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Archive for July, 2006

(Originally made aware of article through Catchen’s Xanga Site)

Another Day, another article.

This article from the New York Times describes a pastor at a evangelical megachurch who was able to stand up and say what a lot of non-conservative, non-Republican Christians have been struggling with: The way the right-wing political movement has claimed complete ownership of the Christian vote.

The problem has less to do with Republicans versus Democrats or Liberals versus Conservatives than with whether one can be a Christian who disagrees. The Republicans may support Christians a bit more, but it is a huge stretch to say that their entire platform is even remotely Christ inspired. In the same way, there are many aspects of the Democratic party platform which are probably better supported by the Bible.

The dialogue-destroying rhetoric in politics today is only further magnified in the Christian community, where debate often degenerates into accusations of not being Christian, or loyal, or faithful.

I found this particular point especially telling, and unfortunately, accurate:

Mr. Boyd lambasted the “hypocrisy and pettiness” of Christians who focus on “sexual issues” like homosexuality, abortion or Janet Jackson’s breast-revealing performance at the Super Bowl halftime show. He said Christians these days were constantly outraged about sex and perceived violations of their rights to display their faith in public.

“Those are the two buttons to push if you want to get Christians to act,” he said. “And those are the two buttons Jesus never pushed.”

The article is reproduced below:

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I find myself often trying to explain the merits of using RSS to filter and keep up with the internet.  The web is pretty overwhelming otherwise.  Basically RSS is a format or “feed” that allows a user to subscribe to various webpages and then allows the user to read updates on a webpage through a central reader.  My personal favorite RSS reader is Bloglines.

There is a page that tries to explain RSS on About.com.  It is laughably complicated for a “netforbeginners” section, but you might like it if you’d like to read more.  Unfortunately, if you do a search on Google for “What is RSS” you’ll get a whole lot of results showing technical pages that explain how web designers can publish an RSS feed.

 Anyway, for those in the medical profession, one of the great uses of RSS feeds is that you can set up PubMed to create a custom feed of any search you like, and then have the feeds update whenever a new academic paper gets published within that search.  David Rothman at http://davidrothman.net/, has an excellent entry that takes you step by step through how to set up a PubMed feed using Bloglines.  Hopefully, those of us in the medical academics will be better able to keep up with the overwhelming research that occurs around the world.

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I’ve been looking at some blogging options lately, and I’ve been particularly impressed with WordPress. I’ve actually been double posting on both Xanga and WordPress for the past few weeks, just to try it out.

My page is here: davidkpark.wordpress.com

WordPress is kinda like the old-school Blogger.com, where it is a blogging engine as well as a hosting site. WordPress.com is a pretty functional host, and comes with all kinds of themes which make it pretty easy to setup a site and get it running.

On WordPress, I really like the categories, and really like the clean page (xanga has tons of clutter). I also like the portability of my data. I have almost 3 years of posts on xanga, and even if I download it by paying for a Premium account, I don’t know how to convert the posts into something useful. The geeky side of me also likes how wordpress plugs in to the greater blogosphere, connecting my post to other blogs that are talking about the same thing through Technorati and the like. Some part of me likes to think that by posting about a topic, I’m contributing the greater discussion, and maybe even changing a few minds.

On the other hand, Xanga is really easy to use once you are in the network. Setting up subscriptions are really easy as long as you have a xanga account. WordPress uses RSS feeds to do the same thing, but RSS is not that well understood by non-geeks. (For a quick explanation for RSS, check out an explanation here. (I highly recommend Bloglines as a web reader). At some point, I’ll post about how RSS is the best thing that has happened to the internet in a while….

I guess I can use WordPress for more topic oriented stuff, while using Xanga for more personal blogging. That said, you’d notice how rarely I blog about personal stuff on this site….

Anyone who has looked into these hosts care to comment?

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From our friends at the New York Times:

(Given that links sometimes die, i’m posting a copy of the entire article).

p.s. I will vouch for the fact that the slow churned ice cream is excellent.

The article is reproduced below:

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stevenashnewdoo.jpg
He looks a little emaciated, frankly. I never thought I’d say this, but he may look better with those nasty locks.

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Portrait of a Blogger

The The Pew Internet & American Life Project released the results of a survey regarding bloggers on the internet. I found some of the results surprising.

About 50% of bloggers are women, which is much higher than just about any other online activity. 8% of internet users blog, which also breaks the rule of 10s… (1% create content, 10% interact with content like comment.)

It also breaks down why people blog, and what people blog about. I thought this might be interesting to those in the xanga community. 🙂

— Addendum

Why did I start blogging? Those of you who were with me from the beginning (or who read all the way back) know that this blog started as an exclusively medical blog. It’s still isn’t very personal, although now many of my friends read it. Yes yes, I’ve heard your complaints. 🙂

Anyway, I started writing because I wanted to record ideas and thoughts in a “diary” sort of way, but also because I wanted to practice writing for a public audience. I was afriad that as I started my medical residency that I’d slowly degrade into the type of doctor who only made sense talking to other doctors. A major motivation for starting a blog was because I wanted to polish a writing style that reaches out to a wider (aka “normal”) audience.

Why did you start blogging?

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Lazy post today, but 3 hours of absolutely goodness. 🙂

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Another day, another alarmist article on society from the New York Times.

It seems that guys make up only 42% of the college applicants now, compared to 58% women. Some colleges actually have campuses where women outnumber men 2:1. Apparently some colleges have actually started to favor guys to even up the proportions. Now all the alarm surrounds “The New Gender Divide” and “What’s Wrong with the Boys?”

Anybody who’s been around teenagers and college aged kids know that many girls at the higher levels are more academically inclined that guys. I’m still waiting until women start representing in Fortune 500 companies and various high end professions, however. Labor statistics still show that women make 70% for every dollar her male counterpart makes.

On a side note, what’s going on with Harvard and the grade inflation? The Times states that 55% of the women are graduating with honors. I thought only 20% of the graduating class was supposed to graduate with honors. I don’t know what the overall numbers are, but this grade inflation stuff is getting ridiculous.

The Article reproduced below:

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Another article from the New York Times. Many physician joke that the health section is the only medical journal they read. Most of the time, it’s only a joke.

The article discusses a case of a family winning a case against Johnson and Johnson for the tune of $772,500 after the patient had an unexpected death thought to be due to overdose/defect of a duragesic (fentanyl) patch. I’m not sure if the patches were actually defected, and I certainly agree that the death of a such a young woman is indeed tragic. It’s not clear if the jury knew if the defect existed or not as well. It is also not clear if the patient died due to intentional (but misguided) overuse.

My concerns regard the reverberations of this case. According to the article:

“Johnson & Johnson, based in New Brunswick, N.J., added warnings to the patch’s label last July, saying doctors should not prescribe them for patients who cannot tolerate similar drugs or who might be prone to abusing them.The patches, introduced in 1990, release the opiate fentanyl through the skin. Researchers say fentanyl can cause addiction or death in some users.”

Vague terminology like “some” and “might” are entirely unhelpful guidelines.

The medical field tends to undertreat pain, and duragesic patches have done wonders toward relieving pain to thousands if not millions of patients in the US suffering from intractable pain. However, the “guidelines” put out by Johnson and Johnson are just broad statements designed to protect themselves from lawsuits and push the liability onto the physicians that prescribe them. If JNJ seriously thought that fentanyl patches are dangerous to an undefinable segment of the pain-suffering population, perhaps they should pull the product entirely. Of course, they don’t do anything such as that.

This practice is all too common, and physicians have found themselves in a bind as pharmaceuticals create unhelpful guidelines without the best interest of the patient in mind. Many medications are used routinely as “off-label,” and are considered standard of care and best practice. The problem is that a drug only can become FDA approved for that indication if the company applies for it. At times one will find a disconnect where the medical research clearly shows the benefit of the drug and the company simply does not apply to get the medication “officially approved” for that reason.

In the end, it is because of these kinds of lawsuits that JNJ has to charge so much money for their drugs to cover their costs. It is because of these lawsuits that they make statements to push away liability. It is because of these lawsuits that doctors pay high malpractice premiums and eventually leave practice. It is because of these lawsuits that the United States is spending 16% of it’s GDP on healthcare, even as over 40 million people don’t have health insurance.

Time to get off the Saturday morning soapbox….

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The article from the New York Times today reports on how there will be an exemption on the new law that requires documented proof of citizenship on application for Medicaid. The part that really struck me was a section in the middle:

“The new documentation requirement is part of the Deficit Reduction Act, signed by President Bush on Feb. 8. It is meant to stop the “theft of Medicaid benefits by illegal aliens,” in the words of Representative Charlie Norwood, Republican of Georgia, a principal author of the provision.”

The attempt to withhold care to certain populations is rather mind-boggling. The truth is that society pays for the care of these patients, one way or another. Furthermore, study after study shows that paying for whatever outpatient care they need is cost-effective…. you can give a patient 20 expensive medications for months and the cost still would not equal a single night of stay in an intensive care unit (ICU).

If these patients don’t get outpatient care, they clog up the ER. Yes, yes, I know the studies that show that ERs are clogged by non-underserved people as well. Sick people is bad for productivity, bad for the economy, and is a public health hazard. What happens if the government refuses to pay? The hospitals will take the hit at first, and they’ll have to bill those who can pay in order to make ends meet. If they can’t, they will close down, and not provide care to anyone. Eventually, the government will have to bail them out, thus costing more taxpayer money.

The evidence is there. Also see another article regarding a homeless drunk housing project in Seattle. It’s simply cheaper to take care of these people. It is a social good. We don’t have to like them, but we have to realize that by ignoring them and pretending that they don’t exist, we’re costing ourselves a whole lot of money.

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