Taller babies and confusing correlation with causation

BBC NEWS | Health | Taller babies earn more later on

A study shows 1 yo height correlates with income. Interesting, but then the study's author is quoted saying something startling:

Report author Professor David Barker said he hoped the findings would make people realise the first year was critical in a child's development.

I can't imagine how this study, as reported, could possibly support this conclusion. He's making all kinds of logical leaps to get from a relationship to causality to therapeutic intervention.

When we have studies showing that interventions in wealthy nations in the first year of life affect later income, or even 1 year height, then let's talk along these lines ....

Grand Old Payola Party

The New York Times > Arts > Frank Rich: The White House Stages Its 'Daily Show'

Frank Rick looks at at how much money the Bush administration paid for PR/propaganda. Based on the numbers, the fake journalism scandal may be quite large. A quarter of a billion dollars would pay for a several thousand mouthpieces. Lawyers are doubtles looking for ways to open up the Ketchum budget, and tell us what portion of that fortune was paying for illegal propaganda.

... The money that paid for both the Ryan-Garcia news packages and the Armstrong Williams contract was siphoned through the same huge public relations firm, Ketchum Communications, which itself filtered the funds through subcontractors. A new report by Congressional Democrats finds that Ketchum has received $97 million of the administration's total $250 million P.R. kitty, of which the Williams and Ryan-Garcia scams would account for only a fraction. We have yet to learn precisely where the rest of it ended up.

The pre-fab "Ask President Bush" town hall-style meetings held during last year's campaign (typical question: "Mr. President, as a child, how can I help you get votes?") were carefully designed for television so that, as Kenneth R. Bazinet wrote last summer in New York's Daily News, "unsuspecting viewers" tuning in their local news might get the false impression they were "watching a completely open forum." A Pentagon Office of Strategic Influence, intended to provide propagandistic news items, some of them possibly false, to foreign news media was shut down in 2002 when it became an embarrassing political liability. But much more quietly, another Pentagon propaganda arm, the Pentagon Channel, has recently been added as a free channel for American viewers of the Dish Network. Can a Social Security Channel be far behind?

... The inability of real journalists to penetrate this White House is not all the White House's fault. The errors of real news organizations have played perfectly into the administration's insidious efforts to blur the boundaries between the fake and the real and thereby demolish the whole notion that there could possibly be an objective and accurate free press...

The Bush policy wouldn't work if we had an aggressive and active free press left. I don't see any evidence of that -- outside of a few old pros like Frank Rich and the under financed and unread blogosphere. We, the American people, just aren't interested any more. We'll get the nation we deserve.

The top 100 gadgets of all time

Mobile PC - Features - The Top 100 Gadgets of All Time

Find out where your favorite gadget is. This is a terrific site and will be insanely popular.

Planet sorrow

A Devastating Decision for Ill Ethiopian Mothers (washingtonpost.com)

A world of sorrow.

...Six-year-old Radeat Behonegn used to spend hours at the window of the Hope for Children orphanage, waiting for her parents to return. They left her here two years ago, and soon afterward died of AIDS related illnesses...

...Children dropped off at the orphanage can grow hysterical, sending others into a panic. Recently, Tamrat had to start a new policy, telling parents they should bring their children in to play a few times and then, on the last day, just leave quietly. Later, the children are told that their parents are dying.

The fathers in these stories are often despicable. CARE is open for business.

Bush the deity

Salon.com News | Among the believers:

Indeed, Goebbels is topical:

In January, Paul Craig Roberts, assistant secretary of the treasury during the Reagan administration and associate editor of the Wall Street Journal's far-right editorial page, published a damning column in the progressive Z Magazine about fascist tendencies in the conservative movement. 'In the ranks of the new conservatives, however, I see and experience much hate. It comes to me in violently worded, ignorant and irrational emails from self-professed conservatives who literally worship George Bush,' he wrote. 'Even Christians have fallen into idolatry. There appears to be a large number of Americans who are prepared to kill anyone for George Bush … Like Brownshirts, the new conservatives take personally any criticism of their leader and his policies. To be a critic is to be an enemy.'

Privacy? Surely you jest. A web site for those who would resist.

No Place to Hide - The Center for Investigative Reporting

I came across this site via Gillmor. It's a foundation funded site about privacy loss:

When you go to work, stop at the store, fly in a plane, or surf the web, you are being watched. They know where you live, the value of your home, the names of your friends and family, in some cases even what you read. Where the data revolution meets the needs of national security, there is no place to hide.

I think this is a futile effort, but I admire the sentiment.

How to steal identies: method #5

MercuryNews.com | 02/16/2005 | 145,000 Americans' identity data stolen

A company that sells personal data on consumers said Wednesday that it's alerting 145,000 Americans -- including 35,000 Californians -- that they might be vulnerable to identity theft after a crime ring paid for their credit reports, Social Security numbers and other sensitive information.

ChoicePoint, a Georgia company that boasts it has compiled the deepest database in the nation, said Tuesday that it had alerted 35,000 Californians that they were vulnerable, as required by state law. But it balked at first at notifying a far larger number of potential victims outside California.

About seven years ago a group of scammers set up a California bank so they could purchase credit card account information. This is a variant on this technique.

It's much more effective to subvert the legal trade in identity information than it is to go out and steal the information oneself. The companies selling this information have to held liable for its misuse. That will, of course, increase the cost of the information for legitimate users. One wonders, however, how many legitimate uses of this information are truly essential.

Aging drivers: a vast growth industry

DeKalb Medical Center - Providing Healthcare Services in Decatur, GA and DeKalb County

DeKalb medical center (Atlanta) offers driving skills assessments through their rehab center:

Driving Solutions Program (Inpatient and Outpatient)

This specialty program provides driver assessment, training and adaptive equipment recommendations for vehicle operation. The assessment process includes tests of vision, visual perception and reaction time, as well as assessment of cognitive and physician functioning. Driver training is available to new and experienced drivers to promote safety and competency behind the wheel. Training in the use of adaptive equipment is available.

When I was in practice the aging driver was one of my tougher management challenges. It's not only that driving ability decreases with advanced age, it's also that judgment often deteriorates in parallel with visual, sensory and motility loss.

As we boomers age, we're going to turn the roads into a slaughterhouse. For a time no-one will dare take the wheel from our voting hands. Bicyclists will become extinct (I suspect rising bicycle fatalities is a leading indicator of aged drivers), until finally the survivors will rise up. We'll then have to go through regular (q1-2y) examinations. Ultimately there will be enough of us near-suicidal 75+ yo non-drivers that we'll actually get a decent transit alternative going.

Or maybe cars will get "smart" enough that they can be "driven" by a fairly impaired person...

Goebbels is topical

A gentleman sitting by me at the Beanery referred me to a reference that's quite topical: Goebbels on Propaganda in 1931. In a world in which the Republican payola scandal (don't like the news? change it) and Rupert Murdoch's empire continue to grow, it pays to reread the master of mass movement fear-based propaganda: Goebbels.

Here Goebels is introducing a new magazine (Will and Way) that is to be a communication forum and messaging source for party activists. Will and Way was a key part of Goebbel's overall propaganda (messaging) strategy. The "Will" is the program, the "Way" is the propaganda channel.

I think of Will and Way as a cross between a community forum, a blog, and a newsletter. Here are excerpts from his introduction with my emphases (I deleted the irritating drivel that is typical of Nazi writing):

It is the task of National Socialist theory to construct a program that can hold its own in the daily political struggle. We have worked on this program since the start of the movement. Its basics are laid out in the 25 points [the party's official program, adopted in 1920]. The 25 points provide the foundation of all of National Socialist practice.

... It will not be the goal of this magazine to spread and deepen National Socialist theory and practice... Rather, our goal is to show practitioners the methods they can use to gradually gain power by winning the souls of the people.

... each of these methods requires a political group to win the sympathies of the broad masses, if it wishes over the long run to maintain is power. But the sympathy of the people does not come of itself; it must be won.

The means of gaining that support is propaganda. The task of propaganda is not to discover a theory or to develop a program, but rather to translate that theory and program into the language of the people, to make them comprehensible to the broad masses of the people. The goal of propaganda is to make what the theorists have discovered clear to the broad masses.

... No other political movement as understood the art of propaganda as well as the National Socialists. From its beginnings, it has put heart and soul into propaganda. What distinguishes it from all other political parties is the ability to see into the soul of the people and to speak the language of the man in the street. It uses all the means of modern technology. Leaflets, handbills, posters, mass demonstrations, the press, stage, film and radio — these are all tools of our propaganda. Whether or not they serve or harm the people depends on the use to which they are put.

In the long run, propaganda will reach the broad masses of the people only if at every stage it is uniform. Nothing confuses the people more than lack of clarity or aimlessness. The goal is not to present the common man with as many varied and contradictory theories as possible. The essence of propaganda is not in variety, but rather the forcefulness and persistence with which one selects ideas from the larger pool and hammers them into the masses using the most varied methods.

Therefore, we named this magazine "Will and Way." The will of the National Socialist movement is laid out in its program. The way changes every day...

... Today, we have a tight network of National Socialist propaganda throughout the country...National Socialist propaganda serves to educate the people. Its task is not only to win them for the tasks of today, but to assist in the transformation of the character of the broad masses. We are convinced that a new politics in Germany is possible only after a complete transformation of our national character, after an entirely new national way of thinking.

... Our goal in these pages is to bring will and way together in an unified synthesis of practical techniques. We are not writing for the general public, but rather for those active in daily politics throughout the country. It is a forum for discussion firmly tied to the party. Each who has something to say has the right and duty to speak. We will here exchange experiences, make proposals, criticize mistakes and suggest improvements.

These pages should over the course of time become a resource that political fighters will need for their daily battles. They should receive teaching, education and strength. They will receive the power to bring our ideas to Germany, and learn the ways and means to put a good theory into effective practice...

So what do we know about depression anyway?

Drugs Raise Risk of Suicide (washingtonpost.com)

A meta-analysis is reported to claim that the SSRIs increase suicide risk. This WaPo article didn't mention the effect size, but suicide is, in technical terms, a "hard end point". It can be measured fairly clearly. If the suicide-outcomes are unclear then that's important. The study suggests the SSRIs are not dramatically lowering suicide risks compared to placebo. I doubt this study really answers questions; but it may tell us we know even less than we thought we did.

This doesn't mean, but the way, that non-SSRI anti-depressants are safer. Maybe they increase suicide rates too compared to placebo. I remember 20 years ago that my teachers warned of "activation" during early treatment being associated with suicide. (As soon as the depressed patient gets more energy, they get around to actually getting something done -- but that something is suicide.)

At the end of the day the main lesson is that we (meaning the quite corrupt government that we electand reelect) let the pharmas get away with selective publication of efficacy and safety data. As a result we lack important answers. That has to change.

Another lesson concerns all the beatings primary care physicians get about "undertreating depression". I've long been skeptical of those studies because:

1. Even when primary care docs treat depression payor rules and patient preferences often mean euphemistic ICD-9 codes are used.
2. I've not felt comfortable about the data we had on the disorder. I don't feel we understand the disorder(s) or the therapies very well -- especially outside of referral clinics treating depression with psychotic features.

This doesn't mean I or my primary care colleagues did a great job with depression. Instead I'd say more humility is needed from every quarter.

By the way, we also need to do something about corruption in government.

Gwynne Dyer's site has 8 new articles

2005

The eccentric web site of Gwynne Dyer, an iconoclastic journalist and military historian, suddenly has 8 new articles to read from his Jan/Feb publications. All are worth reading. I'd quote and blog from a few but the odd web pages confound the BlogThis! bookmarklet.

I tried to get the webmaster to complement the site with an RSS feed, but s/he really didn't understand what I was writing. I am curious as to why Dyer does it this way. Heck, I'd make him a better site for free! I can only guess it's done by a relative.

Free business ideas: outsourcing claims processing for patients AND a web site for business idea distribution and related services

For various reasons we spend a fair bit of time in our household dealing with errors in healthcare claims processing. (See also my prior post!)

Both providers and payors commonly make errors in healthcare claims processing. It's a complex process in which failure is not merely an accident, it's an emergent property of the system. Ultimately we (ok, my wife) is called upon to resolve the errors.

The work of error resolution is tedious and time consuming. We would like to outsource it; we'd be willing to pay a good amount per claim to have someone else track payment, make calls, resolve complaints. I think this could be a viable business. A reasonably well designed set of processes could probably turn a tedious chore for a person into a routine 5-15 minute task for a well run business. At $15 per managed error each worker could bring in about $90 an hour. Increased automation could improve that earnings stream substantially.

Perhaps some enterprising bookkeeper, working at home, would want to launch such a business. If they kept costs low they could grow it off cash flow (early profitability) while gaining expertise and scaling upwards.

Anyone want to try? No rights reserved on this idea!

PS. Here's another business idea. Set up a web site where one could submit requests for new businesses. Charge $2 to people who want to outline a business they'd like someone to deliver. Then support the site by advertising and on revenue for business requests. All ideas would enter the public domain. For an extra fee charge would-be entrepreneurs for business-process patent searches around the business ideas. Then grow the web site with additional services around implementing the business proposals. This business could be fairly big and interesting -- except the barriers to entry are low so the competition would be significant. Maybe eBay or Amazon would buy a well run startup.

I come up with business ideas all the time. They're all for things I'd like to have. I'm happy to give them away. So here are two business ideas for today. No rights reserved, but if they're not patented I've just placed them in the public domain. So don't try to patent them.

Aggregate databases: what my shadow medical profile will look like

In an earlier post I noted the inevitable rise of the "total information awareness" "shadow profile", the picture of a person that emerges when one aggregates data across a diverse set of databases with a variety of primary purposes: Faughnan's Notes: The national identification card and database.

My profile will make interesting reading. Due to an uncharacterized error in a payor's/provider manager information system a variety of claims are being directed against one of my employer's benefits program. The claims are for services are not covered by this benefit program, so the claims are being rejected.

In addition to not being covered, they are also not my claims. They belong to another person.

Depending on how the benefit program manages data associated with rejected claims, however, the diagnostic codes (ICD-9) may well be retained in the system and associated with my name. Ten years from now, the corrupted descendant of "total information awareness" will be browsing shadow profiles identifying persons to be added to various "yelllow and black and grey". This particular database will have an interesting range of ICD-9 codes in the database; a set that might put me on a "yellow" list.

I'll also be uninsurable. Chances are there won't be any way to know why I'll be rejected for insurance, or strip-searched every time I fly, and there will be no way to correct the error. The only saving grace is that a lot of people will be in the same boat. We can commiserate in the restricted areas where undesirables might be allowed to congregate..

The use of databases for purposes other than their original intent will cause no end of problems.

Godel, Newton, Pauling: betrayed by intuition?

The New York Times > Arts > Connections: Truth, Incompleteness and the Godelian Way

This NYT Connections column has the most succinct description of Godel's most famous work that I recall reading:

Before Godel's incompleteness theorem was published in 1931, it was believed that not only was everything proven by mathematics true, but also that within its conceptual universe everything true could be proven. Mathematics is thus complete: nothing true is beyond its reach. Gdel shattered that dream. He showed that there were true statements in certain mathematical systems that could not be proven. And he did this with astonishing sleight of hand, producing a mathematical assertion that was both true and unprovable.

[jf: actually if memory serves a better statement might be: "He showed that there were true statements in certain nontrivial and interesting mathematical systems that could not be proven. And he did this with astonishing sleight of hand, producing a mathematical assertion that was both true and unprovable."]

But Godel's genius came with a price:

... those leaps and connections could go awry. Godel was an intermittent paranoiac, whose twisted visions often left his colleagues in dismay. He spent his later years working on a proof of the existence of God. He even died in the grip of a perverse esotericism. He feared eating, imagined elaborate plots, and literally wasted away. At his death in 1978, he weighed 65 pounds.

Genius, connections, intuition, courage, fascination with the infinite, then madness.

Thomas Nash, a nobel prize winner disabled for many years by paranoid schizophrenia comes to mind, but Godel was old for the onset of schizophrenia. What do we know, however, of the psychiatric disorders of genius? We are much more familiar with more conventional minds. I think also of Isaac Newton, who spent the latter half of his life wrapped up in Alchemy. Linus Pauling, who's powerful but misdirected intuition made him a peculiar pusher of vitamin C.

These extraordinary minds excelled at making connections and drawing inferences, at rethinking and radical leaps. Is the price of such excellence a predisposition to leaps beyond the bounds of reason?

"Whom the gods would destroy they first make mad".

The Tsunami: Things disappear.

The New York Times > International > Asia Pacific > Nam Khem Journal: The Tsunami's Horror Haunts a Thai Fishing Village

It was fate,' said Am Changkraichok, 68, a fisherman. 'If you were meant to die, you died. People visiting here to see friends, or foreigners here on holiday, all were here because their time had come to die.'

'I've lived here all my life but I was spared,' he said. 'How do you explain that? My time had not yet come. When I think like this, it makes me feel better. Nature decides. Things come and things disappear. If you don't just let go, it can make you crazy.'