Tuesday, December 11, 2007

National Review Votes Romney

The National Review is the nation's premiere conservative magazine. The writers and editors have come to the consensus that Mitt Romney is the candidate that best represents the core conservative principles socially, economically, and with regard to foreign affairs. They say that selecting Giuliani as the Republican nominee would split the conservative base due to his liberal social views and Huckabee would split the conservative base due to his views and inexperience on economic and foreign policy issues. They criticize Thompson and McCain for poorly run campaigns. The Editors laud Romney for representing all of Bush's conservative principles but making up for most if not all of his flaws. In their view, only Romney has all the the pieces to unite the party for a win in the final election.

Tuesday, November 20, 2007

Emergency Medicine Practice Group Questions

1. Department Status: is Emergency Medicine a department within the hospital with a chair that sits on the executive committee of the hospital or is EM only a division of surgery or other department without direct representation? How often does the EM chair meet with hospital administrators and other department chairs? Have their been any money spent recently on new equipment purchases or renovations in the ED?
2. Volume: what is the ED volume per year, per day, and patients per hour?
3. Shifts: what is the shift length? How many shifts qualify for full time? Is there a guaranteed minimum number of shifts?
4. Coverage: what is the physician, mid-level provider coverage. Is there a fast-track?
5. Charting: is charting done by template, dictated, voice, or computer?
6. Mental Health: how is mental health paperwork and transfer arrangements made? How long does this process take?
7. Acuity: what is the % acuity, % trauma, % admitted? What patients are transferred out to other hospitals.
8. Hearts: Cath lab vs. TPA? What is the time to cath lab?
9. Coding and Billing: How is coding and billing handled? Who decides the level of charge or any upgrades or downgrades?
10. Teaching Responsibility: is there any teaching responsibility?
11. Overcrowding: How is overcrowding handled (hall, chairs, stable admit)? How often is the overcrowding protocol used?
12. Meetings: what meeting are there, and who is expected to attend?
13. Radiology: what is the radiology coverage at night (24 hr, telerad)?
14. Ultrasound: what is the ultrasound coverage at night (tech on call)?
15. Labs: what is the lab turn-around time? What POC labs are available in the ED? Does the ED employ a lab tech? Do RN's or RT's draw ABG's?
16. Admit orders: who writes admit orders? (ED physician, on-call, phone orders)?
17. Thru-put: what are the average wait time, time to labs, time to rads, and time to admit?
18. Press Gainey Scores
19. Diversion: when and how often does the ED go on diversion? Who decides (ED or Admin)?
20. Financial Package: Productivity, RVUs, hourly, tiered, Base+bonus, night shift differential, or incentivized.
21. Remuneration: Base salary, benefits, malpractice, CME, bonus, paid vacation.
22. Turnover: How long do doctors stay in the group? Is the contract vulnerable. What is the number of physicians who have left in the last 5 years and why? Why is your group hiring?
23. Future: what is the future of the group in 5-10 years?
24. Vesting: What % of the partnership is yours. Is there delayed vesting?
25. Profit Sharing: Is profit sharing done quarterly, yearly, is it based on productivity or hours worked, acuity, or patient satisfaction?
26. Partnership: Is there a partnership track, a buy-in?How is partnership decided (unanimously)?
27. Complaints: How are patient complaints handled? Who does Q&A.
28. Leaving: what happens when I leave? Is there tail coverage? What happens if I die?

Friday, September 28, 2007

Global Warming and Milankovitch Cycles

New Scientist has published a second article reporting on several studies which support the theory that global warming is not due to man-made CO2 but that it is instead due to slight changes in Earth's orientation toward the sun can cause it to cool or warm in so-called Milankovitch cycles. Milankivitch cycles and other similar phenomenon describe variations in the Earth's axis as well as the extend of spherical vs elliptical shape of the Earth's orbit around the sun. Since the Southern Hemisphere's surface is comprised of more water than the Northern Hemisphere, if the Earth is tilted so, that the Southern Hemisphere receives more light, then the global oceans will warm to a greater extent.

The famous Artic and Antartic ice-core temperature/CO2 data mis-used by Al Gore in his "An Inconvenient Truth" docudrama clearly shows that CO2 elevations lag 800 years behind elevations in ocean temperature. This clearly suggests that as the oceans warmed by another mechanism, the warmer water disolved less CO2 which was released into the atmosphere. When the cause of ocean warming stopped, the atmospheric CO2 disolved back into the ocean.

These recent studies suggest that Milankovitch cycles are the main driver of global warming. Yes, we shouldn't pollute and yes, we should become more energy independent, but we need to be careful when the UN tries to tell us that all scientists are unified in the opinion that man-made Co2 is the cause of global warming. The UN was clearly trying to take advantage of an environmental issue to dictate global policy.

Friday, September 21, 2007

2 Meter VHF HT Handheld Ground Plane, Tiger Tail, Lambda Wire Antenna

I have been an Amateur Radio or "HAM" radio operator for over 2o years. My call sign is KB7BXP. I was about 10 or 11 when I first got into the hobby. However, I haven't been active in the hobby for the last 12-15 years until the last couple months. I needed something to do while making a long 1 1/2-hr commute. Amateur radio has been the perfect answer to keep me awake on the long drive home after a 12-hour shift.

The first radio I purchased was the Yaesu VX-170 2-Meter Handheld or HT. This is a great little radio. However it comes with the traditional "Rubber Duck" antenna that has only marginal performance. I also purchased a 5/8 Mag-mount external antenna to use while I drive. But I wanted to extend the performance of my HT while using the radio around the house or when walking around town or the neighborhood.

That's when I read about a simple little antenna modification that greatly increases the receive and transmit capability of any handheld radio. This antenna modification is referred to as a "Tiger tail," "Rat Tail," Lambda wire, ground plane, or counterpoise antenna. This modification simply comprises a 1/4 wave length of wire attached to the body or base of the antenna in some fashion. After a quick trip to the Walmart Automotive section and 10 minutes of cutting and crimping, the project was complete and the results speak for themselves. The following pictures describe the project.

Needed Supplies:

Wire Cutting, Stripping, and Crimping Tool.
Spool 12-gauge automotive electrical wire.
Package automotive electrical ring connectors.

Making the Antenna:
Cut one or odd number of 1/4-wave lengths of wire.
Strip 1/4 cm of outer plastic sheath from one end.
Place stripped end into ring connector and crimp yellow plastic section X 2.

2-Meter 1/4-wave at 146 MHz = 20 1/4 in. But anything close such as 19 1/4 or more will work.

Connecting Antenna:

Attach ground plane wires to base of SMA connector or from belt clip screw on back of radio chassis or battery case.

Any kind of wire can do. I have also used twin-lead speaker wire and attached 3 1/4-wave wires to one ring connector.

Sunday, September 16, 2007

Emergency Essentials

The following Costco products help to meet the food, water, and emergency supply requirements requested by the Department of Homeland Security and the Department of Health and Human Services.

Thursday, July 26, 2007

Custom LASIK Answers

I did a little more homework and I think that I sufficently answered my questions. Unfortunately, because of the competition, there is so much misinformation out there. Everyone wants to do your LASIK so they are going to convince you that their machine, or method is the best and anyone else is going to make you blind. Overall, I think I could get a good result at any of the clinics but I think EyeCareOne/MCG is the best. Trouble is that the technology is new and there isn't a lot of data yet.

LASIK factory vs. General practice
It seems the optho guys who just do LASIK want to convince you that they're the one who should do your procedure because they do so many every day. They caution you about those other guys who just do a couple on the side to pad their income. I think it is important that a practice do a critical number of them and has the best resources. But, apart from having the best machince, since the flap is the most technical step, if the optho guy is a good surgeon he is gonna make a good flap. I don't see how an optho guy who couldn't hack it in the OR can say he has anything over another optho surgeon who does complex lense, cornea, and retinal surgeries. Besides, the new microkeratomes are now automated anyways.

Intralase vs. microkeratome
The intralase people make it sound like the microkeratome is a butter knife. Actually, I don't see how a laser is better than a knife. We don't use lasers in the OR or ED because they actually can cause more tissue damage by heating up surrounding tissues and cause more inflammation, which could impede healing. I'm not sure If the data shows any difference, but I don't buy it that a laser is better just because its a laser. The new microkeratomes are just as precise and just as automated. The new ones are actually machine driven. Although they do look a lot like a meat slicers. Give me the meat slicer!

The 15th street people were telling me that the microkeratome was going to forsure result in corneal wrinkling or other abborations and subject me to a higher risk of needing a redo. After considering the issues, I don't see how this could be true. I think flap problems have less to do with what makes the flap and more to do with flap thickness, how the flap is replaced, and healing than anything else. And interlase still requires the surgeon to choose the flap size and thickness, the flap to be manually retracted and the flap to be manually replaced after the procedure.

Wavefront guided vs. Wavefront optomized
Allegretto Wave Excimer Laser at 15th steet is infact only wavefront optomized. It says it in their broshure. And when I asked their people about it they first told me I didn't know what I was talking about and then that its all the same and then it could do both guided and optomized. Haha, nice try.

It is my understanding that the difference between wavefront guided and optomized is that wavefront guided is a truly custom LASIK. The wavefront guided machine will do sophisticated mathematics to measure not only spherical and cylindrical corrections but also "higher-order abberations" (which cause night halos and stars) and correct for those exact abberations. Wavefront optomized measures for higher-order abberations but only uses a pre-set "one-size-fits-all" correction. That't akin to knowing you are far-sighted and just going to the local CVS and picking up reading glasses from the cheap-o reading glasses display. Consequently, only a wavefront guided correction is a true custom LASIK correction.

LASIK on dilated or nondilated eye.
Eye Care One/MCG performs the procedure on a dilated eye. Although having a dilated eye is rather annoying for 3 days, I don't think it matters. MCG says they do it dilated so that they don't overcorrect. 15th strest says they measure the cornea and perform LASIK on an undilated eye so they can treat the eye in its relaxed state. MCG says that paralyzing the ciliary body may help lessen inflammation and mostly because I believe their particular corneal mapping machine requires it. I'm not sure that it matters. The important thing is the if you take the measurements with a dilated eye that you do the LASIK with a dilated eye and visa versa.

Allegretto vs. VISX
EyeCareOne/MCG uses the VISX’s CustomVue WaveFront System, with the newly added Fournier transform wavefront algorithm upgrade to calculate ablation shapes with more precision and individualize treatment to each patient. Additionally the VISX Customvue system offers Iris Registration and Activetrak™ to compensate for intra-operative cyclotorsional movement, and to ensure treatment is delivered to each eye accurately. Allegretto uses an activetrak-like system too but you can't beat a machine that can do fournier transforms.

Wednesday, July 25, 2007

Custom Lasix Questions

I have decided to get laser vision correction surgery also known as LASIK. In addition to shopping around for the best deal I quickly realized that not all LASIK is created equal. As I have been researching the procedure, I have become more familiar with the terms that differentiate regular LASIK vs. custom LASIK, wavefront-guided vs. wavefront-optimized, higher order abberations vs. spherical and astigmatism and all-laser intralase vs. microkeratome. The following is a list of questions I emailed my opthomology resident friend Chris. I will post the answers to these questions at a later date.

What I have learned so far is that I definately want custom LASIK. In addition to correcting for the typical spherical abberation and astigmatism, custom LASIK also corrects for other "higher-order" imperfections in the cornea which cause glare, halos, stars, contrast, and night vision problems. Custom LASIK uses the same technology used by modern telescopes to correct for atmospheric distortion. I have problems with night halos and stars and measurements clearly show I have a promenent Coma abberation, so custom LASIX is what I want. Unfortunately, there are other issues to consider.

Intralase vs. microkeratome
I can't really get a good sense on the internet about the pro's and cons of Intralase to make the corneal flap vs. using a microkeratome. The guys who use the ketatome say that using the intrlase technique may have longer healing time and that they have been doing great flaps for years with the microkeratome. The guys who use the Intralase say that the laser is more precise and results in less chance of a winkled cornea (abberation) and the need for a redo later. Intralase people seem to ascribe all future redos to a failure of the microkeratome. I doubt this. Is there a downside to Intralase?

Wavefront guided vs. Wavefront optomized
The LASIK clinic on 15th street use intralase and the Allegretto Wave Excimer Laser. They claim it is wavefront-guided but I see some internet info which say some Allegretto machines are only wavefront-optimized which means it is not truely custom LASIK and the higher-order abberations are corrected using some pre-programed values and not actual precise measurements of your cornea. Do you know if that clinic does true wavefront-guided or just wavefront-optimized? They say its wavefront-guided.

Microkeratomes and Quality of Flap
I didn't appreciate it at the time but it sounds like making the flap is a big deal. Is it a big deal? I am wondering what kind of microkeratome Dr. Bogorad uses. Is there anything special about it? Is is a Bouch & Lomb or AMADEUS II or Zytopic XP? Does it really matter? Does Dr. Bogorad make good flaps? Would he be doing the flap or a resident. If you were helping, would you be doing the flap. Do you think I should have you or another resident do the flap? Are flaps really that difficult to do? I am willing to pay full price if the flap is that critical.

Thickness of Flap
Are thick flaps better than thin flaps. Someone was bragging about their Amadeus II making thin flaps but then I read that thin flaps are more likely to develop a wrinkle. My corneal thickness is over 500 microns which is twice the cutoff of 250. So, Dr. Bogorad or whoever should not be constrained when making a flap.

Size of Flap
Also, the Intralase poeple seem to make a big deal about the size of the flap. The laser supposedly makes a nice big even flap so that a night when your pupil dilates you have less chance of the corneal scar intering into the visual field causing night halos or stars. However, Dr. Bogorad's people assure me that they make big flaps.

LASIK on dilated or nondilated eye.
I wasn't sure if Dr. Bogorad does LASIK on a nondilated or dilated eye. It seems to me that I remember the optho tech saying they do it on a dilated eye. Does this determine how big of a corneal flap you can make? The reason I ask is that I had 2 eye exams yesterday; one not dilated and one dilated. Well, my presciption seemed to be somewhat different dilated than nondilated. My nondilated exam presciption (spherical and astigmatism correction) turned out to be similar to my past presciption. And when they were corrected I could see 20/20 and nearly 20/15. But after my eye was dilated I could see 20/20 but not as well as before and I think the correction numbers where also different. So, I guess I am asking what numbers will they put in the machine. I suppose that if they dilate my eye they should use the dilated numbers and if they dont dilate my eyes during LASIK that they should use the nondilated numbers? What I am really asking is, which is better, not dilating the eye and using the interlaze or dilating the eye and using the microkeratome? Why do you bother to dilate the eye at all. Do you need to dilate the eye to cut a big flap?

Wednesday, July 18, 2007

Envirocare and Energy Solutions

Nuclear power can be one of the cleanest sources of energy. It's the making of nuclear weapons that is dirty. Uranium is a naturaly occuring element in the Earth's crust. Uranium ore is comprised of two major isotopes; U238 and U235. What is an isotope? The smallest unit of an element that still retains the physical properties of that element is the Atom. Atoms are made up of electrons, protons, and neutrons. Protons and neutons comprise the nucleus of the atom, while electons form energy shells surrounding the nucleus. While the electons and protons do not vary for a given element, the neutrons can vary without changing the element. An example of this is carbon-14. Most carbon on Earth is carbon-12 with 12 electrons, protons, and neutrons. But a small amount has 14 neutrons instead of the usual 12. The ratio of C12/C14 is used by scientists to date ancient carbon-containing samples like fossils.

Like carbon, Uranium exist as multiple isotopes. 99% exists as U238, while less than 1% exists as the radioactive/fissionable U235 isotope. Neutrons stabilize the nucleus of an atom. U235 with 3 fewer neutrons, does not contain enough neutrons to stabilize such an enormous nucleus. Consequently, U235 atoms will spontaneously split, releasing additional neutrons and enormous amounts of energy. The brake-down products of this natural radioactive decay includes smaller atoms such as lead, and radon gas. Radon that many people worry about in the basements of their homes is the by-product of the radioactive decay of naturally occuring U235 found in the Earth's crust.

Because uranium exists mostly of the non-radioactive U238 isotope, it must be processed before it can be used as fuel in a nuclear reactor. But, separating isotopes is not an easy or inexpensive process. To purify and consentrate U235 from U238, the metal is converted into a gas which is spun in an ultracentrifuge. The sliqht difference in mass is enough to separate U235 from U238. The gas is then converted back into a metal (Zirconium) which is then processed into fuel rods for use in a nuclear reactor core. Now the purifying and processing part is the hard part. And because it's so expensive, the process is absolutely clean; not an atom of U235 is wasted. The left-over U238 is not radioactive and is used by the military as tank armor and as depleted uranium in armor piercing munitions.

Making electricity from reactor-grade uranium is easy. Have you ever seen Indiana Jones and the Temple of Doom. It's kinda like when Indiana places the Shinkara Stones next to each other causing them to glow. That's how uranium works. You simply get enough U235 in one place and it heats up. If you reach critical mass, then you get a self-sustaining reaction where neutrons from the fission of one U235 cause the fission of neighboring U235 and so-on causing a nuclear explosion. Inside a reactor core, U235 is separated into fuel rods which are separated by a series of neutron absorbing boron control rods which prevent the U235 fuel rods from overheating and melting (meltdown) or exploding. The fuel rods and control rods are placed in a pressurized water boiler. The control rods are remotely removed from inbetween the fuel rods, the rods heat up and heat up the surrounding water making steam which then is used to drive the turbins of electric generators.

You don't need 100% U235 to run a nuclear reactor. Reactor grade uranium is only 3-4% U235. On the other hand, weapons grade uranium is 90% U235. So, instead of purifying uranium to weapons grade purity, the US has adopted a cheaper and dirtier method of obtaining large amounts of fissionable material for bombs. Plutonium. Making plutonium is easy. You simply put U238 next to U235 and you make Pu239. Separating Pu239 from U238 is easy. Becuase Pu and U are different elements they have different chemical properties and can be separated using solvents. However, that creates 2 problems. First, you created something radioactive out of something that originally wasn't radioactive and Second, you have all this left-over solvent with traces of radioactive Pu239 in it.

I am living in Augusta, Ga which just so happens to be home to one of the nation's most important nuclear labatories, the Savannah River Site. The SRS is the country's center for putonium production and processing. Consequently, after decades of bomb making, SRS is full of thousands of barrels of toxic mixed waste and radioactive sludge left over from separating Pu239 from U238. Already, the barrels of high-level mixed waste are rusting, the concrete liners are cracking and radioactive solvent is seeping into and contaminating local ground water.

Fortunately, SRS scientists have come up with an ingenious way to help this situation. The process is called vitrification or glassification. Currently, the tens of thousands of barrels of solvent are undergoing a process whereby the solvent is safely evaporated away leaving only a radioactive tar or precipitate salt behind which is then encased in glass, which is encased in concrete and then steel. These new containers are being prepared for safe shipment to a permenent repository at Yucca Mountain.

Fuel rods don't last forever. On average, a fuel rod is changed every 3 years . Within a reactor core, 1/3-1/4 of the fuel rods are replaced every 12-18 months. This is because, as the controlled fission occurs, fission products build up and poison the reaction. The fuel rods themselvs can become brittle as the uranium metal degrades into byproduct salts. The fuel rods can fracture if not replaced. This usually leaves a large percentage of unreacted U235 which some countries like France recycle. However, others are against recycling because it creates more mixed waste and radioactive salts that would also require disposal. The US produces plenty of U235 and therefore currently practices a "use once" policy for its fuel rods.

Utah is one of the largest sources of uranium ore in the world. Expensive oil and fears of global warming are triggering a new uranium mining and processing boom in Utah. Fear over nuclear energy hurt the the uranium economy in Utah during the 1980's and 90's. Uranium processing companies which operated in the 1940's and 50's left behind large tailing piles and contaminated soil which later became EPA superfund sites. One of these sites was located in South Salt Lake. Thousands of tons of tailings and contaminated soil were trucked from the old processing factory which was once outside city limits in 1950 but now was in the middle of residental section of Salt Lake City today. All that dirt was moved to a dump site in west Utah dessert.

Not long after, a company bought desert realestate nextdoor to the dump site and asked the state for permission to create a business there to dispose of medical-grade and low-grade radioactive waste. Utah approved the request and Envirocare was born. Other states like Washington, Denver and South Carolina have similar companies but Envirocare had a huge advantage. Other states taxed their businesses because they feared that after the company had made it's money, the state would be left with a nuclear waste dump which could have caused problems centuries into the future. The collected tax funds were placed in an account to cover future clean-up costs. However, Utah does not tax Envirocare because Evirocare smartly started up shop nextdoor to an existing radioactive dump site. They don't get taxed because the area was already a low-level radioactive waste dump. Consequently, Envirocare can undersell all of its competitors.

A couple of years ago Envirocare got ambitious and wanted to expand the kinds of waste it was approved to receive. It didn't want fuel rods or mixed waste; that's for Yucca Mountain. What it wanted was the contaminated equipment, gloves, and boots, and suits the people who work at places like SRS wear and use while processing the high-level mixed waste. Well, had Envirocare won approval, that would have put waste companies in Colorado and Washington out of business. So, Colorado launched one of the most impressive political campaigns since the state's ski resorts combated Utah's drink-by-the-glass initiative. Colorado sponsored a huge misinformation campaign and sent in representatives to gather names on a petition for a ballot proposal which would have put Envirocare out of business. They were successful in getting the signitures and Envirocare was forced to spead millions of dollars on TV, radio, mailers, and newpaper ads fighting the proposition. The ballot proposition failed and Envirocare won its request to receive the new types of low-level radioactive waste.
Envirocare learned an important lesson about the importance of good public relations. Like many companies, they ignored public relations, but when their competition started the negative PR campaign against them, noone in Utah knew who Envirocare was and readily believed the negative propaganda. I was suspicious when I listened to a presentation in favor of the ballot initiative during a lunch-time meeting and every other side in the presentors powerpoint had a mushroom cloud in it.

Since that experience, Envirocare has needed to transform its image. First it changed its name to Energy Solutions. And then the company started sponsoring local events such as the Salt Lake Marathon and other charitable events. But the king of them all is that they paid enough money to rename the Delta Center, home of the Utah Jazz, the Energy Solutions Center. They even started advertizing in Augusta, GA on radio and TV. A neighbor who is a nuclear engineer at SRS told me that the waste contracts were up for bid and Energy Solutions was the clear victor. In fact, Energy Solutions just purchased it's South Carolina competitor NUKEM.

Monday, July 02, 2007

Admissions Formula for the University of Utah School of Medicine for the BYU Pre-Med Student

I recently spoke with a BYU alumnus and past Utah resident who is currently in an MD-PhD program but held some resentments about the admissions process at Utah as well as the application process at BYU. I don't think Utah should be responsible for all the hard feelings felt by every applicant who was not accepted. However, over the last few years, I have had similar conversations with dozens of people. Although some of this resentment is unavoidable, I think the fact that such resentments exist, especially by people who go on to be talented physicians, is a negative for Utah's image. I think some of the preventable resentment comes from a mistaken sense that the admissions process is unfair; and that Utah does not accept the "most qualified" applicants. I think this sense of unfairness comes from misunderstanding of what Utah considers "qualified." Therefore, this article details some of my thoughts on how Utah could, hopefully, prevent some of this resentment.

Most, if not all, of the information that a pre-med at BYU learns about what Utah is looking for comes from Dr. Bloxham and his "intro into medicine" course. When I applied to Utah, I was fortunate to have grown up next door to the Medical School and had the benefit of some insider information from several current Utah medical students and alumni. When I was at BYU, It seemed the things Dr. Bloxham emphasized were not exactly congruent with what my neighbor's were saying Utah emphasized. Luckily, I listened to my neighbors. But, because of this disconnect of goals and expectations, there are a large number of BYU students who get an excellent committee letter from Dr. Bloxham but end up not scoring well with Utah. Consequently, there exists a population of BYU grads who go on to have wonderful medical careers but somehow feel cheated because they feel like they did everything that Dr. Bloxham emphasizes better than everyone else but didn't get into Utah. Therefore, they conclude that Utah must not accept the best students.

Now this feeling that Utah does not accept the best students is not a trivial matter. It was such an issue while I was in medical school that the first lecture I received as a medical student focused on all the accomplishments and diversity of my classmates. I remember Dr. Judd (past Dean of Admissions) going through a list saying "Someone in this medical school class did such-and-such" and "Someone else in this medical school class became so-and-so." The presentation was very memorable. However, despite the great achievements of my classmates, several years later I recall several students needing counseling to deal with the sense of inadequacy, which was a byproduct of the Utah legislature's audit of the SOM's admission's process. So, I think that communicating very clearly about the admissions process is important not only for the image of the medical school but also the for the overall morale of the student body.

Now, I understand that Dr. Bloxham is focused on getting as many pre-meds accepted into medical school as possible and not just getting students accepted to Utah. I'm sure, in his mind, focusing on what Utah is looking for may not be the best strategy. As I see it from Dr. Bloxham's perspective, Utah is going to accept a certain number of BYU students regardless. And after Utah takes its 30-40 students, he is left with the other hundred or more qualified pre-meds. So, Dr. Bloxham has an admissions formula which maximizes the total number of pre-med students accepted to medical school overall. His formula is not designed to maximize the number of students accepted to Utah.

Dr. Bloxham's Emphasis:
1. MCAT (score 10 or better in each section)
2. Science GPA: (3.5 GPA or better)
3. Brief research experience (semester in a lab)
4. Brief clinical experience (shadow a doctor)
5. Brief volunteer experience (go on a medical vacation to Africa)
6. Pick up a quick talent (run a marathon).

Utah's Formula (Each variable is assigned a value from 1-4 based on subjective or objective criteria):

Average (MCAT + GPA + Clinical + Research + Volunteer + Diversity/Talent + Recommendations + Personal Statement + Interview + Economic Hardship)

All of Dr. Bloxam's criteria are a part of the Utah admissions equation. And, if a pre-med student does all these things he is very likely to get accepted to a medical school somewhere but probably not at Utah. While Dr. Bloxham's formula focuses on what pre-med students can do in the short term to "pad" their résumé's, Utah's emphasis seems to be looking for more "long-term" involvement, commitment, and contribution in a research, clinical, volunteer, or other activity. As my neighbor put it, "Utah is looking for someone who has really done something." You will quickly notice that the MCAT and GPA only account for 20% of the overall score. Knowing this early on, I was able to direct my efforts more into "long-term" involvement into several extracurricular areas. Even knowing Utah's formula, I was rejected my first year, initially rejected the second year, appealed, wait-listed, and then eventually accepted.

Consequently, the Bloxham formula creates a large number of excellent pre-med students who may have a 40 MCAT and 4.0 GPA; who have also done their semester in a lab, and shadowed a doctor a couple of times, ran a marathon, and then went to Africa and did some skin grafting for a couple of days and then hiked Mount Kilimanjaro; who think that there is a seat up at Utah with their name on it. These same students end up being greatly disappointed and resentful when other students with a lower MCAT and GPA get into Utah instead of them. They get a great letter of recommendation from Dr. Bloxham, they get into medical school somewhere else, but not at Utah.

On the other hand, the most attractive applicants from Utah's perspective are those who not only satisfy Utah's MCAT and GPA requirements but also demonstrate "long-term" participation, commitment, and contribution to research, clinical, volunteer and other extracurricular activities. Because of their "long-term" participation, these applicants are more likely to get several outstanding letters of recommendation, have a better personal statement, and interview better. The applicants who contribute to "long-term" extracurricular activities will score higher in these areas because they will be able to both write and speak with passion about their endeavors. Passion is the kind of thing that is extremely difficult to fudge in a personal statement and near impossible to fake in an interview.

To prevent further misunderstanding and resentment, I recommend that representatives from Utah SOM speak annually to the freshman and junior pre-med students at BYU during Dr. Bloxham's "intro into medicine" and clearly make a distinction between the elements which earn points in Dr. Bloxham's system and those "long-term" activities which will not only make these students more attractive applicants at Utah, better physicians, and better overall citizens in their communities.

Saturday, June 23, 2007

Rule #1 Investing

At some future point I hope to be able to start putting aside money for retirement. I am currently finishing a medical residency and together with a mortgage, school loans, and a car loan I am over 300,000 in debt. When I finish residency and get a real job, I am hoping to get into a very modest home and my goal is to be completely out of debt in 5 years. Now some would say that is unwise considering the low interest rates on my school loans. However, I feel the right thing is to pay debts immediately. That said, I am looking forward to starting on saving for retirement. Accordingly, I have been working on my financial literacy. Finance is a rich world with a complex language and culture. All these new terms: capital, assets, equity, price earnings ratio, book value per share, and earnings per share. When I look at all these terms a quote from Johann von Neumann comes to mind, "when it comes to math you don't understand things, You just get used to them." I think the same thing can be said of finance.

My wife learned of my interest in finance and checked out a great new book to help me "get used to" the concepts in investing. The book is entitled "Rule #1" by Phil Town. Phil made a fortune on investing in the stock market and is now making a fortune selling his book and teaching others his stock market investing formula. Actually, Phil's formula is not Phil's. His strategy came from none other than Warren Buffett. Warren Buffett, after learning this strategy from Benjamin Graham and David Dodd while attending Columbia University, went on to become the single most successful investor of our day and went on to became one of the richest men in the world; second only to Bill Gates.

Mr. Town begins his book by telling his own American rags-to-riches, Horatio Alger story. Mr. Town started out as a river guide working for Outward Bound, an adventure wilderness rehab program for troubled teens and adults. On one occasion he was guiding a group of VIP donors down the Colorado River and just narrowly escaped dying in the most dangerous rapid on the river. Afterwards, one of the VIP's expressed his appreciation to Mr. Town for saving his life (or not ending it) and offered to teach him how to invest in the stock market. Phil Town started out with only $1000 and 5 years of "Rule #1 investing" later, he was a millionaire.

So, what is Rule #1? Simply put, Rule #1 is: Don't lose money. And as Warren Buffett says, "Rule #2 is: Don't forget rule number one." So, how do you assure that you never lose money in the stock market? First, Mr. Town dispelled some very pervasive investment myths.

First, many money managers teach that to avoid risk, you should diversify in bonds, mutual funds, and spread your money across a huge swath of random companies. According to Town, Buffet, Graham and other so-called "value investors," they believe the best way to avoid risk is to invest in a few meaningful, healthy, well-managed, under-valued companies. Town argues that bonds, which earn 5%, take 20 years to double. 5% hardly covers for inflation. Mutual funds and index funds make 10% but are subject to the ups and downs of the stock market. The Dow Jones, for instance, has long periods with no change punctuated by a few brief ups and downs. "Rule #1" investing, on the other hand, promises at least a 15% return regardless of whether the stock market goes up down or stays the same. As you will see below, the difference between 10% and 15% is huge.

The second myth is that you need someone else to manage your stock portfolio. Town says, no way. Thanks to the Internet, the information and tools that were once only available to the experts is now available to everyone. Town likens the influence of the Internet to finance with that of the printing press and religion. For the first time, everyone has access to the financial statements of all the best companies in the world, enabling us to see which companies are profitable, sustainable, well-managed, and undervalued. If we then invest in only these low-risk companies then we are guaranteed to earn healthy 15% returns.

So, what makes a company a "Rule #1" company. Town says that a company worth investing in has to satisfy the 4 M's. First, the company must be meaningful to you. That is, you should be familiar and understand what the company does. Also, you should only invest in those companies you feel are a benefit to society. This makes sense long term as harmful companies are usually only out to make a quick buck and then end up crumbling (i.e. Enron). You should be proud to be a part-owner of the company itself and not just consider yourself an owner of stock.

Second, the company needs to have a moat. A moat is a company's protection from competition. Effective moats can be a brand, patent, low-price, or monopoly. Other protective moats are companies whose services are offered elsewhere but switching to another company is too much of a hassle (H&R Block).

The third M is management. A great company is lead by a great CEO and board. Signs of great management include a CEO who receives a modest salary, does not issue stock options, and has little debt. Other signs of good management are CEO's who talk candidly in their quarterly summaries about real problems, takes responsibility for them, and then talks about how the company is going to solve them. Another sign of good management is a company who buys shares of its stock back from time to time.

Town also gauges a companies health though several calculation he calls the "Big 5 numbers." Basically, he looks up on the companies financial summary available on MSN, and looks for consistent, double-digit growth in Sales, Equity(BVPS), Cash, Earnings Per Share(EPS), and Return on Capital(ROC). If the company is consistently experiencing 15-20% growth per year in all these areas then their stock will likely experience similar growth.

The 4th M is where the value in "value investing" really comes into play. The 4th M stands for "Margin of safety." This has to do with the principle of only buying stock at 50% off. Many finance experts teach that the price of a stock always reflects the value of a company. Town says, not so. The market usually reflects the value of a stock but, as the Internet bubble shows, the market can act irrationally and emotionally and over- or under-value stocks from time to time. So, buying stocks at a discount requires calculating the correct price of the stock and then patiently waiting for the price to fall at least 50% below its "sticker price."

E.1: Stock Price = P/E * EPS
E.2: EPS = Net Earnings / Outstanding Shares
E.3: P/E ~ 2 * Projected EPS Growth Rate (Historical Equity or BVPS Growth Rate)

So, how do you determine the sticker price of a stock? First, according to equation (E.1), you have to know the current EPS. Then you need to know the projected EPS growth rate over then next 5-10 years. You can calculate this from the historical equity growth rate (BVPS not EPS) or by using the analysts projections which are usually a tad more conservative. Using those values you than can calculate the future EPS in 10 years. The next step is to obtain a value for the future PE which is either the current PE, or 2 x the projected EPS growth rate (historical equity growth rate (BVPS)). Using the most conservative numbers and equation (E.1) you can calculate the projected price of the stock in 10 years. Then assuming a minimum acceptable return of 15% per year, you can back calculate what the stock should be priced today. 50% of this "sticker price" is the discounted MOS price.

[These calculations can be made automatically at the Rule#1 Investor website or you can use the rule of 72 which tells you how many years it will take for a number to double for a given % compounded annual growth rate: e.g. 72/35% = 2 years, 72/20% = 3 years, 72/15% = 5 years, 72/10% = 7 years; 10 years at 15% = 2 doublings.]

Here is a sample calculation. Lets say Microsoft has an EPS of 1.5 and a projected EPS growth rate of 15%. That means in 10 years the EPS will double twice according to the rule of 72 (see above). So, the future EPS will be 1.5 * 2 * 2 = 6. The future PE can be assumed to be the same as the current PE, or 2 times the projected EPS growth rate, which would be 15% * 2 = 30. Then, using Equation (E.1) we can calculate the future stock price as 6 * 30 = $180/share. Then we can approximate the appropriate present sticker price by using the rule of 72 and assuming a 15% minimum growth rate (always use 15% here). That means that in 10 years the stock price would have doubled twice, every 5 years. So presently, the stock should only be worth: $180 / 2 / 2 = $45/share. Then calculating the Margin of Safety, $45 / 2 = $22.5/share. So, even though Microsoft is doing well and is a consistent gainer, a Rule #1 investor would not buy stock until its price fell to around $22.5/share.

So, once you know the MOS price of a stock, Mr. Town recommends patiently holding your retirement savings (IRA) in short-term bonds while you monitor a handful of "Rule #1" companies until their stock inappropriately, emotionally, or otherwise irrationally falls near their MOS price. Then you go all in and ride the stock all the way back up.

I should point out that stocks rarely ever get much above $100/share except if your Google because big stock prices seem to scare people away or otherwise make it difficult for people to buy stock. Consequently companies will routinely split their stocks which halfs their price per share. Long term grafts of stock prices adjust for, rescale, and consequently hide these splits so it appears like stocks had small initial growth and then just shot up in the last 10 years.

Some people just buy cheap stocks on big companies that are hurting hoping they will turn things around. This strategy is risky and not "Rule #1" investing. If you have done your homework and the company has it's 4 M's and great Big 5 numbers and therefore is a great "Rule #1" company, you can be certain the stock price will rebound.

US T-Bills at 5% double every 2o years. So, $100,000 only becomes $200,000 at retirement age. 5% of $200,000 only generates $10,000 per year while in retirement. Mutual and Index funds average 10% per year if there isn't a recession or stock market crash. So, $100,000 doubles every 7 years. So in 20 or so years that's 3 doubles. $100,000 becomes $200,000, becomes $400,000, becomes $800,000. During retirement, that mutual fund investment would generate an annual salary of $80,000. If you sell and transfer to bonds at that point at 5% then your annual salary becomes $40,000. And that is before taxes for a 401K.

But lets assume instead, that you earn a 15% per year return with a "Rule #1" company. That same %100,000 would double in only 5 years to $200,000. And over the next 15 years it would double again to $400,000 , and again to $800,000, and yet again to %1,600,000. If you stopped there and left the money invested in your "Rule #1"company and lived off the 15% growth; your investment would generate an annual salary of $240,000. That kind of money would provide a rather comfortable retirement where you would be free to travel, spoil the grand kids, and contribute to numerous humanitarian and missionary projects. The difference between the average 10% return and the target 15% return makes all the difference.

Mr. Town hopes you never have to sell your stock. Your "Rule #1" company should continue to earn money far into the future. But, the Internet empowers the individual investor in selling stocks and not just in buying stocks. See, mutual fund managers cannot protect your money from a stock market downturn. They manage so much money, (14 of 17 trillion dollars) they just can't sell all their shares in a company overnight. That would trigger a panic, and cause a stock to tank even lower. So, if he wants to sell, your mutual fund manager has to sell slowly over weeks, months and even years. (Warren Buffett is cashing out of Coke, GEICO, Gillette etc by transferring his wealth to Bill Gates Foundation over the next 10-20 years). Consequently, If the stock market tanks overnight, you and your mutual fund manger tank with it.

However, the individual investor can operate swiftly and anonymously. When dealing with hi- or mid-cap stocks (Blue Chip), the buying and selling a couple hundred or thousand shares won't affect the price at all. Therefore, you can sell at any time. If you set up an account with an online broker like Etrade or TDAmeritrade you can set automatic sell signals. So, if anything happens suddenly your money is safe. Also, the tools at MSN and Yahoo allow you to see more gradual changes. You can actually watch the big fund managers buy and sell.

When viewing the chart for Microsoft on MSN or Yahoo, click on MACD (12-26-9) or (8-17-9). As you watch the MACD line diverge from the EMA line you know that a fund managers slowly buying stock or selling stock (solid green bars). I prefer to view the YTD chart with MACD and moving average displayed. At $10 per stock trade you are free to sell when the stock is high and appears to be turning downward (MACD intersecting EMA) and to buy again when the MACD is developing a positive slope and again crosses EMA (especially with a large positive or negative slope). Mr. Town says he may buy and sell a "Rule #1" stock 1o or so times a year which maximizes his gains throughout the year. And since you are only watching 1 or a couple stocks, managing them only takes a couple of minutes a day or 15 minutes a week. Or if that's too much, simply place an automatic sell and forget it.

So, it sounds simple. Maybe too good to be true. But so far I can't see any flaws in the logic. I am currently reviewing companies I know. I am in the medical field so I have some familiarity with the pharmaceutical companies and medical equipment companies. I use a computer and am familiar with the companies that sell the hardware and software. I also go to the store and am familiar with retail. Mr. Town suggests starting slow by creating a watch list of "Rule #1" companies and then creating a virtual portfolio at MSN or Yahoo. He recommends practicing these techniques and seeing if they work before I actually trying it for real.

Wednesday, June 06, 2007

An End to Poverty

We all want to live in a better society. It seems everyone has their own ideas on what our society should look like. First off, how do you define the ideal society? The definition is really very simple. An ideal society has no poverty. I am not just talking economically. Every person has a set of needs which includes temporal, spiritual, emotional and psychosocial aspects of their lives. Temporally speaking, every person needs proper nutrition, healthcare, housing, and protection. Spiritually speaking, every person needs to feel like they are living according to their conscience and in a manner that God approves of. Their spirituality should help them deal with adversity and death. Psychosocially and emotionally speaking, everyone needs to feel like there is purpose in their life. They need to belong and feel their life is of value.

You may not consider spiritual and phychosocial needs of much importance. However, consider what happens when people don't feel needed or valued. They feel depressed and negatively stressed. And when people feel depressed, hopeless and negatively stressed they well seek to cope. And if they feel hopeless, then they will feel like no amount of personal effort and no amount of divine intervention could ever make their situation better. Consequently, they may turn to unproductive, unhealthy, unnatural and destructive behaviors to escape from the feelings of depression caused by their unmet needs.

To escape feelings of hoplessness, people turn to addictive behavior. People turn to alcoholism, tobacco, illicit drugs. People turn to increased sexual behavior and pornography. These behaviors can then lead to health problems, mental illness, suicide, crime, and injury. I work in an ER and I see the results of poverty on a daily basis.

One of the biggest contributers to poverty in the US is illigitamacy. A single mother simply is less likely than a married couple to have the resources available to satisfy the needs of her children. In recognition of this fact. Some advocate birth control and abortion. But this is a failed policy that fails to treat the cause or even the symptom. My wife attended an inner-city school in Atlanta and she said you couldn't pass out enough birthcontrol because many girls she knew got pregnant on purpose. They didn't get pregnant because they didn't know how not to get pregnant. They wanted to be pregnant. Why? They wanted to feel needed. They wanted to belong. They wanted to feel like they had a purpose and were of value.

A new Gallup poll demonstrates the erroding of morality and tradition family values in the US. Especially among those that consider themselves liberal. However, the poll also shows when it comes to the morality of sex before marriage, the vast majority of both liberals and conservatives feel that such behavior is moral. However, despite birthcontrol and abortion, people who have sex make babies. And those babies who are born are more likely to be born to parents who didn't want them, or who are mature enough to care for them, or who are not commited to each other. These children are denied their right to be born into a family with both a mother and a father who are committed to each other and who have the resources available to take care of their individual needs. In many cases the reason the pair were having prematarital sex might have been to cope with their unmet needs. Now pregnant, these same needy, often emotionally bankrupt individuals are expected to provide for the needs of another person.

There is both a left-wing and right-wing conspiracy in the county. We are fighting a battle of political extremism in the US. Liberal secular progressives as well as neo-conservatives both have their right-wing and left-wing conspiracies. Liberals feel like the government can fullfil everyones needs. Yes, the government can provide some symptomatic relief. But, the government programs and welfare themselves are not designed to treat the root cause of poverty.

The family is considered the fundamental unit of society. What does this mean? It means that the family with a father who works outside the home and a mother who works inside the home is empowered with all the resources to fulfull all the temporal, spiritual, emotional, and psycho-social needs of it's members. Even when it comes to education needs, home-schoolers have shown that children can be effectively educated at home. The goverment is expected to institute laws which reflect and protect the ideal moral values of society and support and empower the family in it's important role.

At the same time. The far-right also contibutes to poverty in the US Business through social-darwinism. They practice "survival of the fittest." These are people who say "let the markets work" because the market just happens to benifit them. I'm not anti-capitalist. But, when business practices are cut-throat or look for loop-holes in the law and exploit others for power and wealth; this behavior is wrong. Just because an action is technically legal does not make it ethical or morally right. The constitution expects us to govern ourselves to a higher standard. Infortunately, our laws get more and more complex as more and more people are caught lying, cheating, stealing, and otherwise taking advantage of their neighbor to make a buck. Greed is the error of the far-right just as much as sexual immorality is the error of the far left.

Ilegal immigration is a good example. Businesses in the US have always attracted illegal immigrants. Immigrants are cheap labor. Businesses who employ them are not technically breaking the law. However, businesses can employ these low-paid workers and in many cases do not provide medical, disability and retirement benifits legal citizens expect and need. Immigrants come to this country because they want a better life. They have unmet needs but then support a huge illegal industry of illegal immigrant trafficing which is associated with an array of dangerous consequences.

The clash of the far-right and the far-left is over control of the government. The far-left wants to institute laws which protect their so-called "individual freedoms" to have sex with whomever, whatever, whenever they want or to smoke or otherwise shoot up whatever they want. They say, as long as what I do doesn't hurt anyone else, then the goverment should stay out of it. But no man is an island and all these descructive behaviors such as substance abuse and casual sexual activity have clearly documented ill-effects on our society. The far-right likewise wants to be free to take advantage of their neighbor. "Let the markets work". "Survival of the fittest." "It's not personal, it's business." These are the mottos and reflect the behavior of the far-right.

Because business does not respect it's workers. Workers do not respect their companies. Workers no longer expect to work with the same company. We see in sports, a player moves from one team to another following after the allmightly dollar. We all have the attitude, I'm just looking out for myself irregardless of how it affects other people or the agreements we have made in the past. Unfortunately, we live in a self-centered, self-absorbed, dis-respectful, irreverent society were people expect instant gratification and live only for themselves. This attitute is refected in the severe epidemic of consumer dept and personal bankrupcy.

To end poverty, we need to return to our morals before the sexual revolution. We need to return to our traditional sense of honor. We need our great institutions of this country to conduct their affairs with principaled ethics and integrity. We need business leaders who take responsibilily and respect their workers and the community so that the community and their workers will in-turn respect the great institutions and companies of this country. People will feel needed and valued as a part of such a wonderful institution which also allow their workers to satisfy the temporal needs of their families. To end poverty and live in peace and prosperity, our country needs to return to its traditional ideals of morality and integrity.

Wednesday, May 16, 2007

Mitt Romney for President

The 2008 presidential race is already heating up. The GOP candidates have now participated in their second public debate. FOXNEWS moderated last night's debate in Columbia, SC preceding the nation's first presidential primary election. After having studied each candidate, Mitt Romney is the clear favorite for my vote. What do I like about him and why do I think he is the best candidate for president? Look at this guys insane resume!
1. He excelled in his education.

Mitt Romney didn’t just attend an IVLeague school and coast by. After attending Stanford for 2 semesters and serving an LDS mission he transferred to Brigham Young University, where he was valedictorian, earning his B.A. summa cum laude in 1971. In 1975, Romney graduated from a joint JD/MBA program coordinated between Harvard Law School and Harvard Business School, where he was named a Baker Scholar. He graduated cum laude from the law school and in the top 5 percent of his business school class.
2. He is a proven leader and a financial genius.

Romney is a former vice-president and then CEO of Bain & Company. While working as a vice president, Romney broke away and formed Bain Capital. Bain Capital was an immediate success while Bain & Co. approached bankruptcy. Only a few years after founding Bain Capital, Mitt was asked to rescue Bain & Co. Romney accepted and merged the two companies. Under Mitt's direction, Bain & Co. became one of the most successful private equity investment firms worldwide.

Next, Romney was asked to rescue the almost bankrupt Salt Lake 2002 Winter Olympics. After the bribery scandal, the games had lost nearly all their sponsorship. With Romney as CEO, the games ended up one of the most profitable Olympic games of all time. Salt Lake City was left with several state-of-the-art Olympic venues and a trust funds to cover their upkeep (unprecedented!).

After the Olympics, Mitt Romney (a republican) was elected Governor of Massachusetts (the bluest of the blue states). The state was in a financial crisis whose citizens looked to Mitt Romney for financial salvation. In 4 short years, Mitt Romney turned a $3 billion state budget deficit into a $1 billion surplus; without raising taxes.

Romney also instituted one of the most ingenious healthcare programs ever. From 2001-2004, Massachusetts experienced a double-digit rise in the number of uninsured due to rising healthcare premiums. Without raising taxes, Romney expanded state Medicaid to subsidize low-income residents in purchasing their own private insurance. Since 2005, "Romney-care" has achieved double digit decreases in the number of uninsured. And, what is all this progress causing the taxpayer? Not a dime! By helping people afford to purchase private insurance, the individual citizen pays some of the costs, and are also then able access preventive medical care instead of showing up to the ER with an expensive medical crisis. Through "Romney-care", the state is using the same state Medicaid dollars more efficiently.

3. He is not a career politician.

Mitt is a true Washington outsider who’s a relative newbie in politics (just 4 years). However, as a former CEO and governor he has demonstrated that he can manage enormous, and complex institutions. Through these experiences, Mitt has developed the necessary leadership skills necessary for the President of the United States. The most important skills being the ability to set worthy goals, see the path to achieving them, and then to inspire others with that same vision.

4. He exemplifies moral integrity and family values.

Mitt Romney has the clearest vision for America. When he says he wants a stronger America, a better America, with stronger families, better education, and more prosperity; Mitt's life exemplifies that vision. His vision of America is not some theoretical Utopia. Mitt is actually living his American dream. And he wants everyone to share in the prosperity and happiness he has enjoyed in his family life, career, and civic life.

So, As I consider who will win my vote for President in 2008, I first look at the biggest issues facing this country: national debt, Medicare, social security, national security, healthcare, immigration, disintegration of family values. Then I look at the qualification of the applicants. After careful consideration, the choice is clear. In my mind, only Mitt Romney has the credentials to tackle our foreign and domestic problems and lead a stronger America into the 21st century.

Sunday, April 22, 2007

The Great Global Warming Swindle

Happy Earth Day! Please see the "Global Warming Swindle" a wonderful documentary done by the BBC.

Newest link to the video:
1. Blinkx
2. Google

The documentary makes a compeling case against the causal link between human CO2 and global warming. Looking at the same ice-core data that Al Gore features in his "An inconvienent truth," If you actually superimpose the CO2 and temp data there is a clear 800-year lag of Co2 behind temp. This is a further reminder of that age old scientific maxim that "correlation does not equal causation." Especially something that doesn't correlated very well.

The reason why CO2 goes up with temp. is because as the oceans warm due to increased solar luminocity, gas is less soluble is warm water than cold water. So, more Co2 diffuses out of the ocean into the atmosphere without any appreciable, additional affect on atmospheric temperature. The Co2 eventually maxs out as the oceans and atmosphere reach a new equalibrium. Then as the sun's luminosity decreases and the earth and oceans cool, the CO2 dissolves slowly back into the oceans again.

Yes, there is global warming caused by increased sun's luminosity (Mars ice cap is shrinking too), and that may cause global catastrophy and yes, we should be kinder to the environment, but the causal link of human CO2 and global warming is baseless.

[see also http://ldsdoctrine.blogspot.com/2007/03/family-values-vs-global-warming.html]

Monday, April 16, 2007

Abstenince Education

A recent study reports that more teens are having sex than ever before and and that this is evidence that abstenince education is not working. However, I interpret the data differently. (1)Our nation is reaping the consequences of the sexual revolution. Now, it has become not only socially acceptable to have pre-marital sex, but it is expected. Some would suggest giving up and simply instituting a risk management strategy.

Despite this most recent data, recent CDC data shows that up to 2004, the teenage pregnancy rate continues to decrease and is now 1/2 the rate it was in 1994. (2) CDC data also show that in 2005 “The birth rate for teenagers declined 2 percent in 2005, falling to 40.4 births per 1,000 women aged 15-19 years, a 35-percent drop compared with the most recent peak in 1991 (61.8), and the lowest ever recorded in the 65 years for which a consistent series of rates is available” (3) However, the same report also shows that children born to unmarried women as a whole hit record levels and increased 4 percent overall. (4) So, it seems clear that sex, pregancy, and birth by unmarried women is becoming more and more common for all age groups. Yet, despite this, the rate of teenage pregnacy and and birth is down.

Now my point is that if we were passing out condoms in schools, those against abstenince education would be patting themselves on the back saying, “see, our way works. Teen pregnancy and birth is down.” Yet when it come to abstinence only, they measure it’s success by a different standard.

Sex outside of marriage is morally wrong and should be illegal (not criminal). We have rights in this country so long as they do not violate the rights of others. I believe and so does the LDS church that all children have the right to be born into a family with both a mother and a father. This is the ideal and not always possible, but our laws should reflect our ideals and not the least common denominator. Sex out of marriage should be illegal (not criminal) even in the age of contraception. All contraception have documented failure rates even when used as directed. Furthermore, illegitimacy is the biggest single contibutor to poverty, government dependence, drug-use and crime.

Teens and adults are both mostly ignorant about birth control. The practice of cloitus interruptus and rhythm method is widespread and obviously ineffective. But, data also show that teens using the pill, and condoms are not much more effective. The reasons teens can't be told to put their faith in birthcontrol is because they are not mature enough to use it consistently. Also, studies show that teen sexual activity is highly associated with alcohol consumption which further impairs judgement. Therefore, it would be wrong to promise a teen that if they depended on the pill or condoms they will be safe, because we would be expecting them to do something that many teens are just not deveopmentally ready to strictly follow. A law of child development states that you cannot teach a child something that they are not developmentally ready to learn.

I think a good compromise would be to teach abstinence education and then focus on the limitations of various birth control methods. Condoms only protect an individual from most STD’s in most situations but they have a high failure rate because of their documented highly erratic pattern of usage. The documented bc failure rates do not take into account the human element. Other studies looking at real-life bc failure rates are consistently and significantly higher than those published on the box.

Some of the more effective methods of bc (depot, patch, and ring) which take the human element out of the equation do not protect from STD’s at all. Therefore, these methods are likely contibuting to the lower rates of teenage pregnancy but STD’s and ectopic pregnancy are off the charts. STD's and ectopic pregnacy can be lifethreatening and in can rob women of their ability to bear children later in life. Also, my wife points out that many teens she knew actually got pregnant on purpose for various insecure and immature reasons.

Opponents of abstience education say that it is somehow dishonest to expect kids to put their trust in abstience. However, we forget that abstience education has worked for generations. The problem now is that now the social landscape is changed. Parents church and school is having a hard time competing with a oversexualized pop culture and internet. On the other hand, the data shows that it would be dishonest for us to expect kids to put their faith in condoms and other forms of birth control. So, the only honest choice we are given is to clean up our media, pop culture, internet and continue to teach abstienence and review the actual failure rates of various bc methods.

Friday, February 16, 2007

Instinct vs. Conscience

Some economists hold up the capitalistic, free-market economy of supply and demand as a perfectly self-regulating system. Any perceived failings of our economy are due to artificial government regulation. On the other hand, a total deregulation of the free market would be harmful to many individuals. Healthcare is a good example. If doctors were completely deregulated, people would have to die for the consumers to learn which doctors were qualified and which were not. This economic regulation argument parallels the nature nurture debate that influences many other social issues in our society today. This article will attempt to define human instinct and conscience in order to better understand the arguments on issues such as: gay marriage, illicit drug legalization, poverty, welfare, and health care.

Our brains are designed with complex pathways to assure our survival and the survival of the human species. The brain accomplishes this through a system of sensation rewards and punishments. Our brains are designed to interpret our environment and judge whether that environment is safe or harmful. Our brain takes in all sorts of information: temperature, vibration, position, texture, sight, sound, taste, and smell. If our brain determines our environment to be dangerous or damaging, then it will generate an unpleasant, noxious, or painful sensation. Our brain is also set up to generate powerful sensations of reward, joy, happiness, well-being, laughter, and pleasure when our brain interprets our environment to be favorable to our survival and our ability to pass on our genetic material.

Our brain also has intricate chemoreceptors that monitor the amount of water, salt, and sugar in our bodies. If we are dehydrated our body will generate a thirst sensation. If we are low on salt, we will have the sensation known as the “munchies.” If our blood sugar is low and we are burning reserve fat and glycogen in our liver and muscles then we will feel hunger.

All of these sensations also stimulate a complex array of behaviors and reflexes. If we feel pain, we automatically withdraw from the stimulus. If we are cold we will start to shiver to generate more body heat and seek shelter. If we are hot our bodies will sweat and we will seek shade. If we are fighting an infection, we generally will feel tired and “malaise” or ill-feeling, and want to rest and sleep more in order to devote more energy to fighting the infection and healing.

Because our species requires sex between the genders to procreate and because the creation of social bonds with other humans can be beneficial or harmful to survival, our brains are designed to recognize and interpret a complex assortment of interpersonal and empathic information such that we can guess how another person is feeling. Our brains are designed to recognize language, facial expressions, body position and other forms of non-verbal communication. Our brains also create a complex array of sensations and feelings as rewards and punishment. Feelings such as jealousy, envy, hatred, heartbreak, guilt and shame can be as noxious and unpleasant as “somatic” physical pain from a burn or cut.

Human instinct is not infallible. Therefore, relying on our human instincts alone is not enough. In one example, it is clear that while working outside on a hot day, a person cannot rely alone on his or her sense of thirst to prevent dehydration. Human science has discovered that it is best to drink so many ounces of fluid with electrolytes each hour to prevent heat illness or death. This small example suggests another important aspect to behavior.

Humans are notoriously unpredictable. Many people in many situations do things they don’t want to do. Freud called this influence the “superego.” Others more commonly refer to the superego as the conscience. In contrast, Freud referred to the animal appetite or instinct as the “id.” What is conscience? Some experts would interpret the conscience as just an extension of the id. This familial protective instinct is used to explain charitable or altruistic behavior. Because family members carry similar genetic information, a person my feel influenced to help and protect them. However, I don’t think this explanation completely explains why people would send money to help children in foreign countries and not tell others about it. When I talk about conscience, I am not talking about the religious notion of the Holy Spirit. I am talking more about what the Bible refers to as the Light of Man or Light of Christ. Conversely, when I talk about the id, I am not talking about demonic temptation. I am referring to what the Bible refers to as the natural man, or appetites of the flesh.

So, what is the conscience or the Light of Man. Is it a real influence on behavior? I say yes. Many look at the conscience as a manifestation of nurture, or rather, a reflection of the morals and norms of society. When a person goes against the norms and values of society, the body can generate severe and powerful feelings of depression, guilt, shame, and worthlessness. This influence has been pointed out as playing a role in the high suicide rate of homosexuals in Utah. In response, gay-rights activists are seeking for more tolerance in the Utah community. This example would tend to support the idea that conscience is a powerful influence transmitted and acquired by our social environment through teaching and example.

In light of this destructive example of conscience, should conscience be suppressed and Darwin reign supreme? I think not. Because we all know that unbridled passions can equally be destructive. It is human nature to be generally lazy, self-serving, and intolerant. Somewhere along the way, a human ancestor discovered upon the concept of sacrifice, which is to set aside what you want now and work for something better in the future. The most successful humans of our species are able to visualize the end reward and the steps necessary to arrive at the end goal. Our society calls these people CEOs, presidents, visionaries, seers, or prophets. Others who follow these leaders may not have the same vision as their leader but are asked to work towards the goal based on faith and trust. However, the best workers are able at some point to arrive at the point where they share the vision of their leaders.

It should also be pointed out that new genetic and social science has discovered that instinct and conscience or nature and nurture are not mutually exclusive. Our environment can change our genetics and visa versa. If fact, new research is verifying that human baby brains are set up to acquire and incorporate information from their social environment from birth. Whooping Cranes are an excellent example. Whooping cranes are the tallest bird in North America but unfortunately they are an endangered species on the verge of extinction. The only few thousand birds remaining spend their summers in Canada and migrate in the fall to winter in South Texas. A new program is being developed to establish new breeding grounds and new wild populations for the cranes. A group of scientists is currently raising cranes in Wisconsin and then imprinting the young birds to follow an ultra-light aircraft with is then used to lead the cranes to new winter breeding grounds in Florida. This crane experiment illustrates the relationship of instinct and conscience. Bird migration has always been a mystery. How do animals learn to migrate back to the exact place where they were conceived? This crane experiment suggests that they imprint and follow someone who knows the way.

From these explanations it seems clear that nature and nurture, instinct and conscience are critical in the survival and fitness of the human species. Therefore, any arguments that would emphasize one influence over the other are false arguments. Examples of these arguments are found on both sides on every issue: “just let the free markets work,”
“It’s not personal, it’s just business,” “I can’t help it, I was born this way,” “if it feels good, do it,” “just do whatever makes you happy,” “what’s right for one person isn’t right or another person,” and “I deserve it because I earned it.”

Social scientists are discovering a troubling shift in the rising generation. Past generations were guided by the values of honor. In a so-called honor generation, individuals find self-worth and importance by contributing or being part of something bigger and more important than themselves. This is called being “internally motivated” or having an “external locus of control” or just simply being unselfish. Experts are seeing evidence that generation X and generation NEXT are becoming more and more selfish. The rising “Me Generation” (of which I belong) seems to be obsessed with acquiring more wealth, fame, power and glory as it can get however it can get it. Lying and cheating in school, business, and in our personal relationships is almost become a virtue. On the other hand, the concept of an honor generation can go too far the other way. No one wants to go back to the age of duels and honor suicide. But it is my opinion that the pendulum has swung too far away from honor and selflessness.

An interesting argument to support same-sex marriage, adoption of children, and invitro-fertilization is that a more diverse social arrangements would make our species more fit according to the laws of natural selection. However, these social arrangements are against the traditional foundation principles of our society and therefore, against the conscience of a majority of people. Supporters of alternative lifestyles and families support a change in society morals and values claiming benefits according to instinct at the expense of conscience. Both are important. Conscience is not necessarily unchangeable. But, to warrant a change, they would have to prove a benefit to society with real outcome data such as better health, increased wealth, and psychological wellbeing. I have yet to see such data to support a change in our traditional values.

In conclusion, as we engage in the discussion of social issues such as legalizing marijuana and abortion I would hope that we would get past the simple arguments that instinct trumps conscience or conscience trumps instinct and talk about the real benefits or risks, pros and cons are with regard to the issues.

Friday, February 09, 2007

Thoughts on Nuclear Energy

Uranium is a naturally occuring element in the Earth's crust. It is already ratioactive and is continually degrading spontaneously to form all sorts of radioactive byproducts such as radon. Uranium exists in two main forms or isotopes: 99% U238 and <1% U235. U238 is a stable isotope and not considered radioactive. U238 is denser than Lead and just slightly less dense than gold and is used by the millitary as "depleted uranium" as tank armor and in armor peircing shells.

U235, on the other hand, is the highly radioactive fissionable isotope. If you just get enough U235 together in one place at one time the spontaneously splitting atoms of U235 will give off extra neutrons which in-turn cause more U235 to split, resulting in an uncontrolled chain reaction giving off enormous amounts of heat and light. After reaching "critical mass" the U235 would create a blinding blue flash of light and then vaporize and explode into the familiar mushroom shaped cloud. However, this reaction would only be about 1% efficent because the vaporized metal would quickly dissipate; breaking the chain reaction.

Nuclear bombs are designed to be more efficent by using a polonium/berylium core to add extra neutrons to the reaction and U238 shielding. In a more controlled setting, if you simply purify U235 into a 6-8 sub-critical fuel rods and just get them close together they will get hot, make steam, which is used to make electricity. It's just like how the Shankarah Stones in Indiana Jones and the Temple of Doom glow when they are next to each other. It really is that easy, but you wouldn't want to hold hot U235 fuel rods.

Neutron absorbing control rods are placed in-between the U235 rods to absorb extra neutrons and prevent the core from getting so hot the fuel rods melt down, flow together into a super-critical mass and explode into a hiroshima-like mushroom cloud, or vaporize all the tritiated heavy water and blow the roof off the building that is housing the reactor (Chernobyl).

A new design of nuclear reactor called the pebble-bed reactor uses spheres of U235 encased in a shell of neutron shielding/slowing material (boron). The reactor is run by simply adding more or less spheres to the bottom of the heavy water tank. The shielded spheres are designed such that even when surrounded by other spheres, they can never get hot enough to melt down. They will heat up and make steam, but thats it. More pebbles makes more steam, and more electricity, but the U235 spheres will never get so hot that they melt.

U235 should be considered a clean way of producing electricity bacause it does not create more ratioactivity. U235 is already in the ground and highly radioactive. Using it to generate electricity requires processing it and concentrating it and then having to dispose of the same amount of radioactive material that was originally mined out of the Earth. Using heavy water (D2O) to cool and shield the reactor does create some tritium but its is reliatively short-lived.

U235 is very difficult to separate from U238. It requires very expensive and sophisticated gas-diffusion ultracentrigation techniques. However, at the same time, the process of separating the U235 isotope from U238 is very clean and generates almost no waste. The leftover U238 is used as tank armor. On the other hand, if you take that same non-radioactive U238, and put it in a reactor next to U235, it will capture a neutron and become the unstable and highly radioactive element plutonium (Pu239). This is much easier to separate from U238 with solvents but much more problematic. If you use solvents to separate U238 and Pu239, then you are left with hundreds of thosands of gallons of solvent with traces of Pu239 in it.

The Savannah River Site in CSRA Central Savannah River Area on the border of South Carolina and Georgia is one of the country's centers of plutonium production. Since the cold war, the site has been innundated with thousands of barrels of left-over solvent with radioactive residue known as "mixed waste." The site has pioneered a process of vitrification or "glassification'" in which the solvent is slowly and gently evaporated off and the remaining radioactive sludge, residue, and/or precipitate is encased in glass which is then encased in concrete which is then encased in a stainless steel jacket.

Although innovative, the production of plutonium from U238 is creating additional radioactive material from matter that was not originally radioactive. However, Pu239 will continue to be produced because it is the preferred fissile material used in US atomic warheads. It is my opinion that Atomic energy from processed, concentrated U235 using the new pebble-bed reactor design is both safe and enviromentally friendly. Absolutely no carbon dioxide or other polutant (except tritium) is produced in the the reaction. I encourage the US to focus more on Uranium-based reactors over Plutonium-based atomic energy.