Most recently, a study published this month in the New England Journal of Medicine found that men whose early-stage prostate cancer is carefully monitored but not treated right away appear to live as long as men whose cancer is immediately operated on, and that they also avoid the troubling side effects of urinary problems and erectile dysfunction. The study isn't definitive, and its findings might not apply to all forms of prostate cancer or to younger men.The public, though, seems a little doubtful about pronouncements that Americans are over-tested and over-treated, and it's easy to see why. Our very nature tells us that if there's a bad thing in us like cancer, we want it out. Also, insurance companies and the government have been warning that runaway increases in medical costs are unsustainable. This makes patients worry that important medical tests and treatments will be withheld for financial rather than health considerations. What many people fail to realize is that some unnecessary tests and treatments are currently being ordered for a different financial reason: in order to earn doctors money. Many procedures are profit centers for medical providers; in other cases, they are ordered to shield practitioners against possible malpractice suits, rather than because they are medically necessary and appropriate.The sensitive new technologies that enable doctors to find and diagnose more medical problems have also led them to find, explore and treat things that never would have caused problems, according to Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. "We now recognize that we all harbor abnormalities," Welch said in a Times story last year.
Let's be pessimists and say that you decide that only four of them are worth buying again. On future store visits, you'll save $0.75 each time you buy that generic item instead of the name brand version. If you buy these four items each an average of once a month, you're going to be saving $36 a year and you won't notice a difference compared to what you already buy.Of course, that's a low-end estimate for your family. We use store-brand paper towels, salad dressings, saltine crackers, liquid soap, Kleenexes, and many other items. I would estimate that we save a couple hundred dollars a year simply by focusing on generics.Many of those items, such as ketchup and applesauce, have identical ingredient lists and nutrition facts labels as name brand versions. As far as we can tell, they're the same product - except that the generic version is substantially cheaper.There are other items that might not be quite as good as the name brand version, but the quality difference is small enough that it doesn't really matter. Kleenexes are a good example of this. The only time you'll see a difference is if it's going to be an intense use of the item, in which case you just double up on the generic (or, in my case, use a handkerchief). You'll still save money.In my experience, the big challenge with generics is getting past the mental block that name brands are somehow better.
Al Salam Polleria's success, as well as its distinction, can be found in its East L.A. location and in its name -- al salaam is Arabic for peace, polleria is Spanish for poultry shop.It was never their intention to end up in East L.A. But as they would find, it was quite fortunate.Elrabat-Gabr's father, Safwat Elrabat, emigrated from Egypt, figuring he could fill a niche in Los Angeles by selling fresh poultry killed according to Islamic law, called halal.How he arrived on this stretch of Whittier Boulevard, a heavily Latino neighborhood, came down to zoning laws that allow the storage and slaughter of live animals. Still, when Elrabat and his brother-in-law opened the shop in 1984, they expected a line of fellow Muslims trailing out the door."Yeah, it didn't happen that way," Elrabat-Gabr said.Instead the local community embraced the new polleria. It still does. Here, there is no culture clash.It also didn't hurt that Elrabat placed a super-sized white chicken on the roof, like the Michelin Man, a kind of lighthouse beacon welcoming the neighborhood. In fact, local residents began shopping here with such regularity that Elrabat and most of the family quickly learned enough Spanish to know exactly what customers wanted.Elrabat-Gabr sees strong similarities between the Egyptian and Latin cultures. Both place great importance on family and on respect, she said, and because the Moors controlled parts of Spain for hundreds of years, the languages share similar words.
Gaddis's subtitle, An American Life, reminds the reader that George Kennan's intellectual and emotional ambivalences are anything but atypical of America's 20th-century upper-middle class, that they are interesting to us because they explain, to some extent, the class that gave the American Century its character, and that such things are among the deepest sources of American conduct. The most basic factor among them was a sense of superiority to the mass of Americans. Like others of his class, Kennan loved the America of his own reminiscences, imagination, and close acquaintances, while loathing the rest of Americans and the civilization they represented. He recalled lovingly his youth at his family's compound on a Wisconsin lake, and treasured his gentleman's farm in exurban Pennsylvania, as equivalents of Chekov's spiritual communion with the cherry orchard of his doomed character, Ravenskaya. These "stood for certain ideals of decency and courage, and generosity." Kennan's attitude toward the rest of America seems a paraphrase of the Pharisee's prayer in the Temple: "Lord I thank thee that I am not like other Americans...."Thus when Kennan looked at Hitler's Germany in the 1930s he saw primarily "a great garden, well kept and blooming...populated by clean and healthy people." By the same token, while he recognized that Communism negates the soul--Soviet funerals showed "the meaninglessness of life expounded and argued from the meaninglessness of death"--he nevertheless thought it was better "to sell one's soul...than to let it dry up in its own bitterness and get nothing for it whatsoever."Lack of soul, or indeed of anything worthy, is what Kennan saw in ordinary Americans. He wished that Americans might "have their toys taken away from them, be spanked, educated, and made to grow up." That would take a "strong central power (far stronger than the present constitution would allow)." Meanwhile, he expressed revulsion at the sight of well-fed, "shapeless, droopy" Americans, getting out of their cars "tired from not walking," "a skin disease of the earth." He told his diary: "I hate democracy; I hate the press.... I hate the 'peepul;' I have become clearly un-American." America was unworthy of him. [...]In 1947 Kennan became a victim of the Peter Principle. Having become a celebrity, he was promoted out of his competence as a reporting diplomat and into the role of a policymaker, which encouraged him to pontificate, to indulge his prejudices and inner instability.He began well enough. In the spring of 1947, as the "X" article was being printed, he advised Secretary of State George C. Marshall that containing the Soviets in Europe required relieving the continent's misery, which in turn required massive American economic aid with the sole condition that plans for it be coordinated among Europeans and agreed upon with Americans. The ensuing "Marshall Plan" indeed started the process that Kennan had advocated, of "turning former enemies into allies." But it was downhill from there.As theoretically sound and similarly influential, but pregnant with trouble, was Kennan's critique of President Truman's pledge of aid to Greece and Turkey. The decision was the first manifestation of the "Truman Doctrine," a promise to intervene in any and every situation where there might be danger of the Soviets gaining any advantage, no matter how small or temporary. Kennan's general point was valid enough: surely no principle of policy applies automatically to any and all circumstances. Indeed, Gaddis reminds us that Kennan's formulation of containment had implied both automaticity and universality, rendering his critique of the Truman Doctrine a refutation of his own words.Kennan the policymaker argued strenuously for retrenching U.S. commitments. Czechoslovakia should be allowed to fall to the Communists, never mind the sad precedents of 1938-39. Even China, he argued, on which America had placed so many hopes and expended so much blood and treasure, should be permitted to go Red--the sooner the better. To boot, he urged driving the anti-Communist side out of Taiwan. He repeated that the Soviets could not hold onto such conquests, that they would choke on them in the long run. But Gaddis notes that in Kennan's original formulation, containment's virtue consisted substantially of depriving the Soviets of vital psychological satisfaction. Would Communist victories in China and Czechoslovakia not give them that satisfaction? And what would their victories do to us psychologically? Why would Kennan's new version of "containment," which seemed to be about containing America more than the Soviet Union, not dispirit and destroy us instead of them?Because Kennan never addressed such questions directly, we may well suspect that his enthusiasm for retrenchment came, not from any understanding of history or principles of statecraft, but instead from his increasing socio-political identification with Americans who believed Soviet advances and American retreats were inherently good. Indeed, to the extent he got involved in policy and politics, he set principles aside. His mind seemed to work on two mutually exclusive levels. For example, he seemed unaware that his statement of diplomatic principles in American Diplomacy, 1900-1950 was identical to the argument of A Foreign Policy for Americans, published in the same year by Robert Taft, whom he loathed socio-politically. In later years, he reacted with outright disbelief when discovering that his views matched those of conservatives.
Singer Brittany Howard has the bearing, power and charisma of a star twice her age, but on stage, she's positively dominant.
The average annual pension for Suffolk County cops who have retired since 2007 was US$86,702 (RM274,108), according to figures from the Manhattan Institute, a public policy think tank, against US$37,270 for other county employees, excluding teachers. The county, facing a three-year deficit of US$530 million, declared a fiscal emergency in March.Traditionally, US voters have backed generous pay and benefits for the cops and firefighters willing to risk their lives to keep citizens safe. That was especially so after the deaths of many emergency workers in the Sept. 11, 2001, attack on the World Trade Centre in New York.But as economic conditions have worsened and many local governments have run into severe fiscal problems, that attitude has started to change. Since the 2007 recession, some cities have tried to roll back pension benefits and pay, among the most rigid and, in some cases, highest expenses in municipal budgets.From New York to California and points in between, cops and firefighters have been drawn into pitched battles over their pay and benefits.In San Diego and San Jose, California's second and third biggest cities, voters in June overwhelmingly backed sweeping pension reforms. In San Jose, all employees will have to choose between reduced benefits or higher retirement contributions.In the mid-sized California cities of Stockton and San Bernardino, officials say public safety costs were among the factors that forced both to declare bankruptcy. In Vallejo, a former US Navy town near San Francisco that emerged from a three-year bankruptcy last year, public safety pay and benefits were consuming three-quarters of the city's general fund.Detroit, plagued with one of the highest crime rates in the country, nonetheless cut pay and healthcare benefits for city workers, including police, by 10 percent just over a week ago, a move the mayor says will save the cash-strapped city US$102 million a year.A legal challenge by the Detroit Police Officers Association failed, even as union President Joe Duncan publicly complained of what the cuts would mean for Detroit's ability to hire police, noting that the city is "already 50th on the list of pay for the biggest 50 cities in the United States."St. Louis this month approved an overhaul of the firefighter retirement system that rolls back decades of increases, while Miami officials trying to plug a US$60 million budget gap this week declared "financial urgency," which will let them alter employee contracts. Among the city's proposals: limit overtime for firefighters and require higher health care contributions.According to an analysis by New York-area newspaper Newsday published last month, police and sheriff's department employees in Nassau and Suffolk counties reached nearly two-thirds of each county's payroll."That is why a lot of municipalities are choosing bankruptcy, because it's the only way - other than getting a state control board - of getting out of these salary and pension requirements,'' said the former top official of Suffolk County, Steve Levy.
Missouri, the state that was once considered the nation's ultimate bellwether, looks as though it is likely to be out of reach for President Obama this year, unless there is a significant shift toward him in the final 100 days of the campaign.A Mason-Dixon poll of the state, released on Saturday, gave Mitt Romney a nine-point lead there. Mr. Romney's nine-point lead matches his advantage from another poll of the state, conducted by the firm We Ask America, which was released earlier this week.The forecast model now estimates that Mr. Romney has an 88 percent chance of winning Missouri in November. And Missouri has fallen off the list of tipping point states, meaning that it is very unlikely to be a decisive state in determining the winner of the Electoral College. The cases where Mr. Obama wins Missouri are probably those where he is headed toward some sort of near-landslide in the national race, like because of an unexpected rebound in the economy.
As a wise young man once informed his math teacher, "I'll never need to even know what a polynomial is in real life."There are many defenses of algebra and the virtue of learning it. Most of them sound reasonable on first hearing; many of them I once accepted. But the more I examine them, the clearer it seems that they are largely or wholly wrong -- unsupported by research or evidence, or based on wishful logic. [...]Nor is it clear that the math we learn in the classroom has any relation to the quantitative reasoning we need on the job. John P. Smith III, an educational psychologist at Michigan State University who has studied math education, has found that "mathematical reasoning in workplaces differs markedly from the algorithms taught in school." Even in jobs that rely on so-called STEM credentials -- science, technology, engineering, math -- considerable training occurs after hiring, including the kinds of computations that will be required. Toyota, for example, recently chose to locate a plant in a remote Mississippi county, even though its schools are far from stellar. It works with a nearby community college, which has tailored classes in "machine tool mathematics."That sort of collaboration has long undergirded German apprenticeship programs. I fully concur that high-tech knowledge is needed to sustain an advanced industrial economy. But we're deluding ourselves if we believe the solution is largely academic.A skeptic might argue that, even if our current mathematics education discourages large numbers of students, math itself isn't to blame. Isn't this discipline a critical part of education, providing quantitative tools and honing conceptual abilities that are indispensable -- especially in our high tech age? In fact, we hear it argued that we have a shortage of graduates with STEM credentials.Of course, people should learn basic numerical skills: decimals, ratios and estimating, sharpened by a good grounding in arithmetic. But a definitive analysis by the Georgetown Center on Education and the Workforce forecasts that in the decade ahead a mere 5 percent of entry-level workers will need to be proficient in algebra or above. And if there is a shortage of STEM graduates, an equally crucial issue is how many available positions there are for men and women with these skills. A January 2012 analysis from the Georgetown center found 7.5 percent unemployment for engineering graduates and 8.2 percent among computer scientists.
[T]here is a remarkable underlying pattern in American presidential history: While the United States has elected 16 presidents to second terms, in 15 of those cases, the president was reelected by a wider margin than in his first-term election. (The outlier: Woodrow Wilson was re-elected in 1916 by a razor-thin margin in what was essentially a referendum on whether America should enter World War I. His campaign theme: "He kept us out of war." Eleven weeks into his second term, at Wilson's urging, the US declared war against Germany. Fascinating history, but I digress.)There is a lesson in that wider-margin-required-for-reelection statistic. Second term presidential candidacies are ultimately a thumbs-up/thumb-down verdict on a president's first term in office. Either the first term has been successful enough to win over even some of those who voted against the president the first time around, or the president loses. The question in the minds of voters -- especially those who did not vote for the incumbent the first time around -- boils down to: "Do I want four more years of this?"And in the case of President Obama, who won 53% of the vote last time out, it's hard to see what segments of the electorate would be clamoring to answer that question in the affirmative at all, let alone in higher percentages than he received in 2008. His job approval numbers are far below that 53% level already.Obama's 2008 margin of victory was 7%. Now, let's assume that 2008 Republican voters remain Republican; if just one in 13 Americans who supported Obama switch their vote, he loses. And if he can't repeat the enthusiastic turnout numbers from various demographics he won in 2008, he's in even bigger trouble.On the way out? President Barack Obama (photo credit: Amos Ben Gershom/ GPO/Flash90)Ready for some campaign arithmetic?