31 March 2012
Joyeux Anniversaire!
30 March 2012
If I had a . . .
29 March 2012
Back to School
27 March 2012
Windmolens
26 March 2012
21 March 2012
Write it down
Wed, 21 Mar Max: 15°C (59°F) Min: 6°C (42°F) 9mph / 14kph (ENE) | |
Thu, 22 Mar Max: 17°C (63°F) Min: 9°C (48°F) 10mph / 17kph (E) | |
Fri, 23 Mar Max: 19°C (67°F) Min: 9°C (48°F) 7mph / 11kph (ENE) | |
Sat, 24 Mar Max: 18°C (65°F) Min: 8°C (46°F) 7mph / 12kph (NE) | |
Sun, 25 Mar Max: 17°C (63°F) Min: 8°C (47°F) 8mph / 13kph (NE) |
20 March 2012
Pitloos
17 March 2012
In the Dark
16 March 2012
Purloined Paraplu
13 March 2012
No Brainers
What you Lose When You Sign That Donor Card
by Dick Teresi
The last time I renewed my driver's license, the clerk at the DMV asked if she should check me off as an organ donor. I said no. She looked at me and asked again. I said, "No. Just check the box that says, 'I am a heartless, selfish bastard.'"
Becoming an organ donor seems like a win-win situation. Some 3.3 people on the transplant waiting list will have their lives extended by your gift (3.3 is the average yield of solid organs per donor). You're a hero, and at no real cost, apparently.
But what are you giving up when you check the donor box on your license? Your organs, of course—but much more. You're also giving up your right to informed consent. Doctors don't have to tell you or your relatives what they will do to your body during an organ harvest operation because you'll be dead, with no legal rights.The exam for brain death is simple. A doctor splashes ice water in your ears (to look for shivering in the eyes), pokes your eyes with a cotton swab and checks for any gag reflex, among other rudimentary tests. It takes less time than a standard eye exam. Finally, in what's called the apnea test, the ventilator is disconnected to see if you can breathe unassisted. If not, you are brain dead. (Some or all of the above tests are repeated hours later for confirmation.)
Here's the weird part. If you fail the apnea test, your respirator is reconnected. You will begin to breathe again, your heart pumping blood, keeping the organs fresh. Doctors like to say that, at this point, the "person" has departed the body. You will now be called a BHC, or beating-heart cadaver.
Still, you will have more in common biologically with a living person than with a person whose heart has stopped. Your vital organs will function, you'll maintain your body temperature, and your wounds will continue to heal. You can still get bedsores, have heart attacks and get fever from infections.
"I like my dead people cold, stiff, gray and not breathing," says Dr. Michael A. DeVita of the University of Pittsburgh Medical Center. "The brain dead are warm, pink and breathing."
You might also be emitting brainwaves. Most people are surprised to learn that many people who are declared brain dead are never actually tested for higher-brain activity. The 1968 Harvard committee recommended that doctors use electroencephalography (EEG) to make sure the patient has flat brain waves. Today's tests concentrate on the stalk-like brain stem, in charge of basics such as breathing, sleeping and waking. The EEG would alert doctors if the cortex, the thinking part of your brain, is still active.
But various researchers decided that this test was unnecessary, so it was eliminated from the mandatory criteria in 1971. They reasoned that, if the brain stem is dead, the higher centers of the brain are also probably dead.
But in at least two studies before the 1981 Uniform Determination of Death Act, some "brain-dead" patients were found to be emitting brain waves. One, from the National Institute of Neurological Disorders and Stroke in the 1970s, found that out of 503 patients who met the usual criteria of brain death, 17 showed activity in an EEG.
Even some of the sharpest critics of the brain-death criteria argue that there is no possibility that donors will be in pain during the harvesting of their organs. One, Robert Truog, professor of medical ethics, anesthesia and pediatrics at Harvard Medical School, compared the topic of pain in an organ donor to an argument over "whether it is OK to kick a rock."
But BHCs—who don't receive anesthetics during an organ harvest operation—react to the scalpel like inadequately anesthetized live patients, exhibiting high blood pressure and sometimes soaring heart rates. Doctors say these are simply reflexes.
What if there is sound evidence that you are alive after being declared brain dead? In a 1999 article in the peer-reviewed journal Anesthesiology, Gail A. Van Norman, a professor of anesthesiology at the University of Washington, reported a case in which a 30-year-old patient with severe head trauma began breathing spontaneously after being declared brain dead. The physicians said that, because there was no chance of recovery, he could still be considered dead. The harvest proceeded over the objections of the anesthesiologist, who saw the donor move, and then react to the scalpel with hypertension.
Organ transplantation—from procurement of organs to transplant to the first year of postoperative care—is a $20 billion per year business. Average recipients are charged $750,000 for a transplant, and at an average 3.3 organs, that is more than $2 million per body. Neither donors nor their families can be paid for organs.
It is possible that not being a donor on your license can give you more bargaining power. If you leave instructions with your next of kin, they can perhaps negotiate a better deal. Instead of just the usual icewater-in-the-ears, why not ask for a blood-flow study to make sure your cortex is truly out of commission?
And how about some anesthetic? Although he doesn't believe the brain dead feel pain, Dr. Truog has used two light anesthetics, high-dose fentanyl and sufentanil, which won't harm organs, to quell high blood pressure or heart rate during harvesting operations. "If it were my family," he said, "I'd request them."
—Mr. Teresi is the author of "The Undead: Organ Harvesting, the Ice-Water Test, Beating-Heart Cadavers—How Medicine Is Blurring the Line Between Life and Death."09 March 2012
Where there's hope
08 March 2012
07 March 2012
Gimmick or genius?
06 March 2012
Touristy
04 March 2012
Ikeadom
02 March 2012
The Roaring 20's
Obsolète le rêve américain ? La promesse qu'un homme de rien puisse, aux Etats-Unis, plus que nulle part ailleurs, nourrir les espoirs de fortune les plus délirants, n'est-il plus qu'une chimère ? Le constat cruel, presque déshonorant pour la première économie mondiale, a été dressé par les équipes mêmes du président américain, Barak Obama, mi-février. En page 177 du rapport économique annuel du président remis au Congrès figure ce qu'on appelle "la courbe de Gatsby le Magnifique". Le roman de Francis Scott Fitzgerald, peinture de la vanité bourgeoise de l'Amérique des années 1920, donne son nom à un graphique où se croisent, sur un axe horizontal, les données mesurant le degré d'inégalité des revenus et, à la verticale, le lien entre le revenu du père et celui de ses descendants, baromètre de la mobilité sociale.
Que nous dit cette courbe ? Quel que soit l'angle sous lequel on l'observe, les Etats-Unis sont les plus mauvais. Les inégalités de richesses se mêlent à un immobilisme social que l'on pensait réservé à la Veille Europe. L'Amérique de Paris Hilton se range ainsi loin derrière les pays nordiques, mais aussi derrière la France, la Nouvelle-Zélande, le Japon et le Royaume-Uni...
L'ampleur et la distorsion des richesses outre-Atlantique ont déjà été démontrées par les travaux de l'économiste et historien français Thomas Piketty. Mais abordercette question avec un Américain et il vous sera répondu que "les riches sont riches parce qu'ils le méritent". Que l'idée quasi communiste qui consisterait àprendre aux fortunés pour donner aux plus démunis n'est pas une juste récompense du talent. A force de pugnacité, un citoyen américain ne doit-il pas un jour ou l'autre être en mesure d'atteindre le haut de la pile ? "No pain, no gain", entend-on. La "courbe de Gatsby le Magnifique" offre un démenti cinglant à cette théorie. Et aux Etats-Unis comme ailleurs le "talent" se résume bien souvent àhériter.
Le système éducatif américain, autrefois considéré comme le meilleur "égalisateur de société", est partie responsable. Une étude récente du Michigan, citée par le New York Times, révèle que l'écart de performances entre les étudiants riches et pauvres a bondi de 50 % depuis les années 1980. Plus que la race, la richesse fait aujourd'hui la différence à l'école.
Et ensuite ? L'espoir de la bonne fortune d'un ouvrier américain s'amoindrit aussi. La crise et le chômage qui tendent l'un comme l'autre à comprimer les salaires n'expliquent pas tout. Car en page 65 du même rapport figure "l'autre graphique le plus commenté" par les experts : une courbe démontrant que, depuis les années 2000, le travail d'un Américain est de plus en plus mal rétribué alors que les entreprises amassent de plus en plus de bénéfices. Résultat, les profits des compagnies américaines à 13 % du produit intérieur brut sont historiquement élevés, observe Evariste Lefeuvre, chez Natixis à New York.
Le sujet du rapport économique, remis en pleine année électorale, ne doit rien au hasard. En insistant sur les inégalités sociales, le document offre des arguments censés être imparables aux démocrates pour défendre l'idée d'une fiscalité plus redistributive. Quitte à surfer sur le populisme.
Après avoir vanté la "Règle Buffett", du nom du milliardaire américain Warren Buffett appelant à taxer davantage les super-riches comme lui, le président a lancé, mercredi 22 février, une salve contre les profits des entreprises. Une initiative audacieuse et dangereuse dans un pays où la liberté d'entreprendre est sacrée. Pour ne pas choquer, l'idée a consisté en façade à réduire le taux d'imposition sur les bénéfices de 35 % à 28 %. En façade seulement, car le dispositif vise aussi àsupprimer la plupart des niches fiscales utilisées par les multinationales. Le projet mort né - il n'a aucune chance d'être adopté par un Congrès où la chambre des représentants est à majorité républicaine - a néanmoins permis de démontrer que les compagnies américaines ne payaient presque jamais le taux plein. De quoinourrir des rancoeurs inédites ? Quelques jours plus tard, le 24 février, le quotidien USA Today titrait sur l'explosion de l'extrême pauvreté aux Etats-Unis, indiquant que le nombre de familles vivant avec moins de deux dollars par jour avait plus que doublé en quinze ans, passant de 636 000 en 1996 à 1,5 million en 2011.
Mais l'argument le plus favorable à Barack Obama se trouve peut-être tout simplement chez son adversaire, le candidat républicain Mitt Romney. Ancien patron de la société de capital investissement Bain Capital, l'homme est à lui seul une démonstration de l'injustice fiscale américaine. Sa petite fortune engrangée grâce à son fonds d'investissement est taxée à hauteur de 15 % comme tout revenu du capital. De quoi ranger le candidat dans le camp de ces hommes d'affaires moins imposés que leur secrétaire puisque les revenus du travail, eux, sont taxés entre 10 % et 35 %.
Quelques mois après les manifestations des Occupy Wall Street opposant les 1 % de privilégiés qui continuent imperturbablement à s'enrichir aux autres 99 %, le débat que tente de faire naî Barack Obama peut avoir un parfum de lutte des classes. Inadéquat avec la culture américaine ? Un sondage publié par le New York Times et la chaîne de télévision CBS News soulignait, en octobre 2011, que 66 % des Américains pensent que la distribution des revenus et des richesses aux Etats-Unis devrait "être plus équitable".
By Claire Gatinois
LE MONDE/Worldcrunch
Is the American Dream obsolete? Has the promise that people can “make it” in the United States better than anywhere else on the planet become nothing more than an illusion? That cruel conclusion, which seems almost to dishonor the world’s biggest economy, was punctuated this February inside Barack Obama’s White House.
On page 177 of the President’s annual report to Congress on the state of the economy, there is mention of the “Great Gatsby Curve.” F. Scott Fitzgerald’s novel, which so masterfully paints a picture of bourgeois vanity in 1920s America, has given its name to a graph on which data measuring the degree of income inequality is charted on the horizontal axis, and the link between a father’s income and that of his descendants – a barometer of social mobility – on the vertical.
What does this curve tell us? No matter what the frame of reference of the person examining it, its bottom line is unambiguous: the United States – not supposedly fusty Europe -- rates lowest in terms of this relationship in the distribution of riches and social mobility. Yes, Paris Hilton’s America ranks way below the Scandinavian countries, but also below France, New Zealand, Japan, the United Kingdom, and others.
French economist and historian Thomas Piketty has already demonstrated out how America’s wealth is as distorted as it is vast. But should you discuss this particular matter with an American citizen, you will be told that “the rich are rich because they deserve it.” The quasi Communist idea of taking from the rich to give to those in need is not a fair reward for talent.
If an American is tenacious enough, shouldn’t he or she be able some day to make it to the top of the heap? "No pain, no gain," as they say. But the Great Gatsby Curve says No. So much so that in the United States, as elsewhere, “having talent” may just be another way of saying "having inherited money."
The American system of education, at one time considered to be “the great equalizer,” is partly responsible for this state of affairs. A recent study conducted in Michigan and quoted by the New York Times shows that the discrepancy in performance levels between rich and poor students has risen by 50% since the 1980s – which means that wealth, more than race, is what makes the difference in school.
What now? The hopes of American workers of “making it” are waning. But the crisis and high unemployment, both factors that have a compressing effect on salaries, cannot explain everything. On page 65 of the President’s report is the “other most commented-on graph”: a curve showing that, since the 2000s, American workers are being increasingly badly paid as businesses amass larger and larger profits. The result, as Evariste Lefeuvre of the Natixis corporate and investment bank in New York points out, is that the profits of American companies amounting to 13% of GDP are at a historic high.
That this subject is addressed by the President’s report in an election year is no accident. By focusing on social inequality, the document offers supposedly irrefutable arguments that open the door for the Democrats to push a redistributive fiscal agenda that flirts with populism.
After praising the “Buffett Rule,” which takes its name from American billionaire Warren Buffett's call for the super-rich like him to be taxed more, President Obama goes on to attack high business profits – an audacious, even dangerous thing to do in a country where freedom of enterprise is sacred. So as not to make it too much of a shock he put another face on it, so it looked like a reduction of taxes on profits from 35% to 28%. What’s actually behind it, however, is a plan to get rid of most of the fiscal loopholes used by multinational companies to pay less taxes.
While this plan has no chance whatsoever of being approved by the Congress, with its Republican majority in the House of Representatives, it has however managed to reveal that American companies hardly ever pay their full tax share – a revelation certain to unleash its share of bitterness. And indeed: just two days later, on February 24, the USA Today daily published a feature on extreme poverty in the United States, reporting that the number of families living on less than $2 a day had more than doubled in 15 years, going from 636,000 in 1996 to 1.5 million in 2011.
But the argument most favorable to Barack Obama may well lie with the man he could be facing in the general election: Republican candidate Mitt Romney. A former bigwig in the investment firm Bain Capital, Romney is a walking example of American fiscal injustice. He pays 15% tax on the fortune he made thanks to his investment fund – which puts him in the category of businessmen who pay lower tax rates than their own secretary.
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February 29th, 2012 - 10:02Want to know more about the Great Gatsby Curve? Here you go.