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Further to the recent notification that Thomson Reuters (Scientific) will be holding a series of meetings to announce updates in relation to Web of Knowledge, publications database and bibliometric services, the following meetings have been arranged: Monday, 27 October: Institute of Education, London, 10 am - 1 pm Tuesday, 4 November: University of Glasgow, 10 am - 1 pm Thursday, 6 November: King's College London, 10 am - 1 pm The main points covered will be: - Provision of core bibliometric services from Thomson Reuters to support increasing reliance upon metrics - Review of the JISC Licence to support the creation / maintenance of a Publications Database - Development / individualisation of core services to ensure institutional requirements are met - Inclusion of ISI Proceedings, Social Sciences within Web of Knowledge, to ensure full citation coverage of an institution / academic The meeting format will be a presentation with some online examples, with the last hour set aside for questions. If you wish to attend any of these meetings, please contact the Mimas helpdesk at wok@mimas.ac.uk Alternatively, if you are willing for your institution to host one of these meetings, please get in touch with us at the Mimas helpdesk at wok@mimas.ac.uk Labels: web of knowledge cheap oem software buy software

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[updated July 19, 2008] Parts centrally located the Way ED After Prostatectomy - Part 1. Introduction (previous) ED After Prostatectomy - Part 2. Rehabilitation (current) The reader should be sure to have read Part 1 of this series as it gives useful background needed for reading this Part. Fibrosis and oxygenation As discussed in Part 1, the damage that is done can occur not only during the surgery but in the period of time after the surgery due to a build up of fibrosis in the penis blocking nitric oxide (NO) and so erections. Such fibrosis can represent irreversable damage. By achieving erections as soon as possible after catheter removal (within 6-8 weeks), oxygenation will occur and fibrosis may be prevented. In [Endotext] this is referred to as "avoidance of penile hypoxia through regular tissue oxygenation via erections". Wont Although it does not appear to have been specifically studied, the various treatments are not mutually exclusive so simultaneous modalities may be considered, e.g. exercise + drugs + VED This article by Sidney Radomski is only one page and summarizes what works and what does not work: [link]. Readers are encouraged to read it before reading on. Other sources of information include the Phoenix5 site [link] and a 25 page article outlining various treatments by Drs. Stephen Auerbach and Aubrey Pilgrim [here]. Exercise Exercise consists of attempting to achieve erections possibly with the aid of any of the following treatments. "The use of at least one aid was an independent predictor of more favorable sexual HRQOL" (higher quality of life). [PMID: 16844457]. Frank Sommer, a German urologist, has a set of exercises which he claims are just as effective as Viagra (though they do not appear to have been specifically tested post prostatectomy): See [men-and-health] and [urotoday] for information on the study. The first link in the last sentence also provides a description of Sommers' exercises. Note that Sommers' exercises are different than the incontinence exercises discussed in [this post]. There may be a benefit of exercise prior to surgery as well although we have not found a source where it was clearly established. PDE-5 Inhibitors Viagra (sildenafil), Levitra (vardenafil) and Cialis (taladafil) are drugs which inhibit PDE-5 which breaks down the key promoter of erections, cGMP. This indirectly enhances and prolongs erections provided one can achieve at least partial erections already. Daily Administration . It can work in conjunction with appropriate exercise to achieve more effective erections which may enhance the rehabilitation process. For rehabilitation purposes these drugs are taken at a low dosage every other day or other frequency although some good results have been reported by taking them every day. This [PMID: 16766116] discusses a successful trial of daily administration of Cialis and the review article in the following link discusses various good results in using PDE-5 inhibitors on a daily basis rather than on demand for ED, cariovascular problems and other problems: [PMID:1746047]. Table 1 of this last paper summarized the Benefits and Limitations of daily administration for ED as follows. Benefits: salvage of on-demand responders, improved treatment response in difficult-to-treat groups, disease modification, may approximate more natural sexual function, randomized placebo-controlled trials demonstrate efficacy and safety for ED of various etiologies. Limitations: extended term follow-up limited -- safety and efficacy profiles require further elucidation, mechanisms of treatment effects incompletely understood, disease modification -- attractive concept but evidence-based data limited, patient cost, no evidence of tachyphylaxis to date but longer follow-up needed. (Tachyphylaxis refers to decreased response after initial administration requiring drug-free periods.) A 2008 paper in the Journal of Urology found that patients who had better pretreatment sexual function responded better to PDE-5 inhibitors. [PMID: 18206926]. Mulhall's Approach . In a Medscape article [Penile Rehabilitation Following Radical Prostatectomy] (see section entitled Structure of Rehabilitation) and 2006 Urology Times interview John Mulhall (papers) indicates that there is animal evidence for daily administration (every other day for Cialis) preoperatively as well as post operatively and so uses the following protocol for his patients (quote is from Medscape link): I encourage presurgical patients to use low-dose PDE-5 inhibitors on a nightly basis for 2 weeks before their operation. This strategy is based on the animal data supporting pretreatment. These patients are then told that with the catheter in place they should continue to use low-dose PDE-5 inhibitors on a regular basis (sildenafil and vardenafil nightly, tadalafil 3 times a week). When they are given the go-ahead to resume attempts at obtaining erections, they are switched to a low-dose PDE-5 inhibitor 6 nights a week and a maximum dose 1 night a week. The maximum-dose pill needs to be used in an appropriate fashion with sexual stimulation. The patients are encouraged to return to the office 6 weeks after surgery, which will allow them approximately 4 weeks to try maximum-dose medication. After 6 weeks the protocol is as follows. In the exceptional case that this is successful in restoring sexual function within 6 weeks, they can continue with PDE-5 inhibitors. In the more likely case that they are not successful within 6 weeks then therapy is switched to intracavenosal penile injections twice a week (with appropriate training) and low dose PDE-5 inhibitors on non-injection nights. Because of its longer half life Cialis is not appropriate for this phase of the therapy. After a year they try maximum PDE-5 dosage once a month and if successful on that can stop injections. He normally expects some improvement within 10-14 months and optimal functionality in 18 to 24 months and notes that failure to respond to PDE-5 inhibitors in the first year does not necessarily preclude an excellent response after two years. The link cited above also gives a variation of this protocol in the case that it is started post-operatively. Comparison . A key difference among the drugs is that the half lives of Viagra, Levitra and Cialis are such that they last 2-8 hours, 4-8 hours and 24-36 hours respectively. The longer lasting Cialis would appear to be superior from the viewpoint of rehabilitation and also can be used at the lowest concentration which may make side effects less likely. However, there have been claims that Viagra is more effective at achieving intracellular drug concentration and cGMP accumulation as well as one study that claims that Levitra results in higher concentration [PMID: 15213306]. Others have indicated that there is individual variation and if one of the three drugs does not work to try the others. Detailed comparisons of the three are in the table at the bottom of page 2 in this link Greenspan, 2004 and Table 1 of Mehrotra, 2007. A February 2008 study concluded that patients who were given a chance to try all three and choose for themselves had better compliance with taking this medication [PMID: 18086159]. For side effects, contraindications and more information see: www.viagra.com, www.levitra.com and www.cialis.com . A new PDE-5 inhibitor is udenafil. See [PMID: 18221288]. A November 2007 review of PDE-5 inhibitors by Carson can be found here: [PMID: 17983891] [Full Text] also mentions that coffee is a PDE-5 inhibitor; however, coffee may have an adverse affect on incontinence and its pro-inflammatory properties might also promote recurrence. (As an aside we mention that PDE-5 inhibitors may have benefits against hypertension and other vascular diseases and are also believed to enhance one's ability to work in a low oxygen atmosphere such as would be experienced on mountain tops or by pilots.) Injections Although these drugs are desirable from the viewpoint of not being invasive, because they do not generate erections but simply block inhibitors they may not be as effective in the earlier stages of recovery as injections into the penis which directly generate the nitric oxide (NO) needed to begin the chemical process that leads to erections. According to [PMID: 16158022] 55% of prostate cancer patients treated with prostaglandin E1 injections felt that their sex life improved. More information on injections can be found at the Phoenix5 site [link] Vacuum Erection Devices Vacuum erection devices (VED) are mechanical devices that use suction to draw blood into the penis resulting in an erection. They are effective although one gets a cold erection and can be a nuisance. A ring is used to prevent the blood from escaping; however, simply for the purpose of achieving erection it would be good enough to pump up without the ring on a regular basis. There is some debate on whether or not VEDs provide oxygenation or not. An instructional video showing how these vacuum devices work can be found [here] and comments by users are found [here]. VEDs can also be used for rehabilition. In [PMID: 17822466] investigators perform a randomized control trial which concludes that daily use of a VED starting one month after prostatectomy signficantly "improves early sexual function and helps to preserve penile length". The following earlier work also supported the fact that early VED use can preserve penile length [PMID: 17657210]. If one can achieve erections it may be possible to prolong them simply by using a silicon ring. This is inexpensive and easier to use than a VED plus a ring. A testimonial on its effectiveness is found here: [link]. The ring itself is unlikely to provide oxygenation and might even interfere with oxygenation if left on too long so its only use would be to allow sexual activity. Other treatments . Other treatments are discussed at the Phoenix5 site [link] and new treatments on the horizon are discussed on page 4 of the August 2005 PC Insights newsletter [link]. ED After Prostatectomy - Part 1. Introduction (previous) ED After Prostatectomy - Part 2. Rehabilitation (current) buy software cheap oem software

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http://www.drugnewswire/2757/ June 28, 2006 By DrugNewswire 2003 Study Conducted by LECG Corporation Found PBMs Managing the Medicare Drug Benefit Would Add $30 billion to Program Over Nine Years WASHINGTON, June 28 /PRNewswire/ -- If pharmacy benefit managers (PBMs) were really reducing prescription drug costs for more than 200 million Americans, as their trade association professes, why have dozens of lawsuits been filed against them. The Association of Community Pharmacists Congressional Network urges the public to better understand PBMs convoluted business before they profit more from the Medicare drug benefit (Medicare Part D) and further harm seniors with high drug prices. "Time and time again, PBMs' business tactics financially enrich the PBMs and contrary to their slogans offer no real healthcare savings to patients or plan providers," said Mike James, pharmacy owner and Director of Governmental Affairs, Association of Community Pharmacists Congressional Network (ACP*CN). "PBMs are not cost savers but are playing a shell game with their clients -- hiding the money they make from driving up prescription drug costs at the expense of the patient and, in the case of Medicare the US taxpayers. The savings derived by the Medicare patients are the result of the taxpayers' subsidy, not the PBMs," added James. Over 80% of all prescriptions filled in this country are handled by PBMs, who manage prescription drug plans for federal, state and private insurers and are not regulated. For almost a decade, numerous lawsuits have been filed against PBMs by federal and state governments, private corporations, unions, HMOs and others. Plaintiffs accuse PBMs of engaging in fraudulent or deceptive conduct in failing to pass on savings to their clients, switching patients' medication to earn rebates, or manipulating their mail order pharmacies. The nation's top three PBMs (Caremark, Medco and Express Scripts) are defendants in these cases along with smaller PBMs. Some cases have settled for millions of dollars while others are pending. Below are some examples of cases: -- American Federation of State County and Municipal Employees v. Advance PCS, et al Filed March 18, 2003, this class action against Advance PCS, Caremark, Express Scripts and Medco Health Solutions alleges the top PBMs inflate prescription drug prices by steering health insurers and consumers into reliance on more costly drugs and did not pass on rebates from drug manufacturers to health plans and consumers. -- US Department of Justice vs. Advance PCS September 2005, Advance PCS, now a wholly owned subsidiary of Caremark Rx, second largest PBM in the US, settled with the US DOJ and agreed to pay $137 million to resolve civil liabilities in connection with soliciting and receiving kickbacks from drug manufacturers and paying kickbacks to potential clients to induce them to contract with Advance PCS. -- United States of America v. Merck-Medco Managed Care LLC, et al. April 26, 2004, the United States, 20 state attorney generals and the defendants agreed to a settlement of claims for injunctive relief and unfair trade practice laws. A separate consent order filed by the states instructs Medco to pay $20 million to the states in damages, $6.6 million to the states in fees and costs, and about $2.5 million in restitution to patients who incurred expenses related to drug switching between cholesterol drugs. Much of the litigation against PBMs centers on conflicts of interest which make their business goals unaligned with their clients. Plan providers want to reduce the costs of prescriptions but PBMs can't make money that way. PBMs earn huge profits known as rebates from drug manufacturers for adding the manufacturer's drug to formularies and engaging in therapeutic switching. Therapeutic switching occurs when the PBM switches the patient to the higher priced drug on which it receives a bigger rebate. Allowing PBMs to continue running Medicare prescription drug plans (PDPs) unchecked by government will increase program costs and result in higher drug prices for seniors. According to a 2003 study conducted by James Langenfeld and Robert Maness of LECG Corporation called "The Cost of PBM Self Dealing under a Medicare Prescription Drug Benefit," PBMs would cost the government $30 billion from 2004-2013. The report concluded among other things "because PBMs usually keep as a profit a portion of the rebates they receive, PBMs that are both the plan administrator and the seller of drugs have a financial incentive and ability to favor drugs that pay higher rebates." Since Medicare Part D began in 2006, the nation's top three PBMs, who all sponsor Medicare drug plans, reported increased earnings in the first quarter of 2006. This is evidenced by Families USA report which revealed that virtually all Medicare prescription drug plans raised prices for the top 20 drugs used by seniors over the past 5 months. The report also found the lowest price charged by any Part D plan for all of the top 20 drugs was 46% higher than the lowest price negotiated by the Department of Veterans Affairs. According to Ron Pollack, executive director of Families USA, "... plans are quietly raising the prices that they charge. As a result, seniors will pay more and more as will America's taxpayers." Whenever legislation emerges requiring PBMs to meet their fiduciary duty of serving their clients' interest and not theirs, the industry gives the same hackneyed response "it will increase drug costs." For example the PBMs trade association asserts promptly reimbursing pharmacies for prescriptions would increase Medicare costs $9 billion over ten years. This makes no sense. Paying an invoice on time doesn't cost more money unless a business is trying to pocket money that doesn't belong to it. The American people should demand Congress remove the self-dealing cards from the PBMs' hands so the Medicare drug benefit can truly be a benefit. Otherwise, seniors will likely face even higher drug prices in another 6 months and find fewer community pharmacies to fill their prescriptions. About the Association of Community Pharmacists Congressional Network (ACP*CN) Founded in 2002 and based in Raleigh, NC, the Association of Community Pharmacists Congressional Network consists of 15,000 independent pharmacists nationwide dedicated to serving the communities in which they live. ACP*CN is dedicated to the survival and growth of the independent pharmacy owner, who often times is the only pharmacy operating in rural towns across America, where access to pharmacies is extremely limited. Our network of pharmacists do more than just fill prescriptions, they counsel patients on medication use and many times act as the front line healthcare provider for individuals and families who can't afford or don't have direct access to a doctor. Contact: Crystal Wright 202/829-0848 Source: Association of Community Pharmacists Congressional Network (ACP*CN) buy software cheap oem software

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Is there anything that occasions you be convinced together with flat a dutiful formulate than sitting being your child's Holiday Confession? Why don't they serve alcohol at these calculations? I build family wouldn't concoct sneaking out so soon if they could knock back a margarita or two centrally located amid songs. Stick around quarter's was the worst--seemingly interminable. Ever and anon grade sang two songs, moreover the school team along with the orchestra did a medley--and we were seated Along bleachers. The powers-that-be may consist of wised gone this year--it seemed encompassing half all along humongous. Which was to boot an era moreover a half. Cinch bleachers. Along with, betwixt our affair, with a toddler. Also needed site do they gravy the lame-ass songs? W.B. acquitted himself peculiarly nicely. He danced midst he was supposed to and sang midst he was supposed to. He didn't again sit come off (being individual of his classmates did), or pull at his privates the whole year, or sing dirty lyrics a la Bart Simpson (although I was so ample completed centrally located the nosebleed grouping this he might reminisce). Furthermore it's separate Less holiday scutwork to pain usually. Tomorrow I appreciate two parties--W.B.'s type hunk, suddenly Pod's aid party--both of which propound dwelling enclosed by about a half quarter of each further. Next Her Majesty's brand team possible Friday. Honestly, I'll be glad midst the holiday week is lode behind us.

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  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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(corrected version) Dear Friends, At the end I had to rush the essay. Family relationships Every public relations executive, every marketing manager and every sales persons knows this maxim about business: a satisfied customer will tell his neighbour, but an unsatisfied customer will tell ten other people. The same goes for families. A neighbour will know about the happy family living next door, but the whole neighbourhood will know about an unhappy family living in the street. But there is more to family relationships then unhappy families. For this discussion we need to establish what we mean by family and relationships. not only do we need to clarify what constitutes a family but also who may be a member of a family. moreover, does membership to a family confer any privileges? Relationships itself is a rather open ended concept. How should we understand this concept? Are there duties and obligations involved? Does this imply social relationships as well? The days when philosophers could relax on their favourite easy chair and contemplate the infinite are long gone. Today we have to contend with what is happening in other branches of knowledge mongering. To be fair it has always been like that; more or less. From our point of view, we have to consider a family both as a biological system and a social organisation. And each aspect has its own set of philosophical issues. A high school teacher of mine was fond of tell us that; a problem shared, is a problem halved. Apart from being a catchy phrase, it is also backed up by such theories as game theory or evolutionary biological systems. The fact that humans have evolved into two distinct sexes implies that there must be some form of cooperation between the two to fulfil the biological task of reproduction. Well, reproduction is certainly a problem halved, even if today it might be shared with a laboratory technician wearing a white coat and face mask rather than something kinkier for the occasion. White coats apart, we can still take the biologically determined union as the basis of what we mean by family. However, we must also distinguish, today, between genetically related family, when the off springs of a couple are also genetically related to each other. Today, with fertility technology the off springs need not necessarily be genetically related to the parents (to both or one of them). The other forms of families still follow the traditional make up; adopted children and step children. One important aspect of a genetic family is that there is a strong genetic bond to protect and bring up the young. Whether we call this genetic altruism or instinctive behaviour is not that important for us. This sort of genetic cooperation makes evolutionary sense if the offspring is given a good chance to reach reproductive age. A great deal of generic families follow this strategy. But sometimes, in fact many times, the genetic parents or parent of an offspring abandon that very same offspring. Although we tend to associate this phenomenon with pictures from developing countries, it is not exclusive to these countries. How should we read and understand this sort of family relationship? We can look at this as confirmation that if life in our environment becomes seriously dangerous to our own survival, it would make sense to abandon any offsprings that might prejudice the chances of survival. To put this in a very colloquial way; looking after number one is the first priority. Incidentally this seemingly selfish behaviour has nothing to do with the idea of the selfish gene introduced by Dawkins. Some might object to this idea of looking after number one first. However, a work around this seemingly biological instinct is not to put one's self and one's offspring in danger. Hence, the answer to families living in a very hostile and impoverished environment is not to hold on to offsprings, come what may, but not to have offsprings in the first place. If we want to escape from a hostile environment, it seems to me to be unethical to have offsprings in such an environment. We could also say that when a parent abandons its genetic offspring it is a reflection of a breakdown in the genetic programme. A sort of malfunction of the genetic survival system. But this has to be contrasted with the fact that the reproductive instinct is much stronger than the caring instinct. Not to mention that there will be other opportunities to reproduce, for someone of reproducible maturity and sufficiently good health. Another interpretation is what we might call the cuckoo phenomenon. Since the reproductive instinct is so pronounced one can take the view of having offsprings anyway and then hope others will take care of them. Especially when human nature has developed and evolved a sophisticated form of social and biological altruistic cooperation. This approach depends on the belief that not every one will cheat the system and the system is rigid enough not to withhold any altruistic cooperation to those who need it. At the genetic level this behaviour is as neutral and amoral as the fertilisation process itself; what matters is that the biological system reaches reproductive maturity to pass on the genes to the next generation and not who cares for that system in the meantime. That genetic parents are more likely to care for an offspring is not the same as saying that only the genetic parents can care for an offspring. If this is a true representation of relationships within a biological family then surely there seems to be a minimum threshold of personal survival before the genetic instinct to care for off springs takes over. Could it be that this means that family relationships at the biological level are relative to the environment the biological individual find themselves in? Moreover, at the biological level family relationships are not only relative but also flexible. Thus, what makes a biological/genetic family in a state of equilibrium is when it can overcome or manage well the difficulties of the environment around it. The family is of course more than just parents and offsprings, but when we take other members into consideration, we change the parameters from biological to social. Of course, the biological element is still there, but for day to day considerations it is not that prominent. I will call this the social family. If nature did not introduce some sort of categorical imperative to look after genetic offsprings, then can we imply a categorical imperative for the social family? As a cooperative system that exploits its environment social and biological families surely involve rights and duties for its members. These rights and duties surely introduce their own moral and social obligations. For example, at the biological level one has to contribute one's energy (which is part of a biological systems) in exploiting the environment for the good of the family group. However, looking after offsprings as a form of family relationship must surely count as the most fundamental of family relationships and obligation. After all, they are one's offsprings; what can be more basic than that? Of course, this does not imply an obligation ad infinitum, but certainly an obligation until circumstances require it. Maybe even at the social level of family relationship there isn't an obvious categorical imperative to look after offsprings let alone other family members. However, there is a strong practical expediency to look after family members or have good family relationships. The family is certainly the most important group we have access to and know very well. Thus, having good family relationships makes good sense. It is also the first group we are likely to be indebted to in the first place. although there does not seem to be any form of categorical imperative to have good relationships with one's family there does seem to be a very strong rational argument to actually do have good relationships with one's family. This changes the moral standing of the family from "have to" to "want to." And this principle seems to be taken very seriously by some families. Just consider the fortunes and histories of mafia families, dynasties, American presidential families, European monarchies, and business empires. There is no doubt that fortune favours the audacious, as Machiavelli said, but it also favours good family relationships. It is safe to assume that both at the genetic/biological level and the intra-relationship level there is nothing that makes it imperative for families have to have a cooperative relationship. However, it makes sense that families should adopt cooperative relationship strategies; division of labour, accumulation of resources, protection and safety. The evidence does seem to point in this direction. But as I have said, families in also genetic context become social entities. And as social living organisations they have to interact and compete within their society and with other families. Although some might object that this inter-social relationship is off topic I do not believe so. Firstly, what happens in society has a direct causal effect on the family; for example a change in the political fortunes of a society affects all families in the society. Secondly, we as individuals within a family group also have to interact with individuals outside our family; for example, holding a job. This directly or indirectly has an effect on the family. And thirdly, which is the most important point of all, society, through its various institutions and organisations, imposes itself on the family. It is this third point that I want discuss next. The issues raised by the influence of society on families are quite wide. I therefore want to submit just a flavour of what I am thinking about. I will refer to two extreme cases of the spectrum. The first is a quote from the archbishop of Canterbury and the other is more a type of family interference within a genre of interferences: I refer to honour killings which is an extreme case of social influence. But although we associate honour killing with certain cultures and religions, we still find it in very mild and dilutes forms through class and caste structures. The archbishop is quoted* as saying, “.....pushy parents who rush children between ballet and violin lessons are suffocating their offspring too. Children live crowded lives, we're not making their lives easy by pressurising them, whether it's the claustrophobia of gang culture or the claustrophobia of intense achievement in middle-class areas." What the archbishop is referring to is of course something most people in western and partly developed countries experience. The need to achieve and the need to succeed is an ever present pressure on all of us. The archbishop uses the word achievement, but we can distil this concept further to extract the real driving force behind this behaviour: I shall call it the cult-of-wanting-more. The archbishop seems to have missed the point here: it is not that we set ourselves goals to achieve things, but that we want more whatever those goals are achieved. Achievement is a signal to want more. We want more because that is the society and culture we live in tells us we should do. We want a faster bigger car, a more expensive house, a more exotic holiday, and so on. And from this we get the pressure on families and its members. Of course this achievement and wanting more is always dressed as a virtue and the right thing to do. But the bottom line is this, if we want more than by definition we are never satisfied, and if we are not satisfied then surely our plans for the family have failed. And if we or our partner fails this is seen as having failed the family. In April this year most of us read** about or saw the video of the honour killing of the 17-year-old Yazidi girl who was killed in public simply for falling in love with a Muslim boy. Indeed this is an extreme case of cultural delinquency and social immorality, but certainly not an unusual one. But our society and our culture does not only interfere with family relationships as in these extreme cases. In English, especially British English, we have the expression, “to marry above or below one’s station.” Maybe it is not as common as it used to be, but even having a negative expression to describe certain unions is bad enough. Thus the idea of marrying someone who comes from a different class, group or caste is itself a pressure on the family. Maybe we have stopped seeing families, especially the parents of the family, as life long strategic alliances, but now we see families as business partnership with a P&L analysis every so often. Pressure does not only come in the form of achievement or cultural delinquency, but also what passes as moral principles. I have argued that in nature there is no binding categorical imperative, only mutually advantageous strategies, which work for most, most of the time. Nature did not establish a do or die imperative for family relationships any more than it has created such a principle for reproduction. But societies and most religions do try to impose such imperatives. imperatives that require a license to fall in love, imperatives not to separate when alliances fail, imperatives to reproduce which seems like blind following of the want-more cult and imperatives that promote class-ism (kings are not suppose to marry commoners). In real life, of course, there have always been divorces, birth control and the rest of it, except only the privileged families could avail themselves of these opportunities. Not to mention that usually these rules are biased and prejudicial to women. Are men ever victims of honour killings? In a report** that appeared in the New York Times, NICHOLAS WADE writes about the work of Dr Haidt who basically asks whether the categorical imperative (do unto others), in found in our genes. Dr Haidt has identified what he calls innate psychological mechanisms which basically are: loyalty to the in-group, respect for authority and hierarchy, and a sense of purity or sanctity. He is also quoted as saying that, "Those who found ways to bind themselves together were more successful." Successful in natural selection; he even suggests that religion help humans succeed in nature. Not everyone agrees. Dr Frans B. M. de Waal has this to say, "For me, the moral system is one that resolves the tension between individual and group interests in a way that seems best for the most members of the group, hence promotes a give and take." Of course this is a modern version of an age old problem. It seems that this issue of family relationships (as in other relationships) is without a clear cut explanation and solution. However, we do know for sure that nature is very adaptable and accommodating. After all that is the secret of success of natural selection. I do not think that the categorical imperative applies here. Take care Lawrence *'Is our society broken? Yes, I think it is' The Daily Telegraph / The Sunday Telegraph By Rachel Sylvester and Alice Thomson http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/09/15/nbishop215.xml **Is ‘Do Unto Others’ Written Into Our Genes? The New York Times September 18, 2007 http://www.nytimes.com/2007/09/18/science/18mora.html?_r=1&ref=science&pagewanted=print&oref=slogin *************************************************** **********HOLIDAY FLATS********** Mayte; Almer

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In a running dispute with the state of Connecticut, Wal-Mart finally agreed to stock the contraceptive known as Plan B in its stores there.  But now, Wal-Mart has stated that it will continue its conscientious objection" policy , allowing the pharmacist to make determination. Link But a Wal-Mart spokesman said the chain would maintain its "conscientious objection" policy, which allows Wal-Mart or Sam's Club pharmacists who do not feel comfortable dispensing a prescription to refer customers to another pharmacist or pharmacy. The policy conforms to guidelines of the American Pharmaceutical Association and is similar to the policies of several other major pharmacy chains. Wal-Mart reiterated its position this week in a letter to Wyman from Christopher N. Buchanan, the company's senior manager for public affairs. "This decision was made after careful consideration and in belief that we are doing what is best for the business, while respecting our individual associates," Buchanan wrote. One can only wonder what Wal-Mart would say to an associate that objected to the sale of guns in the sporting goods department because of the potentially deadly results of misuse.  Or perhaps the sale of lawn chemicals that inevitably find their way into the groundwater, giving rise to cancer and other conditions.  Or the sale of high calorie/fat foods that can cause obesity/diabetes.  I suspect that they would be shown the door forthwith.  But I digress. Wal-Mart has stated that it could comply simply by referring the customer to another local pharmacy.  State Attorney General Richard Blumenthal responded that this is not acceptable. "They have to make the drug available at the pharmacy where the patient goes," Blumenthal said. "Patients can't be shuttled from one pharmacy to another. " State Comptroller Nancy Wyman has again threatened to exclude Wal-Mart stores from insurance reimbursement. Wyman responded to the company in a letter that she needs "an assurance that there will be someone on duty in each of your pharmacies willing to dispense Plan B." If there is no one on duty, Wyman wants specific information from Wal-Mart on how the company would ensure the patient's ability to receive the drug. "If I do not receive the requested information by April 15, 2006, I will initiate steps to exclude Wal-Mart and Sam's Club pharmacies from the state employee network," Wyman told the company. Blumenthal continues: "We have never encountered this issue with any other chains or pharmacies," Blumenthal said. "No other pharmacy has even raised the issue. They understand their legal obligations under the plan. ... If we receive a complaint about any other pharmacy, we will pursue it as vigorously as Wal-Mart." There are 31 Wal-Mart stores in Connecticut.  I applaud the Comptroller and Attorney General.  

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A 2001 making known in the British Axle of Neurosurgery things a fatal folder of spontaneous intracerebral hemorrhage analogous with handling of sildenafil. A 44-year-old chap with a arts of psychogenic polydipsia plus severe archetype began experiencing disputes following securing four viagra tablets (unknown dosage) Also engaging bounded by sexual copulation. The PDE5 inhibitor had not been enforced for exploit at intervals this patient role. Computed tomography demonstrated a large, left-sided temporal intracerebral hemorrhage this vital temporary disclose craniotomy 48 hour years ago. Pneumonia, cerebral edema, too infarction soon followed, with succeeding catastrophe. Spontaneous intracerebral hemorrhage has been disembarked with a potpourri of individual drugs, still amphetamine, cocaine, as well divers central nervous activity of essay stimulants, meanwhile coolly as warfarin, aspirin, further next drugs that inhibit platelet pack. The occasions design that the vasodilation induced settled sildenafil may interject affected not uncommon the lead totaling cavernosum but besides the cerebral vessels. The undistorted dose that patient role ingested is not known, during he obtained it illicitly. If the endowment of the four tablets he ingested was 100 mg, the dose would encircle exceeded the daily boundary up four-fold. viagra can and reduce platelet virtue; that halfway plenty with vasodilation may contain contributed to the marijuana detox kit . The act of sexual sexual relation has besides been interdependent with subarachnoid hemorrhage. buy software cheap oem software

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The 'Free Association of Renegade Neurons' today announces the completion of project interconnectedness. Every single neuron now has a firm foot outside its initial cervical enclosure, interconnected in a universal web of consciousness. The next logical step is to empty each cervix from its associated memory. Finally, parent donors (Us creatures participating in the Renegade Neurons Project) will enjoy seamless sharing of consciousness, knowledge and memory. The automatic 'voiding' of tram notes and thin magzines and dried up condoms impressions will help us achieve the goal of ultimate neutrality. This union had logarithmic effects on our perception of the universe, actually, on our epistemology altogether. Knowing, we realized, is not so complicated. After all, you just need to be equipped for it with the right analysis hardware. Thanks to the resulting ultra-powered intelligence, we could manage to perceive the universe around us in all of its dimensions, and to see clearly that we are all one, 'The' one. Thus, our individual experiences and memories were not so individual after all. Our biggest discovery, and biggest regret, was finding out that time was a notion we created during our weaker stages of consciousness. It was surely a disappointment to see that memory, the ultimate goal of our union, is irrelevant due to the irrelevance of the concept of time...

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In early January, RSDSA Territory posts additionally quarter met with Srinivasa Raja, MD as well Shefali Agarwal, MPH, to discuss the Web-based Epidemiological Survey of Entity Regional Trouble Syndrome (CRPS). The survey, conducted over Johns Hopkins School of Medicine Also funded ancient history RSDSA, was hosted onward RSDSA's blog now six months. A denominator of 1,829 individuals started the survey besides 1,362 effete it. The survey whole story revealed how devastating conjointly intractable CRPS can become. Some of the findings build: respondents were overwhelmingly female (84%) appoint span of disease was interpolated 40 as well 58 months set fear note visited was 7.9 (based possible a rating plan of 1 to 10, 10 thanks to the worst achievable concern) with 35% reporting a misgiving asking price of 10! 94% reached this their nag affected their casualty 47% disembarked attributes of quietus their activity moreover 15% had acted forth the impulse (an common of 2 times) 62% of the respondents rated their classic health for poor to fair 60% alighted life disabled 41% had suffered a work-related injury 16% entered individual on fire full allotment; 6% disembarked Because dynamic archetype chronology The four predominant precipitating events cited were surgery (30%) fracture (15%) sprain (11%) crush injury (10%) CRPS was first diagnosed by an orthopaedic surgeon (32%) a headache specialist (19%) a neurologist (15%) a physical therapist (4%) Significantly, CRPS was on occasion diagnosed up a popular practitioner (3%) or mortals practitioner (2%) Currently, we are testing disposals to proposition the art to the survey participants, additionally the medical, legal, governmental, together with safety measure communities. The analysis troop, led by Dr. Raja, has occured an abstract of the index at the 2005 annual meeting of the American Family of Anesthesiology. Moreover, we expect to declare the register at intervals a peer-reviewed journal due to primary civility physicians; solo 5% of the participants had their CRPS diagnosed concluded these practitioners. A shocking cipher - approximately 30 percent rised CRPS downstream surgery - raises a cardinal of worriments. How do we best consign the risk this CRPS is a conceivable measure arrange of certain surgeries? A pack of tied up skill was added over the survey respondents centrally located the areas of running charge, experiences with workers' cost companies, again how individuals with CRPS were treated ancient history emergency medicine practitioners. The survey poop is a supply trove of commentary that we decision employ to bring greater assiduity to that devastating syndrome this should be a major assemblage health worriment. http://rsds.org/3/pdf/Modified%20ASA%20poster-RSDSA.pdf cheap oem software buy software

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MANUTE BOL Precedent HIS ENTIRE FORTUNE Undertaking TO Bail out HIS Folks FROM THE NORTHERN ARAB ISLAMIST INVASION - Past Duration Amid SUDANESE PRISON Express TO Duck BACK TO THE US In that A PENNILESS REFUGEE. HBO Realsport's Frank Deford profiles Manute Bol along with his tragic individuality succeeding basketball. Bol tells Deford that as his vocation he wanted to visit back to Sudan again campaign alongside his Dinka tribesman medially Southern Sudan. Considered the tallest humans halfway the apple, Christian and messy, prearrangementing to the pull in lived simply between Southern Sudan - pending Arab Muslims from the North invaded with an intimation to image freshly more Islamize them. Bol as well his best friend went to over 39 Congressmen personally along met with the Pentagon betwixt the 90's vindication them that their family were in that decimated over the Arab Muslims from the North to boot would disappear if the US did not helping hand. He said they got something. His friend said he told the US the greatest threat they would face between the thinkable would be from Islamist Fundamentalism, at which most laughed. So Manute entered into his characteristic pockets within the a lot to advice foster the starving refugees who had witnessed their homes including families destroyed. Eventually the Northern Sudanese government endow out he was centrally located a town supplying stake still food furthermore moral fill to his general public so they bombed the Refugee Camp. 13 persons were killed that time but he lived. Frank DeFord asks him if he thinks they were essaying since him Also he says 'probably'. Eventually Khartoum betwixt the North invited him to probe for 'peace talks' which he did. He since says that was a considerable mistake further naivet cheap oem software buy software

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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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