Quotulatiousness

September 16, 2017

It’s “as if Justin Trudeau had just invented marijuana, and the stuff’s mystical properties are unfamiliar to every police officer in the land”

Filed under: Cancon, Health, Law, Liberty — Tags: , — Nicholas @ 03:00

As the old joke had it, marijuana can cause paranoia, confusion, and total loss of reality in people who’ve never taken them. Canadian police organizations are desperate to keep legal marijuana from becoming a thing:

I cannot be the only one who feels the world is a little upside-down after Wednesday’s hearings on marijuana held by the House of Commons standing committee on health. The day’s proceedings were essentially broken into two parts. First, high-ranking Canadian police came before the committee to complain that they didn’t have the technical resources or the training to deal with legalized marijuana. They pleaded for the passage of the Liberals’ Cannabis Act to be delayed.

Then officials and scholars from the states of Colorado and Washington appeared to talk about their initial experiences with legalized marijuana. The contrast was remarkable. Canadian cops are behaving as if marijuana is a new problem for them—as if Justin Trudeau had just invented marijuana, and the stuff’s mystical properties are unfamiliar to every police officer in the land. The general thrust of the American testimony was not in conflict with the police demand to delay the legislation. Indeed, their major messages included going slow, getting it right, and learning from the history of the pot states. But none of the American witnesses, particularly the Washington and Colorado revenue bean-counters, showed any particular appetite for going back to the days of prohibition.

They could have come to Canada and said, “Oh, God, what are you crazy SOBs thinking?” There was little evidence of any such sentiment. I think it is safe to say that committee members who favour legalization, or who are anything other than implacably hostile to it, must have come away from the testimony broadly reassured.

Washington and Colorado have not descended into a nightmare of chaos because they have legalized “recreational marijuana.” By most social measures these states are about what they were before legalization. Youth use of pot is being watched closely, and it appears to be steady, possibly reduced. The states’ coffers have seen a modest benefit, and some of the money from pot taxation is made available for general drug education and abuse prevention—not just the more intensive outreach to young people about weed.

September 4, 2017

The mental health crisis on campus

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

In Spiked, Naomi Firsht shares the concerns of Jonathan Haidt about the rise of mental health issues at US universities:

The heightened vulnerability of college students has had a chilling effect on discussion in the academic world, and Haidt sees this in his day-to-day experience on campus. “There is a rapidly spreading feeling that we are all walking on eggshells, both students and faculty. That we are now accountable, not for what we say, but for how anyone who hears it might take it. And if you have to speak, thinking about the worst reading that anyone could put on your words, that means you cannot be provocative, you cannot take risks, that means you will play it safe when you speak… This is what I’m seeing in my classes when topics related to race or gender come up – which we used to be able to talk about 10 years ago, but now it’s painful and there’s a lot of silence.”

This is disastrous for academic life, as Haidt points out: “A university cannot function if people will not put their ideas forth, will not contest ideas that they think are wrong, will not stand up for ideas that they think are right.”
He is keen to emphasise that this is not a right-left issue. “Several people on the left are noticing that college students are less effective politically as activists, as progressives, when they have this morality and this ethos with such heavy concept creep.”

Haidt believes there is a mental-health crisis on campus: “I have never seen such rapid increase in indicators of anxiety and depression as we have seen in the past few years”, he says. But his suggested approach is unlikely to find favour with student communities fond of Safe Spaces and therapeutic puppy-petting. “If you think about it as a mental-health crisis”, he explains, “then you might be tempted to say: we need more help, more counselling, more protection for those who are suffering from mental illness. But if you look at it that way you will miss the broader pattern, which is that for 20 to 30 years now, Americans have been systematically undermining the development of resilience or toughness of their children.” Referencing the work of Lenore Skenazy, author of Free-range Kids, he concludes: “We have made our children too safe to succeed.”

In his forthcoming book Misguided Minds: How Three Bad Ideas Are Leading Young People, Universities, and Democracies Toward Failure, Haidt claims that certain ideas are impairing students’ chances of success. Those ideas being: your feelings are always right; what doesn’t kill you makes you weaker; and the world is divided into good people and bad people. “If we can teach those three ideas to college students”, he says, “we cannot guarantee they will fail, but we will minimise their odds at success”.

So how can we resolve the problem of vulnerability among young Americans? Haidt says part of the solution must begin in childhood and will require parents to give their children daily periods of “unsupervised time”. “We have to accept the fact that in that unsupervised time there will be name-calling, conflict and exclusion. And while it’s painful for parents to accept this, in the long-run it will give them children that are not suffering from such high rates of anxiety and depression.”

August 17, 2017

Safe injection sites go rogue … to save lives

Filed under: Cancon, Health, Law — Tags: , , , , — Nicholas @ 03:00

In the National Post, Chris Selley wonders why the federal government has been so slow to come around to accepting the overall harm reduction offered by legal safe injection sites:

I suspect this generation of policymakers, and the previous one especially, will struggle to explain to their grandchildren just what on earth they thought they were doing about opioid addiction. I don’t mean the likes of Donald Trump, who seems to think a get-tough policing approach — a “war on drugs,” perhaps — might get the job done. I mean smart, reasonably compassionate Canadians, by no means all conservatives, whose worries about safe injection sites in particular look bizarre even today, when people are still using them.

“It’ll attract rubadubs” — as if Vancouver’s Downtown Eastside was a middle-class utopia before Insite set up shop. “There’ll be needles in the streets” — more than if the safe injection site weren’t there, you mean? And, of course: “Addicts should go to treatment instead” — as if people haven’t been trying and failing to get and stay clean this whole time; as if the alternative, on a day to day basis, might be not waking up the next morning to go get treatment.

To its credit, the Liberal government in Ottawa has loosened the regulatory reins. There are nine approved “supervised consumption sites” up and running across the country: five on the Lower Mainland, one in Kamloops, and three in Montreal. Six more, in Victoria, Ottawa, Toronto and Montreal, are approved and awaiting inspections. An additional 10 are in the approval process; four in Edmonton applied more than three months ago; one in Ottawa has been in the works, officially, since February.

This looks like progress, and to a great extent it is. But on Sunday, a group of activists in Toronto implicitly asked another trenchant question: why does it take so bloody long to set up a supervised injection site? Why are we waiting? It’s just clean needles, chairs and tables, overdose treatment medication, a nurse and a phone.

August 13, 2017

QotD: The measurement problem in government

Filed under: Britain, Government, Health, Quotations — Tags: , , , , , — Nicholas @ 01:00

Now take health insurance. (Or, if you live, like me, in a country with a national healthcare system that has a single comprehensive payer, the health system.) There are periodic suggestions that we should punish bad behaviour, behaviour that increases medical costs: Scotland has an alcoholism problem so we get the Alcohol (Minimum Pricing)(Scotland) Act, 2012. Obesity comes with its own health risks, and where resource scarcity exists (for example, in surgical procedures), some English CCGs are denying patients treatment for some conditions if they are overweight.

It should be argued that these are really stupid strategies, likely to make things worse. Minimum alcohol pricing is regressive and affects the poor far more than the middle-class: it may cause poor alcoholics to turn the same petty criminality observed among drug addicts, to fund their habit. And denying hip replacements to overweight people isn’t exactly going to make it easier for them to exercise and improve their health. But because we can measure the price of alcohol, or plot someone’s height/weight ratio on a BMI chart, these are what will be measured.

It’s the classic syllogism of the state: something must be controlled, we can measure one of its parameters, therefore we will control that parameter (and ignore anything we can’t measure directly).

Charles Stross, “It could be worse”, Charlie’s Diary, 2015-10-09.

July 17, 2017

Debunking some myths about sulfites in wine

Filed under: Health, Science, Wine — Tags: , — Nicholas @ 05:00

By way of Scientific American, here’s a bit of clarity from Monica Reinagel about the issue of sulfites in both red and white wine and what relationship it has to wine headaches:

Myth #1: Organic or bio-dynamic wines are sulfite free.

In order to be certified organic, a wine must not contain added sulfites. However, sulfites are produced naturally during the fermentation process as a by-product of yeast metabolism. Even though no sulfites are added, organic wine may contain between 10-40 ppm sulfites.

You may also see wines labeled as being made from organic grapes, which is not the same as organic wine. Wine made from organic grapes may contain up to 100 ppm sulfites.

If you do get a hold of wine made without sulfites, I don’t suggest keeping it in the cellar very long. Wine made without sulfites—especially white wine — is much more prone to oxidation and spoilage.

Myth #2: Red wine is higher in sulfites than white wine

Ironically, the exact opposite is likely to be true. Red wines tend to be higher in tannins than white wines. Tannins are polyphenols found in the skins, seeds, and stems of the grapes. They also act as antioxidants and preservatives so less sulfite is needed.

In fact, while European regulations allow up to 210 ppm sulfites in white wine, the limit for red wine is only 160 ppm.

Other factors that affect how much sulfite is needed are the residual sugar and the acidity of the wine. Dryer wines with more acid will tend to be lower in sulfites. Sweet wines and dessert wines, on the other hand, tend to be quite high in sulfites.

Myth #3: Sulfites in wine cause headaches

The so-called “red wine headache” is definitely a real thing. But it’s probably not due to sulfites. For one thing, white wine is higher in sulfites than red wine but less likely to cause a headache. That suggests that it’s probably something else in red wine that’s responsible for the notorious red wine headache. Other candidates include histamines, tyramine, tannins, not to mention the alcohol itself!

July 14, 2017

The Peltzman Effect

Filed under: Economics, Government, Health, USA — Tags: , , , — Nicholas @ 05:00

The odd situation where increasing the safety of an activity by adding protective gear is offset by greater risk-taking by the participants:

In the 1960s, the Federal Government — in its infinite wisdom — thought that cars were too unsafe for the general public. In response, it passed automobile safety legislation, requiring that seat belts, padded dashboards, and other safety measures be put in every automobile.

Although well-intended, auto accidents actually increased after the legislation was passed and enforced. Why? As [Professor of Economics Steven E.] Lansburg explains, “the threat of being killed in an accident is a powerful incentive to drive carefully.”

In other words, the high price (certain death from an accident) of an activity (reckless driving) reduced the likelihood of that activity. The safety features reduced the price of reckless driving by making cars safer. For example, seatbelts reduced the likelihood of a driver being hurt if he drove recklessly and got into an accident. Because of this, drivers were more likely to drive recklessly.

The benefit of the policy was that it reduced the number of deaths per accident. The cost of the policy was that it increased the number of accidents, thus canceling the benefit. Or at least, that is the conclusion of University of Chicago’s Sam Peltzman, who found the two effects canceled each other.

His work has led to a theory called “The Peltzman Effect,” also known as risk compensation. Risk compensation says that safety requirements incentivize people to increase risky behavior in response to the lower price of that behavior.

Risk compensation can be applied to almost every behavior involving risk where a choice must be made. Economics tells us that individuals make choices at the margin. This means that the incentive in question may lead the individual to do a little more or a little less of something.

[…]

The fact that incentives reduce or increase behavior is an economic law: Landsburg posits that “the literature of economics contains tens of thousands of empirical studies verifying this proposition and not one that convincingly refutes it.” Incentives change the effectiveness of government policy and shape day-to-day life.

Brace yourself for the next round of Obamacare [repeal | reform | tweaking | posturing]

Filed under: Health, Politics, USA — Tags: , , , — Nicholas @ 03:00

Megan McArdle doesn’t view this latest attempt to “fix” Obamacare with any great optimism:

Mitch McConnell is once again announcing that the Senate is going to come out with a new health-care bill and try to hold a vote next week. That exhaustion you feel is the same despair that seeps over you when a pair of ill-matched friends announce for the 17th time that they’re getting back together.

As with those friends (we all have them, don’t we?) there seems to be no set of mutual goals upon which a durable partnership can be built. Many Republican legislators want Obamacare to die. Others would probably attend the funeral with ill-concealed delight, but they don’t want a reputation for having killed it. Still others would like to be able to tell voters that they “did something” about Obamacare, even though in reality they are loath to actually, you know, do something — because their states would lose money, or voters would lose insurance.

[Wearily] So what can be done here? Realistically.

As an exercise on paper, the answer is easy:

  1. Stop trying to make this a tax-cut bill, and focus on reforms that can pave the way to fiscal stability, and dismantling many of the perverse incentives that have so distorted our health-care system.
  2. Leave Obamacare’s taxes intact. (Yes, even the dumb ones, of which there are many.)
  3. Turn Medicaid into a fixed grant rather than an open-ended entitlement, either by making it a block grant, or switching to a flat per-beneficiary payout — but don’t try to make block grants a confusing cover for very deep cuts to the program.
  4. Provide generous funding to stabilize the individual health-insurance exchanges, but demand in return very wide latitude for states to decide how they stabilize their insurance markets — including jettisoning any of the Obamacare regulations they think are getting in the way.
  5. Meanwhile, move the system more aggressively toward health-savings accounts plus catastrophic insurance — and get Democrats on board by offering to have the government fund some portion of those health savings accounts for low-income citizens.

Is that my ideal health-care system? No. But it gives Republicans some of what they want (a more consumer-driven, pro-market program in the individual market, and a big start toward reforming the bloated and byzantine mess that is the Medicaid program). It gives Democrats some of what they want (money for people who don’t have very much of it, plus they don’t get splattered by the fallout of Obamacare exchanges melting down). In theory, it could pass.

And in theory, I could play third base for the Yankees, if Joe Girardi were willing to hire me. The truth is that after years of complaining about obstructionism, Democrats have developed a sudden taste for the stuff; there’s a substantial faction of both politicians and voters who want the Democrats to stand by and do nothing, nothing, that Republicans might like. And even among those who think they want bipartisan compromise — well, I spend a lot of time listening to those folks, and when you get down to it, frequently their idea of a “compromise” is that they get a huge government program that costs hundreds of billions of dollars, and Republicans get trivial increases in the size of health-savings accounts, and maybe to twiddle with a few of the outer decimal points on growth rates. In other words, what they think is a vision of compromise is too often actually a vision of America ca. 1992, when Republicans were a minority party who had to come begging for crumbs.

July 9, 2017

Getting closer to science fiction technology every day

Filed under: Health, Science, Technology — Tags: , , — Nicholas @ 05:00

In Lois McMaster Bujold’s Vorkosigan Saga novels, one of the imagined technological innovations to play a key part in the story is the Uterine Replicator (spoiler: it’s used to save the life of a premature baby, who grows up — in a manner of speaking — to be the main protagonist of the saga). In Reason, Katherine Mangu-Ward looks at just how close we are getting to the gee-whiz tech Ms. Bujold invented some thirty years ago for her novels:

In April, researchers announced they had managed to keep several extremely premature lambs alive and growing in artificial wombs. After spending up to four weeks in a clear plastic “extra-uterine device” at the Children’s Hospital of Philadelphia, each sheep transformed from a decidedly undercooked fetal specimen to a much more robust critter with long limbs and a fluffy wool coat, the sort of animal you wouldn’t be terribly alarmed to see plop to the ground in a field on a spring afternoon.

The setup strongly resembles a sous vide cooking apparatus: a tiny, tender lamb floats in a large plastic ziplock, hooked up to tubes and monitors. But a video clip posted by the researchers has the emotional heft of feeling a fetus kick when you put a hand on a pregnant woman’s belly. Visible through the clear plastic, the lamb’s hooves twitch gently as it snuffles its nose and wiggles its ears.

The lambs in the experiment were selected for their developmental similarity to human babies born right on the edge of viability, or about four months premature. Babies born that early are equal parts horrifying and marvelous. Tiny creatures with organs visible through their translucent skin, they’re often called “miracle babies.” But there’s nothing particularly mysterious about those little beings curled up in nests of tubes and wires; they live because of the inspiration and hard work and risk-taking and study and pain of hundreds of people.

There are actually more of these struggling newborns now than there were a decade ago, simply because we’ve gotten so much better at keeping extremely premature babies — born before 24 gestational weeks — alive. Yet in the U.S., one-third of all infant deaths and one-half of all cases of cerebral palsy are still attributed to prematurity. Of the babies born that early who survive, more than 90 percent have severe and lasting health consequences, especially with their lungs, eyes, and intestines.

Previous efforts to improve those numbers have been stymied by difficulties duplicating the functions of the placenta, but the device attached to the “Biobag” looks deceptively simple: a pumpless blue plastic box hooked up to the umbilical cord that oxygenates the blood, removes carbon dioxide, and adds nutrients.

In their paper, published in Nature Communications, the Philadelphia researchers are careful to say that human applications of their work are at least a decade away. Yet these little pink lambs are already taking sledgehammers to some of the most precarious coalitions in American politics.

July 7, 2017

Despite the headlines, the world is getting much better, much faster

Filed under: Economics, Health, Media — Tags: , , — Nicholas @ 05:00

The mainstream media has a built-in bias for bad news, which is understandable: bad news draws eyeballs and clicks because as a species we’re much more attuned to detecting risks than anything else — it’s a good pro-survival trait. Our bias (and reinforcement offered by the media’s bias) leads us all to think things are going much worse than they really are, pretty much all the time. Scott Sumner offers a bit of counterpoint:

The news media is good at storytelling. That’s no surprise, as people like to learn through stories, indeed this preference is probably hardwired into our brains. The news media can’t survive without readers and viewers, and so naturally they focus on storytelling. And the most riveting stories involve war, terrorism, natural disasters, and other serious problems. While the individual stories are usually true, the overall effect is to present a very false image of the world. As a result, at least 90% of Americans literally have no idea as to what is actually going on in the world. Here’s Nicholas Kristof:

    Nine out of 10 Americans say in polls that global poverty has been staying the same or worsening. So let’s correct the record.

    There has been a stunning decline in extreme poverty, defined as less than about $2 per person per day, adjusted for inflation. For most of history, probably more than 90 percent of the world population lived in extreme poverty, plunging to fewer than 10 percent today.

    Every day, another 250,000 people graduate from extreme poverty, according to World Bank figures. About 300,000 get electricity for the first time. Some 285,000 get their first access to clean drinking water. When I was a boy, a majority of adults had always been illiterate, but now more than 85 percent can read.

    Family planning leads parents to have fewer babies and invest more in each. The number of global war deaths is far below what it was in the 1950s through the 1990s, let alone the murderous 1930s and ’40s.

    Aneri and I are reporting from a country whose name, Liberia, evokes Ebola, civil war and warlords like General Butt Naked. That’s partly because we journalists have a bias toward bad news: We cover planes that crash, not planes that take off.

Unfortunately these true lies are hard to push back against. Statistics tells us that the world is getting better at a mind-boggling rate (Seriously, can your brain even imagine the improvement in human welfare associated with 250,000 people a day rising above extreme poverty? I can’t.) But that’s not the world people tend to see. As a result, they elect politicians who pander to their ignorance of the world.

July 3, 2017

QotD: Smartphones, the Internet-of-things, and social controls

Filed under: Government, Health, Quotations, Religion, Technology — Tags: , , , — Nicholas @ 01:00

It’d be interesting (in a gruesome sort of way) to see what Da’esh (or the government of Saudi Arabia) could do with a citizen score. Currently enforcement of public morality in hardcore Salafi Muslim states is carried out by the Committee for the Promotion of Virtue and the Prevention of Vice in Saudi Arabia, and other religious police in other states. As with all police forces, there is a cost associated with putting boots on the ground. If you have, for example, a modest dress code, you could go some way towards enforcement by feeding purchases of garments into the citizen’s score. (Buy too much of the wrong kind of underwear and you could be singled out for an in-person check by the mutaween. And heaven forbid they catch you streaming music from a western cloud service.) Signs of non-conformity could be punished indirectly: it’s a lot harder to resist ubiquitous peer pressure than it is to dodge external resource-limited law enforcement.

In The Handmaid’s Tale, Margaret Atwood’s Republic of Gilead subordinates women rapidly by taking control over the financial system. But that’s a comparatively crude mechanism. The more data you’ve got, the more tightly you can constrain your reward/punish metrics and the more accurately you can focus your oppression — and micro-focussed oppression minimizes the risk of generating wide-scale resistance. Everybody’s experience is different, isolated, locked inside an invisible cell with asymmetric walls that their neighbors can’t see. And if you can’t see the invisible walls locking your neighbours in, you can’t establish solidarity and exert collective pressure against them.

We are heading towards a situation where we all carry smartphones, all the time; where we need them to call a cab, or check a bus timetable, or unlock our cars, or pay for something. Your smartphone knows who you are, knows where you’ve been, reads all your correspondence, and hears everything you say. The discrete activity of placing a voice phone call is in the process of replaced by barking “phone, put me through to Sandy in Sales”, followed by rapid connectivity (unless Sandy is in do-not-disturb mode or talking to someone else, in which case their phone will take a message for you). With always-on recognition, your phone (without which you can’t really exist in an internet-of-things world) will track your mood and your pulse rate and possibly award you citizenship points or penalties if you respond to the wrong stimuli.

But that’s the nightmarish, dystopian grim-meathook-future version of citizenship scoring: a system that facilitates the pervasive enforcement of mandated behavioural standards and punishes quantifiable expressions of individuality. Nobody would vote for (or buy into) that! So it’s going to be even more gamified, to make it fun. You can see your score in real time, get helpful tips on what to do (or not to do) to grind for points, and if you’re thinking about doing something a bit naughty a handy app will give you a chance to exercise second thoughts and erase your sin before it is recorded. But that’s not all. Obviously you didn’t really want to date that manic pixie dream girl (she’ll murder your citizenship score with her quirky and unpredictable fun transgressions) but we can apply the magic of Affinity Analysis to look for someone more suitable for you — similar preferences, similar tastes, and most importantly a similar attitude to social improvement and good citizenship.

Now eat your greens; your phone says you haven’t been getting your five a day this week and if you keep it up we’re going to have to dock you a point.

Charles Stross, “It could be worse”, Charlie’s Diary, 2015-10-09.

June 29, 2017

Homeschooling is looking like a better option all the time

Filed under: Bureaucracy, Education, Health, USA — Tags: , , — Nicholas @ 03:00

Susan Goldberg explains what some states are now asking primary school teachers to do in the way of monthly mental health evaluations of the kids they teach:

On paper it reads like a not-so-vague attempt to socially engineer your child’s behavior. In reality, teacher-led mental health assessments coming to a growing number of public schools are a bureaucratic nightmare. One that will no doubt further clog our nation’s public education system with increased paperwork and administrative costs while putting your child’s future at serious risk.

Thanks to Dr. Aida Cerundolo’s piece in The Wall Street Journal, we are beginning to understand the real-life ramifications of these dangerous educational ideas. Want the Cliffs Notes version? Head over to the excellent summation by Emmett McGroarty and Jane Robbins, detailing the ramifications of the Every Student Succeeds Act (ESSA), a federal bill focused on the buzz-phrase “Social Emotional Learning” (SEL), the latest craze in public education. Schools in states that have ESSA legislation on the books can use the Devereux Student Strengths Assessment (DESSA) to fulfill ESSA paperwork requirements.

    …every month the teacher must answer 72 questions about each of the perhaps dozens of students in her class. She must assess whether the student “carr[ies] himself with confidence,” whatever that means for a 5-year-old, and whether he can “cope well with insults and mean comments.”

    … Dr. Cerundolo’s alarm at the imposition of DESSA is shared by at least some New Hampshire teachers. One of them contacted Ann Marie Banfield, Education Liaison for Cornerstone Action in New Hampshire, to express her objections to completing the DESSA forms on her students. The teacher was especially troubled that the school neither sought parental consent nor even notified parents that their children were being screened by amateurs for mental-health issues. As the mother of public-school students, she worried that other teachers were completing this assessment on her children.

You read that right: if you live in an ESSA state, your child’s mental health will be assessed by a non-medical professional in a non-medical context. The paperwork will not be protected by HIPAA laws, which means that the school district can share a teacher’s assessment of your child’s mental health with literally anyone. Parents are not asked for permission before the DESSA is administered, nor do they have any say over where the records go once they are obtained.

I imagine that primary school teachers will be just overjoyed to take on yet another task for which they may have no formal training or aptitude, in addition to the piddling little details of actually teaching. Were you ever warned about youthful misbehaviour going on to your “permanent record”? Now, it’s not just the big ticket items that will follow your kids from now on in their school careers.

QotD: The medical equivalent of security theatre

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

The most common reason for admission to a psychiatric hospital is “person is a danger to themselves or others”. The average length of stay in a psychiatric hospital is about one week.

Some clever person might ask: “Hey, don’t most psychiatric medicines require more than a week to take effect?” Good question! The answer is “yes”. Antidepressants classically take four weeks. Lithium and antipsychotics are more complicated, but the textbooks will still tell you a couple of weeks in both cases. And yet people are constantly being brought to psychiatric hospitals for dangerousness, treated with medications for one week, and then sent off. What gives?

As far as I can tell, a lot of it is the medical equivalent of security theater.

Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.

June 26, 2017

QotD: Psychiatric hospitals

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

It’s interesting that psychiatric hospitals are used as a cliche for “a situation of total chaos” – I think I’ve already mentioned the time when the director of a psych hospital I worked at told us, apparently without conscious awareness or irony, that if Obamacare passed our hospital would have too many patients and “the place would turn into a madhouse”. There’s a similar idiom around “Bedlam”, which comes from London’s old Bethlehem psychiatric hospital.

In fact, psych hospitals are much more orderly than you would think. Maybe 80% of the patients are pretty ‘with it’ – depressed people, very anxious people, people with anger issues who aren’t angry at the moment, people coming off of heroin or something. The remaining 20% of people who are very psychotic mostly just stay in their rooms or pace back and forth talking to themselves and not bothering anyone else. The only people you really have to worry about most of the time are the manic ones and occasionally severe autistics, and even they’re usually okay.

For a place where two dozen not-very-stable people are locked up in a small area against their will, violence is impressively rare. The nurses have to deal with some of it, since they’re the front-line people who have to forcibly inject patients with medication, and they have gotten burned a couple of times. And we doctors are certainly trained to assess for it, defuse it, and if worst comes to worst hold our own until someone can get help.

Yet in the two years I’ve worked at Our Lady Of An Undisclosed Location, years when each doctor has talked to each of their patients at least once a day, usually alone in an office, usually telling them things they really don’t want to hear like “No, you can’t go home today” – during all that time, not one doctor has been attacked. Not so much as a slap or a poke.

I am constantly impressed with how deeply the civilizing instinct has penetrated. When I go out of the workroom and tell Bob, “I’m sorry, but you’re disturbing people, you’re going to have to stop banging on the window and shouting threats, let’s go back to your room,” then as long as I use a calm, quiet, and authoritative voice, that is what he does. With very few exceptions, there is nobody so mentally ill that calmness + authority + the implied threat of burly security guards won’t get them to grumble under their breath but generally comply with your requests, reasonable or otherwise.

Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.

June 22, 2017

The EU regulators want to get rid of a Belgian food tradition

Filed under: Bureaucracy, Europe, Health — Tags: , , , — Nicholas @ 03:00

Carol Off reports for CBC Radio’s As It Happens:

Belgian Fries, traditionally served with mayonnaise
(photo by vokimberly at Flickr)

Belgium’s government says a new proposal by the European Union could spell disaster for the country’s world-famous fries.

“We adore our fries the way we make them, so just let us do so for the next 100 years, because the last hundred years it wasn’t a problem, so why should it be a problem now?” Flemish Tourism Minister Ben Weyts told Carol Off, host of CBC Radio’s As It Happens.

Traditionally, Belgian fries, are twice fried in fat. First, they go in raw to generate a soft, fluffy interior. Then they are refried at a higher temperature to create a crispy, golden exterior.

This process sets Belgian fries apart from soft and chunky British chips, or the sleek and thin fries preferred by the French.

But the European Commission is proposing that all potatoes be blanched — briefly cooked in boiling water — before they hit the fat.

It’s part of an EU effort to curb exposure to acrylamide, a chemical that can form in foods cooked at high temperatures, and has been linked to cancer in animal tests.

[…]

On the heels of the Belgian backlash, the European Commission has insisted the proposal is a suggestion, not a ban.

“The commission has no intention whatsoever to ban Belgian frites — or any other frites, for that matter,” spokesperson Margaritis Schinas said on Tuesday.

“Instead, the commission is preparing a new regulatory measure to oblige food business operators to apply a code of practice to reduce acrylamide in food, as it is carcinogenic.

“We are all very attached to the rich culinary heritage we find in our member states.”

For more information on Belgian Fries, see The One and Only Original Belgian Fries Website (which hadn’t been updated with this latest existential threat when I checked it).

H/T to Chris Myrick for the link.

June 17, 2017

What Happens When You Take Steroids? – Earth Lab

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

Published on 8 Jun 2017

Have you ever wondered what happens to a human body when it takes anabolic steroids? Well, Greg Foot is here to explain all the science you need to know about steroids and why people use them for muscle growth.

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