McDonalds breakfasts can be fatal

Daily Mail journo Harriet Arkell has no doubt about what killed firefighter Alan Soards:

Firefighter drowned during training exercise at Olympic white water rafting venue moments after he ate a McDonald's breakfast meal

Reading the article, she attempts to justify the headline:

Witnesses said Mr Soards, who was also a lifeboat volunteer, looked out of breath and that his face had turned purple, and he was found face-down in the water at the end of the course.
He was pulled from the water and attempts were made to resuscitate him, but Mr Soards vomited his undigested McDonald’s breakfast while he was being given CPR.

Clearly, it must have been the McDonald's breakfast that killed him. There's no way that someone pounding his chest with nearly their full body weight would have caused anything at all in his stomach (Egg McMuffin, Weetabix or lettuce) to return up his oesophagus. It's not like vomiting is a well-known complication of CPR. Heck, the McDonald's breakfast probably caused him to have broken ribs after CPR.

I can't find Ms. Arkell's degree subject (she studied at Bristol University) but no doubt she specialised in human physiology in order to make this diagnosis. Publicity-seeking empathy-lacking cow that she is. I'd have hoped that Alan Soards's family sue her, but I guess "maliciously self-serving ignorance" isn't legally actionable.

[Hat tip: the estimable Mark Wadsworth]

Queues in coffee shops

I'm encouraged by the length of the average queue in Starbucks and Costa - if you've got a steady stream of customers, nudging you towards your maximum coffee-drink-producing-capacity, you must be doing OK on your business plan.

However, this tweet from @GSElevator strikes a chord with me:

#1: Starbucks needs a separate line for people who have their shit together.

— GS Elevator Gossip (@GSElevator) June 27, 2013

YES. They so need to have this. I'd be more willing to queue up at Starbucks if I knew that everyone in the line would turn up at the counter, spec their order in a compact and unambiguous fashion, have appropriate payment ready and waiting, and move swiftly to the collection area as soon as the transaction had concluded.

It's bad enough when the first person in the line orders eight different blended drinks, and you know how long that will occupy the barista making them until she can turn her attention to your americano. It's so, so much worse when the next person just wants a latte but spends several minutes havering about whether they want soy, what size they want, whether it's for here or to go, and then spends a while rummaging around in their purse for the payment. For heavens' sake, you spent nearly ten minutes in the queue waiting for your turn with a huge display of drinks, sizes and prices right in front of you. How in the world can you not be ready to order?

Obviously, anyone in the "shit together" queue who hesitates or havers during their order or payment will be brutally beaten by the people behind them and pushed to the back of the "shit apart" line.

Sorry for the rant; there are few things more irritable than an engineer kept away from their caffeine.

Sympathising with Rachel Jeantel

Watching the video of Trayvon Martin's girlfriend Rachel Jeantel on the witness stand at George Zimmerman's trial, my overwhelming emotion is sympathy. She's the prosecution's star witness and she was dreadful. Surely, George Zimmerman's defence attorneys can't have believed their luck. The prosecution opened with a witness who was illiterate, lied about any number of small things ("writing" a letter that it turns out she couldn't read, attending Trayvon's wake) and who tweeted a trail of destruction about drinking, getting high and driving under the influence before someone deleted the worst offending tweets just before her testimony.

Rachel has clearly been coached and steered by the prosecution team (and possibly hangers-on) on what to say, how to say it and how to present herself. This is part of the game of trials, and everyone does it. But she doesn't really understand what she's been brought into - the personal risk she's bearing with every falsehood she admits to. She's 19 years old, and boys and girls of that age do dumb things. Most of the time no-one's really looking at their acts apart from their mates, but now everyone in the USA has a laser focus on this case and Rachel looks untrustworthy, unreliable, lacking self control and generally everything that a court witness cannot afford to be.

My heart aches that a 19 year old woman can't read - or, presumably, write - cursive script. It's not surprising that Rachel was embarrassed about this, and lied about it. Unfortunately (for the prosecution) this blows a hole a mile wide in the case - reasonable doubt must be a slam-dunk at this point, unless something unexpected crops up in the forensics.

This case should never have been brought to trial. It wasn't headed for trial until political pressure (with cries of "racist killing!") forced the state to prosecute. Political influence on prosecution stops at the courtroom door, and this jury will find George Zimmerman not guilty of the murder of Trayvon Martin. It may even be that at the conclusion of the prosecution case the defence will successfully move for a dismissal, showing that the state has not proved its case; honestly, though, it would be a very brave judge to let that motion pass. In the mean time Zimmerman has been jailed, forced to spend huge sums on a legal defence, and in effect had his life ruined.

One article I read posed a very interesting (if unprovable) proposition that this case was never intended to succeed. Six months before the 2012 elections in the USA, it was a cause celebre demonstrating homicidal racism in modern America, a rallying point for Al Sharpton and co. The fact that Zimmerman was more Hispanic than white was glossed over, and US media organisations did their part in editing 911 tapes to make Zimmerman appear racist. The elections now over, the race-baiters don't particularly care what happens to Zimmerman; indeed, for them perhaps it's better that he's acquitted so that in 2016 they can rage about that acquittal and "Justice for Trayvon" as another rallying point.

If anyone is serious about improving the lot of black teenagers in the USA - and they damned well should be - they should start by exploring the deficits of the education system that left 19 year old Rachel Jeantel functionally illiterate.

Getting what you pay for in education

In the category of "consequences that anyone with a brain could have predicted", the Toronto District school board's decision to stop teachers being able to carry over their allowance of sick days from one year to the next (and cash them out for money on retirement) has worked out approximately as you'd expect:

New figures from the Toronto District School Board show a 22% spike in teachers reporting in sick last month compared to the previous year, and a 53% jump from three years ago.

Teachers get an allowance of 20 sick days a year - presumably if you take more then they will be unpaid - and up to now if they had any remaining at the end of the year they could add them on to next year's allowance. With no limit on carry-over, it was quite feasible to have 200 days of leave on retirement:

But some school boards — the Ontario government says 40% — also allowed teachers to cash the unused days out, up to 200 days, on retirement. The practice resulted in teachers leaving with a golden handshake worth up to half a year's pay.

What's more, I'm guessing that the days would be paid based on their final salary rather than the salary for the year in which they were allocated.

You'll note that in the old system if a teacher was feeling a bit under the weather they would be incentivised to struggle in to work (thereby infecting their pupils and colleagues); the sick day they avoided taking would be a future source of cash. Now, of course, if they are sick they'll stay at home. This is an improvement, except that there is a view among some teachers that if they have the allocation they might as well take it, as commentator marilynsouth remarks:

When I had 20 sick days and could bank them I hardly took any days off and only when I was really sick, as banking was an incentive. Now you take that away, give me 10 days with no banking, Im taking all 10 days because there is no longer an incentive. I take them or lose them now, So Im taking them, good luck trying to prove if im sick or not....

It's a tricky one to manage. On one hand teachers are exposed to tidal waves of germs as part of their job, you expect them to get sick (especially as they get older) and you shouldn't penalise them for it. On the other hand, setting out a fixed allocation of sick days doesn't seem to be optimal.

What does seem unarguable is that rolling over sick days and allowing them to be taken as cash only really benefits the moderately healthy teachers, and screws over students and less healthy teachers when the sick teacher struggles in to school to recuperate on the taxpayer's dime. While private sector practices vary, I don't know of any major firm who's taken this approach, and probably for a very good reason.

24 hours in A+E: the Guardian version

You couldn't really expect me to pass up the opportunity to blog on this, could you? Grauniad journo Denis Campbell spends a day at Bradford A+E:

"People have come with period pains, ingrowing toenails and wanting sets of false fingernails removed," said [head of Bradford A+E] Wilson. "I once even had a young woman arrive – by ambulance – asking for a pregnancy test when she could have just got one in Boots."

I'd like to invite the audience to imagine how this arose. You're a Generation Y member, moved out from your parents' house and living in a basement flat with no Significant Other in residence. On Friday morning your toe starts to hurt a little, and by Friday evening it's really quite painful. Obvious answer: go and see your GP. Surprise! There's little to no chance of seeing the GP until Monday morning (and even then it's random luck if you get a slot, if it's anything like my previous GP surgery). You have no idea what an NHS walk-in centre is. Easy choice: A+E.

It's all very well for Dr. Wilson to get excised about the undoubted lack of stoicism of the modern public:

Three hundred and fifty million years of evolution means the human body has learned to deal pretty well with most ailments. Yet no one is willing to give things time to get better. They access emergency practitioners for advice when all they really need is two or three days, or a week, to get better

but the reality is that with the parlous state of the job market they often can't afford to take the time off. Even if they did, staying at home for several days to try to recuperate and hope their injury or illness gets better, who would look after them? And what of the people who aren't sure whether their rash and aversion to bright light is just another bug or potentially fatal meningitis? Who makes that call?

People coming to A+E with minor ailments is undoubtedly a serious issue, tying up very scarce resources. The simple way to deal with that is to make GPs more accessible, but the Labour government really screwed the pooch on that one:

The current situation "isn't sustainable", she warns. "We need changes, like GPs being available 24/7," she adds.

Yes, we do. GPs have settled into a very comfortable 5 day week with regular hours, and retained really high pay for this. There are many GPs who go above and beyond for their patients out of hours, but unfortunately way too many who are quite happy to take the cash and do the minimum. My personal experience is that about 50% of GPs earn their money (or deserve more), and 50% are massively overpaid for what they do.

Spencer is also keen to introduce some GPs into their A&E, to handle those with less serious illness.

Now this is a good idea, if they can make it work, get triaging right, and actually find a source of GPs who will do this work without demanding vast sums of cash for the privilege. I wish Sandy Spencer luck, she's going to need it.

That's not the sole problem that A+E faces - even once it has deflected the minor injuries, there are still way too many people who need to be admitted, and not enough beds:

"More patients are more medically complex. People are living longer and therefore older people present with a higher incidence of illness", explains Halstead. "There's now no age discrimination. Previously you'd have said: 'Oh he's 75, that's a good innings, there's nothing more we can do for him.' Whereas these days everybody is treated with whatever is available to relieve their condition, no matter what age they are."

And with a health system with finite resources, the tens of thousands of pounds needed to give an 85 year old an angioplasty rather than letting him or her die will be money that can't be spent e.g. employing more care assistants to ensure adequate coverage on a geriatric ward. Now that may be a trade off that we should be making - or it may not - but no-one seems to want to have that debate for some strange reason.

The NHS has to decide what it wants to do about A+E and how it's going to ration the treatment and budget available against the unbounded demands of the public. If you want healthcare to continue to be free at the point of demand, you're going to find it quite surprising how expensive it can be to supply it. There are hard choices to be made, and we do not ask the Government to make them perfectly; they must, however, make them.

Precision engineering by Honda

This is not a sponsored post

A buddy of mine over Stateside nearly departed the land of the living today. Heading down the freeway at a speed around the limit (65 mph) he moved to avoid a collision, got clipped on the rear, and drove at nearly full speed into the concrete Jersey barriers separating the eastbound from westbound traffic. Those barriers being notable for their inability to yield, his Acura was reduced substantially in length. What was notable, however, was that the trashing of the engine compartment and its subsequent intrusion into the driver space stopped almost exactly at his knees - they were a little sore, and he was disoriented from the various exploding airbags, but he was able to climb out of the vehicle and wait for the emergency services.

While wanting to berate the EMS crews who let him walk away from the wreck and get a ride home without doing the prophylactic collar-and-board that anyone with a PHTLS certification would have carried out, we should stop and marvel at the design and engineering that has successfully dissipated the massive energy in a 50mph+ near-frontal impact into every single bit of the car except the space occupied by people. When we consider the steady decline in traffic fatalities since 1990, it seems pointless to deny the role played by safety engineering and relentless study of the mechanics of road traffic accident injuries.

For those of you looking at a Honda-brand car for your next vehicle, they seem to know what they are doing with regards to safety.

Needless to say, he was wearing his seatbelt. Princess Di conspiracy theorists, take note.

Interviewers don't know jack

At least, that's the impression given by Google's HR head Laszlo Bock:

Years ago, we did a study to determine whether anyone at Google is particularly good at hiring. We looked at tens of thousands of interviews, and everyone who had done the interviews and what they scored the candidate, and how that person ultimately performed in their job. We found zero relationship. It’s a complete random mess, except for one guy who was highly predictive because he only interviewed people for a very specialized area, where he happened to be the world’s leading expert.

For anyone who's done any substantial amount of interviewing, this will ring a bell. Without the data following-up on hired candidate performance in their jobs, there's very little that the individual interviewer receives as feedback on their interviewing. If you consistently have 4+ people doing interviewing the same candidate on closely-related topics you can compare their score and identify interviewers who give diverging scores - but then you have no idea whether the outlying interviewer was correct or not. I sometimes wonder whether in these situations companies should hire a small fraction of candidates who score highly with divergent interviewers but moderate-to-low for the rest. Of course, that's an expensive way of stats gathering.

Megan McArdle analyzes the interview and draws conclusions that I think are slightly off:

Resume and past work history are much better predictors of future performance [than brainteasers]. The problem is that in most fields, these are hard to ascertain unless you're pretty prominent.

I take a little more hope from Bock's analysis. I'd agree with McArdle (and Bock) about the relative useless of brainteasers. I would disagree to some extent with the resume and work history as predictors. What resume and work history really give you as an interviewer is a baseline for what to expect of an interviewee's performance, and to give the interviewer a pointer to the work-related questions to ask.

Example: the resume (CV) claims that the interviewee has experience building distributed systems, and has 8 years of Perl development. Immediately you, as hiring manager, know that one of your interviewers should throw a (company-standard) distributed systems development at them, and expect them to nail most of the high points. All interviewers should expect them to be able to write some Perl on demand and expect it to parse, use modern idioms, and employ efficient and suitable constructs. Falling short on any of these indicates that either the resume is "generous" with the facts or that the interviewee does not learn and increase their ability with experience as quickly as could be expected.

To make use of these facts, as Bock notes, you need to have standardised assessments of your candidates - a smallish bank of interview questions with a calibrated range of possible responses. This may well not be the world's best predictor of ability in a job, but at the very least it's a reliable way of screening out the under-performers and the outright resume fabricators.

Sow the wind of femininity, reap the whirlwind of violence

Annalisa Barbieri in the Guardian is properly concerned about the proliferation of abusive relationships and wonders what can be done to stop it:

We can teach our children about the correct way to deal with emotions such as anger and frustration, and that it's never OK to hit another person. Currently, where do our children learn about this? The top source is from soap operas, where the information may or may not be accurate. Only 13% had learned about it at school. The logical place would be in Personal, Social and Health Education (PSHE), but even in schools where PSHE is taught, (it is not compulsory although the sex education element is) domestic abuse is rarely covered.

PSHE is taught in the age group 10-16. Children (and I use the word advisedly) of that age do not in general have the emotional or social maturity to appreciate the implications of what they are being told. I can't see this making much of a difference to the problem, no matter how good the intentions.

If you want to know why modern young men are so prone to violence in relationships, look at the environment in which they grew up. The usual outlets of the violent impulses that arise naturally in young men (play wrestling with other boys, playing soldiers, physical playground games) have been systematically suppressed. Where else are these violent impulses - strengthening with age - going to be channelled? As Annalisa herself writes "it's never OK to hit another person" - but punching and grappling is what boys thrive on. What they need to learn, and indeed learn as they grow up, is the difference between a moderate punch to the arm or torso to score a metaphorical point, and a punch to the head aiming to cause injury or worse. Remove the opportunity to play fight, and you remove the place where they learn those lessons - where a playful punch grazes your buddy's nose, causes it to bleed profusely and generates remorse and moderate recriminations.

Rory Miller's Meditations on Violence made clear the distinction between playground violence, confrontations for territory / status, and then the third tier of violence intended to injure or kill. This third tier can be seen in UK cities when alcohol or aggression have young men throwing kicks at the heads of innocent victims. A kick at the head has only one purpose - to injure severely or kill. This is bottled-up violence finding an outlet that ruins the lives of people - the injured party, their family, and then the aggressor himself as he is sent down for a number of years.

Barbieri quotes Refuge's CEO Sandra Horley:

If the abuse is physical, she advises, "Never ignore that first push, that first shove."

She's right enough; that's the sign of a man (or woman) who has not learned control over their violent impulses and found an appropriate channel for them. If you're the inappropriate channel, pack your bags and leave. But we want this to be a rare occurrence, we need to restore the time-honoured ways in which young men can relieve the pressure of their violence urges harmlessly. Feminising them is not helping.

Breaking veganism - the new hotness

Tomorrow I'm going to break my usual diet and have toast (unbuttered) with orange juice and coffee for breakfast, a nutburger with lettuce and pickles for lunch, and pasta with tomato sauce for dinner. This will officially qualify as a vegan diet, and so make me a vegan. I'll keep this up for three more days. The day after, I'm going down the diner and having brunch incorporating every animal on the menu. This will officially qualify me as an ex-vegan and thus eligible for the ex-vegan list:

Please do not post names that fall under the following categories:

• Was never vegan
• Pretended to be vegan
• Was vegan for 3 days then sold out.
• SOMEONE WHO IS STILL VEGAN.

I would have thought that last point somewhat redundant given the "ex-" prerequisite, but hey what do I know?

Why do I care? Well, I would love to be listed on exvegans.com, a site dedicated to the persecution of those who have crossed from the (skinny, pale, underfed, too-much-time-on-their-hands) righteous to the animal-eating murdering blood-dripping-from-mouth unrighteous. Extracting a random entry from their hate list:

Jack Scuncio: Once upon a time Jack completely rejected all forms of animal product and was one with nature, now he has embraced the love of murder in such a wholehearted way that he now rejects the consumption of plants almost entirely. He wears leather (and fur!) whenever he can and consumes copious amounts of burnt carcasses, even partakes in gatherings some know as BBQ, but what I would like to call "Murderocalypses"

I hope that this entry was satire - or, indeed, added by Jack himself, but I fear it may just be in earnest. For something beyond satire, I offer you the ex-vegan take on Natalie Portman:

Vegan from 2009 to 2011. Stopped when she got pregnant, and had some ignorant concerns about the health of her unborn child. Her statement on the subject was very uninformed. Having kids isn't vegan anyway.

I'm not sure where you can start on that.

The twistedness of the contributors is captured perfectly in Why People Hate Vegans. When this site publishes contributions like:

The spirits of the billions murdered have risen to deliver: The Vegan Sellout List – an online directory of those who have regressed from moral consistency to moral depravity.

even the most considerate animal-loving pacifist feels a primeval urge to bludgeon the nearest tasty animal to death and eat it. "When an Irishman drives a pig, he ties a string to the pig's rear leg - the pig reacts by running forwards." Ironically, ex-vegans may be just that pig.

Fatal buttock enhancements

In the category of "unintended consequences of medical advances", I give you the Mississippi woman who has been charged in a second death related to giving buttocks-enhancing injections without being trained or licensed:

Garner had been on house arrest awaiting trial in a similar case in the 2012 death of an Atlanta woman.

If (and it's a big, huge "if") I were looking for someone to give me a cut-price buttock enhancement injection, I might just draw the line at someone who was already under house arrest - and, no doubt, featuring in the popular press - for homicide in a similar situation. Still, what do I know?

This is obviously unfortunate for her victims, seekers of cut-price buttock pertifying which led to a probably unanticipated early exit from this mortal coil. On the other hand, think of the headstone engraver who can engrave her epitaph.

It's not all upsides on the publicity front, however:

Records show Garner was in the Hinds County Detention Center on Monday. Her attorney, John Colette, was not immediately available.

I'll bet he wasn't. Assuming that Ms. Garner is rather strapped for cash and Mr. Colette is a state-appointed defender, he's not being paid anywhere near enough to try to defend Ms. Garner in the popular press, where his name will be permanently attached to the search "silicone buttocks death", which (for me) finds this case dominating the top 20.