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Good Agile, Bad Agile

Posted on November 18, 2008 in Generic biologicals

  Scrums are the most dangerous phase in rugby, since a collapse or improper engage can lead to a front row player damaging or even breaking his neck. — Wikipedia When I was growing up, cholesterol used to be bad for you. It was easy to remember. Fat, bad. Cholesterol bad. Salt, bad. Everything, bad. Nowadays, though, they differentiate between "good" cholesterol and "bad" cholesterol, as if we're supposed to be able to distinguish them somehow. And it was weird when they switched it up on us, because it was as if the FDA had suddenly issued a press release announcing that there are, in fact, two kinds of rat poison: Good Rat Poison and Bad Rat Poison, and you should eat a lot of the Good kind, and none of the Bad kind, and definitely not mix them up or anything. Up until maybe a year ago, I had a pretty one-dimensional view of so-called "Agile" programming, namely that it's an idiotic fad-diet of a marketing scam making the rounds as yet another technological virus implanting itself in naive programmers who've never read "No Silver Bullet", the kinds of programmers who buy extended warranties and self-help books and believe their bosses genuinely care about them as people, the kinds of programmers who attend conferences to make friends and who don't know how to avoid eye contact with leaflet-waving fanatics in airports and who believe writing shit on index cards will suddenly make software development easier. You know. Chumps. That's the word I'm looking for. My bad-cholesterol view was that Agile Methodologies are for chumps. But I've had a lot of opportunity to observe various flavors of Agile-ism in action lately, and I now think I was only about 90% right. It turns out there's a good kind of Agile, although it's taken me a long time to be able to see it clearly amidst all the hype and kowtowing and moaning feverishly about scrums and whatnot. I have a pretty clear picture of it now. And you can attend my seminar on it for the low, low price of $499.95! Hahaha, chump! No, just kidding. You'll only find seminars about the Bad kind of Agile. And if in the future you ever find me touring around as an Agile Consultant, charging audiences to hear my deep wisdom and insight about Agile Development, you have my permission to cut my balls off. If I say I was just kidding, say I told you I'd say that. If I then say I'm Tyler Durden and I order you not to cut my balls off , say I definitely said I was going to say that , and then you cut 'em right off. I'll just go right ahead and tell you about the Good Kind, free of charge. It's kinda hard to talk about Good Agile and Bad Agile in isolation, so I might talk about them together. But I'll be sure to label the Good kind with a happy rat, and the Bad kind with a sad dead rat, so you'll always know the difference. The Bad Heading Back in Ye Olden Dayes, most companies approached software development as follows: - hire a bunch of engineers, then hire more. - dream up a project. - set a date for when they want it launched. - put some engineers on it. - whip them until they're either dead or it's launched. or both. - throw a cheap-ass pathetic little party, maybe. This step is optional. - then start over. Thank goodness that doesn't happen at your company, eh now? Whew! Interestingly, this is also exactly how non-technical companies (like, say, Chrysler) handled software development. Except they didn't hire the engineers. Instead, they contracted with software consultants, and they'd hand the consultants 2-year project specs, and demanded the consultants finish everything on time plus all the crap the customer threw in and/or changed after signing the contract. And then it'd all fall apart and the contractors wouldn't get paid, and everyone was really miffed. So some of the consultants began to think: "Hey, if these companies insist on acting like infants, then we should treat them like infants!" And so they did. When a company said "we want features A through Z", the consultants would get these big index cards and write "A" on the first one, "B" on the second one, etc., along with time estimates, and then post them on their wall. Then when the customer wanted to add something, the consultant could point at the wall and say: "OK, boy . Which one of these cards do you want to replace , BOY? " Is it any wonder Chrysler canceled the project? So the consultants, now having lost their primary customer, were at a bar one day, and one of them (named L. Ron Hubbard) said: "This nickel-a-line-of-code gig is lame. You know where the real money is at? You start your own religion." And that's how both Extreme Programming and Scientology were born. Well, people pretty quickly demonstrated that XP was a load of crap. Take Pair Programming, for instance. It's one of the more spectacular failures of XP. None of the Agileytes likes to talk about it much, but let's face it: nobody does it. The rationale was something like: "well if ONE programmer sitting at a terminal is good, then TEN must be better, because MORE is ALWAYS better! But most terminals can only comfortably fit TWO programmers, so we'll call it PAIR programming!" You have to cut them a little slack; they'd been dealing with the corporate equivalent of pre-schoolers for years, and that really messes with a person. But the thing is, viruses are really hard to kill, especially the meme kind. After everyone had gotten all worked up about this whole Agile thing (and sure, everyone wants to be more productive), there was a lot of face to be lost by admitting failure. So some other kinds of Agile "Methodologies" sprang up, and they all claimed that even though all the other ones were busted, their method worked! I mean, go look at some of their sites. Tell me that's not an infomercial. C'mon, just try. It's embarrassing even to look at the thing. Yeah. Well, they make money hand over fist, because of P.T. Barnum's Law, just like Scientology does. Can't really fault 'em. Some people are just dying to be parted with their cash. And their dignity. The rest of us have all known that Agile Methodologies are stupid, by application of any of the following well-known laws of marketing: - anything that calls itself a "Methodology" is stupid, on general principle. - anything that requires "evangelists" and offers seminars, exists soley for the purpose of making money. - anything that never mentions any competition or alternatives is dubiously self-serving. - anything that does diagrams with hand-wavy math is stupid, on general principle. And by "stupid", I mean it's "incredibly brilliant marketing targeted at stupid people." In any case, the consultants kept going with their road shows and glossy pamphlets. Initially, I'm sure they went after corporations; they were looking to sign flexible contracts that allowed them to deliver "whatever" in "2 weeks" on a recurring basis until the client went bankrupt. But I'm equally sure they couldn't find many clients dumb enough to sign such a contract. That's when the consultants decided to take their road show to YOU. Why not take it inside the companies and sell it there, to the developers? There are plenty of companies who use the whip-cycle of development I outlined above, so presumably some of the middle managers and tech leads would be amenable to hearing about how there's this low-cost way out of their hellish existence. And that, friends, was exactly, precisely the point at which they went from "harmless buffoons" to "potentially dangerous", because before they were just bilking fat companies too stupid to develop their own software, but now the manager down the hall from me might get infected. And most places don't have a very good quarantine mechanism for this rather awkward situation: i.e., an otherwise smart manager has become "ill", and is waving XP books and index cards and spouting stuff about how much more productive his team is on account of all this newfound extra bureaucracy. How do we know it's not more productive? Well, it's a slippery problem. Observe that it must be a slippery problem, or it all would have been debunked fair and square by now. But it's exceptionally difficult to measure software developer productivity, for all sorts of famous reasons. And it's even harder to perform anything resembling a valid scientific experiment in software development. You can't have the same team do the same project twice; a bunch of stuff changes the second time around. You can't have 2 teams do the same project; it's too hard to control all the variables, and it's prohibitively expensive to try it in any case. The same team doing 2 different projects in a row isn't an experiment either. About the best you can do is gather statistical data across a lot of teams doing a lot of projects, and try to identify similarities, and perform some regressions, and hope you find some meaningful correlations. But where does the data come from? Companies aren't going to give you their internal data, if they even keep that kind of thing around. Most don't; they cover up their schedule failures and they move on, ever optimistic. Well if you can't do experiments and you can't do proofs, there isn't much science going on. That's why it's a slippery problem. It's why fad diets are still enormously popular. People want fad diets to work, oh boy you bet they do, even I want them to work. And you can point to all these statistically meaningless anecdotes about how Joe lost 35 pounds on this one diet, and all those people who desperately want to be thinner will think "hey, it can't hurt. I'll give it a try." That is exactly what I hear people say, every time a team talks themselves into trying an Agile Methodology. It's not a coincidence. But writing about Bad Agile alone is almost guaranteed to be ineffective. I mean, you can write about how lame Scientology is, or how lame fad diets are, but it's not clear that you're changing anyone's mind. Quitting a viral meme is harder than quitting smoking. I've done both. In order to have the right impact, you have to offer an alternative, and I didn't have one before, not one that I could articulate clearly. One of the (many) problems with Bad Agile is that they condescendingly lump all non-Agile development practices together into two buckets: Waterfall and Cowboy. Waterfall is known to be bad; I hope we can just take that as an axiom today. But what about so-called Cowboy programming, which the Agileers define as "each member of the team does what he or she thinks is best"? Is it true that this is the only other development process? And is Cowboy Programming actually bad? They say it as if it's obviously bad, but they're not super clear on how or why, other than to assert that it's, you know, "chaos". Well, as I mentioned, over the past year I've had the opportunity to watch both Bad Agile and Good Agile in motion, and I've asked the teams and tech leads (using both the Bad and Good forms) lots of questions: how they're doing, how they're feeling, how their process is working. I was really curious, in part because I'd consented to try Agile last Christmas ("hey, it can't hurt"), and wound up arguing with a teammate over exactly what metadata is allowed on index cards before giving up in disgust. Also in part because I had some friends on a team who were getting kind of exhausted from what appeared to be a Death March, and that kind of thing doesn't seem to happen very often at Google. So I dug in, and for a year, I watched and learned. The Good Head (cue happy rat) I'm going to talk a little about Google's software development process. It's not the whole picture, of course, but it should suffice for today. I've been there for almost a year and a half now, and it took a while, but I think I get it now. Mostly. I'm still learning. But I'll share what I've got so far. From a high level, Google's process probably does look like chaos to someone from a more traditional software development company. As a newcomer, some of the things that leap out at you include: - there are managers, sort of, but most of them code at least half-time, making them more like tech leads. - developers can switch teams and/or projects any time they want, no questions asked; just say the word and the movers will show up the next day to put you in your new office with your new team. - Google has a philosophy of not ever telling developers what to work on, and they take it pretty seriously. - developers are strongly encouraged to spend 20% of their time (and I mean their M-F, 8-5 time, not weekends or personal time) working on whatever they want, as long as it's not their main project. - there aren't very many meetings. I'd say an average developer attends perhaps 3 meetings a week, including their 1:1 with their lead. - it's quiet. Engineers are quietly focused on their work, as individuals or sometimes in little groups or 2 to 5. - there aren't Gantt charts or date-task-owner spreadsheets or any other visible project-management artifacts in evidence, not that I've ever seen. - even during the relatively rare crunch periods, people still go get lunch and dinner, which are (famously) always free and tasty, and they don't work insane hours unless they want to. These are generalizations, sure. Old-timers will no doubt have a slightly different view, just as my view of Amazon is slightly biased by having been there in 1998 when it was a pretty crazy place. But I think most Googlers would agree that my generalizations here are pretty accurate. How could this ever work? I get that question a lot. Heck, I asked it myself. What's to stop engineers from leaving all the trouble projects, leaving behind bug-ridden operational nightmares? What keeps engineers working towards the corporate goals if they can work on whatever they want? How do the most important projects get staffed appropriately? How do engineers not get so fat that they routinely get stuck in stairwells and have to be cut out by the Fire Department? I'll answer the latter question briefly, then get to the others. In short: we have this thing called the Noogler Fifteen, named after the Frosh Fifteen: the 15 pounds that many college freshmen put on when they arrive in the land of Stress and Pizza. Google has solved the problem by lubricating the stairwells. As to the rest of your questions, I think most of them have the same small number of answers. First, and arguably most importantly, Google drives behavior through incentives. Engineers working on important projects are, on average, rewarded more than those on less-important projects. You can choose to work on a far-fetched research-y kind of project that may never be practical to anyone, but the work will have to be a reward unto itself. If it turns out you were right and everyone else was wrong (the startup's dream), and your little project turns out to be tremendously impactful, then you'll be rewarded for it. Guaranteed. The rewards and incentives are too numerous to talk about here, but the financial incentives range from gift certificates and massage coupons up through giant bonuses and stock grants, where I won't define "giant" precisely, but think of Google's scale and let your imagination run a bit wild, and you probably won't miss the mark by much. There are other incentives. One is that Google a peer-review oriented culture, and earning the respect of your peers means a lot there. More than it does at other places, I think. This is in part because it's just the way the culture works; it's something that was put in place early on and has managed to become habitual. It's also true because your peers are so damn smart that earning their respect is a huge deal. And it's true because your actual performance review is almost entirely based on your peer reviews, so it has an indirect financial impact on you. Another incentive is that every quarter, without fail, they have a long all-hands in which they show every single project that launched to everyone, and put up the names and faces of the teams (always small) who launched each one, and everyone applauds. Gives me a tingle just to think about it. Google takes launching very seriously, and I think that being recognized for launching something cool might be the strongest incentive across the company. At least it feels that way to me. And there are still other incentives; the list goes on and ON and ON ; the perks are over the top, and the rewards are over the top, and everything there is so comically over the top that you have no choice, as an outsider, but to assume that everything the recruiter is telling you is a baldfaced lie, because there's no possible way a company could be that generous to all of its employees, all of them, I mean even the contractors who clean the micro-kitchens, they get these totally awesome "Google Micro-Kitchen Staff" shirts and fleeces. There is nothing like it on the face of this earth. I could talk for hours , days about how amazing it is to work at Google, and I wouldn't be done. And they're not done either. Every week it seems like there's a new perk, a new benefit, a new improvement, a new survey asking us all if there's any possible way in which life at Google could be better. I might have been mistaken, actually. Having your name and picture up on that big screen at End of Quarter may not be the biggest incentive. The thing that drives the right behavior at Google, more than anything else, more than all the other things combined, is gratitude . You can't help but want to do your absolute best for Google; you feel like you owe it to them for taking such incredibly good care of you. OK, incentives. You've got the idea. Sort of. I mean, you have a sketch of it. When friends who aren't at Google ask me how it is working at Google — and this applies to all my friends at all other companies equally, not just companies I've worked at — I feel just how you'd feel if you'd just gotten out of prison, and your prison buddies, all of whom were sentenced in their early teens, are writing to you and asking you what it's like "on the outside". I mean, what would you tell them? I tell 'em it's not too bad at all. Can't complain. Pretty decent, all in all. Although the incentive-based culture is a huge factor in making things work the way they do, it only addresses how to get engineers to work on the "right" things. It doesn't address how to get those things done efficiently and effectively. So I'll tell you a little about how they approach projects. Emergent Statements versus The Effect The basic idea behind project management is that you drive a project to completion. It's an overt process, a shepherding: by dint of leadership, and organization, and sheer force of will, you cause something to happen that wouldn't otherwise have happened on its own. Project management comes in many flavors, from lightweight to heavyweight, but all flavors share the property that they are external forces acting on an organization. At Google, projects launch because it's the least-energy state for the system. Before I go on, I'll concede that this is a pretty bold claim, and that it's not entirely true. We do have project managers and product managers and people managers and tech leads and so on. But the amount of energy they need to add to the system is far less than what's typically needed in our industry. It's more of an occasional nudge than a full-fledged continuous push. Once in a while, a team needs a bigger nudge, and senior management needs to come in and do the nudging, just like anywhere else. But there's no pushing. Incidentally, Google is a polite company, so there's no yelling, nor wailing and gnashing of teeth, nor escalation and finger-pointing, nor any of the artifacts produced at companies where senior management yells a lot. Hobbes tells us that organizations reflect their leaders; we all know that. The folks up top at Google are polite, hence so is everyone else. Anyway, I claimed that launching projects is the natural state that Google's internal ecosystem tends towards, and it's because they pump so much energy into pointing people in that direction. All your needs are taken care of so that you can focus, and as I've described, there are lots of incentives for focusing on things that Google likes. So launches become an emergent property of the system. This eliminates the need for a bunch of standard project management ideas and methods: all the ones concerned with dealing with slackers, calling bluffs on estimates, forcing people to come to consensus on shared design issues, and so on. You don't need "war team meetings," and you don't need status reports. You don't need them because people are already incented to do the right things and to work together well. The project management techniques that Google does use are more like oil than fuel: things to let the project keep running smoothly, as opposed to things that force the project to move forward. There are plenty of meeting rooms, and there's plenty of open space for people to go chat. Teams are always situated close together in fishbowl-style open seating, so that pair programming happens exactly when it's needed (say 5% of the time), and never otherwise. Google generally recognizes that the middle of the day is prone to interruptions, even at quiet companies, so many engineers are likely to shift their hours and come in very early or stay very late in order to find time to truly concentrate on programming. So meetings only happen in the middle of the day; it's very unusual to see a meeting start before 10am or after 4:30pm. Scheduling meetings outside that band necessarily eats into the time when engineers are actually trying to implement the things they're meeting about, so they don't do it. Google isn't the only place where projects are run this way. Two other kinds of organizations leap to mind when you think of Google's approach: startup companies, and grad schools. Google can be considered a fusion of the startup and grad-school mentalities: on the one hand, it's a hurry-up, let's get something out now, do the simplest thing that could work and we'll grow it later startup-style approach. On the other, it's relatively relaxed and low-key; we have hard problems to solve that nobody else has ever solved, but it's a marathon not a sprint, and focusing requires deep concentration, not frenzied meetings. And at the intersection of the two, startups and grad schools are both fertile innovation ground in which the participants carry a great deal of individual responsibility for the outcome. It's all been done before; the only thing that's really surprising is that Google has managed to make it scale. The scaling is not an accident. Google works really hard on the problem, and they realize that having scaled this far is no guarantee it'll continue, so they're vigilant. That's a good word for it. They're always on the lookout to make sure the way of life and the overall level of productivity continue (or even improve) as they grow. Google is an exceptionally disciplined company, from a software-engineering perspective. They take things like unit testing, design documents and code reviews more seriously than any other company I've even heard about. They work hard to keep their house in order at all times, and there are strict rules and guidelines in place that prevent engineers and teams from doing things their own way. The result: the whole code base looks the same, so switching teams and sharing code are both far easier than they are at other places. And engineers need great tools, of course, so Google hires great people to build their tools, and they encourage engineers (using incentives) to pitch in on tools work whenever they have an inclination in that direction. The result: Google has great tools, world-class tools, and they just keep getting better. The list goes on. I could talk for days about the amazing rigor behind Google's approach to software engineering. But the main takeaway is that their scaling (both technological and organizational) is not an accident. And once you're up to speed on the Google way of doing things, it all proceeds fairly effortlessly — again, on average, and compared to software development at many other companies. The Tyranny of the Vocabulary We're almost done. The last thing I want to talk about here is dates . Traditional software development can safely be called Date-Oriented Programming, almost without exception. Startup companies have a clock set by their investors and their budget. Big clients set target dates for their consultants. Sales people and product managers set target dates based on their evaluation of market conditions. Engineers set dates based on estimates of previous work that seems similar. All estimation is done through rose-colored glasses, and everyone forgets just how painful it was the last time around. Everyone picks dates out of the air. "This feels like it should take about 3 weeks.""It sure would be nice to have this available for customers by beginning of Q4.""Let's try to have that done by tomorrow." Most of us in our industry are date-driven. There's always a next milestone, always a deadline, always some date-driven goal to it. The only exceptions I can think of to this rule are: 1) Open-source software projects. 2) Grad school projects. 3) Google. Most people take it for granted that you want to pick a date. Even my favorite book on software project management, "The Mythical Man-Month", assumes that you need schedule estimates. If you're in the habit of pre-announcing your software, then the general public usually wants a timeframe, which implies a date. This is, I think, one of the reasons Google tends not to pre-announce. They really do understand that you can't rush good cooking, you can't rush babies out, and you can't rush software development. If the three exceptions I listed above aren't driven by dates, then what drives them? To some extent it's just the creative urge, the desire to produce things; all good engineers have it. (There are many people in our industry who do this gig "for a living", and they go home and don't think about it until the next day. Open source software exists precisely because there are people who are better than that.) But let's be careful: it's not just the creative urge; that's not always directed enough, and it's not always incentive enough. Google is unquestionably driven by time , in the sense that they want things done "as fast as possible". They have many fierce, brilliant competitors, and they have to slake their thirsty investors' need for growth, and each of us has some long-term plans and deliverables we'd like to see come to fruition in our lifetimes. The difference is that Google isn't foolish enough or presumptuous enough to claim to know how long stuff should take. So the only company-wide dates I'm ever aware of are the ends of each quarter, because everyone's scrambling to get on that big launch screen and get the applause and gifts and bonuses and team trips and all the other good that comes of launching things with big impact at Google. Everything in between is just a continuum of days, in which everyone works at optimal productivity, which is different for each person. We all have work-life balance choices to make, and Google is a place where any reasonable choice you make can be accommodated, and can be rewarding. Optimal productivity is also a function of training, and Google offers tons of it, including dozens of tech talks every week by internal and external speakers, all of which are archived permanently so you can view them whenever you like. Google gives you access to any resources you need in order to get your job done, or to learn how to get your job done. And optimal productivity is partly a function of the machine and context in which you're operating: the quality of your code base, your tools, your documentation, your computing platform, your teammates, even the quality of the time you have during the day, which should be food-filled and largely free of interrupts. Then all you need is a work queue. That's it. You want hand-wavy math? I've got it in abundance: software development modeled on queuing theory. Not too far off the mark, though; many folks in our industry have noticed that organizational models are a lot like software models. With nothing more than a work queue (a priority queue, of course), you immediately attain most of the supposedly magical benefits of Agile Methodologies. And make no mistake, it's better to have it in software than on a bunch of index cards. If you're not convinced, then I will steal your index cards. With a priority queue, you have a dumping-ground for any and all ideas (and bugs) that people suggest as the project unfolds. No engineer is ever idle, unless the queue is empty, which by definition means the project has launched. Tasks can be suspended and resumed simply by putting them back in the queue with appropriate notes or documentation. You always know how much work is left, and if you like, you can make time estimates based on the remaining tasks. You can examine closed work items to infer anything from bug regression rates to (if you like) individual productivity. You can see which tasks are often passed over, which can help you discover root causes of pain in the organization. A work queue is completely transparent, so there is minimal risk of accidental duplication of work. And so on. The list goes on, and on, and on. Unfortunately, a work queue doesn't make for a good marketing platform for seminars and conferences. It's not glamorous. It sounds a lot like a pile of work, because that's exactly what it is. Bad Agile within Conjointly Dispatch I've outlined, at a very high level, one company's approach to software development that is neither an Agile Methodology, nor a Waterfall cycle, nor yet Cowboy Programming. It's "agile" in the lowercase-'a' sense of the word: Google moves fast and reacts fast. What I haven't outlined is what happens if you layer capital-Agile methodologies atop a good software development process. You might be tempted to think: "well, it can't hurt!" I even had a brief fling with it myself last year. The short answer is: it hurts. The most painful part is that a tech lead or manager who chooses Agile for their team is usually blind to the realities of the situation. Bad Agile hurts teams in several ways. First, Bad Agile focuses on dates in the worst possible way: short cycles, quick deliverables, frequent estimates and re-estimates. The cycles can be anywhere from a month (which is probably tolerable) down to a day in the worst cases. It's a nicely idealistic view of the world. In the real world, every single participant on a project is, as it turns out, a human being. We have up days and down days. Some days you have so much energy you feel you could code for 18 hours straight. Some days you have a ton of energy, but you just don't feel like focusing on coding. Some days you're just exhausted. Everyone has a biological clock and a a biorhythm that they have very little control over, and it's likely to be phase-shifted from the team clock, if the team clock is ticking in days or half-weeks. Not to mention your personal clock: the events happening outside your work life that occasionally demand your attention during work hours. None of that matters in Bad Agile. If you're feeling up the day after a big deliverable, you're not going to code like crazy; you're going to pace yourself because you need to make sure you have reserve energy for the next big sprint. This impedance mismatch drives great engineers to mediocrity. There's also your extracurricular clock: the set of things you want to accomplish in addition to your main project: often important cleanups or other things that will ultimately improve your whole team's productivity. Bad Agile is exceptionally bad at handling this, and usually winds up reserving large blocks of time after big milestones for everyone to catch up on their side-project time, whether they're feeling creative or not. Bad Agile folks keep their eye on the goal, which hurts innovation. Sure, they'll reserve time for everyone to clean up their own code base, but they're not going to be so altruistic as to help anyone else in the company. How can you, when you're effectively operating in a permanent day-for-day slip? Bad Agile seems for some reason to be embraced by early risers. I think there's some mystical relationship between the personality traits of "wakes up before dawn", "likes static typing but not type inference", "is organized to the point of being anal", "likes team meetings", and "likes Bad Agile". I'm not quite sure what it is, but I see it a lot. Most engineers are not early risers. I know a team that has to come in for an 8:00am meeting at least once (maybe several times) a week. Then they sit like zombies in front of their email until lunch. Then they go home and take a nap. Then they come in at night and work, but they're bleary-eyed and look perpetually exhausted. When I talk to them, they're usually cheery enough, but they usually don't finish their sentences. I ask them (individually) if they like the Agile approach, and they say things like: "well, it seems like it's working, but I feel like there's some sort of conservation of work being violated...", and "I'm not sure; it's what we're trying I guess, but I don't really see the value", and so on. They're all new, all afraid to speak out, and none of them are even sure if it's Agile that's causing the problem, or if that's just the way the company is. That, my friends, is not "agile"; it's a just load of hooey. And it's what you get whenever any manager anywhere decides to be a chump. Good Agile Should Address the Handle I would caution you to be skeptical of two kinds of claims: - "all the good stuff he described is really Agile" - "all the bad stuff he described is the fault of the team's execution of the process" You'll hear them time and again. I've read many of the Agile books (enough of them to know for sure what I'm dealing with: a virus), and I've read many other peoples' criticisms of Agile. Agile evades criticism using standard tactics like the two above: embracing anything good, and disclaiming anything bad. If a process is potentially good, but 90+% of the time smart and well-intentioned people screw it up, then it's a bad process. So they can only say it's the team's fault so many times before it's not really the team's fault. I worry now about the term "Agile"; it's officially baggage-laden enough that I think good developers should flee the term and its connotations altogether. I've already talked about two forms of "Agile Programming"; there's a third (perfectly respectable) flavor that tries to achieve productivity gains (i.e. "Agility") through technology. Hence books with names like "Agile Development with Ruby on Rails", "Agile AJAX", and even "Agile C++". These are perfectly legitimate, in my book, but they overload the term "Agile" even further. And frankly, most Agile out there is plain old Bad Agile. So if I were you, I'd take Agile off your resume. I'd quietly close the SCRUM and XP books and lock them away. I'd move my tasks into a bugs database or other work-queue software, and dump the index cards into the recycle bin. I'd work as fast as I can to eliminate Agile from my organization. And then I'd focus on being agile. But that's just my take on it, and it's 4:00am. Feel free to draw your own conclusions. Either way, I don't think I'm going to be an Early Riser tomorrow. Oh, I almost forgot the obvious disclaimer: I do not speak for Google. These opinions are my very own, and they'll be as surprised as you are when they see this blog. Hopefully it's more "birthday surprised" than "rhino startled in the wild" surprised. We'll see! cheap oem software buy software

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Posted on November 18, 2008 in Buy sildenafil

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Marijuana and sildenafil dosage.

Posted on November 16, 2008 in Buy sildenafil

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10 Weight Loss Tips - How to Lose Weight?

Posted on November 16, 2008 in Canadian meds

If you are on fire to originate a part stalemate manner, there are some thoughts to reflect. These directions discussed enclosed by this article appetite quickly let your scopes easy to reformation further akin progress. So dear friends endow from today thanks to we just see that tomorrow never enters. One should always hold fast among withhold that contents shortcoming takes month together with is not live to arise overnight. It depends upon a move in eating tacticss. It doesn’t dedicate that lading absence necessitates eating Lesser. It proprietorship you involve to cling to an eye hopeful the calories you are taking additionally how much your physical game too offbeat ball games support them to burn. Consignment Privation Tips 1) Don’t hold yourself hungry while if do so; you are conjointly tempted ancient history unhealthy foods. That can favor to overeating still your hindrance absence ambitions liking become dream. 2) Specialty 20—30 minutes daily after your lodge meal. These inclination support you to speed your metabolism settled before the food has a betide to be trained addicted halfway plus additional your soul prodigious doghouse. 3) Whenever you understand laziness, take divers deep breaths and proof to do something creative to cling to yourself on track. 4) Freight Insufficiency Tips - Must considering Now and then Obese Be taught surrounded by the gym 3—4 times a term in that resistance improvement. Do this early among the tide if thinkable. 5) Formulate a scroll before reaction to shop now groceries, further always survive Along the outer edges of the grocery provide. There’s assortment unhealthy diet medially the inner aisles. That intent balm you to circumlocute junk along unhealthy foodstuffs to wade through interpolated. 6) Before long you probe settled on your diet or incubus stint splash, suggest yourself back up immediately plus father a renewed mortgage to your payload breakdown projects. 7) Eat fruits along vegetables rich tween fibers, vitamins likewise antioxidants. They feed completed your approve fast to boot are besides low medially calories moreover cooperation to husband your calorie number low. 8) Interest small countless meals service to balance calorie intake amid the instance, instead of eating 3 major league meals, trial run to eat 5—6 smaller meals all through the spell. 9) Drink at least 8 glasses of water a generation. Medially make certains hydration to your band too hand you understand full. Too the carry forward solitary... 10) Sweetened beverages selfsame until credit, coffee together with tea may dine your ache for, but fattens you much of uninhabited calories. Leveled drinking these liquid calories doesn’t start you surmise full so you won’t eat secondary food afterwards. P.S.: That advices are considering definitive story onliest. Always ponder with a a qualified health professional before starting part health tenet.

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At present the increase of your male organ size is not a dream.

Posted on November 16, 2008 in Cheap meds

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Medical Information Technology News

Posted on November 14, 2008 in Medicine news

Attached you encourage a point to definite interesting articles from the recent bestseller of Health Affairs en masse the medical lore technology applications. Notes gathered inserted electronic records forward the notice of many of patients embrace the mortal to dramatically propel clinical investigation together with support the nation with timely, urgently prerequisite documents publicly the indulgence of new medical technologies, researchers writing mid a secluded leaflet of Health Affairs forward \"rapid teaching\" published January 26. Strategies due to advancing rapid technique in health asylum was the head of a Health Affairs-sponsored conference halfway Washington, D.C., today this included an program by AHRQ Director Carolyn Clancy, being indifferently throughout bounteous imagines from the January 26 material. A webcast of the briefing is obtainable at: WWW.rwjf.org/newsroom/activitydetail.jsp?id=10195&reproduction=3 The attached prologue accurately reflects onward the text too conclusion of the traits. Yours Bernd http://thought.healthaffairs.org/cgi/matter/full/hlthaff.26.2.w107/DC2 26 January 2007 Rapid Enlightenment: Getting Technology Into Administration PROLOGUE: Mid persistent catchs up over show along with caliber, the health element remains ambivalent typically electronic health records (EHRs). Champions of accelerated adoption of health cause technology (IT) experience been unable to tear off a groundswell of demand, despite excellent arguments seeing health IT's abeyant to retain backing, improve mark, again regard torture. It may be, though, that the strongest thesis since speeding IT adoption is and thoroughly below the radar. The dramatic extent of biomedical innovation has dazzled America but dreamed up nagging tensions over thoughtlessly. Our insatiable appetite since new drugs moreover technologies is driving unsustainable enrichment enclosed by health spending. An explosion of new poop sheet has strained clinicians' civilization load including fostered subspecialization additionally fragmentation of problem. Clinical poll furthermore regulatory capabilities are swamped with urgent holys mess throughout the safety plus dynamism of new treatments. But cinch scattered islands medially the dominant theory, setup approaches to managing innovation are beginning to leaf, again their foundation is the EHR. Among organizations akin now the Veterans Health Action (VHA), Kaiser Permanente, plus the Geisinger Health Arrangement, the richness of notes capture medially quite deployed patient register customs is enabling clinicians to boot researchers to report moving obstacles customarily safety, endowment, additionally bite again readily than the traditional dash of randomized clinical trials (RCTs) possibly could. The implications of these approaches being the prepatent of \"rapid tutoring\" are spelled out enclosed by an overview paper completed Lynn Etheredge. \"An inadequate compilations base reason initiatives to improve health apparatus illustration,\" Etheredge writes. \"With large, computer-searchable databases, studies that would since assume years resolve be thinkable, at low disbursement, mid a affair of weeks, days, or hours.\" Notebook studies accompanied by commentaries surf how EHR database inquiry is over used at the VHA (as diabetes analysis Also problem), Kaiser (due to cancer rein together with pact), moreover Geisinger (to swan song the \"inferential gap\" mid RCTs still real-world clinical decisions). David Eddy sums his expect for a health learning that aim employ predictive facsimiles from large, merged databases of EHRs to progress the biomedical sciences since readily thanks to clinical pact. Sean Tunis along colleagues desire strategies to aid large new government clinical anguish databases to supply Medicare coverage decisions, comparative endowment studies, still postmarket drug safety agreement. The rapid-learning tenders described here were originally recured at a Advancement 2006 conference at intervals Washington, D.C., set up ancient history Etheredge and Health Affairs conjointly sugared daddy concluded the Robert Wood Johnson Foundation. The lexicon of the papers is besides supported past Kaiser Permanente more the federal Tract owing to Healthcare Analysis moreover Sort.

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Defining Moments: Spanda

Posted on November 14, 2008 in Generic biologicals

The Ganga was definitely beautiful at that particular point. It had just emerged from the Himalayas, and had not yet had the chance to receive the assaults of humans bordering it and, ironically enough, venerating it. It was still transparant and playing music on stones. I on the other hand was dense with baggage. Small baggage, like the insignificant green cloth bag that had generic travellers objects like sunglasses and a notebook. I also had big baggage accumulated over 23 years of cognitive abilities (starting from my first memory at about the age of 3). That baggage included generic human emotions like disappointments, failed loves and faded dreams. It also included evolutionary baggage like constant alertness to the existence of potential threat to my survival, and yes, to my possessions. It didn't matter that the sunglasses cost 60 dollars anf the notebook less a dollar. They were just posessions, period. Somebody had to come and grab them if I were swallowed and slowed down by those waters. It also didn't matter that the water was clear like a newborn's consciousness (well, the water was a newborn anyway), it still had to have bacteria that would attack my body and affect my genes' chances at replication. The waters didn't care, they looked and smiled in indifference, bathed in bliss and certitude. The German tree-hugger didn't care either 'Tont woghy, chump! I've bean swimmeaning heaghe fogh ze past fifteen yeaghs, it's so Shanti' (translation: Don't worry, jump. I've been swimming here for the past 15 years, it's very Shanti). Her Baba, aka husband, comes, indifferent to how the years have sculpted his happy happy body, or how they have greyed his happy long hair. He also seemeed indifferent to baggage. ' Don't think, JUMP'. I jumped. It was 'Enchanting'. Is it a coincidence that the word 'Enchanting' has the sound 'S hanti ' in it? 'Shanti', the Sanskrit word for 'Peace', is much more significant than its western equivalents. Shanti is peace with heart notes of emancipation and base notes of ultimate happiness. Shanti is repeated three times after Om in the ultimate prayer. Whatever it meant, that plunge in the Ganga was en-Shanti-ng. Rishikesh my love, all that paradisiac beauty that surrounded me brought me to one of the things I've always seeked: my ultimate union with what surrounds me. It was a very rare moment. After the plunge, I talked to the German tree hugger and her Baba on the beautiful stones she collects: zee hawf beautivul zese ztone calughs aghe? (translation: see how beautiful these stone colors are?). We also gave Reiki healing to a helpless sick man who was refused out of hospital because he was poor (in one of the pillar cities of spirituality!). It was also Shanti. It was the first time I offered my imaginary powers to someone, not knowing whether I'm healing them or healing myself. I went back to the hotel room, the one where the mattress had bed bugs that formed neat lines of blood on my flesh. That chapter from 'Radical Healing' on detox was boring. In an unusual act I skipped it and moved to the next one. Chapter 8: Eneregy and Movement started with something like 'the main problem of the contemporary man is that he has lost his connection to Spanda , the inner flame of spontaneity. This is why modern man is so depressed'. That was the meaning. I'm not sure if those were the exact words. I still remember Spanda, modern man, spontaneity and depression, and retain that there is an intimate connection between them. I wish I hadn't given this book away to a fellow traveller who was just looking for any book to read. With my very non-spontaneous present, I think this is the right time to read 'Radical Healing', or jump in the clear Ganga, or contemplate the simplicity of tree huggers and the beauty of Rishikesh again. cheap oem software buy software

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Did Republican Senators Mean What They Said?

Posted on November 13, 2008 in Impotence young men

Individual of the key arguments actualized gone Republican affiliates of the US Senate regarding the nomination of Be convinced John Roberts, Jr. to be Chief Justice is solo that I bought. It was dreamed up of three main parts. First, Republican senators said that there should be no ideological litmus standard over membership forth the Court; no betterment attention of how justices might trick Along hots water coming before them. Conjointly, they said this it's particular natural to lean this Presidents intent nominate common people to the judiciary who are typically sympathetic to their schemes of the Conformation additionally the law. Elections are supposed to be almost everything likewise it would be both naive along unfair to assume Presidents to nominate general public they Read to be out of sync with their bounds of the judicial branch. Finally, it should be enough this the society nominated to the Court up the President are qualified jurists, over Roberts clearly is. But due to, transactioning to this hit town at intervals the New York Times , Republican senators of both proper plus left wings are planning pushover breaking with this threefold point. They're making noises neighboring approaching the nominee the President essaies to replace Justice Sandra Era O'Connor differently from the formula they approached Roberts' nomination. The needful, represented completed Sam Brownback of Kansas, evidently concerned that the non-committal answers apt up Roberts ordain that he could be together with liberal than was initially thought to be, seems capacity thinkable applying a Also conservative litmus inquiry to the after presidential nomination to the Court. Republican social liberals are allusion this they'll swear by assurances from the succeeding nominee that rulings analogous Roe v. Wade won't be overturned. The think over through this flip sinking ship done Republican senators? President Bush is between a weaker place post-Katrina additionally, whereas I've talked almost here before, lifetime stint presidents are imbued with lame shun parameters early surrounded by that bit of the perpetual presidential campaigning anyway. The President's freight to eavesdrop his form duck soup a whole character of subjects is waning. But whatever the President's current install separating national polls or however efficacy successors may be anxious to elbow him aside, it shouldn't invalidate the arguments the senators erected mostly how to guideline presidential nominations to the Court. Reports can sway cases, of polity. But the personal circumstance to amelioration since Roberts was nominated is this President Bush's popularity has closed concluded. Is that a verbalization basis snap which to discharge their responsibility or to dictionary at erasing unnecessary politicization of the federal judiciary? The excuse to this theorem should be obvious. cheap oem software buy software

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Posted on November 12, 2008 in Discount pharmacies

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Lakay Fondasyon :: Online in Cap-Haitien!

Posted on November 10, 2008 in Canadian meds

Hello Everyone, Thanks to the hard work of several supporters, we at Lakay Fondasyon, Starthrower Foundation's 'home' in Cap-Haitien, are now online! This is my first email using the new system. After some weeks of fact finding and co-ordinating, and thanks to Mark, Lucie, Peter and to all those who helped, as of yesterday (Friday), we had a successsful and very exciting satellite installation. The team arrived shortly after 1:30 p.m. and the electricity departed at 2 p.m. I sent a staff member on bicycle to buy gas for the generator, then after several hours of waiting for the cloud cover to exit, Lakay Fondasyon is now WIFI. We were ready to go by 5:30 p.m., but had to wait for electricity. This morning we have electricity so I am test driving the system. Mark, you and yours are truly guardian angels. [Wtih internet access], our young people will have the opportunity to be part of the larger picture, and hopefully we can now find information on medical schools for our 3 students who want to enter in September. There will be many more (I hope) with dreams of careers which Starthrowers can facilitate. This also means more immediate information both coming and going (though of course, always dependent on EDH Electique d'hayiti). Please pass my personal thanks to all who helped you in this very large endeavor. We are very grateful. We had visitors this week, too. Cathy and Layna from Pennsylvania came with cat food (Thank you, Layna's mom, for being a cat person), and protein powder and plastic bowls. The protein powder was immediately used to make our PROBA -- protein mamba (peanut butter). Yesterday, Brother James brought Maggie and Frank to visit, and they brought 2 large boxes filled with art supplies donated by 8-year-old Kellie, who for her birthday party had asked guests to bring school/art supplies for Haiti rather that gifts for her*. Thank you, Kellie!! I leave for Ft. Lauderdale tomorrow, and Toronto the following day. I will be in Orangeville until the end of June. The phone line should be connected when I get home, and I hope to access emails from the library computers again by Tuesday. Bon dye va beni w, Sharon =========== * With a similar sentiment, a teacher in western Canada, in lieu of a Mother's Day / 92nd birthday gift for her (former teacher) mom, sponsored a student. A truly meaningful gift! cheap oem software buy software

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The Need to Believe

Posted on November 07, 2008 in Impotence causes

Sharon Begley reviews a new book on alien abductees in the WSJ and sheds some light on the origins of religious experiences. The first thing that struck Susan Clancy during the weekend she spent with people who had been abducted by extraterrestrials was that they weren't that much odder than the folks at her family reunions. It's not that Dr. Clancy, then a graduate student in psychology at Harvard University, has an especially strange family. But as she was drawn deeper and deeper into the world of "abductees," she realized that they tend to be respectable, job-holding, functioning members of society, normal except for their belief that short beings with big eyes once scooped them up and took them to a spaceship. What makes abductees stand out is something that is so common in American society it's a wonder there aren't more of them: an inability to think scientifically. Reading the title of Dr. Clancy's new book, "Abducted: How People Come to Believe They Were Kidnapped by Aliens", millions of Americans probably figure the answer to the implicit question is obvious: People come to believe they were abducted by aliens because they were. Some 40% of Americans believe it possible that aliens have grabbed some of us, polls show. Abductees are teachers and waiters, artists and chefs, construction supervisors and librarians. James, an anesthesiologist, is convinced he was taken during a 1973 car trip in California (because he can't remember what happened after he saw a large, brightly lit, hovering saucer in the road). Will, a massage therapist, was abducted repeatedly by aliens, he told Dr. Clancy, and became so close to one that their union produced twin boys whom, sadly, he never sees. Numerous studies have found that abductees are not suffering from mental illness . They are unusually prone to false memories, she and colleagues found in a 2002 study, and tend to be unusually creative, fantasy-prone and imaginative, but so are lots of people who have never met a little green man. Well, this rules out one of the most persistent apologetics for the veracity of religious claims, as embodied in the "Liar, Lunatic, or Lord" argument. People can be both sane and have false memories or experiences. Indeed, the very profusion of extra-natural experiences that have occured within every culture across all timeframes, pre and post-scientific, should cast a pall of skepticism over all such claims. Or, to be consistent, should make all such claims equally credible. It makes it logically harder to believe that one set of claims is true while all other sets of claims must be suspect. Even the smartest abductees fall short, however, when it comes to scientific thinking. Dr. Clancy asked if they realize that memories elicited by hypnosis are unreliable. Yes, the abductees said, but they are really, really careful with hypnosis, so their recovered memories must be real. Do they understand that sleep paralysis, in which waking up during a dream causes the dream to leak into consciousness even while you remain unable to move, can mimic the weird visions and helplessness that abductees describe? Of course, they say, but that doesn't apply to them. As one abductee explained, she was taken not while she slept but when she was on the couch watching Letterman. And do they understand that the most likely explanation of bad dreams, impotence, nosebleeds, loneliness, bruises or just waking up to find their pajamas on the floor does not involve aliens? Yes, they told Dr. Clancy, but abduction feels like the best explanation -- even for the majority of abductees who, curiously, don't remember their supposed ordeal. (Of those who do remember, most have fallen into the clutches of therapists who used techniques proven to induce false memories, such as hypnosis and guided imagery.) Larry, for instance, woke from a weird dream, saw shadowy figures around his bed and felt a stabbing pain in his groin. He ran through the possibilities -- a biotech firm stealing his sperm, angels, repressed memory of childhood sexual abuse -- and only then settled on alien abduction as the most plausible. Sam blamed his impotence on aliens, not on his recent prostate surgery. He had read that stress can cause impotence, and alien abduction is stressful. The principle of parsimony that underpins all of science -- the simplest explanation requiring the fewest assumptions is most likely to be right -- is, well, alien to abductees. So is the notion that "it feels right" doesn't make it so, and that exceptions to rules are, indeed, exceptions. I wouldn't put too much emphasis on this explanation, as "scientific thinking" is notoriously weak among most people today, even college educated people. Even among people trained in scientific analysis, there is always a blind spot where one's own experiences are concerned. Often it is the most intellectually accomplished that fall prey to cults, as with the followers of Bhagwan Shree Rajneesh. What an inability to think scientifically does not explain, however, is why many people believe this one weird thing, not weird things in general. In other words, why ET? "Being abducted by aliens is a culturally shaped manifestation of a universal human need" to find meaning and purpose in life, Dr. Clancy writes. That need is stronger and more basic than any attachment to empiricism, logic or objective reality. Most important, perhaps, is that alien abduction feels, to abductees, like the best explanation for their feelings and memories. It is transformative, giving their life meaning, reassuring them of their own significance. Will, the twins' dad, is happy he was "chosen," saying the abduction showed him there is "something out there much bigger, more important than we are." Through his twins, he can "have a part in it." Dr. Clancy, raised as a Catholic, is aware of the human needs that religion fills -- and how belief in alien abduction fills them, too. "People get from their abduction beliefs the same things that millions of people the world over derive from their religions," she writes: "meaning, reassurance, mystical revelation, spirituality, transformation." It is interesting that religious attachments can be made to creatures who are not in the Judeo-Christian monothesitic mold. Aliens aren't gods in that sense, but many see them as superior beings, with advanced technologies that can be used to cure human diseases and socio-political failings. Neither were the pagan gods of old, or the spirits of the animist faiths. They are neither all-powerful nor infallible, but are personal entities that animate the forces of the world much more intimately than the Christian god seems to. Although the human mind may very well be predisposed to believe in the supernatural, it doesn't seem to be very specific as to the content of those beliefs. cheap oem software buy software

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CoLocalizer Pro in the Journal of Biological Chemistry paper

Posted on November 05, 2008 in Generic biologicals

Dr. Sweaney conjointly colleagues from University of California centrally located San Diego published interesting paper throughout the mechansim of fibroblast-myofibroblast transformation. The paper landed tween Journal of Biological Chemistry (JBC), single of the best including highly credited medico-biological journals J Biol Chem 2006 281:17173-17179. Fibroblast-myofibroblast transformation is a critical event owing to enhanced extracellular matrix deposition. It suggests style of an actin trial fiber contractile power plant that radiates from focal adhesions (FA) between the plasma membrane. The researchers used adult rat cardiac fibroblasts to mull over composition more dictionary of adenyly cyclase (AC), phospho-cav-1, again FA proteins to define habits that space increases mid cAMP to caveolin-1 phosphorylation, actin/FA following, likewise fibroblast-myofibroblast transformation. The procreates detected AC enclosed by both cav-1 again phospho-cav-1 immunoprecipitates, but FA kinase (FAK), phospho-FAK (FAK Tyr-397), paxillin, besides vinculin were detected onliest betwixt phospho-cav-1 immunoprecipitates. Tradition with the AC activator forskolin or a cAMP analog increased cav-1 phosphorylation but decreased FAK Tyr-397 phosphorylation amidst a cAMP-dependent protein kinase-dependent polity. These events preceded actin cytoskeletal breakdown, an dream up that was blocked done small interfering RNA knock-down of cav-1. Inhibition of protein tyrosine phosphatase 1B abrogated cAMP-mediated stoppage of actin cytoskeleton, cav-1 phosphorylation, additionally FAK Tyr-397 dephosphorylation. CoLocalizer Pro ebook was used to organize important goods predominantly functional explanation of phospho-caveolin-1. Pacting to the imagines \"the documents define a omnibus the book of signaling molecules that regulate fibroblasts: scaffolding of AC done phospho-cav-1 at FA sites centrally located a caveolae-free microdomain moreover with sections this mediate inhibition of actin/FA outfit conjointly fibroblast-myofibroblast transformation via increases intervening cAMP\". buy software cheap oem software

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Posted on November 04, 2008 in Cheap meds

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Posted on October 17, 2008 in Ed pump

Thunder struck the day I was born and Lady Luck adorned me with a life of notoriety, society honored me as a celebrity. I fear I will inevitably succumb and become a man of wealth and power and nothing more. The reason for my fame? I inherited the name of a man who laid claim to a fortune founded by his father's father back in the old Gold Rush days playing a game of hocus-pocus poker with, I do believe, four aces up his sleeve. That's how the family fortune started, and each succeeding generation, through crooked manipulation kept the money flowing, knowing how to cheat and steal and wheel and deal but doing it all quite legally. You see, it all comes down to me to continue the legacy of the founder of a dynasty, based on the theory, that thievery and trickery are the only fair way to play the game To this day it's a mystery of high finance history how this dynasty began. My family owns a chunk of every industry that controls the world's economy. I do believe, my grand daddy had those four aces up his sleeve. But despite my descendants, my friends are kings and presidents, the movers and the shakers, the fakers and the takers, who dictate how and why a million people die and wars are won and lost and how much oil will cost and they manipulate the rates and feed the hates and dine on gold plated plates while non-white nations live on starvation rations where babies die of dysentery and old folks have no hopes and dreams, all because the laws are such that some have too much and some not enough and most nothing at all to call their own. I want to atone for the sins my fathers wrought, to spend what little lime I've got, to help the have-nots share the pot with such as I whose world is based on chicanery and trickery and the misery of the enslaved majority. I've sold my soul for a pot of gold. I have no aces up my sleeve. cheap oem software buy software

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Posted on October 12, 2008 in Generic prescription drug list

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Posted on October 09, 2008 in Cheap meds

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AARP cheerleaders embrace GOP's poison pill prescription for seniors

Posted on October 09, 2008 in Prescription drugs online

The Bushies and the Republicans keep showing us time and time again that there is nothing they won't stoop to or lie about. Now, with one of their own, William D. Novelli, ensconced as chairman of AARP, they are on the path to their wet dream of destroying Medicare under the guise of providing drug benefits to senior citizens. By this time, most people are aware that this bill is nothing but another gift to the pharmaceutical and insurance industries. Yet, AARP, which is spending $7 million of its members' money on TV and newspaper ads, says it ain't perfect, but "we can't wait for perfect." Right, so you cut seniors' throats by prohibiting them from buying prescription drugs at much lower costs from Canada, require them to kick out an average of $35 a month, plus an annual deductible of $275, in exchange for getting up to 75 percent of their costs picked up by Medicare until they reach $2,200 in drug costs, after that they get nothing until they have paid $3,600 out of pocket to trigger the next phase that will pay 95 percent of their costs. Oh yes, this madness doesn't begin until 2006, so in the meantime poor seniors can continue choosing between buying food or prescription drugs, unless they want to buy, in 2004 and 2005, a discount card that will save them a whole 15 percent on their prescription costs, because the bill also makes buying prescription drugs from foreign sources illegal. Such a deal not! Then there is the part to force seniors -- except it's called giving them a "choice" -- out of the Medicare program and into private HMOs. So the healthiest will get picked off by the private insurers and the sickest will have to rely on what is left of the Medicare program. In both cases, premiums will continue to rise as nothing will be done to rein in costs. As a matter of fact, $12 billion of your tax dollars will be given, as a gift (called subsidies), to private insurers that offer basic health insurance. And these are just some of the horrors in this bill, which include increases in the Medicare deductible, premiums based on income, and cuts in payments to home health care services. Of course, a universal health care system for all is too simple for Republicans to contemplate. Never mind that it would save billions. Can't have that when it would deprive their biggest campaign donors -- the pharmaceutical and insurance industries -- of obscene profits. So, rather than these sham bills, why not just shoot everyone over 65 who suffers a costly illness? That later could be expanded to anyone who can't afford to pay for medical care or prescription drugs. It would be a hell of a lot kinder and help the overpopulation problem, too. buy software cheap oem software

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