Linkee-poo Mondays

Herman Wouk, and so it goes.

Today seems a day for remembering.

"So, was it really an overall reduction in fat that helped protect against death from breast cancer? Or did the benefit come from eating more fruits, vegetables and whole grains that are full of healthy micronutrients and fiber?… The answer is: The researchers don't know."

Meanwhile, in Ohio… "There's an apparent partisan split over what supporters call the Clean Air Bill and opponents label a nuclear power plant bailout… So (the Committee Chairman, a Republican) moved on after allowing questions from two of his fellow Republicans and then not recognizing one from Rep. Kristin Boggs (D-Columbus), saying he 'looked both ways, I’m sorry.'… Democrats left and called it a 'stunt committee meeting', and returned more than an hour later after talking with Vitale." And "Speaker Larry Householder says he talked to Democrats and the Republican committee chair overseeing the hearing. And Householder says they all came to an agreement that would allow the process to move forward. But he says it’s taking some time to come to agreement on the legislation."

John Oliver on the American Death Investigation system. Yes, it's fucked. Although I'll just say one of our ER doctors worked in the local coroner's office (they don't anymore) to keep his medical license current. If I had to go to the ER he is the doctor I would want. He's a fantastic doctor, and he does the one thing that all doctors should do (but rarely do), he does a full assessment of the patient before ordering tests.

"Cruelty, violence, badness... This episode of Radiolab, we wrestle with the dark side of human nature, and ask whether it's something we can ever really understand, or fully escape." With an explanation or expose on the infamous Milgram experiments. I highly recommend listening to at least that part so you understand exactly how we are in the political situation we are in. Also with an eye to a link farther down about a man who voted for Trump for "the greater good." Many people think the Milgram experiment shows how humans will follow orders and hurt their fellow humans. That's actually not what the experiments shows. As participants in the experiment began to object, Milgram had four levels of statements to gain their cooperation. The first 3 levels appealed to "the greater good" that the participants were expanding "science" and they should continue. Only the 4th level could be construed to be an order, telling the participants that they had "no choice" but to continue. That 4th statement has the dubious place in the experiment of having a 100% non-compliance rate. That is, when people were given "no choice" but to hurt other humans, all of them rebelled and stopped participating in the experiment. What Milgram shows is that people will commit what they feel are "atrocities" if it is for "the greater good." Make American Great Again.

Remember the conservatives argument that buying drugs from Canada or Mexico was really dangerous because those drugs might not be manufactured in the US and who knew what quality standards they may have? And it might be my mind, but that was the late 90s, early 2000s, right? "As the cost of prescription medication soars, consumers are increasingly taking generic drugs: low-cost alternatives to brand-name medicines. Often health insurance plans require patients to switch to generics as a way of controlling costs. But journalist Katherine Eban warns that some of these medications might not be as safe, or effective, as we think… She notes that most of the generic medicines being sold in the U.S. are manufactured overseas, mostly in India and China." Sometimes it's just that "biologic similars" aren't exactly the same thing, sometimes it's patent owners not telling the truth about drugs (for which Pfizer was called out for in Canada which lead them to lose their patent of Viagra six-years earlier than in the US) so the generic doesn't have all the active ingredients. But some of it is cost cutting and lax oversight of regulations. In the past few years there have been a number of instances where the generic just wasn't as good as the name brand. And in health care, caveat emptor is not the best policy.

You might remember me saying that all diagnostic imaging is not the same (in arguments about costs). "Although Walmart and other large employers in recent years have been steering workers to medical centers with proven track records for specific procedures such as transplants, the retail giant is believed to be the first to prod workers to use specific imaging providers based on diagnostic accuracy — not price, say employer health experts." you may read the line about "Studies show a 3% to 5% error rate each workday in a typical radiology practice…" and wonder at that, so let me explain a little. If your radiology center says they have a 0% error rate, run the fuck away from there. It's impossible and they are lying. That error rate includes what we call "repeats." Which means we messed up the image (wrong exposure, inaccurate positioning, motion, you forgot you kept your cell phone in your bra and even though you removed the bra, the cell phone was still under your breast… yeah, that happened to me). And we take another image after correcting for those errors. This is normal, not everybody is exactly the same and we don't know that until we take the actual image. That CT can have errors effecting 30% of diagnosis is, again, not uncommon. While you're in pain hold your breath for 30 seconds, or if you are in an "altered mental status" try and keep your head still while we scan you for 45 seconds when you can't understand English, hold a thought for more than 5 seconds, or are in just so much pain you can't hold still. It doesn't happen perfectly every time. "Because of pt condition, best films possible" is something I type at least once a shift. But here is the difference, the tech sees the error first and corrects it, they repeat the image. Sometimes we can't repeat. Now misdiagnosis is a major problem and it's one that AI should help with (but note my earlier statements about AI not replacing a human looking at the image). But you'll find (if you read the actual reports) that radiologist are very good at CYA readings. And that's annoying. This is before you factor in all the technological issues affecting diagnostic imaging.

"A now-dead Ohio State team doctor sexually abused at least 177 male students over nearly two decades, and numerous university officials got wind of what was going on but did little to stop him, according to a report released by the school Friday." Failures all the way around. IIRC, Ohio added coaches and instructors to the mandatory reporting list in the late 80s.

You may have heard that McD's in Scotland stopped selling milkshakes while certain politicians were campaigning. How did that go? "Pro-Brexit British politician Nigel Farage was hit with a milkshake while campaigning in the European Parliament election on Monday — the latest in a spate of attacks on politicians with the sticky beverages." A banana and salted caramel milkshake? Oh UK, we need to have a talk.

You might remember me saying something about how to counter fake news isn't really government action, but public education. Well, Finland is getting it right. "The course is part of an anti-fake news initiative launched by Finland’s government in 2014 – two years before Russia meddled in the US elections – aimed at teaching residents, students, journalists and politicians how to counter false information designed to sow division." The most interesting point is Finland hired US experts to help them design their public education courses. Also note the emphasis on critical thinking skills and voter literacy, the very thing one party of our two-party system is waging a war against. (Grokked from Scott Kennedy)

How go the Trade Wars? "The Trump administration has reached a deal to lift tariffs on steel and aluminum imports from Canada, in a move that could put the two nations a step closer to ratifying the USMCA — the trade deal that would update the NAFTA agreement." Remember the USMCA? The president hasn't even submitted it to Congress yet.

"The Trump administration will delay tariffs on cars and auto parts imports for six months while it negotiates trade deals with Japan and the European Union, the White House announced Friday." Who wants to bet against those tariffs going into effect?

"The Government Accountability Office (GAO) ruled Thursday that Housing and Urban Development (HUD) Secretary Ben Carson violated the law with unauthorized purchases of dining ware and a dishwasher for the secretary's office." Add that to the table, the side board, the carpet… (Grokked from Jim Wright)

A story in the LA Times about a citizen who married an illegal and thought the Shirley Exception would be made for him. "He probably wouldn’t vote for Trump again, he said. Still, he isn’t really sure that he made a mistake… Sometimes he feels stupid or duped or betrayed. But then he thinks back to how he didn’t vote for himself personally but for the greater good — for what he sees as the 'noble' cause of outlawing abortion." I'm not sure how to say this fully, but fuck him. Sure, I feel bad for the kid, especially as his fought cancer (fuck cancer). But sorry, this is exactly how Nazis are formed. I do hope the couple are reunited, but not for his sake, but because there's no way to actually enact the greater good and exclude people. That's not how the greater good works.

"Bob Best enthusiastically supports President Trump's tough policies against China and other countries… Best supports the president's actions even though they affect him directly. The price of the heating and air conditioning units that his company sells went up by as much as $150 apiece after the cost of building them went up because Trump placed tariffs on steel and aluminum imports last year. He was forced to pass the increase onto his customers." So basically he's not really hurting, yet. Ah, the pretzels we twist ourselves into for the "greater good."

"President Donald Trump warned Iran early on Monday not to threaten the United States again or it would face its 'official end,' shortly after a rocket landed near the U.S. Embassy in Baghdad overnight and only 48 hours after he seemingly sought to soften his tone." Okay boys, just whip them out on the table and we'll get a ruler to settle this. Although I'm reminded when Sparky pulled the same stunt with North Korea. I wonder if him and and Rouhani will be scribbling "BFF" in their yearbooks next year?

"Republicans are moving fast to squelch Justin Amash's rebellion against Donald Trump before his conclusion that the President 'engaged in impeachable conduct' -- the first by a GOP lawmaker -- can gather momentum."