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danstr

Published Letters: 273
Editor's Choice: 61

Tuesday, March 25, 2008 08:19 AM

Interesting......at the time, of course, the country was not divided,

and the US was far from the only country nibbling at Korea. Japan was warming up to its invasion, seeing Korea as a handy land bridge to China & Manchuria; Korea was and had been for time a suzerain state of China; and Russia was busy protecting its interests. And there were western missionaries. Who got executed.

The second US gunboat incident you refer to actually occurred on an island, so it was somewhat confined, but did nothing to improve relations with Korea or its rulers. A pity, since Queen Min was walking a knife's edge trying to keep her country independent of Japan (although I don't think she was queen yet in 1866).

The division of the country at the 38th parallel actually did occur maybe 30 years later, before the Russo-Japan war, when Russia and Japan agreed that that line was a good place to divvy up their spheres of influence. Russia, of course, was looking for that legendary warm-water port, and wanted Port Arthur. Didn't do them much good, because Japan attacked them only a year or so later. Still, it makes me think the seemingly arbitrary division at the 38th parallel after WW2 had historical roots.

Tuesday, March 25, 2008 01:43 PM

That's an interesting point, cdunlea

Korea defeated Japan, after protracted hostilities, during the Hideyoshi shogunate in part because they had a masterful battle admiral, but also because they had more advanced technology, viz. the armor-plated turtle boats (with cannon in the turtle's mouth).

Wednesday, March 26, 2008 11:16 AM
Original article: The other abortion pill

A minor statistical caution......

Lynn, the failure rate is not represented by "about half of the women they see have already attempted to use misoprostol". This answers the question (excuse the Jeopardy phrasing) of "What proportion of women requiring a visit to a clinic for surgical abortion have attempted a drug abortion unsuccessfully?"

The proper question is, "what proportion of women who attempt an abortion with misoprostol then need to go on to a surgical abortion?" and to answer that you'd need to know how many women are attempting the misprostol abortion, in addition to what you already know of the failures coming in to the clinic.

Friday, March 28, 2008 08:21 AM

What you started to talk about but then seemed to back away from

is something that disturbs me a lot not only about the vegan movement but a number of other reasonable causes. It's disturbing enough that many of them often become in their essence religions, but that in their confidence in the righteousness of their cause, decide that any means is justified.

Tuesday, April 22, 2008 08:26 AM
Original article: Race and the white coat

Excellent article - thanks....

I'd like to add a couple of points.

On the knotty problem of access to care, the only way to really test that is in a large, diverse population within a closed, integrated health care system. Fortunately, I'm in the research department in just such a system, and we recently hired a scientist who specializes in health disparities, who is jumping into this with great enthusiasm. It won't be as straightforward as one might think, because poorer people have a harder time with transportation, and because our physicians are not white males, although there are some - but the majority are women (reflecting current US medical school graduates) and there's a thorough mix of ethnicities and nationalities, reflecting our location. So, we can disentangle a couple of issues and tease out where the major effects are.

On stereotyping by physicians and by other clinicians as well - it's a tricky balancing act. I teach research methods, critical reading, and epidemiology to medical students, residents and fellows, and the occasional nurse. I find that the better the clinician, the more individually oriented they are. Therefore they have a difficult time grasping the concept that statistics do not apply to individuals. This was illustrated very well by an African ob/gyn who gives a lecture to the second year medical students at one of my institutions on racism. He points out that black American women used to have a much higher death rate from ectopic pregnancy than whites. The reason for this, it turns out, that docs are taught that black women have a higher risk of pelvic inflammatory disease (an end result of STD). Both ectopic pregnancy and PID tend to appear at the ER with severe pelvic pain. The physician sees the white woman and runs a pregnancy test immediately (which in the old days took a couple days) and begins presumptive treatment for the ectopic pregnancy. The black woman is assumed to have PID and gets loaded up with antibiotics but no pregnancy test.....and shortly thereafter dies from the ectopic pregnancy. The only thing that changed this was that much faster pregnancy tests came along, so now any pelvic pain in the ER gets a quick pregnancy test.

Finally, there's a shortage of African-americans in medicine - don't know quite why, but there it is. A group at UCLA is working on trying to understand that, and part of seems to stem from the root of the problem of trying to recruit blacks into research studies - a deep distrust of the medical community and widespread awareness of tragedies such as the Tuskegee study.

Tuesday, April 22, 2008 09:08 AM
Original article: Race and the white coat

@Rocky57

Regardless of statistical adjustment, questions always remain about how much of the effect is left of other disparities. The consensus is "quite a lot", since many of those factors are so tightly interwoven. I'm not sure if Dr. Parikh realizes that, but I'm sure if you check the original papers you would find that awareness.

Friday, April 25, 2008 07:46 AM

This is very odd, both

in timing and in what they claim happen. There is what seems to my eye good evidence that Syria was not the target of that attack at all,

http://ratiocinatonsofasavageheart.blogspot.com/

and it's been forgotten but this attack happened shortly before the nuke-tipped cruise missles were shuttled around the country.

It makes me suspect something was about to hit the news from the original attack, and this is a diversion to claim it was something other than what it actually was.

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