I’ve had a few more thoughts about the recommendations of the USPSTF recommendations since my last post. Suspicious thoughts. One’s I thought I’d share.
One of the centerpieces of the current health care reform debate is the idea that there’s a need to be more efficient and effective in our use of health care resources. That there is a need to assess what works and what doesn’t in order to minimize costs. And to have a more universal approach to treatments. (What we have now varies widely depending on where you live). Sounds like practical advice for the most part. But out of this idea came the idiotic notion that there would be “death panels” deciding who gets care and who doesn’t at the end of life. This idea has thankfully largely been debunked.
Now we have a panel that seems to have done this effectiveness analysis on another level. They looked at the data regarding routine mammograms as a tool for detecting breast cancer (not as a diagnostic tool) vs the risk from radiation. Apparently they believe that statistically it’s a wash and therefor not worth the risk.
Considering only raw numbers and statistics I can possibly see how they’ve come to this conclusion. What strikes me is there’s an interesting and rather obvious parallel here. Looking at health this way is exactly what insurance companies do. Raw numbers, bottom line, statistics – that’s how they make their decisions.
So we have here a government panel looking a lot like an insurance company. And we have a great deal of outrage generated by the advice of this panel. I then begin to question motives in the timing of the release of these recommendations – coming right when the health care reform debate is peaking. Is this a ploy to manufacture outrage against health care reform? Is it to provide ammunition for those who want to say “see, you don’t want big bad government interfering with medicine”? I don’t know about you but it seems awfully strange timing to me.
Posted in: Politics, Society.
Tagged: healthcare
Through the busyness of my day today I caught wind of the latest report by a group of doctors called the US Preventative Services Task Force (USPSTF). I’m all for improving health care by encouraging better preventive care. Good, well rounded preventative care will keep us all healthier. But the decisions of this group are indeed quite puzzling. Beyond puzzling. They’ve gotten me so incensed that I’m firing off this hastily written post. In case you haven’t heard yet this panel has reversed an earlier recommendation, by the same group (but with different members), and now don’t think women between the ages of 40-49 should routinely get mammograms to screen for breast cancer. The key word here is “routinely”. The don’t flat out say no one in this age group should get them, just that the risk vs benefits should be a conversation between the woman and her doctor and a decision made from that point. Shouldn’t ALL of us be having thoughtful conversations with out medical providers about a whole host of risk vs benefit situations? Isn’t that a sound place to begin taking better care of ourselves? That conversation isn’t the problem. What I see as a huge potential problem is now women and their doctors may face additional battles when it comes to paying for these mammograms. And coming at a time when the country is hashing out the details of health care reform makes me all that more suspicious of the motivation behind these recommendations. If you can’t see the potential problems with insurance companies and these recommendations then you’re rather blind to how insurance companies are working these days. Oh, they might not make changes right away – they’ll wait until the news of these recommendations has left the media news cycle before they do that.
Aside from the issue of mammograms I find another recommendation of the panel even more startling and disturbing. Unbelievably they don’t think doctors should be teaching their patients about regular self breast exams. Apparently they’re worried about the poor widdle women having anxiety if they find something. Excuse me?!?! Anxiety? You’ve got to be kidding me! How about educating women that breast cancer is quite survivable especially when detected early. Or teaching them that just because you’ve discovered a lump it doesn’t even mean you have cancer for goodness sakes. That would go a very long way to reducing anxiety. And I’d sure as hell rather be anxious than dead. Hell, why not teach patients how to deal with anxiety. And I’m not talking about prescribing another little “fix me” pill. I’m talking about proven stress reduction techniques. How about treating women as the intelligent adults we are?
This recommendation is so outrageous I’d almost go as far as to think that this borders on gendercide. I know, that’s taking it a bit too far considering the statistics but come on, why in the world should doctors be encouraged to have their female patients know LESS about their bodies? Unless perhaps if you know less about your body you’re less apt to ask intelligent questions of your doctor and more inclined to buy something from big daddy pharma to fix your problems.
Guess what? I don’t give a frak what this panel says about breast exams I intend to continue to be well acquainted with the look and feel of my breasts. Hell I may even continue to enlist the help of others in keeping track of any changes. I encourage every woman reading this to do the same and every man to encourage every woman they know to do the same too – and to teach your children about the importance of being well acquainted with their own bodies. And you, my not so esteemed panel of “experts”, ought to be downright ashamed of discouraging self knowledge. How the hell is that “preventative” medicine? How do you explain violating your oath of “do no harm”?
The next thing I’m curious about is what they’ll have to say about testicular cancer.
Posted in: Politics, Society.
Tagged: rants
Pardon me folks while I take a mintue to post a rant at Apple this morning.
What the hell were you thinking Apple??? Putting controls to the new teeny tiny shuffle on propritary earbuds? Earbuds that hurt my ears, fall out of my ears at the slightest move, have inferior sound quality, and just plain suck. You’ve got to be kidding! I have several ipods and I can’t remember the last time I used your crappy headphones with any of them. Now you’ve rolled out a product that will have half of it’s features unavailable to me if I use my regular headphones (Etymotic ER6i) Give me an effing break. I sure as hell hope you don’t intend to make this stupid moves like this on other ipod products in the future. Take a good hard look at your development process and reconnect it with the users of your products. I’m betting there are thousand and thousands of us out there that can’t stand your crappy earbuds. I’ve used macs for years and while not a rabid fanboy I do prefer most of your products. More moves like this one and I’ll start to rail loud and long against you.
Posted in: Computers, Reviews.
The other day it occurred to me that we are experiencing a giant collective case of the breakup blues. I’m not just talking about the banks and businesses that are breaking up. I’m talking about our relationship with the world as we knew it that got up and walked out the door sometime last September.
We can pine all we want for it. We can try to devise plans to woo it back but it’s moved on and wants nothing to do with the way we were. And we’re all in the throes of the breakup blues, not quite knowing what to do next. All of the familiar habits that come with long-term relationships are fractured or missing entirely.
We don’t quite know what to do without the cozy comfort of a consumer society. It was always there to make us feel better about who we were by offering us up the latest whatnot or whatzit. And we’ve yet to come to grips with the idea that we were in love with something that instead of truly loving us back was merely buying us off to distract us from the underlying issues in our relationship.
We’re like a teenager who falls for the cheerleader or the jock not because of who they are but because of an idea of what they’ll make us – more popular, more beautiful, more accepted. We are now learning those relationships can’t be sustained. And what we need to learn how to do is how to build a relationship with the world around us that brings out the best in both of us.
We need to stop waiting around for that call from a former lover that will never come and pick ourselves up and move on. We also need to be patient as we’re learning how to grow up.
Posted in: Musings, Society.
Once again I have recognized how difficult it is to consistently maintain a blog. And here I am writing a rather indulgent piece on “oh poor me, this is sooo hard”. I realize that I don’t have to do this at all. Having a blog is not a necessary element of my life by any means. And you the reader certainly have better things to do than listen to me whine about not knowing what to write. (oooops, there I go making the cardinal mistake of chasing away my potential audience). If you will indulge me for just a bit I hope I won’t disappoint you with this entry and I think you’ll find something worthwhile by the time it’s finished.
The trickiest thing about keeping a blog like this is figuring out what shape it wants to be. As some would say it’s the challenge of “finding my voice”. And I suppose that search is exactly why I’m interested in keeping a blog like this to begin with. I’m not a professional writer but I do seem to have at least somewhat of a facility with words and it’s a skill I’m interested in honing. My hope, as is the hope of any writer, is that there will be some who find reading what I write worthwhile.
As I play with the form in front of me I’ve spent some time considering what kinds of blogs are out there already and whether I could or even want to write in those veins. In the process I’ve learned what I do not want to do. I don’t want to merely use this space and your time to regurgitate the writings of others by having a long list of links to other blog postings that catch my eye. Though I may choose to do this from time to time. I don’t want to create yet another space on the net for snarky cultural commentary. Snarkiness has it’s place, but not in my brain. I’m not naturally snarky and I don’t particularly care to learn how to be more cynical. These days I have a hard enough time fighting off creeping cynicism as it is. I don’t have the technical expertise to turn this into a critique of gadgetry nor do I have the right connections turn this into a tome of political analysis and I’m not a mommy so I can’t sit here and write about the trials and tribulations of motherhood. Finally, the net does not need yet another blog about GTD/Productivity/Lifehacks. Lord knows I have too much to learn in those catagories to be spouting advice about it.
One of the skills I do have is that I’m good at, and enjoy, observing the world around us and asking questions. I must’ve been a student of Socrates in another lifetime. I hope by sharing my observations and raising questions that every now and then at least I’ll be able to get you to consider, if even for a moment, another perspective on the world we share. There’s a part of me that’s a sculptor at heart and as such appreciates the need to look at things from a variety of angles to build an accurate model, even if that model is purely imaginary.
Posted in: miscellaneous.
A week or so ago, as I surfed around the web, I noticed something strange seemed to be happening with marriage around the world. There was an odd vortex of reports that made me question what was up in the world of marriage.
First we have this report from MSNBC where a California man was arrested for trying to sell his 14-year-old daughter into marriage in exchange for a large quantity of liquor and some cases of meat and Gatorade. Unbelievably the man called the police himself when the promised payment for his child was not delivered. (hmmm I wonder if Gatorade will use this bit of free publicity in a future commercial?)
Next in a report from CNN I read about how a major religious leader in Saudi Arabia reaffirms that it’s actually ok for parents to marry off girls as young as eight years old and that those who object are actually being unfair to the child in question. Now I realize that other cultures have different standards but I just can’t wrap my brain around the concept that turning a child into a piece of property is unfair to the child. The idea that to refuse these marriages would cause the child to “lose their sense of security and safety [and that] it destroys their feeling of being loved and nurtured. It causes them a lifetime of psychological problems and severe depression.” makes sense only if you’ve constructed a world view in which women are inherently fragile and men are inherently predatory and thus females cannot survive outside the enclosures constructed by men. If you study history at all it’s evident that this hypothesis is dead wrong.
And finally, to cap off this strange week I read an article from the Times of India where in order to prevent the spread of mysterious diseases two young girls were married to frogs. You read that right, in a full religious ceremony they were married to frogs. At least now I know where the fairytale of the frog prince probably originated.
Now, could somebody please explain to me how allowing two loving members of the same sex to marry is a threat to the sanctity of marriage?
Posted in: Musings, Society.
I’ve watched a fair number of inaugurations in my life so far. Sometimes I’ve been excited, sometimes watched with dread. But I don’t know if I’ve ever been so deeply moved as today.
It’s not because he’s black, although I recognize and honor that fact.
It’s not because he’s not Bush, although the relief I and many others feel about that fact is immense.
It’s because he begins with gratitude and because he places the responsibility squarely on the shoulders of each and every one of us. No one person can make the changes these times require. But one can lead the way. And one can reminds us all once again how to hope.
Posted in: Musings, Politics, Society.
Sitting here starting to watch the events leading up to the inauguration of Barack Obama I find myself overwhelmed by what I’m witnessing. Words are hard to find to describe this. Just now a thought sums it all up…
On the morning of September 11, 2001 the world changed in an instant.
On the morning of January 20, 2009 it will change again.
Fill your lungs with the fresh air of this change and make it your own. It belongs to all of us - as does the work ahead.
Posted in: Musings, Politics, Society.
One of the sessions I attended at this years Mac Expo was “Maintaining Your Mac” and was offered by Joe Kissel. I found it to be useful and I took some notes so I thought I’d take some time to summarize what I learned add my own insights and pass it on.
Tips to keep your mac running well…
OS and Application Updates
- Make sure you’re running the latest OS available for your machine. Updates often fix bug/holes/problems. My own caveat to this is to wait a day or more before installing the latest and greatest updates. There have been a few times when these updates have caused major problems so I’ll let the early adopters flush those out and once they’ve proven reasonably safe I’ll run software update. This is also why I never run software update automatically. You can change the settings for software update in the system preferences panel. To see if there have been any major issues with an update I usually check out the MacFixit website. They’ve proven to be reliable in the past.
- The parallel to making sure your OS is current is to make sure your applications are current. Again I’m not an early adopter of application updates most of the time. This is an area where I’ll wait even longer if the application is crucial to the work I do. For example I’ve never updated Quicken past the 2006 version and from reading the complaints on the Intuit website I’m very happy I never have. On the other hand I’ve recently paid for an upgrade to Adobe Lightroom 2 and couldn’t be happier. My advice would be to have an installation path for an older version of a program available whether it be on disc or dmg or backup. This way if an update causes problems you can revert to a previous version. Before updating make sure any important data is backed up as well before upgrades. More on backing up later.
- Joe recommended a widget called App Update to check on what programs might have updates available. It sounds good but since I haven’t actually used it myself I’ll refrain from recommending it myself.
- Removing applications isn’t always straightforward. If all you do is drag them to the trash they can leave little bits and pieces behind in places like Library folders. The simple solution to this is to use a nifty little program called AppZapper. Simply drop the application you want to delete in to the AppZapper window and it does the rest.
Backup BackUp BACKUP
Here’s a biggie. Set Up A Backup System. You’ve heard it before and you’ll hear it again but believe me having one and using it can save yourself a ton of trouble. I have to admit I need improvement in this area myself. Maybe writing this entry will inspire me to do more. The way I see it there are several components to a good backup system.
- A bootable duplicate of your OS and applications
- Archives for data
- Offsite backups
A bootable backup of your OS and applications will make reinstallation via Migration assistant a breeze in case of a major meltdown. This is also the kind of thing that won’t need updating very often unless you alter your OS or applications.
Archives for data need to be done more often as this involves your most current work, whatever it may be. These backups are generally what’s known as incremental. After running your first backup they are for backing up only new data/documents along with any that have changes. Remember to include your mail folder in this backup as it is often separate from where you keep your documents/files. Having a consistent way of storing and organizing your work as you go will make archiving easier as well.
Offsite backup is an aspect of a through backup program that often gets overlooked. In many ways it’s the ultimate insurance policy in case of major physical damage such as fire, flood, theft etc. Imagine you were on the plane that just went down in the Hudson River. Your laptop is toast along with everything on it. So are the external hard drives you carried with you for backup. An offsite backup will get you back up to speed in no time and will be one less thing to worry about. An offsite backup could be hard drives stored at a the house of a friend or family, placed in a safety deposit box. Or you could use an internet backup system such as mobileme.com (formerly .mac), Mozy, CrashPlan, or BackBlaze. Disclaimer, I have not used any of these internet backups so I cannot vouch for them. They were recommended to me in this workshop and I do know others that use them. Do your own homework so that you take responsibility for your own backups. The important thing is to have one.
Weekly
- Clean off your desktop. The reason this is important is the more icons on your desk the more RAM is used to keep track of them. The OS sees each icon as an open window and wastes useful resources. How you keep your physical desktop is up to you but I’d recommend clearing it off as well so that you don’t accidentally spill something on your keyboard.
- Update OS and Applications as needed. For some this could be a monthly instead of a weekly task.
- Reboot your computer. If you’re the type of person usually just puts your computer to sleep instead of shutting it down a weekly reboot will allow the OS to run it’s built-in housekeeping routines. These run automatically upon startup.
- Run backup routine. Whatever routine you settle on run it at least once a week, especially for your data.
Monthly
- Empty your trash. You’d be surprised how much can accumulate and how much hard drive space can go to waste when it’s “out of sight, out of mind”.
- Update as needed (see weekly)
- Run Disk Repair in the Disk Utility Program. This cannot be run on a startup disk. Another good reason to have an externally bootable drive.
- Clean your screen and clean your mouse/trackball. The mouse/trackball cleaning is especially important if the environment your computer is in is full of dust and/or pet hair.
Monitoring your computer’s “health”
- Check the S.M.A.R.T. status of your drives in Disk Utility. If it reads as “not verified” you may be headed for an imminent hard drive failure. S.M.A.R.T. is a built in self check in many newer hard drives. It stand for Self-Monitoring, Analysis, and Reporting Technology.
- Use a program to like MenuMeters (recommended in this workshop) to monitor various aspects of your computer such as temperature, memory usage, battery life, etc. I personally like the widget iStat Pro for this purpose. Saves on menubar clutter and covers a weath of information with a very customizable interface. Both are freeware.
Well, I’ve reached the end of my notes from this informative half-hour session at MacWorld. I hope you’ve found this article useful. Now all I need to do it put some of these ideas that I haven’t been following into practice myself!
Posted in: Computers.
Tagged: habits · macintosh
