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Canonical link: https://siderea.dreamwidth.org/1355110.html

[We interrupt the previously scheduled rant for another rant.]

At some point, if you are so lucky, you will be old. You may already be old. Somebody you love may already be old. Old people, being people, require medical care, and are often treated – because this is basically what primary care in our society consists of – with medications.

Thing is, old bodies handle medicine differently than young ones.

Take the liver... [3,340 Words] )

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[sci hist] A Most Remarkable Week

Sep. 17th, 2017 12:52 am
siderea: (Default)
[personal profile] siderea
(h/t Metafilter)

This link should take you to the audio player for The Moth, cued to a story, "Who Can You Trust", 12 minutes long.

The Moth, if you didn't know, is an organization that supports storytelling – solo spoken word prose – true stories. This story is told by Dr. Mary-Clare King, the discoverer of BRC1. It concerns a most extraordinary week in her life, when pretty much everything went absurdly wrong and right at all once. It is by turns appalling and amazing and touching and throughout hilarious.

It's worth hearing her tell herself before the live audience. But if you prefer transcript, that's here – but even the link is a spoiler.

Recommended.

incremental progress

Sep. 15th, 2017 12:08 pm
kareila: (escherknot)
[personal profile] kareila
We didn't get any bad weather here from Irma, just a pleasant temperature drop and two school-free days. The worst impact from the storm among people I know who were affected seems to be the extended power outages.

Will made the Scholar's Bowl team at school, and practices start next Tuesday. I don't expect to hear anything about Math Team until October, but those practices have been on Wednesdays, so he shouldn't have a problem doing both.

Connor's after school Spanish class isn't meeting this year because not enough students enrolled. I've found an alternate activity for him on Wednesdays, some sort of board game club, but it only meets twice every six weeks. He has a field trip next week to some sort of environmental preserve, so I signed up as a chaperone in order to tag along and investigate.

Symphony chorus rehearsals start back Monday. Sadly we are no longer scheduled to participate in the Harry Potter soundtrack performance, but we do have the tribute piece and the Bach Magnificat to look forward to learning.

I've just acquired some of the latest LEGO Dimensions expansions, although I had to go to my local Best Buy to find them - surprisingly, Amazon hasn't stocked them. I'm hearing rumors that LEGO is going to quietly stop releasing new expansions, which is too bad, but I can understand why if the game wasn't successful enough to justify the continued expense of developing new content. And the update process is still very frustrating - my console has been trying to download and install the latest updates for over an hour now, and I had to free up system storage again before it would even get started.

I need to sign off now - I have a meeting in 45 minutes with one of Will's teachers and I haven't eaten anything yet.

Cake or Death?

Sep. 15th, 2017 03:58 am
earthling177: (Glasses)
[personal profile] earthling177
Garry Kasparov / The Resistance said:

"The American democratic awakening spurred by resistance to Trump will be short-lived and ineffective if more people don't vote.

Nearly 100 million Americans didn't vote for president in 2016. Trump won with just 26% of the eligible vote. That is a crisis level.

Apathy is self-censorship and it concedes power. Treat your democratic rights like duties. They will weaken and be lost if you do not."

Ailsa Cunningham Ek said:

"Problem is, we need greater citizen input into the primaries first. Closed primaries are undemocratic. Superdelegates are super undemocratic. The election shouldn't be a choice between two incredibly unpalatable individuals selected by someone else, or if they want to be able to pick them for us, we need a "None of the above" option.

Come downtown to stand in line for hours to choose between being kicked in the balls or shot in the head. Bugger that, I'm not going to *ask* to be kicked in the balls. If so few people volunteer to be kicked in the balls that we all end up shot in the head instead, among other things it says something about people's desire to be kicked in the balls, and maybe, just maybe, if we had listened to everyone's opinions on the matter, we might have had different options."

To which David Policar responded:

"Given a choice between being shot in the head and not shot in the head, I choose not being shot in the head.

Sure, I'd rather choose not being shot in the head and eating cherry pie than not being shot in the head and being kicked in the balls. Absolutely. No question.

But either way I choose not being shot in the head."

Well, I guess the ones who know me probably can predict what's coming, but for the benefit of folks who do not know me very well, here it goes...

I would like not only to agree with David Policar, but add to it: the results of the last election basically convinced me that for now, the *best* thing we can do is to close the primaries: if you want to vote in the primary, register for the party you want to win; I think that many people did in this election what they've done in many many many previous elections -- they wanted party A to win, so they gave up voting in their own primary and went across the isle to vote in party B's primary for a candidate so unpopular that they thought *no one* would vote for them and then stay home.

What they forgot is that Liberals fall in love, and if their favorite candidate did not win the primary, they do everything (fail to vote, vote 3rd party, write-in their favorite etc) but vote for the one who won the primary. Meanwhile, Conservatives fall in line, they hem and haw about how awful so-and-so is, but you will notice they vote for so-and-so *anyway*.

That's how we got Bush I, Bush II and now Trump.

Do you remember when a candidate could lose just for flip-flopping? Or for lying about something? Or refused to serve in times or war? Or for being perceived as nasty to women, or having an affair, or for even showing sympathies for Russia?

Can you honestly show me *one*, just one wrong thing from the immense list of "candidates that did this do not win" that Trump has not checked? I am under the impression that he personally went and "checked" every single box in the "this is not a good candidate if..." list and he *won* *anyway*, because for decades now, there are about 30% of registered Republicans, and they *all* vote, so they win even if there are over 50% registered democrats.

Please tell us honestly: if this were any kind of game (D&D, videogame, *any* game), do you think Republicans with such bad candidates would have won so very often if it depended on random chance? Worse yet, if over 50% of the players were D and barely 30% of the players were R, wouldn't you expect D to win almost all the time if it depended on simple voting?

People say they didn't vote this time because the Clinton wasn't leftist enough, or progressive enough, or because they wanted to "teach the Democratic Party to select better candidates". Among other things.

Well, guess what, you can't teach an organization to select a "better candidate" unless *you* vote for the better candidate, otherwise, the only data that the Democratic Party will add to their already large amounts of data is that "the American public likes extreme-right candidates, in the future, if we want to win, we need to offer someone more like Trump than more like Sanders, Clinton or Warren". *That's* what they learn, and that's why over the last 50 years the politics in America has moved so far to the right that Clinton and Obama are considered "centrists" and Sanders is consider "left wing" -- I want you to appreciate that by all we know, Sanders is a right wing guy compared to Nixon, who, despite being the extreme right of his time, would appear to be completely pinko-communist today; if you are not aware, Nixon tried to have this country pass laws for affordable college, universal health care *and* Universal Basic Income. In fact, Nixon tried for Universal Basic Income *twice* and it nearly passed, but Republicans and Democrats couldn't agree on the yearly *salary*.

Meanwhile, I'd describe the situation that you described as "shot in the head or kicked in the balls" a bit differently.

I'd say Bernie's and Hillary's platforms/agendas were so *close* that we couldn't insert a vacuum cleaner crevice attachment in between them. I remember many years ago, I got my rental car in the airport in Omaha NE, this was before simple people like me could have GPS, and I made one wrong turn and ended up across the river in Iowa, luckily all I had to do was turn around and I was where I needed to be again.

So anyway, I felt like we were in Chicago and Bernie offered us to go to Iowa and Hillary offered us to go to Nebraska, or vice-versa. But, they both said, "eventually our goal is to end up in San Francisco". Instead, people kept bitching about how the destination couldn't possibly be Nebraska or Iowa, even if just for 4 years, because the *only* good places are on the West Coast, and "if they can't pick California, we won't go, just to teach them a lesson!"

Well, now we are lost halfway in the Atlantic Ocean, because, despite the fact it was *obvious* that Sander's and Clinton's platform were a millimeter apart and their platforms were 10 miles to the left of Trump's, people thought they "could walk back" the 10 miles after 4 years. To teach the Democrats a lesson. Now you are, with the rest of us, over 1,000 miles *off* course, because the idiotic president currently there doesn't even know how to serve food at the soup kitchens he visited for hurricane relief.

And no, I am not blaming you personally. I'm super pissed off at my own people who think they'd keep their souls pure and their hands clean if they didn't vote for Clinton.

Well, if you ask the rest of the world, they do not make this differentiation -- they think *all* Americans are to blame for Trump. Any crap that he starts internationally *will* be a stain on our personal and collective souls.

With all that in mind, I humbly ask you to please stop repeating Soviet Russia Propaganda designed to divide the progressives. About 2 centuries ago there were not even "primaries" -- the parties put out their candidates and you voted in the general election. *All* coalition building currently happens at the primaries in US and, if you want to influence the candidates for the general, vote in the primary. All this "closed primaries are not democratic" and "super delegates are not democratic" are *all* propaganda straight from Putin's hands. The Republicans *wished* they had super delegates, they could have gotten rid of Trump no problem that way. Notice that the Republican Party per se could have just voted for completely new rules and just said "we don't like Trump, the second winner is the candidate *this* time around", which is even less democratic than well, the Democratic super delegates.

My point, and I do have one, is that *anyone* and *anything* the Democrats could have offered this time was better than Trump and we *knew* it: Bernie, Clinton, a prairie dog or a baked potato. It doesn't take a genius IQ to get to that conclusion, but we, collectively, decided it was better to bet the country on the guy who got us lost in the middle of the Atlantic Ocean and about to start a nuclear war, because we didn't want to be the ones to be blamed for a brief stop over in Iowa or Nebraska on our way to California.

If we can't recognize that we were not being invited to sleep with Clinton or Bernie or even just have dinner with them, we did not have to *like* them at all, they are just the president that was going to be *much* better than Trump even if not ideal, do we even deserve a chance to get better as a country?

If we can't recognize that Clinton was *right* about all that she warned us about Trump, and that he's been doing everything she told us about -- if we can't recognize that she *knew* more than we did -- do we really deserve to get better and do we really have a leg to stand on asking other countries not to laugh at us?

I hope most agree with me those are much more serious things to think about than "shot in the head" vs "kick in the balls".

Also, despite some thinking that Clinton was unpalatable, I say I've heard that lots of dishes are an acquired taste. But Trump is a metric ton of manure, and I've never heard anyone claim they like or even tolerate eating manure.

Peace,
   -- Paulo.
siderea: (Default)
[personal profile] siderea
I have a recollection of hearing a filk song, I think from a tape, that had a climactic line or repeated like in the refrain, to the effect of "And that's what cities get from trains". I have an impression it was a Leslie Fish song, but I don't know that for sure.

Not having any joy of google. Does anybody recognize it?
siderea: (Default)
[personal profile] siderea
(h/t Metafilter)

I just heard about Senior House. Goddamn.

Also. I hadn't realized that dealing with the administration in his capacity as Senior House's housemaster is what drove Henry Jenkins from MIT. Goddamn.

I am surprisingly angry and sad about this, given that I'm not a SH affiliate.

The shutdown of Senior House would be bad news, by itself. This is appalling:
The questionnaire, the Healthy Minds Survey, was administered by the University of Michigan. Many schools around the country give it to students as a way to pinpoint problems on campus and decide how best to allocate resources. When MIT administered it in 2015, they told students that it was a confidential survey intended to help them. One of the chancellor’s assistants who had lived in Senior House when she was an undergraduate went to Senior House and specifically requested that the residents take it. They did, in large numbers.

What they didn’t know—and what they couldn’t have known from reading the consent form that accompanied it—was that MIT had embedded metadata that allowed the administration to pinpoint the location of those filling out the questionnaire, enabling them to segment the results by dorm. The only question about dorm type in the survey was vague—“What kind of dorm do you live in? Small, large, off campus?”—but by tracking the metadata, Barnhart and the administration were able to see exactly where respondents lived.

It was this data that enabled Barnhart to see what she called a troubling hot spot of drug use. “If it wasn’t a direct violation, it was at least a violation of the spirit of informed consent,” Johnson says.
In light of that...
As Senior House students spread out across campus this year, former advisers worry that they’ll be at even greater risk. They can reach out to MIT’s mental health services if they need it, the chancellor says.
Is there some reason that MIT students should trust MIT Med to keep their information confidential? When MIT just used the confidential results of a "Healthy Minds Survey", which was advertised as a way of seeing where resources were needed, to eliminate resources from vulnerable populations? And the relevant IRB gave it a pass?

(Dear MIT students, and alums concerned about them: it is apparently hypothetically possible for students on the default MIT student health insurance ("extended" plan) to see therapists unaffiliated with MIT, but it has a pretty punative copay:
If you are covered by the MIT Student Extended Plan, and you see a mental health clinician who participates in the Blue Cross Blue Shield (BCBS) PPO, your first 12 visits in a calendar year are covered in full (100%). After that, you will have a $25 copay for each visit.

If you are covered by the MIT Student Extended Plan, and you see a mental health clinician who does NOT participate in the Blue Cross Blue Shield (BCBS) PPO, your first 12 visits in a calendar year are covered at 100 percent of the BCBS allowed amount. After that, your insurance will cover 80 percent of the allowed amount, and you will pay the other 20 percent. For all of your visits, your clinician may bill you for the difference between the BCBS allowed amount and his or her charges. This is something you should discuss with your clinician ahead of time.
I don't know for certain what BCBS's "allowed amount" is, but I know they're paying master's level therapists about $85 per therapy session, so I'm guessing that's it. So if a therapist's regular fee is $100, you'd be paying ($85*0.2)+($100-$85)=$32 per session. A lot of therapists are charging rather more that $100/session these days. At $120/session that's $52/session.

That copay/cost-sharing is absurd. Obviously, many students couldn't possibly afford $25/week copay – specially the most vulnerable ones. So that's a hell of an incentive to seek care from MIT Mental Health and Counseling Service directly: as they proudly state, no copay or other fees to see the therapists that work for MIT.

Less obviously, it's not even vaguely in line with the market right now. I see people who have jobs and pay $10 and $15 copays on other insurances. That students would be charged a $25 copay to see a therapist – in-network! – is incredible. Honestly, students being charged any copay is pretty out of line.

Seriously: MIT students, the people who stock the shelves in the Star Market behind Random have better access to mental health care than you do. That grocery store shelf stocker qualifies for a subsidized Medicaid Expansion plan, which covers at least a therapy session per week, with no copay. Also, their plan has hundreds, if not thousands, of therapists to choose from, none of whom report to your landlord cum diploma-granter-maybe cum civil authority cum boss of your local police.

Also, availing yourself of the option of seeing a non-MIT therapist on your MIT student insurance, even though it's through BCBS, requires a "referral" from MIT Med:
If you are already seeing an outside clinician or have a specific outside clinician in mind, you don’t have to make an appointment at MIT Medical to get a referral. Just call the Mental Health and Counseling Service at 617-253-2916, and ask to speak with someone about getting a referral for your outside treatment.
This may be completely pro forma, but the upshot is that MIT is making it a requirement on you that you notify MIT if you're getting psychotherapy, and that you divulge to them from from whom you are getting it. That someone is in therapy and from whom they get that therapy is highly confidential information, that frankly MIT has no business knowing. You should be able to see a therapist on your student insurance without MIT even knowing about it.

So if you wanted to work for the benefit of students' mental health, there's a great target: demand that MIT's insurance for students provides off-campus, unaffiliated psychotherapy with no copay, cost sharing, or balance billing – or radically less than at present, so MIT students can freely avail themselves of treaters not on MIT payroll; and abolish the need for a referral, because info about your utilization of mental health care is prejudicial, privileged information that can be used against you. But be careful to keep a third-party insurance co in the loop, instead of MIT directly paying therapists; whomever pays the therapist is allowed to snoop in your psychotherapy records.

Or, honestly, given some of the crappy-ass general health care friends of mine have gotten through the Med Center, maybe just agitate for all students to just get a regular BCBS PPO membership instead of having to go to the Med Center, at all. Or given how much BCBS sucks, try to get students into the Medicaid Expansion, so students get a choice of providers. That would be harder.

P.S. Disclosure of conflicts of interest: none – I don't take BCBS, so even if the copay/cost-share/balance-billing were eliminated, and students started flocking to off-campus therapists, I still wouldn't benefit by any of that business, unless somehow you managed to get students into Medicaid Expansion, and then only if students were willing to travel all the way to Medford to see me – I just have it in for MIT Med, and MIT MHCS especially.)

(no subject)

Sep. 10th, 2017 07:45 pm
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[personal profile] coraline
[personal profile] flexagon said she'd encountered a tasty "people chow" type food in the cafeteria, and it sounded like something I might like, so I found a recipe and tried it.

How can Serious Eats and Ottolenghi go wrong? Well... )

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