True. You sound like you know what you're talking about.
But as BitterOak said, there are other applications. I go to medical conferences. I take notes and write reports. Very often, I record a 1-hour lecture and transcribe the whole thing. I've always dreamed about having a cheap stenography machine, which would give me a rough transcript right there, either from a qwerty keyboard or from a stenotype keyboard, like the stenographers I see at court hearings. I type 70wpm, and 180wpm would be all I need. If it would take me 200 hours to get up to 180wpm, the learning time would be justified.
Actually, I thought the market is expanding. There are federal requirements for closed captioning, and they won't be able to do that with machine transcription in the immediate future.
Another big market is medical transcription (although that's a little easier for DragonDictate, since the since one doctor can dictate a report after training DragonDictate on his own voice).
One thing that's shrinking is the pay. In the old days, court stenographers made more than some lawyers. But they didn't just get it from skill. First, they had to be on good terms with the judges who would assign that work. Second, they sold transcripts to the lawyers on both sides in big cases for exorbitant page fees ($2 a page in the 1980s). So the top stenographers could make $80,000 or $100,000 a year. It was a great life.
The real problem for stenographers now is price competition from India.
Chicago Public School teachers are paid between $50-97K, based on education and time in job, plus pension and healthcare benefits.
Since the average income of full-time workers with a master's degree is $62,000 http://www.census.gov/prod/200... , that doesn't seem unreasonable. I'm not one of those conservatives who wants to reduce everybody in the country except themselves to Wallmart wages. I want to live in a country in which I'm getting a good salary for a job well done and everybody else is getting a good salary for a job well done.
There seem to be different kinds of teachers -- some of them work hard to keep up in their field, and give their students the attention they need, and some of them don't.
I think good teachers deserve the money. The bad teachers don't. If they're bad teachers, they should be trained to improve. If they can't be trained to improve, they should be fired.
Take a science teacher. I know a lot of science teachers who read Science magazine every week to keep current with the field. I read Science magazine (most) every week just to keep current with biology, and it's a tough job. Imagine if I also had to keep up with physics. They go to science conferences and teaching conferences. They keep ahead of their kids with computers (no easy task). They help their students do science fair projects. Every so often, they have to learn an entirely new curriculum. That's a big job and they may need the summer just to catch up with their work.
Somebody is going to say, "Why do science teachers have to spend so much time preparing their courses? It's all done. They can just recite the textbook." That's a complete misunderstanding of what science teachers do. Teaching science isn't teaching revealed truth, like the Bible. Science teachers have to understand what's going on in the entire world of science, and then select the subset which is most appropriate for their students. When the Higgs boson was discovered, and kids were interested in it, science teachers had to prepare to teach what the Higgs boson was and its significance (I couldn't).
Just as important, teachers have to learn how to teach.
For example, there are certain topics that kids can understand at a certain age. If you go beyond what they can understand, they won't learn anything, and you'll bore them or confuse them and they'll be turned off on science completely.
For example, according to the science curriculum, molecules are too abstract for most middle-school kids. I was surprised at that, but it makes sense. Suppose you tell an 11-year-old kid, "There are things called molecules, that you can't see, that you can't verify experimentally, and you'll have to trust me that they exist, and here's an artist's impression of what they look like." That's not teaching science. That's memorization. You could say exactly the same thing about angels. You can't verify them experimentally either.
Understanding what and how to teach about science is a tough job. If a science teacher were doing a good job of educating my kids, I wouldn't resent him or her for getting $100,000 a year. How much is it worth to you to have a kid who understands science?
Some people are going to say, "My wife is a teacher and she works seven hours a day and gets the summer off, and forgets about work once she's outside the school door."
Sure, there are bad teachers, but how many? Look at the Vergara case, where the anti-union, anti-tenure and charter school advocates got their chance to argue that the schools were filled with incompetent tenured union-protected teachers. What was the best evidence they could come up with, and based on that, how many incompetent teachers were there?
A guess from an expert who, when pressed, said that there were 1-3% "at maximum" who were, not incompetent, but gave "cause for concern" http://www.slate.com/articles/...
http://www.kevinmd.com/blog/20... A virtual office visit for your cold is not a good idea Kevin Pho, MD | Kevin's Take | February 10, 2013
But something is lost through these virtual connections. There is value to face-to-face interaction, where a provider talks to and examines a patient in person. For example, I’ve seen a patient convinced that he had a sinus infection only to find that he had a tumor inside his nose. Another complained of minor ear pain, but after examining her, I saw that it had spread to the point where she needed to be hospitalized for intravenous antibiotics. Both of these diagnoses would have been missed had I only treated them over the Internet.
Without the ability to talk to and examine patients in the exam room, many doctors play it safe and reflexively prescribe drugs, whether patients need them or not. A recent study from the Journal of the American Medical Association http://www.medpagetoday.com/Pr... found that patients who were treated through Internet-based virtual visits had higher antibiotic prescription rates for their sinus infections, compared to patients whom were seen in the office.
That's actually Archives of Internal Medicine (now JAMA IM). "Physicians ordered fewer tests, but prescribed antibiotics more often, when they evaluated patients for sinusitis and urinary tract infections (UTIs) via Internet-based virtual office visits versus in-person visits, a study of four primary care practices showed," as MedPage Today put it. Mehrotra A, et al "A comparison of care at e-visits and physician offices visits for sinusitis and urinary tract infection" Arch Intern Med 2012; DOI:10.1001/2013/jamainternmed.305.
It's frustrating to see how they keep prescribing antibiotics for sinus infections. You can't do a quick strep test on Skype (not that a negative strep test will stop many inappropriate prescriptions for antibiotics). JAMA IM had 2 articles lately about patients who got inappropriate antibiotics for sinusitis, and went on to Clostridium difficile, one of them fatal. It's interesting to see the answers doctors give when you ask them, "Why are you giving me antibiotics for a viral infection?"
Oh, you wanted to know what I thought of the value of a physical examination. I told my doctor, "I want whatever the U.S. Preventive Services Task Force says I should have." I want him to follow the guidelines, whenever there are guidelines. You can't do a lot of the stuff in the guidelines over Skype.
I'm not sure that you can do much more on Skype than you can over the phone. And my doctor (and his covering doctors) are not willing to do much over the phone, I think not because of the money but because they don't feel confident diagnosing someone over the phone. I'd like to be able to discuss things over the phone, with the understanding that I'd follow up with an office visit when appropriate. But doctors don't do that.
Last time I went to the doctor, it was because some nurse on the phone told me that, based on my symptoms, I might have heart failure. (It was ridiculous.) So there you go: standard exam for heart failure. In addition to listening to my history, my doctor listened to my chest, observed my neck veins, and ordered blood and urine tests. You can't do that on Skype.
Skype sounds like a gimmick, which may be appropriate in rural Alaska or Africa, but not in developed countries. Typical American marketing: You can do something equally well with a simple, cheap phone call or a fancy hi-tech teleconference. Which do you do?
There were studies which found that telephone psychotherapy was as effective as in-person visits. I wouldn't be comfortable with that, but if they have good published evidence for it, I'll go along with it.
Please note that C. elegans has 959 cells in it. Humans have 100 billion neurons. We're still many, many orders of magnitude off from simulating the effect of drugs on a human body.
Costs in commercial labs are actually much higher than costs in university labs.
There was an article in the New England Journal of Medicine about the test for PKU.
It was first developed by some academic researchers, They made some prototype test kits, but they wanted it to be used as widely as possible, so they signed a distribution contract with a commercial company who presumably could do it more efficiently.
The commercial company had startup problems, so the academic researchers started distributing their own kits, in somebody's FDA-certified basement. I'm recalling from memory, so you'll have to check me, but they sold their kit for about $6.
Then the commercial company went into production. They sold their kit for $100. The PKU charities were very annoyed, because they had funded it and now it was unaffordable.
Anytime something is "publicly funded" the cost shoot up.
Which is why the Canadian health care system costs half of that in the US, and gets the same outcomes with high consumer satisfaction.
http://www.openmedicine.ca/art... Open Medicine, Vol 1, No 1 (2007) Home > Vol 1, No 1 (2007) > Guyatt Research A systematic review of studies comparing health outcomes in Canada and the United States
The VA health system and the National Institutes of Health already sponsor and pay for some of the biggest, best-designed and most important randomized controlled clinical trials.
They tend to be trials that answer questions doctors need answered, rather than the ammunition the drug companies need for FDA approval and marketing campaigns.
For example the VA studied a lot of drugs used in heart attacks, so that cardiologists would finally know which ones were effective. They compared prostate cancer drugs. They compared surgery for colon cancer and found out why some hospitals did better than others. In many specialties of medicine, the experts refer to "the VA study" which was the definitive word on a treatment. A lot of the VA studies find that the standard, expensive, dangerous treatment is ineffective.
There are a few drugs that drug companies are totally responsible for, but most drugs come from government-funded academic research.
http://www.sciencemag.org/cont... Science 18 July 2014: Vol. 345 no. 6194 pp. 252-257 DOI: 10.1126/science.345.6194.252 The elusive heart fix Jennifer Couzin-Frankel
“In mouse studies there's always dramatic improvement,” says Joseph Wu, a cardiologist studying stem cells at Stanford University in Palo Alto, California. “Once you go to a large animal study, it's moderate improvement, once you go to a phase I trial, it's decent improvement, and once you go to phase II, phase III, there's no improvement. This happens again and again and again. It's the entire field of biological research.”
"It is important to keep in mind that a large-scale provision of treatments and vaccines that are in very early stages of development has a series of scientific and ethical implications," the organization said in a statement.
Which means, we haven't figured (worked) out yet the costs and payment plans for this drug, so we aren't going to use it to help those people already suffering who otherwise have no chance of survival. Let's just say they are "expendable", in the name of commerce, of course.
If anyone believes that hogwash about ensuring safety and efficacy and yada yada...well the mighty dollar beats all that.
No, what it means is that if they inject somebody with a large therapeutic dose of a drug that has only been tested in mice, they're liable to have life-threatening adverse reactions, like anaphylactic shock from the mouse antibodies, and it's much easier to keep the adverse reactions from killing them in a state-of-the-art western hospital than it is in the field, where they have trouble maintaining refrigeration, and don't have x-ray machines (much less CAT scans), among many other problems.
I can't find the quote, but a researcher told Science that things work great in mice, well in monkeys, passably well in phase I trials, poorly in phase II trials, and not at all in phase III trials.
Actually, it's the pharmaceutical companies that want to speed up drug approvals in order to increase their profits, and the Clinton and Bush administrations gave them their wish. According to a few articles in the New England Journal of Medicine, every time the FDA sped up drug approvals, they wound up approving drugs that had fatal adverse effects and had to be withdrawn from the market, like that Merck COX inhibitor.
You can't make a baby in 1 month by getting 9 women pregnant.
Science magazine had a good article about the drugs being developed for Ebola. One drug, TKM-Ebola, is in Phase I trials, but the FDA put them on hold because they wanted to change the protocol to protect participants' safety.
One researcher, Erica Ollmann Saphire, said that, because of the high case fatality rate, if she were exposed to Ebola, "I'd run for the freezer and ask for forgiveness instead of permission." But in cases like this, they usually can get FDA permission, under compassionate use. One German researcher got a needlestick, and they rushed the VSV-vaccine to her. But those were individual cases, in western hospitals, and they can't give an untested drug to a population in Africa (although some American pharmaceutical companies have tried that, and it didn't go too well).
http://www.sciencemag.org/cont... Science 25 July 2014: Vol. 345 no. 6195 pp. 364-365 DOI: 10.1126/science.345.6195.364 Infectious Diseases Ebola drugs still stuck in lab Martin Enserink
For you suckers who are stuck behind the paywall, it had a good table that summed it all up:
VACCINES
VSV-based vaccines. Profectus BioSciences; Public Health Agency of Canada
Adenovirus-based vaccines. At least three different labs/companies
DRUGS
TKM-Ebola (RNAi-based). Tekmira Pharmaceuticals Corp. In phase I trials, but the FDA put a hold
Nucleoside analog. U.S.Army Medical Research Institute of Infectious Diseases
Monoclonal antibodies. Many labs/companies
AVI-7537 (antisense-based). Sarepta Therapeutics.
Everybody who does clinical research knows that most of the drugs that work great in mice, work reasonably well in monkeys, passably well in Phase I trials, poorly in Phase II trials, and not at all in Phase III trials.
There were a few articles in the New England Journal of Medicine on the FDA's fast track approvals. They found that when the FDA started speeding up drug approvals, they started approving more drugs with life-threatening side effects that had to be withdrawn from the market.
Of course, if you're dying of a disease now, the calculus is different.
Astonishing how backyard the USA in some aspects are. And also astonishing how retarded the democratic system is where every 'power' believes it can hinder any other 'power' by counter voting etc.
In germany something like this would simply be impossible.
For one thing, the parties in the German political system seems to have more cooperation and consensus than we do in the U.S. Republican party leaders actually said that their goal was to prevent Barak Obama, the Democrat, from accomplishing anything.
We have a strong political movement, which has taken over all of the Republican party and much of the Democratic party, which literally claims that government can't do anything right, and that we should abolish government services and lower taxes.
The rational (such as it is) motivation for this is that it would benefit the very wealthiest Americans, who have to pay more in taxes and benefit less from public services. Paul Krugman, the Nobel laureate economist, has explained this anti-tax and anti-government movement in his New York Times column.
So for example college can cost $25,000 a year, for four years. A German friend of mine told me that the German students were demonstrating in the streets when the German government tried to impose a $1,000 a year charge for college, and they backed down. I wish our college students were demonstrating in the streets.
One of the reasons we got needle exchange programs was that people with AIDS were very organized, and their activists were demonstrating in the streets.
For another thing, running for office in our elections are very expensive, and we allow millionaires and corporations to contribute money to political campaigns in a way that would be considered bribery in Germany.
The drug war itself in the U.S. has become a big business. It's a very good job to be a prosecutor, and it's very easy to prosecute people for drug offenses. It can actually be a criminal offense to possess hypodermic needles, and it's very easy for a cop to get a lot of arrests by searching drug users.
(BTW, there are some new drugs for HCV which work much better than interferon and ribavirin. They can cure it more than 90% of the time in 6 months. Unfortunately the manufacturers charge about $100,000 for that dose. https://en.wikipedia.org/wiki/... Another thing we don't have in the U.S. is that the government can't negotiate prices for drugs.)
And if one service offers an obstensibly cheaper price but has deficiencies that could actually cost you more money, result in tragedy, etc., how do you know that?
You can check independent review sites, such as yelp.
The medical journals and doctors' blogs have been paying a lot of attention to rating services like Yelp. Doctors complain that when they practice good medicine -- not giving antibiotics for a viral cold, which are useless and sometimes fatal -- patients post bad ratings about them on Yelp. Somebody wants a medical excuse for a handicapped sticker, and they don't give it to them -- they get bad ratings on Yelp. Patients want an immediate appointment on a busy day and have to wait an hour -- they get bad ratings on Yelp.
Even when people give honest opinions about legitimate issues, their ratings aren't accurate. Doctors who give good treatment get bad ratings, and vice versa. Researchers have studied this by having experts review the patient charts, and comparing the actual treatment to the patient's satisfaction rating. There's very little correlation.
Bad doctors often get good ratings. That's how they get by despite being bad doctors. The extreme case is one doctor who got convicted of murdering his elderly patients. It turned out that he had very good patient manners, and was very popular and beloved among his patients because he paid them so much attention and showed concern for their complaints.
And of course there are lots of "social media" companies that will log on to doctors' sites and leave positive ratings. (Although I think it's worse in the hotel industry.)
Look at any of our heavily regulated industries (Oil, Airlines, Medicine, Finance) and tell me how well that regulation is doing at averting tragedies and reducing the prices people pay?
Governments regulate an industry when the free market fails, usually with a disaster.
In medicine (just taking the drug industry), the drug companies had a pretty free hand to do whatever they wanted, until thalidomide. That was the tranquilizer that was promoted to pregnant women and resulted in a particular birth defect -- children born with short flippers instead of arms and legs. We came very close to selling thalidomide in the US, but an FDA examiner held it up.
There was no way you could evaluate a drug on the free market. Drug companies didn't have to do randomized, controlled trials, and they didn't have to report adverse effects. Their excuse was, "This drug is successful on the free market, so it must be good." It took a long time before people realized that this epidemic of flipper babies was caused by thalidomide, and drugs with more subtle adverse effects took even longer.
After many disasters, we finally got the political will to regulate the drug industry, and require them to do randomized, controlled trials and (only recently) report adverse effects. In a free market, you had no evidence on which to base a buying decision.
Re:The Free Market has the Technology Now
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The Great Taxi Upheaval
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So we see lots of innovations in unregulated industries like semiconductors and software, and little innovation in heavily regulated industries like plumbing.
Depends. There's a reason for regulation: the unregulated industry was ignoring public safety.
For example, when I bought my first car in 1960, I couldn't buy an American car with seat belts (and the American manufacturers dominated the American market). We had about 50,000 deaths a year from motor vehicle accidents, seat belts would have reduced them by about half, they were the most cost-efficient safety improvement, and yet the American automobile manufacturers refused to install them -- or to make any safety improvements. For documentation, read Ralph Nader's book, Unsafe at any Speed. Even some of the auto executives Nader interviewed couldn't figure out why. They continued to resist safety regulation until they lost a big product liability case, Larson vs. General Motors, which held them responsible for injuries due to unsafe products. Once they lost in the courts, they were willing to accept regulation. I used to deal with auto safety engineering a lot, and the U.S. regulators seemed to have done a good job. The free market didn't.
A contrary example would be the airline industry, one of the most innovative industries around. During WWII, the government subsidized aircraft design and production, and was its biggest customer. After the war, they wanted to develop a commercial aircraft industry. The problem was that flying wasn't that safe. Potential customers were worried that they would die in an aircraft accident, and everybody would say how reckless they were. The solution was industry-government cooperation, to develop safety standards. The Federal Aviation Administration established standards for licensing, for maintenance procedures, etc., and aircraft companies had both their own inspectors and government inspectors double-checking them. Sure enough, fatalities went down. They established a model system of safety management, which was adopted by other industries. Back then, government and industry cooperated.
In coal mining, some companies established rigorous safety procedures, while others didn't. The ones without safety procedures had more fatal accidents. Coal miners can't shop around for jobs. The free market failed. The government stepped in. There are many employers who were happy to let their workers die if they could save money. That's why we have OSHA.
What exactly is meant with 'needle exchange'!? the fact that drug abusers exchange needles amoung each others, or something different? And if the first is the case, how can anyone be 'wrong' about it?
Needle exchange programs give out clean needles and syringes to IV drug users, who give their used, dirty needles in exchange for safe disposal. In quantity, they cost about 5 cents apiece. I've talked to heroin addicts about them. They're very effective.
They've significantly reduced the spread of AIDS (and hepatitis C, which kills even more people than AIDS, and is more expensive) in programs around the US and the world. The evidence is overwhelming. Public health doctors have done a lot of research and published many medical journal articles about it. It was one of the most effective, and cost-effective, ways to prevent the spread of AIDS.
The federal government had funds allocated for preventing AIDS, but Congress prohibited them from using it for needle exchange programs, supposedly because they encouraged IV drug use. So most of the programs were funded by private organizations or local governments. Finally the evidence became overwhelming, and the federal government allowed funding for needle exchanges again. But just recently, I saw that the Republican congressmen had cut needle exchanges out of the budget again.
The prohibition on needle exchange programs is one of the classic examples of a stupid government policy that goes against overwhelming scientific evidence and medical advice, kills people, encourages the spread of AIDS (especially to newborns), and costs the government a huge amount of money.
Organizations, politians etc. usually don't fuck up in stuff like this.
Your question: how many.... my answer: ZERO. So how is it in your country? Care to give some examples where health organizations fucked up?
How many professionals have admitted that they fucked up? I've heard a few. One doctor admitted to me that he was wrong to oppose needle exchanges. I read medical journal articles every week in which doctors say, in effect, "We thought this would work, but this shows we were wrong."
The sign of a good scientist is that he's willing to admit it when he's wrong.
Do you really believe the USA governments health agency carries an US citizen into the US if it was not perfectly safe? In what paranoia 1984 world do you live?
Unfortunately the US Congress just voted to prohibit federal funds from going to needle exchange programs. They prohibited medical marijuana research even after AIDS patients found that it could stop them from dying from AIDS wasting syndrome (according to a lecture I heard from Don Abrams, who was treating them). Bill Clinton fired Joycelin Elders for saying that sex education courses should teach about masturbation. They prevented the graphic cigarette warnings which were so effective in Australia.
I've talked to government public health officials, and I've heard them deflect controversial questions. I can see them thinking, "If I told the truth, I'd get fired, and then I couldn't accomplish anything."
I'll probably get fired for saying this, but: America is not perfect.
It is well understood how ebola is transmitted and we have very well established containment protocols that we know work well.
Many of the victims of SARS were doctors and especially nurses, who were following the established protocols. They work well, but how reliably? 99%? 99.9%?
Actually there ARE some experimental treatments and antivirals, both general and specific to Ebola, being worked on. At Emory, in particular. (It's their business.)
In fact, according to previous reports, THIS GUY was working on them. And he had ONE dose of one of them WITH him.
Unfortunately, when he and a colleague both started showing symptoms, THIS GUY gave the ONE DOSE to the OTHER GUY.
Actually, the infected doctor, Kent Brantly, gave the treatment to another missionary, Nancy Writebol, and she's also being evacuated on that plane. http://www.washingtonpost.com/... They haven't announced what the treatment is, but it might have been IgG blood serum http://www.livescience.com/471... separated from the blood of one of the other victims. Or it might have been a new untested adenovirus vaccine, which works (on monkeys) even after they're infected. Or it might have been a monoclonal antibody. Or it might have been an experimental RNA virus. http://www.nature.com/news/ebo... I can't understand why they're keeping it a secret.
These untested treatments are all desperate measures. From what I've read in the New England Journal of Medicine clinical cases, these are the kind of treatments that they use when everything else fails, the patient is dying, they don't know what else to do, and there's nothing to lose.
As I understand it, the odds are against it, but they're the best doctors in the world, and I hope it works.
I also don't understand why they're bringing them to the U.S. The only treatment is supportive care. I think they also have planes that are set up with a transportable ICU, so they should be able to treat them on site.
There is a risk of the virus getting out, no matter how careful they are. They're doing this all for the first time. One problem is that handling a case like this is so complicated, and you only have to make one mistake. An ICU is full of equipment. Since ebola can't be treated, an epidemic spreads until it kills off so many of its victims that there's nobody left to infect, and it burns itself out.
With SARS, a lot of medical workers, particularly nurses, got infected, and they were a large number of the fatalities.
Your example doesn't provide evidence that Israel is fascist.
They're not literally fascist, in the sense of adopting a fascist economy, etc. They are fascist in the sense that demonstrators used to refer to the cops who beat them up at demonstrations as "fascist pigs," that is, they're being brutal to their political enemies just like the Nazis were. And indeed, the reports of Israeli human rights violations are uncomfortably similar to the descriptions of the Nazis.
That's not just one example. It's from the Goldstone report, and if you read the Goldstone report, or just search for "white flag", you'll find dozens of incidents just like that. And if you read the B'Tselem and Amnesty International reports, you'll find hundreds of incidents like that.
As for the water resources, I read a few articles about that in the New Scientist and elsewhere. You're absolutely right.
Because it is as accurate to claim that the Hamas Charter represents Hamas' unchangeable views as it is to claim 1 Samuel represents Jewish unchangeable views.
The Republican pollster Frank Luntz in his The Israel Project memo popularized the idea of promoting the Hamas Charter as the literal beliefs of Hamas today. If you read his memo you'll see he says that you shouldn't say things because they're true, but because they'll convince people. One of Luntz' students became an Israeli citizen and is now Israel's ambassador to the US.
Hamas has made repeated peace offers to Israel, and they've been repeatedly rejected. Ahmed Jabari was head of Hamas' military wing, had arranged the Giliad Shalat exchange, and was in charge of keeping the non-Hamas militant movements under control when Hamas was trying to keep a cease-fire with Israel. Jabari was working on a permanent peace agreement with Israel, and had just received the final draft, when the Israelis killed him with an air-to-surface missile in his car. That was no accident. The Israelis didn't want peace, because then they'd have to give up the settlements.
Quoting the Hamas Charter to prove that you can't make peace with Hamas is one of Luntz' strategies to avoid dealing with the facts. Luntz tells his clients that they should lie, and they do.
If that allegation is true is may constitute a war crime - if it is true and there are no mitigating factors. The truth of that allegation isn't clear, and it is completely unrelated to the organization of Israel's government.
The evidence shows major inconsistencies and contradictions in the Abed Rabbo incident. NGO Monitor, CAMERA , and other researchers have documented at least 14 significantly different versions of the story. NGOs have published 6 distinct accounts, and 8 others are from the media. The evolution of these accounts also suggests motivations for promoting allegations that may be far from the truth.
Oh come on. I used to work in Israeli public relations. I know what they're doing. I've talked to them on the phone and in person, and I went to their meetings. When I first started out, I actually believed in it myself.
NGO Monitor and CAMERA are propaganda organizations paid by the Israeli government and their American millionaire and billionaire pro-settler supporters, as you can see from their Wikipedia entry. They don't have any investigators on the ground. They don't talk to witnesses or go to the scene. Everything they do is second-hand and third-hand, from their offices in Morningside Heights or wherever they're working. They have never researched a case and concluded that Israel was wrong. Try to find one.
The Rabbio incident was investigated by many human rights groups and news media, who sent people to the scene to look it over and interview witnesses. It was investigated by the Goldstone commission. Goldstone was appointed because he had unimpeachable Zionist credentials, until he came to a conclusion that they didn't like. The Israeli government itself didn't even try to challenge the facts. It's as true as anything we can know without a criminal proceeding, and Israel refuses to investigate it themselves. You might as well say the truth of the Holocaust isn't clear.
I've talked to many Israeli government officials about human rights abuses and killings. Their consistent response is to deny it all. And I regularly caught them in lies. They would admit it and brush it off.
NGO Monitor and CAMERA do one thing that is so deceptive and misleading that I have to call it out. I've worked with lawyers (on matters that have nothing to do with Israel) and they taught me something about how they (and the police) do investigations and interview witnesses. The cross-examination textbooks say that if you interview 5 different people about an incident, you'll get 5 different versions, even if they're all trying to tell the truth. There are always inconsistencies and contradictions in truthful testimony.
In fact, the lawyers who do cross examination say that if you get different people giving you the same version without inconsistencies and contradictions, that's a sign that they got together and colluded on their testimony. So that's a sign they're lying.
NGO Monitor and CAMERA are taking evidence of the accuracy of their testimony and using it to make it seem that it's evidence of inaccuracy.
Slashdot Mirror
True. You sound like you know what you're talking about.
But as BitterOak said, there are other applications. I go to medical conferences. I take notes and write reports. Very often, I record a 1-hour lecture and transcribe the whole thing. I've always dreamed about having a cheap stenography machine, which would give me a rough transcript right there, either from a qwerty keyboard or from a stenotype keyboard, like the stenographers I see at court hearings. I type 70wpm, and 180wpm would be all I need. If it would take me 200 hours to get up to 180wpm, the learning time would be justified.
Actually, I thought the market is expanding. There are federal requirements for closed captioning, and they won't be able to do that with machine transcription in the immediate future.
Another big market is medical transcription (although that's a little easier for DragonDictate, since the since one doctor can dictate a report after training DragonDictate on his own voice).
One thing that's shrinking is the pay. In the old days, court stenographers made more than some lawyers. But they didn't just get it from skill. First, they had to be on good terms with the judges who would assign that work. Second, they sold transcripts to the lawyers on both sides in big cases for exorbitant page fees ($2 a page in the 1980s). So the top stenographers could make $80,000 or $100,000 a year. It was a great life.
The real problem for stenographers now is price competition from India.
Chicago Public School teachers are paid between $50-97K, based on education and time in job, plus pension and healthcare benefits.
Since the average income of full-time workers with a master's degree is $62,000 http://www.census.gov/prod/200... , that doesn't seem unreasonable. I'm not one of those conservatives who wants to reduce everybody in the country except themselves to Wallmart wages. I want to live in a country in which I'm getting a good salary for a job well done and everybody else is getting a good salary for a job well done.
There seem to be different kinds of teachers -- some of them work hard to keep up in their field, and give their students the attention they need, and some of them don't.
I think good teachers deserve the money. The bad teachers don't. If they're bad teachers, they should be trained to improve. If they can't be trained to improve, they should be fired.
Take a science teacher. I know a lot of science teachers who read Science magazine every week to keep current with the field. I read Science magazine (most) every week just to keep current with biology, and it's a tough job. Imagine if I also had to keep up with physics. They go to science conferences and teaching conferences. They keep ahead of their kids with computers (no easy task). They help their students do science fair projects. Every so often, they have to learn an entirely new curriculum. That's a big job and they may need the summer just to catch up with their work.
Somebody is going to say, "Why do science teachers have to spend so much time preparing their courses? It's all done. They can just recite the textbook." That's a complete misunderstanding of what science teachers do. Teaching science isn't teaching revealed truth, like the Bible. Science teachers have to understand what's going on in the entire world of science, and then select the subset which is most appropriate for their students. When the Higgs boson was discovered, and kids were interested in it, science teachers had to prepare to teach what the Higgs boson was and its significance (I couldn't).
Just as important, teachers have to learn how to teach.
For example, there are certain topics that kids can understand at a certain age. If you go beyond what they can understand, they won't learn anything, and you'll bore them or confuse them and they'll be turned off on science completely.
For example, according to the science curriculum, molecules are too abstract for most middle-school kids. I was surprised at that, but it makes sense. Suppose you tell an 11-year-old kid, "There are things called molecules, that you can't see, that you can't verify experimentally, and you'll have to trust me that they exist, and here's an artist's impression of what they look like." That's not teaching science. That's memorization. You could say exactly the same thing about angels. You can't verify them experimentally either.
Understanding what and how to teach about science is a tough job. If a science teacher were doing a good job of educating my kids, I wouldn't resent him or her for getting $100,000 a year. How much is it worth to you to have a kid who understands science?
Some people are going to say, "My wife is a teacher and she works seven hours a day and gets the summer off, and forgets about work once she's outside the school door."
Sure, there are bad teachers, but how many? Look at the Vergara case, where the anti-union, anti-tenure and charter school advocates got their chance to argue that the schools were filled with incompetent tenured union-protected teachers. What was the best evidence they could come up with, and based on that, how many incompetent teachers were there?
A guess from an expert who, when pressed, said that there were 1-3% "at maximum" who were, not incompetent, but gave "cause for concern" http://www.slate.com/articles/...
You are correct. Thanks for the citation.
Kevin Pho wrote about this on his blog.
http://www.kevinmd.com/blog/20...
A virtual office visit for your cold is not a good idea
Kevin Pho, MD | Kevin's Take | February 10, 2013
But something is lost through these virtual connections. There is value to face-to-face interaction, where a provider talks to and examines a patient in person. For example, I’ve seen a patient convinced that he had a sinus infection only to find that he had a tumor inside his nose. Another complained of minor ear pain, but after examining her, I saw that it had spread to the point where she needed to be hospitalized for intravenous antibiotics. Both of these diagnoses would have been missed had I only treated them over the Internet.
Without the ability to talk to and examine patients in the exam room, many doctors play it safe and reflexively prescribe drugs, whether patients need them or not. A recent study from the Journal of the American Medical Association http://www.medpagetoday.com/Pr... found that patients who were treated through Internet-based virtual visits had higher antibiotic prescription rates for their sinus infections, compared to patients whom were seen in the office.
That's actually Archives of Internal Medicine (now JAMA IM). :10.1001/2013/jamainternmed.305.
"Physicians ordered fewer tests, but prescribed antibiotics more often, when they evaluated patients for sinusitis and urinary tract infections (UTIs) via Internet-based virtual office visits versus in-person visits, a study of four primary care practices showed," as MedPage Today put it. Mehrotra A, et al "A comparison of care at e-visits and physician offices visits for sinusitis and urinary tract infection" Arch Intern Med 2012; DOI
It's frustrating to see how they keep prescribing antibiotics for sinus infections. You can't do a quick strep test on Skype (not that a negative strep test will stop many inappropriate prescriptions for antibiotics). JAMA IM had 2 articles lately about patients who got inappropriate antibiotics for sinusitis, and went on to Clostridium difficile, one of them fatal. It's interesting to see the answers doctors give when you ask them, "Why are you giving me antibiotics for a viral infection?"
Oh, you wanted to know what I thought of the value of a physical examination. I told my doctor, "I want whatever the U.S. Preventive Services Task Force says I should have." I want him to follow the guidelines, whenever there are guidelines. You can't do a lot of the stuff in the guidelines over Skype.
I'm not sure that you can do much more on Skype than you can over the phone. And my doctor (and his covering doctors) are not willing to do much over the phone, I think not because of the money but because they don't feel confident diagnosing someone over the phone. I'd like to be able to discuss things over the phone, with the understanding that I'd follow up with an office visit when appropriate. But doctors don't do that.
Last time I went to the doctor, it was because some nurse on the phone told me that, based on my symptoms, I might have heart failure. (It was ridiculous.) So there you go: standard exam for heart failure. In addition to listening to my history, my doctor listened to my chest, observed my neck veins, and ordered blood and urine tests. You can't do that on Skype.
Skype sounds like a gimmick, which may be appropriate in rural Alaska or Africa, but not in developed countries. Typical American marketing: You can do something equally well with a simple, cheap phone call or a fancy hi-tech teleconference. Which do you do?
There were studies which found that telephone psychotherapy was as effective as in-person visits. I wouldn't be comfortable with that, but if they have good published evidence for it, I'll go along with it.
Please note that C. elegans has 959 cells in it. Humans have 100 billion neurons. We're still many, many orders of magnitude off from simulating the effect of drugs on a human body.
Just 30,000 genes. How complicated can it be?
Fuck paywalls
Aaron Swartz lives.
Costs in commercial labs are actually much higher than costs in university labs.
There was an article in the New England Journal of Medicine about the test for PKU.
It was first developed by some academic researchers, They made some prototype test kits, but they wanted it to be used as widely as possible, so they signed a distribution contract with a commercial company who presumably could do it more efficiently.
The commercial company had startup problems, so the academic researchers started distributing their own kits, in somebody's FDA-certified basement. I'm recalling from memory, so you'll have to check me, but they sold their kit for about $6.
Then the commercial company went into production. They sold their kit for $100. The PKU charities were very annoyed, because they had funded it and now it was unaffordable.
Anytime something is "publicly funded" the cost shoot up.
Which is why the Canadian health care system costs half of that in the US, and gets the same outcomes with high consumer satisfaction.
http://www.openmedicine.ca/art...
Open Medicine, Vol 1, No 1 (2007)
Home > Vol 1, No 1 (2007) > Guyatt
Research
A systematic review of studies comparing health outcomes in Canada and the United States
set up publicly funded drug trials
The VA health system and the National Institutes of Health already sponsor and pay for some of the biggest, best-designed and most important randomized controlled clinical trials.
They tend to be trials that answer questions doctors need answered, rather than the ammunition the drug companies need for FDA approval and marketing campaigns.
For example the VA studied a lot of drugs used in heart attacks, so that cardiologists would finally know which ones were effective. They compared prostate cancer drugs. They compared surgery for colon cancer and found out why some hospitals did better than others. In many specialties of medicine, the experts refer to "the VA study" which was the definitive word on a treatment. A lot of the VA studies find that the standard, expensive, dangerous treatment is ineffective.
There are a few drugs that drug companies are totally responsible for, but most drugs come from government-funded academic research.
I found the quote:
http://www.sciencemag.org/cont...
Science 18 July 2014:
Vol. 345 no. 6194 pp. 252-257
DOI: 10.1126/science.345.6194.252
The elusive heart fix
Jennifer Couzin-Frankel
“In mouse studies there's always dramatic improvement,” says Joseph Wu, a cardiologist studying stem cells at Stanford University in Palo Alto, California. “Once you go to a large animal study, it's moderate improvement, once you go to a phase I trial, it's decent improvement, and once you go to phase II, phase III, there's no improvement. This happens again and again and again. It's the entire field of biological research.”
To quote TFA:
"It is important to keep in mind that a large-scale provision of treatments and vaccines that are in very early stages of development has a series of scientific and ethical implications," the organization said in a statement.
Which means, we haven't figured (worked) out yet the costs and payment plans for this drug, so we aren't going to use it to help those people already suffering who otherwise have no chance of survival. Let's just say they are "expendable", in the name of commerce, of course.
If anyone believes that hogwash about ensuring safety and efficacy and yada yada...well the mighty dollar beats all that.
No, what it means is that if they inject somebody with a large therapeutic dose of a drug that has only been tested in mice, they're liable to have life-threatening adverse reactions, like anaphylactic shock from the mouse antibodies, and it's much easier to keep the adverse reactions from killing them in a state-of-the-art western hospital than it is in the field, where they have trouble maintaining refrigeration, and don't have x-ray machines (much less CAT scans), among many other problems.
I can't find the quote, but a researcher told Science that things work great in mice, well in monkeys, passably well in phase I trials, poorly in phase II trials, and not at all in phase III trials.
Actually, it's the pharmaceutical companies that want to speed up drug approvals in order to increase their profits, and the Clinton and Bush administrations gave them their wish. According to a few articles in the New England Journal of Medicine, every time the FDA sped up drug approvals, they wound up approving drugs that had fatal adverse effects and had to be withdrawn from the market, like that Merck COX inhibitor.
You can't make a baby in 1 month by getting 9 women pregnant.
Science magazine had a good article about the drugs being developed for Ebola. One drug, TKM-Ebola, is in Phase I trials, but the FDA put them on hold because they wanted to change the protocol to protect participants' safety.
One researcher, Erica Ollmann Saphire, said that, because of the high case fatality rate, if she were exposed to Ebola, "I'd run for the freezer and ask for forgiveness instead of permission." But in cases like this, they usually can get FDA permission, under compassionate use. One German researcher got a needlestick, and they rushed the VSV-vaccine to her. But those were individual cases, in western hospitals, and they can't give an untested drug to a population in Africa (although some American pharmaceutical companies have tried that, and it didn't go too well).
http://www.sciencemag.org/cont...
Science 25 July 2014:
Vol. 345 no. 6195 pp. 364-365
DOI: 10.1126/science.345.6195.364
Infectious Diseases
Ebola drugs still stuck in lab
Martin Enserink
For you suckers who are stuck behind the paywall, it had a good table that summed it all up:
VACCINES
VSV-based vaccines. Profectus BioSciences; Public Health Agency of Canada
Adenovirus-based vaccines. At least three different labs/companies
DRUGS
TKM-Ebola (RNAi-based). Tekmira Pharmaceuticals Corp. In phase I trials, but the FDA put a hold
Nucleoside analog. U.S.Army Medical Research Institute of Infectious Diseases
Monoclonal antibodies. Many labs/companies
AVI-7537 (antisense-based). Sarepta Therapeutics.
Everybody who does clinical research knows that most of the drugs that work great in mice, work reasonably well in monkeys, passably well in Phase I trials, poorly in Phase II trials, and not at all in Phase III trials.
There were a few articles in the New England Journal of Medicine on the FDA's fast track approvals. They found that when the FDA started speeding up drug approvals, they started approving more drugs with life-threatening side effects that had to be withdrawn from the market.
Of course, if you're dying of a disease now, the calculus is different.
Astonishing how backyard the USA in some aspects are.
And also astonishing how retarded the democratic system is where every 'power' believes it can hinder any other 'power' by counter voting etc.
In germany something like this would simply be impossible.
For one thing, the parties in the German political system seems to have more cooperation and consensus than we do in the U.S. Republican party leaders actually said that their goal was to prevent Barak Obama, the Democrat, from accomplishing anything.
We have a strong political movement, which has taken over all of the Republican party and much of the Democratic party, which literally claims that government can't do anything right, and that we should abolish government services and lower taxes.
The rational (such as it is) motivation for this is that it would benefit the very wealthiest Americans, who have to pay more in taxes and benefit less from public services. Paul Krugman, the Nobel laureate economist, has explained this anti-tax and anti-government movement in his New York Times column.
So for example college can cost $25,000 a year, for four years. A German friend of mine told me that the German students were demonstrating in the streets when the German government tried to impose a $1,000 a year charge for college, and they backed down. I wish our college students were demonstrating in the streets.
One of the reasons we got needle exchange programs was that people with AIDS were very organized, and their activists were demonstrating in the streets.
For another thing, running for office in our elections are very expensive, and we allow millionaires and corporations to contribute money to political campaigns in a way that would be considered bribery in Germany.
The drug war itself in the U.S. has become a big business. It's a very good job to be a prosecutor, and it's very easy to prosecute people for drug offenses. It can actually be a criminal offense to possess hypodermic needles, and it's very easy for a cop to get a lot of arrests by searching drug users.
(BTW, there are some new drugs for HCV which work much better than interferon and ribavirin. They can cure it more than 90% of the time in 6 months. Unfortunately the manufacturers charge about $100,000 for that dose. https://en.wikipedia.org/wiki/... Another thing we don't have in the U.S. is that the government can't negotiate prices for drugs.)
And if one service offers an obstensibly cheaper price but has deficiencies that could actually cost you more money, result in tragedy, etc., how do you know that?
You can check independent review sites, such as yelp.
The medical journals and doctors' blogs have been paying a lot of attention to rating services like Yelp. Doctors complain that when they practice good medicine -- not giving antibiotics for a viral cold, which are useless and sometimes fatal -- patients post bad ratings about them on Yelp. Somebody wants a medical excuse for a handicapped sticker, and they don't give it to them -- they get bad ratings on Yelp. Patients want an immediate appointment on a busy day and have to wait an hour -- they get bad ratings on Yelp.
Even when people give honest opinions about legitimate issues, their ratings aren't accurate. Doctors who give good treatment get bad ratings, and vice versa. Researchers have studied this by having experts review the patient charts, and comparing the actual treatment to the patient's satisfaction rating. There's very little correlation.
Bad doctors often get good ratings. That's how they get by despite being bad doctors. The extreme case is one doctor who got convicted of murdering his elderly patients. It turned out that he had very good patient manners, and was very popular and beloved among his patients because he paid them so much attention and showed concern for their complaints.
And of course there are lots of "social media" companies that will log on to doctors' sites and leave positive ratings. (Although I think it's worse in the hotel industry.)
Look at any of our heavily regulated industries (Oil, Airlines, Medicine, Finance) and tell me how well that regulation is doing at averting tragedies and reducing the prices people pay?
Governments regulate an industry when the free market fails, usually with a disaster.
In medicine (just taking the drug industry), the drug companies had a pretty free hand to do whatever they wanted, until thalidomide. That was the tranquilizer that was promoted to pregnant women and resulted in a particular birth defect -- children born with short flippers instead of arms and legs. We came very close to selling thalidomide in the US, but an FDA examiner held it up.
There was no way you could evaluate a drug on the free market. Drug companies didn't have to do randomized, controlled trials, and they didn't have to report adverse effects. Their excuse was, "This drug is successful on the free market, so it must be good." It took a long time before people realized that this epidemic of flipper babies was caused by thalidomide, and drugs with more subtle adverse effects took even longer.
After many disasters, we finally got the political will to regulate the drug industry, and require them to do randomized, controlled trials and (only recently) report adverse effects. In a free market, you had no evidence on which to base a buying decision.
So we see lots of innovations in unregulated industries like semiconductors and software, and little innovation in heavily regulated industries like plumbing.
Depends. There's a reason for regulation: the unregulated industry was ignoring public safety.
For example, when I bought my first car in 1960, I couldn't buy an American car with seat belts (and the American manufacturers dominated the American market). We had about 50,000 deaths a year from motor vehicle accidents, seat belts would have reduced them by about half, they were the most cost-efficient safety improvement, and yet the American automobile manufacturers refused to install them -- or to make any safety improvements. For documentation, read Ralph Nader's book, Unsafe at any Speed. Even some of the auto executives Nader interviewed couldn't figure out why. They continued to resist safety regulation until they lost a big product liability case, Larson vs. General Motors, which held them responsible for injuries due to unsafe products. Once they lost in the courts, they were willing to accept regulation. I used to deal with auto safety engineering a lot, and the U.S. regulators seemed to have done a good job. The free market didn't.
A contrary example would be the airline industry, one of the most innovative industries around. During WWII, the government subsidized aircraft design and production, and was its biggest customer. After the war, they wanted to develop a commercial aircraft industry. The problem was that flying wasn't that safe. Potential customers were worried that they would die in an aircraft accident, and everybody would say how reckless they were. The solution was industry-government cooperation, to develop safety standards. The Federal Aviation Administration established standards for licensing, for maintenance procedures, etc., and aircraft companies had both their own inspectors and government inspectors double-checking them. Sure enough, fatalities went down. They established a model system of safety management, which was adopted by other industries. Back then, government and industry cooperated.
In coal mining, some companies established rigorous safety procedures, while others didn't. The ones without safety procedures had more fatal accidents. Coal miners can't shop around for jobs. The free market failed. The government stepped in. There are many employers who were happy to let their workers die if they could save money. That's why we have OSHA.
Regulation is the sign of a failed free market.
What exactly is meant with 'needle exchange'!? the fact that drug abusers exchange needles amoung each others, or something different?
And if the first is the case, how can anyone be 'wrong' about it?
Needle exchange programs give out clean needles and syringes to IV drug users, who give their used, dirty needles in exchange for safe disposal. In quantity, they cost about 5 cents apiece. I've talked to heroin addicts about them. They're very effective.
They've significantly reduced the spread of AIDS (and hepatitis C, which kills even more people than AIDS, and is more expensive) in programs around the US and the world. The evidence is overwhelming. Public health doctors have done a lot of research and published many medical journal articles about it. It was one of the most effective, and cost-effective, ways to prevent the spread of AIDS.
The federal government had funds allocated for preventing AIDS, but Congress prohibited them from using it for needle exchange programs, supposedly because they encouraged IV drug use. So most of the programs were funded by private organizations or local governments. Finally the evidence became overwhelming, and the federal government allowed funding for needle exchanges again. But just recently, I saw that the Republican congressmen had cut needle exchanges out of the budget again.
The prohibition on needle exchange programs is one of the classic examples of a stupid government policy that goes against overwhelming scientific evidence and medical advice, kills people, encourages the spread of AIDS (especially to newborns), and costs the government a huge amount of money.
Every single slashdotter is an expert in infectious diseases. Guess I should edumicate myself with some more Tom Clancy novels to get up to speed.
Actually, a surprising number of Slashdotters are experts in infectious diseases. Maybe you should get up to speed with Nature.
The aircraft was specially outfitted for this type of scenario. You can't compare this to a scheduled flight on a commercial airliner.
OTOH this is a rare event. It's not something they do every day, with long experience about how things can go wrong.
Organizations, politians etc. usually don't fuck up in stuff like this.
Your question: how many .... my answer: ZERO.
So how is it in your country? Care to give some examples where health organizations fucked up?
How many professionals have admitted that they fucked up? I've heard a few. One doctor admitted to me that he was wrong to oppose needle exchanges. I read medical journal articles every week in which doctors say, in effect, "We thought this would work, but this shows we were wrong."
The sign of a good scientist is that he's willing to admit it when he's wrong.
Do you really believe the USA governments health agency carries an US citizen into the US if it was not perfectly safe? In what paranoia 1984 world do you live?
Unfortunately the US Congress just voted to prohibit federal funds from going to needle exchange programs. They prohibited medical marijuana research even after AIDS patients found that it could stop them from dying from AIDS wasting syndrome (according to a lecture I heard from Don Abrams, who was treating them). Bill Clinton fired Joycelin Elders for saying that sex education courses should teach about masturbation. They prevented the graphic cigarette warnings which were so effective in Australia.
I've talked to government public health officials, and I've heard them deflect controversial questions. I can see them thinking, "If I told the truth, I'd get fired, and then I couldn't accomplish anything."
I'll probably get fired for saying this, but: America is not perfect.
It is well understood how ebola is transmitted and we have very well established containment protocols that we know work well.
Many of the victims of SARS were doctors and especially nurses, who were following the established protocols. They work well, but how reliably? 99%? 99.9%?
Actually there ARE some experimental treatments and antivirals, both general and specific to Ebola, being worked on. At Emory, in particular. (It's their business.)
In fact, according to previous reports, THIS GUY was working on them. And he had ONE dose of one of them WITH him.
Unfortunately, when he and a colleague both started showing symptoms, THIS GUY gave the ONE DOSE to the OTHER GUY.
Actually, the infected doctor, Kent Brantly, gave the treatment to another missionary, Nancy Writebol, and she's also being evacuated on that plane. http://www.washingtonpost.com/... They haven't announced what the treatment is, but it might have been IgG blood serum http://www.livescience.com/471... separated from the blood of one of the other victims. Or it might have been a new untested adenovirus vaccine, which works (on monkeys) even after they're infected. Or it might have been a monoclonal antibody. Or it might have been an experimental RNA virus. http://www.nature.com/news/ebo... I can't understand why they're keeping it a secret.
These untested treatments are all desperate measures. From what I've read in the New England Journal of Medicine clinical cases, these are the kind of treatments that they use when everything else fails, the patient is dying, they don't know what else to do, and there's nothing to lose.
As I understand it, the odds are against it, but they're the best doctors in the world, and I hope it works.
I also don't understand why they're bringing them to the U.S. The only treatment is supportive care. I think they also have planes that are set up with a transportable ICU, so they should be able to treat them on site.
There is a risk of the virus getting out, no matter how careful they are. They're doing this all for the first time. One problem is that handling a case like this is so complicated, and you only have to make one mistake. An ICU is full of equipment. Since ebola can't be treated, an epidemic spreads until it kills off so many of its victims that there's nobody left to infect, and it burns itself out.
With SARS, a lot of medical workers, particularly nurses, got infected, and they were a large number of the fatalities.
Your example doesn't provide evidence that Israel is fascist.
They're not literally fascist, in the sense of adopting a fascist economy, etc. They are fascist in the sense that demonstrators used to refer to the cops who beat them up at demonstrations as "fascist pigs," that is, they're being brutal to their political enemies just like the Nazis were. And indeed, the reports of Israeli human rights violations are uncomfortably similar to the descriptions of the Nazis.
That's not just one example. It's from the Goldstone report, and if you read the Goldstone report, or just search for "white flag", you'll find dozens of incidents just like that. And if you read the B'Tselem and Amnesty International reports, you'll find hundreds of incidents like that.
As for the water resources, I read a few articles about that in the New Scientist and elsewhere. You're absolutely right.
Because it is as accurate to claim that the Hamas Charter represents Hamas' unchangeable views as it is to claim 1 Samuel represents Jewish unchangeable views.
The Republican pollster Frank Luntz in his The Israel Project memo popularized the idea of promoting the Hamas Charter as the literal beliefs of Hamas today. If you read his memo you'll see he says that you shouldn't say things because they're true, but because they'll convince people. One of Luntz' students became an Israeli citizen and is now Israel's ambassador to the US.
Hamas has made repeated peace offers to Israel, and they've been repeatedly rejected. Ahmed Jabari was head of Hamas' military wing, had arranged the Giliad Shalat exchange, and was in charge of keeping the non-Hamas militant movements under control when Hamas was trying to keep a cease-fire with Israel. Jabari was working on a permanent peace agreement with Israel, and had just received the final draft, when the Israelis killed him with an air-to-surface missile in his car. That was no accident. The Israelis didn't want peace, because then they'd have to give up the settlements.
Quoting the Hamas Charter to prove that you can't make peace with Hamas is one of Luntz' strategies to avoid dealing with the facts. Luntz tells his clients that they should lie, and they do.
If that allegation is true is may constitute a war crime - if it is true and there are no mitigating factors. The truth of that allegation isn't clear, and it is completely unrelated to the organization of Israel's government.
The evidence shows major inconsistencies and contradictions in the Abed Rabbo incident. NGO Monitor, CAMERA , and other researchers have documented at least 14 significantly different versions of the story. NGOs have published 6 distinct accounts, and 8 others are from the media. The evolution of these accounts also suggests motivations for promoting allegations that may be far from the truth.
Oh come on. I used to work in Israeli public relations. I know what they're doing. I've talked to them on the phone and in person, and I went to their meetings. When I first started out, I actually believed in it myself.
NGO Monitor and CAMERA are propaganda organizations paid by the Israeli government and their American millionaire and billionaire pro-settler supporters, as you can see from their Wikipedia entry. They don't have any investigators on the ground. They don't talk to witnesses or go to the scene. Everything they do is second-hand and third-hand, from their offices in Morningside Heights or wherever they're working. They have never researched a case and concluded that Israel was wrong. Try to find one.
The Rabbio incident was investigated by many human rights groups and news media, who sent people to the scene to look it over and interview witnesses. It was investigated by the Goldstone commission. Goldstone was appointed because he had unimpeachable Zionist credentials, until he came to a conclusion that they didn't like. The Israeli government itself didn't even try to challenge the facts. It's as true as anything we can know without a criminal proceeding, and Israel refuses to investigate it themselves. You might as well say the truth of the Holocaust isn't clear.
I've talked to many Israeli government officials about human rights abuses and killings. Their consistent response is to deny it all. And I regularly caught them in lies. They would admit it and brush it off.
NGO Monitor and CAMERA do one thing that is so deceptive and misleading that I have to call it out. I've worked with lawyers (on matters that have nothing to do with Israel) and they taught me something about how they (and the police) do investigations and interview witnesses. The cross-examination textbooks say that if you interview 5 different people about an incident, you'll get 5 different versions, even if they're all trying to tell the truth. There are always inconsistencies and contradictions in truthful testimony.
In fact, the lawyers who do cross examination say that if you get different people giving you the same version without inconsistencies and contradictions, that's a sign that they got together and colluded on their testimony. So that's a sign they're lying.
NGO Monitor and CAMERA are taking evidence of the accuracy of their testimony and using it to make it seem that it's evidence of inaccuracy.