IANAL, but this would support premeditation -- not necessarily that she COMMITTED the murder. This type of evidence could go a long way in changing a murder 2 case in to a murder 1 case.
Your bias has blinded you to objectively reviewing Linux benefits. You completely fail to comprehend the flexibility that is inherent in the operating systems (aka distros) made using the Linux kernel. No, it's not the best kernel for everything, but it sure is insanely useful from embedded to high-availability systems. And it's getting better.
Wow. It's amazing what you can read from a person using tarot cards, huh? I say tarot cards because you make some amazing statements about me based on the tiny bit of information in my post. There's no other explaination. You must be psychic or know the way of the tarot.
Our shop has, among it's resources, 2 linux-based servers (we're a fairly small shop -- 150 workstations over 4 geographically separate locations). Yet my bias has blinded me?
Further, you appear to approve that if linux advocates "..deliberate conspiracy to deceive..", it's A-OK. You state "That's just what it takes to be in Sales. Microsoft's marketing practices aren't deceptive?" Can you say "tu quoque"?
I think you're one of the wacked out linux zealots the article mis-named "advocates".
I think the thing that bothers me the most about Linux is IT advocacy. IT shouldn't be an advocate of any product, because it needs to make determinations between them.
I think my eyes are messing with me. IT shouldn't be an advocate of any product? Am I missing something?
He's right, it's our job to determine the best product for a given task given budget constraints, resources available, etc. But once we determine the best product, how can we NOT advocate it?
This following quote is very telling about the author's motives:
The reason Linux has been abstracted into a concept is so it doesn't have to compete on merit. It can be anything, in concept, it needs to be to win a deal.
Enderle clearly implies there was some sort of deliberate conspiracy to deceive by the people advocating linux. WTF? Does he really believe that?
I hate Linux Nazis and I don't think Linux or OSS is the best solution in all -- or even most cases. However, there are a lot of things in this article that are just wacky.
That said, Enderle does make some very good observations on community based works (that apply outside of IT as well) and some interesting comments on security. Just read him with an extra critical eye.
Just on a side note, here in Utah we have some of the lowest per capita spending on K-12 and yet somehow Utah schools consistently rank at the top in every measure of educational achievement.
I live in CA and have my children in a private elementary school. I pay less than half of what the state spends per student for my children to attend this school. Students who graduate from this school are statistically far more likely to attend college than those who attend public school. Further, they do far better on state standard tests, have overall better GPAs once they move on to high-school (even if they move to a public high-school) and take higher-level courses (AP, calc, physics, etc).
I hear a lot of people wanting the feds to stay out of education -- I which the state and CITY would stay out of it.
Yeah... that makes sense. However, is that cash in hand? Or would they be justified in keeping it as "damanges" for needing to address user complains/credits? I know two customers who spent time on the phone on more than one occation to get SMS credit due to spam. They got their money back, but Verizon spent "time/money" addressing/fixing their customer's problem.
How much time/effort needs to be put in to determining who gets what?
Most labs have moved away from conventional pap smears to liquid based. Further, you can run CT/GC and HPV off the same sample. When I refer to paps, I was refering to liquid based (although there are still a number of drs/agencies who demand old-style pap smears).
Look it up. Paps (reimbursed at around $10-$20) in low risk women run are recommended every 2-4 years. Further, the use of the pap will not be eliminated so there would not be a savings from fewer paps (not at first, and probably smallish in 10-20 years if the recommended frequency of paps is increased). These services are already available to under served women via PPFA or state/local hospitals. They just aren't accessed.
From what I've read, there is no intention on the part of obstetricians to discontinue regular pap smears. In fact, it'd be irresponsible for them to stop, because doing so would be a virtual death sentence (in the form of a late diagnosis) to those affected by all the cervical cancer unabated by this vaccine.
In all fairness, if the HPV works as advertised over a greater period of time than now known and doesn't prove to have any nasty side effects (3 headed babies, liver failure, foot fungus), then I wouldn't be surprised if the recommended frequency of the pap in low-risk women would drop from 2-4 years to 3-6 years. You would see SOME decrease in cost, but certainly not what has been suggested.
I work for a lab which specializes in services for underserved women. The infrastructure is there via PPFA or city/state hospitals. It's more that access is not used than not available.
When you take the big picture...thinking about what OTHER things this country blows money on...I'm having a hard time buying your argument.
When you take in the big picture, I'm having a hard time buying that you can't see that unlimited spending is unsustainable. We can't have EVERYTHING we want for EVERYBODY.
I would like to know where you get your numbers...
I work with this stuff. I'm quite familiar with it. Further, I've been a contributor to a number of research papers following HPV, CIN I-III, etc... I'm also taking part in a study gathering data on post vaccinated women.
but the fact that this vaccine covers the four serotypes that most commonly cause cervical cancer (90%)
Actually, thats about 70%, not 90%. It covers 90% of HPV LINKED cancer.
HPV is the most common STD.
Actually, it's Chlamydia Trachomatis thats most common.
There are 15 serotypes that cause cancer (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82).
Actually, the word is "LINKED" to cancer. There is nothing that states they CAUSE cancer. Further, the typical HIGH-RISK HPV genotypes are 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. These are typically tested for using a high-risk hpv probe -- often using the same material from the pap (if liquid based). Further, there are a number of low-risk HPV genotypes that are checked for: 6, 11, 42, 43, 44. Gardasil blocks (6, 11, 16, & 18). Two low risk and two high risk.
HOWEVER, the greatest reason why this vaccine needs good US marketing is because of places like Africa, where cervical cancer is one of the biggest killers of women due to lack of adequate preventitive medicine.
Great. Get the nations of africa to make vaccination manditory. Forcing the US to vaccinate on something which will most likely be unnecessary is virtually all women in an effort to help africa is crazy. Let them pay for it. The topic is forced vaccination in the US, not africa, so my argument stands.
Wow a country of 300 million people have 100 million virgin girls. I should head south more often. You may want to get your census information from a source other then "out of my own ass."
Who said anything about "vergins"? Perhaps you shouldn't comment on things you know nothing about.
The vaccine is recommended for women 11-26. According to census.gov current population estimates based on the 2000 census data (add about 10%-15%), that number currently falls in the 60 million range. If you bring the age down to 9 and up to 30, you're pushing close to 100 million. At 50 million, you're still talking over 20 billion dollars in vaccine.
You're only considering the cost of the pap smear. So, what do you do when you confirm the woman has cancer with the pap smear? Send her on way, and tell her, "good luck"? There are additional costs involved after a woman is diagnosed with HPV, cervical dysplasia, or cervical cancer. A large chunk of these costs is more than $400 (I would bet the follow up visit alone is that much). Do the math on all those woman who are being told after a positive pap smear that they need additional treatment
Cervical cancer is rare -- and getting rarer without the vaccine. Me do the math? I would suggest you do the math. Of the small percentage of women who get treated for full blown cervical cancer, it would not justify that nearly 1 billion a year after a 40 billion inital expense.
BTW, "postive pap smear" does not exist. It's WNL (within normal limits), UNSAT, or EPITHELIAL CELL ABNORMALITY (there are a few others, but that covers most of the board). Only a small portion fall in the abnormal range. And only a TINY portion of those are actually cancer. Most are HPV/ASCUS.
We're talking about spending this money on something JUST out of phase I testing. How about we wait until the results of phase II at least (preferably phase III) are in?
And getting rarer at the constant rate of 4% per year -- without the vaccine.
As a pathologist, you are well aware of treatment options and how frequently (or infrequently, I should say) actual cancer shows up, say CIS -- or even HSIL.
Do you really think it's wise to spend tens of billions in the US alone -- and close to a billion a year for every year after that on a solution just out of phase I testing? Don't get me wrong -- I like the vaccine and am hopeful phase II and III studies will show a much greater lenth of protection -- and perhaps prevent abnormal changes in pre-exposed women who get vaccinated. I'm not ready to make that leap. I'm honestly not sure I'd ever be ready for that leap. Thats a HUGE expense and the money has to come from somewhere.
Disclaimer: I've provided aid in a number of studies following HPV, CIN I, II, III, etc... and have been listed as a contributer in a few research papers. I've also been asked to help facilitate data collection for a number of post-vaccination studies.
Ok... I got it. You don't know what you are talking about.
A little background for your benefit:
There are about 100 types of HPV. About a dozen-twenty are linked to about 80% of cervical cancers. The vaccine in question (Gardasil) offers resistance to 4 of them which account for the (around 90%) of HPV linked cancers. That still leaves a HUGE number of HPV strains for which there is no vaccine that have been linked to cervical cancer. That also leaves non-hpv linked cervical cancer.
You're statement that "only those few types of HPV cause cervical cancer" is untrue. There are many. It would, however, be true to say that most hpv-linked cancers are casued by 4 different strains of HPV.
Who said anything about universal healthcare. IMO, that would be a disaster.
Most under served women already have access to GYN care (though PPFA or various state/city clinics) with rembersement coming from uncle sugar or private donations. They just aren't UTILIZED as often as they should.
Just wondering? How could it possibly be 100% effecting in preventing cervical cancer when only 3 or 4 strains of HPV are targeted by the vaccine? And around 20% of cervical cancers are unrelated to HPV exposure?
Do they sprinkle the vaccine with magic faerie dust?
I think several hundred million a year to prevent 70% of cases of cervical cancer is probably a better investment.
I think that spending a fraction of that to provide GYN care to under served women would be a better investment still. The cost of treating CIN I in a small percentage of the population is a HELL of a lot cheaper than spending 800 million a year (not counting the initial expense of $400 x 100 million woman).
My opinion may change after the phase II studies. It may not.
The problem is most of those dx's and deaths are in under served women. Women who do not get regular pap smears due to social or economic reasons. Get those women to have regular pap smears and you'll see a huge reduction in those numbers.
8.5 years? That should read 5 years. It has yet to be determined if there is decreasing effectiveness over time. Thats what the phase II trials will monitor. Will boosters be necessary? Full re-vaccinations? Perhaps. Perhaps not.
Further, if you've been exposed to HPV-6, then get vaccinated, you still get the benefit of resistance to HPV 16, 11 and 18. Further, Gardasil has made the claim that vaccination AFTER exposure MAY help prefent cellular abnormality over time that leads to cancer for strains of HPV the patient had already been exposed to.
If this proves to be true, wouldn't it be much more economic to vaccinate woman who come up positive for high-risk HPV strains?
Pap smears are an effective diagnostic tool, a way to tell if a woman is already infected with HPV and has precancerous cells, but it's not a preventative tool that does anything about the infection in the first place. It's a related issue, but neither one is a replacement for the other
It is true that the pap is not a preventative but diagnostic tool. Paps will continue to be needed as the HPV vaccines only work for 3 or 4 HPV types (and theres like 20 which are linked to cancer).
We're talking about fairly small number of cases a year (and dropping by 4% every year consistantly WITHOUT the vaccine) compared to the entire body of women who've been exposed to HPV. The "surgical treatment", when caught early consists of a colposcopy is most cases - like the removal of a mole. It's a SIMPLE outpatient procedure. Not "fun", but certainly not something to get in a fret over.
I also completely disagree with you about it having a "lower social and economic cost" over time. The vaccine is JUST out of phase I studies. Just BEGINNING phase II. To make such predictions at this point is an excercise in obtuse guessing.
Most woman don't need a pap every year. Most can do with a pap every 2-4 years. At $10-$20 a pap, most woman would never generate enough revenue from PAPs to equal the cost of the vaccine.
Don't get me wrong, I'm not against the vaccine -- I'm against the request to make it MANDATORY. It's a HUGE expense right now without the benefit of further study.
Disclaimer: I've worked on a number of studies tracking HPV, CIN I, II & III as well as having written a number of custom queries for various LIS databases to pull data which will be part of the phase II studies (tracking vaccinated woman over time). I'm not an MD/PHD, but I work with them.
HPV infection does not automatically lead to cancer. I'm talking about the stains that have been linked to future cancer. You make it sound like if a woman gets HPV... thats it. She WILL get cancer. If that were the case, there would be a HELL of a lot more cancer cases every year.
from cancer.gov:
Recently, the U.S. Food and Drug Administration (FDA) approved a vaccine that is highly effective in preventing infection with types 16 and 18, two "high-risk" HPVs that cause most (70 percent) cervical cancers, and types 6 and 11, which cause most (90 percent) genital warts (4).
and
Having many sexual partners is a risk factor for HPV infection. Although most HPV infections go away on their own without causing any type of abnormality, infection with high-risk HPV types increases the chance that mild abnormalities will progress to more severe abnormalities or cervical cancer. Still, of the women who do develop abnormal cell changes with high-risk types of HPV, only a small percentage would develop cervical cancer if the abnormal cells were not removed. Studies suggest that whether a woman develops cervical cancer depends on a variety of factors acting together with high-risk HPVs. The factors that may increase the risk of cervical cancer in women with HPV infection include smoking and having many children (3).
We're talking about a HUGE expense ($400 a pop) x 100 million woman initially (that fit in to the age group in the US) -- then about $400 a pop x 2 million a year for all 11 year old girls. Compare that to the cost of making a $10-$20 pap available to the underserved and high-risk woman who would benefit from it.
Slashdot Mirror
IANAL, but this would support premeditation -- not necessarily that she COMMITTED the murder. This type of evidence could go a long way in changing a murder 2 case in to a murder 1 case.
Wow. It's amazing what you can read from a person using tarot cards, huh? I say tarot cards because you make some amazing statements about me based on the tiny bit of information in my post. There's no other explaination. You must be psychic or know the way of the tarot.
Our shop has, among it's resources, 2 linux-based servers (we're a fairly small shop -- 150 workstations over 4 geographically separate locations). Yet my bias has blinded me?
Further, you appear to approve that if linux advocates "..deliberate conspiracy to deceive..", it's A-OK. You state "That's just what it takes to be in Sales. Microsoft's marketing practices aren't deceptive?" Can you say "tu quoque"?
I think you're one of the wacked out linux zealots the article mis-named "advocates".
I agree. I would be less critical of this article had the author chosen to use "zealotry" rather than "advocacy".
He's right, it's our job to determine the best product for a given task given budget constraints, resources available, etc. But once we determine the best product, how can we NOT advocate it?
This following quote is very telling about the author's motives
Enderle clearly implies there was some sort of deliberate conspiracy to deceive by the people advocating linux. WTF? Does he really believe that?
I hate Linux Nazis and I don't think Linux or OSS is the best solution in all -- or even most cases. However, there are a lot of things in this article that are just wacky.
That said, Enderle does make some very good observations on community based works (that apply outside of IT as well) and some interesting comments on security. Just read him with an extra critical eye.
What was also missed are the various LANGUAGES those packages come in. So multitply that by about 50 or 100 each...
I hear a lot of people wanting the feds to stay out of education -- I which the state and CITY would stay out of it.
Yeah... that makes sense. However, is that cash in hand? Or would they be justified in keeping it as "damanges" for needing to address user complains/credits? I know two customers who spent time on the phone on more than one occation to get SMS credit due to spam. They got their money back, but Verizon spent "time/money" addressing/fixing their customer's problem.
How much time/effort needs to be put in to determining who gets what?
...because they didn't spend any money going after the spammer...
If they were to cover their legal bills with that, then what ever's left over went to the "victums", I'd say "great".
Most labs have moved away from conventional pap smears to liquid based. Further, you can run CT/GC and HPV off the same sample. When I refer to paps, I was refering to liquid based (although there are still a number of drs/agencies who demand old-style pap smears).
Look it up. Paps (reimbursed at around $10-$20) in low risk women run are recommended every 2-4 years. Further, the use of the pap will not be eliminated so there would not be a savings from fewer paps (not at first, and probably smallish in 10-20 years if the recommended frequency of paps is increased). These services are already available to under served women via PPFA or state/local hospitals. They just aren't accessed.
I work for a lab which specializes in services for underserved women. The infrastructure is there via PPFA or city/state hospitals. It's more that access is not used than not available.
Who said anything about "vergins"? Perhaps you shouldn't comment on things you know nothing about.
The vaccine is recommended for women 11-26. According to census.gov current population estimates based on the 2000 census data (add about 10%-15%), that number currently falls in the 60 million range. If you bring the age down to 9 and up to 30, you're pushing close to 100 million. At 50 million, you're still talking over 20 billion dollars in vaccine.
Cervical cancer is rare -- and getting rarer without the vaccine. Me do the math? I would suggest you do the math. Of the small percentage of women who get treated for full blown cervical cancer, it would not justify that nearly 1 billion a year after a 40 billion inital expense.
BTW, "postive pap smear" does not exist. It's WNL (within normal limits), UNSAT, or EPITHELIAL CELL ABNORMALITY (there are a few others, but that covers most of the board). Only a small portion fall in the abnormal range. And only a TINY portion of those are actually cancer. Most are HPV/ASCUS.
We're talking about spending this money on something JUST out of phase I testing. How about we wait until the results of phase II at least (preferably phase III) are in?
As a pathologist, you are well aware of treatment options and how frequently (or infrequently, I should say) actual cancer shows up, say CIS -- or even HSIL.
Do you really think it's wise to spend tens of billions in the US alone -- and close to a billion a year for every year after that on a solution just out of phase I testing? Don't get me wrong -- I like the vaccine and am hopeful phase II and III studies will show a much greater lenth of protection -- and perhaps prevent abnormal changes in pre-exposed women who get vaccinated. I'm not ready to make that leap. I'm honestly not sure I'd ever be ready for that leap. Thats a HUGE expense and the money has to come from somewhere.
Disclaimer: I've provided aid in a number of studies following HPV, CIN I, II, III, etc... and have been listed as a contributer in a few research papers. I've also been asked to help facilitate data collection for a number of post-vaccination studies.
Ok... I got it. You don't know what you are talking about.
A little background for your benefit:
There are about 100 types of HPV. About a dozen-twenty are linked to about 80% of cervical cancers. The vaccine in question (Gardasil) offers resistance to 4 of them which account for the (around 90%) of HPV linked cancers. That still leaves a HUGE number of HPV strains for which there is no vaccine that have been linked to cervical cancer. That also leaves non-hpv linked cervical cancer.
You're statement that "only those few types of HPV cause cervical cancer" is untrue. There are many. It would, however, be true to say that most hpv-linked cancers are casued by 4 different strains of HPV.
Who said anything about universal healthcare. IMO, that would be a disaster.
Most under served women already have access to GYN care (though PPFA or various state/city clinics) with rembersement coming from uncle sugar or private donations. They just aren't UTILIZED as often as they should.
Just wondering? How could it possibly be 100% effecting in preventing cervical cancer when only 3 or 4 strains of HPV are targeted by the vaccine? And around 20% of cervical cancers are unrelated to HPV exposure?
Do they sprinkle the vaccine with magic faerie dust?
I think that spending a fraction of that to provide GYN care to under served women would be a better investment still. The cost of treating CIN I in a small percentage of the population is a HELL of a lot cheaper than spending 800 million a year (not counting the initial expense of $400 x 100 million woman).
My opinion may change after the phase II studies. It may not.
The problem is most of those dx's and deaths are in under served women. Women who do not get regular pap smears due to social or economic reasons. Get those women to have regular pap smears and you'll see a huge reduction in those numbers.
8.5 years? That should read 5 years. It has yet to be determined if there is decreasing effectiveness over time. Thats what the phase II trials will monitor. Will boosters be necessary? Full re-vaccinations? Perhaps. Perhaps not.
Further, if you've been exposed to HPV-6, then get vaccinated, you still get the benefit of resistance to HPV 16, 11 and 18. Further, Gardasil has made the claim that vaccination AFTER exposure MAY help prefent cellular abnormality over time that leads to cancer for strains of HPV the patient had already been exposed to.
If this proves to be true, wouldn't it be much more economic to vaccinate woman who come up positive for high-risk HPV strains?
We're talking about fairly small number of cases a year (and dropping by 4% every year consistantly WITHOUT the vaccine) compared to the entire body of women who've been exposed to HPV. The "surgical treatment", when caught early consists of a colposcopy is most cases - like the removal of a mole. It's a SIMPLE outpatient procedure. Not "fun", but certainly not something to get in a fret over.
I also completely disagree with you about it having a "lower social and economic cost" over time. The vaccine is JUST out of phase I studies. Just BEGINNING phase II. To make such predictions at this point is an excercise in obtuse guessing.
Most woman don't need a pap every year. Most can do with a pap every 2-4 years. At $10-$20 a pap, most woman would never generate enough revenue from PAPs to equal the cost of the vaccine.
Don't get me wrong, I'm not against the vaccine -- I'm against the request to make it MANDATORY. It's a HUGE expense right now without the benefit of further study.
Disclaimer: I've worked on a number of studies tracking HPV, CIN I, II & III as well as having written a number of custom queries for various LIS databases to pull data which will be part of the phase II studies (tracking vaccinated woman over time). I'm not an MD/PHD, but I work with them.
from cancer.gov:
and
We're talking about a HUGE expense ($400 a pop) x 100 million woman initially (that fit in to the age group in the US) -- then about $400 a pop x 2 million a year for all 11 year old girls. Compare that to the cost of making a $10-$20 pap available to the underserved and high-risk woman who would benefit from it.