Why I Get Angry

Please read this excellent post by one of the best medical bloggers out there, Dr. Rob.
Uvealblues
Something touched a nerve yesterday. I kind of lost my composure when someone tried to defend the insurance industry and responded out of emotion – perhaps putting aside some reason in the process.
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I have health insurance. I do understand why it needs to exist, but I also see how harmful the current state can be to my patients. I get frustrated with Medicare and Medicaid as well, but that is not my point. Just because government run insurance has problems doesn’t do anything to change the problems with private insurance. The fact that you can be killed by firing squad doesn’t make the gallows any better.

My Problems with the Business of Medicine

This post by "Topher" seems to hit the proverbial nail on the head...
uvealblues

The value of having access to a physician (let’s say you have diabetes) that can take an active role in your care, help you correct some mistakes that are leading to uncontrolled glucose levels, and not only extend your life but help you extend it without the complications of the disease is incredible! But as only one man, the number of people for whom he can do this is limited. His service is not scalable.
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Only he’s trapped. In the interim of dropping his Medicare patients, seeing to it that his billing is changed and that no new claims are filled in the next two years, and educating his patients about the changes, his malpractice insurance premiums continue to consume what’s left and he has no chance for air. Gulliver himself couldn’t escape the net of obligations that are binding him to this system and taking away his freedom. In the time it takes to change, he’ll be bankrupt anyway. He closes the money-sink that was once his shining creation. He locks the door on his practice.

Right now, this is what medicine looks like to me. Terrifying, right? I have hopes on hopes that I am wrong and that there is a way to avoid Dr. A’s fate (maybe I’m awfulizing). And I know that there are plenty of doctors running practices, making money, and living comfortably but unless they are completely free of the forces that took down Dr. A in my example, they’re just the last line before the firing squad. Even if I manage to escape it (as physicians do by having concierge or cash-only practices from the start), I don’t want any other physicians to have to deal with it. It’s unjust.

Beyond the Biopsy: A Tiny Monitor for Cancer

DOCTORS doing a needle biopsy to analyze tissue for cancer may one day add a second step to the procedure: depositing a tiny device at the site to report on growth of a tumor — and even the effects of chemotherapy.

Researchers at the Massachusetts Institute of Technology have created prototypes for cancer monitors the size of a grain of rice, small enough to fit easily into the bore of a biopsy needle. Tiny coated particles inside the devices can bind with molecules linked to cancer at the site, creating minuscule clumps that can be detected by a non-invasive scan like an M.R.I., said Michael J. Cima, a professor of materials science and engineering at M.I.T. and leader of the team that created the devices.

Increase Your Happiness With These Six Scientifically Proven Strategies

In recent years there has been an explosion of research on happiness, optimism, positive emotions and healthy character traits. While psychology has traditionally concerned itself with what ails the human mind--such as anxiety, depression, neurosis, obsessions, paranoia, and delusions--, a new branch of psychology, aptly named “positive psychology”, asks the question: "What are the enabling conditions that make human beings flourish?" That is, the goal of positive psychology is to study what actively makes people feel fulfilled, engaged, and happy.

In addition, neuroscientists are studying how the brain can be rewired in such a way that makes happiness more likely. Below you’ll find six strategies from the fields of positive psychology and neuroscience that will help you increase your current level of happiness.

There Are More Slaves Today Than at Any Time in Human History

One writer spent four years inside the world of modern-day slavery; an industry that produces huge profits and countless wasted lives.

The world suffers global recession, enormous inequity, hunger, deforestation, pollution, climate change, nuclear weapons, terrorism, etc. To those who say we’re not really making progress, many might point to the fact that at least we’ve eliminated slavery.

But sadly that is not the truth.

How Different Groups Spend Their Day

The American Time Use Survey asks thousands of American residents to recall every minute of a day. Here is how people over age 15 spent their time in 2008. Related article

Check out the link for the interactive graphic--quite interesting indeed...

Genocide From the Inside

Tracy Kidder's previous book, "Mountains Beyond Mountains," documenting the life of Dr. Paul Farmer is one of my favorites. This seems that this will be a worthwhile read as well...The description below of the hollow, caved in skills with empty eyeholes staring at you, imploring you....accurately describes my feelings as well when I was at the Holocaust Museum in Rwanda last year around this time..

Tracy Kidder asks how a traumatized African becomes an American.

We have preserved the massacre site. We have preserved the death," the young Rwandan man said to me with a bewildering smile. He was leading me briskly through a school where a decade earlier, hundreds of men, women, and children had been hacked to death. Pools of dried blood made the floor sticky. In one corridor, old bits of skull and bone made it crunchy. And then we came to the bodies.

The dead were covered in some kind of greenish preservative and laid out in long rows on the floor. A child—frozen forever at 4 or 5—had her skull split open in one clear blow. A woman's stomach had been hacked, and the contents must have spilled out somewhere: She was empty now. I would like to be able to say the faces of the hundreds of bodies I marched past had an accusatory stare that asked: How could you let this happen to us? But, in reality, they were glassy-eyed and gone.

What happens when you travel in a single 12-hour flight from the splattered heart of this genocide to the streets of New York City? That's what happened to Deogratias Niyizonkiza, a 24-year-old man who had narrowly survived a genocide in two countries and suddenly in 1994 found himself on a flight to a place he had only heard of—America.
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Deogratias fled across a river already beginning to choke with Tutsi corpses into the forests. After days hiding out in the woods—to echoed screams—he realized he had to get out of Burundi. He thought he had an option for safety—to make his way across the border to Rwanda. He nearly didn't make it. He was stumbling from one catastrophe to another—straight into the heart of the Rwandan genocide. The president there was murdered, too, and the extermination of nearly 1 million people—mostly by machete, wielded at high speed–erupted. It took 100 days. "Before the end of the night, the cockroaches are not going to wake up again," the mobs would sing on their killing frenzies.

And suddenly Deogratias was standing in an American airport, with $200 in his pocket and trauma cluttering his head, claiming he had work to do in New York City. A friend had pointed him toward Burundi's airport and urged him to get as far away as he could. He slept in boarded-up buildings and in Central Park and marvelled: "Almost everyone looked happy. Or at least no one looked alarmed. And no one looked terrified. These were people just going about their business, greeting their friends and their families, as if they didn't know there were places where dogs were trotting about with human heads in their mouths. But how could they not know?"

Kidder's descriptions of Deogratias seeing New York for the first time are some of the best in the book. He was so shocked by people wearing their pants low and strolling oddly that he became convinced America was afflicted by an epidemic of broken hips. When he stumbled into Central Park one day, he exclaimed: "My God, I just discovered a forest!"

Why is the African continent poor?

The desolate, dusty town of Pibor on South Sudan's border with Ethiopia has no running water, no electricity and little but mud huts for the population to live in.

You would be hard put to find a poorer place anywhere on earth.

I went there as part of a journey across Africa to ask the question "Why is Africa poor?" for a BBC radio documentary series.

Pictures of the Day

Many great pictures here...

The Women’s Crusade

IN THE 19TH CENTURY, the paramount moral challenge was slavery. In the 20th century, it was totalitarianism. In this century, it is the brutality inflicted on so many women and girls around the globe: sex trafficking, acid attacks, bride burnings and mass rape.

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There’s a growing recognition among everyone from the World Bank to the U.S. military’s Joint Chiefs of Staff to aid organizations like CARE that focusing on women and girls is the most effective way to fight global poverty and extremism. That’s why foreign aid is increasingly directed to women. The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution.

Sunrise At Nudgee Beach in Australia

What a beautiful photo taken by Christolakis at Flickr...

Fatty Foods Affect Memory and Exercise

Eating fatty food appears to take an almost immediate toll on both short-term memory and exercise performance, according to new research on rats and people.

It’s already known that long-term consumption of a high-fat diet is associated with weight gain, heart disease and declines in cognitive function. But the new research shows how indulging in fatty foods over the course of a few days can affect the brain and body long before the extra pounds show up.

Why Exercise Won't Make You Thin

The conventional wisdom that exercise is essential for shedding pounds is actually fairly new. As recently as the 1960s, doctors routinely advised against rigorous exercise, particularly for older adults who could injure themselves. Today doctors encourage even their oldest patients to exercise, which is sound advice for many reasons: People who regularly exercise are at significantly lower risk for all manner of diseases — those of the heart in particular. They less often develop cancer, diabetes and many other illnesses. But the past few years of obesity research show that the role of exercise in weight loss has been wildly overstated.

"In general, for weight loss, exercise is pretty useless," says Eric Ravussin, chair in diabetes and metabolism at Louisiana State University and a prominent exercise researcher. Many recent studies have found that exercise isn't as important in helping people lose weight as you hear so regularly in gym advertisements or on shows like The Biggest Loser — or, for that matter, from magazines like this one.

The basic problem is that while it's true that exercise burns calories and that you must burn calories to lose weight, exercise has another effect: it can stimulate hunger. That causes us to eat more, which in turn can negate the weight-loss benefits we just accrued. Exercise, in other words, isn't necessarily helping us lose weight. It may even be making it harder.

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Could pushing people to exercise more actually be contributing to our obesity problem? In some respects, yes. Because exercise depletes not just the body's muscles but the brain's self-control "muscle" as well, many of us will feel greater entitlement to eat a bag of chips during that lazy time after we get back from the gym.
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Closing the Energy Gap
The problem ultimately is about not exercise itself but the way we've come to define it. Many obesity researchers now believe that very frequent, low-level physical activity — the kind humans did for tens of thousands of years before the leaf blower was invented — may actually work better for us than the occasional bouts of exercise you get as a gym rat. "You cannot sit still all day long and then have 30 minutes of exercise without producing stress on the muscles,"
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There's also growing evidence that when it comes to preventing certain diseases, losing weight may be more important than improving cardiovascular health. In June, Northwestern University researchers released the results of the longest observational study ever to investigate the relationship between aerobic fitness and the development of diabetes. The results? Being aerobically fit was far less important than having a normal body mass index in preventing the disease. And as we have seen, exercise often does little to help heavy people reach a normal weight.

Phys Ed: Can Running Actually Help Your Knees?

An article in Skeletal Radiology, a well-respected journal, created something of a sensation in Europe last year. It reported that researchers from Danube Hospital in Austria examined the knees of marathon runners using M.R.I. imaging, before and after the 1997 Vienna marathon. Ten years later, they scanned the same runners’ knees again. The results were striking. “No major new internal damage in the knee joints of marathon runners was found after a 10-year interval,”
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Instead, recent evidence suggests that running may actually shield somewhat against arthritis, in part because the knee develops a kind of motion groove. A group of engineers and doctors at Stanford published a study in the February issue of The Journal of Bone and Joint Surgery that showed that by moving and loading your knee joint, as you do when walking or running, you “condition” your cartilage to the load. It grows accustomed to those particular movements. You can run for miles, decades, a lifetime, without harming it. But if this exquisite balance is disturbed, usually by an injury, the loading mechanisms shift, the moving parts of the knee are no longer in their accustomed alignment and a “degenerative pathway” seems to open. The cartilage, like an unbalanced tire, wears away. Pain, tissue disintegration and, eventually, arthritis can follow.

Pro-Democracy Leader in Myanmar Is Convicted

How sad--for a Nobel Peace Prize winner who had won 92% of the popular vote in a national election...

BANGKOK — Daw Aung San Suu Kyi, the Burmese pro-democracy leader, was sentenced Tuesday to three years of hard labor for violating the terms of her house arrest, but her sentence was quickly commuted to a new term of house arrest of up to 18 months.
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“The outcome of this trial has never been in doubt,” Jared Genser, her international counsel in Washington, said Tuesday after the verdict was announced. “The real question is how the international community will react — will it do more than simply condemn this latest injustice?”

The charge against Mrs. Aung San Suu Kyi was prompted by a strange incident in early May when an American intruder swam across a lake in central Yangon, Myanmar’s main city, and spent two nights in her villa, saying he wanted to save her from assassins.

The intruder, John Yettaw, 53, of Falcon, Mo., was given a seven-year sentence on Tuesday, including four years of hard labor, for abetting Mrs. Aung San Suu Kyi’s actions and for violating immigration law and local ordinances, according to diplomats reached by telephone in Yangon.

8 totally awesome natural phenomena you probably didn’t know about

When you hear a name like maelstrom, you just know it’s about something wicked. Introduced in English by Edgar Allan Poe from the Nordic languages, from which it came from the Dutch word maelstrom (maalstroom in modern spelling), it literally means crushing current, which is quite a very good description.

Genome Sequencing Gets 99.9833% Price Cut

Dr. Quake of Stanford University only needed $50,000 and a month's time to complete a genome sequencing process which previously took $300 million, over 250 people, and several years. How cheap would Windows 7 be with this guy's cost-cutting?

Fungus Makes Zombie Ants Do All the Work

A tropical fungus has adapted to infect ants and force them to chomp, with surprising specificity, into perfectly located leaves before killing them and taking over their bodies.

Fire risk 'super' ants discovered

Ants believed to have a "kamikaze attraction" to electricity have been discovered in one of England's finest National Trust gardens.
(..)They are naturally drawn to electrical currents so can pose a fire risk.
The species was first identified in Budapest 20 years ago. The ants look like a common black garden variety.
English Heritage and the National Trust carried out investigations into infestations within the Hidcote estate to identify them as lasius neglectus.

Their compulsion to follow electricity is stronger than their need for food or drink.

Top websites

PC magazine names the top 100 websites of 2009 here.

How to Sign Documents Electronically - No Ink or Paper Required

Amit Agarwal has one of the best tech blogs on the web. Here is an excellent post on digital signatures..

Cheese and Burger Society

Strictly for carnivores, here is a link to a variety of burger recipes...

Just When Africa’s Luck Was Changing

TWO years ago, when Dubai World said it would invest $230 million in Rwandan tourism, officials here rejoiced.

Among the many projects the company trumpeted were a sprawling luxury hotel on the 18-hole golf course here and an ecolodge in the Akagera National Park, a swampy grassland further northeast where herds of elephants and water buffalo roam.

In an interview at his offices in Kigali last fall, Rwanda’s president, Paul Kagame, cited the Dubai investment as one of many that his small east African country had managed to attract in its effort to reduce its dependence on aid in favor of private investments.

But just last month, Dubai World ratcheted back its ambitious investment plans, its coffers strained by the global financial crisis. The company says it will go forward with only two of the eight projects it had planned in Rwanda, and the Kigali hotel and Akagera ecolodge didn’t make the cut.
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Continentwide figures for foreign direct investment so far this year are not available. But in the sub-Saharan African countries, the International Monetary Fund estimates, foreign direct investment will drop roughly 18 percent in 2009 from about $30 billion in 2008.

“The decline in investment will reduce the ability of African governments to fund health, education, infrastructure and nutrition programs,” said Léonce Ndikumana, director of the development research department at the African Development Bank.

Organizations like the development bank have stepped up their efforts to limit the impact of the credit crisis. But many fear that the moves will not be enough. The World Bank said recently that international financial institutions by themselves could not currently cover the shortfall in capital and investments to emerging-market countries.

According to the Organization for Economic Cooperation and Development, the amount of private investment going to Africa had begun to outpace aid. M. Nathaniel Barnes, Liberia’s ambassador to the United States and the country’s former finance minister, says that while foreign aid is still crucial for African countries, it usually focuses on humanitarian issues like emergency food and shelter or medical supplies. In contrast, he said, foreign investment provides long-term sustainability and growth.

“Instead of talking to Usaid, I’d rather be talking to a company like Nike,” Mr. Barnes said. “Having a partner like that means jobs and economic growth, and you just don’t get that from aid.”