Posts by B Jones
Last ←Newer Page 1 2 3 4 5 Older→ First
-
Hard News: Complaint and culture, in reply to Deborah,
The comment was from Amy Tuteur, who writes The Skeptical OB, so she perhaps has an agenda. Even so, the stats she reports are alarming. Which is why it would be bloody useful to have some decent stats tracking the experience in NZ.
There's this. It's a shame it doesn't go very far back, though. I suppose you could compare it to this, but unless you could see a sharp change at the time of changeover between systems, it wouldn't be much use to work out how effective the new policy is. Technology and best practice have changed over time (there are more c-sections done now and fewer ventouse/forceps, because the former has gotten safer), as well as the populations giving birth - more obesity=more gestational diabetes=bigger babies etc.
Dr Amy totally has an agenda, but so do Ben Goldacre and so on. She doesn't seem to stand to gain financially from it, as a retired OB, whereas many of the people she gets stuck into are professional advocacy organisations and working in the field. I'm not sure I'd want her delivering my baby, but I'd be happy with her looking over safety isues in the back office. She seems to have a good grasp of statistics.
-
Hard News: Complaint and culture, in reply to Lucy Stewart,
home births are illegal in a lot of states, for starters
I'm not sure if you can make home births illegal as such. After all, it happens accidentally all the time. But you can make it illegal for formally trained midwives to attend homebirths, which mainly means only unlicensed ones do it. I'm not sure if we have, or want, that kind of choice here.
-
How does one, having been put off from looking at the magazine thanks to the atrocious cover (which screamed "sensationalist and unrepresentative of real obstetric practice"), get hold of a copy of the Failure to Deliver story? As a consumer of midwifery services as well as a voracious reader of international debate over related issues, I'm keen to find out whether it goes beyond the standard patch-protection carping between former GP/OBs and midwives and into something a little more substantive. It's an international debate and deserves more than rehash of the LMC arguments; on the other hand, the medical regulatory market in the US is so different from ours*, the debates in that arena don't necessarily translate here.
There are so many facets to the issue - how does providing a high-quality medical service conflict with meeting consumer demand for alt-med practices, how effective are the processes for escalating high risk pregnancies, is it funded adequately overall, do we actually have a problem compared with comparable countries, what do the regular reviews of Maternity and Perinatal Morbidity and Mortality show as the biggest problems, and so on. Least useful but most media-ready of these are the inevitable anecdotes from patients and their families. But that's as hard as second-guessing other technical specialists like lawyers and mechanics - some things might be obvious like poor customer relations, but it's often hard to tell whether a bad or good outcome is the result of plain old luck or skills outside the norm.
*In some US states, you can practice as a home-birth midwife without any special training, licensing or supervision. Here, it's a four-year degree.
-
Hard News: 2011: The Year Of What?, in reply to Stephen Judd,
As for Wishart, well, even a blind chicken can peck corn. A stopped clock is right twice a day. My presumption is that he's probably wrong on any given thing, but it's not a given.
I wonder if part of his thing is a natural contrarianism. Not useful when you're railing against the overwhelming majority of evidence, since it tends to see conspiracies rather than fold in favour of the evidence, but occasionally useful when there's a public lynch mob charging around looking for someone to tar and feather. Stopped clock principle and all.
King's in about the same legal position as Robin Bain (or would be, if he were alive); neither charged nor convicted, but raised by the defence as reasonable doubt for a more likely perpetrator. It's an unfortunate place to be. Yet I don't recall such an outcry over any of the many books on either side of the Bain case.
-
Speaking of upper upper Karori, on the bank of usually grassy farmland above my street I couldn't help but notice at lunchtime a number of skidmarks of the sort someone or someones very very keen might perhaps make with a snowboard. At least hopefully it wasn't the result of all the cows losing their footing.
-
We bought a house in which previous owners had replaced an open fireplace with a logburner. I remember thinking at the time (and on many cold mornings, evenings and kindling chopping sessions since) that if I was starting from scratch a heat pump would have been about as expensive but less work and therefore better. Then last night, at about the second or third power hiccup, I changed my mind. Always good to be independent of the grid for some things. I just wished it was one of those lovely old things you could put a kettle on top of.
Investigation in the basement has revealed the remnants of an old heating oil system, which fits with the house being built just before the oil shock. Was obviously cheaper in those days to burn stuff rather than insulate the house.
Various persistent HRV salesmen have tried to convince us to add one of them - I doubt it would do anything that our existing dehumidifier and ceiling fan don't already handle.
-
Hard News: Is that it?, in reply to Kumara Republic,
When is nanny statism not nanny statism? When it's paternalism.
When the Prime Minister is male? There's a funny gendered undercurrent to this - see John Armstrong:
It is the kind of policy that a lateral-thinking Labour Party should have been promoting to confound its critics and shed once and for all its lingering image of political correctness in order to recapture some of the huge number of male voters who have switched to National.
I thought it was the huge number of female voters who switched to National after Brash left that tipped the balance, but nevermind. I'm not sure of the answers there but it bears thinking about on those terms, especially after that whole "men who think like men" business.
Izogi:
Or do the young and job-less all get forced to live in a small town with a 4-square and a closed meat-works factory, because that’s the only place where rent is low enough for the allowance?
Where they're not allowed to move to while they're on the dole because there are no jobs there, thanks to a policy change in the early-mid 2000s. Catch 22.
The part of me who vaguely remembers studying economics in the early 90s would hope that someone affected by this policy would be able to choose an appropriate balance of rent/food/utilities costs to suit their own needs. Otherwise it's central planning that interferes with people maximising their utilities, imposing a cost to the economy. The essential difference between a neoliberal and a conservative is food stamps.
-
The Brownie Promise, as it stood in about 1985, required a bit of mumbletymumble: I promise to do my best, to love God, to serve the Queen and my Country blahblahblah. 8 year old atheist republicans have a hard time of it.
-
Hard News: How much speech does it take?, in reply to Russell Brown,
Certainly not all at the same point.
But a couple of them worried me...
There's also the spectrum of competent political mass murder* and incompetent political mass murder. Breivik's at the competent end - those guys in the UK with cars full of petrol and nails were at the other.
*terrorism not being a helpful term here, partly because it's conflated with Al Qaeda, but also because I see it as targeting random civilians to generate mass panic rather than targetting political opponents.
Bringing the two topics together, Breivik's estranged father is reported as saying he should have killed himself. Hells bells.
-
We all did cooking, sewing, woodwork and metalwork at intermediate, and in third form, one Computer and Keyboard Skills course kind of integrated the future programmers and secretaries. It's a good way to do things I think.