Friday, March 27, 2015

Christian Militias in Iraq

[Google translate]
Americans in the Iraqi Christian militia to fight Daash
Mustafa Saadoun
US volunteers fighting alongside the Iraqi Christian militias against Daash

In the nearby village of Qaraqosh of the city of Mosul village Tlsagv (northern Iraq), Brett Weiss Americans and his colleagues are trying to support Christian militants fighting organization of the Islamic State (Daash), after thousands of them migrated to other towns when he entered the city on June 10, 2014.

Elements of the Assyrian Christian militia that joined the US Besvovha volunteers, they start fighting with Daash most of the time after sunset, when the organization is trying to invade their premises and whereabouts. No comparison between the two parties weapon, Fdaash has developed a weapon, while the defenders of their land Vslaham mostly from Russian arms Astorda Iraq before 2003.

For the first time in its history deserted city of Mosul after June 19, 2014 of Iraqi Christians, in the largest exodus of the people of this religion after World War II. Following their displacement from their hometowns in northern Iraq, offered them to emigrate to France, announced the French Foreign Minister Laurent Fabius is ready to receive them, but the call was not well received by the Chairman of the Rafidain Bloc (Christian) in the Iraqi Council of Representatives Kanna, who described these calls as "agendas Foreign seeking to empty Iraq of Christians. "

"The destruction and war and killing innocent people and the displacement of minorities, all of these reasons led me to fight in Iraq," said Pier 22 Brett Weiss, who came from the United States to fight in the ranks of the Christian militias.Weiss adds that "fighting with innocent people and defend them, constitutes a base station in my life. I need to be more Highness in the defense of humanity."

Weiss from his trip to Erbil and down to the village Tlsagv was full of hope and wishes to achieve something that can help women and children on the salvation of the "epidemic named Daash." Weiss said: "We support Christian friends in the defense of their land. There are those who want to create a gap between human beings when he says we can not have access to Iraq to defend these innocent people."

American fighters based on their own money for the duration of their stay in Iraq. Five are armed with the Christian faction, but they formed the impetus for these Christians morally fighters. "Their presence among us gave us a great motivation for fighting. They come from other countries, assures us that the world rejects terrorism," says Rami Paul Pier 22, a Assyrians fighters.

John Williams, who arrived in Iraq after weeks Weiss, opines that "all the wars waged by terrorist gangs against innocent people must pay everyone to go to that place, because humanity does not stop at national borders, or when, nationality or religion."

Williams intends to marry a Christian Bashabh after the completion of the fighting. "Everything in Iraq leads me to defend him, the people here are innocent, Mnachhm beautiful, walk among the trees in northern Iraq gives you a great psychological comfort," said Pier 22.

Kalashnikov weapon carried by Williams, gave him to Rami, when he arrived at the village, the American Valmttoa leave his job in an American company and preferred to go to Iraq to fight with the Christian militias. "Every bullet fired by terrorist gangs make me feel happy and proud," the 42-year-old son said.

As Rami Paul has left his studies at the University of Mosul, after the tenth of June 2014 events and said he no longer sees anything important than getting children to play in the streets of the town. He is also looking for a sweetheart who were displaced from the unit neighborhood in Mosul, two days of control of the city after Daash, and contact was lost.

Rami deals with breakfast daily with Weiss and his colleagues, on a tree trunk Aqttath One of the shells. And its relationship to American fighters, said: "What unites us all now is the rights and defend our cause. Will end the war with Daash will continue our relationship."

Iraqi Christians lived hundreds of years ago in the towns of northern Iraq, before finally abandon them. Towns that did not inhabit a place to live and entertainment only, but they get their power which, through the wine and sweets industry and the briber. Now, did all those things longer exist. Raised black flags over the houses and churches there.

Complain fighters in the Christian militias of the few weapons, they did not find any tributary or provide them with a source of it, but to rely on what they Abiouna in their homes. "We need to arms and ammunition," says Pier 22 Khaddida Emanuel, a company commander Assyrians fighters.

Emmanuel, who was working in the liquor industry in terms of Bashiqa (12 km from the city of Mosul), his family sent to the Kurdistan region of Iraq, then returned and joined the ranks of the fighters against Daash. Complain about the company commander of the lack of reinforcement and the lack of an Iraqi government support for elements of combat, but he praises coordination posed by fighters with elements of the Kurdish Peshmerga.

A large number of Christians fighters did not previously trained on the weapon, and probably did not touch the gun basically. Always known for their love of the Assyrians him even to those who attack them, but Weiss and his colleagues trained them superficially on how to use weapons and fight street battles. And himself, Weiss said: "Previously trained to fight with friends in America, and action films gave me more aware of how to fight."

The role of Christians and American fighters is not limited to just fighting, but were able to play a humanitarian role through the transfer of medical and food aid to the displaced children of their religion in other cities and villages.

Fighters Assyrians and believes that "barriers erected on the borders of the village Tlsagv will be removed after the expulsion Daash from other villages", but they assert that "everything will be fine if you no longer church bells to the usual ticking."

Saturday, March 21, 2015

Tunisia Note

More images and a video in Arabic at the link
Tunisian Jews in the synagogue in Djerba (AP)
Tunisia: where religious minorities quietly coexist
Mohammed Haggag

Learn Jewish Ibadi and Shiite minorities in Tunisia and on the nature of their relations by a majority of the Tunisian people if minorities in Tunisia: Some consider that the Shiites either repent or go to Iran, while others consider that belief as a private matter

Unlike a number of Arab countries, where is the question of minorities from the problematic issues of what might come out of the social and sectarian tensions, does not pose the question that sharpness in Tunisia. Tunisian minorities vary among themselves in terms of size and history also differ in terms of the role they play within the social fabric at all levels.

The oldest Jewish minorities in TunisiaTunisian Jews in the synagogue in Djerba (AP)

The estimated number of Tunisian Jews currently three thousand people. And the majority of them living in the island of Djerba, southeast of the country, while the rest is distributed to other cities such as Tunis, Sfax, Gabes and Zarzis. And hails Tunisia's Jews from the two groups, the first is the "Tunisian", which is said to have made to the country since the destruction of Solomon first structure, and the second is the Jews "Algrana" Latinos who disbanded in Tunisia since the sixteenth century, after being expelled from Europe, they settled in the country, refusing to mating with communities the other, including the Tunisian Jews.

And Djerba, which includes the largest number of children of the Jewish community where three schools Talmudic children learn Jews and Jewish history and Hebrew. Despite the migration of many members of the community in the twentieth century to Israel, a large number of them preferred to stay in order to preserve their property and who knew the big their contribution to the economic and commercial life of the country.

Most of Tunisia's Jews working in the fields of trade, especially formulated trade. The gold market is almost the island of Djerba to be monopolized by them as nearly fifty stores where Jews traders knew their ability to accomplish their work professionally and gained the trust of customers works. Tunisians general economic culture of the Jews has been influenced by them and they took a lot of the secrets of buying and selling, savings and control the market.Therefore, when you knew that Tunisians "Jerabh", Djerba residents, and "Elsafaksah", Sfax's population, they are more subtle, and the people of Tunisia superiority in the fields of trade, thanks to the experience gained from their relationships with Jews.

Tunisian Jews and their festivals and rituals that cling to them and keep them, there is hardly a month goes by without a celebration to evaluate what.Understanding celebrating New Year (year Droush) and holiday Yom Kippur (Kidur) and Holiday silence (Ashaich) and Hdhukan (lamp) and feast of Easter and other events that abstain from work is not selling, not buying and fast foods in most of these holidays. Also celebrating the holidays with some related varieties of food such as dates and holiday feast and chicken feast of unleavened bread.

It remains "pilgrimage" to the exotic temple in the spring, the holiday feast at Tunisia's Jews. Performing religious rituals during which days and Echttamonha big night pilgrimage which is about a concert during festive recognize Jews to each other and they declare Alkhtobat, wills and collecting donations for the needy children of the community. Most of the pilgrims to the synagogue are Jewish Arabs with Tunisian assets or Libyan or Algerian living in America and Europe. She talks about the genesis of the Jewish novel exotic woman synagogue link provided to Djerba, there lived a pious chastity and that she died in the place of the construction of the synagogue where he also sits one of the oldest copies of the Torah as the novel itself.

Ibadi sect and the search for identity 
The exact number of statistics absent in Tunisia, and live side by side with other minorities. Djerba, an island southeast of the country and is the most important strongholds of this sect dating back to Tunisia in the year 766 with the founding of the state Rustumiya by Abdul Rahman bin Rustam, which lasted 130 years before Azahaa Fatimids and Alobeidion 901 years.

But the demise of Rustumiya State did not end the existence Ibadites in Tunisia as continued adherence to the Berber tribes thought to this day. Talk about this minority has returned to pop up again. Was formed several associations to demand the reinstatement of a doctrine and her followers as an ethnic minority.However, the impact of that denomination differs from weighing in Algeria and Libya, for example, they are melted and fused in Tunisian society to a large extent as a result of state policies after independence, which dealt with the Tunisian citizen, regardless of race, color and creed. Not surprisingly, and Mr. Abdul Hamid Alerakec went to be considered Ibadi sect of minorities "silent" in Tunisia.

Dr. Farhat Aldjabera which is one of the flags Ibadi in Djerba and symbols, opines that the whole heritage Ebadi Babarha and their homes and mosques of Djerba. It has been possible for this community to maintain its integrity and existence, thanks to an internal system did not know when other denominations or minorities, which was known as "Aezzabh" system caused by the year 409 AH Sheikh Mohammed bin Abu Bakr Alqrstani a system he oversees the governance of the people and meeting their needs when they are State in the case of weakness. The Dr. Aldjabera mosques that represent the bulk of the inheritance toes on the island such as the Mosque of Abu gated and collector Salem Zayed Mosque and although a number of them became empty and turned into shrines to seek blessing Grown Ups righteous.

Libraries of the tributaries of the Ibadi heritage in the island of Djerba is also considered. Perhaps the most famous of these libraries library Albaronah, which turned into a contemporary electronic library deals with researchers from various flung, and the Jacobite Library along with other libraries vary in terms of size and in terms of accessibility of such Batoria library and library Gadoah.

Shiite tide in Tunisia

Although 85% of the country's population follow the Maliki school, which is one of the four Sunni schools, the limited proportion of Tunisians Shiites. The bias in the new Tunisia old phenomenon as rooted in the pre-Fatimid state and the spread of the Fatimid Shiism from the Tunisian town of Mahdia. Newly doctrine Jaafari in Tunisia has spread since the fifties of the twentieth century and Spaanyate and specifically after the famous Dr. Muhammad al-Tijani, a Tunisian Shiism codes, to Iraq, which planted the seeds of Shiism in Tunisia trip. Today, there are in Tunisia Shia Imami and deployed in several states of the country, such as Gafsa, Gabes, Sousse, Tunis and Mahdia.

Is among several that Tunisia from countries where Shi'ism is witnessing a significant expansion, especially during recent years, however, this issue is still not officially on the table and in the media, with the exception of some of the writings on the Internet. There are several explanations for this fact, the man who said that freedom of religion is guaranteed by the country's constitution. The state does not interfere in people's beliefs and persuasions, and among those is up to the tolerant nature of Tunisians and their ability to co-exist despite the different beliefs.

Despite the absence of official figures on the number of Shiites in Tunisia, the Tijani heavenly estimated the number at "hundreds of thousands" and say they are deployed in most of the country's provinces and practicing their rituals and rites without being exposed to them in bad one. Tunisia Shiites believe that the doctrine of al-Bayt is no stranger to the country and its roots date back to hundreds of years.

Shiism has passed the country's historical stages four: stage of barbarism and the stage of the Fatimid state, and the stage of the founding of Mahdia the year 921, and the stage of the sixties and early seventies which saw the entry doctrine Jaafari to Tunisia, was the most prominent symbols of Dr. heavenly, and the fourth stage was the eighties stage any immediately after the victory of the revolution Islamic Iran and calls Imad Eddin Hamrouni, the head of the household and Cultural Association, the stage of the "modern Shiism."

How to coexist with the majority of minorities?

The nature of the relationship between minorities and the majority reinforce the impression carried by most people for tolerance of Tunisians and accepting the other without being obscure, some behaviors that are often isolated and not live up to the level of incitement. confirms Benjamin's speech, the rabbi of the Great Synagogue in Tunis, that everything is okay and that members of the Jewish community enjoy a safe life in Tunisia was not recent events impact on their relationship with their neighbors and good Muslims and their religious rituals. The same is confirmed by Hai Camus, one of the Jews of Djerba, who said he did not feel any fear or concern for his safety or the safety of his family.

Dr. Farhat Aldjaabera a symbol of Ibadi codes in the island of Djerba ,emphasizes that the community is not an integral part of a complete system and from home part, and therefore, this community does not want to be isolated from its surroundings, but you want to be the center of the national system and dealing with others and coexist with them without conflict or oppose between the different currents. On the evidence of this coexistence that mosques Ibadi became open to all and that the people attending mosques Ibadi Maalikis without embarrassment or restlessness. It has been confirmed by recent events, while designated the Ministry of Religious Affairs in Tunisia a Ibadi sect followers imam of a mosque in the town of Mlaq kindergarten in the island of Djerba after he had seized by Salafists and thus resolved the dispute in favor of the Ibadi.

As for the attitude of the Tunisian Shiites is subject taking reportedly among those who accept them reluctantly and those who did not see the mind an coexistence with them. This Sheikh Bashir Bin Hassan, leader of the Salafi, is not Tunisia Sunni-Shi'ite no place for this community and say: "either to repent or to go to Iran," saying the Shiites of the most dangerous groups in the country's security. While human rights activist Abdul Raouf Ayadi believes that Shiites Tunisians free citizens and their right to profess the doctrine that it is want of freedom of religion in. The activist Ahmed Kahlawi goes on to say "if the Shiites Tunisia in the service of their people issues, there is no problem if they are in the service of other nationalities policies, this begs the question."The Mubarak Baadah Shiite icon in the Tunisian south region confirms that the community live in harmony with the year without recording what would disturb the relationship between the two communities.

Co-existence of minorities with the majority again reinforces the idea held by many Tunisians generally about tolerance and acceptance of difference and live with what surrounds the coexistence of unrest and tensions circumstantial do not affect the overall climate of tolerance that characterizes the social fabric of the country. This may be due to the fact that the majority are the overwhelming majority do not feel threatened minorities.

Wednesday, March 18, 2015

End of Life Links -- A Checklist

UPDATE: This post was originally dated April, 2013. Nearly two years have passed and I'm adding a few caveats about hospice. Hospice and palliative care continue to be under-utilized and avoided by many, but word is getting out. Mention of the word is not thought of as a death sentence as often as it once was. But here are three anecdotal links that reveal a dark side of hospice.

First, here is a comment left at a post at The Health Care Blog.
Gawande’s book is marvelous. But it did strike me that he had no new answers. In a way, how could he? There aren’t any. Yes, knowing what one wants at the end of life, understanding your values and so forth are helpful. But those are not answers to the fundamental issues of how society manages to give this care. Gawande knows that. 
I am not familiar with Wachter’s later work. The seminal Wachter/Goldman article gives short shrift to patient satisfaction. It may, in part, have set the tone. Then, this being the US system, anything that can be monetized, is. 
In the interests of full disclosure, I read the Gawande book while my mother was dying. She died about a week after I finished it. It was not a “good death”. My brother and I have been told many times in the past month our experience was common. If you’re of the mind, I write about it on my blog: 
Until hospitalists, case managers and policy hounds understand what is really happening to patients and families in the community, the Gawande book will be a good start. But not an answer.
The subject of the post was an interview with Atul Gawande whose book, Being Mortal, (also published since this post was started) is a must-read. The rest of the Health Care Blog post and comment thread is also recommended reading, but first a couple more anecdotes.

Christine's comment in January received this response in the wee hours of this morning, from Todd Fraser.
Could not agree more Chris|. 
We had a similar experience with my partner’s family member. The process of managing her father did not go well. As someone from the industry, it was easy to see where it went off the rails, and the various holes in the cheese lining up. 
But after presenting it all to the hospital, clearly identifying that we wanted nothing more than to help them improve their service to the community, we were given nothing more than excuses and buck shifting. 
Fundamentally, our profession needs to smarten up its act and remember what it is here to do. Serve the public to the best of their abilities. And sadly, to do so means being honest with yourself about your performance.
To which I had to add the following...
Todd, something tells me that cases like yours and Chris’ are more numerous than many want to believe. That link at Christine’s post referring to an explosion in the number of for-profit hospice enterprises is not the good indicator it should be. In my post-retirement job as care-giver I have seen several hospice situations, and not all are what I would call admirable. They range from not-for-profit residential settings at the luxury end to the most minimal collections of on-call nurses who mostly put in their time and move on to the next client. 
I am at a loss to know the way out, but I do know that competition for that little $5000 hospice benefit offered by Medicare (or whatever it is) is driving the wrong kind of results. Just a couple weeks ago I heard a story form a friend that his father-in-law was in a residential hospice setting and they had the nerve to call and tell someone in the family that they were not prepared to keep anyone unless they had less than two weeks to live. That, of course, is not legal and the person was prepared to take legal action against the hospice company, but the man did, in fact, soon die. 
All this is “anecdotal” as are your and Christine’s stories. But there is more here than meets the eye, and as you said, the profession needs to remember what it’s here to do.
In the interest of completeness, this is Christine's account of their unhappy hospice experience as recorded at her blog, Kapsacare Resources
(Go to the other link for Christine's backstory.) 

I don’t know how the legion of health care types all decided my mother was hospice fodder without a terminal illness. Perhaps they used the data analysis dreamed up by Health Catalyst, discussed in a past blog. (Many of Health Catalyst’s key people are former employees of the well-known health care system where my mother was hospitalized.) Maybe the “cost reduction through managing populations” algorithm ended in a Hopeless Case box at the bottom. 
Eject to hospice. 
Any thought of palliative care was jettisoned early. Palliative care and hospice have become synonymous. I didn’t know the full implications of signing hospice certification for my mother. I had no idea I was signing away any possibility that any physician would take remote interest in her care again. By the time I realized what had happened, she was too sick for it to matter. 
The events as they unfolded:
  • My mother was assigned a nurse practitioner as attending “physician” on admission to the facility. I’m an NP, so was comfortable with this idea. Until this NP proved less than expert.
  • My mother developed a raging urinary tract infection from a botched catheterization. After the attending NP proved unable to manage this problem, I asked for a physician to see my mother. Was told no physician was available.
  • I then asked for the hospice medical director to see my mother. Impossible. The medical director lives and practices out of state, almost 400 miles away from the hospice where she has legal, clinical and moral obligations.
  • Requested the medical director’s physician-designee examine my mother. Impossible. No such person existed. All in violation of state and federal regs.
  • The facility made a 911 call and my now-delirious mother was summarily shipped to the emergency room. Where the ER doc, with breathtaking arrogance, told me my mother should be in hospice. When I asked whether he’d read the intake notes, he walked away.
  • With Mom screaming in delirium down the hall, he came back to tell the family he would discharge her. I said, “She isn’t stable.” He told us there was nothing further he could do and he would discharge her. “You discharge her and we’ll file an EMTALA in the morning.” (EMTALA is the acronym for Emergency Medical Treatment and Labor Act, a federal law that prohibits hospitals from discharging or transferring unstable patients or women in labor. Violations can incur hefty penalties for hospitals and doctors.) He walked away again.
  • He came back a few minutes later, having found a bed. The palliative care specialist who had admitted Mom earlier in the fall agreed to assume her care on the condition she is discharged to his hospice agency. This physician saw my mother on November 25th, the day before she was discharged. It was the last time she was ever seen by a physician.
  • Mom returned to the assisted living facility where she had been for a year and liked. Now she was a hospice patient and bedridden, the facility was willing to take her back. Go figure.
  • Her care was given by nursing assistants. There were brief visits by a registered nurse. Based on their observations, the doses of narcotics and tranquilizers given to my mother increased sharply and quickly. Requests the doctor call me to talk about the medications went unanswered.
  • Mom was stuporous the last time my brother and I saw her alive, the evening before her death. Perhaps it was disease. Perhaps it was a drug overdose. Or both. We’ll never know. We didn’t say good-bye, there was no chance.
The number of for-profit hospices has risen from 756 to 1828 (that number is likely outdated) from 2000 to 2009. The public education efforts to convince Americans of the desirability of hospices, advance directives and “good deaths”—whatever those may be—have soared along with hospice profits. 
My mother did not have a “good death”. My brother and I are left with gut-wrenching questions for which there are no answers. 
My mother’s death certificate was signed by a physician who hadn’t bothered to see her in almost two weeks. It lists multi-organ failure as the cause of death. The physicians responsible for her care suffer organ failure, too. The heart.
Her threat to file an EMTALA complaint turns out to have been the best weapon available to force hospice to do what they are in business to do.  In the case of my friend whose family faced a similar situation with his father-in-law's case, that threat would have served the same purpose.

Fortunately he, like Christine, knew his rights and was prepared to confront hospice with that threat. But health care in general and hospice in particular should never need to be made worse by avoidable developments like those.

I note them here as words to the wise until the system rectifies what appears to be a growing problem.


[Original post begins here.]
This morning's notice of Google's "Inactive Account" feature sent me looking for a blog I had followed a year or two ago specifically focused on end-of-life issues. I never found the blog I was looking for but was surprised to see a host of related links, most of which have come up recently. 
What follows is part of what I found. The amount of material that has appeared in just a year or two is truly amazing.
This is a very long post. To save reading time and trouble I have copied whole contents with a single link to sources instead of including all the secondary links.

Monday, March 16, 2015

Springer Theater Notes

The Springer Theater in Columbus, Georgia was one of the most important parts of my early adult life. I was fortunate to be part of a community effort to rescue the place from the wrecking ball from 1964 until I was drafted in 1965. The story is better told at this link.
The great old theatre survived as a movie house for awhile but a lack of maintenance and the eventual decline of Columbus' historic commercial district began the Springer's slide into near oblivion. 
In 1964, the theatre where the Barrymore's and the Booth's performed was slated for demolition. As the wrecking ball hovered above the stage house, a group of citizens determined to save the Springer aroused community support and began to raise the funds to bring it back to life. When the newly renovated Springer Opera House reopened in 1965, Southerners once again hurried to their seats beneath the huge brass chandelier to enjoy the very best in theatre, music and dance.
After being discharged from the Army I returned to the Springer, this time as part of one of the country's best community theaters. Before I again left Columbus to finish college I had a great time working on sets and taking part in several productions.  I was pleased today to see this post at the Springer Facebook page.

Announcement of Devil's Disciple, 1968

Thursday, March 12, 2015

Common Core Notes

The political opposition to Common Core is reaching critical mass. The PBS headlines a few days ago tell the story.  When children become mobilized to protest and parents urge them to "opt out" of the testing, the writing is on the wall. This most recent effort to pull American academic standards up is a lost cause.  A piece in Britain's Guardian says it all -- Anti-Intellectualism is Taking Over the US. 
The rise in academic book bannings and firings is compounded by the US's growing disregard for scholarship itself
Political correctness really works! Sorry, conservatives, but science just said soTexas school bans seven 'obscene' books in banned books week
My Facebook status as 2014 came to an end was this...
Common Core R.I.P.

NPR aired an end of the year piece including, among other developments, the demise of Common Core. After all the bi-partisan work, including governors as well as educational experts, the program seems to be on the way to the dumpster.

Too bad. My ideas about education are as off the wall as my politics, so I never expected any understanding of Mortimer Adler or Erik Erikson, but when I first looked at Common Core and compared it with the rest of he civilized world, then compared it with the dukes mixture of approaches to learning that litter the American educational landscape, I was (and still am) encouraged to think America might be on the way to national improvement. American public education is a global embarrassment and most Americans are blind to that reality.

But like so many other advances, ratcheting up our educational standards will wait for another day. Dedicated, organized opposition to Common Core will see to that. Many of our post-secondary schools are among the world's best. It's no accident that families from all over the world send college students to study in America. But the only foreigners with kids in primary and elementary school are those trapped here who can't afford to send them to private schools.

Meantime, the trend to private and charter schools, and home schooling will continue to skim the cream from the public education crop, leaving behind a student population from which the most promising peers (role models) have been removed, along with many of the best teachers and administrators. And we wonder what's wrong with public education...

I could drone on, but what's the use? I don't expect to see much change during the remaining years of my life. Part of the problem with Commonn Core was the name itself. Thanks to an already dumbed-down population most people don't even understand the meaning of the world "common."
It has two implications. Most people hear the word "common" and think "vulgar...ordinary...pedestrian." But the word also has a less subjective meaning. Common, in the case of Common Core, simply means "universal." It's too bad the program wasn't called Raising the Bar or some other sports-like phrase. Americans are more excited about improving their bodies than their minds. Too many people misunderstood "Common Core" to have it's worst possible interpretation.

Nine grades of meaning are listed for the word "common."  

Wednesday, March 11, 2015

Getting Tired

I plan to refer to this Facebook status report as time passes.

Monday, March 9, 2015

Religious Freedom Restoration Act (RFRA)

Facebook asked "What's on your mind?"
This came out... 

In the Beating-a-dead-horse Department the Georgia Legislature is adding our state to the list of others passing a version of the 1993 Religious Freedom Restoration Act (RFRA). It was declared unconstitutional soon after being signed into law by President Clinton, but continues to live on in some form or other thanks to the Free Exercise clause of the First Amendment.

There are good reasons to have such legislation enacted. One reason for its original passage was to allow Native Americans to use peyote, an hallucinogenic controlled substance, in religious ceremonies. As a conscientious objector I was obliged to cite "religious training and belief" to justify my status. And I'm sure there are other compelling reasons as well. The Wikipedia article is full of links and a Web search yields over eight hundred thousand hits.

But I have a hunch that the current revival of interest has less to do with those arcane reasons and more to do with opposition to a string of politically-charged subjects -- namely opposition to marriage equality and other LBGTI rights, vaccinations, Common Core standards, immigrants, Muslims, contraceptives and abortion.  Discussions of science that stray into evolution or climate change can have a religious angle viewed through some religious kaleidoscopes, as well as any suggestion that America may not be a Christian nation. The very title of these bills -- Religious Freedom RESTORATION Act -- implies that somehow religious freedom has been abridged or restricted and therefor needs a legal remedy to have it "restored," despite the examples mentioned above and the widespread presence of every kind of religious group imaginable.

Mennonites, Rastifarians, snake handlers (not far from where I live), Colleges and Universities founded by religious communities, global TV networks with rivers of UNTAXED revenue funding lifestyles that rival those of the rich and famous in sports and entertainment -- all are testimony to the fact that religious freedom in America is as safe and widespread as firearms, baseball, hot dogs, apple pie and Chevrolet.

And still we have righteous indignation memes wanting to mandate public displays of the Ten Commandments and huge crosses on otherwise natural landscapes. Every year cities and towns all over the country display elaborate Christmas decorations -- often including a Christmas tree in the middle of town (as well as Rockefeller Center) -- but we still have to hear about the War on Christmas and War on Religion. Say Happy Holidays to some of these people and prepare for a sideways glance and "Merry Christmas" through pursed lips.

That's what's on my mind this morning, Facebook friends and followers. Thanks for reading. I feel better now having put my gripes into words.

Sunday, March 8, 2015

Advance Directives -- CABG

We all hope never to face the need for CABG -- Coronary Artery Bypass Graft Surgery -- but this procedure is no longer the cutting edge procedure (no pun intended) that it once was. It does involve, however, several enabling surgical techniques that can be life-threatening as well as the life-extending benefits of a successful outcome. This from NIH is food for thought.

I'm not telling anyone what to do. I'm blessed to have lived past seventy never having to face heart problems. But my instinct is that one's age has a lot to do with whether or not this is appropriate. Twenty or thirty years ago I would have had little hesitation telling the doctors to go ahead. But now I'm not sure. And I feel confident saying that ten years from now I would say "Nope. Call the palliative care people, and tell me if I'm certified for hospice."   
What To Expect After Coronary Artery Bypass Grafting
Recovery in the Hospital

After surgery, you'll typically spend 1 or 2 days in an intensive care unit (ICU). Your heart rate, blood pressure, and oxygen levels will be checked regularly during this time.

An intravenous line (IV) will likely be inserted into a vein in your arm. Through the IV line, you may get medicines to control blood circulation and blood pressure. You also will likely have a tube in your bladder to drain urine and a tube to drain fluid from your chest.

You may receive oxygen therapy (oxygen given through nasal prongs or a mask) and a temporary pacemaker while in the ICU. A pacemaker is a small device that's placed in the chest or abdomen to help control abnormal heart rhythms.

Your doctor may recommend that you wear compression stockings on your legs as well. These stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting.

While in the ICU, you'll also have bandages on your chest incision (cut) and on the areas where an artery or vein was removed for grafting.

After you leave the ICU, you'll be moved to a less intensive care area of the hospital for 3 to 5 days before going home.

Recovery at Home

Your doctor will give you specific instructions for recovering at home, especially concerning:
  • How to care for your healing incisions
  • How to recognize signs of infection or other complications
  • When to call the doctor right away
  • When to make followup appointments
You also may get instructions on how to deal with common side effects from surgery. Side effects often go away within 4 to 6 weeks after surgery, but may include:
  • Discomfort or itching from healing incisions
  • Swelling of the area where an artery or vein was removed for grafting
  • Muscle pain or tightness in the shoulders and upper back
  • Fatigue (tiredness), mood swings, or depression
  • Problems sleeping or loss of appetite
  • Constipation
  • Chest pain around the site of the chest bone incision (more frequent with traditional CABG)
Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is needed for nontraditional CABG.

Your doctor will tell you when you can start physical activity again. It varies from person to person, but there are some typical timeframes. Most people can resume sexual activity within about 4 weeks and driving after 3 to 8 weeks.

Returning to work after 6 weeks is common unless your job involves specific and demanding physical activity. Some people may need to find less physically demanding types of work or work a reduced schedule at first.

Ongoing Care

Care after surgery may include periodic checkups with doctors. During these visits, tests may be done to see how your heart is working. Tests may include EKG (electrocardiogram),stress testing, echocardiography, and cardiac CT.

CABG is not a cure for coronary heart disease (CHD). You and your doctor may develop a treatment plan that includes lifestyle changes to help you stay healthy and reduce the chance of CHD getting worse.

Lifestyle changes may include making changes to your diet, quitting smoking, doing physical activity regularly, and lowering and managing stress.

Your doctor also may refer you to cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.

Rehab programs include exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Doctors supervise these programs, which may be offered in hospitals and other community facilities. Talk to your doctor about whether cardiac rehab might benefit you.

Taking medicines as prescribed also is an important part of care after surgery. Your doctor may prescribe medicines to manage pain during recovery; lower cholesterol and blood pressure; reduce the risk of blood clots forming; manage diabetes; or treat depression.

Friday, March 6, 2015

Are Nuclear & Solar the KSA Plan B?

Memorandum of understanding on nuclear energy between Saudi Arabia and South KoreaWed Mar 4, 2015 9:38 am GMT
Saudi Arabia's King Salman during a
meeting in Riyadh, 24 January 2015,
(Reuters photograph of a representative)
[Google translate]

Al Khobar (Saudi Arabia) (Reuters) - Saudi Press Agency said that the Kingdom has signed a memorandum of understanding with South Korea on cooperation in the development of nuclear energy after a previous agreement signed by both parties in 2011.

The official said that the agency head of South Korea's Pak John Hay met with Saudi King Salman in Riyadh on Tuesday as part of an official visit.

South Korea's presidential office said in a statement that the MOU includes an invitation Korean companies to participate in the construction of at least two nuclear reactors from small or medium-sized in Saudi Arabia.

The statement said "in the case to proceed in the two units would amount to the cost of the contract (approximately) two billion dollars."

And Saudi Arabia aspires to possess nuclear energy of 17 gigawatts by 2032 and about 41 gigawatts of solar energy. The country does not produce oil exporting any nuclear power now.

The head of the King Abdullah City for Atomic and Renewable Energy, overseeing such projects, said in January that those plans are likely to take until 2040.

The Atomic Energy City said in a statement on Tuesday: "This note comes Based on what has been signed by the international joint agreement between Saudi Arabia and the State of South Korea, which emphasizes the common desire of both countries to expand and strengthen cooperation in the development and application of nuclear energy for peaceful purposes."

The agreement includes cooperation in research and development, construction and training.

Separately, Saudi Electricity Company signed four agreements in the field of energy on Tuesday with General Electric America Foundation and Korea Electric Power and with Doosan Heavy Industries & Construction Bank of exports and imports.

It includes the Korean Energy Foundation cooperation agreement in the nuclear and renewable energy development.

Hassan Ghazi Ibrahim Shaker Company signed a non-binding memorandum of understanding with LG Electronics of South Korea on cooperation in the cooling systems used in nuclear reactors.

The United Arab Emirates became the first Arab Gulf country begins to build a nuclear power station. In December 2009 the UAE has established a contract to build four reactors capacity of 1400 MW, led by Korea Electric Power Corporation group so as to meet the growing demand for electricity.

(Preparation Ahmed Inspirational Arab Bulletin - Edit Nadia Juweili)

This interesting snip was at the site linking the one above.  I don't find any supporting data, but it seems the long-term vision is to get power from both nuclear and solar sources.
If and when KSA runs low on oil, they have even more energy potential from sunlight.