May 31, 2014 archive

Cross posted from The Stars Hollow Gazette

This is your morning Open Thread. Pour your favorite beverage and review the past and comment on the future.

Find the past “On This Day in History” here.

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May 31 is the 151st day of the year (152nd in leap years) in the Gregorian calendar. There are 214 days remaining until the end of the year.

On this day in 1859, Big Ben goes into operation in London

The famous tower clock known as Big Ben, located at the top of the 320-foot-high St. Stephen’s Tower, rings out over the Houses of Parliament in Westminster, London, for the first time on this day in 1859.

After a fire destroyed much of the Palace of Westminster–the headquarters of the British Parliament–in October 1834, a standout feature of the design for the new palace was a large clock atop a tower. The royal astronomer, Sir George Airy, wanted the clock to have pinpoint accuracy, including twice-a-day checks with the Royal Greenwich Observatory. While many clockmakers dismissed this goal as impossible, Airy counted on the help of Edmund Beckett Denison, a formidable barrister known for his expertise in horology, or the science of measuring time.

Denison’s design, built by the company E.J. Dent & Co., was completed in 1854; five years later, St. Stephen’s Tower itself was finished. Weighing in at more than 13 tons, its massive bell was dragged to the tower through the streets of London by a team of 16 horses, to the cheers of onlookers. Once it was installed, Big Ben struck its first chimes on May 31, 1859. Just two months later, however, the heavy striker designed by Denison cracked the bell. Three more years passed before a lighter hammer was added and the clock went into service again. The bell was rotated so that the hammer would strike another surface, but the crack was never repaired.

Great Bell

The main bell, officially known as the Great Bell, is the largest bell in the tower and part of the Great Clock of Westminster. The bell is better known by the nickname Big Ben.

The original bell was a 16.3-tonne (16 ton) hour bell, cast on 6 August 1856 in Stockton-on-Tees by John Warner & Sons. The bell was named in honour of Sir Benjamin Hall, and his name is inscribed on it. However, another theory for the origin of the name is that the bell may have been named after a contemporary heavyweight boxer Benjamin Caunt. It is thought that the bell was originally to be called Victoria or Royal Victoria in honour of Queen Victoria, but that an MP suggested the nickname during a Parliamentary debate; the comment is not recorded in Hansard.

Since the tower was not yet finished, the bell was mounted in New Palace Yard. Cast in 1856, the first bell was transported to the tower on a trolley drawn by sixteen horses, with crowds cheering its progress. Unfortunately, it cracked beyond repair while being tested and a replacement had to be made. The bell was recast at the Whitechapel Bell Foundry as a 13.76-tonne (13 1/2 ton) bell. This was pulled 200 ft up to the Clock Tower’s belfry, a feat that took 18 hours. It is 2.2 metres tall and 2.9 metres wide. This new bell first chimed in July 1859. In September it too cracked under the hammer, a mere two months after it officially went into service. According to the foundry’s manager, George Mears, Denison had used a hammer more than twice the maximum weight specified. For three years Big Ben was taken out of commission and the hours were struck on the lowest of the quarter bells until it was reinstalled. To make the repair, a square piece of metal was chipped out from the rim around the crack, and the bell given an eighth of a turn so the new hammer struck in a different place. Big Ben has chimed with an odd twang ever since and is still in use today complete with the crack. At the time of its casting, Big Ben was the largest bell in the British Isles until “Great Paul”, a 17 tonne (16 3/4 ton) bell currently hung in St Paul’s Cathedral, was cast in 1881.

Cross posted from The Stars Hollow Gazette

The recent scandal about the possibility of patient deaths, long waiting lists for appointments and falsified data in the Veterans Administration run hospitals across the country has it roots in a very obvious fact: too many patients and too few doctors.

At the heart of the falsified data in Phoenix, and possibly many other veterans hospitals, is an acute shortage of doctors, particularly primary care ones, to handle a patient population swelled both by aging veterans from the Vietnam War and younger ones who served in Iraq and Afghanistan, Congressional officials, veterans affairs doctors and medical industry experts say. The department says it is trying to fill 400 vacancies to add to its roster of primary care doctors, which last year numbered 5,100. [..]

But the inspector general’s report also pointed to another factor that may explain why hospital officials in Phoenix and elsewhere might have falsified wait-time data: pressures to excel in the annual performance reviews used to determine raises, bonuses, promotions and other benefits. Instituted widely 20 years ago to increase accountability for weak employees as well as to provide rewards for strong ones, those reviews and their attendant benefits may have become perverse incentives for manipulating wait-time data, some lawmakers and experts say. [..]

The precise role incentives and performance reviews might have played in falsifying waiting-list data remains unclear. In Phoenix, the inspector general’s office said, investigators plan to interview scheduling supervisors and administrators to “identify management’s involvement in manipulating wait times.”

But documents suggest that using the data in annual performance reviews may be commonplace. One review for a Pennsylvania veterans medical center director showed that a significant portion of the director’s job rating was tied to “timely and appropriate access,” which would include waiting times for doctor appointments. One of those goals would be met only if nearly all patients were seen within 14 days of their desired appointment date – a requirement not found in the private hospital industry.

While greed may well be part of the problem, it all stems directly back to the influx of new patients and the lack of primary care physicians to manage their cases. According to the article, primary-care appointments have increased 50 percent over the last three years while the department’s staff of primary care doctors has increased by only 9 percent. There are only so many hours in the day.

The other issue for doctors in the VA system is the pay disparity with the private sector.

V.A. primary care doctors and internists generally earn from about $98,000 to $195,000, compared with private sector primary care physicians whose total median compensation was $221,000 in 2012, according to the Medical Group Management Association, a trade group.

Privatization is not the solution. The private sector is no better equipped to handle to large influx of patients, especially patients with special needs that stem from the wars. It is also wildly unpopular with veterans and veterans groups. The Republicans in congress have other ideas because they perceive the VA as socialized medicine which they hate.

The Republican Party Has a VA Problem, Too: Privatization Isn’t Popular

By Brian Beutler, The New Republic

In light of the GOP’s decision to fold the Veterans Affairs scandal into a broader ideological crusade, I noted on Wednesday that in seeking redress, liberals shouldn’t lose sight of the fact that the GOP’s answer to every administrative blunder is to dissolve whatever program or agency screwed up. The unspoken corollary is that, by using the VA scandal as a narrative building tool, they’ll face pressure to put up a “small government” alternative to the VA that would be a better deal for actual veterans. And that carries risk, because the Republican alternative is unpopular. And yet…

 

The chairman of the House Veterans Affairs Committee is calling on the Obama administration to permit veterans waiting for care at VA hospitals to seek treatment outside that system, if they want.

   Rep. Jeff Miller, a Florida Republican, called on President Barack Obama to issue an executive order that would allow those veterans to act on their own and charge the government for outside care.

As Brian pointed out, when Mitt Romney suggested that veterans be given vouchers, he was vehemently criticized by veterans. Romney, being the political coward, did an immediate reversal, proposing instead spending more money as demand increased. How liberal of him.

MSMNB’s Rachel Maddow did an extensive report on the VA crisis, highlighting the problems within the military medical care system and the new details outlined in the V.A. inspector general’s interim report. She also had interviews with Paul Rieckhoff, founder and executive director of the Iraq and Afghanistan Veterans Association and Senator Bernie Sanders, Chairman of the Veterans’ Affairs Committee.

I don’t believe that firing Secretary of Veterans’ Affairs Eric Shinseki is the solution. The solution is hire more doctors and that would require making the position more competitive with the private sector.  

Welcome to the Health and Fitness News, a weekly diary which is cross-posted from The Stars Hollow Gazette. It is open for discussion about health related issues including diet, exercise, health and health care issues, as well as, tips on what you can do when there is a medical emergency. Also an opportunity to share and exchange your favorite healthy recipes.

Questions are encouraged and I will answer to the best of my ability. If I can’t, I will try to steer you in the right direction. Naturally, I cannot give individual medical advice for personal health issues. I can give you information about medical conditions and the current treatments available.

You can now find past Health and Fitness News diaries here and on the right hand side of the Front Page.

I don’t put much stock in the concept of “super foods,” but if you do, blueberries should be on your list. Their health benefits are well documented in the scientific literature. One study, published last year in BMJ, showed a correlation between the consumption of blueberries, apples and grapes, but especially blueberries, and a significantly lower risk of Type 2 diabetes. Scientists who are looking at foods that contain fibers that nourish probiotics, or beneficial microflora, in our lower intestines are finding that blueberries and other berries have a lot of potential in this area. [..]

One great thing about blueberries and blackberries is that they freeze exceptionally well, especially blueberries. All you have to do is make sure they are dry and seal them airtight in freezer bags or containers. You can throw them, frozen, right into baked goods. Toss them first with a very small amount of flour if you don’t want them to bleed when they bake.

~Martha Rose Shulman~