Freshly elected Bush, enjoying the support of the his party's majority in Congress, did not bail-out Enron in 2001. Likewise MCI got liquidated in 2006. What made GM and Chrysler different?
GM and Chrysler didn't defaud their owners (the shareholders, i.e. Wall Street).
Both Enron and MCI pumped up their reported earnings and other financial stats through accounting fraud on a staggeringly huge scale, inflating the values of their stocks (and the executive's stock options). The car makers merely lost truckloads of money -- which is bad business but not a crime, although many Americans seem to treat it as such.
If you can genetically engineer cancer-killing T-cells, couldn't you just inject those into healthy patients (i.e. all the rest of us) as well, as a sort of immunization, just like you can get vaccination against influenza or tetanus?
The Chimeric Antigen Receptor T-Cell (CAR-T) technique actually requires a new lineage of modified cells to be created for each individual patient, engineered from each person's own immune cells. Unfortunately, this is an expensive and time-consuming task, and scaling to mass-production will be very difficult.
A second problem is that cancers may have differences from normal cells, but the differences are subtle compared to a microbe or virus -- precisely because they are not foreign, they are "us" in a sense, being born from our own normal cells. With exceptions (too few exceptions, unfortunately), there is no "cancer antigen" that marks it as being such. In this case, the patient has a cancer that arises from B-Cells. So what they've done is create a T-cell that ignores the usual proscription against attack the Self, and indiscriminately kills all B-cells (healthy or cancerous), wiping them all out.
Of course, B-cells are what produce Antibodies for us, so afterwards each patient needs a steady supply of IVIG (produced from the Antibodies in donated blood or plasma) to replace the Antibodies they are no longer producing. Still, it beats dying of Leukemia.
i am sorry this is not biochemistry this is made up "science". When ketosis is entered (by depleting ready carbohydrate resources) the body can metabolise fat into ketones (via the liver). The reason this myth persists is because for decades medical researchers couldn't imagine the brain running without glucose, which is a necessary condition of ketosis.
A bit of medical history: Prior to the 1920's or so, ketogenic states were commonly encountered in two medical conditions: Epileptics, and Type I diabetics.
For epileptics, a ketogenic diet was one of the few methods of seizure control available, prior to the invention of anti-epileptics -- the whole goal was to run your brain mostly on ketone bodies. It's still used in some difficult cases, although it takes a great deal of discipline and attention, as the requirements are stricter than what a weight-control ketogenic diet requires.
For the Type I diabetics, a ketogenic diet (with intake set at near-starvation levels) was the only way to keep them alive, prior to the discovery of insulin -- but it could not keep them healthy, as they gradually wasted away and either died in a state of starvation, or in a state of diabetic keto-acidosis. Once mass-produced insulin became available, the skeletal figures of diabetics plumped up, and the ketogenic diet fell by the wayside.
Unfortunately, these two medical uses of the ketogenic diet also meant that the ketogenic state became associated with disease conditions, and thus something to be avoided.
They have patients coming in day in and day out who swear they eat like a bird and they exercise regularly and are still gaining weight. Perhaps 1 in 1000 of these patients have some medical condition; the rest will likely have been eating candy bars in the waiting room, or will constantly snack on "energy bars", or whatever. And they hold bizarre ideas of what sorts of foods "don't count" (like celery... with dip).
Indeed. There have been a number of studies that have sought to compare self-reported caloric intake data to objective measurements of actual values, and under-reporting is rampant:
The historical disparity values for men and women were 281 and 365 kilocalorie-per-day, (95% CI: 299, 264 and 378, 351), respectively. These results are indicative of significant under-reporting. The greatest mean disparity values were 716 kcal/day and 856 kcal/day for obese (i.e., 30 kg/m2) men and women, respectively.
How much electricity does a fossil-fuel vehicle use in a day while sitting, turned off?
I recently had to troubleshoot something like this (turned out the culprit was a flaky switch in the trunk that would leave the trunk light on constantly). For a typical older-model car like mine, the expected current load is generally less than 30mA. A newer model car may be several times that, due to the increased parasitic draw from various built-in devices.
The incandescent bulb in my car's trunk drew several hundred milli-amps, which was enough to drain the battery within a day or two.
The process goes something like: gently push. Doesn't work. wiggle a bit. Still doesn't work. Flip over and try again. Neither of those work either. Then repeat a little bit harder until eventually it goes in or breaks.
Wait, we're still talking about USB ports here, right?
In the second, as in Shaun of the Dead, not everyone who dies becomes a zombie--contact with a zombie beforehand is required. This allows the interesting dynamic of escaping zombification by committing suicide.
Let's just go ahead and say it -- it is unlikely there would be enough people willing to commit suicide to form a fire-break against a zombie disease spread. The "interesting dynamic" of escape for this type of zombification is mass-murder.
Happy *IOPS*! I am *squirting happy SATA*! Why? The reason. Orz have the drives that *dissolve* or burst into several. *Capitalist friends* have come to Toshiba *playground*. Why are you coming to this? Orz are just Orz.
From what I can tell, essentially a bubble burst occurs when prices have become so inflated that people are priced out of buying in. This creates a lack of buyers, causing the sellers to dramatically drop their prices
"Nobody goes there anymore. It's too crowded." -- Yogi Berra
Do a search on STEM postdoc job ads - $50k is considered very generous. No, you won't starve, some people get by on less (though usually in low cost-of-living places rather than the high CoL areas where the better universities typically are). $50k/yr is about $24/hr assuming 40 hr weeks, but that's a ridiculous assumption.
I'll agree with you that 50k is not much for someone with a STEM education. However, most people get by on less, as 50k is in the 56th percentile for incomes in America.
Create a new "Employee rental company" with separate management whose sole purpose in life is to manage all the low-wage employees. For example: "McDonalds Employee Rental company." or "McDonalds Outsourced Customer service and Kitchen Operatins Inc."
If I were the sole manager left who got shuttled off to run the McDonalds Employee Rental Co. (MERC?), I'd find myself pretty unhappy to be the one Executive that had to live with the new wage cap. Time to subcontract to a new McDonalds Employee Rental Rental Company.
You aren't successful because there is no evidence to back you idea. It's been looked at, many times. Fact is, there is no scientific evidence that any antibiotic resistance is coming from give antibiotics to cows. Yes, I know it's counter intuitive, but when you look at the data it's clearly coming from too places: People not finishing the regime, and hospitals.
On a dark street, a man encountered a neighbor who was searching the ground beneath a streetlight. On questioning, he stated that he had dropped my house keys and I'm looking for them. The man joined the hunt, but no key was found anywhere under the light. He stopped and asked, "Are you sure you dropped your keys here?" The neighbor replied, "No, they could be anywhere".
"So, why are you only searching here?" The neighbor looked back at the man and replied, "I'm looking here because the light's much brighter."
Infections in humans and hospitals are much more closely researched and tracked. On the other hand, the agri-business industry in the US has been rather unfriendly towards attempts to study problem of antibiotic resistance there, and research funding is a tiny fraction of what is spent on diseases in humans.
Another major problem is that --outside of a few far-sighted individuals -- only in recent times has the spread of multi-drug resistance become a topic of concern among researchers (with concern among politicians and the general public being an ephemeral awareness that comes and goes with the mass-media news cycle). Antibiotic use in animals simply wasn't being studied at the time resistance was first arising, and to a large degree we're trying to figure out what happened after the fact.
So you are correct, the preponderance of evidence shows antibiotic resistance first being found in humans, and circulated between humans. However, be aware this preponderance may be an artifact.
Antibiotics is the number one reason there are so many people alive right now in the world
I absolutely agree with your assessment of how enormous the burden of infectious disease once was. But speaking as a medical student, water and sewage systems have saved more lives than doctors ever have.
After Imperial Japan surrendered to the Allies in 1945, Douglas MacArthur became the Supreme Commander of the Allied Powers, rebuilding Japan during the Allied occupation. MacArthur secretly granted immunity to the physicians of Unit 731, including their leader, in exchange for providing America, but not the other wartime allies, with their research on biological warfare.
Rare-earths in a catalytic converter? That's the first I've heard of that. That could bring down the cost quite a bit, since rare-earths are quite a bit cheaper that the precious metals, like platinum and palladium, that I'm used to them using.
There actually are such things as rare-earth catalytic converters, although I have no idea if they are useful for wood-burning stoves or not.
Once sucrose is cleaved in to fructose and glucose a few ms after hitting the stomach, there is no chemical difference between HFCS and Sucrose.
An natural, whole foods, organic fructose molecule cleaved from sucrose behaves bizarrely similarly to any other fructose molecule.
The parent post only claims it is "more harmful", while the response starts talking about lack of chemical differences. I see this every time the topic of HFCS comes up, two groups talking right past each other.
The additional harm, if any, is in the evidence HFCS gives that the food producer is willing to go to any lengths to cut costs.
And there you are. Nobody destroys their liver chugging pints of Honey, because Honey is relatively expensive. On the other hand, HCFS is so cheap, it's cheaper than the actual food it's replacing.
Likewise, fructose is in apples, but it isn't physically possible to consume the multiple bucket-fulls of apples that it would take to add up to a Big-Gulp fructose-equivalent.
Over a century ago, In the age before vaccines and antibiotics, mortality from childhood diseases was once rampant. Orphanages -- which featured dense concentrations of deprived and often poorly-nourished children -- were especially vulnerable to mass outbreaks, which could sometimes wipe out entire cohorts. With the development of germ theory, a new idea emerged for a solution to the terrible mortality rates that were common in those institutions.
Henceforth, orphans would be brought up with a minimum of human contact, carefully separated from each other. Caretakers would handle them only when necessary, and with all the accouterments of modern hygiene. Thanks to the carefully enforced isolation, disease outbreaks plummeted. Unfortunately, the children did not do as well as hoped.
Infants and young children became listless and depressed; they stopped eating, lost weight, and withered away. Survivors were often emotionally damaged, either failing to form attachments or forming them abnormally. It quickly became clear that frequent attention and contact was a vital part of human growth and development, every bit as necessary for survival as essentials such as food or warmth. More than any other reason, this new understanding led to the decline and eventual demise of orphanages in the West, and it's replacement by the system of adoption and fostering we use today.
The best example I can give is how doctors would assume that a header is a sign of something huge, when in fact the great majority of the time is the result of dehydration (because people replaced water with favored/sugary drinks) or due to neck muscle tension caused by sleeping with old (or wrong kind of) pillows.
As a current medical student, I would have to say that doctors are well aware that most headaches are harmless. However, in prioritizing differential diagnostic possibilities, the actual probability of each must be heavily weighted with the urgency and severity of the diagnosis -- both for the patient's own safety, as well as to produce defensive documentation in the event of a lawsuit.
When seen by a family doc who has known you for years, it is likely that you will get a recommendation for conservative treatment; the physician has a good idea of what your baseline presentation looks like, and likely trusts you will give a truthful and accurate history to him. On the other hand, walking into an ER may get you scanned and probed thoroughly, especially likely if you have anything in your history that marks you as having even just a slightly special risk, whether this happens to be an actual medical risk, or a risk that you could be -- even unintentionally -- be giving an inaccurate or incomplete history somehow.
On the other end of the spectrum, the calculations by Lokuge et al. (2004) of the dis- ease burden from arsenic exposure that take into account only "strong causal evidence" from existing studies estimate that arsenic-related disease leads to the loss of 174,174 disability- adjusted life years (DALYs) per year among the population exposed to arsenic concentrations of more than 50 ppb, which amounts to 0.3% of the disease burden, compared with diarrheal disease which accounts for between 7.2% and 12.1% of the total disease burden.
Since infant mortality results in a disproportionate DALY impact compared with adult morbidity and mortality, I suspect the percentage of DALY disease burden impact gets skewed, but overall I think my previous point stands.
A decade or two later, we found that many of these wells accessed aquifers that were contaminated by arsenic. And that thus we kids had funded the wholesale poisoning of people in Africa, and that a lot of them had arsenic-induced cancers that were killing them.
Are you sure you're not mixing up two different stories here? Although trace amounts of Arsenic are common in aquifers that contact certain kinds of alluvial sediments, only a few areas have experienced really high concentrations. In particular, this has happened with shallow tube wells in India and Bangladesh. These types of wells were extremely cheap, and were drilled in the millions starting around the 1970's with UNICEF assistance; I am unaware of any similar large-scale occurrence of contamination in Africa.
On looking at the morbidity and mortality modeling from the WHO link, I wouldn't automatically label it an complete tragedy right away, either. The amount of Cancer and other diseases from arsenic contamination (chronic ingestion, the concentration is not the kind required for acute poisoning) is definitely non-trivial. However, following the implementation of the tube wells, infant mortality dropped by something like half (keeping in mind this that the high starting point of mortality means half of a fairly big number), with substantial reductions in prevalence of waterborne diseases. It is entirely possible that the number of lives (and maybe person-years of life) saved by the wells could outnumber those that were lost.
Actually, I strongly suspect that the person-years of life saved could be greatly more than the number lost, but I can't directly substantiate the possibility with numbers, except to say there is evidence that recent anti-arsenic campaigns have resulted in increases in infant mortality, due to avoidance or loss of well water leading to greater use of microbially contaminated water supplies.
Obviously, it would be great to have both clean water with no arsenic at all. Possible with deeper but more expensive wells that have been gradually replacing the older wells (it sounds like other strategies like filtration and rain-water storage have sustainability problems when implemented out in the field), but I doubt UNICEF or similar charitable organizations can get the money they need these days to replace them all at a sweep.
Slashdot Mirror
I'd like to propose a name for this new venture, "Windows Alternative: Nokia + Google Android", or WANGdroid .
Freshly elected Bush, enjoying the support of the his party's majority in Congress, did not bail-out Enron in 2001. Likewise MCI got liquidated in 2006. What made GM and Chrysler different?
GM and Chrysler didn't defaud their owners (the shareholders, i.e. Wall Street).
Both Enron and MCI pumped up their reported earnings and other financial stats through accounting fraud on a staggeringly huge scale, inflating the values of their stocks (and the executive's stock options). The car makers merely lost truckloads of money -- which is bad business but not a crime, although many Americans seem to treat it as such.
Anybody else recall anything of the like?
Dunno, does Goonswarm count? :)
If you can genetically engineer cancer-killing T-cells, couldn't you just inject those into healthy patients (i.e. all the rest of us) as well, as a sort of immunization, just like you can get vaccination against influenza or tetanus?
The Chimeric Antigen Receptor T-Cell (CAR-T) technique actually requires a new lineage of modified cells to be created for each individual patient, engineered from each person's own immune cells. Unfortunately, this is an expensive and time-consuming task, and scaling to mass-production will be very difficult.
A second problem is that cancers may have differences from normal cells, but the differences are subtle compared to a microbe or virus -- precisely because they are not foreign, they are "us" in a sense, being born from our own normal cells. With exceptions (too few exceptions, unfortunately), there is no "cancer antigen" that marks it as being such. In this case, the patient has a cancer that arises from B-Cells. So what they've done is create a T-cell that ignores the usual proscription against attack the Self, and indiscriminately kills all B-cells (healthy or cancerous), wiping them all out.
Of course, B-cells are what produce Antibodies for us, so afterwards each patient needs a steady supply of IVIG (produced from the Antibodies in donated blood or plasma) to replace the Antibodies they are no longer producing. Still, it beats dying of Leukemia.
i am sorry this is not biochemistry this is made up "science". When ketosis is entered (by depleting ready carbohydrate resources) the body can metabolise fat into ketones (via the liver). The reason this myth persists is because for decades medical researchers couldn't imagine the brain running without glucose, which is a necessary condition of ketosis.
A bit of medical history: Prior to the 1920's or so, ketogenic states were commonly encountered in two medical conditions: Epileptics, and Type I diabetics.
For epileptics, a ketogenic diet was one of the few methods of seizure control available, prior to the invention of anti-epileptics -- the whole goal was to run your brain mostly on ketone bodies. It's still used in some difficult cases, although it takes a great deal of discipline and attention, as the requirements are stricter than what a weight-control ketogenic diet requires.
For the Type I diabetics, a ketogenic diet (with intake set at near-starvation levels) was the only way to keep them alive, prior to the discovery of insulin -- but it could not keep them healthy, as they gradually wasted away and either died in a state of starvation, or in a state of diabetic keto-acidosis. Once mass-produced insulin became available, the skeletal figures of diabetics plumped up, and the ketogenic diet fell by the wayside.
Unfortunately, these two medical uses of the ketogenic diet also meant that the ketogenic state became associated with disease conditions, and thus something to be avoided.
They have patients coming in day in and day out who swear they eat like a bird and they exercise regularly and are still gaining weight. Perhaps 1 in 1000 of these patients have some medical condition; the rest will likely have been eating candy bars in the waiting room, or will constantly snack on "energy bars", or whatever. And they hold bizarre ideas of what sorts of foods "don't count" (like celery... with dip).
Indeed. There have been a number of studies that have sought to compare self-reported caloric intake data to objective measurements of actual values, and under-reporting is rampant:
Validity of U.S. Nutritional Surveillance: National Health and Nutrition Examination Survey Caloric Energy Intake Data, 1971–2010:
The historical disparity values for men and women were 281 and 365 kilocalorie-per-day, (95% CI: 299, 264 and 378, 351), respectively. These results are indicative of significant under-reporting. The greatest mean disparity values were 716 kcal/day and 856 kcal/day for obese (i.e., 30 kg/m2) men and women, respectively.
How much electricity does a fossil-fuel vehicle use in a day while sitting, turned off?
I recently had to troubleshoot something like this (turned out the culprit was a flaky switch in the trunk that would leave the trunk light on constantly). For a typical older-model car like mine, the expected current load is generally less than 30mA. A newer model car may be several times that, due to the increased parasitic draw from various built-in devices.
The incandescent bulb in my car's trunk drew several hundred milli-amps, which was enough to drain the battery within a day or two.
That's a wildly disproportionate punishment!
"Kill the Chicken to Scare the Monkey" -- Chinese Saying
The process goes something like: gently push. Doesn't work. wiggle a bit. Still doesn't work. Flip over and try again. Neither of those work either. Then repeat a little bit harder until eventually it goes in or breaks.
Wait, we're still talking about USB ports here, right?
In the second, as in Shaun of the Dead, not everyone who dies becomes a zombie--contact with a zombie beforehand is required. This allows the interesting dynamic of escaping zombification by committing suicide.
Let's just go ahead and say it -- it is unlikely there would be enough people willing to commit suicide to form a fire-break against a zombie disease spread. The "interesting dynamic" of escape for this type of zombification is mass-murder.
If god favors my group, then the other groups are not favored and are therefore inferior and unworthy of my concern.
Charlamagne: "Oh God -- we who fight in your name and in the name of your Son -- ask for victory in combat tomorrow."
Pippin: "Father, is the Visigoth king praying for victory, too?"
Charlamagne: "Oh yes. Old King Aleric is one of the best prayers in the business."
May be they should rename to orz
Happy *IOPS*! I am *squirting happy SATA*!
Why? The reason. Orz have the drives that *dissolve* or burst into several.
*Capitalist friends* have come to Toshiba *playground*.
Why are you coming to this?
Orz are just Orz.
From what I can tell, essentially a bubble burst occurs when prices have become so inflated that people are priced out of buying in. This creates a lack of buyers, causing the sellers to dramatically drop their prices
"Nobody goes there anymore. It's too crowded." -- Yogi Berra
Do a search on STEM postdoc job ads - $50k is considered very generous. No, you won't starve, some people get by on less (though usually in low cost-of-living places rather than the high CoL areas where the better universities typically are). $50k/yr is about $24/hr assuming 40 hr weeks, but that's a ridiculous assumption.
I'll agree with you that 50k is not much for someone with a STEM education. However, most people get by on less, as 50k is in the 56th percentile for incomes in America.
Create a new "Employee rental company" with separate management whose sole purpose in life is to manage all the low-wage employees. For example: "McDonalds Employee Rental company." or "McDonalds Outsourced Customer service and Kitchen Operatins Inc."
If I were the sole manager left who got shuttled off to run the McDonalds Employee Rental Co. (MERC?), I'd find myself pretty unhappy to be the one Executive that had to live with the new wage cap. Time to subcontract to a new McDonalds Employee Rental Rental Company.
Turtles all the way down!
You aren't successful because there is no evidence to back you idea. It's been looked at, many times. Fact is, there is no scientific evidence that any antibiotic resistance is coming from give antibiotics to cows.
Yes, I know it's counter intuitive, but when you look at the data it's clearly coming from too places:
People not finishing the regime, and hospitals.
On a dark street, a man encountered a neighbor who was searching the ground beneath a streetlight. On questioning, he stated that he had dropped my house keys and I'm looking for them. The man joined the hunt, but no key was found anywhere under the light. He stopped and asked, "Are you sure you dropped your keys here?" The neighbor replied, "No, they could be anywhere".
"So, why are you only searching here?" The neighbor looked back at the man and replied, "I'm looking here because the light's much brighter."
Infections in humans and hospitals are much more closely researched and tracked. On the other hand, the agri-business industry in the US has been rather unfriendly towards attempts to study problem of antibiotic resistance there, and research funding is a tiny fraction of what is spent on diseases in humans.
Another major problem is that --outside of a few far-sighted individuals -- only in recent times has the spread of multi-drug resistance become a topic of concern among researchers (with concern among politicians and the general public being an ephemeral awareness that comes and goes with the mass-media news cycle). Antibiotic use in animals simply wasn't being studied at the time resistance was first arising, and to a large degree we're trying to figure out what happened after the fact.
So you are correct, the preponderance of evidence shows antibiotic resistance first being found in humans, and circulated between humans. However, be aware this preponderance may be an artifact.
Antibiotics is the number one reason there are so many people alive right now in the world
I absolutely agree with your assessment of how enormous the burden of infectious disease once was. But speaking as a medical student, water and sewage systems have saved more lives than doctors ever have.
I'd put antibiotics third place, behind vaccines.
http://en.wikipedia.org/wiki/Unit_731#Surrender_and_immunity
After Imperial Japan surrendered to the Allies in 1945, Douglas MacArthur became the Supreme Commander of the Allied Powers, rebuilding Japan during the Allied occupation. MacArthur secretly granted immunity to the physicians of Unit 731, including their leader, in exchange for providing America, but not the other wartime allies, with their research on biological warfare.
Urine Powered Robotic Overlords!
Morpheus: Unfortunately, no one can be told what the Matrix is. You have to pee it for yourself.
Rare-earths in a catalytic converter? That's the first I've heard of that. That could bring down the cost quite a bit, since rare-earths are quite a bit cheaper that the precious metals, like platinum and palladium, that I'm used to them using.
There actually are such things as rare-earth catalytic converters, although I have no idea if they are useful for wood-burning stoves or not.
Once sucrose is cleaved in to fructose and glucose a few ms after hitting the stomach, there is no chemical difference between HFCS and Sucrose.
An natural, whole foods, organic fructose molecule cleaved from sucrose behaves bizarrely similarly to any other fructose molecule.
The parent post only claims it is "more harmful", while the response starts talking about lack of chemical differences. I see this every time the topic of HFCS comes up, two groups talking right past each other.
The additional harm, if any, is in the evidence HFCS gives that the food producer is willing to go to any lengths to cut costs.
And there you are. Nobody destroys their liver chugging pints of Honey, because Honey is relatively expensive. On the other hand, HCFS is so cheap, it's cheaper than the actual food it's replacing.
Likewise, fructose is in apples, but it isn't physically possible to consume the multiple bucket-fulls of apples that it would take to add up to a Big-Gulp fructose-equivalent.
Over a century ago, In the age before vaccines and antibiotics, mortality from childhood diseases was once rampant. Orphanages -- which featured dense concentrations of deprived and often poorly-nourished children -- were especially vulnerable to mass outbreaks, which could sometimes wipe out entire cohorts. With the development of germ theory, a new idea emerged for a solution to the terrible mortality rates that were common in those institutions.
Henceforth, orphans would be brought up with a minimum of human contact, carefully separated from each other. Caretakers would handle them only when necessary, and with all the accouterments of modern hygiene. Thanks to the carefully enforced isolation, disease outbreaks plummeted. Unfortunately, the children did not do as well as hoped.
Infants and young children became listless and depressed; they stopped eating, lost weight, and withered away. Survivors were often emotionally damaged, either failing to form attachments or forming them abnormally. It quickly became clear that frequent attention and contact was a vital part of human growth and development, every bit as necessary for survival as essentials such as food or warmth. More than any other reason, this new understanding led to the decline and eventual demise of orphanages in the West, and it's replacement by the system of adoption and fostering we use today.
The best example I can give is how doctors would assume that a header is a sign of something huge, when in fact the great majority of the time is the result of dehydration (because people replaced water with favored/sugary drinks) or due to neck muscle tension caused by sleeping with old (or wrong kind of) pillows.
As a current medical student, I would have to say that doctors are well aware that most headaches are harmless. However, in prioritizing differential diagnostic possibilities, the actual probability of each must be heavily weighted with the urgency and severity of the diagnosis -- both for the patient's own safety, as well as to produce defensive documentation in the event of a lawsuit.
When seen by a family doc who has known you for years, it is likely that you will get a recommendation for conservative treatment; the physician has a good idea of what your baseline presentation looks like, and likely trusts you will give a truthful and accurate history to him. On the other hand, walking into an ER may get you scanned and probed thoroughly, especially likely if you have anything in your history that marks you as having even just a slightly special risk, whether this happens to be an actual medical risk, or a risk that you could be -- even unintentionally -- be giving an inaccurate or incomplete history somehow.
Wanted to post a clarification:
http://web.mit.edu/j-pal/www/book/Arsenic_InfantMortality_feb10.pdf
On the other end of the spectrum, the calculations by Lokuge et al. (2004) of the dis-
ease burden from arsenic exposure that take into account only "strong causal evidence" from
existing studies estimate that arsenic-related disease leads to the loss of 174,174 disability-
adjusted life years (DALYs) per year among the population exposed to arsenic concentrations
of more than 50 ppb, which amounts to 0.3% of the disease burden, compared with diarrheal
disease which accounts for between 7.2% and 12.1% of the total disease burden.
Since infant mortality results in a disproportionate DALY impact compared with adult morbidity and mortality, I suspect the percentage of DALY disease burden impact gets skewed, but overall I think my previous point stands.
A decade or two later, we found that many of these wells accessed aquifers that were contaminated by arsenic. And that thus we kids had funded the wholesale poisoning of people in Africa, and that a lot of them had arsenic-induced cancers that were killing them.
Are you sure you're not mixing up two different stories here? Although trace amounts of Arsenic are common in aquifers that contact certain kinds of alluvial sediments, only a few areas have experienced really high concentrations. In particular, this has happened with shallow tube wells in India and Bangladesh. These types of wells were extremely cheap, and were drilled in the millions starting around the 1970's with UNICEF assistance; I am unaware of any similar large-scale occurrence of contamination in Africa.
On looking at the morbidity and mortality modeling from the WHO link, I wouldn't automatically label it an complete tragedy right away, either. The amount of Cancer and other diseases from arsenic contamination (chronic ingestion, the concentration is not the kind required for acute poisoning) is definitely non-trivial. However, following the implementation of the tube wells, infant mortality dropped by something like half (keeping in mind this that the high starting point of mortality means half of a fairly big number), with substantial reductions in prevalence of waterborne diseases. It is entirely possible that the number of lives (and maybe person-years of life) saved by the wells could outnumber those that were lost.
Actually, I strongly suspect that the person-years of life saved could be greatly more than the number lost, but I can't directly substantiate the possibility with numbers, except to say there is evidence that recent anti-arsenic campaigns have resulted in increases in infant mortality, due to avoidance or loss of well water leading to greater use of microbially contaminated water supplies.
Obviously, it would be great to have both clean water with no arsenic at all. Possible with deeper but more expensive wells that have been gradually replacing the older wells (it sounds like other strategies like filtration and rain-water storage have sustainability problems when implemented out in the field), but I doubt UNICEF or similar charitable organizations can get the money they need these days to replace them all at a sweep.