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Believe it or not, it must be difficult to be a politically correct lefty in the Twin Cities these days. Not because spirited conservatives are taking the battle to you, but because you really have to get creative to outdo your own brethren. Right now, everyone stands in awe of the city of Minneapolis. The Star Tribune might shill the liberal party line day in day out, but there's nothing new or creative in that. The city of St. Paul can raise property taxes to pay for more government waste, but Minneapolis has been doing that for years. The DFL controlled state legislature might pass ridiculous, impractical laws that impose on the rights of businesses, but again, that's nothing the liberals in Minneapolis haven't been doing for decades. The city of Minneapolis continues its old anti-business agenda and increasing crime rate, but additionally has one-upped everyone on the political correctness scale by hiring and refusing to fire an inept and possibly criminal fire chief who happens to be (read was given the job solely because she is) a lesbian. No one is more jealous of Minneapolis' PC posturing than the Marxists at the University of Minnesota. Their political correctness just doesn't measure up. The women's studies department hasn't been news in decades. The university has been relegated to attracting PC kudos by giving Al Gore an honarary degree. As if honoring another dead white male could score real PC points with those who keep track of that sort of thing. I however, have an idea so radical that it would put the U of M on the front page of every newspaper in the country. It is an unfortunate fact that the athletic departments of major universities garner more headlines than any of the academic departments. Late in 2006, the University of Minnesota was forced to fire the coaches of its two money programs (men's basketball and football) due to gross incompetence. After the firings occurred, sports experts suggested that the university could end accusations of aspiring to atheletic mediocrity by hiring a "big name" coach in one of the two sports. Examples of "big name"coaches included Tony Dungy in football and Flip Saunders or Rick Majerus in basketball. People who understood the aspirations of mediocrity of the U of M suggested that there would be no "big name" coach hired in either sport and instead suggested that the U would hire such non-big names as one or both of the "big time" coaches from non-rival North Dakota State. The U of M responded by hiring a nobody named Tim Brewster for the football coach position. Brewster is certain to field a team no better than that of his predicessor Glenn Mason. However, the U can still make history. They could hire basketball coaching legend Pat Summitt. Summitt would be the first ever woman to coach NCAA men's basketball. However, she would be more than an atheletic Bonnie Bleskachek. Summitt's overall record stands at 913-177, with 6 NCAA women's titles. Compare that to Mike Kryzewski or Bob Knight, with respective records of 771 wins and 3 NCAA Titles and 887 wins and 3 NCAA Titles. Unlike Bonnie Bleskachek, Pat Summitt is a qualified coach. Her record is second to none. The NCAA is currently wringing its hands that it doesn't have enough minority football coaches. Yet they have more than one for decades. There has never been a woman coach of an NCAA men's basketball team. This is an obvious display of sexism. Many men have coached NCAA women's teams. The University of Minnesota can once and for all claim PC supremacy by naming Pat Summitt its men's basketball coach. To do anything else would reinforce the existing patriarchy and make Wellstone followers everywhere cry. buy software cheap oem software

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Part 4 of a 4-part series of short posts intended to clear out my bloggestive tract. Hold your nose! Well, I held out for a week. Then I read the comments. Argh! Actually they were fine. Nice comments, all around. Whew. I don't have any big themes to talk about today, but I've got a couple of little ones, let's call 'em bloguettes, that I'll lump together into a medley for today's entree. Bloguette #1: Ruby Sneaks ended accessible Python I was in Barnes today, doing my usual weekend stroll through the tech section. Helps me keep up on the latest trends. And wouldn't you know it, I skipped a few weeks there, and suddenly Ruby and Rails have almost as many books out as Python. I counted eleven Ruby/RoR titles tonight, and thirteen for Python (including one Zope book). And Ruby had a big display section at the end of one of the shelves. Not all the publishers were O'Reilly and Pragmatic Press. I'm pretty sure there were two or three others there, so it's not just a plot by Tim O'Reilly to sell more books. Well, actually that's exactly what it is, but it's based on actual market research that led him to the conclusion that Rails and Ruby are both gathering steam like nobody's business. I like a lot of languages. Really, I do. But I use Ruby. I'm not even sure if I like Ruby. The issue might just be irrelevant to whether I use it. I like OCaml, for instance, but I don't use it. I don't like Java, but I do use it. Liking and using are mostly orthogonal dimensions, and if you like the language you're using even a little bit, you're lucky. That, or you just haven't gotten broad enough exposure to know how miserable you ought to be. I use Ruby because it's been the path of least resistance for most of my programming tasks since about 3 days after I started messing with it, maybe 4 years ago. I don't even really know Ruby all that well. I never bothered to learn it. I did read "Ruby in a Nutshell" cover-to-cover, but it's a short read (and it's a bit out of date now.) Then I read bits of "Programming Ruby", but not all of it. And now I use Ruby for everything I can, any time I have any choice in the matter. I don't even mind that I don't know the language all that well. It has a tiny core that serves me admirably well, and it's easy to look things up when you need to. I do a lot more programming in Python than in Ruby -- Jython in my game server, and Python at work, since that's what everyone there uses for scripting. I have maybe 3x more experience with Python than with Ruby (and 10x more experience with Perl). But Perl and Python both have more unnecessary conceptual overhead, so I find I have to consult the docs more often with both of them. And when all's said and done, Ruby code generally winds up being the most direct and succinct, whether it's mine or someone else's. I have a lot of trouble writing about Ruby, because I find there's nothing to say. It's why I almost never post to the O'Reilly Ruby blog. Ruby seems so self-explanatory to me. It makes it almost boring; you try to focus on Ruby and you wind up talking about some problem domain instead of the language. I think that's the goal of all programming languages, but so far Ruby's one of the few to succeed at it so well. If only it performed better. *Sigh*. Well, its performance is in the same class as Perl/Python/JavaScript/Lua/Bash/etc., so there are still plenty of tasks Ruby's admirably suited for. I think next year Ruby's going to be muscling in on Perl in terms of mindshare, or shelf-share, at B&N. Bloguette #2: Java's Biggest Dog (Indeed) I still do most of my programming in Java -- at least half of it, maybe more. The Java platform continues to make amazing strides. The newest incarnation (JDK 6) has lots of goodies I can't wait to play with. Like Rhino, for instance, and although they appear to have gutted it, it's still awesome. I think it's the best choice they possibly could have made. Thank God they didn't bundle Groovy. What a catastrophe that was, and still is, and would have been for Java if they'd bundled it. Rhino rocks. The JVM is just getting faster and more stable, and there are even some OK libraries that come with it. I used to think the Java platform libraries were the cat's meow. Heck, I thought they were the whole damn cat. But working with better libraries in miscellaneous other languages has got me thinking that Java's libraries are hit-or-miss. Example: Java's concurrency libraries (java.util.concurrent[.*]) are to die for. I mean, if you're stuck with threads. I think in the fullness of time, hand-managed threads will be history, but in the meantime, Java's concurrency libraries are just superb. I recently ported a medium-sized Python program I'd written (about 1200 lines of fairly dense Python code) to Java, because the Python was taking about an hour to run, and I wanted to parallelize the work. I spent about 3 days doing the rewrite: one day on the straight port, a day adding in the threading, and a day fine-tuning it. The straight port wound up as 1300 lines of Java (surprising that it wasn't bigger, but maybe I code in Python with a Java accent?), and ran about 50% faster, down to about 30 minutes. After adding in the threading and state machine, the program ran in 50 to 60 seconds. So I got an order of magnitude improvement with only about a 50% increase overall in program size. The vast majority of the improvement was attributable to the threading, which in turn would have taken me FAR longer if I'd been using raw synchronization primitives. The java.util.concurrent stuff made it a snap. On the other hand, Java's DOM implementation completely blows chunks. It quickly became the bottleneck in my application, due to an O(n) algorithm I stumbled across with no good workaround for. I can't remember exactly where it was (this was back in July), but I found a sheepishly apologetic comment from the author in the online docs. It was something to do with setting attributes on nodes while you're doing a traversal of some sort: something you'd definitely want to be fast, but it had at least linear performance, maybe worse, and now accounts for 95+% of my app's processing time. And of course Java's DOM interface blows too, because you can't create subclasses or decorators or do anything useful with the DOM other than use it as a temp container until you've transfered the data to something more flexible. Java's collections library is decent, but not superb. It's nice having the data structures they provide, but they're not very configurable, and the language itself makes them often cumbersome. For instance, you can have a WeakHashMap (nice), or an IdentityHashMap (nice), or a ConcurrentHashMap (also nice), but you can't combine any two of those three properties into a single hashtable. Lame. And java.util is missing implementations and/or interfaces for a bunch of important data types like priority queues (you're stuck using a TreeSet, which is overkill), the disjoint set ADT, splay trees, bloom filters, multi-maps, and of course any kind of built-in graph support. Java hyper-enthusiasts will tell you: "well, go write your own! Or use one of the many hopefully robust implementations on the web!" That seems lame to me. We're talking about data structures here: they're more fundamental than, say, LDAP libraries and much of the other stuff Sun's bundling these days. It's smartest to provide robust, tuned implementations of these things, because it empowers average Java programmers to write faster, more reliable code. Oh, and let's not even get me started with java.nio. What a mess! It's pretty gross, especially if you come from the comparatively simple background of select() and poll() on Unix. But maybe the grossness was necessary. I'll give them the benefit of the doubt. What bugs me isn't that the API is conceptually weird and complex (and buggy as hell last time I checked); what bugs me is that nobody at Sun bothered to put a layer atop java.nio for ordinary programmers. Like, say, a nonblocking DataInputStream that takes a type to read, a Buffer, and a callback to call when it's finished reading. So every frigging Java programmer on the planet has to write that exact class -- or just flail around with the raw APIs, which is what I think most of them do. And look what they did to poor LDAP! I mean, the LDAP bindings are dirt-simple in every language I've ever used. It's supposed to be lightweight -- that's what the "L" stands for, fer cryin' out loud. JNDI is this huge monster. So is JMX. I mean, Java libraries have this way of being so bloated and overengineered. But whatever; I've digressed. Java's libraries are not its biggest failing. The libraries (as I said) are decent, and the platform (in terms of tools, speed, reliability, documentation, portability, monitoring, etc.) really raises the bar on all those other loser languages out there. All of 'em. It's why no better languages have managed to supplant Java yet. Even if the language and its libraries are (on the whole) better than Java's, they also have to contend with the Java platform, and so far nobody's been able to touch it, unless maybe it's .NET, but who cares about .NET? Certainly not Amazon.com or Yahoo! or Google or any other important companies that I'm aware of. Literals Anyway, Java's biggest failing, I've decided, is its lack of syntax for literal data objects. It's an umbrella failing that accounts for most of the issues I have with the language. The idea behind literals is that you have some sort of serialized notation for your data type, and it's part of the language syntax, so you can embed pre-initialized objects in your code. The most obvious ones are numbers, booleans and strings. It's hard to imagine life without support for numeric literals, isn't it? Well, Java's support is limited at best. There's no syntax for entering a binary value, for instance, like "0b10010100". And there's no BigInteger/BigDecimal syntax, so working with them is a disaster and nobody does it if they can help it. Heck, Java doesn't even have unsigned ints and longs. But Java does more or less the bare minimum for numbers, so people don't notice it much. Imagine if there were no String literals, so that instead of this: String s = "Hello, world!"; you had to do this: StringBuffer sb = new StringBuffer(); sb.append('H'); sb.append('e'); sb.append('l'); sb.append('l'); sb.append('o'); sb.append(','); sb.append(' '); sb.append('W').append('o').append('r').append('l').append('d').append('!'); String s = sb.toString(); Not only is the latter bloated and ugly and error-prone (can you spot the error in mine?), it's also butt-slow. Literals provide the compiler with opportunities for optimization. Well, unfortunately this OOP garbage is exactly what you have to do when you're initializing a hashtable in Java. Nearly all other languages these days have support for hashtable/hashmap literals, something like: my_hashmap = { "key1" : "value1", "key2" : "value2", "key3" : "value3", ... } That's the syntax used by Python and JavaScript, but other languages are similar. The Java equivalent is this: Map<String, String> my_hashmap = new HashMap<String, String>(); my_hashmap.put("key1", "value1"); my_hashmap.put("key2", "value2"); my_hashmap.put("key3", "value3"); ... It might not look that much worse from this simple example, but there are definitely problems. One is optimization; the compiler is unlikely to be able to optimize all these method calls, whereas with a literal syntax, it could potentially save on method call overhead during construction of the table (and maybe other savings as well.) Another is nested data structures. In JavaScript (and Python, Ruby, etc.) you just declare them in a nested fashion, like so: my_thingy = { "key1": { "foo": "bar", "foo2": "bar2"}, "key2": ["this", "is", "a", "literal", "array"], "key3": 37.5, "key4": "Hello, world!", ... } It would be hard to do this particular one in Java 5 because of the mixed value types, though it's probably not an issue since using mixed-type data structures is something you rarely do in practice, even in dynamically-typed languages. But even if all the values were hashes of string-to-string, how are you going to do it in Java without literals? You can't. You're stuck with: Map<String, Map<String, String>> my_hashmap = new HashMap<String, HashMap<String, String>>(); Map<String, String> value = new HashMap<String, String>(); value.put("foo", "bar"); value.put("foo2", "bar2"); my_hashmap.put("key1, value); value.clear(); value.put("foo3", "bar3"); value.put("foo4", "bar4"); my_hashmap.put("key2, value); ... And then you find out later that your clever clear() optimization (instead of creating a new HashMap object for each value) busted it completely. Whee. Java programmers wind up dealing with this kind of thing by writing generic helper functions, and it winds up layering even more OOP overhead onto something that ought to be a simple declaration. It also tends to be brutally slow; e.g. you could write a function called buildHashMap that took an array of {key, value, key, value, ...}, but it adds a huge constant-factor overhead. This is why Java programmers rely on XML so heavily, and it imposes both an impedance mismatch (XML is not Java, so you have to translate back and forth) and a performance penalty. But the story doesn't end there. What about Vector/ArrayList literals? Java has primitive array literals, which is nice as far as it goes: String[] s = new String[]{"fee", "fi", "fo", "fum"}; Unfortunately, Java's primitive arrays are a huge wart; they don't have methods, can't be subclassed, and basically fall entirely outside the supposedly beautiful OOP-land that Java has created. It was for performance, to help capture skeptical C++ programmers, and they have their place. But I don't see why they should have all the syntactic support. I mean, the [] array-indexing operator is ONLY available for Java arrays. Sure would be nice to have it for ArrayLists, wouldn't it? And Strings? And FileInputStreams? But for some reason, Java gave arrays not one, but TWO syntactic sugarings, and then didn't give that sugar to anything else array-like in the language. So for building ArrayLists, LinkedLists, TreeMaps and the like, you're stuck with Swing-style code assemblages. I think of them as Swing-style because I used to do a lot of AWT and Swing programming, back when I was a Thick Client kind of guy, and they have a distinct(ly unpleasant) footprint. It looks vaguely like this, in pseudo-Swing: Panel p = new Panel(new FlowLayout()); JButton b = new JButton("Press me!"); b.setEventListener(somethingOrOther); p.add(b); JSomething foo = new JSomething(blah, blah); foo.setAttribute(); foo.setOtherAttribute(); foo.soGladIDontDoThisKindOfThingAnymore(); p.add(foo); ... Building UIs in Swing is this huge, festering gob of object instantiations and method calls. It's OOP at its absolute worst. So people have come up with minilanguages (like the TableLayout), and declarative XML replacements like Apache Jelly, and other ways to try to ease the pain. I was on a team at Amazon many years ago that was planning to port a big internal Swing application to the web, and we were looking at the various ways to do web programming, which at the time (for Java) were pretty much limited to JSP, WebMacro, and rolling your own Swing-like HTML component library. We experimented with the OOP approach to HTML generation and quickly discarded it as unmaintainable. (Tell that to any OOP fanatic and watch their face contort as they try to reconcile their conflicting ideas about what constitutes good programming practice.) The right solution in this case is, of course, a Lisp dialect; Lisp really shines at this sort of thing. But Lisp isn't so hot at algebraic expressions, and the best Lisp machines no longer look so cutting-edge compared to the JVM, and blah blah blah, so people don't use Lisp. So it goes. The next-best solutions are all about equally bad. You have your XML-language approaches (like Jelly, but for the web), but they don't give you sufficient expressiveness for control flow -- presentation logic really does require code, and it gets ugly in XML in a real hurry. You have your JSP-style templating approaches, and they aren't bad, but they can have as many as 4 or 5 different languages mixed in the same source file, which presents various problems for your tools (both the IDEs and the batch tools). And then you have a long tail of other approaches, none of which manage to be very satisfying, but that's not really the fault of the languages. It's the browsers' fault: they START with three languages (HTML, CSS, and JavaScript), rather than having just one language to control the entire presentation, and it only goes downhill from there. But NONE of the approaches to web templating is as bad as Swing-style programming, with a huge thicket of calls to new(), addChild(), setAttribute(), addListener(), and the like. The only approach that's worse (and even it might just be tied) is raw HTML printing: print("<html><body>...</body></html>"); So we're all in agreement. OOP-style assembly of parents and children is the worst way to generate HTML. You want to use declarations; you want a template , something that visually looks like the end result you're trying to create. Well, it's the exact same situation for data structures, isn't it? You'd rather draw a picture of it (in a sense, that's exactly what you're doing with syntax for literals) than write a bunch of code to assemble it. This is all assuming that you're working with a small data set, of course. But that happens all the time in real-world programs; it's ubiquitous. So you kinda want your language to support it syntactically. And so far we've only covered literal syntax for HashMaps and ArrayLists (which you can combine to produce various kinds of custom Trees.) Already Java's way behind other languages, and we haven't discussed any richer data types. Like, say, objects. JavaScript does it the best here, IMO, in the parity between hashes and objects. It's not really possible in Ruby or Python to declare a class, then create instances of the class using literal notation the way you can in JavaScript, where the keys are the names of instance variables. Fortunately you can accomplish this in either Ruby or Python with just a smidge of metaprogramming, so it's spilt milk at worst. In Java, you only have one big hammer (instantiation), and one big wrench (the method call), so that's what you use. All you can really do to help is create a constructor that takes arguments that populate the instance variables. But if any of your instance variables are collections (other than arrays), then you're back to the old create-setprops-addchild, create-setprops-addchild pattern again. And what about functions? Ruby and JavaScript and Lisp and Scheme and Lua and Haskell and OCaml and most other self-respecting languages have function literals. That is, they have a syntax for declaring an instance of a function as a data object in your code that you can assign to a variable, or pass as a parameter. (Python has them too, but unfortunately they can only be one line, so Python folks prefer to pretend anonymous functions aren't very important. This is one of the 10 or so big problems caused by Python's whitespace policy. Don't ever let 'em tell you it doesn't cause problems. It does. Maybe it's worth the trade-off; that's a personal style preference, but they should at least admit the tradeoff exists.) Well, Java sort of has them, but Java's static type system doesn't have a literal syntax for a method signature. It's pretty easy to imagine one, e.g. something like: (int, int) -> String x; This imaginary syntax declares a variable x that takes 2 ints as parameters and returns a string. Lots of languages have signature-syntax of some sort, and Java's syntax space is definitely sparse enough that they could pick a good syntax for it without fear of collisions, even conceptual collisions. But no such luck. Instead, when you want to do this sort of thing you have to declare a named interface, and then inside of it declare at least one named method (which is where the params and return type show up), and then you're still not done, because when you create the function you have to create an anonymous (or named) class that contains the definition of the function that matches the interface. Yuck. But at least they let you do it; the alternative of not having it at all is definitely worse. Still... isn't syntactic sugar nice? I mean, they added the "smart" for-loop, which Java programmers just rave about. So someone, somewhere in the Java community thinks syntax is good. I'm not sure many of them really understand the difference between syntactic sugar (into which category the "smart" for-loop falls) and orthogonal syntax, in which the basic operators apply to all data types for which those operators make sense, and there are literal declarations possible for every data type. Let alone the next step, which is extensible syntax -- but that idea strikes fear into the hearts of many otherwise brave Java programmers, and Rubyists and Pythonistas as well, so let's back it up a notch to "orthogonal", and keep everyone calm. So there you have it: Java's biggest failing. It's the literals. No literal syntax for array-lists (or linked lists or tree sets), nothing for hashtables, nothing for objects of classes you've personally defined, none for functions or function signatures. Java programmers all around the world spend a *lot* of their time working around the problem, using XML and YAML and JSON and other non-Java data-declaration languages, and writing tons of code (whole frameworks, even) for serializing and deserializing these declarations to and from Java. For the smaller stuff, they just write helper functions, which wind up being bloated, inefficient, error-prone, and extremely unsatisfying. Java's next-biggest failing may well be the lack of orthogonality in its set of operators. We can live without operator overloading, I suppose (the simplest form of extensible syntax), but only if Sun makes operators like [] and + actually work for objects other than arrays and Strings, respectively. Jeez. Epiblogue You can draw your own conclusions about why suddenly there are all these books on Ruby appearing on the bookshelves. It's a mix of truths, no doubt. And you can draw your own conclusions about why Sun's adding support for scripting languages to the JVM, rather than simply fixing Java so that people don't want (need, really) to use those other languages. But when you dig down into a programming language, and you get past all the hype and the hooplah, what you find is a set of policies and decisions that affect your everyday life as a programmer in ways you can't ignore, and that no amount of hype will smooth over. If your language is sitting on you like an invisible elephant, and everyone using the language is struggling to work around the same problems, then it's inevitable that other languages will come into play. Libraries can make you more productive, but they have almost no effect on the scalability of the language. Every language has a complexity ceiling, and it's determined by a whole slew of policy and design decisions within the language, not the libraries. The slew includes the type system (with its attendant hundreds of mini-policies), and the syntax, and it also includes the language's consistency: the ratio of rules to exceptions. Java's demonstrating quite clearly that at a certain level of complexity, the libraries and frameworks start to collapse under their own weight. People are always writing "lightweight" replacements for existing fat Java libraries and frameworks, and then the replacements get replaced, ad infinitum. But have you ever seen anyone write a replacement for XPath? Nope. It's not like everyone is rushing out to write the next big XML-querying framework. This is because XPath is a language , not a library, and it's orders of magnitude more conceptually scalable than the equivalent DOM manipulations. Object-Oriented Programming. Touted even by skeptics as a radical leap forward in productivity, and all OOP really is boils down to a set of organizational techniques. Organization is nice, sure. But it's pretty clear that OOP alone doesn't cut it; it has to be supplemented with Language-Oriented Programming and DSLs. And all languages, DSLs and general-purpose languages alike, have to be designed to maximize consistency; each inconsistency and special-case in the language adds to its conceptual overhead and lowers the complexity ceiling. So you can look at the shelves filling up with Ruby books and chalk it up to marketing hype, but I have a different theory. I think it's entirely due to complexity management: Ruby does a better job of helping managing complexity than its competitors. It doesn't do a perfect job, mind you -- far from it. But it's enough of a step forward in productivity (even over Perl and Python) that it's managing to shoulder its way in to a pretty crowded language space. With that in mind, despite my griping about Java's failings, I think Sun might actually be doing the right thing by introducing scripting languages (and improving support for them in the JVM.) Maybe. Their investment isn't really so much in Java as it is in the JVM; the JVM is their .NET. Java's not really about productivity, not really -- it's got a lot of strengths (performance, deployment, reliability, static checkability, and so on), but productivity isn't high on the list. So maybe the best way to address the productivity issue, for folks who really need it more than raw performance, is to introduce new JVM languages rather than try to pull Java in two directions. We'll see. And with that, I think I've officially un-blocked myself; I seem to be able to blog again. So I'm declaring the Blogger's Block series finished! BloggersBlock block = new BloggersBlock(); block.setFinished(true); block.tieOffAndStuff(); blog.addChild(block); ... cheap oem software buy software

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That’ll Be The Day “All I know is just what I read in the papers.” Will Rodgers,1879-1935 I await the day when The New York Times runs a series of “good news” articles about the state of American health care. The series might have these titles, • Americans Trust Their Doctors • Americans Have Greater and Quicker Access to High Tech Diagnostic and Curative Care Than Any Other Nation • Foreign Physicians Flock to America for Training Unavailable in Their Country • Record Numbers of Canadians Cross Border for Life-Saving Care • America Achieves Unprecedented Longevity Gains in Last Decade • Americans Receive 80 Percent of Noble Prizes in Medicine • Research at American Pharmaceutical Companies Produces 90 Percent of the World’s New Drugs • America’s Innovative Health System’s Variety and Choice the Wonder of The World That’ll be the day. The Times in 2005 and 2006 had a series of a dozen articles entitled “Being A Patient.” These focused largely on the perils of being a patient in America. Now The Times is embarked on a series on medicine and money, focusing on profit-mongering drug and medical device companies in league with greedy specialists to bilk the public. It all comes down to altitude and attitude. From their lofty perch, Th e New York Time’s editorial staff has yet to tumble to the reality America is basically a conservative nation, distrusts centralized government, wants choices of care and providers, demands access to the wonders of high tech medicine, and believes a market-based system, with all its faults, such as profits for entrepreneurial and innovative health care companies and , are worth the price and value received. It is almost as though The Times denies the existence of entrepreneurial capitalism in American health care. Our health system blends innovative large and small firms striving for economic growth. Such a system entails risk – workers who lose jobs and health insurance, widening of gaps between winners and losers, competition with some jobs going to skilled workers abroad who have increasing skills, occasional bankruptcies among those unable to pay health care bills. American capitalism is imperfect. It requires oversight to reduce risks without losing entrepreneurial vigor. Unremitting accusations of bad faith and constant “bad news” stories don’t strengthen health care. Read the The New York Times, and you’ll come away believing pervasive avaricious greed corrupts American health care and will break our already “broken” system. From May 9 through May 11, The Times ran 10 articles on how drug companies deceived the public and entered into unholy alliances with doctors to sell more drugs to produce more revenue for doctors, how doctors willingly entered into these alliances solely for material gain, and how lobbyist-tainted and incompetent FDA failed to monitor new drugs and harmed patient safety. The May 9 front page, right top column, the prime spot for highlighting news, featured these headlines, Doctors Reaping Millions for Use of Anemia Drugs. Payments from Industry. Concerns over Safety – Critics See Incentives for Higher Doses. The opening Section read: “T wo of the world’s largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe the medicines at levels that might increase patients’ risks of heart attacks or strokes. Industry analysts estimate that such payments — to cancer doctors and the other big users of the drugs, kidney dialysis centers — total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the makers of the drugs, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business.” The Times appears bent on publishing on its front pages “All the Bad News that’s Fit to Print about U.S. Health Care.” The May 9 article is part of a series of medicine and money, all decrying collusive relationships between big business and bad doctors. The Times series focus on the pharmaceutical industry and medical device industries , and how these industries reward specialists who overuse products for financial gain. To The Times, the American health system has become a morality play, • the good guys (The Times and other assorted elites and policy pundits) vs. the bad guys (profiteering health companies and doctors); • the greedy (well-healed executives and “rich” doctors) vs. the needy (poor patients in the throes of cancer or kidney dialysis); • the high brows (academics and journalists who know what’s right for the common good) vs. the low brow commercial types (who do almost everything wrong as long as it suits their own financial self-interest). I don’t wish to pick a fight with a media outlet who buys ink by the barrel. I know “bad news” sells better than “good news.” I know The Times considers itself the Watchdog and Whistle-Blower against mean-spirited, profiteering conservatives. I don’t question our capitalistic system needs oversight to reduce abuses. I’m simply seeking more balance in The Times reporting. For an example of this imbalance, in its May 9 piece, The Times dismisses America doctors’ overuse of anemia-correcting drugs for cancer and dialysis as a deliberate effort to make money. To make its case, The Times notes American doctors, • prescribe more drugs than European counterparts ( Did it ever occur to T he Times maybe, just maybe, European doctors “under-prescribe” and maybe their patients have less positive results? ) • conssciously endanger patients for profit when they know anemia drugs are unsafe (Has it occurred to The Times American physicians prescribing these drugs believe higher hemoglobin levels are “good” for improving health and alleviated distressing symptoms attributable to anemia.) • Continued to prescribe drugs even after studies indicated hemoglobin levels above 12 might endanger patients ( Did it ever occur to The Times the studies indicating “possible” risk studies were far from conclusive and only appeared in March?) Nor does The Times point out doctors themselves often criticize thenselves. For instance, on a May 11 blog, “The Doctors Weighs in on Cancer,” Dr. Dov Michaeli, an academic physician and biochemist who does cancer research takes the American Society of Clinical Oncologists (ASCO) to task for responding to the Times defensively (see epilogue to this blog for a reprint of ASCO letter to The Times). Of the ASCO letter to the times (reprinted in epilogue), Dr. Michaeli acidly comments “ASCO makes that same argument that professional people make when colleagues are caught with their hands in the cookie jar: most of us are conscientious, hardworking people. Granted, but it turns a blind eye to the corrosive influence of pharmaceutical companies on the use of drugs. This is denial of how our health system ‘works’ on a daily basis.” Michaeli concludes: “As the wheels are coming off our broken health system, more revelations of waste, abuse, greed and outright criminality are bound to surface. What are we going to do about it?” Good question. I suggest we start with a more balanced view of the system. • First, I reject the notion the system is “broken” – and constant reference by academic critics of greed by practitioners as a cause for this brokenness ( Michaeli, an academic researcher, shows some of this bias when he says, “ ASCO is led by academic clinicians and researchers, whose motivation and dedication is admirable. But many of the rank and file, community practitioners, are not beyond temptation.” I doubt medical academicians, who compete for pharmaceutical company grants and who run clinical trials, are beyond temptation. I’m unaware academic physicians wear halos and only practicing doctors are vulnerable to “temptation.” • Second, I believe critics ought to acknowledge health care is an innovate force in our economy, will soon represent 20 percent of the nation’s GNP, and is the nation’s largest employer. Professional managers, whose job is to maximize resources and revenues, run most health care enterprises - hospitals, medical practices, drug and device manufacturers. If overzealous pursuit of revenues and resources leads to excess, managers should be condemned, even fined and jailed, but it shouldn’t be assumed or taken for granted pharmaceutical and medical device companies and doctors are always seeking mutually beneficial arrangements are ipso facto evil doers. What the media in general, and The New York Times in particular, needs is a more balanced view. An occasional dollop of good news, such as more than 50 percent of cancer victims are now surviving, more than 10 million cancer victims are living with their disease, and genetically engineered cancer drugs are contributing significantly to cancer cures, would help achieve that balance. I’m pleased to report the May 12 issue of The Times contains a “good news” piece on Becton, Dickinson & Company. It’s buried on the third page of the business section. It’s titled “Medical Gear That Rarely Makes News.” It consists of an interview with Edward J. Ludwig, CEO of Becton and Dickenson, with revenues of $5.7 billion last year, on sales of syringes, diagnostic kits, lab equipment, and related gear. The unifying theme behind the company’s success is its emphasis on safety in its products to protect doctors, nurses, and patients with shields, sliding clasps, and needle retracting into the device. Its ambition is to make a significant dent in the 2 million infections each year from antibiotic resistant staphococci killing 90,000 Americans each year and costing $6 billion yearly to treat. Toward that end, B &D has acquired a diagnostic system allowing them to quickly identify the offending bacteria. Use of this system to screen every patient. entering Evanston Northwestern Hospital reduced infections by 60 percent. Ludwig contend s private innovation will help the “broken” health system to heal itself by attacking safety problems, and improving care. What the media needs is a new more flexible mindset allowing them to become more innovative in reporting the “good news” of our resourceful and responsive health system. Epilogue : In the interest of being “fair and balanced” (a term the mainstream media now considers anathema since Fox News adopted it as their slogan), I reprint six letters from the May 13, Sunday, New York Times. The Times deserves credit for publishing letters representing both points of view. Best Drug, or Best Money Maker? (6 Letters) 1) To the Editor: So two drug companies are paying hundreds of millions of dollars to doctors who prescribe anemia medicines that lack effectiveness and put a patient’s health at risk. This is not a surprise because it reflects our broken health system, a system driven by greed. Although drug companies say their intentions are not to promote the use of more medicine for profit, there will always be the risk that some doctors will prescribe higher doses to gain that extra dollar. As patients, we should work to eliminate the incentives to doctors and to raise patient awareness about them. We deserve the right to know the benefits of a medicine, both for us and for the doctors. Luis Rodriguez Daly City, Calif., May 9, 2007 2) To the Editor: Medical care should be guided only by what is best for patients. But throughout the medical system, rebates and volume discounts are common and can create the perception of improper incentives. Our organization has long advocated evidence-based guidelines, including those we produced in 2002 with the American Society of Hematology on erythropoietin use for chemotherapy-related anemia. With the appropriate use of erythropoietin, many thousands of patients have avoided potentially dangerous blood transfusions. Oncologists care deeply about their patients, and the overwhelming majority treat them based on the best available evidence. In the case of erythropoietin, recent studies prompted the Food and Drug Administration to issue a “black box” warning in March about the potential dangers of using erythropoietin to boost hemoglobin to levels higher than guidelines recommend. Early evidence suggests that doctors factored this new data into their prescribing decisions and have reduced erythropoietin use. As a whole, the medical community needs to better determine the impact financial incentives may have on prescribing patterns and patient care, to ensure that patient needs continue to be at the forefront of medical decisions. Allen S. Lichter, M.D. Exec. V.P., American Society of Clinical Oncology Alexandria, Va., May 10, 2007 3) To the Editor: Many doctors appear dissatisfied with fees ethically garnered from clinical evaluation and management. They can and will prescribe for personal profit, and will readily reshape and expand diseases to suit the available reimbursement. Without disclosure, patients are typically the last to know there might be a problem. The investigation of anemia drugs no doubt could expose the self-serving logic, unethical inducements and poor administrative surveillance that permit exploitation of the public’s soft financial underbelly. Unfortunately, there are plenty of other specialties of medicine where such professional betrayals occur. And adequate regulation is not likely to occur in the financial free-for-all of private medicine. James H. Lampman, M.D. Bismarck, N.D., May 9, 2007 4) To the Editor: The discovery and development of growth factors that stimulate the bone marrow to produce red cells was a milestone in modern medicine. In the appropriate setting, these growth factors can improve blood counts and quality of life and spare patients time-consuming, expensive, short-lasting and risky transfusions. In our practice the increasing use of these medicines is driven by the fact that they work so well. As with any new therapy, these medicines need to be used within established and developing guidelines to avoid serious side effects. Since there are two competing and equally effective drugs, the drug makers are offering incentives for preferential use — the natural outcome of a free-market economy. Deciding how regulators might control drug makers is an important undertaking, but it should not detract from the tremendous benefits of these drugs when used in the right situation. Birjis Akhund, M.D. Chief of Medical Oncology Huntington Hospital Huntington, N.Y., May 9, 2007 5) To the Editor: America has the best medical care in the world. It is the most advanced and expensive. The first two qualifications are debatable, but the third is difficult to refute. The great expense is complicated by the high cost of drugs and procedures of dubious benefit. The likelihood of being prescribed drugs of dubious benefit is obviously increased by kickbacks to doctors. The kickbacks may be legal, but should they really be allowed? The cost of medicine is increased by this practice, and the quality is sure to suffer. Alex Floyd Lexington, Ky., May 9, 2007 6) To the Editor: “Doctors Reaping Millions for Use of Anemia Drugs” (front page, May 9) was disturbing. I found it equally disturbing that the continuation of the article was in Business Day. In the past two decades, I have observed that news of important medical advances increasingly appears in, or is continued in, the business section. This practice advances the thinking that health care is primarily a business in which providers reap riches, rather than a humane social endeavor in which providers earn their living. Ira D. Feirstein, M.D. New York, May 9, 2007

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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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Why Texas misss additionally (furthermore better) lawyers at intervals its promulgate legislature: Achievable 8 November 2005 Texans rapaciousness grasp the opportunity to vote forward a rhythm of checkList initiatives. Pitch 2 means to marriage. My suppose is that the two chambers of the Texas Legislature wanted preemptively to invalidate chip proposed statute this might legitimize same-sex associate civil unions, marriages, or runnerup accommodations. Tom Sit out's TRMPAC successfully divergent the political regularity of the Texas legislature, however, furthermore the current crop of statesmen consist of written a hit this would, on its face, eliminate heterosexual marriage (or civil unions) over lot. The conversation onward the initiative (from the Texas Secretary of Speak's web site) dip intos Prop. 2 HJR 6 Chisum - Staples Catalogue Vocalization \"The constitutional correction providing that marriage surrounded by this make known consists solo of the union of separate unit additionally one woman together with prohibiting that sound off or a political bureau of this express from creating or recognizing moiety legal span undifferentiated or affiliated to marriage.\" \"Enmienda constitucional que dispone que en este estado el matrimonio consiste exclusivamente en la uni buy software cheap oem software

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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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Word slinger: Jay Ashley The period infertility refers to the abnormal incapacity to conceive children concluded natural proves of significance. It plus refers to the incapability of a woman to visit for the entire hour of pregnancy. Particular couples until the sphere meditate hard to erect a child, however some find strong difficulty among doing so and thus liking medical maintenance to be successful. Any which way percent of the persons interpolated the reproductive term are infertile prearrangementing to the American Mortals owing to Reproductive Medicine, a third of twin cases impinge females, supporting third incriminates males, likewise 15 percent regard both branches. Technically, a couple is considered infertile if they are unable to visualize a child medially six months of unprotected sexual intercourse (or 12 months if the woman is during 35 years old), dealing to the INCIID (International Council on Infertility Science Dissemination). There are hundreds reasons this may derive. Conforming details may relate either the male or the female, or both partners. Reasons of Male Infertility There are numerous articles this could gravitate to male infertility. A customary illustration is the point with sperm push. An infertile male may be producing veritably little sperm cells or Oddly weak/immobile sperm cells. A soul may to boot be affected concluded an underlying disease or medical condition approximating pending endocrine obstacles, diabetes, Kallmann's syndrome, hypogonadism, hyperprolactinemia, drug too alcohol-related troubles, this hinder the salt mines of hormones necessary for sperm daily grind. Some army might receive boxs mortal their reproductive organs themselves. Bounded by identical causes carry Klinefelter's syndrome, testiscular trauma, mumps, Idiopathic basket case, seminoma, varicocele, hydrocele, cryptorchidism, conjointly the like. These causes reminisce issue coins conceivable the testicles themselves, which are the organs responsible over sperm attempt. Some multitude might be able to initiate healthy again teeming of sperm cells but append predicaments of releasing them Because impeccable intercourse. They might fathom an obstruction surrounded by the vas deferens (the tube that links the testicles to the penis), infection, retrograde ejaculation, erectile dysfunction, besides hypospadias. That prevents the successful truck of sperm to the female reproductive lore. Causes of Female Infertility Thanks to a effigy to the shapes of male infertility, females might recognize disputes with the exertion of healthy egg cells. They might comprehend quandarys intervening their ovaries cognate owing to polycystic ovary syndrome, luteal dysfunction, lacking ovarian reserve, Turner syndrome, anovulation, ovarian neoplasm further premature menopause, which hinder the healthy maturation further amen impart of egg cells. A woman may including be infected closed at odds reasons that affect her reproductive health. Midway analogous conditions work in diabetes mellitus, adrenal disease, liver ailments, kidney malfunction, thyroid disorders, along psychological issues. A woman may as well include botherations with certain glands this accomplish necessary hormones Because repetition. Inserted undifferentiated diseases constitute Kallmann syndrome, hypothalamic dysfunction, hypopituaitarism, conjointly hyperprolactinemia. Some troubles may likewise be affect the cervix, making it difficult due to sperm to order the egg cell. Approximative disputeds point accommodate anti-sperm antibodies, cervical stenosis, more insufficient secretion of mucus over the freight of sperm. The uterus or the womb itself might not be conducive due to conveying a child. There could be uterine malformations, leiomyoma or uterine fibroids, additionally Asherman's Syndrome. Infertility is a difficult headache. Fortunately, the wonders of medical erudition has reared several treatments since both male further female infertility. To feel certain moreover generally them, only can surely favor a fertility clinic, a gynecologist or a urologist. All Rights Separate, That content may be reprinted due to hurting for for it remains unchanged Also the urls are intact conjointly active. Almost the writer: Infertility of a major respect tween millions households but it does not incorporate to be twin moil at intervals your body. Thanks to more cause conjointly earnings regarding infertility checkout Jay's scene todayat http://WWW.perfectinfertility.picture too start getting the answers you've been yearning through. Natural Fertility Store A Much Better Way Natural Living & Parenting Blog Social Bookmark BlinkList del.icio.us Digg it Furl ma.gnolia Netvouz RawSugar Shadows Simpy Spurl Yahoo MyWeb Create Social Bookmark Links cheap oem software buy software

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Years ago the news splashed totally spent the media today that older adults are, indeed, having sex, my first bustle was to laugh together with state, \"Duhhh!\" The doctrine that senior sex is in process seemed to me through often a news note over the revelation this most community give feet at the plan of their legs! But there was much plus to the answer. \"A Go through of Sexuality likewise Health amid Older Adults midway the United States,\" published today tween the New England Journal of Medicine, was a major type of 3005 U.S. adults (1550 besides 1455 command) 57 to 85 years of flourish which revealed some fascinating goods together with a few surprises: The majority of older adults are sexually active including take sexuality when an important part of going. The frequency of sexual agility declines with quarter, yet a substantial have of platoon including women engage betwixt vaginal intercourse, shibboleth sex, further masturbation consistent amidst the eighth Also ninth decades of interval. The frequency of sexual vim reached by sexually active older adults (thrive 57+) is intertwined to the prevalence appeared within adults 18 to 59 years of spell. The comprehend visited that 78% of throng 75 to 85 years of continuance, now compared with 40% of women separating this go lot, had a spousal or advertise relationship. Through women going longer, as well forward accepted, older division marry younger women, that antithesis can be accounted now bygone the decrease of earthly division in that the older unique women. The sexually active folks surrounded by the oldest develop cast interviewed -- 75 to 85 years of go -- attained having sex at least two to three times per duration, furthermore 23% visited having sex once a month or too. En masse half of the sexually active pack again women attained at least sui generis \"bothersome sexual affair,\" further over solitary third reached having multiple questions. The women's most bountiful sexual disputes were low commercial, difficulty with vaginal lubrication, inability to climax, finding sex not pleasurable , besides misgiving, normally over memorandum. The most varied sexual nuts being cavalry were erectile difficulty (14% of really flight interviewed reported using medication or supplements to improve sexual faculty), drive for of bag intervening sex, climaxing again dexterously, anxiety overall model, together with inability to climax. Publicly singular rule of sexually active older adults with a sexual thesis landed warding off sex mid a consequence. Most surprising, inclined the line of these pickles this prevented sex from cat satisfying or pleasurable, was that fact: Indivisible 38% of throng too 22% of women reached having discussed sex with a physician owing to the instant of 50. The tracing snarls up that the expectations considering poor publicity have the unwillingness of both patients to boot physicians to palaver mostly sex together with the gender additionally age differences inserted patients besides their physicians. Negative societal attitudes about women’s sexuality and sexuality at older ages may also inhibit such discussions. When I give workshops and talks, both women and men frequently bring up physical problems that affect their sexuality and want me to provide a solution. I always say, "Please get a diagnosis from your doctor." I emphasize that the problem may be caused by retreating hormones, or by an underlying health condition that you don't know you have, or a medication, or interactions of medications. You can't treat a problem until you know what's causing it. As the NEJM article states, Sexual problems may be a warning sign or consequence of a serious underlying illness such as diabetes, an infection, urogenital tract conditions, or cancer. Undiagnosed or untreated sexual problems, or both, can lead to or occur with depression or social withdrawal. Patients may discontinue needed medications because of side effects that affect their sex lives, and medications to treat sexual problems can also have negative health effects, yet physician–patient communication about sexuality is poor. I invite your comments! buy software cheap oem software

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