Thank You For Your Thoughtful Comment

Thank you for taking some of your immensely valuable time to post a comment on my social media. Rest assured that I read at least some of it, and I’m certain the remainder was logical, factual, well written, free of grammatical or spelling errors, and did not at all resemble a word salad.

The reason you received this link is because there appears to be some disagreement between what I posted and what you believe to be true. And so, you bravely took it upon yourself to chastise the bad person on the internet for having an opinion different from yours. I expect your mother is most proud of such a laudable accomplishment. Tell her I said "Hi!"

If it gives you solace, you may consider me properly castigated by your impeccable logic, your intelligent use of facts and your cutting wit.

I do understand your desire is to have me reply directly to your comment, but I’m afraid I’m not the master of time management you are. As a result, I find I’m often behind in my work and cannot afford the specific care and attention such thoughtful prose deserves so that we may spend hours going back and forth in an ultimate quest to prove who is the greater master of the caps lock key.

If you believe you have been directed to this link in error, please send me $100 US for every 100 words you would like me to type in reply.

Have an amazing day.

Picky, picky Lulu finally picks a smart watch

I have been wanting a rechargeable watch ever since I reached my 40s and the time that an average watch battery lasts started to fly past me. Well, no, what I really liked was the idea of changing the watch faces easily. Um... no I think I craved a way to know whether fishing my phone out of my purse was worth it to talk to the caller I was getting. I was also feeling the peer pressure to get a fitness tracker. (Peers like my mother. And my doctor.)

I have been *thinking* about getting a smart watch for a long time. And reading reviews. And being stingy.

I also wanted to see what Apple would finally offer.

Apple is so annoying. They steal your music. Their products are too pricey. And they are the last to offer an option. Still I waited because clearly there is something wrong with me.

I settled on a Pebble, which as you know was one of the earliest smart watch offerings. I use a 4s because my Samsung Galaxy failed me, and my son had moved on to a 5s, leaving his old phone up for grabs. Yeah, it only has 8 GB. I use very few apps, and I sync all my photos to Flickr, and all my contacts to Google. This works fine for me.

The Pebble Time (Round) is compatible with up to the 6 (s?) and as far back as the 4s. This gives me space to upgrade to a newer phone at some point. And Target had one on clearance this week for $99.99. I had found my smart watch at last!

It holds a charge. It doesn't have a touch screen but this is good for my fumbly, middle aged fingers. It's fairly intuitive and easy to navigate. It has lots of free faces. (Shiny!) It syncs with Apple Health on my iPhone. It's lightweight, and very sexy.

I like to change my faces often, and show off my faces to friends. There's a quick launch for that! I like to review my notifications! There's a quick launch for that, too! It doesn't make a noise, it only vibrates. This is all I want and need.

But my 50 year old eyes need a thing it doesn't do. In the daytime, in order to read it without getting out the reading glasses, I need the backlight intensity set to "blinding" (yes, this is what they call it!). At night, in the dark, I need it set to "medium". There is no quick way to do this. "Display" is low on the scrolling menu, that doesn't loop, and "Intensity" is low on *that* menu... that doesn't loop. Quick lunch cannot be set for Intensity.

I looked on Pebble Reddit and saw that, so far at least, there is no app that can compensate for this.

So, though I know 50-somethings are probably not your target demographic, know that this 50-something appreciates the simplicity of the Pebble Time Round, but could really use an app for intensity toggling to set a quick launch to.

FYI, the Pebble Time Round is currently available at Best Buy for $150. The $100. one I got at Target? I think I snagged the last one. :-D

Elves and Gnomes for the holidays

If you love wine and hate waste as I do, you have a cork collection, as I do. I also happened to have some 1 inch wooden beads and a hot glue gun. Putting the two together make a perfectly serviceable doll peg. "Gmones" for Waldorf education, like "Math Gnomes" can be found all over the web. They are doll pegs dressed in felt costumes. Similarly are embroidered gnomes, also dressed in felt. I have plenty of wool and acrylic felt, and I may just use it for peg dolls at some point, but what I find most soothing is crochet, both simple and complicated. This project required you to know how to single crochet, something many crafters can easily do.

Ain't she a cutie?



I could have chosen to use felt for the non-crochet bits of this project, too, but I don't like the "hand" of felt as much in such a small doll as I like t-shirt fabric. In a small project, the t-shirt fabric has a more realistic/nicer drape. As I recycled my son's t-shirts into a quilt this year, I have many colors of t-shirt scraps left over. But you can use felt, if you prefer. Felt is very Christmassy, too.



Start by cutting a circle of your chosen fabric. For an elf, I wanted to use red as a contrast, but you can match your crochet thread, if you like. I also cut a strip for the hat headband and scarf. Use the photo for scale, I just eyeballed it.



Next with a fine needle and regular matching thread, blanket stitch around the circle. The stitches should be small, about the size of a single crochet stitch.



(Wonders if Margaret Atwood crochets?)

I chose size 3 crochet thread for this. This is as large as you should go, IMO. Anything larger will give you something too bulky and out of scale. It will look less like her mama crocheted her a sweater and more like some fumbling hooman accosted her with a crochet hook.



Pull a loop of your crochet thread through any single blanket stitch, then single crochet all around the circle. Be careful not to pull your stitches too tight!



For the second round, single crochet into back loops only. Then check to make sure the proto-sweater fits snugly but not tightly around the bottom of your cork doll.



For all the remaining rounds, just single crochet. I crocheted with the sweater in place, but you don't have to. Just check the fit every few rounds to make sure your stitches aren't too tight.



You can either stitch the "neckline" with the sweater on the doll, which I chose to do, or you can use a yarn needle use a running stitch to snug things up at her neck.



Next is the hatband. You will want this to be able to fold up, so make it twice as wide as the space you want covered. Measure around the head with a little overlap, and cut. Here also, you blanket stitch, but unlike in this photo, I found it works better to sew closed the loop with a seam up the back first, then sew around the loop.



Again, pull a loop of crochet thread through and single crochet all around. I prefer to crochet the second row back loops only, but this isn't critical. Every row above that, drop one stitch, over the seam in the hatband. This will be the back of the hat. It gets a little tricky as you reach the top. at the very top, chain two to finish. Leave a good few inches of crochet thread for the beads.



Fold the rest of the fabric strip in half lengthwise and artfully tie it around the doll's neck. Using the matching sewing thread stitch in place a "knot"



Fold hatband in half, or "up" over the bottom row of crochet. Glue hat into place. I used hot glue, but had bad results on another peg doll with hot glue. So, I recommend NOT using hot glue. You want to use a glue that stays wet long enough for you to move the hat to exactly where on her head you want the hat to sit. Hot glue locks the hat in the first place you set it, like it or not, "cute" or not. Of course, if you use slow set/slow dry glue for better results, you will need to let the glue dry completely before moving on to the next step.



Next you will need a tiny buckle. Or, you will need some wire and some tools. I *think* this is 16 gauge. Not sure. I like silver for elves and Santas and such.



Using flatnose pliers, bend an end of wire 90 degrees, then wrap the wire all the way around.



You will wind up with something like this. Use dykes to snip it off the wire. There is your buckle. Cut a strip of fabric the width of your buckle and the distance around your cork. I used grey. Threat the "belt" through the "buckle". Hot glue is prefered for gluing this into place, or you can stitch it.



Thread a piece of that same wire through the chain at the top of the hat, then use round nose pliers to work it into a swirly "s" hook. On that left over crochet thread at the top of the hat, thread some glass and silver beads, then a crimp bead. Use flatnose pliers the crimp the bead flat.



Leave the face blank if you like. That is the Waldorf style. If you like a face like the one on mine, I made two dots with a Sharpie, and make her cheeks rosy with a some blush and an eyeshadow brush.

Make many in different colors, and give as gifts. Or tie to gift wrapping. Or just keep for your own tree. For our Jewish friends and family, I also made a "Hanukkah gnome". See how her hat is crooked/rumpled? This illustrates the problem with using hot glue for the hat. Don't!



Merry Christmas, Happy Hanukkah, and all that!

I'm in the button biznez, bitchez!

                                                                 Are you thinking about buying a button maker for your organization? Different badge or button makers specialize in different sizes. Some companies don't make anything smaller than 1 5/8 inches. I opted for a 3 in one system from Badge-A-Minit. Big. Mistake. I planned on making MOSTLY the 1.25 inch size, the 2.25 and 3 inch mostly for novelty. Seriously the 3 inch size is like a frying pan. 

But the B.A.M. system cannot make 1.25 inch buttons properly. It's far to easy to over press and underpress. I had success about 1 time in 10 making a presentable 1.25 inch button. I wrote to them. I chatted with them. They sent more explicit instructions that raised my fail rate from 9 in 10 to 8 in 10. But nothing else. No replacement parts, no new machine parts, no refund. Their lifetime warranty is worth nothing.

SO... I cut my losses and bought a 1.25 inch only machine. It cost as much as the whole 3 in one B.A.M. system, but it is worth it! Foolproof is an understatement. I bought the model 250 from TheMadShop.com onEtsy. Seriously, if you need small buttons, Badge A Minit is not for you.

No Treatment or Vaccine for Ebola, but a $1000 Pill for Hepatitis C

Posted on August 3, 2014 by Lambert Strether on Naked Capitalism 

http://www.nakedcapitalism.com/2014/08/treatment-vaccine-ebola-1000-pill-hepatitis-c.html

By Roy M. Poses, MD, Clinical Associate Professor of Medicine at Brown University, and President of FIRM, the Foundation for Integrity and Responsibility in Medicine, a not-for-profit organization (NGO) designed to raise awareness of external threats to the core values in health care as the first step toward addressing them. Originally published at Health Care Renewal.

The Ebola virus epidemic in West Africa continues to grow, and now appears to be the worst known epidemic of that disease to date.  In the US and Western Europe, press reports are now raising concerns that the disease could spread there.  For example, CNN, in an article entitled “Ebola Fears Hits Close to Home,” was a section headed “Could Ebola spread to the US?” An ABC article was entitled, “How the US Government Could Evacuate Americans with Ebola.”

Reasons for fear of spread are the increased mobility of people made possible by air travel, and the lack of specificity of early symptoms of Ebola, so infectious people may not realize the dangers their travel might pose.  A US citizen with Ebola was on his way back to the US via several connections, and made it as far as Lagos, Nigeria before becoming too ill to travel further (per CNN).  Making the fears worse are the high fatality rate of Ebola, the current epidemic included.  According to Vox, the current outbreak is the Zaire subtype of the virus, with an expected mortality rate of 68%.  Finally, there is no known effective treatment or vaccine for the Ebola virus.

Economics, not Science the Reason for Lack of Medical Options for Ebola

The reason there are no vaccines or treatments available for Ebola does not appear to be the scientific difficulty involved in developing them.  Vox also published a discussion for the economic genesis of the problem:

 Researchers have devoted lots of time to building a vaccine that could stop the disease altogether — and according to Daniel Bausch, a Tulane professor who researches Ebola and other infectious diseases, they’re making really significant progress.

Bausch says that the obstacle to developing an Ebola vaccine isn’t the science; researchers have actually made really great strides in figuring out how to fight back against Ebola and the Marburg virus, a similar disease.

‘We now have a couple of different vaccine platforms that have shown to be protective with non-human primates,’ says Bausch, who has received awards for his work containing disease outbreaks in Uganda. He is currently stationed in Lima, Peru, as the director of the emerging infections department of Naval Medical Research Unit 6.

The problem, instead, is the economics of drug development. Pharmaceutical companies have little incentive to pour research and development dollars into curing a disease that surfaces sporadically in low-income, African countries. They aren’t likely to see a large pay-off at the end — and could stand to lose money.

Prof Bausch elaborated,

These outbreaks affect the poorest communities on the planet. Although they do create incredible upheaval, they are relatively rare events. So if you look at the interest of pharmaceutical companies, there is not huge enthusiasm to take an Ebola drug through phase one, two, and three of a trial and make an Ebola vaccine that maybe a few tens of thousands or hundreds of thousands of people will use.

Of course, that assumes that this outbreak, like previous ones, will remain relatively confined, at least to Africa.

The 10/90 Gap

So the implication is that had things been otherwise, those in developed countries now worried that Ebola could spread their way could have been reassured by the availability of a vaccine, or other treatment. 

The irony, if that is the right word, is that we do not have an effective treatment or vaccine for a viral disease that is relatively easily spread, and could likely rapidly kill nearly 70% of those infected.  Yet in the last months, we have been arguing about how the use of an extremely expensive treatment for another viral disease that is difficult to spread, and may kill a few percent of its victims over up to 20 or 30 years after infection. 

I am referring, of course, to Sovaldi, the recently announced $1000 pill for hepatitis C.  Hepatitis C does affect a lot of people, including relatively affluent people in developed countries.  As we noted previously, though, the majority of people infected with hepatitis C will never have serious medical repercussion from it.  Small proportions of patients will eventually develop severe liver disease, including cirrhosis, liver failure, and liver cancer, and may die from the disease.  (See the report by the Center for Evidence Based Policy). Yet the treatment is being promoted for all patients with hepatitis C, most of whom could not benefit from treatment.  Furthermore, the evidence that treatment will actually prevent bad clinical outcomes, cirrhosis, liver failure, liver cancer, and premature death, is weak (lookhere).   Yet considerable money was devoted to developing multiple hepatitis C treatments, with the expectation that huge amounts of money could be made from selling them. 

This is an example of the 10/90 gap.

A long time ago, in 1998, I was invited to Forum 2 of an organization called the Global Forum for Health Research  The GFHR was an organization dedicated to overcoming the “10/90 gap”:

Less than 10% of the worldwide expenditure on health research and development is devoted to the major health problems of 90% of the population

Yet the 10/90 gap is probably getting worse.  In the US, our health care has now been heavily influenced by advocates of neoliberalism, or economism.  Health care is now largely run by generic managers trained in business schools, with no specific training or expertise in health care, and doubtful loyalty to its values.  Current business school dogma emphasizes the primacy of economic efficiency over all other goals (look here), to maximize “shareholder value,” which usually practically means maximizing short term revenue, to the immediate advantage of shareholders sometimes, but nearly always to the great and immediate financial advantage of paid managers and executives.  The emphasis on short term revenue uber alles helps explain how we have multiple expensive hepatitis C drugs, and no Ebola drugs or vaccines. 

The real irony is now that some very well paid managers may be worrying about the possibility of contracting Ebola whose transmission was facilitated by our increasingly global economy, globalized in part due to the advocacy of those advocating neoliberalism and economism. 

Summary

Unfortunately, the fortunes of the Global Forum for Health Research seem to have faded.  It went into sudden decline in 2010, and was subsumed into COHRED, the Council on Health Research for Development.  The last Global Forum meeting was in 2012, although there seem to be plans for another next year.    Meanwhile, multiple international organizations. including Medicins Sans Frontieres, established a Drugs for Neglected Diseases initiative, although its progress seems to be slow (see Pedrique B, Strub-Wourgaft N, Some C et al.  The drug and vaccine landscape for neglected diseases (2000-11): a systematic assessment.  Lancet Glob Health 2013; 1: e371.  Link here.).

In my humble opinion, as long as much of the health care system is run so as to put short-term revenue ahead of all else, a manifestation of financialization encouraged by the generic managers who run so much of health, partly in their own self-interest, and by business schools promoting the shareholder value theory, we will not make much progress on the 10/90 gap.  Ironically, the realization that even rich generic managers may no longer be protected from some of the deadliest diseases that used to only afflict the poorest people in the world may have an effect on this problem.   

As I have said before,  true health care reform would put in place leadership that understands the health care context, upholds health care professionals’ values, and puts patients’ and the public’s health ahead of extraneous, particularly short-term financial concerns. We need health care governance that holds health care leaders accountable, and ensures their transparency, integrity and honesty.

But this sort of reform would challenge the interests of managers who are getting very rich off the current system.  So I am afraid the US may end up going far down this final common pathway before enough people manifest enough strength to make real changes.

Adventures in Networking, Parental Edition

My Mothers' Day treat was last night at Rendezvous in Central Square. *Today* we went to my parents' to give Mom her present: Make Netflix work on her Wii again, for the first time since they moved to a new apartment, months ago. The first 30 minutes we spent trying to make the Wii "find" the WiFi network. Eventually we realized that we had to MOVE the router into the middle of the bed room. After 20 tries the network finally appeared in the list.

The next 1/2 hour Jason (and I at his insistence) entered the PIN instead of the network key. Tried this security setting, tried that one, but always with the PIN. Three times he told me not to bother calling Nintendo for help because they won't be available on a Sunday. And if you want to get along with your man, you don't argue about this. You let him try until you can say, see? YOU NEED HELP!

The next 30 minutes we spent working with the Nintendo guy, who picked right up when we called and was wikkid helpful. Once we entered the *network key* like we should have attempted originally, it STILL didn't work. We would have had to call anyway for the guy at Nintendo to tell that us the key had probably been changed from the factory default, and that we could find this password on my parent's desktop. Only my Dad had accidentally kicked the power cord out of the router. 90 minutes in and the desktop stopped accessing the internet. I thought Dad was going to freak out.

About 10 minutes of stress, Jason finds the cord is out and powers the router back up. Dad hovers now at the computer because we have to WAIT for the internet to come back up and he is now sure we have completely FUBARed his desktop so bad only my brother Dan can fix it. Once it is working again he says, "DON'T DO ANYTHING MORE!" Because he thinks the loss of his desktop connection was OUR fault. So I talk him down and get back to the computer. The network key HAD been changed to something very short and easy, probably at Dad's request, but there was no way we could make him understand what we needed in his increasingly senile state. (Believe me, we tried) Within 5 minutes we the Wii internet settings working and have Netflix running.

But Mom had disconnected her account, since she hadn't been using it. And she needed to put in a new credit card, the one in the system was no longer any good. Only we don't use American Express, so we keep putting the wrong security code in and keep getting rejected. My Dad is so high strung about people touching his stuff and our annoyed tones of voice, he is ready to insist we give up after nearly two hours. He leaves, not quite storms out, to take a walk. He is back nearly instantly.

So now we have to call Netflix to figure out what we are doing wrong, and the girl there tells us not to use the Wii to reinstate, but use the website. Back to the desk top. Only Dad sits by and hovers and we wait in the living room. We can hear Dad asking Mom to give up and send us home, so I send Jason in (because Dad won't yell at him) to see if he can help Mom. On the Netflix site, there is a little question mark one can click on that explains what we are doing wrong with the security code (What? We haven't used American Express in over 20 years!) And finally, Netflix is working on the Wii on my parents' big-ass flatscreen. Yay.

This is when Dad announces that Netflix sucks and that their selection is crappy. I tell him with a smile of course, "Well, it's Mothers' Day and we are here to please Mom, not you!"

For the last 15 minutes I show Mom how to use the Skype app on her iPad to get ahold of AJ, who is ALWAYS on Skype. She video calls him, coos over his curls and is happy. Two and a half hours of WTF and we finally have Mom hooked up and happy. We kissed them, listened to Dad grumble and Mom thank us profusely, then left.

We stopped at the package store on the way home for some MUCH needed wine. The end

Epilogue: *sips wine*

If not us, then who? Some corrupt attention whore!

I have been roving around the circles of the spiritual community for 30-ish years, in the Happy Valley, around JP, recently out in metro west, and I keep bumping up this very frustrating fact: Of the people within these circles that I encounter the *vast* majority consider themselves "above" politics.

"I'm not political"

"I don't vote"

I understand their belief that they way to make the world a better place is to focus on positive energy, personal responsibly, taking their own inventory, but the reality is, what that mostly does is make the space closest to them a better place. You can make a great space for people to come and heal from the cruel world yes. Yes, it has some effect on the rest of reality outside your vicinity. But while folks are using (don't get me wrong, very valuable) healing arts, doing their drumming, yoga, or what ever, very un-spiritual, very sick, negative energy people are making policy that is crushing the souls of billions, making people physically sicker, or outright blowing poor souls to bits in wars that the sick, *willing* political participants are inflicting on the rest of the planet.

Why not get involved in making the *policy* that will heal the world, make it less cruel, make folks in it less in *need* of spiritual healing?

Sure, voting isn't working the way the system works now. But we didn't give up on medicine when "physicians" were bleeding people to death. We knew that doctoring had to happen, and it took brave souls to stand up to the established order and say "Healing: You're doing it wrong!" And brave souls to go to those doctors the established order disdained.

I just met a young man last week in yoga class who lived in a town from which I needed a signature to get my candidate onto the ballot for state rep in November. I asked him if he was registered to vote and he said no. I asked him if he would please register and I would ask him again to sign the next week. He seemed affable and amused, but when I returned to yoga this week, he was harsh. He asked me, "Why don't you just ask God?' I didn't understand. "Instead of asking people to help you get him on the ballot, you might as ask God because he will never win." (Mind you, this is someone who considers himself FULL of positivity and light!)

So I dropped back to my old stand by question: Do you consider yourself intelligent? Most people say yes, and then I say, "So if the smart people are too smart for politics, we will always be run by idiots!" Or some such quip. But this young man asked, "Smart in what sense?" I said in any sense. And he said blithely with a little grin "I don't know." Well, I knew what to say to that!

"Isn't that who should be making policy? People who *aren't* completely satisfied that they have already learned everything they need to know? If the compassionate, positive, spiritual people won't run for office, vote against the duopoly, get involved in *policy* making, then it will be left to the corrupt, the heartless, the attention whores!"

Well, he clearly thinks himself smarter than at least me, because he said one last time before leaving, "You can't win." But he said it with a smile. 

Way to stay positive.