Domain: cmaj.ca
Stories and comments across the archive that link to cmaj.ca.
Comments · 33
-
Re: Yelp
1) That's ACUTE appendicitis. It would be nice to use the proper terminology, don't you think?
2) "All that is necessary is a physical exam.". Sure, read below, the next comment... 58002338
3) " That is why a certain number of appendectomies performed show on final pathology anything from cancer to a negative appendicitis."THAT'S the problem. A weird fixation on this "negative appendectomy rate", which leads to some sort of bizarre pressure on personnel to RULE OUT APPENDICITIS at all costs. I guess surgeons are busy doing frivolous surgeries and have no time for a gross appendectomy.
You assume that only one thing can happen to a person at a time. What about pure, stupid, COINCIDENCE?
What can cause black stools? And how can black stools make a doctor overlook other symptoms in the rush to RULE OUT APPENDICITIS!??
Just because someone called it "colitis" and it responded to antibiotics, doesn't mean it was colitis.
All it means is it responded to antibiotics and symptoms went away.
Acute appendicitis is such a condition. Not only is it known since at least 1962 that antibiotics can treat acute appendicitis in cases were surgeons are not immediately available, but it is also known since 1962 that antibiotics can MASK symptoms of acute appendicitis.... And if you go further back this knowledge actually came from the time before penicillin: it was already known from the time of sulfa compounds! Duh!
So, tell me, why isn't this common knowledge? And knowing that, shouldn't it be FUCKING OBVIOUS that since AA is a common problem and antibiotics are EVERYWHERE, that some percentage of people will be misdiagnosed and treated with antibiotics? ESPECIALLY with this mental disturbance modern medicine has about ruling out appendicitis because of a made-up statistic called the "negative appendectomy rate"?
I suspect that doctors want to masquerade their field as being more rigorous than it actually is by inventing all kinds of statistical tools and buzzwords to hide the basic fact that a lot of medicine is touch and go. The problem with making fancy statistics and graphs and computer models is that "garbage in, garbage out". I've started hearing doctors marveling that acute appendicitis cases have been going down in the last few decades.
I propose that acute appendicitis is a constant in the population and the rate of diagnosis is going down, not the number of real cases.
And given how easily the SYMPTOMS of AA are treated with antibiotics, and how "perplexed" the poor radiologists are by the five different possible positions and variable size of the appendix, would it not be more prudent to simply let ER doctors wait and see and make sure it IS acute appendicitis instead of ruling it out and and getting out the antibiotics bazooka?
Here is the case of Patrick Roy, a popular hockey player in Montreal.
http://www.cmaj.ca/content/cma...
In his case, has was positively diagnosed with AA, but that's easy with a private team doctor that knows you well and is always around, isn't it? In any case, Roy was a hothead and refused surgery on account he wanted to play against the Bruins. The antibiotics firehose came out, and the symptoms went away, and Roy played hockey. Later the appendix came out.
Now what happens to that appendix had it NOT come out? Can it scar over? Can it reinfect, presenting differently the second time?
Why not?
Anyways, here is what I think is cooking inside me
https://www.mdmag.com/journals...
I love this part
"Although CT scanning is usually accurate in imaging a fluid-filled appendix, the appendix was often missed on CT scans for workup of coexisting conditions."
You doctors should KNOW about the fucking appendix being difficult to visualize (for whatever reason. I don't know. I *do* know that I am unimpressed by the images I'
-
Re:Cost of some where other than South-East Asis
In 2002, for example, the top 10 drug companies in the United States had a median profit margin of 17% ( http://www.cmaj.ca/content/171/12/1451.full ).
Just to give an idea. 'Obscene' seems appropriate.
CC.
-
Re:increase wasn't apparent in overweight
The evenness of the cutoff's in standard BMI interpretation (nice, round numbers like 25 and 30) is a really good clue that these are not scientifically-validated numbers. There are a lot of studies on BMI vs. mortality; here's a peer-reviewed article in the Canadian Medical Association Journal, and a crucial slide. Note that the model-derived curve supports the usual interpretation that BMI in the 18.5-25 range is optimal; the bars showing actual data, though, show that BMI between 27 and 28 is optimal.
A summary recommendations for your patients: for men, BMI of 23-30 looks healthy. For women, BMI of 18.5-30 looks healthy.
For all patients (as I am sure you already know): exercise! The data showing health benefits from even moderate exercise are compelling, and exercising more is better for you, within a very broad range.
[Sorry - I just accidantally posted the text above as Anonymous Coward - not my intention.]
-
Re:increase wasn't apparent in overweight
The evenness of the cutoff's in standard BMI interpretation (nice, round numbers like 25 and 30) is a really good clue that these are not scientifically-validated numbers. There are a lot of studies on BMI vs. mortality; here's a peer-reviewed article in the Canadian Medical Association Journal, and a crucial slide. Note that the model-derived curve supports the usual interpretation that BMI in the 18.5-25 range is optimal; the bars showing actual data, though, show that BMI between 27 and 28 is optimal.
A summary recommendations for your patients: for men, BMI of 23-30 looks healthy. For women, BMI of 18.5-30 looks healthy.
For all patients (as I am sure you already know): exercise! The data showing health benefits from even moderate exercise are compelling, and exercising more is better for you, within a very broad range.
[Sorry - I just accidantally posted the text above as Anonymous Coward - not my intention.]
-
Re:increase wasn't apparent in overweight
The evenness of the cutoff's in standard BMI interpretation (nice, round numbers like 25 and 30) is a really good clue that these are not scientifically-validated numbers. There are a lot of studies on BMI vs. mortality; here's a peer-reviewed article in the Canadian Medical Association Journal, and a crucial slide. Note that the model-derived curve supports the usual interpretation that BMI in the 18.5-25 range is optimal; the bars showing actual data, though, show that BMI between 27 and 28 is optimal.
A summary recommendations for your patients: for men, BMI of 23-30 looks healthy. For women, BMI of 18.5-30 looks healthy.
For all patients (as I am sure you already know): exercise! The data showing health benefits from even moderate exercise are compelling, and exercising more is better for you, within a very broad range.
-
Re:increase wasn't apparent in overweight
The evenness of the cutoff's in standard BMI interpretation (nice, round numbers like 25 and 30) is a really good clue that these are not scientifically-validated numbers. There are a lot of studies on BMI vs. mortality; here's a peer-reviewed article in the Canadian Medical Association Journal, and a crucial slide. Note that the model-derived curve supports the usual interpretation that BMI in the 18.5-25 range is optimal; the bars showing actual data, though, show that BMI between 27 and 28 is optimal.
A summary recommendations for your patients: for men, BMI of 23-30 looks healthy. For women, BMI of 18.5-30 looks healthy.
For all patients (as I am sure you already know): exercise! The data showing health benefits from even moderate exercise are compelling, and exercising more is better for you, within a very broad range.
-
Re:It's gender discrimination !
On the other hand, apparently the men-women ratio in nursing is 1:19 (yes, one guy for every 19 women). But I suspect if some organization started offering men-only scholarships for nursing there'd be riots.
I suppose it's just a shame that we have to bribe women to go against the trend, rather than just changing society. (I have a five year old daughter, and I will make damned sure she gets a chance to try a little bit of everything, gender-bias be damned.)
-
Re:Normally
As opposed to when cigarettes were illegal? Except they weren't. In your theory, the higher the taxes, the lower the smoking, but this is just another form of punishment. Empirically, if your theory were correct, European countries with high taxes on cigarettes would have low smoking rates, and yet they don't.
I did some googling on this after reading your post and this was the first hit (PDF warning). Figure 1 shows a pretty clear inverse correlation between tax rate and cigarette consumption. Other studies say the same thing. I think your error may be in that you're comparing smoking rates between countries - countries which undoubtedly have different social views of smoking. So their smoking rates are inherently different for reasons other than tax rate. Most of the studies I found which saw no decrease in smoking rates from increased taxes only found this to be the case for older smokers who already had a habit. The higher taxes were successful at deterring younger people from starting to smoke, thus lowering the overall smoking rate.
It's a fallacy to think that 100% of a tax gets passed down. If that were true, in 1946, when the top tax rate was 94%, then the government would have gotten around 94% of the money. And yet, it only got 20% of GDP or so. Check it out, these figures are easily available on the web.
It took me a while to figure out what you were trying to say because it didn't make sense. You're conflating a percentage with the amount that's passed down. OP's claim was that when the top tax rate was 94%, then only 94% of the income of top taxpayers would be passed down as extra expenses for everyone else. This works out to a lot less money than 94% of GDP. If the 94% rate applied to (say) just the top 1% of income earners who earned (say) 10% of the country's income, then their taxes would amount to just 9.4% of GDP.
-
Re:It's not for you
"Panhandlers in Toronto reported a median monthly income of $300 from panhandling..." (source)
300 / 30 days per month / 8 hours per day = $1.25 per hour
So I think $1-$3 is a reasonable range. I'm sure skilled panhandlers can get more, but most of the people on the streets aren't exactly skilled in anything.
-
Re:Personally, I think it is a matter of social cl
There's no need to bring Rush Limbaugh into this.
It's not universally true, but it is more or less an accepted fact.
Fertility rates are inversely proportional to income.
In the modern world there are a lot of reasons for this. The rich tend to have access to better education. therefore, they tend to try to start a career before a family (illustrated in comedic fashion by the Mike Judge movie Idiocracy). Then with their career dominating their lives, they usually only have a couple kids at the most.
More wealthy folks have better access to birth control. Again, better education plays into this. On the extreme end of the spectrum, you have folks who have superstitious beliefs. That doesn't help keep their fertility rates down any...
Economists and demographers have known about this correlation for centuries. And it's interesting because it goes across religions, across nationalities, race, and other factors. Poor Americans are just as likely to have a higher fertility rate as poor French, or Japanese. Poor Nigerians or Indians are even more likely because a poor American is fairly well off by Nigerian standards.
Side Rant: The Israelis in particular are worried about this effect because Israel is a democracy. And the Israeli Palestinians have a fertility rate several times that of Israeli Jews. Again, the average Israeli Palestinian is much poorer than the average Israeli Jew.
The Israelis are concerned because with the higher fertility rates of the Palestinian Israeli citizens, the Palestinians may become a majority in the "Jewish State" in a couple generations. This brings up all kinds of moral dilemmas for the Israeli government, who must try to balance it's commitment to a homeland for the Jews to it's commitment to democracy for all it's citizens.
A few minutes of on the Google came up with these:
http://www.economist.com/opinion/displaystory.cfm?story_id=14744915
http://www.economist.com/sciencetechnology/displaystory.cfm?story_id=14164483
http://www.cmaj.ca/cgi/content/full/177/8/846/F19
http://en.wikipedia.org/wiki/Sub-replacement_fertility
http://www.indexmundi.com/g/correlation.aspx?v1=67&v2=31&y=2004Also, I have no idea why you brought Rush Limbaugh into this. I'm about as progressive a character as you're likely to meet. I don't know anyone that disputes this data.
Cause is another matter. Progressives would tend to contend that the reason is education, the nature of pre-industrialized societies, higher mortality rates among poor nations, the tempo of life in wealthy nations and classes.
And Rush would say they all want their welfare checks or something.
You're right about the lack of heredity for short-fatness though. It is environmental / cultural, not genetic.
-
Re:The same for drug industry
That number for drug R&D costs is described by some commentators as "9-digit fairy tale" (source article http://www.cmaj.ca/cgi/content/full/180/3/279). It is true that you cannot market directly to consumers in many countries, the industry can and do market to doctors. Although the doctors are relatively few in numbers, the pandering they receive is far more expensive.
-
VA - Pretty Good
Go talk to someone in the military about that whole free government provided healthcare...you get what you pay for...
I agree that the VA is underfunded relative to its size and patient population but, given its funding limitations, it's actually the best performing health system in the US when measured objectively in terms of patient outcomes.
-
Re:In FEMA's defense
I prefer to let the numbers speak for themselves - It would seem private insurance is just more expensive
-
Re:Euro/Japan envy is getting stupid
You pay for health insurance right? Whats the difference between that and a tax? Oh yea. (warning PDF) It universally costs less to socialize it (to any degree more than what the US is right now).
-
Re:There's a reason for the gridlock.
Missed embedding the url correctly:
-
Re:I'm in Australia (Adelaide) Looking to move cou
You're clearly a fervent believer in laissez-faire free market capitalism, in the divine power of self-regulating markets that somehow miraculously both return profits for shareholders, economic growth, and somehow at the same time serve the interests of the community.
This is a lie, don't buy into it, it has been proven time and time again that completely free market systems while useful in some situations do not serve the public interest when it comes to essential services.
a) Universal health care works, it is cheaper (for users as well as the government) than a US style wholly private system. Private health care is bad social policy, and it's bad economic policy. The US spends more money as a percentage of GDP on its healthcare system than any other OECD country
b) I may not know what I'm talking about, but I have been through the uni system during the Howard years, I graduated in 2003. I saw what successive funding cuts did to my university, and I watched it transition from a research and learning centre into a corporation funded by commercial grants with cost cutting at every corner. I saw the standard of learning corrode even in the time I was there. I watched as more and more places were given over to full fee paying, and thus denied to those relying on the HECS/HELP system.
You might not be paying a cent now, but you will be paying more than ever before when it comes time to pay off that HELP debt.
c) I would be suprised if your friends losing their jobs had nothing to do with workchoices being rolled back, because it hasn't in fact been rolled back yet. The government has just stipulated that no new AWAs can be implemented, and that workers currently on AWAs should transition to an equivalent agreement under the new framework, with a fairly generous timeframe for this to take place.
d) Nonsense. The majority of universities in Australia are public universities, not private universities. That is, they are (or should be) funded by public money. They are not there to make money, they are there to provide quality education to Australia's youth, at a cost that makes them available to anyone regardless of their economic status.
e) Again, nonsense. This is where free market economics fails, and fails badly. The power of competition doesnt work in this scenario because of patents. Drug companies own patents on novel treatments effectively handing a monopoly to that company who can then charge whatever the hell they want for it. You need external market controls. Additionally, it's actually not in pharmaceutical companies best interests to research new drugs, because it costs a lot of money and doesnt give great ROI when compared to say evergreening your existing products. In fact, pharmaceutical companies spend only 11-14% of their budget on R&D and a whopping 35% on marketing their products - http://www.cmaj.ca/cgi/content/full/171/12/1451#R7-12
That was just the first article I found on the ills of the pharmaceutical industry, there are plenty more out there.
If you want to see what happens to drug prices under a free market system, just go and get sick in the US. You will not believe how much they pay over there compared to us. -
Re:No link to wired article?
Its like the holy grail of data analysis;
And just like the holy grail, it doesn't exist. Ever heard the expression "garbage in, garbage out"? Now imagine how that applies to a huge database of information compiled from diverse sources (including unverified, anonymous tips), where nothing is ever thrown away, and where nobody's quite sure what they're looking for.
The human brain is amazingly good at finding patterns - so good that it often finds patterns that aren't really there. Even with years of experience, training, and peer review, professional scientists are pretty bad at handling problems like confirmation bias, post hoc reasoning and the file-drawer effect - how are law enforcement agents likely to fare, with no statistical training and no effective oversight?
The people constructing these databases are falling into the trap of believing that more data means better data. That's an understandable mistake for people who are usually "data-poor", such as archaeologists, historians and detectives. But anyone from the "data-rich" sciences will tell you that once you have the data you face a whole new set of problems, and I very much doubt that counterterrorism officials, working in conditions of secrecy and under pressure to justify their jobs, are going to handle those problems in a rigorous way.
Please note that I'm not trying to say "police officers are too stupid to understand statistics" - scientists make these mistakes all the time, but they operate in an atmosphere of relative transparency and competition, where it's usually in some other scientist's interest to bring errors to light. The same conditions don't apply to government officials.
What does this mean? It means that false positives will lead to innocent people being monitored, blacklisted and imprisoned without trial, while false negatives will mean genuine threats go undetected. We urgently need to make our governments understand that more data doesn't necessarily lead to better decisions.
-
Re:Generalizing Generations
>I'm curious how being in that in-between state has affected you. As someone born in the early years but well into Gen X, I've never experienced that in-between feeling. Do you feel it has stripped you of opportunities or made you feel like an outsider?
As you say, everyone's experience *is* different. It's removed some opportunities, and left others. The net is somewhere a bit towards the negative for opportunities.
Major events, a large amount of these happened during high-school for those of us in "that" gap:
- Removal of advanced high-school classes for those born in the new generation (thereby causing a double-cohort into university/college and making competition ridiculous)
- Complete changes to high-school course requirements, making the next generation have a completely different experience (high school diplomas are no longer just given out for getting good grades, they also now depend on volunteer work)
- Experiencing one of the first (only?) teacher's strikes up to that time
- Sharp increases in tuition fees for post-secondary education. One of many examples.
- Attempt of Quebec to secede from Canada, Quebec French-only (Charter violating) sign laws, Quebec using notwithstanding clause
- Sharply increasing costs of home-ownership as this specific generation is getting ready to purchase homes, out of all my friends (from the same generation gap, generally), only one presently "owns" a home.
Oddly enough, as you see, most of the major events happened during high-school. There's probably other events (the usual stuff, of course, berlin wall falling, cold war ending, gulf war, etc, etc), but they're not coming to me that easily right now. :-) -
Re:I can feel the kindness
From "Excess in the pharmaceutical industry" by Marcia Angell, http://www.cmaj.ca/cgi/content/full/171/12/1451
Although the pharmaceutical industry claims to be a high-risk business, year after year drug companies enjoy higher profits than any other industry.
In 2002, for example, the top 10 drug companies in the United States had a median profit margin of 17%, compared with only 3.1% for all the other industries on the Fortune 500 list.1 Indeed, subtracting losses from gains, those 10 companies made more in profits that year than the other 490 companies put together. -
Re:humanity vs capitalism
There are a lot of people inside pharma that care... but the CEOs sure don't-- they rather maximize their profits and see people die than do the right thing.
If you believe otherwise, you've been drinking too much of the company Kool-Aid. Pharma is consistently the most profitable business out there.
Their business plan is:
1. Dupe existing product, i.e. create "me-too" drug
2. Get a time limited monopoly from the government
3. Run a huge ad campaign to convince ppl their drug is better
4. Screw people that can't buy in volume, i.e. the uninsured
5. $$$ Profit $$$
You don't have to believe me... read what a bunch of Harvard people have to say about it:
"In 2002, for example, the top 10 drug companies in the United States had a median profit margin of 17%, compared with only 3.1% for all the other industries on the Fortune 500 list. Indeed, subtracting losses from gains, those 10 [pharma] companies made more in profits that year than the other 490 companies put together... [in a 'bad year' t]he industry's profits were still an extraordinary 14% of sales, well above the median of 4.6% for other industries. A business that is consistently so profitable can hardly be considered risky." [emphasis added]
As for "no more drug industry"... drugs would still be made and they might actually help the majority of people; the drugs industry has failed to deliver in many areas. Also, the drive to fleece the public through monopoly power and commericalization of university research has probably led to less development and fewer real discoveries. M. -
Here's CanadaCanadian health care is as good as or better than U.S. health care, at half the cost.
Gordon Guyatt et al. just published "A systematic review of studies comparing health outcomes in Canada and the United States," in volume 1, issue 1 of Open Medicine, a new Canadian journal with an editorial board composed of some of the world's top medical experts, and a staff that just quit or got fired from Canada's formerly top medical journal.http://www.openmedicine.ca/article/view/8
/ 1 The review's conclusion is:"Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent."
The article also says that, in 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003.
The journal Open Medicine is another story. John Hoey, editor of CMAJ, the journal of the Canadian Medical Association, was fired last year by the CMA, and most of the staff resigned. http://content.nejm.org/cgi/content/full/354/19/1
9 82 http://www.cmaj.ca/cgi/content/full/174/1/9 http://www.cmaj.ca/cgi/content/full/173/12/1435 Hoey sent reporters to buy morning-after pills in pharmacies around Canada. They found out that pharmacists illegally asked for personal information, which was entered in their computers. The Canadian Pharmacists Association complained to the CMA, and the CMA censored the story. The CMAJ staff now founded this new journal, Open Medicine, and they have loaded the first issue with the best studies they could get. -
Here's CanadaCanadian health care is as good as or better than U.S. health care, at half the cost.
Gordon Guyatt et al. just published "A systematic review of studies comparing health outcomes in Canada and the United States," in volume 1, issue 1 of Open Medicine, a new Canadian journal with an editorial board composed of some of the world's top medical experts, and a staff that just quit or got fired from Canada's formerly top medical journal.http://www.openmedicine.ca/article/view/8
/ 1 The review's conclusion is:"Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent."
The article also says that, in 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003.
The journal Open Medicine is another story. John Hoey, editor of CMAJ, the journal of the Canadian Medical Association, was fired last year by the CMA, and most of the staff resigned. http://content.nejm.org/cgi/content/full/354/19/1
9 82 http://www.cmaj.ca/cgi/content/full/174/1/9 http://www.cmaj.ca/cgi/content/full/173/12/1435 Hoey sent reporters to buy morning-after pills in pharmacies around Canada. They found out that pharmacists illegally asked for personal information, which was entered in their computers. The Canadian Pharmacists Association complained to the CMA, and the CMA censored the story. The CMAJ staff now founded this new journal, Open Medicine, and they have loaded the first issue with the best studies they could get. -
Re:So how much Vitamin D do I need? Need a number
You can find the official recommended intake amounts
And you can find Vieth's explanation of why there is no RDA for Vitamin D here: Vitamin D insufficiency: no recommended dietary allowance exists for this nutrient
Another thing I found out is that you can't get an optimal amount of Vitamin D from supplements because it is all preformed vitamin D so your blood levels will track your intake, and nobody really knows exactly how much is best. When skin gets exposed to sunlight on the other hand, the vitamin D is stored and released appropriately to maintain the optimum concentration (assuming there's enough sunlight).....
Yes, we are still learning how much is best. No, we are not completely without informed opinions. It is generally accepted that serum 25OH-D status is the best indicator of Vitamin D status. There is an emerging consensus that you need to keep your serum levels above 70 or 80nmol/L to keep your skeleton from falling apart as you age.
Who said they were waiting to see that too much vitamin D causes some other serious illness? It causes "hypercalcemia", at least.
Please cite your cases. Or perhaps you meant to say "COULD cause hypercalcemia in some patients, but rarely in any who have not take INDUSTRIAL amounts of the substance". You may want to start by reviewing Vieth's seminal paper in which he systematically dismantles published accounts of Vitamin D poisoning.
If you were to consume a bottle of vitamin D supplements that would be lethal
Now you have passed along an utter untruth. You're probably unaware that it is not uncommon in Europe for doctors to use "stoss therapy" to assure Vitamin D status in particular patients. Stoss therapy consists of an annual injection of perhaps 150,000IU to 300,000IU -- much, much more than can be found in your local grocery store bottle of Vitamin D. I seem to recall a recent study in which infants (infants!) with rickets were given 600,000IU. I personally took an entire bottle (90,000IU) of Vitamin D3 the last time I started coming down with a cold (checks pulse -- yes, still completely alive!).
Can anyone make a useful comment about those sunlamp things, *please*?
If you elect to use sunlamps, buy from someone who can supply the relative known fraction of UVA/UVB (you want UVB for D production -- you don't really want the UVA that much). Sperti is a possibility. There is a flourescent bulb that really closely emulates the sun's UV frequency power ratios. Unfortunately, as far as I can tell it's only being used in industrial hoods, not consumer sun lamps.
I just want some dam numbers!
Get the #1, most important number: go to your doctor and get a prescription for a test to measure your 25OH-vitamin D serum levels. Make sure the test technology is either Diasorin RIA, or high-performance liquid chromotography with tandem mass spectrometry (or just insist on going to Quest Diagnostics -- I *think* they now uniformly use the latter technology).
-
Re:Come get some
One cup of vitamin D fortified milk supplies about one-fourth of the estimated daily need for this vitamin for adults.
First of all, one cup of milk contains a completely unknown amount of Vitamin D. Spot checks have found levels all the way down to zero.
Second, we don't know what the daily need for this vitamin is. I refer you to Vieth's Vitamin D insufficiency: no recommended dietary allowance exists for this nutrient
but it is still important to routinely use sunscreen whenever sun exposure is longer than 10 to 15 minutes.
Well, that's a good recommendation if you're a black person trying to get rickets. Although it would be simpler if we were all the same color as the people who write shoddy nutrition information, the reality is that we come in lots of different kinds of skin shades. The safety rules for sun exposure depend on your skin type, but it's worth noting that sunscreen is much better at blocking UVB that creates Vitamin D than it is at blocking UVA that causes skin cancer. Hopefully, sunscreen that is actually effective for UVA will be widely available someday.
In the meantime, the simplest sun safety rule is: terminate sun exposure well before your skin starts to redden. Do not ever get burns!
-
Patents profit maximizers...
I'm surprised the GAO has just now caught up with reality. That me-too drugs are the main ingredient of big pharma's money machine was described a few years ago. The problem can be traced back to the Bayh-Dole law. Like it is said about health care more generally --that private care is a profit maximizer, not cost minimizer-- the patent systems seems to have been perverted into a profit maximizer as opposed to a maximizer of innovation.
-
Patents profit maximizers...
I'm surprised the GAO has just now caught up with reality. That me-too drugs are the main ingredient of big pharma's money machine was described a few years ago. The problem can be traced back to the Bayh-Dole law. Like it is said about health care more generally --that private care is a profit maximizer, not cost minimizer-- the patent systems seems to have been perverted into a profit maximizer as opposed to a maximizer of innovation.
-
Re:Surely it is time?
I didn't think I had to since those numbers were presented by several different people already and modded highly in this article. Here is one of the pertinent ones that is also well written http://yro.slashdot.org/comments.pl?sid=210866&cid =17175778 [slashdot.org]. Not one person I saw in the entire discussion presented numbers indicating that violent crime (as opposed to "gun crime") correlates favorably with gun control legislation.
Huh? Nothing he mentioned in any way contradicts anything I've said on the matter. The whole thrust of his argument was to put gun related deaths into prospective. I agree, for instance, that the average citizen is far more likely to killed by a car than by a gun. I simply believe that society would be better off if more and better gun laws were put in place (esp. those that would reduce concealed weapons, readily available/loaded weapons, etc).
Several points:
First, the data does not compare gun ownership, frequency of use, and method of use to the deaths and injuries so it tells us little about the risks on a marginal basis. By this same fuzzy rationale I might come to conclude that Russian Rulette is relatively safe because only 3 minors died of it last year (or whatever the exact # would be... certainly very small).
Second, it does not mention any study of correlation of gun ownership in general to any of the various bad things (murder, violent crime, robbery, etc).
Three, it particularly does not discuss specific gun laws as it relates to specific crimes. This is absolutely necessary to persuade me. I believe that responsible ownership of rifles is an acceptable risk generally, but that laws that allow most people to carry and own weapons that are readily concealed (including driving around with a loaded weapon at all times--handgun or not) results in a marginal increase in murders and serious injury (I do not believe that it tends to reduce crime across the board). In other words, even if one were to accept that "gun ownership does not cause an increase in violent crime" this says nothing about particular gun laws, murder rates, etc. That argument is kind of like arguing that, because we can prove that modern medicine correlates strongly with people living longer and healither lives, that any specific doctor or medicine is safe (e.g., untested medicines, unlicensed doctors, etc)."the facts show that there is simply no correlation between gun control laws and murder or suicide rates across a wide spectrum of nations and cultures.
As for these very limited statements you've presented, I disagree with the conclusions you are drawing from them. The mere fact that someone who studied it failed prove correlation in a particular study (or even several) does not mean that there is not a causative impact. There are a lot of other variables involved and the data collection is difficult (different places measure crime and gun ownership different) whether you are comparing two different places or two different times (before and after).
What's more, there are studies that do suggest positive correlation between gun ownership rates and homicide rates...
http://dx.doi.org/10.1016/S1359-1789(03)00044-2
http://dx.doi.org/10.1016/j.aap.2005.02.003
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=PubMed&list_uids=11130511&dopt=Citatio n
http://www.cmaj.ca/cgi/content/abstract/148/10/172 1 -
Re:Income tax misnomerbut one's own? Why not? Because it hurts? Because it can be fatal?
No, because, Mr. Oblivious, it would result in the poor nearly all missing kidneys, ligaments, lungs, bone marrow, parts of intestines and whatever else. It would result in women selling their scalps to old but rich witches, young men to old ones etc and so on. It would result in impoverished women selling their bodies and dying in the process so that their children can have food for the next year or so and thus have some chance of survivial. It would result in a mass influx of body parts from Africa and Asia to the US because a $100 is a fortune in some village in Cambodia. And so on an so forth. It is an arrogant, dog-eat-dog idea, meant for the wealthy to be using other people as spare parts because of their financial situation. I can't believe I have to be explaining this. It is paramount to trading in human life. On the other hand this probably explains why the whole question of Medicare and many other things, have such terrifyingly selfish and egoistic tone with you and why matters of most basic decency escape you completely.
but a brief return from January 2003 to May, 2004 proved that they hadn't gone down much, and services had gone into the sewer: Metro Toronto had a shortage of 1400 doctors,
Caused by increase in training time, erroneous reduction of training spots in the 1990s when there was a surplus, immigration restrictions and only 3% due to brain-drain. Also the number itself is highly questionable and debatable. Loosening the immigration quotas alone would increase supply by 22% according to this, speedier training by another 24%. That is in addition to increases in funding already in the system.
Prior to that I had savings which were earning in excess of the tax-free $1,000 interest limit
Right. You had savings by age of 14 which earned more then $1,000 in interest. A really fat piggie bank, that you needed a front loader to move. The discussion really ends here as it is futile debating spoiled, priviledged brats who have no clue how life works for most people. All that whining and victimhood complexes of yours and your father's should have been a clear warning sign of greed monkeys at large.
and the local school didn't even sand or salt their parking lots.
I am sure that had a lot to do with the budgets and not anything to do with the anti-salt crusade which has been sweeping major cities for some time now. Perhaps they used sand as everybody else seems to be nowadays (as to shut the rusty car owners up and another thing, supposedly to prevent concrete from crumbling).
Should I just cut them off, then?
No, you should pay plentiful taxes to a sane, civilised government so that your taking advantage of them today can be at least partially recompensed to them when they need medical care or help when they get old. You probably think that you are doing them great favours by paying them somewhat more then the least possible minimum and not realising that it is only a stop-gap and ultimately very selfish meeasure as it leaves them completely dependant on your whim and their own good health.
-
Re:Good Grief
Well let's start with Fried et. al., who concluded that ongoing heavy use of marijuana has a signficant negative impact on IQ.
And then we can in fact see the short term memory impairment,
Heyser, C.J.; Hampson, R.E.; and Deadwyler, S.A. Effects of delta-9-tetrahydrocannabinol on delayed match to sample performance in rats: Alterations in short-term memory associated with changes in task-specific firing of hippocampal cells. Journal of Pharmacology & Experimental Therapeutics 264(1):294-307, 1993.
And let's not pretend that smoking marijuana isn't going to have a negative effects on the lungs,
Tashkin, D.P. Pulmonary complications of smoked substance abuse. West J Med 152:525-530, 1990., and
Sarafian, T.A.; Magallanes, J.A.; Shau, H.; Tashkin, D.; and Roth, M.D. Oxidative stress produced by marijuana smoke. An adverse effect enhanced by cannabinoids. Am J Respir Cell Mol Biol 20(6):1286-1293, 1999.
Or the immune system
Srivastava, M.D.; Srivastava, B.I.; and Brouhard, B. Delta-9 tetrahydrocannabinol and cannabidiol alter cytokine production by human immune cells. Immunopharmacology 40(3):179-185, 1998.
Marijuana capable of producing psychotic symptoms? Yes.
Fergusson, David M., John Horwood & Elizabeth M. Ridder, "Tests of Causal Linkages Between Cannabis Use and Psychotic Symptoms," Addiction, Vol. 100, No. 3, March 2005, p. 363.
The original poster was talking about chronic use, implying ongoing, so let's also examine the effects of current intoxication: Learning and memory are in fact impaired by cannabis:
Grant, Igor, et al.,(2003) "Non-Acute (Residual) Neurocognitive Effects Of Cannabis Use: A Meta-Analytic Study," Journal of the International Neuropsychological Society. Cambridge University Press, 9, p. 685.
Long term permanent damage? Absolutely, but only to the lungs.
Negative impacts on the brain during ongoing use? Absolutely.
Maybe you ought to be familiar with the research yourself before attacking other people? This is just a tiny fraction of all the research conducted. A simple 5 second google search would have turned up all you needed to know to not look like the jackass you do now. -
Re:The root problem is For Profit health care
The parent is absolutely right about most current research is done strictly for profit. An area that comes to mind is the effort in recent years to find naturally occuring chemicals that aid in healing. Essentially they are checking various herbs and other plants for these chemicals, often by checking out natural treatments used for generations by oriental apothecaries, midwives and native shamen. Once they think they have isolated a chemical they believe is beneficial and synthesize it, test it and if they can claim any benefit from its use, patent it. This would be a great area for some charitable organization of great wealth to promote research in, not to patent chemicals but to test and promote the use of readily growable, inexpensive and beneficial treatments. The charitable organization could further promote the work by showing some of the potential to corporations who are eyeing the drain on their profits from medical insurance. Universities specializing in the area of medicine known as Osteopathy would probably be easier to convince to research this then the M.D.s who are deeply involved with the drug companies. So, to the Bill and Melinda Gates Foundations of the world, how about setting up a foundation to promote and finance natural treatments for disease? Or if a honest one does exist already, contributing to it? It could lower medical bills for everyone and would likely be better then constantly adding to the current antibiotics problems etc.
-
Lets hope it becomes a trend...
Elsevier isn't happy 'cause they've made lotsa money sucking at the academic tit.
I hope that this will nudge more medical journals in the direction of freely available. The Canadian Medical Association Journal (http://www.cmaj.ca/) is currently the only major open access journal (CMAJ March 1, 2005; 172 (5).) (http://www.cmaj.ca/cgi/content/full/172/5/621). The British Medical Journal experimented with the idea for a while but decided to close up again... perhaps they'll now reconsider.
If you read the CMAJ article above... you'll know that Nature Publishing Group is okay with authors making the final version of their articles available six months post-publication. Things are moving in the right direction. :) -
Lets hope it becomes a trend...
Elsevier isn't happy 'cause they've made lotsa money sucking at the academic tit.
I hope that this will nudge more medical journals in the direction of freely available. The Canadian Medical Association Journal (http://www.cmaj.ca/) is currently the only major open access journal (CMAJ March 1, 2005; 172 (5).) (http://www.cmaj.ca/cgi/content/full/172/5/621). The British Medical Journal experimented with the idea for a while but decided to close up again... perhaps they'll now reconsider.
If you read the CMAJ article above... you'll know that Nature Publishing Group is okay with authors making the final version of their articles available six months post-publication. Things are moving in the right direction. :) -
Of _Course_ It's The GamesWhy, nobody ever sniped before violent video games were around or popular. And nobody in other countries would ever do such a thing. Especially Canada.
People seem to think that sniper attacks are a new and American phenomenon. That just ain't so. It's just another kind of murder, and murder's been around for a while, now.