Archive for: June, 2011

My Weekend Off

Jun 13 2011 Published by under Wackaloonacy

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Lovely weekend with the spouse and sprog. Watched a couple of the offspring's games Saturday (one loss, one win) and then enjoyed college baseball superregionals Saturday evening. Now my hubby is driving back to the new place, while the son and I watch True Grit.

Monday begins my final full week at my present job.

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Circular Steps

Jun 10 2011 Published by under Wackaloonacy

A number of folks have been exploring a Wikipedia exercise this week after it was highlighted on xkcd. Click on the first link not in parentheses  in any Wikipedia entry. Keep doing this and eventually, you end up at Philosophy.

A number of inquiring minds have shared their trips through the wikis; to date, everyone ends up at Philosophy. The only variable is the number of clicks.

What happens if you start with Philosophy? How long does it take to get back?


  1. Reason
  2. Rationality
  3. Economics
  4. Social Sciences
  5. Academic Disciplines
  6. Academia
  7. Community
  8. Interaction
  9. Causality
  10. Event (Philosophy)
  11. Property (Philosophy)
  12. Modern Philosophy
  13. Philosophy

And now we know. Have a good weekend; I will be taking some time away from le blogge to enjoy my visiting spouse and watch the sprog play baseball.

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Shocking SEO

Jun 10 2011 Published by under [Information&Communication], Wackaloonacy

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I love computers and the internet, a statement that I know shocks no one reading a blog. My HTML skills remain rudimentary, though, and I have not ventured into the world of search engine optimization (SEO) since it often means inserting stuff into the underlying code of web pages.

This week I decided to make the giant leap and have my hosting service provide one of their SEO reports. The verdict: "Dude, you need keywords and other shit on your sites." OK, not quite in language that straight-forward, but the vibe was there. Oh, and they offered an SEO service for the site that would let me do analysis and fix things without HTML for a minimal fee, less than I spend on iced tea each month.

So I signed up for one of my sites, and loaded up the program. The first step involved choosing keywords for each page in my site. My first surprise was how many pages my site had. I thought it numbered four, but each tag category could be counted as a page for SEO purposes (although luckily not for host charging purposes). Once keywords were identified based on page based on its content and my intent for the page, another service within the product suite showed search ranking results for various terms containing the keyword of interest.

For example, "women" popped up in the top three on most pages, and the phrase rankings for "women" were:

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"Women dressed and undressed" did not entirely surprise me at the top of the list. I was heartened to see "mature women" beating out "hot women" by almost 2:1, although personally I feel like I could fit in both categories.

"Hairy women" beats out "beautiful women" in this world; I really don't want to know how "tall women lifting men" or "women milking men" ranked so high. Weird...

Of course, the most reassuring information was "women kicking men in the groin" beating "videos of women being chloroformed" by more than 1,600. My faith in humanity has been restored with that information.


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Foolish Choices Cost Lives and Money

Jun 09 2011 Published by under MedicoLegal Concerns

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The June 9 issue of New England Journal of Medicine includes a Perspective piece from a nephrologist and hospitalist at the county hospital in Houston, TX. They discuss an issue well-known to those of us in the nephrology community, the care of illegal immigrants with kidney failure. Kidney disease strikes a disproportionate number of ethnic minorities, including those of African, Hispanic, and Native American Ancestry.

US citizens qualify for public funding for their dialysis and transplants, either through the Medicare or Medicaid programs. Federal law prohibits the use of federal funds for non-emergency services for undocumented residents. Raghavan and Nuila describe the plight of these people:

Santiago is in the ER again. He sits in a special row of 20 patients, all of whom are waiting for one result: the potassium. Is it high enough today? Two days ago he was here, and it was only 6 meq per liter. We discharged him. Right now his chest hurts, and he is short of breath. Nothing new, and Santiago knows that if he's to be dialyzed today, these symptoms don't matter. Only the potassium matters.

Thrice weekly hemodialysis, the current standard-of-care for citizens, costs $72,000 per patient per year. Some would argue that this regimen is inadequate, that we should be providing more dialysis to improve patient outcomes, but many of these patients can work and live reasonable lives. Emergency dialysis for undocumented residents places the lives of these people at risk, as well as resulting in ER visits and hospitalizations for emergencies that must be paid for by our public hospitals (using local and state tax dollars and subsidized by increasing charges to other patients). Total costs average $200,000 annually for each of these emergency-dialysis patients.

My direct experience deals with the children without papers, who came to this country with their parents. Sometimes the families can save and fund-raise and get their children transplanted, although then they must bear the burden of the costs of immunosuppression for the rest of their lives. Sometimes good parents allow their children to become wards of the state so they can get the medical care that will give them better lives.

The examples that Raghavan and Nuila provide illustrate the problems of current policy. People who came to this country illegally, but to work hard to support families, can no longer work because of the inadequate care they receive for their conditions. This inadequate care not only prevents them from contributing to the economy via their work, purchases, and sales taxes, but ends up costing the public more than if we provided standard in-center dialysis. The authors admit that this issue "lies at the intersection of debates over the soaring cost of health care and the need for immigration reform."

Do we have an ethical duty to provide the same standard of care for all sick patients within our borders? Or would mandating the providion of health care (and of maintenance-dialysis treatments) create an incentive for illegal immigration and worsen the current situation?

There is no easy solution. But with this particular disease, there are cheaper, more compassionate alternatives...

They make an excellent case for the foolishness of our current choices. Should we let these people die of their disease? Should we continue to provide our current torture care at almost 3 times the cost of standard care? Or can we come up with a more effective and cost-effective scheme for dealing with this problem?

Note: This article is not live on the NEJM site as I schedule this post; I will add a direct link to the text later on June 9. And that link is now live.

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Better Blogging

Jun 07 2011 Published by under [Information&Communication]

An article in (June issue) dealt with writing better business blogs. It covered the usual stuff, but pointed out two web sites to assess and, perhaps, improve readability.

Readability tools measure the educational level necessary to understand the material. These tools use measures of words per sentence, syllables per word, and other proxy measures of difficulty. Microsoft Word will generate a number of these via its proofreading tools. Below is the information for a one-page agreement for my son to play American Legion baseball this summer:

The analysis starts with basic count of words, characters, paragraphs, and sentences. The program then calculates sentences per paragraph, words per sentence, and characters per word. The first readability indicator, the percentage of passive sentences, has been addressed in earlier posts. Flesch Reading Ease purports to measure just that, with higher scores being easier. The Flesch-Kincaid Grade Level presents the years of school needed to understand the text.

What if you work online rather than in Microsoft Word? The article presents two websites that can measure readability by URL. I tested a recent post of mine on stereotype threat, first at, which generates the following scores:

Flesch Kincaid Reading Ease

Based on a 0-100 scale. A high score means the text is easier to read. Low scores suggest the text is complicated to understand.

206.835 - 1.015 x (words/sentences) - 84.6 x (syllables/words)

A value between 60 and 80 should be easy for a 12 to 15 year old to understand.

Grade Level indicators

These equate the readability of the text to the US schools grade level system.

Flesch Kincaid Grade Level

0.39 x (words/sentences) + 11.8 x (syllables/words) - 15.59

Gunning Fog Score

0.4 x ( (words/sentences) + 100 x (complexWords/words) )

SMOG Index

1.0430 x sqrt( 30 x complexWords/sentences ) + 3.1291

Coleman Liau Index

5.89 x (characters/words) - 0.3 x (sentences/words) - 15.8

Automated Readability Index (ARI)

4.71 x (characters/words) + 0.5 x (words/sentences) - 21.43

Coleman Liau and ARI rely on counting characters, words and sentence. The other indices consider number of syllables and complex words (polysyllabics - with 3 or more syllables) too. Opinions vary on which type are the most accurate. It is more difficult to automate the counting of syllable as the English language does not comply to strict standards!

So how did my post on a fairly complex topic with lots of pull quotes do?

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For a general adult audience in the US, experts recommend a Reading Ease score of 60-70; Reader's Digest comes in at 65 while Harvard Law Review scores about 30.

Four indices show easy readability, while the Reading Ease score suggests a more difficult text. The Coleman Liau index suggests the text would be moderately challenging for most adults.

Another site, Juicy Studio, offers many of the same tests, but with more information on the scores. Here is a table they post on typical Gunning-Fog scores:

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How did my post do at Juicy?

The two sites must not calculate in the same manner. Read-able gave my post a less readable score for Reading Ease and a higher Grade Level than the Juicy site. However, the Gunning Fog index on Juicy suggested the post was written at the level of Time Magazine, while Read-able put it at the level of Reader's Digest.

The scores suggest that my blog writing hits the right level for this audience; when I write medical information for families, I keep the grade level 5-6 and the Reading Ease close to 70 so all of the people I serve can understand it. Of course, our baseball team produced a document that players (13-18 years old) and their parents had to sign that tests out far more difficult than my sample blog post. Someone should probably revise that document!

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Unanswered Question

Jun 03 2011 Published by under Uncategorized

I keep asking myself how there could be a congressional representative named Wiener and I didn't know it. With that name something like this was bound to happen eventually. I believe late night comedians hacked his account because, well, how could they resist, really? And they caught him with his firewall down.

Next you're going to tell me some rising politico has the middle name Douche. He should be careful.

I think I have this out of my system now.

- Posted using BlogPress from my iPad

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Taking the Cosmic Hint: Stereotype Threat

Jun 02 2011 Published by under [Education&Careers]

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Over the past couple of weeks, three items dealing with stereotype threat have landed in my lap. Who am I to ignore such an alignment of the stars when I have blog space to fill?

So what is stereotype threat?

Why should we care?

And what can we do about it?


From the website Reducing Stereotype Threat:

Stereotype threat refers to being at risk of confirming, as self-characteristic, a negative stereotype about one's group (Steele & Aronson, 1995). This term was first used by Steele and Aronson (1995) who showed in several experiments that Black college freshmen and sophomores performed more poorly on standardized tests than White students when their race was emphasized. When race was not emphasized, however, Black students performed better and equivalently with White students. The results showed that performance in academic contexts can be harmed by the awareness that one's behavior might be viewed through the lens of racial stereotypes.

In other words, reminding people of stereotypes before an activity may influence their performance toward the stereotype. The Glass Hammer for June 1, 2011, presents a compelling study of how this phenomenon may keep girls out of math and science:

High school students taking the AP Calculus test are generally asked their gender before taking the test. In a field study performed by ETS (Educational Testing Services, the company that designs aptitude tests like the GRE and Praxis), a sample group of girls and boys was asked to indicate their gender after completing it.

Females who received the gender inquiry before the test scored an average AP Formula Score of 12.5, while males scored an average of 16.5. In the groups that received the gender inquiry after the test, females scored an average of 15, while males scored an average of 14. Not only did stereotype threat significantly harm girls’ scores, but boys benefited from being reminded of their gender before taking the test. Aronson said that ETS declined to change the system, even in light of the results of the study.

Before I forget, I have a message for the ETS: Quit being misogynist, racist asshats and collect your demographic data after the damn exam. You collected the evidence; USE IT!!!!!

OK, I feel better now that my rant is over.

Subtle social conditioning about gender and other factors can also alter interests and career choices:

If girls consistently believe they are scoring poorly in math and science because they are biologically not cut out for it, they are less likely to pursue those fields of study at any level. The same goes for Black and Latino children as well. And that’s why its important to change the way we talk about test taking and performance.

The saddest part of this whole discussion is that many simple techniques are already recognized to reduce stereotype threat, such as collecting data on race and gender after the exam rather than before (Are you paying attention yet, ETS?):

The links above take you to Reducing Stereotype Threat which discusses each in detail, with references. There are some criticisms of stereotype threat, as well as some unresolved issues that require further research.

Stereotype threat affects all of us; even white males may be negatively impacted in some venues. Its effects can be minimized with some fairly low-tech, inexpensive techniques. I am glad this showed up in my reading this week; it needs to be on everybody's radar.

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Whiskey Slushies

Jun 01 2011 Published by under Recipes

I was wrong to tease you yesterday by mentioning my mom's best recipe and not providing it:

Image courtesy of

1 large can frozen lemonade

1 small can frozen orange juice

5 cups water

2 cups tea

1/2 cup sugar

3 cups whiskey

Mix all ingredients in a freezer-safe tub, then freeze. Serve with a spoon and, if you like, another shot of whiskey over the top.

Guaranteed to be a crowd-pleaser on a warm summer's day!

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What I Am Reading: Kidney Edition

Jun 01 2011 Published by under Uncategorized, What I'm Reading

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Walter A. Hunt's new book fills a niche in the kidney disease market: a book by a patient about living with the knowledge that your kidneys will fail, living with failed kidneys, and surviving it all to get transplanted. The subtitle, A Guide for Living, sums it up nicely; you can survive and thrive with kidney disease. In this age of self-help and patients empowerment, it seems impossible that no one has written this book before now. Unfortunately, Walter A. Hunt is not a typical kidney disease patient (more on that later), so the book may not have as broad an audience as possible.

The book flows in the predicted fashion, from what kidneys do and why they fail, though the diagnostic tests and treatment options available at each step of the way. Throughout the book, the author remembers that each patient's disease will be different, and that no single prescription can fit everyone, especially before the onset of end-stage kidney failure. Personal insights on adapting and dealing with issues may be of benefit to many patients, especially if they lack an understanding support system.

My major criticism of the book stems from the author's background. Dr. Hunt holds a doctorate in neuropharmacology and performed biomedical research for 30 years before his diagnosis with polycystic kidney disease. While this background certainly helped him understand his condition, the writing in the book likely exceeds the health literacy of much of the population. Terms like "diffuse" may not be familiar to the average kidney patient (even though I am certain most heard it in a science class somewhere along the way), but clearly he assumes that word will be understood:

Dialysis involves filtration. Start with a basic concept: imagine a tank of water into which you carefully place a drop of ink in one corner of the tank. The concentrated ink tends to diffuse over time throughout the entire container of water until it reaches the same concentration in all parts of the tank.

Starting with a definition of diffusion might have been useful for the average adult in the US.

Kidney Disease: A Guide for Living may not be a perfect guide for patients, but it fills an empty slot on the patient's bookshelf. Motivated patients may find it a valuable addition to their kidney disease management tools.

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