Hey, here's one! Drug cartels built a functioning submarine. Er, wait. I guess that's not what I was going for.
Still: kinda neat.
God, I hate to run immediately off onto a tangent, but I had the most confounding conversation today with a friend, who told me his idea for solving the Medicare problem: we should set a date, a year, prior to which procedures paid for by Medicare would be covered; that is, any fancy procedure you want done that was invented after that year -- say, 1985 -- would not be covered (on the theory that it's too expensive), and you'd have to buy supplemental insurance to cover it.
This was apropos of my sketching to him this post of Benen's on the Independent Payment Advisory Board, which would apply evidence-based medical assessment in order to control Medicare costs.
Can we even begin to say what's wrong with my friend's idea? Why, yes, we can, at length and forcefully! In the end he folded and said, somewhat abruptly, that I'd convinced him that his was an idiotic idea. Whew.
The number of wrong-headed notions in place that make someone come up with an idea like that are slightly boggling to me. Never mind the moral hazard. It's chiefly the notion that people are getting all kinds of fancy procedures that people in the old days (pre-1985) did without, and if you're receiving these services while on Medicare, you're acting like some kind of princess or something.
Comment 4 gets it exactly right. How does that even happen?
The number of wrong-headed notions in place that make someone come up with an idea like that are slightly boggling to me
I wouldn't assume bad faith. It's an intuitive approach: reducing it to an already-solved problem. It's probably a more generous Medicare than I will ever see.
They've done a few of these at the University of Louisville. It was all over the local news when I was in high school. Pretty amazing, really.
Before we revert to happiness, no more masturbating to Piss Christ.
Does it count as masturbating if you use your transplanted hand?
That depends whether the ban extends to masturbating with the dead.
This is a happy thread, parsimon.
Sure, transplanting hands, what could possibly go wrong?
In other medical news.
This may be the great loophole. As long as your hand donor is also deceased, it's Katy bar the door!
9: if you masturbated on Piss Christ, would that count as taking sides or would it be confusing?
9: But, maybe just a three day moratorium?
What if you had a hand transplant AND a genital transplant? From different people! Everybody would be so confused!
3: Doesn't Medicare presently feature a similar limit, at least to the extent of not covering dental care because in the '30s people lost all their teeth at what we would now think absurdly young ages?
Happy A solemn and reflective Maundy Thursday to you all, Internet reprobates heathen.
17: A better man than I could come up with a Young Frankenstein joke.
19.last: Tonight's required reading is from Borges.
21: Aw, I love Borges. A while ago I tried to write an imitative-of-him little prose thingy about an incompetent Byzantine saint.
I like this other Borges story, read by Paul Theroux.
23: I first read it based on your mention.
On a lighter Holy Week note, I mentioned today to a retired ecclesiast that, in terms of crowd appeal, the combination of Jesus and candy is a good one, so the shrinking Protestant denominations ought to look into branding other significant Sundays with associated confections.
Laugh now, enjoy First Sunday in Advent coconut creams later, people.
First Sunday in Advent coconut creams
While you're at it, some snappier names for the significant days themselves would help too.
25: from the candy-maker's perspective, the extreme seasonality of demand would hurt the economics of the deal. Far better to create a racket like the makers of dragées have in France. Making your product the official confection of baptisms allows you to spread the demand out across the year (except for Lent, of course).
BTW, in the religious observances of my childhood, Fourth Advent was associated with an orange and a candy bar for every child (the church gave them out at the end of the service). There was no single official brand of candy (sponsorship opportunity!), but I invariably took Almond Joy from among the selection offered.
from the candy-maker's perspective, the extreme seasonality of demand would hurt the economics of the deal
Relatedly, it seems that in communities with large Jewish populations the supermarkets slash the price of the Passover food massively as soon as Passover starts. (In communities without large Jewish populations they just run out entirely.)
This is a happy thread
No one mention the movie with Peter Lorre.
Oh, great. It's already been mentioned.
To wit, doctors can transplant hands?! Neat.
What else have I missed, internet?
25: from the candy-maker's perspective, the extreme seasonality of demand would hurt the economics of the deal.
I'm not so sure about that. Cadbury's does very well out of Easter with Creme Eggs and Mini-Eggs. It also means they only have to advertise for a short time each year.
13: We had this patient who suffered penile fracture after running across the room and trying to penetrate his wife with a flying leap.
And now he doesn't give a flying f*ck.
This is pretty cool: http://bit.ly/f1L3Ue
23: Apparently, Borges was originally going to call that essay "Three Tickets to Paradise", but then the Eddie Money song came out, and he didn't want it to look like he'd ripped it off.
||
Slate via Yggles anxiety in men and women.
Starts off: "Women, according to countless studies, are twice as prone to anxiety as men."
But moves to:"It should be pretty clear by now that the claims about women being far more innately anxious than men are suspect, but before I depart in a blaze of justice, one final point is in order: Men are getting off much too easily in the anxiety discussion. Probably the most significant reason why women get diagnosed with anxiety disorders twice as often as men isn't that they're doubly fearful. It's because anxious men are much less likely to seek psychological help. " ...toward the end.
I liked it.
|>
26: The perfect opportunity to revive Michaelmas and Candlemas et al.
36: By that reasoning, shouldn't women be diagnosed with mental and emotional health problems at twice the rate of men for every disorder?
Rather than focus on holiday-specific treats, the Church could release lines of doctrinal candies that are appropriate the whole year round: Beatterfingers, Ten Commandmints, etc.
39: Soteriolojellies, Caramelitas, etc.
Pure anecdata here of course, but among the people I know personally, anxiety and depression are hugely more prevalent in women than men. Or, at least, anxiety and depression severe enough to interfere with day-to-day activities (which, like the article says, may be as much or more about coping strategies as actual severity). But really, it's not even remotely close.
39: Apostlicles work only in warm-weather climates, but with the target demos spanning both the Northern and Southern Hemispheres, there's a year-round market.
re: 41
Up to a point, I'd agree. However, the unfortunate few people I've known with really severe depression or psychotic illness have largely been men. The successful suicides I've known have been men. But in terms of general instance of (admitted) depression/anxiety, yeah, I'd say among people I know it's skewed female, too.
41: Yeeeahh, but in our culture, you tend to see a lot more men self-medicating for depression, anxiety, etc., with the result that they're problems are medicalized as an addiction, rather than an innate disorder.
39, 40: Apart from The Immaculate Confection, I can't think of anything; those are harder than you'd think (soteriolojellies? Come on). Maybe this has something to do with Jesus' proscription against overly-sweet chocolate treats.
33.--That part really leapt out at me too.
By that reasoning, shouldn't women be diagnosed with mental and emotional health problems at twice the rate of men for every disorder?
For mental/emotional health problems other than anxiety and depression:
It might be that women with such problems are twice as likely as men with the same problems to seek help, but that the problems are ten times as common in men as in women; so the figures will show more cases among men than women, even though they won't show the true extent of the problems in either men or women, and will underestimate the gap between them.
In fact, this is pretty much what the figures suggest; depression is the commonest mental/emotional health problem, but it's also the only one more common among women than among men. All the others appear far more often in men than in women.
It might also be that men and women are taught to deal differently with anxiety, but not with other problems; that men are just as likely as women to seek medical help (or have it sought for them) for psychosis, etc.
"depression is the commonest mental/emotional health problem, but it's also the only one more common among women than among men"
This is false. Borderline springs to mind within seconds; I'm sure I can think of others given a little time.
33, 46: I was going to quote that bit too, but now I see there's no point.
44: Also, even outside the context of addiction, I think people in our society have a tendency to look at aberrant, counterproductive behavior from men and think of it as evidence of bad character -- they're just being assholes, or lazy, or whatever -- where similar behavior from women comes across as a symptom of a psychological disorder.
Doesn't mean there's no difference between the incidence of depression, but I do think there's an equalizing effect there.
That part really leapt out at me too.
*snicker*
Actual psychosis and schizophrenia, OTOH, is heavily male in my same unscientific sample. And practically all of the outwardly violent aberrant behavior.
Also, I think it's an area where anecdata is extra-meaningless, since people can be superb at hiding depression if it clashes with how they want others to see them. I don't think you can hide it from someone you live with, but short of that all bets are off.
Unipolar depression, predicted to be the second leading cause of global disability burden by 2020, is twice as common in women.
...
There are no marked gender differences in the rates of severe mental disorders like schizophrenia and bipolar disorder that affect less than 2% of the population.
I think it's important to draw a distinction between diagnosis and actual incidence - women may in fact be more prone to anxiety/depression, but they may also be more likely to make contact w/ a doctor and enter medical statistics.
53. Also, I believe Antisocial Personality Disorder(s). I read a thing recently where a clinical psychologist working mainly with prisoners stated that diagnoses of men, both in the prison and general populations, were 10x those of women, though obviously both were massively higher in the prison population than generally.
There are no marked gender differences in the rates of severe mental disorders like schizophrenia
This surprises me, and you can't hide schizophrenia very well.
Also, diagnosis can be biased by all these wider cultural assumptions about who is prone to what.
59 is very true, which is one reason I phrased 57 as tentatively as I could. The other reason being that I've no idea how sound the bloke was/is, and I can't find the article now.
55.1: well, that's overall; so including anxiety/depression.
Mind certainly reckons (http://www.mind.org.uk/help/people_groups_and_communities/mens_mental_health#facts) that personality disorders, PTSD, substance abuse and ADHD are all more common in men.
Perfectly happy to admit I was wrong and not _all_ of them are commoner in men. The WHO link also has this interesting one:
"Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms."
This does leave open the question of whether they're overdiagnosing women or underdiagnosing men, though.
I would have gone through all the anxiety disorders, but now I see that's what this conversation is about.
Anyway, internalizing disorders (self-criticism, excessive, negative self-focus, rumination) are more common among women. Externalizing disorders (aggression, impulsivity, substance use, the callous/unemotional variety of disinhibition) are more common among men.
Where are you getting that about PTSD, ajay?
When I google I get this.
(In either case, PTSD is a weird one, because to truly assess gender differentials in risk you should look at rates of PTSD conditioned on experiencing the trauma in the first place, but a quick google suggests higher rates of PTSD for women.)
It would be very surprising to me if the people doing epidemiological research relied primarily on people presenting for treatment to construct their prevalence estimates. I don't read a ton of those papers, so maybe they're all just that dumb, but I wouldn't think so. It's also not a mystery to anyone doing epidemiological research that substance abuse and depression/anxiety disorders frequently co-occur, so if you're trying to do an epidemiological survey, you'd presumably look even harder for anxiety and depression if you saw substance use problems; that's certainly what you'd do in a clinical interview. However, even when you see alcoholism or other externalizing co-occurring with internalizing, it doesn't mean the internalizing is necessarily primary. If you have an impulsive personality/are bad at learning and behaving according to the rules of your environment, and you get punished -- both in the sense of formal discipline and in the sense of negative reactions from your social environment -- frequently and for reasons you don't understand, you're going to be anxious. You may also feel guilty as a result of your "bad" behavior.
That Slate article was pretty irritating. E.g.
If women really were fated to be significantly more anxious than men, we would expect them to start showing this nervousness at a very young age, right?
For the love of Christ, no, not just because of hormonal changes, which the author gestures in the direction of, but also because of the development of your ability to represent and plan for the future -- a core feature of anxiety! -- subserved by the development of a crucial part of the brain (prefrontal cortex) for representing and planning for the the future. What anxiety is and can be changes as children develop, so there's every reason to think the nature gender difference would evolve through development, even if one were presuming exclusively biological causes for that difference. Sheesh. Tendentiousness in favor of either biological or social explanations is annoying.
so maybe they're all just that dumb,
Strike this; I do know how some prevalence estimates have been done in some papers -- I just remembered a discussion I had regarding the realness of the age cohort effect (i.e., that depression is more common now), and it's by very careful interview that makes sure not to ask questions with the words "depression" and "anxiety", but with reference to the symptoms, attempting to use language that accounts for peoples' differences in expectations for life and the way they represent their experiences for themselves, to elicit maximal reporting from people who might tend not to report. I don't know of anyone in the field who thinks the gender difference in rates of depression is artifactual.
Where are you getting that about PTSD, ajay?
From the link I gave - though it does also note that men tend to be more likely to have traumatic jobs in e.g. the military or emergency services.
(soteriolojellies? Come on).
Oh, it's on now.
EsKitKatologies. Chocolate Barths. Licorice Loaves & Swedish Fishes. Deuteronougat. Bonbonhoeffers.* O Heath Bar Night. Hard Corinthians, the jawbreaker with the pleasure-loving, litigious reputation. Annunciation Crunchies (It's like an angelic visitation in your mouth!). Petit-Five Foolish Virgins (Straight from Paris to you!). Prodigal Sunflower Seeds. Joseph and the Rich Milk Chocolate Coating.
* Now I feel guilty.
Swedish Loaves & Fishes. Punchier.
If we're willing to allow snacks outside the realm of sweets (and in Spanish): Papas fritas. (Which might dovetail nicely with my never-to-actually-be realized-plan to bring to market Dictator Tots.)
Papas fritas
Yeah, I want some Jeezy Poofs.
Yeah, I want some Jeezy Poofs.
You win.
||
Homeless 'meters' aim to eliminate panhandling
Ha, no. Unless those things dispense booze and crack, panhandling will continue.
|>
Most of the panhandling in Austin happens at major intersections, so most people have signs. There was a guy around for a while who carried one that said something like, "Let's be honest. I just want to buy a beer." I imagine he did pretty well with that.
(I gave him money, but then I give money to almost anyone who asks.)
Let's be honest. I just want to buy some killer weed.
I take PayPal, Kraab.
Let me clarify: I give money to almost anyone who asks while they're standing in front of me. Come down to Austin and then we'll talk.
I find the number of public places lacking benches disconcerting. Office building fronts are understandable, but San Francisco Civic Center? It feels like a public declaration: "we've decided there will be homeless people forever, and therefore must design public spaces with that constraint in mind."
From the link I gave - though it does also note that men tend to be more likely to have traumatic jobs in e.g. the military or emergency services.
Further, it doesn't actually say PTSD is more common in men than women. It just says people in certain professions are at high risk for PTSD, and those professions also have a lot of men. It's also true that people who are raped are at high risk for PTSD, and those people are likely to be women. In the US women are twice as likely as men to have PTSD. IMO, that's probably due at least in part to differential susceptibility, since PTSD is an anxiety disorder and women are more vulnerable to anxiety, but it's hard to disentangle susceptibility from environmental risk.
I'm a little hurt that no one has run with "Hard Corinthians." I thought we took advantage of low-hanging fruit here.
it's hard to disentangle susceptibility from environmental risk
I'm not sure what any such disentanglement would look like.
OT: I don't know what this means about the recession, but Manhattan Motorcars on 11th Avenue has three (!?) Bugatti Veyrons in the window (and in the "pre-owned" section of their website).
Pope Rocks. Jewbreakers, if you're hewing to the St. John Passion.
I'm a little hurt that no one has run with "Hard Corinthians."
Sounds like a good way to get a fracture.
87: I prefer a little [puts on sunglasses] Bach candy for Easter. [Roger Daltrey yells.]
85: I just meant that since not everyone who experiences trauma gets PTSD, there is something in the individual, or perhaps the individual's social network or something like that, that confers risk or protection. Some of that is probably determined at birth. For example, there's a recent twin study on hippocampal volume and risk for PTSD that showed that having a smaller hippocampus was a genetically determined risk factor for, rather than a result of, PTSD (at least in their sample). Some of that is probably determined by the person's experience leading up to the adult trauma (having been abused as a child is associated with risk for adult PTSD, though I don't think anyone understands why). That's what I meant by susceptibility.
Then you have rates of exposure to violent trauma as an adult. That's what I meant by environmental risk. It doesn't seem clear to me that women experience more violent trauma as adults than men (? is the number of people who get raped higher than the number who are beaten or mugged with a deadly weapon? Maybe -- I don't know). So you have a question: Do women experience more trauma? Are the kinds of trauma women experience more likely to lead to PTSD? Or is rape just more likely to lead to PTSD than a mugging because it happens more to women, and women are more anxious? Anyway, teasing out the answer to the second two questions would be really, really, hard, although a study that matched veterans on combat exposure and looked at preexisting anxious symptoms and life stress history stuff might be informative. Like, if women, when matched for exposure, got PTSD more than men, but highly anxious men got PTSD just as much as women did, then you'd say, well, I guess women are more vulnerable to PTSD because they are more anxious.
I think it's hard to match men and women on rape in the same way as you could match on combat exposure. It just seems to me that the meaning of rape is so fraught with gender role stuff that it's really hard to say it's the same thing for men and women. Combat exposure seems more uniform in meaning across gender to me, but maybe I'm wrong.
Cadbury's does very well out of Easter with Creme Eggs and Mini-Eggs.
I've started in on my third 18-oz. bag of Mini Eggs of the season. I fucking love the Mini Egg time of the year.
What is the first visible sign of the sacrament of the Lord's Supper?
We break a Kit Kat-e-Kism.