehensive to join, let’s say, a sports club or a board game group, than popping in on an online forum discussing sports or joining online gaming club.”

In other words, it’s not that all people who play online games are shy or are using the internet to overcome some of their social problems, but for those who suffer from those problems, online gaming could be a good way for them to meet others. Being online allows people to share a social space without the fears and consequences associated with face-to-face socialization. For example, I rarely went to parties in high school, but I did run events in the online games I played, especially in older MMOs. In more raid-oriented MMOs, people constantly told me I was doing something “different,” something unique or strange, and that made me stand out as also being different. In short, I was using the game world in a different way than other more mainstream gamers did, which echoes Kowert’s research about emotionally sensitive players using game spaces in unique ways. She explains:

    Previous research has largely focused on the relationship between MMORPG play and social outcomes, as MMORPGs are believed to have a unique ability to promote sociability between users (see Mark Chen’s 2009 book Leet Noobs for a more in-depth discussion of the social environment of MMOs). As cooperation between users is often crucial to game play, the social environment of MMORPGs differs from other genres, such as multi-player first-person shooter games where gameplay is more about competition than cooperation and the social environment is more often characterized by competitiveness, trash-talking, and gloating (for more on this research see Zubek & Khoo, 2002 [PDF]). These differences in social environments are likely to differentially impact the social utility of the space as well as the social relationships that may come from it.

The (awful) people of Whole Foods

Filed under: Business, Health, Personal, USA — Tags: , , , — Nicholas @ 04:00

Many years ago, when we lived on “the Danforth”, we were occasional patrons of “The Big Carrot”, an early retail store for the self-consciously “alternative” set. If you wanted gluten-free, or dairy-free, or fair-trade, they were almost the only game in town in the late 80s and early 90s. The selection may not have been great at times, but they did try to provide a variety of foods that you couldn’t get at the mainstream supermarkets of the day. The employees seemed to be mostly good, helpful folks, but almost to a person the customers were incredibly self-centred, self-righteous, arrogant, and intolerant. I don’t know how the staff put up with the constant childish antics and unending whining from the customers. Whole Foods is a much bigger enterprise than Toronto’s Big Carrot … and they seem to have attracted exactly the same customer base:

The problem with Whole Foods is their regular customers. They are, across the board, across the country, useless, ignorant, and miserable. They’re worse than miserable, they’re angry. They are quite literally the opposite of every Whole Foods employee I’ve ever encountered. Walk through any store any time of day—but especially 530pm on a weekday or Saturday afternoon during football season — and invariably you will encounter a sneering, disdainful horde of hipster Zombies and entitled 1%ers.

They stand in the middle of the aisles, blocking passage of any other cart, staring intently at the selection asking themselves that critical question: which one of these olive oils makes me seem coolest and most socially conscious, while also making the raw vegetable salad I’m preparing for the monthly condo board meeting seem most rustic and artisanal?

If you are a normal human being, when you come upon a person like this in the aisle you clear your throat or say excuse me, hoping against hope that they catch your drift. They don’t. In fact, they are disgusted by your very existence. The idea that you would violate their personal shopping space — which seems to be the entire store — or deign to request anything of them is so far beyond the pale that most times all they can muster is an “Ugh!”

Over the years I have tried everything to remain civil to these people, but nothing has worked, so I’ve stopped trying. Instead, I walk over to their cart and physically move it to the side for them. Usually, the shock of such an egregious transgression is so great that the “Ugh!” doesn’t happen until I’m around the corner out of sight. Usually, all I get is an incredulous bug-eyed stare. Sometimes I get both though, and when that happens, I look them square in the eye and say “Move. Your. Cart.” I used the same firm tone as Jason Bourne, with the hushed urgency of Jack Bauer and the uncomfortable proximity of Judge Reinhold. From their reaction you’d think I just committed an armed robbery or a sexual assault. When words fail them, as they often do with passive aggressive Whole Foods zombies, the anger turns inward and they start to vibrate with righteous indignation. Eventually, that pent up energy has to go somewhere, and like solar flares it bursts forth into the universe as paroxysms of rage.

December 22, 2014

A new paper on the exaggerated claims that MMOs are harmful

Filed under: Gaming, Health — Tags: , , , — Nicholas @ 00:04

By way of Massively, the abstract of a new paper by Dr. Rachel Kowert and her co-authors, investigating claims that massive multi-player online games are a public health threat:

Highlights
• The psychosocial causes and consequences of online video game play were evaluated.
• Over a 1- and 2-year period, evidence for social compensation processes were found.
• Among young adults, online games appear to be socially compensating spaces.
• No significant displacement or compensation patterns were found for adolescents.
• No significant displacement or compensation patterns were found for older adults.

Abstract

Due to its worldwide popularity, researchers have grown concerned as to whether or not engagement within online video gaming environments poses a threat to public health. Previous research has uncovered inverse relationships between frequency of play and a range of psychosocial outcomes, however, a reliance on cross-sectional research designs and opportunity sampling of only the most involved players has limited the broader understanding of these relationships. Enlisting a large representative sample and a longitudinal design, the current study examined these relationships and the mechanisms that underlie them to determine if poorer psychosocial outcomes are a cause (i.e., pre-existing psychosocial difficulties motivate play) or a consequence (i.e., poorer outcomes are driven by use) of online video game engagement. The results dispute previous claims that online game play has negative effects on the psychosocial well-being of its users and instead indicate that individuals play online games to compensate for pre-existing social difficulties.

December 15, 2014

The world of the imagination

Filed under: Gaming, Health, Media, Technology — Tags: , , , — Nicholas @ 00:04

At BoingBoing, Jason Louv talks about getting back into his teenage passion (Dungeons and Dragons), but also worries that as a culture, we’re losing our opportunities — and capability — to imagine:

There’s just something about high Arthurian or Tolkienesque fantasy that cuts so deeply into the Western unconscious, finding a far more central vein than anything that Lovecraft or Edgar Rice Burroughs or Jack Kirby were able to mine. Nothing beats the experience of the Grail Quest, of becoming a heroic adventurer in a medieval world full of fantastic creatures, on a mission to slay the dragon and liberate the princess — or at least get some decent gold, treasure and experience points.

Until I left for college, fantasy paperbacks and comics were my world when I was alone, and role-playing games were my world when I was with friends. And how much more real, in a way, the inner palaces of my adolescent imagination felt to me than the gritty “reality” of so-called adult life, of endless war, losing friends to drugs, economic chaos, tumultuous relationships, chasing dollars.

Am I so wrong to want to go back to the Garden?

The Interior Castle

While our culture dismisses any use of the imagination as wasted time — something that distracts us from the “real” world of quantification and monetization — mystics and artists throughout history have told us that the imagination is the vehicle which brings us into contact with reality, not away from it.

William Blake is an exemplar of this approach — “The world of imagination is the world of eternity,” he wrote. “It is the divine bosom into which we shall all go after the death of the vegetated body. This world of imagination is infinite and eternal, whereas the world of generation is finite and temporal.”

In 1577, the Spanish Carmelite nun Teresa of Ávila wrote a prayer manual called The Interior Castle, which describes her path to union with God as a kind of epic single-player Dungeons and Dragons game. In it, she describes a vision she received of the soul as a castle-shaped crystal globe, containing seven mansions. These mansions — representing seven stages of deepening faith — were to be traversed through internal prayer. Throughout the book, she warns that this imaginary internal world will be consistently assaulted by reptilian specters, “toads, vipers and other venomous creatures,” representing the impurities of the soul to be vanquished by the spiritual pilgrim.

Sixty-five years earlier, St. Ignatius of Loyola designed his Spiritual Exercises as the training manual of the Jesuits, in which adherents were to deeply imagine themselves partaking in incidents from the life of Christ, creating inward virtual realities built up over years as a way of coming closer to God. Similar techniques exist in many world religions — in the stark inner visualizations of Tantric Buddhism, for instance. Such mystics speak not just of the vital importance of daydreaming and fantasy, but of the disciplined imagination as literally the door to divinity.

As we progress into the 21st century, this is a door that we are slowly losing the key to. The French Situationist author Annie Le Brun, in her 2008 book The Reality Overload: The Modern World’s Assault on the Imaginal Realm, suggests that information technology is causing blight and desertification in the world of the imagination just as surely as pollution and global warming are causing blight and desertification in the physical world. We are gaining the ability to communicate and hoard information, but losing the ability to imagine.

I literally cannot get my head around what it must be like to be a child or teenager now, raised in a completely digitized world — where fantasy and long reverie have given way to the instant gratification of electronic media. There can be no innocence or imagination or wonderment in the world of Reddit, Pornhub and 4Chan — just blank, numb, drooling fixation on a screen flickering with horrors in a dark and lonely room, the hell of isolation within one’s own id. I recently saw a blog post about a toilet training apparatus with an attachment for an iPad. No, no, no.

Just as electronic media is stripping us of our right to privacy, so is it stripping us of our right to an inner world. Everything is to be put on public display, even our most intimate moments and thoughts.

We need to go back. We need to re-discover the door to the inner worlds — a door that I believe encouraging young people to read printed books, and to play analog role-playing games like Dungeons and Dragons, can re-open.

December 13, 2014

Tobacco – 480,000. Alcohol – 88,000. Marijuana – > 0

Filed under: Health, Law, Liberty, USA — Tags: , , — Nicholas @ 12:06

It’s ridiculous to claim that smoking marijuana is a healthy habit. It does increase the risk of certain kinds of cancers, although the numbers are not huge, they’re also not zero. Jacob Sullum says “Marijuana Kills! But Not Very Often. Especially When Compared to Alcohol and Tobacco.

In a new Heritage Foundation video, anti-pot activist Kevin Sabet bravely tackles “the myth that marijuana doesn’t kill.” Although cannabis consumers (unlike drinkers) do not die from acute overdoses, he says, “marijuana does kill people” through suicide, chronic obstructive pulmonary disease, car crashes, and other accidents.

I won’t say Sabet is attacking a straw man, since overenthusiastic cannabis fans have been known to say that “marijuana doesn’t kill anyone” (although the top Google result for that phrase is an article by Sabet explaining why that’s not true). But I will say that Sabet manages to obscure the fact that marijuana does not kill people very often, especially compared to the death tolls from legal drugs such as tobacco and alcohol, which is the relevant point in evaluating the scientific basis for pot prohibition. Let’s take a closer look at the four ways that marijuana kills, according to Sabet:

Suicide. Some research does find a correlation between suicide and marijuana use, but that does not mean the relationship is causal. A longitudinal study published by The British Journal of Psychiatry in 2009 reached this conclusion:

    Although there was a strong association between cannabis use and suicide, this was explained by markers of psychological and behavioural problems. These results suggest that cannabis use is unlikely to have a strong effect on risk of completed suicide, either directly or as a consequence of mental health problems secondary to its use.

Furthermore, there is some evidence that letting patients use marijuana for symptom relief reduces the risk of suicide. Still, if reefer has ever driven anyone to kill himself, that would be enough to prove Sabet’s point. You can’t say it has never happened!

December 6, 2014

Fran Tarkenton on the NFL’s long-standing drug problems

Filed under: Football, Health, Law — Tags: , , , , — Nicholas @ 10:57

In an interview with Jenny Vrentas, former Viking great Fran Tarkenton discusses this year’s crop of rookie quarterbacks (including the Vikings’ Teddy Bridgewater), the NFL’s ongoing disciplinary issues with Ray Rice and Adrian Peterson, the long-term issues with NFL doctors dispensing painkillers, and the advent of performance-enhancing drugs. On the issue of league discipline, he believes the league should not allow Rice or Peterson to play again:

VRENTAS: Are you saying the Vikings should move on from Peterson because of his age, or because of the child abuse case that led to his suspension?

TARKENTON: I followed the Clippers thing. That owner [Donald Sterling] didn’t get indicted for any crime, but the racial comments he made were totally inappropriate, and we took a stand. The whole world and the NBA, we have zero tolerance to racism. And I think that’s right. I agree with that. But I also think we ought to have zero tolerance to child abuse and domestic violence. I don’t think [Peterson] should play again in the NFL. I don’t think Ray Rice should play again. Either we have zero tolerance, or we don’t. And what is more egregious than domestic violence and child abuse? I don’t know of anything, unless you kill somebody.

VRENTAS: Peterson has not played since the child-abuse charges first surfaced in September, and now he’s been suspended for the rest of the season, pending appeal. Do you think the response shows that teams and the league are starting to take these issues more seriously?

TARKENTON: Kind of. They have been a little bit wishy-washy. [The Vikings] were going to play Adrian Peterson [before reversing course in September]. Other teams were going to play other players [involved in cases of domestic violence]. And the NFL was going to give just a two-game suspension to Ray Rice. I don’t think we’ve gotten beyond “win at any cost” yet. And I think we need to get there. We should have zero tolerance to racism. We don’t believe that, right? Is that more important than zero tolerance to domestic abuse and child abuse? Unless we as a society think that way, then we won’t make progress. And the whole domestic violence thing, that has been tolerated universally, but certainly in the NFL. We can’t tolerate that. All these behaviors that are so egregious continue. We need to set an example.

And on the topic of team doctors and the use of drugs to get players back into games (but which had potentially serious long-term health implicatons:

VRENTAS: You wrote a letter to the New York Times regarding painkiller abuse, in response to the DEA’s recent spot checks of NFL team medical staffs. This has been a subject you have been vocal about. What was your experience with painkiller use during your playing career?

TARKENTON: This has been going on forever. I was playing for the New York Giants, and I hurt my shoulder in a game against the Pittsburgh Steelers. I came in at halftime, and the doctor had a great big long needle, punched a few different places, and told me, “Show me where it hurts the worst.” I said, “Ow,” and he jammed a combination of xylocaine and cortisone into my shoulder. That’s not good for my shoulder, but he’s my team doctor. I don’t think he’s going to do something that hurts my career, right? He’s like my family doctor. If my family doctor tells me to take a pill, I’ll take a pill. So every Friday, I went on the subway from old Yankee Stadium, where we practiced, all the way down to lower Manhattan to St. Vincent’s Hospital, and they did the same thing they did at halftime. They shot my shoulder. It didn’t really help me, but it allowed me to play. Now, when I come back to Minnesota, my shoulder is worse. The year we played the Pittsburgh Steelers in the Super Bowl in New Orleans, my shoulder was already deteriorating, and I hurt it early in the season in Dallas. The rest of the year I could not throw a ball in practice; I could not throw a ball in warm-ups over 10 yards. When I got in the game, I could throw it maybe 40 yards, because my adrenaline was up, but there was nothing on it. But every Friday, guess what they shot me with? Butazolidin. That’s what they shot horses with. Shot me up every Friday, all the way to the Super Bowl. I retired at age 39, and I see my doctors down here [in Atlanta] because my shoulder is killing me. They say, “You’ve got the shoulder of a 75-year old man. You need your shoulder replaced.” I talked to a lot of the old guys — Roger Staubach, Otto Graham, Sammy Baugh, Johnny Unitas, Y.A. Tittle ­— and none of them had shoulders replaced. I had my shoulder replaced, because they shot me up. Where was the conscience back then? People say, “You knew what they were doing.” I knew what they were doing, but I didn’t think they would hurt me. I didn’t think my shoulder was going to fall apart.

December 5, 2014

For our next trick, we need to crack another genetic code

Filed under: Health, Science — Tags: , , — Nicholas @ 00:03

Michael White says we need to follow up our success in reading our own genetic code by decoding a different one:

There are thousands of mutations that occur in the breast cancer-linked genes BRCA1 and BRCA2. Some of these cause breast or ovarian cancer, while others are harmless. When we design a genetic test for predisposition to breast cancer, we have to know which ones to test for. The same is true of almost any gene that plays a role in disease — you’ll find many mutations in that gene in the general population, only some of which cause health problems. So how do we know which mutations to worry about?

We start by using the genetic code. The genetic code, cracked by scientists in the 1960s, makes it surprisingly easy to “read” our DNA and understand how a particular mutation affects a gene. As genetic testing takes on a bigger role in predicting, diagnosing, and treating disease, we rely on this code to help us make sense of the data. Unfortunately, the genetic code applies to less than two percent of our DNA. In an effort to read the rest, researchers are trying to crack a new genetic code — and this next one is turning out to be much more difficult to solve than the first. In fact, scientists may have to give up the idea that we can use a “code” to “read” the rest of our DNA.

When scientists were working out the original genetic code in the 1950s and ’60s, all sorts of complicated schemes were proposed to explain how information is stored in our genes. The problem they were trying to solve was how a gene, made of DNA, codes the information to make a particular protein — an enzyme, a pump, a piece of cellular scaffolding, or some other critical component of the cell’s working machinery. They were looking for a code that would translate the four-letter DNA alphabet of genes into the 20-letter amino acid alphabet of proteins.

[…]

Thanks to its simplicity, the genetic code is a powerful tool in our hunt for mutations that cause disease. Unfortunately, it has also led to the genetic equivalent of a drunk looking for his lost keys under the lamppost. Researchers have put much of their effort into looking for disease mutations in those parts of our genomes that we can read with the genetic code — that is, parts that consist of canonical genes that code for proteins. But these genes make up less than two percent of our DNA; much more of our genetic function is outside of genes in the relatively uncharted “non-coding” portions. We have no idea how many disease-causing mutations are in that non-coding portion — for some types of mutations, it could be as high as 90 percent.

December 4, 2014

QotD: Roman medical advice

Filed under: Europe, Health, History, Media, Quotations — Tags: , — Nicholas @ 00:01

Before I forget it, I must record two valuable health hints that I learned from Xenophon. He used to say: “The man is a fool who puts good manners before health. If you are troubled with wind, never hold it in. It does great injury to the stomach. I knew a man who once nearly killed himself by holding in his wind. If for some reason or other you cannot conveniently leave the room — say, you are sacrificing or addressing the Senate — don’t be afraid to belch or break wind downwards where you stand. Better that the company should suffer some slight inconvenience than that you should permanently injure yourself. And again, when you suffer from a cold, don’t constantly blow your nose. That only increases the flow of rheum and inflames the delicate membranes of your nose. Let it run. Wipe, don’t blow.” I have always taken Xenophon’s advice, at least about nose-blowing: my colds don’t last nearly so long now as they did. Of course, caricaturists and satirists soon made fun of me as having a permanently dripping nose, but what did I care for that? Messalina told me that she thought I was extremely sensible to take such care of myself: if I were suddenly to die or fall seriously ill, what would become of the City and Empire, not to mention herself and our little boy?

Robert Graves, Claudius the God, 1935.

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