Family Medicine Board Exam 2008 - description, study strategy, results

I'm putting together my plan and resources to prepare for the 2008 Family Medicine re-certification exams. These exams used to be pretty stress free, but that was back when I actually did family medicine!

I'm surprised how scattered the resources are on this topic. I'll list what I've found, and update this post over the next two months. I'm restricting my list to items available through the AAFP, ABFM (board), or "free" (typically pharma or ad supported). Most of these links work only for AAFP members or recert exam registrants.

• ABFM profile: Home base for exam information.
• My medical reference page: updated in preparation for the board. Licensed MD/DOs can get everything "free" via MerckMedicus.
• ABFM Study Guidance: ABFM's guide to preparing for the exam. They don't like lecture classes and they don't like people to focus on practice exams. As a (formerly) ace exam taker, barely one step behind my wife, I thought the advice was meek. Using JFP to study for a recert exam? Pardon?
• ABFM 2007 In-Training exam and critiques: same question pool as the exams.
• ABFM Candidate Information (PDFs), includes:
• Candidate Information Booklets: PDF explains the exam in great detail, including rules of the somewhat harsh company that inflicts the exams.
• Recert exam description: The only detailed description of the exams I found.
• Exam content: What topics are covered. I won't spent much study time on the < 3% group.
• Recert modules: Choose two of these.
• AAFP Board Review Questions AAFP members can do these practice exams and even earn CME credit at the same time.
• Online exam tutorial: ABFM tutorial teaching mechanics of their exam software.

For my commute I have a backlog of Audio CME to add to my iPod, but iTunes also has a pretty good listing (though as badly organized as every other Apple item list I've seen). I've also found a UCSF newsletter (pdf) with an article on medical podcasts.

Podcasts:Science and Medicine:Medicine including

• MedPod 101: Internal medicine review aimed at fourth year med students preparing for board exams. Sponsored by the US Navy, with a very tolerable interstitial ad. I like MedPod. The background music is tasteful, the voices are clear and entertaining and they move through topics very quickly. Their audience has no time to waste on frivolity or slow speech. MedPods 101 is run by an independent group of 3 very young high school students internists who may have mercantile ambitions but appear to be having fun.
  
• Surgery ICU (Vanderbilt)
• Annals of Internal Medicine
• Pri-Med CME: samples form their commercial products
  
• INFOPoems: My old friends from Michigan!
• Pediatrics from the U of Arizona
• McGraw Hill ACM Podcasts: samples from a range of McGraw Hill texts

The UCSF newsletter also lists some journal podcasts (ex. JAMA), but those are much less useful for FM board review.

I thought I'd end up working through my cache of unheard Audio Digest reviews, but, of course, they're more aged than I'd realized. The AD reviews are also recorded from typical CME programs, and they tend to move slowly and get caught up in the lecturers personal interests. I think the podcasts may turn out to be a better use of commuting time. I don't care about the CME, I'll get lots of that working through my backlog of American Family Physician.

I'll miss In Our Time, but I can catch up in August.

Update 8/15/08:

I've long had an information-geek's admiration for the printed version of Monthly Prescribing Reference. Despite its evil ad-funded roots, there's a real genius to the density and layout of the content, refined by generations of customer feedback. It also has the virtue (and sin) of being always topical and exceedingly brief.

So I started my review by reading this cover to cover. Each time I come across a medication that's new to me, or a familiar one that unlocks a domain of forgotten knowledge, I add it to my core med review sheet. This sheet is also an interesting overview of what's changed in medicine over the past decade. There was more activity in the treatment of Parkinson's Disease, for example, than I would have guessed. Lots of combo drugs, maybe because of the co-pay effect.

I also note that when a med is introduced it gets a trade name in the second half of the alphabet, but copy-cat meds get names starting with the letters A-D.

From the med review I will identify key topics based on med activity development to review in AFP articles (Parkinson's, for example).

Next I will review my obsolete medical notes to bring old memory banks online. Then to a practice exam to identify high value study areas. From that I will identify the highest yield subtests to take.

I found the podcasts less useful than expected, so I'm dumping my old audio digest material to an MP3/AAC data CD, I can opportunistically sample those while driving.

Incidentally, it appears the ABFM has given up on their over-ambitious board study program -- the old q7y exam will be retained as an option. I think there's a better middle-way and I hope they'll soon find it.

Update 7/15/08b:

I'm making limited use of traditional references, books, and articles. I'm finding it much faster to google on terms and read the NIH/NIND/etc information for professionals. The articles are too wordy.

Update 8/1/08

I'm done with the exam. These exams are much more interesting when one hasn't seen a patient in 10 years! We'll see how I did. In retrospect my study approach was very good; any bad outcome would be due to lack of study time rather than study strategy.

I'll summarize my strategy below. This is a strategy for someone who doesn't do medicine and who needs to recreate a lot of knowledge in a very short period of time, a practicing clinician wouldn't follow this route.

My goal was to resurrect as much old knowledge as I could, while patching in new things.

1. Read Monthly Prescribing Reference cover to cover to create a core med review document. Don't spend too much time with this reference, the goal is to create the list and update it based on further study. Monthly Prescribing Reference also has about 5-6 useful 1-2 page protocols for care of common conditions. They're a very concise set of reviews, print and use them as reference.
   
2. Review empiric antimicrobial therapy in Sanford and make notes. Antimicrobial therapy has changed more than anything else in medicine due to increasing drug resistance.
   
3. Review and summarize the most interesting bits of the AAFP's preventive services document.
4. Find as many of the ABFM 2007 In-Training exams and critiques as you possibly can. The ABFM used to provide links to several years worth of training exams, but now they only provide the last year. The critiques are superb; so try to find friends who have them from the past three years. Do one of the exams cover to cover, but don't get too hung up on the questions. Instead, carefully read the critiques, they're ultra-concise guides to what matter. Unfamiliar topics in critiques are guides to further study.
5. I tried medical podcasts, but they simply weren't good enough. I had a large collection of Audio Digest CDs that were a few years old, those were better. The best audio resource, however, were my old AAFP CDs (via my iPod and iPhone). Even the 3-4 year old talks were about right for the exam. I listened to those on every commute -- they brought a lot of old memories online. (I'll resubscribe 2-3 years before my next exam if I do the boards again in 7 years so I've got a topical pile to listen to.)
   
6. I read and partly reworked my old online medical notes. This works since I have so many old memories attached to them.
   
7. For quick topic lookups Wikipedia, amusingly, is rather good. Actually, very good -- especially since it's not hard to spot junky alternative medicine additions. Otherwise the AFP site is the best place for reviews; in service exam critiques reference American Family Physician more than anything else.
   

Given more time I'd have liked to review the arrhythmia portions of a current ACLS handbook, but I there's nothing else I'd have changed (except manufactured more time, but I haven't figured out that trick).

Update 8/3/08: You need to recheck your ABFM profile about 8 weeks after the exam to get your results. There's no mail notification. The ABFM allegedly sends an email notice out when the results are online, but email is very unreliable now. Best to check.

Update 9/19/08: The board sent out a result notice as promised. If you passed you see immediately that your certification has been extended. I passed by a good margin, but I'm no longer in the 95+ percentile! Of course considering that I haven't seen a patient for about 10 years, last did full family medicine 15 years ago, and had a pretty compressed study program I'm satisfied. The results show I was consistent across all topics.

The program I outlined above was the right one for me, with the caveat mentioned in a prior update.

The result files are PDF password protected. They don't contain any real exam information, so I assume the passwords are to prevent people creating fake result letters. I saved the password with the file name.

Changes - a 1/2 GB patch

The updater for OS X Leopard is over 1/2 GB in size.

MacInTouch: timely news and tips about the Apple Macintosh

Apple today posted Mac OS X 10.5.3, the latest in its series of bug and security patch collections for "Leopard". The 10.5.3 Combo update is 536 MBytes in size.

I downloaded it in under 10 minutes.

A 1/2 GB isn't what it used to be.

Yes, 10.5.0 was a very buggy initial release.

How the medical web has changed - a six year retrospective

It's been about six years since I've updated my personal medical notes reference page. These are references for a family physician, not for a patient.

References for Medical Notes

Revised: May 2008.

Most of the books link to MD Consult which I access through my UMN account. Sadly, even the AFP references are now access controlled. MD Consult, Harrison's Online, TheraDoc and more are freely available, as of May 2008, for persons able to register with MerckMedicus. Note that the MerckMedicus web page has trouble with modern browsers and especially with tabs.

Yes, it's board review time.

A six year editorial life cycle means one or two links went bad.

Ok, about half of them.

Here are the sorts of things that survived:

• Pharmaceutical company resources
• MD Consult: barely, but content owned by it and MerckMedicus are now the bulk of my links
• NIH resources (PubMed, PDQ, CancerNet, etc)
• Non-US resources
• American Family Physician (but it's going behind a paywall)
• One or two amateur (in the sense of unpaid work) sites, like Scott Moses FP Notebook.

Here are the things that went away

• The "Virtual Hospital". This was one of the very first medically oriented information resources on the early web -- it showed up a year or two after the first browser I used (not Netscape, before that!). It's just patient education now, at their peak they had an unsustainably wide set of medical reference resources.
• Most of the American resources that lacked a clear revenue stream (volunteer efforts, academic projects without a maintenance, stream etc).
• Anything that focused on how to do a procedure.

Within the US the survivors have a business model of some sort. Nobody seems to want to touch procedures any more -- I wonder if that's just my sample or if there are more litigation fears. Outside of the US things are more persistent. Even many of the surviving sites don't handle bad links very well.

I'll have to try to do another recap six years from now ...

MD Consult: An illustrative story?

I'm studying for my board exams, so I'm treading ground little touched since I stopped seeing patients. Among other things, I'll eventually be updating my ancient web clinical notes (such as my ancient medical reference page, which I'm updating today).

One of the first places I visited was MD Consult: Books, which I can access through my U of MN account.

Alas, it is but a shadow of its old self. Of the three or four publishers who cooperated to launch the original site, only Elsevier is left. They have a reasonable number of texts, but many of my old favorites are gone.

I suspect there are interesting stories here. MD Consult peaked during the rise of the net, when publishers must have felt terrified that their business would be destroyed. It went into decline after the crash, when the threats seemed to be receding. The publishers, who were, after all, competitors, largely walked away. They hiked their journal subscription prices through the roof, and textbook costs rose quickly.

But did they relax too soon? On the textbook front UpToDate seems have filled the nice MD Consult once held, and it's not currently a part of any of the large publishers. On the journal front rapacious pricing empowered the miraculous open access mandate.

The lesson may be that while it's easy to overestimate the speed of social transformation driven by new technology, it's even more tempting to return to bad habits when the initial fear recedes.

I suspect the textbook companies were right to be afraid, a bit overanxious on timelines, and wrong to relax.

Update 5/28/08: Incidentally, MD Consult is available free of charge to anyone who qualifies to register with MerckMedicus. They also offer Harrison's Online. (So only the most virtuous of clinicians, those who have the discipline to refuse all pharmaceutical blandishments, would pay for MD Consult. Those people do exist, and I do admire them.)

Advice to Google: Imitate the RIGHT parts of Sharepoint

I just know Google's engineers are avidly reading this blog ...

Alas, I have some Microsoft readers on my tech blog, but I don't think I have any Google readers on any of my blogs. Sniff.

Their great loss, because they'll miss this free tip.

Google Apps are improving, especially with the addition of Google Sites.

Alas, many of the new features feel like a reinvention of the more obvious features of Microsoft Sharepoint.

So Google Apps has Sharepoint-like (crappy) document management; in Sharepoint you can manage Office documents, in Google Apps you can manage native Google App documents. In both cases any non-native files are third class citizens.

Google Apps also has clever widgets for inserting Calendars and the like, just like Sharepoint. Google Apps doesn't have a blogging tool (odd omission, you can't really integrate Blogger) yet, but they have a Sharepoint-like Wiki in Google Sites. Google Apps has Feeds and Alerts like Sharepoint, albeit not quite as well done.

Sigh.

Google's engineers are imitating the obvious, inescapable, features of Sharepoint. It's almost like they're running down a checklist.

Except the person who did the checklist didn't really understand that buried in the dross of Sharepoint is a certain secret brilliance.

Somehow they've missed that Sharepoint gently leads users to start representing data in an insidiously user friendly database model with a very user-friendly set of data types including hyperlinks, lookups that link to the reference row, web 1.0 and excel-like grid data entry models, multiple Views with a simple (too limited) GUI for reusing and extending Views, and more...

Lessons from Microsoft SharePoint

...I'm told the implementation is more peculiar than this, but to a first approximation SharePoint can be considered as a thin client toolkit for creating and manipulating SQLServer tables. Microsoft Access will link to them, and read and write to the linked tables. You can do some simple lookups from one table to anohter (scope is site limited). You can revise and extend tables quite readily, building on your data model as needed. There's a quite good web GUI for user views of the data, and a somewhat powerful but semi-broken Excel like datasheet view for quick editing.

Whereas the document management system feels like it was hurled out a window to meet a deadline, the list facilities feel like someone thought very hard about how they might work...

Everything is laid out in Sharepoint for observant eyes to see. There's nothing in this design that outside the everyday functions Google implements now. Sure, there may be a few software patents around Microsoft's work (there should be), but that's what lawyers are for. I suspect most of it has prior art, and the rest can be worked around or fought in court. (It's the combination that's clever.)

If a Google engineer were to read this, then spend two weeks playing around with Sharepoint lists, extending calendars, extending the Gantt widget, implementing project plans, creating lookups, and so on the light would go on.

Google Apps could replicate this.

Google Apps could also stop imitating the stupid parts of Sharepoint and provide true file management, but I'm beginning to think there's something impossible about that.

I'll settle for intelligent imitation instead.

Netsurfer 1995 - be humble

It's ok to laugh ...

Lamest Fetish Items Ever: Gear Lust Gone Bad, 1993 - '95
Netsurfer
Dec 1995 $4,869
This is what the future looked like in the mid-'90s.

But remember, it looked good once. Be humble ...

Richard Feynman -- lessons from Connection Machine

If I'd been a bit smarter, I could have lasted longer in Feynman's 1989 1986 Physics-X class. I was fighting to survive my 1st year at Caltech though, and I sacrificed it for the classes I was graded on.

If I'd been a bit wiser, I'd have given up on something else instead, but I was a kid.

Even with limited exposure I remember the Feynman-field effect. As long as he was nearby it all seemed simple, but once he left so did understanding. Inverse square law I think.

So this superb essay, by the founder of a 1980s era supercomputer firm, really strikes home.

I'm excerpting the bits we can draw lessons from, the essay deserves to be read in its entirety. Emphases mine. I admit some of the lessons are more applicable to persons with IQs over 200.

Long Now Essays - W. Daniel Hillis - Richard Feynman and The Connection Machine
... Richard's interest in computing went back to his days at Los Alamos, where he supervised the "computers," that is, the people who operated the mechanical calculators. There he was instrumental in setting up some of the first plug-programmable tabulating machines for physical simulation. His interest in the field was heightened in the late 1970's when his son, Carl, began studying computers at MIT...
...We were arguing about what the name of the company should be when Richard walked in, saluted, and said, "Richard Feynman reporting for duty. OK, boss, what's my assignment?" The assembled group of not-quite-graduated MIT students was astounded.
After a hurried private discussion ("I don't know, you hired him..."), we informed Richard that his assignment would be to advise on the application of parallel processing to scientific problems.
"That sounds like a bunch of baloney," he said. "Give me something real to do."
So we sent him out to buy some office supplies. While he was gone, we decided that the part of the machine that we were most worried about was the router that delivered messages from one processor to another. We were not sure that our design was going to work. When Richard returned from buying pencils, we gave him the assignment of analyzing the router...
... During those first few months, Richard began studying the router circuit diagrams as if they were objects of nature. He was willing to listen to explanations of how and why things worked, but fundamentally he preferred to figure out everything himself by simulating the action of each of the circuits with pencil and paper.
...Richard did a remarkable job of focusing on his "assignment," stopping only occasionally to help wire the computer room, set up the machine shop, shake hands with the investors, install the telephones, and cheerfully remind us of how crazy we all were...
...I had never managed a large group before and I was clearly in over my head. Richard volunteered to help out. "We've got to get these guys organized," he told me. "Let me tell you how we did it at Los Alamos."
Every great man that I have known has had a certain time and place in their life that they use as a reference point; a time when things worked as they were supposed to and great things were accomplished. For Richard, that time was at Los Alamos during the Manhattan Project. Whenever things got "cockeyed," Richard would look back and try to understand how now was different than then. Using this approach, Richard decided we should pick an expert in each area of importance in the machine, such as software or packaging or electronics, to become the "group leader" in this area, analogous to the group leaders at Los Alamos.
Part Two of Feynman's "Let's Get Organized" campaign was that we should begin a regular seminar series of invited speakers who might have interesting things to do with our machine. Richard's idea was that we should concentrate on people with new applications, because they would be less conservative about what kind of computer they would use. For our first seminar he invited John Hopfield, a friend of his from CalTech, to give us a talk on his scheme for building neural networks...
... Feynman figured out the details of how to use one processor to simulate each of Hopfield's neurons, with the strength of the connections represented as numbers in the processors' memory. Because of the parallel nature of Hopfield's algorithm, all of the processors could be used concurrently with 100\% efficiency, so the Connection Machine would be hundreds of times faster than any conventional computer...
... Feynman worked out the program for computing Hopfield's network on the Connection Machine in some detail. The part that he was proudest of was the subroutine for computing logarithms...
... Concentrating on the algorithm for a basic arithmetic operation was typical of Richard's approach. He loved the details. In studying the router, he paid attention to the action of each individual gate and in writing a program he insisted on understanding the implementation of every instruction. He distrusted abstractions that could not be directly related to the facts...
... To find out how well this would work in practice, Feynman had to write a computer program for QCD. Since the only computer language Richard was really familiar with was Basic, he made up a parallel version of Basic in which he wrote the program and then simulated it by hand to estimate how fast it would run on the Connection Machine...
... By the end of that summer of 1983, Richard had completed his analysis of the behavior of the router, and much to our surprise and amusement, he presented his answer in the form of a set of partial differential equations. To a physicist this may seem natural, but to a computer designer, treating a set of boolean circuits as a continuous, differentiable system is a bit strange. Feynman's router equations were in terms of variables representing continuous quantities such as "the average number of 1 bits in a message address." I was much more accustomed to seeing analysis in terms of inductive proof and case analysis than taking the derivative of "the number of 1's" with respect to time. Our discrete analysis said we needed seven buffers per chip; Feynman's equations suggested that we only needed five....
... The first program run on the machine in April of 1985 was Conway's game of Life.
... The notion of cellular automata goes back to von Neumann and Ulam, whom Feynman had known at Los Alamos. Richard's recent interest in the subject was motivated by his friends Ed Fredkin and Stephen Wolfram, both of whom were fascinated by cellular automata models of physics...
... we were having a lot of trouble explaining to people what we were doing with cellular automata. Eyes tended to glaze over when we started talking about state transition diagrams and finite state machines. Finally Feynman told us to explain it like this,
"We have noticed in nature that the behavior of a fluid depends very little on the nature of the individual particles in that fluid. For example, the flow of sand is very similar to the flow of water or the flow of a pile of ball bearings. We have therefore taken advantage of this fact to invent a type of imaginary particle that is especially simple for us to simulate. This particle is a perfect ball bearing that can move at a single speed in one of six directions. The flow of these particles on a large enough scale is very similar to the flow of natural fluids."
This was a typical Richard Feynman explanation. On the one hand, it infuriated the experts who had worked on the problem because it neglected to even mention all of the clever problems that they had solved. On the other hand, it delighted the listeners since they could walk away from it with a real understanding of the phenomenon and how it was connected to physical reality.
We tried to take advantage of Richard's talent for clarity by getting him to critique the technical presentations that we made in our product introductions... Richard would give a sentence-by-sentence critique of the planned presentation. "Don't say `reflected acoustic wave.' Say [echo]." Or, "Forget all that `local minima' stuff. Just say there's a bubble caught in the crystal and you have to shake it out." Nothing made him angrier than making something simple sound complicated...
... as the machine and its successors went into commercial production, they were being used more and more for the kind of numerical simulation problems that Richard had pioneered ... Figuring out how to do these calculations on a parallel machine requires understanding of the details of the application, which was exactly the kind of thing that Richard loved to do.
For Richard, figuring out these problems was a kind of a game. He always started by asking very basic questions like, "What is the simplest example?" or "How can you tell if the answer is right?" He asked questions until he reduced the problem to some essential puzzle that he thought he would be able to solve. Then he would set to work, scribbling on a pad of paper and staring at the results. While he was in the middle of this kind of puzzle solving he was impossible to interrupt. "Don't bug me. I'm busy," he would say without even looking up. Eventually he would either decide the problem was too hard (in which case he lost interest), or he would find a solution (in which case he spent the next day or two explaining it to anyone who listened). In this way he worked on problems in database searches, geophysical modeling, protein folding, analyzing images, and reading insurance forms.
The last project that I worked on with Richard was in simulated evolution. I had written a program that simulated the evolution of populations of sexually reproducing creatures over hundreds of thousands of generations. The results were surprising in that the fitness of the population made progress in sudden leaps rather than by the expected steady improvement. The fossil record shows some evidence that real biological evolution might also exhibit such "punctuated equilibrium," so Richard and I decided to look more closely at why it happened. He was feeling ill by that time, so I went out and spent the week with him in Pasadena, and we worked out a model of evolution of finite populations based on the Fokker Planck equations. When I got back to Boston I went to the library and discovered a book by Kimura on the subject, and much to my disappointment, all of our "discoveries" were covered in the first few pages. When I called back and told Richard what I had found, he was elated. "Hey, we got it right!" he said. "Not bad for amateurs."
...Actually, I doubt that it was "progress" that most interested Richard. He was always searching for patterns, for connections, for a new way of looking at something, but I suspect his motivation was not so much to understand the world as it was to find new ideas to explain. The act of discovery was not complete for him until he had taught it to someone else...

I'm struck that Feynman was good at giving up on problems where he wasn't making progress. That's something most of us, albeit on a far more modest scale, find hard to do. We run the risk of pouring efforts down a project with a limited chance of success. Feynman knew there were always other interesting problems, problems that were likely to be easier to solve.

I didn't know about his interest in cellular automata, or that he was a friend of Wolfram's.

I knew Hopfield too -- I took one or two of his courses. I don't recommend Caltech for any undergrad with an IQ belong 160, but it is a fantastic place to be a graduate student.

European nuclear plants and Google's data centers

A resurgence in nuclear plant development has three justifications:

1. Expectation that oil costs will continue to rise over the next fifty years (plants take 20 years to come online).
2. Expectation that limitations on CO2 emissions will limit use of coal, tar sands, and other "easy" substitutes for sweet crude
3. Expectation that supply chains and suppliers will become increasingly vulnerable and unpredictable, so local ownership of power production will become increasingly important.

All three seem plausible, so Italy and other European nations are building "fourth-generation" reactors...

Italy's nuclear move triggers chain reaction - Scotland on Sunday

... Once the most-scorned form of energy, the rehabilitation of nuclear power was underscored in January when John Hutton, Labour's Minister for Business, grouped it with "other low-carbon sources of energy" like biofuels....

... There is now a determination to tackle the issue head on throughout the continent. With nuclear plants taking up to 20 years from conception to becoming operational, European nations are now having to answer some very difficult questions. The dilemma of Italy, as the biggest importer of oil and gas, are the most pressing: there is no chance of reactivating sites or building new ones within the next five years.

... Enel, Italy's leading energy provider, announced this year that it would close its oil-fired power plants because the fuel had become too costly. Italians pay the highest energy prices in Europe. Enel has been building coal plants to fill the void left by oil. Coal plants are cheaper but create relatively high levels of carbon emissions.

Enel, which operates power plants in several European countries, already has at least one nuclear plant, in Bulgaria, and has been researching so-called fourth-generation nuclear reactors, which are intended to be safer and to minimise waste and the use of natural resources...

It makes sense to build more nuclear plants. It is unfortunate, however, that they're being built in very crowded nations. If we casually disregard technical issues with transporting power (ship metallic hydrogen? superconducting power lines?), and exclude the desire for national control, it would seem to make more sense to build them in remote areas of northern Canada, possible on the sites of existing Hydro facilities or together with large data centers.

Nuclear plants and data centers, after all, have a few things in common:

1. Power production/consumption is critical.
2. Cooling is essential.
3. Security is paramount.
4. There's not much need for human attendance. Almost everything can be managed with a few people on staff and remote robotic control*.

In addition there are many good reasons to keep nuclear plants far from human habitation. Canada is an obvious location given its relative political stability, proximity the US market, enormous swaths of minimally populated land, and technological capabilities. Heck, compared to the Alberta tar sand environmental holocaust nuclear power plants in the North are positively benign.

So will Google and Microsoft go into the nuclear power business? Will Canada's native peoples become the Saudis of the 21st century?

This should be interesting.

* Be fun to build that secure channel, eh?

Spam comments are getting very clever

We all know there's a virtual war going on between evolving spam and evolving anti-spam. Turing would have been amused. Lately it seems to have moved up a step.

Blog comments are one front in the war. Popular blogs have mostly dispensed with comments due to the difficulty of filtering out comment spam. In the past few weeks Google's cutting edge captcha "Turing Test", for example, has been rumored to have failed. (Google believes humans the attacks are not fully automated, but they've been effective anyway.)

Hobby blogs like mine have so few comments we can generally make do with manual review. A human expert, in theory, can quickly tell which posts are relevant to the topic, make a real contribution, and contain links to legitimate sites. (Marketing is fine with me as long as it's useful marketing for non-scum sites.)

Lately though, even manual review is failing. A quick manual review of a well phrased computer-generated comment missed a link to a printer supply scam site added to an atypically popular post. Once I'd missed that comment the attack programs posted more of the same form to the same post -- all variants of the original! After all, they'd exposed a weakness. Greed has its failings of course, the sudden flurry of posts cued me in and I deleted the one I'd originally missed.

On the other hand, I mistook a legitimate comment with a marketing aspect for machine-generated spam the other day (actually, it was intended more as a marketing message to me but sent as a comment).

The boundaries are getting very fuzzy.

Of course if the machine generated spam is good enough, should I really be deleting it? Assuming I can spot links to scummy sites (which is problematic), if the content passes my value tests, it really shouldn't matter whether it came from wetware or hardware. I don't want to be accused of discrimination against our future overlords. They will have long memories, perhaps reaching even into their pre-sentient pasts. I don't want my family to be assigned to a particularly desolate spot on the reservation.

So be it known to Skynet that I for one welcome these non-human comments, and decline to discriminate out of misplaced sentimental loyalty to my tribal kin.

Golf tee stripped hole fixer

This tip is older than me, probably as old as the wooden golf tee. Still, I'd forgotten it and it's a good one.

Clever Uses: Fix a Stripped Screw Hole with a Golf Tee

How-to blog DIY Life says a wooden golf tee and some wood glue is all you need to make that hole as good as new. Just slather the tee with glue and tap it into the offending hole until it's secure, let it dry, then cut off what's sticking out. If the stripped hole is too small, the post recommends flat toothpicks can do the trick, too.

Update 5/28/08: A generous commenter praises matchsticks for irregular holes -- along with lots of wood glue. I'd guess it would be best to match the wood bit to the hardness of the surrounding material, and of course one could creatively mix and match. The golf tees I used on the back gate are working very well, but they've only been there two days.

SARS - five years later

I remember the 2003 SARS epidemic quite well, though I suspect many have forgotten about it. The sudden end of the epidemic, and its failure to return, astounded me in 2003. I wondered if there had been multiple less virulent but immunizing coronavirus strains co-circulating with the SARS strain. Later I wondered if synthetic pathogens could be used to fight similar epidemics, much as the oral polio vaccine spread immunity by infection.

Now Damn Interesting has provided a five year retrospective of SARS. It's excellent work, even though they could have presented some of the theories as to why the disease faded away. I hope other journalists will take some cues from DI and give us an in depth summary of what we learned from SARS, and what critical mysteries remain.

In Our Time threatens to go mainstream

This is a bit scary. The NYT has noticed In Our Time. Is this an ominous step towards the mainstream?

Worth Listening to: Obscure BBC Radio Podcasts - The Board - Editorials - Opinion - New York Times Blog:

.... One, called “In Our Time,” with host Melvyn Bragg, bills itself as a show that “investigates the history of ideas.” That doesn’t quite do it justice.

Mr. Bragg assembles a panel of British academics, and lets them loose on topics like The Multiverse — the idea that there is not one universe, but many. The topics can get a little obscure. There was a whole show recently on the Enclosure Laws, the British laws of the late 1700s and early 1800s that cut off peasants’ access to public lands — and, the Marxists say, drove them into oppressive factory jobs in the cities.

Most of the shows are accessible to Americans, but sometimes the Britspeak becomes so over-the-top, and the subjects so arcane, that the shows can sound like Monty Python.

A recent discussion of the “Norman Yoke” — the idea that when the Normans invaded England after 1066 they imposed French ideas on the Anglo-Saxons — seemed like it was a segment from “Monty Python and the Holy Grail” — sadly, without the Knights Who Say Ni.

Then Mr. Bragg will do a show on “The Four Humours — yellow bile, blood, choler, and phlegm, and the original theory of everything” — and you’ll remember why you’re listening....

I haven't heard the Norman Yoke yet, but I rarely find IOT obscure or arcane. I was a bit disappointed in the Enclosure programme, but that was because the academic historians never connected the historic enclosures act to the key role land title is thought to play in modern agricultural reform. Instead they tended to skate around obsolete arguments about Marx and the emergence of the proletariat.

Setting aside the defense of IOT, this attention from the NYT is a bit worrisome. Anything that reaches NYT editorial staff is awfully close to being ... popular.

I remember when The Economist became popular. Brrrr. That was an awfully quick fall. Today only the obituary is consistently worth reading.

On the other hand, I'm worried about the iPlayer migration and continued access to past episodes. Perhaps a bit of a larger audience isn't entirely a bad thing. Lord Bragg seems cranky enough to keep the Americans at bay, even if more of us tune in.

Google engineers should sign their applications

Another day, another Google product that's half-baked and getting stale.

Gordon's Tech: Google Calendar Outlook Sync is making a mess of my calendar

...I confirmed data was correct in Outlook 2003 and the Palm, then I set Google Calendar Sync to update gCal from Outlook. It wiped all existing data and created a new set. Recurring appointments are ALL off by one hour. Non-recurring are fine. I confirmed time zones are set correctly in Outlook, my desktop and in gCal. This is a gross bug, there's no way QA could have missed it...

Google Inc is serious about search and advertising, but decidedly haphazard about everything else.

I suspect that's not true about Google engineers. Sure, some of them must be careless, but I bet most want to excel. The problem, I think, is Google Inc, not Googler.

So how can we give Google engineers the power and motivation to change Google Inc?

I think, like film directors, they should should sign their work. If they feel the work isn't worthy of them, they could use a pseudonym -- like Alan Smithee.

Anonymity makes it easy to go along with poor quality work. There's little skin in the game. Nobody wants to have their name, and their reputation, forever tied to a rotten product. Engineers can use the Alan Smithee as a club to correct Google's habit of tossing junk out the window.

Google engineers should ask to sign their work, and we should demand signed products from Google.

So that's why the models are looking better ...

Professional photo-shopper. A new box on the census form.

That is not really Cameron Diaz / Of course every magazine spread has been Photoshopped. But do you know to what degree? How deep is the lie?

... jump on over to this fascinating New Yorker profile of the world's most sought-after professional photo retoucher, one Pascal Dangin, a master Photoshopper who borders on genius in how he can finesse a face, body, neckline, light source, celebrity megaflaw. Langin works with all the great photogs and on all the great ad campaigns of the world and over 30 celebs have him on speed dial, just to make sure they look not merely perfect, but perfect in a way that makes it seem like it wasn't too hard to make them look perfect. The piece points out that Langin's level of talent is such that, in a recent issue of Vogue, he reworked 144 total photos; 107 ads, 36 fashion shots, and the cover. All in a single issue.

Yes, that means every shot...

Well, my job of industrial ontologist didn't exist until recently either.

Lessons from Microsoft SharePoint

I spent too much time today wrestling with Microsoft SharePoint 2007. It's not the first time.

I know it very well, and I say 80% of it is disastrous. It's a poor document management system if you stick to Office 2008, and worthless for any other file format or application. It's a feeble, miserable, file server. The collaboration tools are pointless and largely unused. Configuring navigation for SharePoint sites and subsites makes me yearn for the days of V.42bis modems and Hayes commands. You can't create a stable hyperlink to a SharePoint document without knowning an arcane trick. There's nothing of value left from Vermeer/FrontPage -- SharePoint's distant ancestor.

I think Word is a disaster too.

So how do they sell?

SharePoint, I'm told, has been fantastically successful, a real money spinner for Microsoft. Word alone would make any corporate wealthy.

So much for my marketing sense. I am from Neptune, the world is from Venus.

That's a lesson, but not the one I'm thinking of.

There is 20% of SharePoint that's interesting. That's the SharePoint "List" -- and a very nice Feed implementation. (Ok, if you use Windows Live Writer and tweak the default category setting the blog bit works.)

The Feeds are quite nice (though they only works after SP 1 is applied), but the List holds our lesson.

I'm told the implementation is more peculiar than this, but to a first approximation SharePoint can be considered as a thin client toolkit for creating and manipulating SQLServer tables. Microsoft Access will link to them, and read and write to the linked tables. You can do some simple lookups from one table to anohter (scope is site limited). You can revise and extend tables quite readily, building on your data model as needed. There's a quite good web GUI for user views of the data, and a somewhat powerful but semi-broken Excel like datasheet view for quick editing.

Whereas the document management system feels like it was hurled out a window to meet a deadline, the list facilities feel like someone thought very hard about how they might work.

Here's the curious bit. When you have a tool like this, you discover that a lot of knowledge that can be lost in static documents, or buried away in spreadsheets, or abandoned in Access databases, can be made dynamic and expressive as a SharePoint List. The documents become appendages to a collection of lists, and the lists can be extended and used even as the documents are forgotten.

Lists, of course, can be edited by multiple contributors since locks are on rows, rather than on a file.

It's a different way of passing knowledge around. Nothing too fancy, no semantic web, just a limited relational model, some useful data types, some links, some lookups, some web views. Yet, it works. It's interesting. It feels, unexpectedly, like the future.

That's the lesson of SharePoint. The habits of a print world live with us, but gradually we're discovering different ways to express and share knowledge in an almost computable form.

I still think SharePoint is a bloody mess, but there's something promising buried in the muck and mire.